Surveillance of endemic human coronaviruses (HCoV-NL63, OC43 and 229E) associated with pneumonia in Kilifi, Kenya

Introduction: Human coronaviruses (HCoVs) circulate endemically in human populations, often with seasonal variation. We describe the long-term patterns of paediatric disease associated with three of these viruses, HCoV-NL63, OC43 and 229E, in coastal Kenya. Methods: Continuous surveillance of pneumonia admissions was conducted at the Kilifi county hospital (KCH) located in the northern coastal region of Kenya. Children aged <5 years admitted to KCH with clinically defined syndromic severe or very severe pneumonia were recruited. Respiratory samples were taken and tested for 15 virus targets, using real-time polymerase chain reaction. Unadjusted odds ratios were used to estimate the association between demographic and clinical characteristics and HCoV positivity. Results: From 2007 to 2019, we observed 11,445 pneumonia admissions, of which 314 (3.9%) tested positive for at least one HCoV type. There were 129 (41.1%) OC43, 99 (31.5%) 229E, 74 (23.6%) NL63 positive cases and 12 (3.8%) cases of HCoV to HCoV coinfection. Among HCoV positive cases, 47% (n=147) were coinfected with other respiratory virus pathogens. The majority of HCoV cases were among children aged <1 year (66%, n=208), though there was no age-dependence in the proportion testing positive. HCoV-OC43 was predominant of the three HCoV types throughout the surveillance period. Evidence for seasonality was not identified. Conclusions: Overall, 4% of paediatric pneumonia admissions were associated with three endemic HCoVs, with a high proportion of cases co-occurring with another respiratory virus, with no clear seasonal pattern, and with the age-distribution of cases following that of pneumonia admissions (i.e. highest in infants). These observations suggest, at most, a small severe disease contribution of endemic HCoVs in this tropical setting and offer insight into the potential future burden and epidemiological characteristics of SARS-CoV-2.

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Surveillance of endemic human coronaviruses (HCoV-NL63, OC43 and 229E) associated with childhood pneumonia in Kilifi, Kenya

Wellcome Open Research ◽

10.12688/wellcomeopenres.16037.2 ◽

2020 ◽

Vol 5 ◽

pp. 150 ◽

Cited By ~ 1

Author(s):

Grieven P. Otieno ◽

Nickson Murunga ◽

Charles N. Agoti ◽

Katherine E. Gallagher ◽

Juliet O. Awori ◽

...

Keyword(s):

Respiratory Virus ◽

Seasonal Pattern ◽

Severe Disease ◽

Age Distribution ◽

Coastal Region ◽

Severe Pneumonia ◽

Human Populations ◽

Surveillance Period ◽

Human Coronaviruses ◽

Epidemiological Characteristics

Introduction: Human coronaviruses (HCoVs) circulate endemically in human populations, often with seasonal variation. We describe the long-term patterns of paediatric disease associated with three of these viruses, HCoV-NL63, OC43 and 229E, in coastal Kenya. Methods: Continuous surveillance of pneumonia admissions was conducted at the Kilifi county hospital (KCH) located in the northern coastal region of Kenya. Children aged <5 years admitted to KCH with clinically defined syndromic severe or very severe pneumonia were recruited. Respiratory samples were taken and tested for 15 virus targets, using real-time polymerase chain reaction. Unadjusted odds ratios were used to estimate the association between demographic and clinical characteristics and HCoV positivity. Results: From 2007 to 2019, we observed 11,445 pneumonia admissions, of which 314 (3.9%) tested positive for at least one of the HCoV types surveyed in the study. There were 129 (41.1%) OC43, 99 (31.5%) 229E, 74 (23.6%) NL63 positive cases and 12 (3.8%) cases of HCoV to HCoV coinfection. Among HCoV positive cases, 47% (n=147) were coinfected with other respiratory virus pathogens. The majority of HCoV cases were among children aged <1 year (66%, n=208), though there was was no change in the proportion infected by age. HCoV-OC43 was predominant of the three HCoV types throughout the surveillance period. Evidence for seasonality was not identified. Conclusions: Overall, 4% of paediatric pneumonia admissions were associated with three endemic HCoVs, with a high proportion of cases co-occurring with another respiratory virus, no clear seasonal pattern, and with the age-distribution of cases following that of pneumonia admissions (i.e. highest in infants). These observations suggest, at most, a small severe disease contribution of endemic HCoVs in this tropical setting and offer insight into their potential future burden and epidemiological characteristics.

