Epidemiology of Respiratory Pathogens in Children with Severe Acute Respiratory Infection and Impact of the Multiplex PCR Film Array Respiratory Panel: A 2-Year Study

Sever acute respiratory infections (SARIs) are a public health issue that are common in children and are associated with an important morbidity and mortality rate worldwide. Although SARI are mainly caused by viruses, they are still a cause of antibiotic overuse. The use of molecular methods especially real-time multiplex PCR allowed to detect a wide range of respiratory viruses and their subtype as well as some atypical bacteria. The aim of this study was to investigate the epidemiology of respiratory pathogens detected in children admitted with SARI and to highlight the role of real-time multiplex PCR in the rapid diagnosis of viral and bacterial SARI. This work is a descriptive observational study from January 2018 to December 2019 including nasopharyngeal secretions collected from 534 children hospitalised in paediatric department. The detection of respiratory viruses and bacteria was performed by the FilmArray® Respiratory Panel. A total of 387 (72.5%) children were tested positive for at least one respiratory pathogen, and 23.3% of them were coinfected with more than one pathogen. Viral aetiology was found in 91.2% (n = 340). The most common viruses detected were HRV (n = 201) and RSV (n = 124), followed by PIV (n = 35) influenza A (n = 29) and human metapneumovirus (n = 27). Bacteria was found in 8.8% (n = 47), and Bordetella pertussis was the most detected. Respiratory syncytial virus and Bordetella pertussis were significantly higher in infants less than 6 months old. The detection of RSV and influenza A presented a pic in winter, and HMPV was statistically significant in spring ( p < 0.01 ). This study described the epidemiology of respiratory pathogens involved in severe respiratory infections in children that were affected by several factors such as season and age group. It also highlighted the importance of multiplex PCR in confirming viral origin, thus avoiding irrational prescription of antibiotics in paediatric settings.

Photodynamic Therapy as A New Technology for Inactivation of Coronavirus Disease (COVID-19)

Purpose: Coronavirus Disease (COVID-19) could be an emerging disease with a severe acute respiratory infection, and its epidemiology and unique medicinal properties are perpetually increasing. Regarding the lack of COVID-19 controls, this needs current technical events to worsen and treat. Antiviral Photodynamic Therapy (aPDT) could also be effective in reducing and inhibiting the coronavirus. aPDT with various photosensitizers is a very favorable procedure to manage viral infections. Materials and Methods: A total of 37 articles related to the publication of this review manuscript were mentioned. Several scientific databases such as Scopus, PubMed, Web of Science (ISI), and Google Scholar have checked the key phrases of COVID-19, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), photodynamic therapy, and antiviral photodynamic therapy. All 50 main studies were found, and 37 related studies were deemed suitable for this study after review. Results: Studies have shown that aPDT with different photosensitizers can be used to treat viral lung complications caused by infectious pathogens such as Middle East Respiratory Syndrome (MERS), SARS-CoV-2, and influenza. Recent studies have shown that aPDT-mediated Methylene Blue (MB) can help control and eradicate coronavirus. In general, more research is needed to use antiviral photodynamic therapy to control COVID-19. Conclusion: Regarding the lack of treatment for COVID-19, MB-mediated aPDT can help reduce the impact of COVID-19. More evidence is needed to support aPDT as a treatment (SARS-CoV-2).

Bibliometric Analysis Of Research on Coronavirus Infection and Patient Safety in Health Care

Objective: The study aimed at analyzing the international scientific publications on coronavirus infection and patient safety in health care. Methods: This research is a bibliometric study carried out by searching published articles in theISIWebofKnowledge/WebofScience database and analyzing the results through bibliometric analysis software HistCite. The selected time frame was between 1970 and 2020, and we used the following descriptors: “coronavirus infection” OR “severe acute respiratory syndrome” OR “COVID-19/SARS-CoV-2”. Results: We found 5,434 publications in 1,491 different journals; they are written by 18,274 authors linked to 4,064 institutions, which are located in 104 countries. In the citations analysis, the h-index was 155, and the average of citations each article received was 30.79. Conclusion: During the studied period, the Web of Science database showed two peaks of publications on coronavirus infections.The first comprised 768 articles published between 2003 and 2004 when a new coronavirus caused an outbreak of severe acute respiratory failure. The second consisted of 576 articles published between 2019 and 2020, during the period of the COVID-19 pandemic COVID-19. The knowledge on coronavirus infection should be widely shared so that new studies can be designed and the world scientific community can contribute to improving patient safety in healthcare and preventing new pandemics of severe acute respiratory infection caused by coronaviruses.

Post- COVID-19 multisystem inflammatory syndrome in children

COVID-19 is a severe acute respiratory infection affecting worldwide population. There are many cases of complications after the COVID exposure occurring nowadays. One among is Post-COVID-19 Multisystem Inflammatory Syndrome in Children (MIS-C). As per CDC report till March 1, 2021, 2617 cases of MIS-C were meeting the definite case criteria and among 33 death cases were reported. Here we report a case of COVID-19 associated Multi-system inflammatory syndrome in a child (MIS-C) interpreted with WHO case definition criteria. The patient was a 7-year-old boy, with initial presentation of moderate fever, non-itchy red blanching rashes, breathlessness, later progressed to cardiogenic shock accompanied by positive SARS-CoV-2 antigen result. The emergency cardiogenic shock treatment protocol was followed with initial stabilization and resuscitation strategy. He was successfully managed by three days of IV Immunoglobulin 2g/kgand Methylprednisolone 2mg/kg/day therapy along with other supportive treatments. The patient was discharged after 20 days of hospital stay with improved health condition. Our case report will strengthen the exposure-outcome relations between the coronavirus infection and MIS-C, moreover the strategies carried out in our case will be a future direction for the effective management of MIS-C.

