Clinical and Laboratory Findings of Viral Influenza among Children Hospitalized in Qazvin Pediatric Hospital in Iran, 2015-2020

Background: Children are one of the most important groups at risk of catching the influenza infection. The consequences of influenza in some children, especially children with chronic and underlying diseases, can be very severe and lead to hospitalization. Objective: Purpose of this research was to determine children with influenza and their clinical and laboratory findings in Qazvin children hospital between 2015 to 2020 years. Methods: In this descriptive cross-sectional study, epidemiological and clinical finding of children hospitalized due to confirmed influenza were considered. A total of 1468 children with a suspected diagnosis to influenza were included in this study. Then, based on the Real-time Polymerase Chain Reaction (PCR) a total of 229 were confirmed positive to influenza. Statistical analysis was done using software SPSS 23.0, Analysis Of Variance (ANOVA) and t-test (p≤0.05). Results: Most of patients (53.7%) were infected with influenza H1N1 type. Most comorbidity was observed with Central Nervous System (CNS) disease and febrile seizure (each one 3.10%). Highest clinical feature was fever (83.4%). Significant relationship was observed between the season (p=0.001), sore in throat (p=0.001), febrile seizure (p=0.051), muscle and joint pain (p=0.059), rhinorrhea (p=0.006) and shiver (p=0.051) and occurrence of influenza. Also 4 children had died from influenza during hospitalization. Conclusion: Children with influenza disease were found in this study. Influenza has some side effects on children health. Due to the irreversible and dangerous effects of the influenza, early diagnosis and appropriate treatment in children is important.

Analysis of COVID-19 Chest X-ray Data using an Ensemble of Different Convolutional Architectures

After every 100 years, a pandemic comes and takes a great toll on the global civilization. This time its COVID-19 and the aftereffects are terrifying. As the symptoms for the disease are very common and are similar to common cold and viral influenza, the detection from symptoms is quite difficult. Although there are many methods devised but the detection of COVID19 has been a problem since the start, and we are still struggling to identify whether a person has the disease. This study proposes a unique model to identify the positive and negative cases using X-ray images of an individual as lungs are the first and most critical body part which gets affected by the virus which causes a deprecation in oxygen saturation. The proposed model is an ensemble of different CNN architectures which are Dense Net, NasNet-Large, Resnet-50, Inception Net, EfficientNetB0 and EfficientNetB1. The results show that the model reaches an accuracy of 99.6% on the tested dataset. Keywords: Deep learning, Convolutional Neural Networks, COVID-19, Ensemble Learning, EfficientNet

EXPRESS: Retrospective study of clinical characteristics and viral etiologies of patients with viral pneumonia in Beijing

Aims: The virus is common in patients with viral pneumonia. However, the viral etiology and clinical features of patients with viral pneumonia in China remain unclear. The main purpose of this study was to analyze the viral causes and epidemiology of patients with viral pneumonia in Beijing, which can significantly improve the pertinence and accuracy of clinical treatment of the disease. Methods: Firstly, 1,539 respiratory specimens of pneumonia (oropharyngeal swabs, nasopharyngeal swabs, saliva samples and bronchoalveolar lavage fluid) were collected from 19 hospitals in Beijing from September 2015 to August 2018. Then, TaqMan low-density microfluidic chip technology was used to detect viral pneumonia specimens in 1,539 respiratory tract specimens of pneumonia, and determine the types of viral bacteria in them. Lastly, the analysis of demographic, clinical and etiological data of patients with viral pneumonia was performed. Results: The results showed that among the 1,539 respiratory tract specimens with pneumonia, 760 were detected as viral pneumonia specimens, with a positive rate of 49.4%. Among which, 467 were infected with mono-viral and 293 were infected with multi-viral. Influenza A virus (Flu A), mycoplasma pneumoniae (MPn), ebola virus (EBV) and herpes simplex virus type 1 (HSV-1) were the major viral components in the samples of these patients. Furthermore, these viral species were significantly associated with sample sources, onset season and certain clinical characteristics. Discussion: Our findings may provide corresponding treatment strategies for viral pneumonia patients infected with specific viruses.

