scholarly journals Increased risk of psychiatric sequelae of COVID-19 is highest early in the clinical course

2021 ◽  
Author(s):  
Ben Coleman ◽  
Elena Casiraghi ◽  
Hannah Blau ◽  
Lauren Chan ◽  
Melissa A Haendel ◽  
...  
Keyword(s):  
Mental Illness ◽  
Anxiety Disorders ◽  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Hazard Ratio ◽  
First Year ◽  
Increased Risk ◽  
Psychiatric Sequelae ◽  
Tract Infections ◽  
New Onset

Background: COVID-19 has been shown to increase the risk of adverse mental health consequences. A recent electronic health record (EHR)-based observational study showed an almost two-fold increased risk of new-onset mental illness in the first 90 days following a diagnosis of acute COVID-19. Methods: We used the National COVID Cohort Collaborative, a harmonized EHR repository with 2,965,506 COVID-19 positive patients, and compared cohorts of COVID-19 patients with comparable controls. Patients were propensity score-matched to control for confounding factors. We estimated the hazard ratio (COVID-19:control) for new-onset of mental illness for the first year following diagnosis. We additionally estimated the change in risk for new-onset mental illness between the periods of 21-120 and 121-365 days following infection. Findings: We find a significant increase in incidence of new-onset mental disorders in the period of 21-120 days following COVID-19 (3.8%, 3.6-4.0) compared to patients with respiratory tract infections (3%, 2.8-3.2). We further show that the risk for new-onset mental illness decreases over the first year following COVID-19 diagnosis compared to other respiratory tract infections and demonstrate a reduced (non-significant) hazard ratio over the period of 121-365 days following diagnosis. Similar findings are seen for new-onset anxiety disorders but not for mood disorders. Interpretation: Patients who have recovered from COVID-19 are at an increased risk for developing new-onset mental illness, especially anxiety disorders. This risk is most prominent in the first 120 days following infection.

scholarly journals Lower Respiratory Tract Infections Associated with Rhinovirus during Infancy and Increased Risk of Wheezing during Childhood. A Cohort Study

PLoS ONE ◽  
2013 ◽  
Vol 8 (7) ◽  
pp. e69370 ◽  
Author(s):  
Cristina O’Callaghan-Gordo ◽  
Quique Bassat ◽  
Núria Díez-Padrisa ◽  
Luis Morais ◽  
Sónia Machevo ◽  
...  
Keyword(s):  
Cohort Study ◽  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Lower Respiratory Tract Infections ◽  
Increased Risk ◽  
Tract Infections

scholarly journals LB2. TORC1 Inhibition with RTB101 as a Potential Pan-Antiviral Immunotherapy to Decrease the Incidence of Respiratory Tract Infections Due to Multiple Respiratory Viruses in Older Adults

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S993-S994 ◽  
Author(s):  
Joan Mannick ◽  
Amelia Tomlinson ◽  
Sarb Shergill ◽  
Grace Teo ◽  
Lloyd Klickstein
Keyword(s):  
Gene Expression ◽  
Older Adults ◽  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Controlled Study ◽  
Double Blind ◽  
Increased Risk ◽  
Intent To Treat ◽  
Tract Infections ◽  
Antiviral Gene

