Respiratory Viruses Other than Influenza Virus: Impact and Therapeutic Advances

SUMMARY Though several antivirals have been developed and marketed to treat influenza virus infections, the development of antiviral agents with clinical activity against other respiratory viruses has been more problematic. Here we review the epidemiology of respiratory viral infections in immunocompetent and immunocompromised hosts, examine the evidence surrounding the currently available antivirals for respiratory viral infections other than influenza, highlight those that are in the pipeline, and discuss the hurdles for development of such agents.

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Differentiating Impacts of Non-Pharmaceutical Interventions on Non-Coronavirus-Disease-2019 Respiratory Viral Infections: Hospital-Based Retrospective Observational Study in Taiwan

10.22541/au.161353156.67766598/v1 ◽

2021 ◽

Author(s):

Po-Liang Chen ◽

Isaac Yen-Hao Chu ◽

Mei-Lin Yeh ◽

Yin-Yin Chen ◽

Chia-Lin Lee ◽

...

Keyword(s):

Influenza Virus ◽

Observational Study ◽

Pediatric Patients ◽

Viral Infections ◽

Respiratory Viruses ◽

Influenza Viruses ◽

Retrospective Observational Study ◽

Enveloped Viruses ◽

Respiratory Viral Infections ◽

Pharmaceutical Interventions

Background Physical distancing and facemask use are worldwide recognized as effective non-pharmaceutical interventions (NPIs) against the coronavirus disease 2019 (COVID-19). Since January 2020, Taiwan has introduced both NPIs but their effectiveness on non-COVID-19 respiratory viruses (NCRVs) remain underexplored. Methods This retrospective observational study examined electronic records at a tertiary hospital in northern Taiwan from pre-COVID (January–December 2019) to post-COVID period (January–May 2020). Patients with respiratory syndromes were tested for both enveloped (e.g. influenza virus and seasonal coronavirus) and non-enveloped RVs (e.g. enterovirus and rhinovirus) using multiplex reverse-transcription polymerase chain reaction assays. Monthly positivity rates of NCRVs among adult and pediatric patients were analyzed with comparison between pre- and post-COVID periods. Results A total of 9693 patients underwent 12127 multiplex RT-PCR tests. The average positivity rate of NCRVs reduced by 11.2% (25.6% to 14.4%) after nationwide PHIs. Despite the COVID-19 pandemic, the most commonly identified enveloped and non-enveloped viruses were influenza virus and enterovirus/rhinovirus, respectively. Observed reduction in NCRV incidence was predominantly contributed by enveloped NCRVs including influenza viruses. We did not observe epidemiological impacts of NPIs on non-enveloped viruses but an increasing trend in enterovirus/rhinovirus test positivity rate among pediatric patients. Our data were validated using Taiwan’s national notification database. Conclusions Our frontline investigation suggests that the current NPIs in Taiwan might not effectively control the transmission of non-enveloped respiratory viruses, despite their protective effects against influenza and seasonal coronavirus. Hydrogen peroxide or chloride-based disinfectants should be integrated into national preventative strategies against respiratory viral infections in the post-COVID-19 era.

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Influenza and other respiratory viral infections associated with absence from school among schoolchildren in Pittsburgh, Pennsylvania, USA: a cohort study

BMC Infectious Diseases ◽

10.1186/s12879-021-05922-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jonathan M. Read ◽

Shanta Zimmer ◽

Charles Vukotich ◽

Mary Lou Schweizer ◽

David Galloway ◽

...

