Acute Respiratory Viral Infections Research Articles

On the Possibility of Using the Topical form of the Recombinant Interferon alpha-2b Drug in the Prevention of Acute Respiratory Viral Infections in Organized Groups

Relevance. Respiratory infections are an urgent problem for organized groups, including military ones, since the transmission of pathogens by airborne droplets and household contact routes, physical and psychological stress on adaptive mechanisms contribute to the development of the epidemic process. There is no doubt that vaccination makes a significant contribution to the prevention of respiratory infections, but the contingent remains vulnerable to other pathogens against which there are no vaccines. Therefore, the search for new methods of non-specific prevention is necessary in maintaining the health of persons permanently residing in collectives. Aim. Evaluation of the possibility of using the topical form of the recombinant interferon α-2b drug for the prevention of acute respiratory viral infections in organized groups. Materials and methods. The work was carried out according to the methodology of a multicenter (3 Centers) double-blind controlled trial involving 3,235 people aged 18 to 22 years, who were divided into three groups: 1 gy. - received a recombinant interferon α-2b (Grippferon) drug 3 drops in each nasal passage 2 times a day in for two weeks; 2 g. - saline solution intranasally according to the same scheme; 3 g. - the volunteers did not receive anything. The frequency of respiratory infections was studied. Results and discussion. Medical monitoring of the study participants, which was carried out for 2 months, showed that in the groups from the Center 1, the incidence of acute respiratory diseases for 2 months in the main group (gr. 1) was 2.3 times lower than in the control (gr. 2) and the comparison group (gr. 3). In the Center 2 The data corresponded to the dynamics of Center 1: the incidence values were 2.4-2.5 times lower in Group 1. In Center 3, the values were 2.0-2.1, respectively. The epidemic effect of intranasal administration of the topical form of the drug recombinant interferon α-2b is due to its effect on the factors of mucosal immunity, which contributes to non-specific protection and increased body resistance against respiratory infections. Conclusions. The presented advantages of the recombinant interferon α-2b drug make it possible to draw attention to the clinical feasibility of its use for preventive purposes in organized groups, including military ones, from the position of high epidemiological effectiveness, both pre-exposure and post-exposure prevention of acute respiratory viral infections.

The role of developmental factors in hypoplasia of deciduous teeth and treatment specifics in pediatric dental practice

Relevance. Congenital and systemic diseases can lead to developmental errors in the enamel organ, resulting in anomalies such as enamel hypoplasia. The high prevalence of these defects illustrates the vulnerability of teeth to changes in the intrauterine and postnatal environments. Enamel hypoplasia contributes to the development of caries and tooth wear by making enamel thinner, more retentive to dental plaque, and less resistant to acid degradation compared to normal enamel. Surfaces of the affected hard tissues are smooth and exhibit a symmetric distribution pattern. The occurrence of enamel hypoplasia in children is a significant factor in the development of caries; thus, they require comprehensive treatment and ongoing preventive care by a pediatric dentist.Purpose. To analyze the impact of factors contributing to the development of deciduous teeth hypoplasia in children, on the frequency of this condition and the specifics of its treatment by a pediatric dentist.Materials and Methods. The study involved the examination and treatment of children aged 4-12 at the Dental and Implantology Department of Kazan (Volga Region) Federal University over a 12-month period. Out of 972 children, 67 were diagnosed with systemic enamel hypoplasia. A questionnaire was developed for statistical research, and data were processed using Statistica 7.0 software Statistica 7.0 (StatSoft, США).Results. The survey revealed chronic diseases in 16.42% of mothers. During pregnancy, 68.6% of the mothers visited a dentist once, and 31.3% visited two to three times. Most mothers experienced early pregnancy toxemia—67% in the first half and 58.2% in the second half of the pregnancy. Additionally, 50.7% suffered from acute respiratory viral infections and influenza, and 25.4% had gastrointestinal diseases. Feeding practices involved breastfeeding in 68.7% of cases and artificial feeding in 31.3% (up to 3 months – 16.4%, up to 1 year – 64.1%, up to 2 years – 19.4%). Examination of the oral cavity in 67 children with systemic hypoplasia revealed a spotted form in 79.1% of cases and a purely destructive form in 20.9% of cases. Contemporary conservative dentistry emphasizes minimally invasive approaches to the treatment of such dental defects.Conclusion. The study of deciduous tooth hypoplasia in children highlighted the importance of the health status of the expectant mother and timely sanitation of the oral cavity. Particular attention should be paid to maternal infectious diseases, specifically influenza and ARVI. The findings underscore the need for preventive measures against temporary tooth hypoplasia from the onset of pregnancy planning to enhance the dental well-being of children.