Abstract Background Respiratory tract infections (RTIs) are a leading cause of hospitalization and death in people age ≥65 years. RTIs are caused by multiple viruses, most of which lack effective treatments. An immunotherapy that enhances pan-antiviral innate immunity may reduce RTI incidence in older adults. Inhibition of targets downstream of target of rapamycin complex 1 (TORC1) was reported to upregulate pan-antiviral gene expression and protect mice from a viral RTI (York AG et al. Cell 2015). We evaluated whether TORC1 inhibition increased antiviral gene expression and decreased RTI incidence in older adults. Methods A randomized, double-blind, placebo, controlled study was conducted to determine whether the TORC1 inhibitor RTB101 alone or in combination with the TORC1 inhibitor everolimus reduced the incidence of laboratory-confirmed RTIs. The study enrolled 652 older adults at increased risk of RTI-related morbidity and mortality (defined as age ≥85 years, or age ≥65 years with asthma, COPD, type 2 diabetes mellitus, or current smokers). Subjects were treated for 16 weeks during winter cold and flu season with oral RTB101 5 mg or 10 mg once daily (QD), RTB101 10 mg twice daily, RTB101 10 mg + everolimus 0.1 mg QD, or matched placebo. The primary endpoint was the percentage of subjects with ≥1 laboratory-confirmed RTI through Week 16. Results RTB101 was well tolerated. In the intent-to-treat analysis, RTB101 10 mg QD was observed to: reduce the percentage of subjects with laboratory-confirmed RTIs by 30.6% compared with placebo (P = 0.025); reduce the incidence of RTIs caused by multiple different viruses; and upregulate interferon-stimulated pan-antiviral gene expression in whole blood (P = 0.00001 vs. placebo, Figure 1). Furthermore, RTB101 10 mg QD was observed to reduce the time to alleviation of moderate to severe RTI symptoms by 5 days, and to reduce the rate of all-cause hospitalization (rate ratio 0.439, 90% CI 0.196–0.983, P = 0.047). Conclusion RTB101 10 mg QD was associated with a significant reduction in laboratory-confirmed RTIs due to multiple viral pathogens that lack effective medicines for treatment or prevention. RTB101 was observed to upregulate interferon-stimulated pan-antiviral gene expression, which may underlie the reduction in RTI incidence. Disclosures Joan Mannick, MD, resTORbio (Employee, Shareholder), Amelia Tomlinson, PhD, resTORbio (Employee), Sarb Shergill, PhD, resTORbio (Employee), Grace Teo, PhD, resTORbio (Employee), Lloyd Klickstein, MD, PhD, resTORbio (Employee).

scholarly journals The Safety of Delayed Versus Immediate Antibiotic Prescribing for Upper Respiratory Tract Infections

2020 ◽  
Author(s):  
Tjeerd Pieter van Staa ◽  
Victoria Palin ◽  
Benjamin Brown ◽  
William Welfare ◽  
Yan Li ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Hospital Admission ◽  
Respiratory Tract Infections ◽  
Population Based ◽  
Upper Respiratory Tract Infections ◽  
Antibiotic Prescribing ◽  
Upper Respiratory Tract ◽  
Increased Risk ◽  
Upper Respiratory ◽  
Tract Infections

Abstract Background This study aimed to evaluate the clinical safety of delayed antibiotic prescribing for upper respiratory tract infections (URTIs), which is recommended in treatment guidelines for less severe cases. Methods Two population-based cohort studies used the English Clinical Practice Research Databank and Welsh Secure Anonymized Information Linkage, containing electronic health records from primary care linked to hospital admission records. Patients with URTI and prescriptions of amoxicillin, clarithromycin, doxycycline, erythromycin, or phenoxymethylpenicillin were identified. Patients were stratified according to delayed and immediate prescribing relative to URTI diagnosis. Outcome of interest was infection-related hospital admission after 30 days. Results The population included 1.82 million patients with an URTI and antibiotic prescription; 91.7% had an antibiotic at URTI diagnosis date (immediate) and 8.3% had URTI diagnosis in 1–30 days before (delayed). Delayed antibiotic prescribing was associated with a 52% increased risk of infection-related hospital admissions (adjusted hazard ratio, 1.52; 95% confidence interval, 1.43–1.62). The probability of delayed antibiotic prescribing was unrelated to predicted risks of hospital admission. Analyses of the number needed to harm showed considerable variability across different patient groups (median with delayed antibiotic prescribing, 1357; 2.5% percentile, 295; 97.5% percentile, 3366). Conclusions This is the first large population-based study examining the safety of delayed antibiotic prescribing. Waiting to treat URTI was associated with increased risk of hospital admission, although delayed antibiotic prescribing was used similarly between high- and low-risk patients. There is a need to better target delayed antibiotic prescribing to URTI patients with lower risks of complications.

scholarly journals Predictors of community acquired childhood pneumonia among 2–59 months old children in the Amhara Region, Ethiopia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Muluken Genetu Chanie ◽  
Mequannent Sharew Melaku ◽  
Melaku Yalew ◽  
Mastewal Arefaynie ◽  
Gedamnesh Bitew ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Maternal Age ◽  
Respiratory Tract Infections ◽  
Amhara Region ◽  
Government Employee ◽  
Childhood Pneumonia ◽  
The Past ◽  
Increased Risk ◽  
History Of ◽  
Tract Infections