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New coronavirus infection in children in the Moscow region: clinical, epidemiological and treatment aspects

Almanac of Clinical Medicine ◽

10.18786/2072-0505-2021-49-032 ◽

2020 ◽

Vol 49 ◽

Author(s):

E. R. Meskina ◽

M. K. Khadisova ◽

T. V. Stashko ◽

A. V. Bitsueva

Keyword(s):

Pediatric Patients ◽

Respiratory Infections ◽

Severe Disease ◽

Age Distribution ◽

Clinical Manifestations ◽

Treatment Strategies ◽

Signs And Symptoms ◽

Generation Cephalosporin ◽

Moscow Region ◽

Epidemiological Characteristics

Aim: To assess clinical and epidemiological characteristics, as well as treatment results in COVID-19 pediatric patients hospitalized to the Department of infectious disease in the Moscow region.Materials and methods: We retrospectively analyzed medical records of 124 pediatric patients aged from 1 month to 17 years with confirmed (63.7%) and highly probable (proven epidemiological association with the infection source) COVID-19 infection. The children were hospitalized from March 25, 2020 to August 11, 2020. Among patients that were hospitalized during this time period, 43% had pneumonia and 30% had acute respiratory disorders. All cases of pneumonia were confirmed by computed tomography. The children were treated according to the standard Russian guidelines.Results: The children had been infected with SARS-CoV-2 mostly from family members (75%; 95% confidence interval (CI) 66.4–82.3). In the families of the children with pneumonia, the number of pneumonia cases in their relatives was higher than in the families of the children with acute respiratory infections (1.7±1.0 vs. 1.1±0.5 respectively; р<0.001). The mean age of the hospitalized children was 8 years (7.4–9.6), with an even age distribution. The main COVID-19 signs and symptoms were as follows: fever (75.8%; 95% CI 67.3–83.0), cough (66.1%; 95% CI 57.1–74.4]), fatigues (38.7%; 95% CI 30.1–47.9), and hyposmia (33.9%; 95% CI 25.6–42.9). The severe disease course was rare (2.4%; 95% CI 0.5–6.9). The rates of positive reverse transcriptase polymerase chain reaction tests for SARS-CoV-2 were rapidly decreased at repeated tests: at day 3, 63.7% of the tests were positive, at day 7, 21.8% and at day 14, 5.6% (р<0.001). The prevalence of pneumonia was 56.4% without any age differences, with mostly minimal areas of lung abnormalities (78.6%). The severity of pneumonia and duration of clinical manifestations in the patients treated with a III generation cephalosporin or its combination with a macrolide were similar. Cough duration in those, who were treated with ipratropium bromide /fenoterol inhalations including their combination with budesonide, was higher than in those who did not use inhalation treatment. Pyrexia of>5 days duration can be a predictor of pneumonia in a pediatric patient with COVID-19 (odds ratio 4.55 (2.1–9.9), sensitivity 61.4%, specificity 74.1%).Conclusion: The results obtained are important to develop further treatment strategies for children with COVID-19.