Point-of-Care Testing for the Emergency Department Patient: Quantity and Quality of the Available Evidence

Context.— Point-of-care test (POCT) instruments produce lab results with rapid turnaround times. Based on that fact, emergency department (ED) POCT requests are predicated on the belief that rapid test turnaround times lead to improved care, typically a decreased ED length of stay (LOS). Objective.— To compile the available peer-reviewed data regarding use of POCT in the ED with an emphasis on ED-LOS. Data Sources.— An English-language PubMed search using the following free text terms: (“EMERGENCY” AND “POINT OF CARE”) NOT ULTRASOUND as well as “RAPID INFECTIOUS DISEASE TESTING.” In addition, the PubMed “similar articles” functionality was used to identify related articles that were not identified on the initial search. Conclusions.— Seventy-four references were identified that studied POCT ED use to determine if they resulted in significant changes in ED processes, especially ED-LOS. They were divided into 3 groups: viral-influenza (n = 24), viral-respiratory not otherwise specified (n = 8), and nonviral (n = 42). The nonviral group was further divided into the following groups: chemistry, cardiac, bacterial/strep, C-reactive protein, D-dimer, drugs of abuse, lactate, and pregnancy. Across all groups there was a trend toward a significantly decreased ED-LOS; however, a number of studies showed no change, and a third group was not assessed for ED-LOS. For POCT to improve ED-LOS it has to be integrated into existing ED processes such that a rapid test result will allow the patient to have a shorter LOS, whether it is to discharge or admission.

Traditional Chinese herbal medicine-potential therapeutic application for the treatment of COVID-19

Traditional Chinese Medicine (TCM) is a complete medical system that has evolved over millennia to include practices and procedures such as acupuncture, herbal medicine, manual therapies, nutrition, and mind–body therapies such as qi gong. In modern-day China and other Asian countries, TCM is a medical subspecialty utilized alongside western biomedicine. During the current Coronavirus Disease 19 (COVID-19) pandemic, TCM and TCM herbal medicine is being used and a number of single herbs and combination formulas have significant bioactivity and therapeutic potential. The purpose of this paper is to highlight the use of TCM in the treatment of COVID-19. This commentary provides the reader with a concise background on COVID-19 and summarizes TCM concepts including identification, pattern diagnosis, and treatment principles commonly used for the treatment of viral influenza-like diseases. It also highlights some of the challenges and potential for using TCM in an integrated medical setting.

Viral Infections in Pregnancy – Part 2: Viral Influenza, Mononucleosis, Mumps, Parvovirus, Rubella, Rubeola, Varicella-Zoster Virus, and Zika Virus

A number of viral infections contribute to morbidity and mortality in pregnancy and the postpartum period [Table 1]. Here we discuss some of the major viral infections that occur in pregnancy. This particular review focuses on viral influenza, mononucleosis, mumps, parvovirus, rubella, rubeola, varicella-zoster virus, and Zika virus; other viral etiologies are discussed separately. It is imperative to understand the risk factors, clinical course, diagnostic methodology, and management of these illnesses in order to optimize perinatal outcome. This review contains 4 figures, 12 tables, and 76 references. Keywords: viral infection, pregnancy, prenatal, perinatal, influenza, mumps, parvovirus, rubella, rubeola, measles, varicella-zoster virus, Zika virus, management

Knowledge, barriers and uptake of influenza vaccine among non-health college students at Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia

