scholarly journals Human Coronavirus (HCoV) Infection Among Adults in Cleveland, Ohio: An Increasingly Recognized Respiratory Pathogen

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S312-S312 ◽  
Author(s):  
Anubhav Kanwar ◽  
Suresh Selvaraju ◽  
Frank Esper
Keyword(s):  
Respiratory Tract ◽  
Clinical Characteristics ◽  
Gastrointestinal Symptoms ◽  
Respiratory Illness ◽  
The United States ◽  
Respiratory Pathogen ◽  
Presenting Symptoms ◽  
Respiratory Tract Illness ◽  
Coronavirus Infection ◽  
Cleveland Ohio

Abstract Background Human Coronaviruses (CoV) have been long recognized as a common cause of respiratory tract disease including severe respiratory tract illness, yet there are few recent studies characterizing disease among adults in the United States. Here, we describe CoV infections and clinical characteristics among adults (>18 years) presenting with respiratory illness in Cleveland, Ohio. Methods Between February 1, 2016 and April 30, 2017, 2949 nasopharyngeal swab specimens were analyzed by NxTAG Respiratory Pathogen Panel in adults presenting with respiratory illness at MetroHealth Medical Center. Clinical data were collected on adults whose samples screened positive for CoV-HKU1, CoV-OC43, CoV-229E or CoV-NL63. Results Coronaviruses were detected in 192 (6.5%) adults including 105 (3.5%) OC43, 67 (2.3%) 229E, 13 (0.4%) HKU1 and 7 (0.2%) NL63. The majority of adults with coronavirus infection were females (66.2%) with a median age of 53 years. Common comorbidities included smoking (40.0%), asthma (38.0%), COPD (35.4%), and inhaled corticosteroid use (28.6%). Eighty-five (46.4%) required admission to the hospital. Common presenting symptoms included shortness of breath (42.7%) and cough (31.0%) whereas fever was uncommon (12.5%). Gastrointestinal symptoms were more common in HKU1 and NL63 infected adults. Seventy-three percent of coronavirus disease occurred between the months of January and March. Despite the recognition of coronavirus infection, 70 (36.5%) received antibiotics for their disease. Conclusion This study provides needed insight into clinical characteristics and severity associated with coronavirus infection in adults. Coronavirus infection should be considered in differential diagnosis of respiratory tract illness in adults including those that require hospitalization, have a history of smoking and have pulmonary comorbidities. Disclosures All authors: No reported disclosures.

scholarly journals Human Coronavirus-HKU1 Infection Among Adults in Cleveland, Ohio

2017 ◽  
Vol 4 (2) ◽  
Author(s):  
Anubhav Kanwar ◽  
Suresh Selvaraju ◽  
Frank Esper
Keyword(s):  
Respiratory Tract ◽  
Influenza A ◽  
Respiratory Symptoms ◽  
Respiratory Infections ◽  
Laboratory Data ◽  
Gastrointestinal Symptoms ◽  
The United States ◽  
Supplemental Oxygen ◽  
Respiratory Pathogen ◽  
Disease Spectrum

Abstract Background Human coronaviruses (CoV) have been long recognized as a common cause of respiratory tract disease including severe respiratory tract illness. Coronavirus-HKU1 has been described predominantly among children less than 5 years of age in the United States with few studies characterizing the disease spectrum among adults. Methods Nasopharyngeal specimens of patients with respiratory symptoms were analyzed for CoV-HKU1 by NxTAG Respiratory Pathogen Panel multiplex assay from February 7, 2016 to April 30, 2016. Epidemiologic, clinical, and laboratory data were collected on adults (patients >18 years) whose samples screened positive. Results Of 832 adult respiratory specimens screened, 13 (1.6%) cases of CoV-HKU1 were identified. Adults age ranged between 23 and 75 years and 6 (46%) were males. All of whom had 1 or more respiratory symptoms, and 5 (38%) also reported 1 or more gastrointestinal symptoms. Eleven (85%) reported history of smoking and 5 (38%) used inhaled steroids. Seven (54%) required hospitalization, 5 (71%) of these needed supplemental oxygen, and 2 (29%) were admitted to intensive care. Median length of hospitalization was 5 days. Eight (62%) received antibiotics despite identification of CoV-HKU1. Infectious work-up in 1 patient who died did not reveal any other pathogen. In 2 (15%) CoV-HKU1-positive adults, the only viral coinfection detected was influenza A. Conclusions Coronavirus-HKU1 accounted for 1.6% of adult respiratory infections and should be considered in differential diagnosis of severe respiratory illnesses among adults.