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Human Coronaviruses: Counteracting the Damage by Storm

Viruses ◽

10.3390/v13081457 ◽

2021 ◽

Vol 13 (8) ◽

pp. 1457

Author(s):

Dewald Schoeman ◽

Burtram C. Fielding

Keyword(s):

Immune Response ◽

Severe Disease ◽

Antiviral Agents ◽

The Elderly ◽

Highly Pathogenic ◽

Vaccine Responses ◽

Cell Mediated Immune Response ◽

Inhibition Antibody ◽

A Cell ◽

Human Coronaviruses

Over the past 18 years, three highly pathogenic human (h) coronaviruses (CoVs) have caused severe outbreaks, the most recent causative agent, SARS-CoV-2, being the first to cause a pandemic. Although much progress has been made since the COVID-19 pandemic started, much about SARS-CoV-2 and its disease, COVID-19, is still poorly understood. The highly pathogenic hCoVs differ in some respects, but also share some similarities in clinical presentation, the risk factors associated with severe disease, and the characteristic immunopathology associated with the progression to severe disease. This review aims to highlight these overlapping aspects of the highly pathogenic hCoVs—SARS-CoV, MERS-CoV, and SARS-CoV-2—briefly discussing the importance of an appropriately regulated immune response; how the immune response to these highly pathogenic hCoVs might be dysregulated through interferon (IFN) inhibition, antibody-dependent enhancement (ADE), and long non-coding RNA (lncRNA); and how these could link to the ensuing cytokine storm. The treatment approaches to highly pathogenic hCoV infections are discussed and it is suggested that a greater focus be placed on T-cell vaccines that elicit a cell-mediated immune response, using rapamycin as a potential agent to improve vaccine responses in the elderly and obese, and the potential of stapled peptides as antiviral agents.

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Analysis of clinical characteristics of severe pertussis in infants and children: a retrospective study

BMC Pediatrics ◽

10.1186/s12887-021-02507-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Caiying Wang ◽

Huimin Zhang ◽

Yanlan Zhang ◽

Lin Xu ◽

Min Miao ◽

...

Keyword(s):

Retrospective Study ◽

Clinical Characteristics ◽

Severe Disease ◽

Severe Pneumonia ◽

Infants And Children ◽

Critically Ill Children ◽

Young Infants ◽

Incidence And Mortality ◽

Increasing Trend ◽

Medical University

Abstract Background The incidence of pertussis shows an increasing trend in recent years, but some clinicians often lack sufficient understanding of the clinical characteristics and risk factors for severe pertussis, and more effective measures should be taken to reduce the incidence and mortality of pertussis in young infants Methods A retrospective study was conducted, and 184 infants and children with pertussis who had been hospitalized in the Department of Pediatrics of Beijing Ditan Hospital affiliated with Capital Medical University from January 2016 to December 2017 were included. Clinical data of the patients were collected and the clinical characteristics were statistically analyzed Results Among the 184 patients, 41.85% were infants < 3 months of age, and 65.22% of the total patients were not vaccinated against pertussis. There were 22 critically ill children, among whom 4 died, and compared with mild cases, they had a higher proportion of children younger than 3 months of age and infants not vaccinated against pertussis (63.64% vs. 38.89% and 100% vs. 60.49%, respectively); a higher proportion of children with severe pneumonia (100% vs. 0%); higher leukocyte count(× 109/L , 35.80 ± 20.53 vs 19.41 ± 8.59); and a higher proportion of children with severe hyperleukocytosis (18.18% vs. 0%, respectively) (P<0.05) Conclusions 1. Infants aged <3 months not vaccinated for pertussis appear more likely to become infected and have more severe disease. 2. Severe pneumonia and hyperleukocytosis are the main mechanisms underlying severe pertussis.

