Retrospective Review of Clinical and Chest X-Ray Findings in Children Admitted to a Community Hospital for Respiratory Syncytial Virus Infection

Introduction. We performed a retrospective study to evaluate demographics, clinical course, outcome, and radiological findings of children with respiratory syncytial virus (RSV) infection. Methods. Four hundred patients admitted between October 2013 and May 2016 were enrolled. Clinical and radiographic trends were evaluated for association with severity of RSV presentation. Severity was defined as hospitalization >2 days, pediatric intensive care unit admission, or need for mechanical ventilation. Results. Common clinical findings included fever (78.5%), coughing (97%), rhinorrhea/congestion (93%), and hypoxia (44.8%). Hypoxia was seen in 64.7% of the severe group compared with 32.0% in the nonsevere group ( P < .001). Airspace opacification was seen in 49.2% of chest X-rays of the severe group compared with 26.4% in the nonsevere group ( P < .001). Conclusion. Higher incidence of hypoxia or airspace opacification on chest X-ray may be predictors of poorer outcomes for patients with RSV infection.

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Fcγ Receptor IIa (FCGR2A) Polymorphism Is Associated With Severe Respiratory Syncytial Virus Disease in Argentinian Infants

Frontiers in Cellular and Infection Microbiology ◽

10.3389/fcimb.2020.607348 ◽

2020 ◽

Vol 10 ◽

Author(s):

María Pía Holgado ◽

Silvina Raiden ◽

Inés Sananez ◽

Vanesa Seery ◽

Leonardo De Lillo ◽

...

Keyword(s):

Respiratory Syncytial Virus ◽

Virus Disease ◽

Severe Disease ◽

Critical Role ◽

Fcγ Receptor ◽

Factors Associated ◽

Severe Group ◽

Rsv Infection ◽

Syncytial Virus ◽

The Relationship

BackgroundMost patients with respiratory syncytial virus (RSV) infection requiring hospitalization have no risk factors for severe disease. Genetic variation in the receptor for the Fc portion of IgG (FcγR) determines their affinity for IgG subclasses driving innate and adaptive antiviral immunity. We investigated the relationship between FcγRIIa-H131R polymorphism and RSV disease.MethodsBlood samples were collected from 182 infants ≤24-month-old (50 uninfected, 114 RSV-infected with moderate course and 18 suffering severe disease). FcγRIIa-H131R SNP genotypic frequencies (HH, HR, RR) and anti-RSV IgG1, IgG2 and IgG3 levels were studied.ResultsGenotypic frequencies for FcγRIIa-H131R SNP were comparable between uninfected and RSV-infected infants. In contrast, we found a significant higher frequency of HH genotype in severe RSV-infected children compared to moderate patients. Among severe group, HH infants presented more factors associated to severity than HR or RR patients did. Furthermore, compared to moderate RSV-infected infants, severe patients showed higher levels of anti-RSV IgG1 and IgG3.ConclusionsWe found an association between an FcγRIIa (H131) polymorphism and severe RSV disease, which points towards a critical role for interactions between FcγRs and immune complexes in RSV pathogenesis. This genetic factor could also predict the worse outcome and identify those infants at risk during hospitalization.

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Respiratory Syncytial Virus and Metapneumovirus Infection Have Different Clinical Presentation in Children

10.21203/rs.3.rs-1039350/v1 ◽

2021 ◽

Author(s):

Jonathan Illan Montero ◽

Alice Berger ◽

Jack Levy ◽

Laurent Busson ◽

Marc Hainaut ◽

...