scholarly journals 2854. Enterovirus D68 Infections in Pediatric Patients in Central Ohio: Clinical Characteristics of a New Outbreak in 2018

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S74-S74
Author(s):  
Alejandro Diaz ◽  
Huanyu Wang ◽  
Isabel Torrus ◽  
Fatima Ara Montojo ◽  
Maria Mele-Casas ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Clinical Presentation ◽  
Gastrointestinal Symptoms ◽  
Respiratory Illness ◽  
Neurologic Manifestations ◽  
Asthmatic Children ◽  
Acute Flaccid Myelitis ◽  
Enterovirus D68 ◽  
Co Detection ◽  
Opsoclonus Myoclonus Syndrome

Abstract Background Many aspects of EV-D68 pathogenesis in children are not fully understood. In 2014, we experienced an outbreak of EV-D68-associated acute respiratory illness affecting mostly asthmatic children with no cases of acute flaccid myelitis identified. Late in 2018, a new outbreak occurred. The objective of this study was to describe the differences in clinical presentation in children diagnosed with EV-D68 infection during the 2018 outbreak. Methods This is a single-center, observational study. Nasopharyngeal (NP) samples from patients <21 years of age that tested positive for rhinovirus/enterovirus (RV/EV) by the FilmArray respiratory panel v1.7 were prospectively collected. EV-D68 was confirmed using a laboratory-developed RT-PCR. Demographic, clinical characteristics, and semiquantitative EV-D68 loads were analyzed according to the clinical presentation. Results From May to October 2018, 1,987/3,633 (55%) samples were RV/EV positive. Of those 399/1,028 (39%) tested positive for EV-D68 (121 outpatients; 278 inpatients). Inpatients were older (3.1 vs. 1.8 year olds; P < 0.01) with no differences in sex or EV-D68 loads (P > 0.05). Within the inpatient cohort, 67 (1.4 year olds) children were previously healthy, 146 (4.1 year olds) had underlying asthma and 65 (2.5 year olds) had chronic medical conditions (24% vs. 53% vs. 23%, respectively). Most patients presented with respiratory symptoms (>95%), followed by fever (51%) or gastrointestinal symptoms (28%). Eleven children (4%) presented with neurologic manifestations including: acute flaccid myelitis in two children, opsoclonus myoclonus syndrome in one child, and seizures in the remaining eight. Rates of viral co-detection were low (8%) and none of the children with neurologic manifestations had another respiratory virus identified. Patients with neurologic findings had lower EV-D68 loads than those who did not (29 vs. 25 Ct values; P = 0.03). Conclusion EV-D68 infection was associated with significant morbidity, affecting children with underlying asthma at greater rates. It was associated with severe neurologic manifestations despite these children having lower EV-D68 loads. Active surveillance for EV-D68 should be routine to allow a better understanding of the epidemiology and severity of disease. Disclosures All Authors: No reported Disclosures.

Effect of Vitamin C supplements on respiratory tract infections: A systematic review and meta-analysis

2021 ◽  
Vol 17 ◽  
Author(s):  
Tahmina Afrose Keya ◽  
Anthony Leela ◽  
Kevin Fernandez ◽  
Nasrin Habib ◽  
Mumunur Rashid
Keyword(s):  
Vitamin C ◽  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Meta Analysis ◽  
Respiratory Illness ◽  
Inclusion Criteria ◽  
Vitamin C Supplementation ◽  
Respiratory Tract Illness ◽  
Meta Analyses ◽  
Tract Infections