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Hepatic steatosis: a risk factor for increased COVID-19 prevalence and severity—a computed tomography study

Egyptian Liver Journal ◽

10.1186/s43066-021-00131-6 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Asmaa Ali ◽

Mona Hasan ◽

Shaimaa Hamed ◽

Amir Elhamy

Keyword(s):

Hepatic Steatosis ◽

Severe Disease ◽

Severe Pneumonia ◽

Liver Disorder ◽

Control Group ◽

Case Group ◽

World Population ◽

Positive Class ◽

The Mean ◽

And Control

Abstract Background Around 25% of the world population was affected by the metabolic-related fatty liver disorder. Hepatic steatosis is frequently observed in conjunction with hypertension, obesity comorbidities, and diabetes. We evaluate the hepatic steatosis frequency found in chest CT exams of COVID-19-positive cases compared to non-infected controls and evaluate the related increased prevalence and severity of COVID. Results Our research includes 355 subjects, 158 with positive PCR for COVID-19 (case group) and 197 with negative PCR and negative CT chest (control group). The mean age in the positive group was 50.6 ± 16 years, and in the control, it was 41.3 ± 16 years (p < 0.001). Our study consists of 321 men (90.5%) and 34 women (9.5%). The number of males in both cases and control groups was greater. In the case group, 93% men vs. 6.9% women, while in controls, 88.3% men vs.11.6% women, p < 0.001. CT revealed normal results in 55.5% of individuals (i.e., CORADs 1) and abnormal findings in 45.5% of participants (i.e., CORADs 2–5). In abnormal scan, CO-RADs 2 was 13.92%, while CO-RADs 3–4 were 20.89% of cases. CO-RADs 5 comprised 65.19% of all cases. Approximately 42.6% of cases had severe disease (CT score ≥ 20), all of them were CO-RADs 5. The PCR-positive class had a greater prevalence of hepatic steatosis than controls (28.5% vs.12.2%, p < 0.001). CO-RADs 2 represented 11.1%, CO-RADs 3–4 represented 15.6%, and CO-RADs 5 represented 73.3% in the hepatic steatosis cases. The mean hepatic attenuation value in the case group was 46.79 ± 12.68 and in the control group 53.34 ± 10.28 (p < 0.001). When comparing patients with a higher severity score (CT score ≥ 20) to those with non-severe pneumonia, it was discovered that hepatic steatosis is more prevalent (73.2% vs. 26.8%). Conclusions Steatosis was shown to be substantially more prevalent in COVID-19-positive individuals. There is a relation among metabolic syndrome, steatosis of the liver, and obesity, as well as the COVID-19 severity.

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Frequency distribution of Wuchereria bancrofti microfilariae in human populations and its relationships with age and sex

Parasitology ◽

10.1017/s0031182000060625 ◽

1990 ◽

Vol 101 (3) ◽

pp. 429-434 ◽

Cited By ~ 23

Author(s):

P. K. Das ◽

A. Manoharan ◽

A. Srividya ◽

B. T. Grenfell ◽

D. A. P. Bundy ◽

...

Keyword(s):

Frequency Distribution ◽

Negative Binomial ◽

Age Distribution ◽

Indirect Evidence ◽

Wuchereria Bancrofti ◽

Parameter Estimates ◽

Human Populations ◽

Sampling Errors ◽

Frequency Distributions ◽

Age And Sex

SUMMARYThis paper examines the effects of host age and sex on the frequency distribution of Wuchereria bancrofti infections in the human host. Microfilarial counts from a large data base on the epidemiology of bancroftian filariasis in Pondicherry, South India are analysed. Frequency distributions of microfilarial counts divided by age are successfully described by zero-truncated negative binomial distributions, fitted by maximum likelihood. Parameter estimates from the fits indicate a significant trend of decreasing overdispersion with age in the distributions above age 10; this pattern provides indirect evidence for the operation of density-dependent constraints on microfilarial intensity. The analysis also provides estimates of the proportion of mf-positive individuals who are identified as negative due to sampling errors (around 5% of the total negatives). This allows the construction of corrected mf age–prevalence curves, which indicate that the observed prevalence may underestimate the true figures by between 25% and 100%. The age distribution of mf-negative individuals in the population is discussed in terms of current hypotheses about the interaction between disease and infection.