Keyword(s):

Respiratory Syncytial Virus ◽

Pediatric Intensive Care ◽

Viral Culture ◽

Centre Hospitalier Universitaire ◽

Hmpv Infection ◽

Common Causes ◽

Rsv Infection ◽

Syncytial Virus ◽

Pediatric Infections ◽

Tract Infections

Abstract Respiratory syncytial virus (RSV) and Human metapneumovirus (hMPV), members of Pneumoviridae family are common causes of acute respiratory tract infections (ARTI) among children. Study material includes routine nasopharyngeal samples obtained during 8-year period for hMPV and one single season for RSV in children aged 0 to 15 years at the Centre Hospitalier Universitaire (CHU) Saint Pierre in Brussels. Positive samples for RSV or hMPV identified by viral culture, lateral flow chromatography test for RSV or direct fluorescent assay for hMPV were selected retrospectively. The medical charts of these patients were reviewed. Hospitalization rate was 37% (219/591) and 39% (187/476) for hMPV and RSV respectively. Children hospitalized for RSV infection were significantly younger and more dyspneic, requiring more respiratory support, longer hospital stay and transfers in Pediatric intensive Care Units (PICU) than those hospitalized for hMPV infection. Pneumonia diagnostic and antibiotics therapies were more significantly associated with hMPV infections.In conclusion, despite their genetic similarities, RSV and hMPV present epidemiological and clinical differences in pediatric infections.

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Early Onset Favipiravir Saves Lives

10.21203/rs.3.rs-142868/v1 ◽

2021 ◽

Author(s):

Ercan KARATAS ◽

Lacin Aksoy ◽

Pinar Elbir Kilic ◽

Arzu Dogru ◽

Ersin Ozaslan

Keyword(s):

Oral Treatment ◽

Clinical Findings ◽

Treatment Resistant ◽

Radiological Findings ◽

Start Time ◽

Laboratory Findings ◽

X Ray ◽

Chest X Ray ◽

New Type ◽

Clinical Worsening

Abstract Background Favipiravir, an antiviral recommended for use in patients with tachypnea (respiratory rate 30 / min) in COVID-19 pneumonia, with SpO2 level below 90% in room air and with bilateral diffuse pneumonia on chest X-ray or tomography, or patients with treatment-resistant fever, is a new type of RNA-dependent RNA polymerase (RdRp) inhibitor. After the administration of Favipiravir, it contributed significantly to reducing mortality in patients with severe COVID-19 positive disease. We performed this study to determine the start time in Favipiravir's covid pneumonia. Material and Method: We evaluated the effect of a total of 5 days of oral treatment as a 2 × 1600 mg loading dose and a 2 × 600 mg maintenance dose of Favipiravir added to the standard COVID-19 treatment received by patients with laboratory-radiology-clinical findings who have advanced or severe COVID 19 pneumonia. Results 180 patients hospitalized at Tuzla State Hospital and given Favipiravir treatment between 20/3/2020 and 30/5/2020 were examined. As of hospitalization, 17 of 101 patients (17%) who were given Favipiravir treatment in ≤ 3 days died, 30 of 79 patients (38%) who were given Favipiravir treatment for in > 3 days died (p:0.002). 33 of 47 patients (70%) who died were > 65 years old. Only 5 of the 47 (11%) patients who died had no comorbid disease. 35 had two or more comorbid diseases. Conclusion Patients with radiological findings indicating that COVID-19 will be severe and laboratory findings at the time of the first 3 days should be initiated with an effective dose of Favipiravir treatment without waiting for the clinical worsening.

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Deep Learning for Screening COVID-19 using Chest X-Ray Images

10.1101/2020.05.04.20090423 ◽

2020 ◽

Cited By ~ 3

Author(s):

Sanhita Basu ◽

Sushmita Mitra ◽

Nilanjan Saha

Keyword(s):

