Pneumococcal Conjugate Vaccine Protection Against Coronaviruses-Associated Lower Respiratory Tract Infection Hospitalization in Children Living With and Without HIV

2020 ◽  
Author(s):  
Marta C. Nunes ◽  
Clare Cutland ◽  
Keith P. Klugman ◽  
Shabir A. Madhi
Keyword(s):  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Lower Respiratory Tract Infection ◽  
Conjugate Vaccine ◽  
Pneumococcal Conjugate Vaccine ◽  
Lower Respiratory Tract ◽  
Vaccine Protection

scholarly journals Effectiveness of 13-valent pneumococcal conjugate vaccine against medically-attended lower respiratory tract infection and pneumonia among older adults

2021 ◽  
Author(s):  
Joseph Lewnard ◽  
Katia J Bruxvoort ◽  
Heidi Fischer ◽  
Vennis X Hong ◽  
Lindsay R Grant ◽  
...  
Keyword(s):  
Older Adults ◽  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Lower Respiratory Tract Infection ◽  
Conjugate Vaccine ◽  
Pneumococcal Conjugate Vaccine ◽  
Lower Respiratory Tract ◽  
Before And After

Importance: In 2014, the US Advisory Committee on Immunization Practices (ACIP) extended existing pneumococcal vaccination recommendations for adults aged ≥65 years to include 13-valent pneumococcal conjugate vaccine (PCV13), primarily to prevent non-bacteremic pneumonia. Objective: To determine PCV13 effectiveness against all-cause inpatient plus outpatient medically-attended lower-respiratory tract infection (LRTI) and pneumonia among US older adults. Design: Prospective, open cohort study following participants from 2016 to 2019. We conducted analyses in a self-matched framework, comparing outcomes during participants' follow-up periods before and after receipt of PCV13. Setting: Kaiser Permanente Southern California (KPSC) integrated healthcare delivery system. Participants: Adults aged ≥65 years who received PCV13 between 2016-2019. Exposures: Receipt of PCV13 at ages ≥65 years, concordant with ACIP guidelines. Main outcomes and measures: We estimated the adjusted hazards ratio (aHR) for first LRTI and pneumonia episodes during each respiratory season, comparing PCV13-exposed and PCV13-unexposed time at risk for each participant using a self-matched inference framework. We computed aHR estimates using Cox proportional hazards models. We defined vaccine effectiveness (VE) as (1-aHR)*100%. We also estimated PCV13-attributable absolute reductions in incidence of LRTI and pneumonia. Results: Observations were available both before and after PCV13 receipt for 42,700 participants. Among these individuals, 1,419 experienced LRTI and 969 experienced pneumonia over approximately 26,000 combined years of follow-up before PCV13 receipt; 3,849 experienced LRTI and 2,727 experienced pneumonia over approximately 74,000 combined years of follow-up after PCV13 receipt. In adjusted analyses, VE was 9.5% (95% confidence interval: 2.2% to 16.3%) against all-cause medically-attended LRTI and 8.8% (-0.2% to 17.0%) against all-cause medically-attended pneumonia. In contrast, we did not identify evidence of protection against LRTI and pneumonia following receipt of 23-valent pneumococcal polysaccharide vaccine. We estimated that PCV13 prevented 0.7 (0.2 to 1.4) and 0.5 (0.0 to 1.0) cases of LRTI and pneumonia, respectively, per 100 vaccinated persons annually. Over a five-year time horizon, one case of LRTI and pneumonia, respectively, was prevented for every 27 (14 to 116) and 42 (-97 to 268) individuals receiving PCV13. Conclusions and relevance: PCV13 vaccination among older adults reduced the burden of medically-attended respiratory illness in this population.

scholarly journals COPD-Lower Respiratory Tract Infection Visual Analogue Score (c-LRTI-VAS) validation in stable and exacerbated patients with COPD

2021 ◽  
Vol 8 (1) ◽  
pp. e000761
Author(s):  
Hendrik Johannes Prins ◽  
Ruud Duijkers ◽  
Johannes M A Daniels ◽  
Thys van der Molen ◽  
Tjip S van der Werf ◽  
...  
Keyword(s):  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Lower Respiratory Tract Infection ◽  
Lower Respiratory Tract ◽  
Visual Analogue Score ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Significant Difference ◽  
Related Quality

BackgroundWe developed the chronic obstructive pulmonary disease (COPD)-Lower Respiratory Tract Infection-Visual Analogue Score (c-LRTI-VAS) in order to easily quantify symptoms during exacerbations in patients with COPD. This study aimed to validate this score.MethodsIn our study, patients with stable COPD as well as those with an acute exacerbations of COPD (AECOPD) were included. The results of c-LRTI-VAS were compared with other markers of disease activity (lung function parameters, oxygen saturation and two health related quality of life questionnaires (St Georges Respiratory Questionnaire (SGRQ) and Clinical COPD Questionnaire (CCQ)) and validity, reliability and responsiveness were assessed.ResultsEighty-eight patients with clinically stable COPD and 102 patients who had an AECOPD completed the c-LRTI-VAS questionnaire. When testing on two separate occasions for repeatability, no statistically significant difference between total scores was found 0.143 (SD 5.42) (p=0.826). Internal consistency was high across items (Cronbach’s apha 0.755). Correlation with SGRQ and CCQ total scores was moderate to high. After treatment for hospitalised AECOPD, the mean c-LRTI-VAS total score improved 8.14 points (SD 9.13; p≤0.001).Conclusionsc-LRTI-VAS showed proper validity, responsiveness to change and moderate to high correlation with other questionnaires. It, therefore, appears a reliable tool for symptom measurement during AECOPD.Trial registration numberNCT01232140.