Background: Respiratory tract infections are a primary cause of illness and mortality over the world. Objective: This study was aimed to investigate the effectiveness of vitamin C supplementation in preventing and treating respiratory tract infections. Methods: We used the Cochrane, PubMed, and MEDLINE Ovid databases to conduct our search. The inclusion criteria were placebo-controlled trials. Random effects meta-analyses were performed to measure the pooled effects of vitamin C supplementation on the incidence, severity, and duration of respiratory illness. Results: found ten studies that met our inclusion criteria out of a total of 2758.The pooled risk ratio (RR) of developing respiratory illness when taking vitamin C regularly across the study period was 0⸳94 (with a 95% confidence interval of 0⸳87 to 1⸳01) which found that supplementing with vitamin C lowers the occurrence of illness. This effect, however, was statistically insignificant (P= 0⸳09). This study showed that vitamin C supplementation had no consistent effect on the severity of respiratory illness (SMD 0⸳14, 95% CI -0⸳02 to 0⸳30: I2 = 22%, P=0⸳09). However, our study revealed that vitamin C group had a considerably shorter duration of respiratory infection (SMD -0⸳36, 95% CI -0⸳62 to -0⸳09, P = 0⸳01). Conclusion: Benefits of normal vitamin C supplementation for reducing the duration of respiratory tract illness were supported by our meta-analysis findings. Since few trials have examined the effects of therapeutic supplementation, further research is needed in this area.

scholarly journals Peculiarities of the course of coronavirus infection COVID-19 in children of Ukraine

2021 ◽  
Vol 9 (2) ◽  
pp. 10-18
Author(s):  
O.K. Кoloskova ◽  
S.O. Kramarov ◽  
T.M. Bilous ◽  
L.A. Іvanova ◽  
T.M. Kaminska ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Clinical Symptoms ◽  
Gastrointestinal Symptoms ◽  
Patient Treatment ◽  
Upper Respiratory Tract ◽  
Reactive Protein ◽  
Increased Risk ◽  
Different Ages ◽  
Coronavirus Infection

Background. Pandemic of coronavirus disease COVID-19 caused by a new coronavirus SARS-CoV-2 still remains a global problem, but the data about the features of the course of COVID-19 infection among children of different ages are limited. The purpose was to conduct a generalized analysis of demographic, epidemiological and clinical features of COVID-19 in children of different ages from different regions of Ukraine. Materials and methods. In accordance with the principles of bioethics, a multicenter retrospective open cohort study of 669 cases of infection caused by coronavirus SARS-CoV-2 in children was conducted at the departments of hospital bases of Kyiv, Vinnytsia, Chernivtsi and Odesa. Clinical, laboratory and instrumental mar­kers of COVID-19 coronavirus infection were determined in hospitalized children. Results. The first (І) group included 67 infants under 2 months of age, the second (ІІ) one — 320 children aged from 60 days to 6 years, a subgroup of 127 patients of junior and middle school age formed the third (ІІІ) group, and the fourth (IV) group consisted of 155 adolescents at the age over 12. Damage to internal organs by SARS-CoV-2 virus was characterized by a multi-syste­mic type and manifested by changes in the upper respiratory tract in 70.1 % of cases, lower respiratory tract lesions — in 54.7 %, infectious and inflammatory changes — in 57.2 %, gastrointestinal symptoms — in 9.2 %, and neurological signs — in 17.8 % of observations. According to the results of study, the most frequent clinical symptoms found in the total cohort of patients were fever (51.1 %), general fatigue (51.6 %), sore throat (70.1 %), cough (54.7 %) and poor appetite (52.8 %). Damage to the lung parenchyma with specific clinical and radiological manifestations as a sign of coronavirus disease COVID-19 was detected in 23.9–25.9 % of children from the different regions of Ukraine, with a significantly increased risk of pneumonia among adolescents (odds ratio (OR) = 7.5). The most frequent changes when using additional methods of examination were leukocytosis (18.8 % of cases), thrombocytosis (14.5 %), leukopenia (11.1 %), increased С-reactive protein (43.7 %). Elevated content of platelets was mainly found in children of the first two months of life (38.3 % of cases), and it reliably increased during the period of in-patient treatment, which coincided with the tendencies to increasing the level of C-reactive protein in this age group (OR = 5.0). Conclusions. The analysis of epidemiological, clinical and laboratory features of the course of coronavirus disease caused by SARS-CoV-2 in children of different age groups from different regional hospital bases of Ukraine was consistent with the course in adult patients with COVID-19, but with higher chances of milder forms of the disease (OR = 3.1) among young children, and with involvement of the lower respiratory tract and higher risk of severe course among older children (OR = 7.3).