Keyword(s):

Cohort Study ◽

Viral Infections ◽

Influenza Infection ◽

Respiratory Viruses ◽

Influenza B ◽

Mixed Effect ◽

School Aged Children ◽

Respiratory Viral Infections ◽

Day Programs ◽

K 12

Abstract Background Information on the etiology and age-specific burden of respiratory viral infections among school-aged children remains limited. Though school aged children are often recognized as driving the transmission of influenza as well as other respiratory viruses, little detailed information is available on the distribution of respiratory infections among children of different ages within this group. Factors other than age including gender and time spent in school may also be important in determining risk of infection but have been little studied in this age group. Methods We conducted a cohort study to determine the etiology of influenza like illness (ILI) among 2519 K–12 students during the 2012–13 influenza season. We obtained nasal swabs from students with ILI-related absences. Generalized linear mixed-effect regressions determined associations of outcomes, including ILI and laboratory-confirmed respiratory virus infection, with school grade and other covariates. Results Overall, 459 swabs were obtained from 552 ILI–related absences. Respiratory viruses were found in 292 (63.6%) samples. Influenza was found in 189 (41.2%) samples. With influenza B found in 134 (70.9%). Rates of influenza B were significantly higher in grades 1 (10.1, 95% CI 6.8–14.4%), 2 (9.7, 6.6–13.6%), 3 (9.3, 6.3–13.2%), and 4 (9.9, 6.8–13.8%) than in kindergarteners (3.2, 1.5–6.0%). After accounting for grade, sex and self-reported vaccination status, influenza B infection risk was lower among kindergarteners in half-day programs compared to kindergarteners in full-day programs (OR = 0.19; 95% CI 0.08–0.45). Conclusions ILI and influenza infection is concentrated in younger schoolchildren. Reduced infection by respiratory viruses is associated with a truncated school day for kindergarteners but this finding requires further investigation in other grades and populations.

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Respiratory viral infections in the elderly

Therapeutic Advances in Respiratory Disease ◽

10.1177/1753466621995050 ◽

2021 ◽

Vol 15 ◽

pp. 175346662199505

Author(s):

Alastair Watson ◽

Tom M. A. Wilkinson

Keyword(s):

Immune System ◽

Viral Infections ◽

Point Of Care ◽

The Elderly ◽

Respiratory Viruses ◽

Morbidity And Mortality ◽

Detection Methods ◽

Respiratory Viral Infections ◽

Tract Infections ◽

Prolonged Hospital

With the global over 60-year-old population predicted to more than double over the next 35 years, caring for this aging population has become a major global healthcare challenge. In 2016 there were over 1 million deaths in >70 year olds due to lower respiratory tract infections; 13–31% of these have been reported to be caused by viruses. Since then, there has been a global COVID-19 pandemic, which has caused over 2.3 million deaths so far; increased age has been shown to be the biggest risk factor for morbidity and mortality. Thus, the burden of respiratory viral infections in the elderly is becoming an increasing unmet clinical need. Particular challenges are faced due to the interplay of a variety of factors including complex multimorbidities, decreased physiological reserve and an aging immune system. Moreover, their atypical presentation of symptoms may lead to delayed necessary care, prescription of additional drugs and prolonged hospital stay. This leads to morbidity and mortality and further nosocomial spread. Clinicians currently have limited access to sensitive detection methods. Furthermore, a lack of effective antiviral treatments means there is little incentive to diagnose and record specific non-COVID-19 viral infections. To meet this unmet clinical need, it is first essential to fully understand the burden of respiratory viruses in the elderly. Doing this through prospective screening research studies for all respiratory viruses will help guide preventative policies and clinical trials for emerging therapeutics. The implementation of multiplex point-of-care diagnostics as a mainstay in all healthcare settings will be essential to understand the burden of respiratory viruses, diagnose patients and monitor outbreaks. The further development of novel targeted vaccinations as well as anti-viral therapeutics and new ways to augment the aging immune system is now also essential. The reviews of this paper are available via the supplemental material section.