Maternal awareness, acceptability and willingness towards respiratory syncytial virus (RSV) vaccination during pregnancy in Ireland.

Respiratory syncytial virus (RSV) is the world's leading cause of viral acute lower respiratory infections (ALRI) in infants. WHO has identified maternal RSV vaccination a priority and candidate vaccines are in development; however, vaccine hesitancy remains an impediment to successful implementation of maternal immunization. This study, the largest antenatal survey conducted to-date, aimed to examine maternal RSV awareness, likely acceptance of RSV vaccination in pregnancy, and attitudes to maternal vaccination. Pregnant women of all gestations attending antenatal clinic of a university maternity hospital in Ireland were invited to participate. An information leaflet provided, consent obtained, and survey administered examining RSV awareness, willingness to avail of antenatal RSV vaccination, factors influencing acceptability and preferred sources of assistance. Research Ethics Committee (REC) approval obtained, and general data protection regulation (GDPR) guidelines followed. 528 women completed the survey. A large proportion (75.6%) had never heard of RSV, yet 48.5% would still avail of a vaccine, 45.8% were undecided and only 5.3% would not. The main factor making vaccination acceptable to women (76.4%) was that it protects their infant from illness (p < .001, CV 0.336 for association with acceptance) and general practitioner (GP) was the preferred guidance source in decision-making (57.7%). Despite low levels of maternal awareness of RSV, pregnant women in Ireland are open to availing of antenatal vaccination. Maternal immunization strategies need to focus on infant's protection from RSV-associated ALRI along with vaccine safety, and build on an interdisciplinary collaboration of maternal, neonatal, primary care and public health services.

Change of epidemiological characteristics of four respiratory viral infections in children before and during COVID-19 pandemic

ObjectivesViruses are the main infectious agents of acute respiratory infections (ARIs) in children. We aim to describe the changes in epidemic characteristics of viral ARIs in outpatient children before and during the COVID-19 pandemic. Patients and methodsFrom 2017 to 2022, the results of viral detection in oral pharyngeal swabs in 479236 children with ARIs in the outpatient department of Children’s Hospital, Zhejiang University School of Medicine, were retrospectively analyzed. Viral antigens, including adenovirus (ADV), influenza A (FLUA), influenza B (FLUB) and respiratory syncytial virus (RSV) were detected by the colloidal gold method. ResultsThe median age was 3.4 (1.6-5.6) years. Among all the children, 159895 cases (33.4%) were positive for at least one virus. The total positive rate for ADV, FLUA and FLUB during the pandemic period was lower than during the pre-pandemic period in every season (pre-pandemic period vs. pandemic period11.7% vs. 4.7%, 13.9% vs. 9.2%, 7.0% vs. 5.2%, respectively, with overall p value <0.001). However, the positive rate fir RSV was not significantly different between the pre-pandemic period and the pandemic period (5.6% vs. 5.8%, p =0.117). Atypical timing of RSV (summer-autumn 2021) and FLUA (summer 2022) was noted. ConclusionsPublic health interventions for different pathogens are maximally effective. While positive rates for ADV, FLUA and FLUB decreased during the COVID-19 pandemic period, positive rates for RSV remained similar. In RSV and FLUA, off-season outbreaks were observed. Measures need to be taken to protect children from possible infection surges due to immunity debt having accrued over the last three years.