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Respiratory Virus Shedding in a Cohort of On-Duty Healthcare Workers Undergoing Prospective Surveillance

Infection Control and Hospital Epidemiology ◽

10.1086/669857 ◽

2013 ◽

Vol 34 (4) ◽

pp. 373-378 ◽

Cited By ~ 15

Author(s):

Jennifer C. Esbenshade ◽

Kathryn M. Edwards ◽

Adam J. Esbenshade ◽

Vanessa E. Rodriguez ◽

H. Keipp Talbot ◽

...

Keyword(s):

Influenza Virus ◽

Confidence Interval ◽

Healthcare Workers ◽

Nasal Swab ◽

Respiratory Virus ◽

Respiratory Viruses ◽

Surveillance Period ◽

Additional Specimen ◽

Viral Shedding ◽

Asymptomatic Subjects

Background.Healthcare-associated transmission of respiratory viruses is a concerning patient safety issue.Design.Surveillance for influenza virus among a cohort of healthcare workers (HCWs) was conducted in a tertiary care children's hospital from November 2009 through April 2010 using biweekly nasal swab specimen collection. If a subject reported respiratory symptoms, an additional specimen was collected. Specimens from ill HCWs and a randomly selected sample from asymptomatic subjects were tested for additional respiratory viruses by multiplex polymerase chain reaction (PCR).Results.A total of 1,404 nasal swab specimens were collected from 170 enrolled subjects. Influenza circulated at very low levels during the surveillance period, and 74.2% of subjects received influenza vaccination. Influenza virus was not detected in any specimen. Multiplex respiratory virus PCR analysis of all 119 specimens from symptomatic subjects and 200 specimens from asymptomatic subjects yielded a total of 42 positive specimens, including 7 (16.7%) in asymptomatic subjects. Viral shedding was associated with report of any symptom (odds ratio [OR], 13.06 [95% confidence interval, 5.45–31.28]; P< .0001) and younger age (OR, 0.96 [95% confidence interval, 0.92–0.99]; P = .023) when controlled for sex and occupation of physician or nurse. After the surveillance period, 46% of subjects reported working while ill with an influenza-like illness during the previous influenza season.Conclusions.In this cohort, HCWs working while ill was common, as was viral shedding among those with symptoms. Asymptomatic viral shedding was infrequent but did occur. HCWs should refrain from patient care duties while ill, and staffing contingencies should accommodate them.

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Pulmonary insults exacerbate susceptibility to oral Listeria monocytogenes infection through the production of IL-10 by NK cells

PLoS Pathogens ◽

10.1371/journal.ppat.1009531 ◽

2021 ◽

Vol 17 (4) ◽

pp. e1009531

Author(s):

Nikki Bortell ◽

Elizabeth R. Aguilera ◽

Laurel L. Lenz

Keyword(s):

Listeria Monocytogenes ◽

Nk Cells ◽

Severe Disease ◽

Bacterial Pathogen ◽

Myeloid Cell ◽

The Elderly ◽

Interleukin 10 ◽

Human Populations ◽

Phagocytic Capacity ◽

Increase Disease Susceptibility

Most individuals who consume foods contaminated with the bacterial pathogen Listeria monocytogenes (Lm) develop mild symptoms, while others are susceptible to life-threatening systemic infections (listeriosis). Although it is known that the risk of severe disease is increased in certain human populations, including the elderly, it remains unclear why others who consume contaminated food develop listeriosis. Here, we used a murine model to discover that pulmonary coinfections can impair the host’s ability to adequately control and eradicate systemic Lm that cross from the intestines to the bloodstream. We found that the resistance of mice to oral Lm infection was dramatically reduced by coinfection with Streptococcus pneumoniae (Spn), a bacterium that colonizes the respiratory tract and can also cause severe infections in the elderly. Exposure to Spn or microbial products, including a recombinant Lm protein (L1S) and lipopolysaccharide (LPS), rendered otherwise resistant hosts susceptible to severe systemic Lm infection. In addition, we show that this increase in susceptibility was dependent on an increase in the production of interleukin-10 (IL-10) from Ncr1+ cells, including Natural Killer (NK) cells. Lastly, the ability of Ncr1+ derived IL-10 to increase disease susceptibility correlated with a dampening of both myeloid cell accumulation and myeloid cell phagocytic capacity in infected tissues. These data suggest that efforts to minimize inflammation in response to an insult at the respiratory mucosa render the host more susceptible to infections by Lm and possibly other pathogens that access the oral mucosa.