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Clinical-epidemiological peculiarities of acute respiratory infections in children from 3 to 12 years and evaluation of effectiveness of antivirus therapy

Journal Infectology ◽

10.22625/2072-6732-2019-11-3-38-45 ◽

2019 ◽

Vol 11 (3) ◽

pp. 38-45

Author(s):

S. A. Khmilevskaya ◽

N. I. Zryachkin ◽

V. E. Mikhailova

Keyword(s):

Viral Infections ◽

Respiratory Infections ◽

Molecular Genetic ◽

Respiratory Viruses ◽

Acute Respiratory Infections ◽

Age Group ◽

Leading Role ◽

Respiratory Viral Infections ◽

Acute Respiratory Viral Infection ◽

Tract Infections

The aim: to study the etiological structure of acute respiratory infections in children aged 3 to 12 hospitalized in the early stages of the disease in the department of respiratory infections of the children’s hospital, and to reveal the features of their clinical course and the timing of DNA / RNA elimination of respiratory viruses from nasal secretions, depending on the method of therapy. Materials and methods: 100 children with acute respiratory infections aged 3 to 12 years were monitored. The nasal secrets on the DNA / RNA of respiratory viruses were studied by PCR. Depending on the method of therapy, patients were divided into 2 groups: patients of group 1 (comparison) received basic treatment (without the use of antiviral drugs), in patients of the 2nd group (main), along with basal therapy, the drug was used umifenovir in a 5-day course at the ageappropriate dosage. Results: In the etiologic structure of ARVI in children from 3 to 12 years, the leading place was taken by rhinovirus, influenza and metapneumovirus infections (isolated – 18%, 19% and 20% respectively, in the form of a mixed infection – 11%). The main syndromic diagnosis at the height of the disease was rhinopharyngitis. Complications were observed in 42% of cases, as often as possible with flu – 53% of cases. Features of metapneumovirus infection in children of this age group were: predominance of non-severe forms of the disease in the form of acute fever with symptoms of rhinopharyngitis, as well as a small incidence of lower respiratory tract infections. The use of the drug umiphenovir in children with acute respiratory viral infections of various etiologies contributed to significantly faster elimination of viral DNA / RNA from the nasal secretion, which was accompanied by a ecrease in the duration of the main clinical and hematological symptoms of the disease, a decrease in the incidence of complications, and reduced the duration of stay in hospital. Conclusion: application of modern molecular genetic methods of diagnostics made it possible to identify the leading role of influenza, metapneumovirus and rhinovirus infections in the etiology of acute respiratory viral infection in patients aged 3 to 12 years, and to determine a number of clinical features characteristic of this age group. The results of the study testify to the effectiveness of umiphenovir in the treatment of children with acute respiratory viral infections of various etiologies and allow us to recommend this drug as an effective and safe etiotropic agent.

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A Lower Level of Post-Vaccinal Antibody Titer against Influenza Virus A H1N1 May Protect Patients with Autoimmune Rheumatic Diseases from Respiratory Viral Infections

Medicina ◽

10.3390/medicina58010076 ◽

2022 ◽

Vol 58 (1) ◽

pp. 76

Author(s):

Milomir S. Milanovic ◽

Djordje M. Kadijevich ◽

Ljudmila Stojanovich ◽

Branislav Milovanovic ◽

Aleksandra Djokovic

Keyword(s):