Abstract Background Worldwide, pneumonia is the third leading cause of death in under 5 years children. Ethiopia is ranked 4th out of 15 countries having the highest burdens of the death rate among under-five children due to pneumonia. Regardless of this fact, efforts to identify determinants of pneumonia have been limited yet in Amhara region. This study was aimed to identify predictors of community-acquired childhood pneumonia among 2–59 months old children in the Amhara region, Ethiopia. Methods Facility-based case–control study was conducted in the Amhara region from June 4 to July 15, 2018, among 28 health centers distributed across the region. The total sample size used was 888 (296 cases and 592 controls) children whose age were 2–59 months. At first, multistage sampling technique was employed. Data were collected on a face-to-face interview. Epi data v. 4.6 for data entry and statistical packages for social sciences version 23 for data analysis were used. Multivariable logistic regression analyses were used to test the associations between the study variables at P-value < 0.05 with 95% CI. As a result, determinants were identified for CAP. Results Among 888 enrolled children (296 cases and 592 controls), who experienced a community-acquired pneumonia had an increased risk of maternal age of 18–24 years (AOR 0.03, at 95%CI (0.01, 0.14), Government employee (AOR 0.19, at 95% CI (0.07,0.54), lack of separate kitchen (AOR 5.37; at 95% CI (1.65, 17.43), history of diarrhea in the past two weeks (AOR 10.2; at 95% CI (5.13, 20.18), previous respiratory tract infections (AOR 8.3, at 95% CI (3.32, 20.55) and history of parental asthma (AOR 4.9, at 95% CI (2.42, 10.18). Conclusion Maternal age of 18–24 years and government employee, lack of separate kitchen, history of diarrhea in the past two weeks; previous respiratory tract infection and history of parental asthma were found statistically significant. Health personnel’s needs to focus on creating awareness to the community on the merit of the separate kitchen for reduction of Community-acquired childhood pneumonia, and focus on prevention and management of childhood diarrheal and acute respiratory tract infections.

scholarly journals 871. Symptomatic Respiratory Syncytial Virus and Adenovirus Upper Respiratory Tract Infections Increase the Risk of Invasive Aspergillosis After Allogeneic Hematopoietic Cell Transplantation

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S24-S25 ◽  
Author(s):  
Chikara Ogimi ◽  
Angela P Campbell ◽  
Hu Xie ◽  
Cynthia Fisher ◽  
Jane Kuypers ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Respiratory Virus ◽  
Hematopoietic Cell Transplantation ◽  
Upper Respiratory Tract ◽  
Research Support ◽  
Increased Risk ◽  
Upper Respiratory ◽  
Syncytial Virus ◽  
Tract Infections

Abstract Background Invasive aspergillosis (IA) is a serious infectious complication following hematopoietic cell transplantation (HCT). Few studies have reported respiratory viral infections (RVIs) as a risk factor for developing IA, and data regarding specific viruses is sparse. We examined whether specific respiratory viruses were associated with increased risk of developing IA post-HCT. Methods In a longitudinal surveillance study of RVIs among allogeneic HCT recipients conducted 2005–2010, weekly post-HCT nasal washes were collected through day 100, then every 3 months, and whenever respiratory symptoms occurred through 1 year post-HCT. Nasal and bronchoalveolar lavage (BAL) samples were tested by multiplex PCR for respiratory syncytial virus (RSV), parainfluenza viruses (PIV)1–4, influenza A/B, human metapneumovirus, adenovirus (ADV), and human rhinoviruses, and coronaviruses. Only respiratory virus detections with symptoms were counted as RVI. Separate Cox proportional hazards models were used to examine adjusted associations between each RVI and the development of first proven/probable IA by 1-year post-HCT. Results Among 437 patients who survived &gt;28 days following HCT, 39 patients developed IA by 1-year post-HCT (median 87 days, range 5–283). After adjusting for age at HCT, neutropenia, high-grade CMV viremia, and HLA status (matched related vs. others) or severe acute graft-versus-host disease (GVHD Grade 0–2 vs. 3–4), RSV and ADV upper respiratory tract infections (URTI) were associated with increased risk of developing IA (figure). Detection of any respiratory virus in the BAL was associated with IA (P &lt; 0.001). Conclusion RSV and ADV URTI are significant risk factors for development of IA post-HCT; the association between PIV URTI and development of IA approached statistical significance. Viral lower respiratory tract infection was associated with IA. Our data provide a rationale to assess IA as an endpoint in preventive studies of novel agents for respiratory viruses and further emphasize the importance of effective infection prevention practices for RVIs after HCT. Disclosures J. Chien, Gilead Sciences, Inc.: Employee and Shareholder, Salary and stocks. A. Waghmare, Ablynx: Investigator, Research support. J. Englund, Gilead: Consultant and Investigator, Consulting fee and Research support. Novavax: Investigator, Research support. GlaxoSmithKline: Investigator, Research support. Alios: Investigator, Research support. MedImmune: Investigator, Research support. M. Boeckh, Asun Biopharma: Consultant and Investigator, Consulting fee and Research support. Gilead Sciences: Consultant and Investigator, Consulting fee and Research support. Chimerix Inc.: Consultant and Investigator, Consulting fee and Research support. Humabs: Consultant, Consulting fee. GSK: Investigator, Research support.