Effect of acute lower respiratory tract infection on pulmonary artery pressure in children with post-tricuspid left-to-right shunt

2021 ◽  
pp. 1-5
Author(s):  
Sakshi Sachdeva ◽  
Shyam S. Kothari ◽  
Saurabh K. Gupta ◽  
Sivasubramanian Ramakrishnan ◽  
Anita Saxena
Keyword(s):  
Tract Infection ◽  
Pulmonary Artery ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Lower Respiratory Tract Infection ◽  
Pulmonary Artery Pressure ◽  
Lower Respiratory Tract ◽  
Systolic Pressure ◽  
Pulmonary Artery Systolic Pressure ◽  
Artery Pressure

Abstract We sought to examine the influence of clinically severe lower respiratory tract infection on pulmonary artery pressure in children having CHD with post-tricuspid left-to-right shunt, as it may have physiological and clinical implications. In a prospective single-centre observational study, 45 children with post-tricuspid left-to-right shunt and clinically severe lower respiratory tract infection were evaluated during the illness and 2 weeks after its resolution. Pulmonary artery systolic pressure was estimated non-invasively using shunt gradient by echocardiography and systolic blood pressure measured non-invasively. Median pulmonary artery systolic pressure during lower respiratory tract infection was only mildly (although statistically significantly) elevated during lower respiratory tract infection [60 (42–74) versus 53 (40–73) mmHg, (p < 0.0001)]. However, clinically significant change in pulmonary artery systolic pressure defined as the increase of >10 mmHg was present in only 9 (20%) patients. In the absence of hypoxia or acidosis, only a small minority (9%, n = 4) showed significant pulmonary artery systolic pressure rise >10 mmHg. In the absence of hypoxia or acidosis, severe lower respiratory tract infection in patients with acyanotic CHD results in only mild elevation of pulmonary artery systolic pressure in most of the patients.

scholarly journals 1502. Psychological Stress and Anxiety among Parents of Children Younger than 5 Years Hospitalized with RSV

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S753-S754
Author(s):  
Krow Ampofo ◽  
Yoonyoung Choi ◽  
Evan G Heller ◽  
Alexander G Platt-Koch ◽  
Per H Gesteland ◽  
...  
Keyword(s):  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Lower Respiratory Tract Infection ◽  
Psychological Stress ◽  
Lower Respiratory Tract ◽  
Salt Lake ◽  
Post Discharge ◽  
Psychological Burden ◽  
Stressor Scale

Abstract Background Respiratory Syncytial Virus (RSV) is one of the most common causes of childhood lower respiratory tract infection (LRTI) worldwide. While financial burdens have been documented, there are few data on parental psychological stress associated with RSV hospitalizations. We evaluated the psychological stress and anxiety of parents whose children were hospitalized with RSV. Methods During the 2019-2020 RSV season, parents with children &lt; 5 years of age hospitalized with laboratory-confirmed RSV LRTI at Primary Children’s and Riverton Hospitals in Salt Lake City, Utah, were surveyed in person, and online after discharge. As part of the survey, parents completed the State-Trait Anxiety Inventory for Adults (STAIAD) instrument (short form) and the parental stressor scale (PSS). We evaluated the difference in parental stress and anxiety reported during hospitalization and at 2-weeks post-discharge using a paired t-test. Results Among 284 Salt Lake County resident children &lt; 5 years, and hospitalized with RSV LRTI, 75 (26%) and 57 (20%) parents completed both surveys on admission and at 2-weeks post-discharge respectively. In 11 of 20 STAIAD items gauging stress and anxiety, parents reported higher levels of stress and anxiety whilst their children were admitted compared to post-discharge (Table 1). Parents’ average score on several items associated with a “positive outlook,” e.g. I feel calm, significantly improved (p &lt; 0.05) at 2-weeks post-discharge. Similarly, several items associated with a “negative outlook,” e.g. I am worried, significantly decreased (p &lt; 0.05) at 2-weeks post-discharge (Table 1). For the PSS items, ≥ 50% of parents rated 15 out of 25 as being “very or extremely stressful”, including: feeling helpless about how to help my baby; my baby’s unusual or abnormal breathing; and when my baby seemed to be in pain (Table 2). Estimates of Psychological Burden of RSV lower respiratory tract infection (LRTI) Hospitalization of Children &lt;5 Years of Age on Parents: State-Trait Anxiety Inventory for Adults (STAIAD) Estimates of Psychological Burden of RSV lower respiratory tract infection (LRTI) Hospitalization of Children &lt;5 Years of Age on Parents: Parental Stressor Scale (PSS) Conclusion RSV LRTI hospitalization among children &lt; 5 years of age, imposed a significant psychological stress and anxiety on parents, which generally persisted up to 2-weeks post-discharge. Prevention of RSV infection through vaccines and immunoprophylaxis will help ease parental psychological burden associated with RSV hospitalization. Disclosures Krow Ampofo, MBChB, Merck (Grant/Research Support) Yoonyoung Choi, PhD, MS, RPh, Merck (Employee) Lyn Finelli, DrPH, MS, Merck & Co Inc, (Employee)

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