scholarly journals Children’s Privilege in COVID-19: The Protective Role of the Juvenile Lung Morphometry and Ventilatory Pattern on Airborne SARS-CoV-2 Transmission to Respiratory Epithelial Barriers and Disease Severity

Biomedicines ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1414
Author(s):  
Norbert Hofstätter ◽  
Sabine Hofer ◽  
Albert Duschl ◽  
Martin Himly
Keyword(s):  
Respiratory Tract ◽  
Disease Severity ◽  
Lower Respiratory Tract ◽  
Clinical Manifestations ◽  
Aerosol Deposition ◽  
Anatomical Site ◽  
Interstitial Region ◽  
Ventilatory Pattern ◽  
Lung Morphometry ◽  
Epithelial Barriers

The incidence of severe COVID-19 in children is low, and underlying mechanisms for lower SARS-CoV-2 susceptibility and self-limiting disease severity are poorly understood. Severe clinical manifestations in adults require SARS-CoV-2 inoculation in the lower respiratory tract, establishing a pulmonary disease phase. This may be either accomplished by direct inoculation of the thoracic region upon exposure to virion-laden aerosols, or by infection of the upper respiratory system and aspiration of virion-laden aerosols originating right there into the lower respiratory tract. The particularities of epithelial barriers as the anatomical site of first viral deposition specifically determine the initial characteristics of an innate immune response, emerging respiratory tissue damage and dysfunctionality, and hence, severity of clinical symptoms. We, thus, investigated by in silico modeling whether the combined effect of juvenile lung morphometry, children’s ventilatory pattern and the peculiarities of the virion-laden aerosols’ properties, render children more resilient to aerosol deposition in the lower respiratory tract. Our study presents evidence for major age-dependent differences of the regional virion-laden aerosol deposition. We identified deposition hotspots in the alveolar–interstitial region of the young adult. Our data reveal that children are void of corresponding hotspots. The inoculum quantum in the alveolar–interstitial region hotspots is found to be considerably related to age. Our results suggest that children are intrinsically protected against SARS-CoV-2 inoculation in the lower respiratory tract, which may help to explain the lower risk of severe clinical manifestations associated with a pulmonary phase.

Respiratory tract damage with bocavirus infection in children

2020 ◽  
Vol 19 (2) ◽  
pp. 14-18
Author(s):  
E. V. Sharipova ◽  
I. V. Babachenko ◽  
M. A. Shcherbatyh
Keyword(s):  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Clinical Manifestations ◽  
Respiratory Viruses ◽  
Community Acquired Pneumonia ◽  
Human Bocavirus ◽  
Long Time ◽  
Clinically Significant ◽  
Tract Infections ◽  
Tract Damage

Long time the main pathogens associated with the development of community-acquired pneumonia were bacteria. However, in recent years in the Russian Federation, like all over the world, the view of the damage of lower respiratory tract changed, including a unique approach to community-acquired pneumonia as a bacterial infection, and respiratory viruses have become seen as a direct cause of lower respiratory tract damage, or as part of a viral-bacterial co-infection. These studies became possible since the widespread introduction of PCR techniques in the clinical setting, identification of respiratory viruses has increased and new microorganisms such, one as human bocavirus have been discovered. Objective: to study the features of respiratory tract damage in acute bocavirus infection in children of different ages. Materials and methods: A retrospective analysis of 97 medical hospital documentation of children with acute bocavirus infection, detected confirmed by PCR in nasopharyngeal aspirate. Results: In this work, it was shown that human bocavirus spread throughout the year with an increase in the incidence of clinically significant forms in the autumnwinter period, including during the period of an increase in the incidence of influenza. HBoV infection requiring hospitals is most significant in the first three years of life. In 74.2% of hospitalized children, bocavirus infection occurs with lower respiratory tract infections in the form of bronchitis — 77.8%, pneumonia — 28.9% and rarely bronchiolitis and is complicated by the development of respiratory failure in 28.9% of cases. Changes in the blood test are non-specific, and the level of C-reactive protein in children with various clinical manifestations of HBoV infection generally does not exceed 50 mg / l. An x-ray of the chest organs does not objectively reflect the existing volume and nature of the inflammatory process in the lungs.

scholarly journals The Role of the Respiratory Microbiome and Viral Presence in Lower Respiratory Tract Infection Severity in the First Five Years of Life