Logistic Regression ◽

Influenza Virus ◽

Antibody Titer ◽

Rheumatic Diseases ◽

Disease Duration ◽

Viral Infections ◽

Binary Logistic Regression ◽

Influenza Virus A ◽

Autoimmune Rheumatic Diseases ◽

Respiratory Viral Infections

Background and Objectives: The concentration of antibodies against virus influenza A H1N1 in the titer (≥1:32) positively correlates with resistance to flu in healthy persons. In elderly and immune-compromised patients, an influenza vaccine may be less immunogenic. Hypothesis: A lower post-vaccinal antibody titer (≥1:16) may be sero-protective against respiratory viral infections in patients with autoimmune rheumatic diseases. Materials and Methods: Fifty patients with autoimmune rheumatic diseases (Systemic Lupus Erythematosus—24; Rheumatoid Arthritis—15; and Sjögren’s Syndrome—11), who were at least 65 years old or whose relative disease duration (disease duration/age) was greater than 1/8, were examined. Thirty-four of them were vaccinated with a trivalent inactivated non-adjuvant influenza vaccine. The antibody concentration against influenza virus A H1N1 was measured using the standardized hemagglutination inhibition test and patients who got any respiratory viral infection were registered. To test the hypothesis, a correlative analysis was applied, followed by a binary logistic regression that included potential confounding variables, such as age, disease duration and therapy (personal/health-related conditions). Results: Vaccinated patients were significantly less affected by respiratory viral infections (21% vs. 75%). The lower titer considered (≥1:16) was significantly present more often among vaccinated patients (68% vs. 6%). The correlation between its presence/absence and that of respiratory viral infections was –0.34 (p < 0.05). The binary logistic regression evidenced the relevance of this correlation, confirming the hypothesis. Vaccination was associated with the 87.3% reduction in the likelihood of getting respiratory viral infections, whereas the lower antibody titer (≥1:16) was associated with the 77.6% reduction in the likelihood of getting respiratory viral infections. The vaccine was well tolerated by all patients and after vaccination no exacerbation of the underlying disease was observed. Conclusions: A lower antibody titer (≥1:16) against influenza virus A H1N1 could be protective against respiratory viral infections for certain autoimmune rheumatic diseases patients, which confirms the clinical effectiveness of influenza vaccination.

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Digging through the Obstruction: Insight into the Epithelial Cell Response to Respiratory Virus Infection in Patients with Cystic Fibrosis

Journal of Virology ◽

10.1128/jvi.01864-15 ◽

2016 ◽

Vol 90 (9) ◽

pp. 4258-4261 ◽

Cited By ~ 10

Author(s):

Matthew R. Hendricks ◽

Jennifer M. Bomberger

Keyword(s):

Cystic Fibrosis ◽

Lung Diseases ◽

Respiratory Virus ◽

Viral Infections ◽

Molecular Diagnostic ◽

Molecular Diagnostic Techniques ◽

Virus Infections ◽

Chronic Lung Diseases ◽

Respiratory Viral Infections ◽

Respiratory Virus Infections

Respiratory virus infections are common but generally self-limiting infections in healthy individuals. Although early clinical studies reported low detection rates, the development of molecular diagnostic techniques by PCR has led to an increased recognition that respiratory virus infections are associated with morbidity and acute exacerbations of chronic lung diseases, such as cystic fibrosis (CF). The airway epithelium is the first barrier encountered by respiratory viruses following inhalation and the primary site of respiratory viral replication. Here, we describe how the airway epithelial response to respiratory viral infections contributes to disease progression in patients with CF and other chronic lung diseases, including the role respiratory viral infections play in bacterial acquisition in the CF patient lung.

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In combat against viruses

Remedium Journal about the Russian market of medicines and medical equipment ◽

10.21518/1561-5936-2021-1-43-49 ◽

2021 ◽

pp. 43-49

Author(s):

Irina Shirokova ◽

◽

Yuliya Prozherina ◽

Keyword(s):

Influenza Virus ◽

Viral Infections ◽

Viral Diseases ◽

Virus Infections ◽

Late 20Th Century ◽

Early 21St Century ◽

High Incidence ◽

Persistent Virus ◽

Further Development ◽

New Mutations

The late 20th century and the early 21st century have been marked by the explosive development of virology due to activation of viral infections. New mutations of the influenza virus, high incidence of persistent virus infections in humans, as well as respiratory viral diseases that have not yet been eradicated has boosted further development of this direction [1].

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Primary and Repeated Respiratory Viral Infections Among Infants in Rural Nepal

Journal of the Pediatric Infectious Diseases Society ◽

10.1093/jpids/piy107 ◽

2018 ◽

Vol 9 (1) ◽

pp. 21-29 ◽

Cited By ~ 2

Author(s):

Jim Boonyaratanakornkit ◽

Janet A Englund ◽

Amalia S Magaret ◽

Yunqi Bu ◽

James M Tielsch ◽

...