The benefits of a systematic assessment of respiratory health in illness susceptible athletes

2020 ◽  
pp. 2003722
Author(s):  
James H. Hull ◽  
Anna R. Jackson ◽  
Craig Ranson ◽  
Freddie Brown ◽  
Moses Wootten ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Breathing Pattern ◽  
Respiratory Health ◽  
Health Assessment ◽  
Respiratory Illness ◽  
Test Analysis ◽  
Respiratory Problems ◽  
Systematic Assessment ◽  
Respiratory Tract Illness ◽  
Nasal Flow

Respiratory tract illness is a leading cause of training and in-competition time-loss in elite athletes. Asthma is known to be prevalent in athletes but the co-existence of other respiratory problems, in those deemed to be susceptible to respiratory tract illness, is unknown. The aim of this study was to apply a comprehensive prospective approach to identify respiratory problems and explore relationships in athletes with heightened respiratory illness susceptibility.UK World Class Performance Programme athletes prospectively completed a systematic review of respiratory health with validated questionnaires and respiratory-focussed investigations, including studies of nasal flow, exhaled nitric oxide, spirometry, bronchoprovocation testing and allergy testing.Systematic respiratory health assessment was completed by 122 athletes (55 females, age 24±4 year). At least one respiratory health issue, requiring intervention, was identified in 97 (80%) athletes and ≥2 abnormalities were found in 73 (60%). Sinonasal problems were the most commonly identified problem (49%) and 22% of athletes had a positive indirect bronchoprovocation test. Analysis revealed two respiratory health clusters; i) asthma, sinus problems and allergy and ii) laryngeal and breathing pattern dysfunction. Respiratory illness susceptible athletes had 3.6±2.5 episodes in the year prior to assessment and were more likely (as odds ratio [95% confidence intervals] to have allergy (2.6 [1.0–6.5]), sinonasal problems (2.6 [1.1–6.0]), and symptoms of laryngeal (5.4 [1.8–16.8] and breathing pattern dysfunction (3.9 [1.1–14.0] than non-susceptible athletes (all p<0.05).A systematic approach to respiratory assessment identifies a high prevalence and co-existence of multiple respiratory problems in illness-susceptible athletes.

scholarly journals New Insights Into the Physiopathology of COVID-19: SARS-CoV-2-Associated Gastrointestinal Illness

2021 ◽  
Vol 8 ◽  
Author(s):  
Christian A. Devaux ◽  
Jean-Christophe Lagier ◽  
Didier Raoult
Keyword(s):  
Respiratory Tract ◽  
Gastrointestinal Symptoms ◽  
Cell Surface Molecules ◽  
Long Distance ◽  
Apparent Paradox ◽  
Viral Receptor ◽  
Viral Dissemination ◽  
Surface Molecules ◽  
Breathing Apparatus ◽  
Respiratory Tract Illness

Although SARS-CoV-2 is considered a lung-tropic virus that infects the respiratory tract through binding to the ACE2 cell-surface molecules present on alveolar lungs epithelial cells, gastrointestinal symptoms have been frequently reported in COVID-19 patients. What can be considered an apparent paradox is that these symptoms (e.g., diarrhea), sometimes precede the development of respiratory tract illness as if the breathing apparatus was not its first target during viral dissemination. Recently, evidence was reported that the gut is an active site of replication for SARS-CoV-2. This replication mainly occurs in mature enterocytes expressing the ACE2 viral receptor and TMPRSS4 protease. In this review we question how SARS-CoV-2 can cause intestinal disturbances, whether there are pneumocyte-tropic, enterocyte-tropic and/or dual tropic strains of SARS-CoV-2. We examine two major models: first, that of a virus directly causing damage locally (e.g., by inducing apoptosis of infected enterocytes); secondly, that of indirect effect of the virus (e.g., by inducing changes in the composition of the gut microbiota followed by the induction of an inflammatory process), and suggest that both situations probably occur simultaneously in COVID-19 patients. We eventually discuss the consequences of the virus replication in brush border of intestine on long-distance damages affecting other tissues/organs, particularly lungs.