Background: Viral influenza, one of the global public health problems is specifically important in Saudi Arabia due to high susceptibility of transmission in hajj and umrah seasons (Islamic pilgrimage to the Mecca), as it has the ability to spread widely to a large proportion, in addition the disease has a higher rate of complications that might lead to death. Vaccination is an important strategy in prevention of viral influenza. Design and methods: The study aimed to describe the association between uptake of influenza vaccine with knowledge as well as identify the barriers that prevent vaccination among Princess Nourah Bint Abdulrahman University (PNU) non-health colleges students. A descriptive cross-sectional study design was undertaken, including 385 students from non-health colleges using a convenience sampling technique. Data was collected using an Arabic self-administered online questionnaire Analysis done by JMP program. IRB approval as well as informed consent were taken. Results: The uptake of the influenza vaccine was 15.3% in the current year and 56.8% in the previous years. No significant association was found between knowledge, and uptake of the vaccine. For the unvaccinated students, the most common encounter barriers stated by study population were concerns regarding the vaccine effectiveness, reduction of immunity the uncertainty of complete protection in a percentage of 12.0% for all. Conclusions: Although the level of vaccine uptake is low for this year, it is not associated with knowledge. There were some barriers that need to be tackled by health education programs.

Antiviral Functional Foods and Exercise Lifestyle Prevention of Coronavirus

Novel coronavirus (COVID-19) is causing global mortality and lockdown burdens. A compromised immune system is a known risk factor for all viral influenza infections. Functional foods optimize the immune system capacity to prevent and control pathogenic viral infections, while physical activity augments such protective benefits. Exercise enhances innate and adaptive immune systems through acute, transient, and long-term adaptations to physical activity in a dose-response relationship. Functional foods prevention of non-communicable disease can be translated into protecting against respiratory viral infections and COVID-19. Functional foods and nutraceuticals within popular diets contain immune-boosting nutraceuticals, polyphenols, terpenoids, flavonoids, alkaloids, sterols, pigments, unsaturated fatty-acids, micronutrient vitamins and minerals, including vitamin A, B6, B12, C, D, E, and folate, and trace elements, including zinc, iron, selenium, magnesium, and copper. Foods with antiviral properties include fruits, vegetables, fermented foods and probiotics, olive oil, fish, nuts and seeds, herbs, roots, fungi, amino acids, peptides, and cyclotides. Regular moderate exercise may contribute to reduce viral risk and enhance sleep quality during quarantine, in combination with appropriate dietary habits and functional foods. Lifestyle and appropriate nutrition with functional compounds may offer further antiviral approaches for public health.

Montelukast in Hospitalized Patients Diagnosed with COVID-19

Background Several therapeutic agents have been assessed for the treatment of COVID-19, but few approaches have been proven efficacious. Because leukotriene receptor antagonists such as montelukast have been shown to reduce both cytokine release and lung inflammation in preclinical models of viral influenza and acute respiratory distress syndrome, we hypothesized that therapy with montelukast would reduce clinical deterioration as measured by the COVID-19 Ordinal Scale.Methods We performed a retrospective analysis of COVID-19 confirmed hospitalized patients treated with or without montelukast. We used “clinical deterioration” as the primary endpoint, a binary outcome defined as any increase in the Ordinal Scale value from Day 1 to Day 3 of hospital stay, as these data were uniformly available for all admitted patients before hospital discharge. Rates of clinical deterioration between the montelukast and non-montelukast groups were compared using the Fisher’s exact test. Univariate logistic regression was also used to assess the association between montelukast use and clinical deterioration.Results A total of 92 patients were analyzed, 30 received montelukast at the discretion of the treating physician and 62 patients who did not receive montelukast. Patients receiving montelukast experienced significantly fewer events of clinical deterioration compared to patients not receiving montelukast (10% vs 32%, p = 0.022). Sensitivity analysis among those without asthma showed a trend toward fewer clinical deterioration events in the montelukast group than non-montelukast groups (11% vs 33%, p = 0.077). Sensitivity analysis among those who did not receive azithromycin showed fewer clinical deterioration events in the montelukast group vs. non-montelukast groups (8% vs 32%, p = 0.030).Conclusions Our findings suggest that montelukast associates with a reduction in clinical deterioration for COVID-19 confirmed patients as measured on the COVID-19 Ordinal Scale. Montelukast may have activity in COVID-19 infection, and future efforts should evaluate this potential therapy.