2021 ◽  
Vol 9 (7) ◽  
pp. 1446
Author(s):  
Ivo Hoefnagels ◽  
Josephine van de Maat ◽  
Jeroen J.A. van Kampen ◽  
Annemarie van Rossum ◽  
Charlie Obihara ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Disease Severity ◽  
Lower Respiratory Tract ◽  
Influenza A ◽  
Pediatric Population ◽  
16S Rrna Gene Sequencing ◽  
Rrna Gene ◽  
Detection Rates ◽  
Tract Infections ◽  
Respiratory Microbiome

Lower respiratory tract infections (LRTIs) in children are common and, although often mild, a major cause of mortality and hospitalization. Recently, the respiratory microbiome has been associated with both susceptibility and severity of LRTI. In this current study, we combined respiratory microbiome, viral, and clinical data to find associations with the severity of LRTI. Nasopharyngeal aspirates of children aged one month to five years included in the STRAP study (Study to Reduce Antibiotic prescription in childhood Pneumonia), who presented at the emergency department (ED) with fever and cough or dyspnea, were sequenced with nanopore 16S-rRNA gene sequencing and subsequently analyzed with hierarchical clustering to identify respiratory microbiome profiles. Samples were also tested using a panel of 15 respiratory viruses and Mycoplasma pneumoniae, which were analyzed in two groups, according to their reported virulence. The primary outcome was hospitalization, as measure of disease severity. Nasopharyngeal samples were isolated from a total of 167 children. After quality filtering, microbiome results were available for 54 children and virology panels for 158 children. Six distinct genus-dominant microbiome profiles were identified, with Haemophilus-, Moraxella-, and Streptococcus-dominant profiles being the most prevalent. However, these profiles were not found to be significantly associated with hospitalization. At least one virus was detected in 139 (88%) children, of whom 32.4% had co-infections with multiple viruses. Viral co-infections were common for adenovirus, bocavirus, and enterovirus, and uncommon for human metapneumovirus (hMPV) and influenza A virus. The detection of enteroviruses was negatively associated with hospitalization. Virulence groups were not significantly associated with hospitalization. Our data underlines high detection rates and co-infection of viruses in children with respiratory symptoms and confirms the predominant presence of Haemophilus-, Streptococcus-, and Moraxella-dominant profiles in a symptomatic pediatric population at the ED. However, we could not assess significant associations between microbiome profiles and disease severity measures.

MIST THERAPY RECONSIDERED; AN EVALUATION OF THE RESPIRATORY DEPOSITION OF LABELLED WATER AEROSOLS PRODUCED BY JET AND ULTRASONIC NEBULIZERS

PEDIATRICS ◽  
1969 ◽  
Vol 43 (5) ◽  
pp. 799-808
Author(s):  
Jack Wolfsdorf ◽  
David L. Swift ◽  
Mary Ellen Avery
Keyword(s):  
Standard Deviation ◽  
Respiratory Tract ◽  
Propylene Glycol ◽  
Lower Respiratory Tract ◽  
Aerosol Deposition ◽  
Geometric Standard Deviation ◽  
Upper Respiratory Tract ◽  
Nasal Breathing ◽  
Upper Respiratory ◽  
Mass Median

Aerosol deposition in the upper and lower respiratory tract using technetium-labelled water aerosol, produced by jet and ultrasonic nebulizers, with and without 10% propylene glycol, was examined under conditions of nasal, normal mouth, and tube breathing in 15 normal adults. With nasal breathing, 91.5% (± 5.5) and 83.2% (± 6.3) of the mass of the aerosol produced by the jet and ultrasonic nebulizers, respectively, was deposited in the upper respiratory tract. Similar fractional depositions were observed with the addition of 10% propylene glycol. When breathing was carried out via a mouth tube, 43% to 59% of the mass of the aerosol produced by the nebulizers was deposited in the upper respiratory tract. The mass median diameters of the available aerosols produced by the jet and ultrasonic nebulizers were 6.0 µ (geometric standard deviation = 2.5) and 2.8 µ (geometric standard deviation = 2.1), respectively; the densities of the aerosols produced were 8 and 34 µl/liter air. With nasal or normal mouth breathing, the volume of water, in aerosol form, that could be deposited per 24 hours in the lower respiratory tract of an adult was calculated to be about 6 ml and 49 ml for the jet and ultrasonic nebulizer, respectively.

scholarly journals Use of MMP-8 and MMP-9 to assess disease severity in children with viral lower respiratory tract infections