scholarly journals Study of Serum IgE levels in Recurrent Respiratory illness in children 6 months to 5 years of age

2020 ◽  
Vol 7 (7) ◽  
pp. 344-350
Author(s):  
Dr. Rashmi Vishwakarma ◽  
◽  
Dr. Anita Sharan ◽  
Dr. Priti Reddy ◽  
Dr. K. Satyanarayana ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Elevated Serum ◽  
Respiratory Illness ◽  
Cross Sectional Study ◽  
Normal Serum ◽  
P Value ◽  
Cross Sectional ◽  
Serum Ige ◽  
Number Of Children ◽  
Respiratory Tract Illness

Objective: The present study was undertaken to study the serum IgE levels in recurrent respiratorytract illnesses in children greater than 6 months to less than 5 years of age and to find thecorrelation between them. Methods: This was a prospective observational cross-sectional study. Thestudy was undertaken to determine the correlation of serum IgE levels with recurrent respiratorytract illness. A total of 99 children were included in this study. 2ml of blood was drawn by peripheralvenous phlebotomy in airtight screw-capped plastic vials for measuring serum IgE levels. The SerumIgE level is assessed by chemiluminescence. Results: Out of 99 children, 48 children had elevatedserum IgE levels and 51 had normal serum IgE levels. Serum IgE levels were significantly higher(66.07%) in males as compared to females (25.58%) with a p-value of 0.0003 (<0.05). Theelevation of serum IgE levels was 48.48% in all children (48 out of 99 children). It’s noticed that thenumber of children suffering from RRTI and the number of children with elevated serum IgE levelsincreased with increasing age. There is a significant increase in serum IgE levels from 10.00% ininfancy to 64.10% in the 49-60th month. Conclusion: This study showed an increasing number ofchildren with recurrent respiratory tract illness and serum IgE levels with increasing age. Males,preterm and bottle-fed babies are more prone. There was a significant role in a family history ofrecurrent respiratory tract illness in children with elevated serum IgE levels.

scholarly journals Clinical Characteristics of Pediatric Respiratory Tract Infection and Respiratory Pathogen Isolation During the Coronavirus Disease 2019 Pandemic

2022 ◽  
Vol 9 ◽  
Author(s):  
Xifeng Tang ◽  
Ge Dai ◽  
Xiaohui Jiang ◽  
Ting Wang ◽  
Huiming Sun ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Tract Infection ◽  
Respiratory Tract ◽  
Clinical Characteristics ◽  
Detection Rate ◽  
Pathogen Detection ◽  
Respiratory Pathogen ◽  
Chain Reaction ◽  
Detection Rates ◽  
Polymerase Chain

Objective: We sought to compare the clinical characteristics of pediatric respiratory tract infection and respiratory pathogen isolations during the coronavirus disease (COVID-19) pandemic to those of cases in 2018 and 2019.Methods: Our study included all children from 28 days to 15 years old with respiratory tract infections who were admitted to the Department of Respiration, in the Children's Hospital of Soochow University, between January 2018 and December 2020. Human rhinovirus (HRV) and human metapneumovirus (hMPV) were detected by reverse transcription polymerase chain reaction (RT-PCR). Mycoplasma pneumoniae (MP) and human bocavirus (HBoV) were detected by real-time fluorescence quantitative polymerase chain reaction (qPCR); In parallel, Mycoplasma pneumoniae was detected by enzyme-linked immunosorbent assays, and bacteria were detected by culture in blood, bronchoalveolar lavage specimen, and pleural fluid.Results: Compared to 2018 and 2019, the pathogen detection rate was significantly lower in 2020. With regard to infections caused by single pathogens, in 2020, the detection rates of MP were the lowest and those of HRV were the highest when compared to those in 2018 and 2019. Meanwhile, the positive rates of respiratory syncytial virus (RSV) and hMPV reported in 2020 were less than those recorded in 2018 but similar to those recorded in 2019. Also, the 2020 rate of adenovirus (ADV) was lower than that recorded in 2019, but similar to that recorded in 2018. There were no statistical differences in the positive rates of HBoV and PIV III over the 3 years surveyed. Infections in infants were significantly less common in 2020, but no significant difference was found among children aged 1 to 3 years. The detection rate of pathogens in children old than 5 years in 2020 was significantly lower than those recorded in the previous 2 years. Notably, the pathogen detection rates in the first and second quarters of 2020 were similar to those recorded in the previous 2 years; however, the rates were reduced in the third and fourth quarters of 2020. As for co-infections, the positive rate was at its lowest in 2020. In the previous 2 years, viral–MP was the most common type of mixed infection. By contrast, in 2020, viral–viral infections were the most common combination.Conclusion: The pathogen detection rate was significantly reduced in Suzhou City during the COVID-19 pandemic. Public interventions may help to prevent respiratory pathogen infections in children.