A case report on Severe Acute Respiratory Infection

Introduction: Severe Acute Respiratory Syndrome is a zootoxic viral respiratory illness caused by the severe acute respiratory syndrome corona virus (SARS-CoV or SARS-The syndrome was the cause of the Severe Acute Respiratory Syndrome outbreak in 2002–2004. The virus was traced back to cave-dwelling horseshoe bats via Asian palm civets in late 2017 by Chinese scientists in Xizang Yi Ethnic Township, Yunnan. SARS was a rare illness; there were 8,422 cases at the end of the pandemic in June 2003, with an 11 percent case fatality rate (CFR) (CoV-1), the initial strain of the SARS corona virus species (SARSr-CoV). Clinical Finding: Swelling over Right. Half of face, Breathlessness. Diagnostic Evaluation: Blood test: Hb – 9.2gm%, Total RBC count- 3.22 millions/cu.mm, HCT- 26.6%, Total WBC count – 6600/cu.mm, Monocytes-02%, granulocytes-85%, lymphocytes-10000 /mcl. HRCT Scan OF Thorax: Multiple ill defined patchy ground glass opacities with consolidation and sepal thickening in bilateral lungs filled s/o infective etiology possibility of atypical viral pneumonia. View of covid positive PCR test; imagine grading corad-6 with CT severity score – 03\25 (Mild). Therapeutic Intervention: Inj.Amphotericin-B 500mg IV, Inj.Piptaz 4.4gm IV x TDS, Inj.levoflox 500 mg x OD, Inj.Clindamycin 300mg x BD, Inj.pantaprazol 40 mg x OD, Inj.Emset 4mg x TDS, Tab. limcee 500 mg x BD. Outcome: After Treatment, the patient shows improvement. His swelling over face decrease, and breathlessness decrease. Conclusion: My patient was admitted in SARI-HDU, AVBRH with complaint of swelling over face Right side, and breathlessness. After getting appropriate treatment his condition was improved.

No evidence of SARS-CoV-2 in hospitalized patients with severe acute respiratory syndrome in five Italian hospitals from 1st November 2019 to 29th February 2020

Background On 9th January 2020, China CDC reported a novel coronavirus (later named SARS-CoV-2) as the causative agent of the coronavirus disease 2019 (COVID-19). Identifying the first appearance of virus is of epidemiological importance to tracking and mapping the spread of SARS-CoV-2 in a country. We therefore conducted a retrospective observational study to detect SARS-CoV-2 in oropharyngeal samples collected from hospitalized patients with a Severe Acute Respiratory Infection (SARI) enrolled in the DRIVE (Development of Robust and Innovative Vaccine Effectiveness) study in five Italian hospitals (CIRI-IT BIVE hospitals network) (1st November 2019 – 29th February 2020). Objectives To acquire new information on the real trend in SARS-CoV-2 infection during pandemic phase I and to determine the possible early appearance of the virus in Italy. Materials and methods Samples were tested for influenza [RT-PCR assay (A/H1N1, A/H3N2, B/Yam, B/Vic)] in accordance with the DRIVE study protocol. Subsequently, swabs underwent molecular testing for SARS-COV-2. [one-step real-time multiplex retro-transcription (RT) PCR]. Results In the 1683 samples collected, no evidence of SARS-CoV-2 was found. Moreover, 28.3% (477/1683) of swabs were positive for influenza viruses, the majority being type A (358 vs 119 type B). A/H3N2 was predominant among influenza A viruses (55%); among influenza B viruses, B/Victoria was prevalent. The highest influenza incidence rate was reported in patients aged 0–17 years (40.3%) followed by those aged 18–64 years (24.4%) and ≥65 years (14.8%). Conclusions In Italy, some studies have shown the early circulation of SARS-CoV-2 in northern regions, those most severely affected during phase I of the pandemic. In central and southern regions, by contrast no early circulation of the virus was registered. These results are in line with ours. These findings highlight the need to continue to carry out retrospective studies, in order to understand the epidemiology of the novel coronavirus, to better identify the clinical characteristics of COVID-19 in comparison with other acute respiratory illnesses (ARI), and to evaluate the real burden of COVID-19 on the healthcare system.

Etiology of severe acute respiratory infections in Ekaterinburg in different epidemic seasons

BACKGROUND: Acute respiratory viral infections are ubiquitous. Part of the cases are severe and require hospital treatment. AIM: Studying the etiology of severe acute respiratory infections in patients of Ekaterinburg hospitals in different epidemic seasons (from 2017 to 2020). MATERIALS AND METHODS: 1,132 cases of severe acute respiratory infection were assessed. The structure of laboratory-confirmed cases was determined. RESULTS: In the assessed seasons, the proportion of respiratory viruses in the etiological structure of severe acute respiratory infections was 56.0% on average. B/Yamagata lineage of influenza viruses was predominant in the season of 2017/2018 (23.9% from the total number of respiratory viruses), influenza А (H1N1)pdm09 viruses were predominant in the season of 2018/2019 (27.7%), and influenza A and B viruses were identified in 2019/2020 (39.4% and 31.7%, respectively). СONCLUSIONS: The obtained results confirm a key role of influenza viruses in the etiology of severe acute respiratory infections among the hospital patients in different epidemic seasons.