Keyword(s):

Primary Infection ◽

Respiratory Virus ◽

Viral Infections ◽

Respiratory Illness ◽

Respiratory Viruses ◽

Repeated Infection ◽

Resource Limited ◽

Respiratory Viral Infections ◽

Repeated Infections ◽

Rural Nepal

Abstract Background Respiratory viruses cause significant morbidity and death in infants; 99% of such deaths occur in resource-limited settings. Risk factors for initial and repeated respiratory viral infections in young infants in resource-limited settings have not been well described. Methods From 2011 to 2014, a birth cohort of infants in rural Nepal was enrolled and followed with weekly household-based active surveillance for respiratory symptoms until 6 months of age. Respiratory illness was defined as having any of the following: fever, cough, wheeze, difficulty breathing, and/or a draining ear. We tested nasal swabs of infants with respiratory illness for multiple respiratory viruses by using a reverse transcription polymerase chain reaction assay. The risk of primary and repeated infections with the same virus was evaluated using Poisson regression. Results Of 3528 infants, 1726 (49%) had a primary infection, and 419 (12%) had a repeated infection. The incidences of respiratory viral infection in infants were 1816 per 1000 person-years for primary infections and 1204 per 1000 person-years for repeated infection with the same virus. Exposure to other children and male sex were each associated with an increased risk for primary infection (risk ratios, 1.13 [95% confidence interval (CI), 1.06–1.20] and 1.14 [95% CI, 1.02–1.27], respectively), whereas higher maternal education was associated with a decreased risk for both primary and repeated infections (risk ratio, 0.96 [95% CI, 0.95–0.98]). The incidence of subsequent infection did not change when previous infection with the same or another respiratory virus occurred. Illness duration and severity were not significantly different in the infants between the first and second episodes for any respiratory virus tested. Conclusions In infants in rural Nepal, repeated respiratory virus infections were frequent, and we found no decrease in illness severity with repeated infections and no evidence of replacement with another virus. Vaccine strategies and public health interventions that provide durable protection in the first 6 months of life could decrease the burden of repeated infections by multiple respiratory viruses, particularly in low-resource countries.

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Macrolide Therapy in Respiratory Viral Infections

Mediators of Inflammation ◽

10.1155/2012/649570 ◽

2012 ◽

Vol 2012 ◽

pp. 1-9 ◽

Cited By ~ 32

Author(s):

Jin-Young Min ◽

Yong Ju Jang

Keyword(s):

Influenza Virus ◽

Viral Infection ◽

Viral Infections ◽

Wide Spectrum ◽

Influenza Virus Infection ◽

Respiratory Viral Infection ◽

Rsv Infection ◽

Respiratory Viral Infections ◽

Syncytial Virus ◽

Viral Titers

Background. Macrolides have received considerable attention for their anti-inflammatory and immunomodulatory actions beyond the antibacterial effect. These two properties may ensure some efficacy in a wide spectrum of respiratory viral infections. We aimed to summarize the properties of macrolides and their efficacy in a range of respiratory viral infection.Methods. A search of electronic journal articles through PubMed was performed using combinations of the following keywords including macrolides and respiratory viral infection.Results. Bothin vitroandin vivostudies have provided evidence of their efficacy in respiratory viral infections including rhinovirus (RV), respiratory syncytial virus (RSV), and influenza virus. Much data showed that macrolides reduced viral titers of RV ICAM-1, which is the receptor for RV, and RV infection-induced cytokines including IL-1β, IL-6, IL-8, and TNF-α. Macrolides also reduced the release of proinflammatory cytokines which were induced by RSV infection, viral titers, RNA of RSV replication, and the susceptibility to RSV infection partly through the reduced expression of activated RhoA which is an RSV receptor. Similar effects of macrolides on the influenza virus infection and augmentation of the IL-12 by macrolides which is essential in reducing virus yield were revealed.Conclusion. This paper provides an overview on the properties of macrolides and their efficacy in various respiratory diseases.

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