2012 ◽  
Vol 84 (9) ◽  
pp. 1471-1480 ◽  
Author(s):  
Kim H. Brand ◽  
Inge M.L. Ahout ◽  
Ronald de Groot ◽  
Adilia Warris ◽  
Gerben Ferwerda ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Disease Severity ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Lower Respiratory Tract Infections ◽  
Tract Infections

scholarly journals Lower Respiratory Tract Infection and Genus Enterovirus in Children Requiring Intensive Care: Clinical Manifestations and Impact of Viral Co-Infections

Viruses ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 2059
Author(s):  
Daniel Penela-Sánchez ◽  
Jon González-de-Audicana ◽  
Georgina Armero ◽  
Desiree Henares ◽  
Cristina Esteva ◽  
...  
Keyword(s):  
Intensive Care ◽  
Tract Infection ◽  
Young Children ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Lower Respiratory Tract Infection ◽  
Lower Respiratory Tract ◽  
Invasive Mechanical Ventilation ◽  
Clinical Manifestations ◽  
Clinical Severity

Infection by rhinovirus (RV) and enterovirus (EV) in children ranges from asymptomatic infection to severe lower respiratory tract infection (LRTI). This cohort study evaluates the clinical impact of RV/EV species, alone or in codetection with other viruses, in young children with severe LRTI. Seventy-one patients aged less than 5 years and admitted to the Paediatric Intensive Care Unit (PICU) of a reference children’s hospital with RV or EV (RV/EV) LRTI were prospectively included from 1/2018 to 3/2020. A commercial PCR assay for multiple respiratory pathogens was performed in respiratory specimens. In 22/71, RV/EV + respiratory syncytial virus (RSV) was found, and 18/71 had RV/EV + multiple viral detections. Patients with single RV/EV detection required invasive mechanical ventilation (IMV) as frequently as those with RSV codetection, whereas none of those with multiple viral codetections required IMV. Species were determined in 60 samples, 58 being RV. No EV-A, EV-C, or EV-D68 were detected. RV-B and EV-B were only found in patients with other respiratory virus codetections. There were not any associations between RV/EV species and severity outcomes. To conclude, RV/EV detection alone was observed in young children with severe disease, while multiple viral codetections may result in reduced clinical severity. Differences in pathogenicity between RV and EV species could not be drawn.

scholarly journals Presumed Risk Factors and Biomarkers for Severe Respiratory Syncytial Virus Disease and Related Sequelae: Protocol for an Observational Multicenter, Case-Control Study From the Respiratory Syncytial Virus Consortium in Europe (RESCEU)

2020 ◽  
Vol 222 (Supplement_7) ◽  
pp. S658-S665 ◽  
Author(s):  
Kimberley Jefferies ◽  
Simon B Drysdale ◽  
Hannah Robinson ◽  
Elizabeth Ann Clutterbuck ◽  
Luke Blackwell ◽  
...  
Keyword(s):  
Risk Factors ◽  
Respiratory Syncytial Virus ◽  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Disease Severity ◽  
Lower Respiratory Tract ◽  
Viral Pathogen ◽  
Rsv Infection ◽  
Syncytial Virus

Abstract Respiratory syncytial virus (RSV) is the leading viral pathogen associated with acute lower respiratory tract infection and hospitalization in children < 5 years of age worldwide. While there are known clinical risk factors for severe RSV infection, the majority of those hospitalized are previously healthy infants. There is consequently an unmet need to identify biomarkers that predict host response, disease severity, and sequelae. The primary objective is to identify biomarkers of severe RSV acute respiratory tract infection (ARTI) in infants. Secondary objectives include establishing biomarkers associated with respiratory sequelae following RSV infection and characterizing the viral load, RSV whole-genome sequencing, host immune response, and transcriptomic, proteomic, metabolomic and epigenetic signatures associated with RSV disease severity. Six hundred thirty infants will be recruited across 3 European countries: the Netherlands, Spain, and the United Kingdom. Participants will be recruited into 2 groups: (1) infants with confirmed RSV ARTI (includes upper and lower respiratory tract infections), 500 without and 50 with comorbidities; and (2) 80 healthy controls. At baseline, participants will have nasopharyngeal, blood, buccal, stool, and urine samples collected, plus complete a questionnaire and 14-day symptom diary. At convalescence (7 weeks ± 1 week post-ARTI), specimen collection will be repeated. Laboratory measures will be correlated with symptom severity scores to identify corresponding biomarkers of disease severity. Clinical Trials Registration NCT03756766.

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