scholarly journals Susceptibilities to Levofloxacin in Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis Clinical Isolates from Children: Results from 2000-2001 and 2001-2002 TRUST Studies in the United States

2003 ◽  
Vol 47 (6) ◽  
pp. 1790-1797 ◽  
Author(s):  
James A. Karlowsky ◽  
Clyde Thornsberry ◽  
Ian A. Critchley ◽  
Mark E. Jones ◽  
Alan T. Evangelista ◽  
...  
Keyword(s):  
United States ◽  
Multidrug Resistance ◽  
Streptococcus Pneumoniae ◽  
Respiratory Tract ◽  
Moraxella Catarrhalis ◽  
Pediatric Patients ◽  
Respiratory Illness ◽  
The United States ◽  
Surveillance Studies ◽  
Resistance To Penicillin

ABSTRACT Among respiratory tract isolates of Streptococcus pneumoniae from children, resistance to penicillins, cephalosporins, macrolides, and trimethoprim-sulfamethoxazole (SXT) increases on an annual basis. Pediatric patients who do not respond to conventional therapy for respiratory tract infections someday may be treated with fluoroquinolones. In this study, MICs of β-lactams, azithromycin, SXT, and levofloxacin were determined and interpreted by using NCCLS guidelines for isolates of S. pneumoniae (2,834 from children and 10,966 from adults), Haemophilus influenzae (629 from children and 2,281 from adults), and Moraxella catarrhalis (389 from children and 1,357 from adults) collected during the 2000-2001 and 2001-2002 respiratory illness seasons in the United States as part of the ongoing TRUST surveillance studies. Rates of resistance to penicillin, azithromycin, and SXT were ≥7.5% higher among patients ≤4 years old than among patients 5 to 10, 11 to 17, and ≥18 years old in both the 2000-2001 and the 2001-2002 respiratory illness seasons. Levofloxacin resistance was detected in 2 of 2,834 isolates (0.07%) from patients <18 years old. Levofloxacin MICs of 0.25 to 1 μg/ml accounted for 99.6, 99.5, 99.3, 99.7, 98.4, and 98.0% of isolates from patients <2, 2 to 4, 5 to 10, 11 to 17, 18 to 64, and >64 years old. Multidrug resistance was twice as common among patients ≤4 years old (25.3%) as among patients 5 to 10 years old (13.7%), 11 to 17 years old (11.9%), 18 to 64 years old (12.1%), and >64 years old (12.4%). The most common multidrug resistance phenotype in S. pneumoniae isolates for all age groups was resistance to penicillin, azithromycin, and SXT (70.3 to 76.6%). For H. influenzae and M. catarrhalis isolates from patients <2, 2 to 4, 5 to 10, 11 to 17, 18 to 64, and >64 years old, levofloxacin MICs at which 90% of the isolates were inhibited were 0.015 and 0.03 to 0.06 μg/ml, respectively, in the 2000-2001 and 2001-2002 respiratory illness seasons. In the 2000-2001 and 2001-2002 respiratory illness season surveillance studies in the United States, 99.9% of pediatric isolates of S. pneumoniae were susceptible to levofloxacin. If fluoroquinolones become a treatment option for pediatric patients, careful monitoring of fluoroquinolone susceptibilities will be increasingly important in future surveillance studies.

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