Increased risk of respiratory tract infections in children with Down syndrome: the consequence of an altered immune system

2010 ◽  
Vol 12 (11) ◽  
pp. 799-808 ◽  
Author(s):  
Beatrijs L.P. Bloemers ◽  
Chantal J.M. Broers ◽  
Louis Bont ◽  
Michel E. Weijerman ◽  
Reinoud J.B.J. Gemke ◽  
...  
Keyword(s):  
Down Syndrome ◽  
Immune System ◽  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Children With Down Syndrome ◽  
Increased Risk ◽  
Tract Infections

scholarly journals Immune Dysregulation and the Increased Risk of Complications and Mortality Following Respiratory Tract Infections in Adults With Down Syndrome

2021 ◽  
Vol 12 ◽  
Author(s):  
Tomer Illouz ◽  
Arya Biragyn ◽  
Maria Florencia Iulita ◽  
Lisi Flores-Aguilar ◽  
Mara Dierssen ◽  
...  
Keyword(s):  
Down Syndrome ◽  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Chronic Respiratory Disease ◽  
Severe Illness ◽  
The Past ◽  
Increased Risk ◽  
Syncytial Virus ◽  
Tract Infections ◽  
Complications And Mortality

The risk of severe outcomes following respiratory tract infections is significantly increased in individuals over 60 years, especially in those with chronic medical conditions, i.e., hypertension, diabetes, cardiovascular disease, dementia, chronic respiratory disease, and cancer. Down Syndrome (DS), the most prevalent intellectual disability, is caused by trisomy-21 in ~1:750 live births worldwide. Over the past few decades, a substantial body of evidence has accumulated, pointing at the occurrence of alterations, impairments, and subsequently dysfunction of the various components of the immune system in individuals with DS. This associates with increased vulnerability to respiratory tract infections in this population, such as the influenza virus, respiratory syncytial virus, SARS-CoV-2 (COVID-19), and bacterial pneumonias. To emphasize this link, here we comprehensively review the immunobiology of DS and its contribution to higher susceptibility to severe illness and mortality from respiratory tract infections.

The Effect of Probiotics on Respiratory Infections and Gastrointestinal Symptoms during Training in Marathon Runners

2007 ◽  
Vol 17 (4) ◽  
pp. 352-363 ◽  
Author(s):  
Riina A. Kekkonen ◽  
Tommi J. Vasankari ◽  
Timo Vuorimaa ◽  
Tari Haahtela ◽  
Ilkka Julkunen ◽  
...  
Keyword(s):  
Placebo Group ◽  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Respiratory Infections ◽  
Training Period ◽  
Upper Respiratory Tract ◽  
Marathon Runners ◽  
Increased Risk ◽  
Gi Symptoms ◽  
Tract Infections

Heavy exercise is associated with an increased risk of upper respiratory tract infections. Strenuous exercise also causes gastrointestinal (GI) symptoms. In previous studies probiotics have reduced respiratory tract infections and GI symptoms in general populations including children, adults, and the elderly. These questions have not been studied in athletes before. The purpose of this study was to investigate the effect of probiotics on the number of healthy days, respiratory infections, and GI-symptom episodes in marathon runners in the summer. Marathon runners (N = 141) were recruited for a randomized, double-blind intervention study during which they received Lactobacillus rhamnosus GG (LGG) or placebo for a 3-mo training period. At the end of the training period the subjects took part in a marathon race, after which they were followed up for 2 wk. The mean number of healthy days was 79.0 in the LGG group and 73.4 in the placebo group (P = 0.82). There were no differences in the number of respiratory infections or GI-symptom episodes. The duration of GI-symptom episodes in the LGG group was 2.9 vs. 4.3 d in the placebo group during the training period (P = 0.35) and 1.0 vs. 2.3 d, respectively, during the 2 wk after the marathon (P = 0.046). LGG had no effect on the incidence of respiratory infections or GI-symptom episodes in marathon runners, but it seemed to shorten the duration of GI-symptom episodes.

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