Deep Learning ◽

Lung Parenchyma ◽

Clinical Findings ◽

Data Sets ◽

X Rays ◽

X Ray ◽

Chest X Ray ◽

Increasing Demand ◽

Novel Coronavirus ◽

Diverse Data

AbstractWith the ever increasing demand for screening millions of prospective “novel coronavirus” or COVID-19 cases, and due to the emergence of high false negatives in the commonly used PCR tests, the necessity for probing an alternative simple screening mechanism of COVID-19 using radiological images (like chest X-Rays) assumes importance. In this scenario, machine learning (ML) and deep learning (DL) offer fast, automated, effective strategies to detect abnormalities and extract key features of the altered lung parenchyma, which may be related to specific signatures of the COVID-19 virus. However, the available COVID-19 datasets are inadequate to train deep neural networks. Therefore, we propose a new concept called domain extension transfer learning (DETL). We employ DETL, with pre-trained deep convolutional neural network, on a related large chest X-Ray dataset that is tuned for classifying between four classes viz. normal, other_disease, pneumonia and Covid — 19. A 5-fold cross validation is performed to estimate the feasibility of using chest X-Rays to diagnose COVID-19. The initial results show promise, with the possibility of replication on bigger and more diverse data sets. The overall accuracy was measured as 95.3% ± 0.02. In order to get an idea about the COVID-19 detection transparency, we employed the concept of Gradient Class Activation Map (Grad-CAM) for detecting the regions where the model paid more attention during the classification. This was found to strongly correlate with clinical findings, as validated by experts.

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PIH2 PEDIATRIC INTENSIVE CARE UNIT (PICU) ADMISSIONS FOR RESPIRATORY SYNCYTIAL VIRUS (RSV) INFECTION IN THE ERA OF PALIVIZUMAB PROPHYLAXIS

Value in Health ◽

10.1016/s1098-3015(11)72517-7 ◽

2010 ◽

Vol 13 (7) ◽

pp. A375

Author(s):

BA Paes ◽

M Butt ◽

M Janes ◽

A Symington ◽

L Elliott ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Respiratory Syncytial Virus ◽

Pediatric Intensive Care Unit ◽

Pediatric Intensive Care ◽

Rsv Infection ◽

Syncytial Virus

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Is lung ultrasonography a useful method to diagnose children with community-acquired pneumonia in emergency settings?

Hong Kong Journal of Emergency Medicine ◽

10.1177/1024907918783491 ◽

2018 ◽

Vol 26 (2) ◽

pp. 91-97 ◽

Cited By ~ 1

Author(s):

Aykut Çağlar ◽

Emel Ulusoy ◽

Anıl Er ◽

Fatma Akgül ◽

Hale Çitlenbik ◽

...

Keyword(s):

Gold Standard ◽

Radiation Risk ◽

Pediatric Emergency ◽

Clinical Findings ◽

Community Acquired Pneumonia ◽

Pediatric Emergency Department ◽

X Rays ◽

Lung Ultrasonography ◽

X Ray ◽

Chest X Ray

Background: Lung ultrasonography is a new method for diagnosing community-acquired pneumonia. Lung ultrasonography has some advantages over chest X-ray, such as lack of ionizing radiation risk, bedside performance, and cost-effectiveness. Objectives: In this study, we aimed to determine the feasibility of lung ultrasonography in emergency settings in children with community-acquired pneumonia. Methods: The study included patients younger than 18 years of age with suspicion of community-acquired pneumonia. On the first evaluation, patients with positive clinical and/or chest X-ray findings were defined to have community-acquired pneumonia, and this was accepted as the gold standard. The chest X-rays were evaluated by the chief of the pediatric emergency department, who was blinded to the patients and the lung ultrasonography results. Lung ultrasonography was performed by another pediatric emergency physician who was also blinded to the chest X-ray results and clinical findings such as fever, respiratory distress, rales, and wheezing. Results: Of the 91 patients enrolled, 71 (78.0%) were diagnosed with community-acquired pneumonia based on clinical and chest X-ray findings. The median (interquartile range) duration of the lung ultrasonography procedure was 4.0 (3.5–6.0) min. Shred sign, air bronchogram, and hepatization were significantly more frequent in the patients with community-acquired pneumonia ( p < 0.01, p < 0.01, and p = 0.01, respectively). Sensitivity and specificity of lung ultrasonography were 78.5% (67.1–87.4) and 95.2% (76.1–99.8), respectively. Conclusion: Lung ultrasonography is a useful diagnostic method for children with suspicion of community-acquired pneumonia.

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