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Longitudinal serology in SARS-CoV-2 infected individuals in India – a prospective cohort study

10.1101/2021.02.04.21251140 ◽

2021 ◽

Author(s):

Ramachandran Thiruvengadam ◽

Souvick Chattopadhyay ◽

Farha Mehdi ◽

Bapu Koundinya Desiraju ◽

Susmita Chaudhuri ◽

...

Keyword(s):

Post Infection ◽

Prospective Cohort ◽

Seroconversion Rate ◽

Severe Disease ◽

P Value ◽

Serological Response ◽

National Capital Region ◽

Rt Pcr ◽

Clinical Predictors ◽

Epidemiological Characteristics

AbstractClinical and epidemiological characteristics of SARS-CoV-2 infection are now widely available, but there are few data on longitudinal serology in large cohorts, particularly from low-and middle-income countries. We established an ongoing prospective cohort of 3840 SARS-CoV-2 RT-PCR positive individuals in the Delhi-National Capital Region of India, to document clinical and immunological characteristics during illness and convalescence. The IgG responses to the receptor binding domain (RBD) and nucleocapsid were assessed at 0-7, 10-28 days and 6-10 weeks after infection. The clinical predictors of seroconversion were identified by multivariable regression analysis. The seroconversion rates in the post-infection windows of 0–7 days, 10–28 days and 6–10 weeks were 46%, 84.7% and 85.3% respectively (n=782). The proportion with a serological response increased with severity of COVID-19 disease. All participants with severe disease, 89.6% with mild to moderate infection and 77.3% of asymptomatic participants had IgG antibodies to the RBD antigen. The threshold values in the nasopharyngeal viral RNA RT-PCR in a subset of asymptomatic and symptomatic seroconverters were comparable (p value: 0.48), with similar results among non-seroconverters (p value: 0.16) (n=169). This is the first report of longitudinal humoral immune responses to SARS-CoV-2 infection over a period of ten weeks from South Asia. The low seropositivity in asymptomatic participants and differences between assays highlight the importance of contextualizing the understanding of population serosurveys.SummaryWe measured anti-SARS-CoV-2 RBD and NC protein IgG in a multi-hospital-based prospective cohort from northern India up to ten weeks post-infection. The lower seroconversion rate among asymptomatic RT-PCR positive participants has public health significance particularly for interpreting community seroprevalence estimates.

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Staphylococcus aureus costochondritis and chest wall abscess in a COVID-19 patient treated with tocilizumab

Turkish Journal of Physical Medicine and Rehabilitation ◽

10.5606/tftrd.2021.8208 ◽

2021 ◽

Vol 67 (3) ◽

pp. 382-385

Author(s):

İlkay Ergenç ◽

Canan Şanal Toprak ◽

Zekaver Odabaşı

Keyword(s):

Intensive Care Unit ◽

Staphylococcus Aureus ◽

Chest Wall ◽

Distress Syndrome ◽

Severe Disease ◽

Severe Pneumonia ◽

Cytokine Release ◽

Cytokine Release Syndrome ◽

Chest Wall Abscess ◽

Promising Treatment

Coronavirus disease 2019 (COVID-19) is a worldwide pandemic, causing a global health threat. Up to 15% of the confirmed cases develop severe disease, requiring hospitalization or intensive care unit (ICU) admission. Tocilizumab, an IL-6 receptor antagonist, is a promising treatment of severe pneumonia with acute respiratory distress syndrome (ARDS) or cytokine release syndrome (CRS) in the course of COVID-19. We report a suppurative costochondritis and chest wall abscess in a severe COVID-19 patient treated with tocilizumab.

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