ANALYSIS OF CONSUMER PREFERENCES AND THEIR INFLUENCE ON THE USE OF HOMEOPATHIC MEDICINES IN THE COMPLEX TREATMENT OF ACUTE RESPIRATORY VIRAL INFECTIONS

This article is devoted to the analysis of consumer preferences in the context of treatment of acute respiratory viral infections (ARVI) using homeopathic medicines. The study covers various aspects such as patients' main motivations for choosing homeopathy, their level of satisfaction with the results of treatment, and factors influencing the use of homeopathic remedies in complex therapy. The authors of the article review data from social surveys conducted on Google Forms portal, medical research, and literature reviews to provide a comprehensive overview of current trends in the use of homeopathic remedies in the treatment of acute respiratory infections. Special attention is paid to the influence of sociocultural and educational factors on patients' decision-making regarding treatment choices. The results of the study may be useful for health professionals, pharmacists and public health organizations, helping to better understand consumer preferences for homeopathy and to develop individualized approaches to the treatment of acute respiratory infections. The aim of the study is to analyse consumer preferences in the use of homeopathic medicines in the complex treatment of acute respiratory viral infections. Materials: Questionnaires and Surveys: Development of structured questionnaires to collect information from patients about their preferences, motivations and experiences of using homeopathic medicines for ARVI. The survey was conducted anonymously on Google Forms platform, which allowed systematisation of the data obtained. Internet resources: Analysis of discussions and reviews on medical forums and social networks related to homeopathy and treatment of acute respiratory infections. Methods: Statistical analysis: Processing data from questionnaires using statistical techniques such as frequency and correlation analyses. Qualified interviews: Conducting interviews with patients, doctors to gain a deeper understanding of motivations and experiences of using homeopathic medicines. Systematic literature review: Examining existing scientific articles and publications related to homeopathy and ARVI to obtain additional data and context. Comparative analysis: Comparison of questionnaire results with literature review and interviews to identify trends and influence of consumer preferences on the use of homeopathic medicines. Results. The study found that homeopathic medicines have the potential to be in demand in the comprehensive treatment of acute respiratory infections. Scope of the findings: the results of the study may be useful for health professionals, pharmacists and public health organisations, helping to better understand consumer preferences for homeopathy and to develop individualised approaches to the treatment of ARVI.

A clinical case of a severe course of the COVID-­19 in a patient with primary progressive multiple sclerosis

Coronavirus disease-2019 (COVID-19), despite the emergence of new pathogen variants, remains the leading cause of acute respiratory viral infections and can be severe in patients with concomitant chronic diseases, including multiple sclerosis (MS). Increased risks of complicated COVID-19 were more often observed in elderly MS patients, males, those with significant physical activity limitations, and progressive disease. While the majority of patients in this category, according to the literature, were characterised by a mild course of COVID-19, even compared to the general population. There are reports that the prolonged quarantine that accompanied the coronavirus pandemic had a negative impact on patients with progressive MS by reducing patients’ physical activity, increasing body weight, and increasing the incidence of depression. Primary progressive MS patients account for about 15 % of all MS patients. They are characterised by a relatively rapid increase in disability and limitation of motor activity. The article presents a clinical case of severe coronavirus disease in an elderly patient with primary progressive MS. The authors note the wave-like course of the immunopathological stage of COVID-19, which was characterised by both the increase in signs of intoxication, fever and respiratory failure, and the prolonged preservation of elevated markers of the inflammatory process (C-reactive protein). Positive dynamics was obtained after prescribing intravenous immunoglobulins, but the patient’s motor activity was significantly limited, general weakness and fatigue increased, and the ability to care for oneself in bed remained. The patient lost the ability to independently move from the bed to the wheelchair.

Disease Burden and Inpatient Management of Children with Acute Respiratory Viral Infections during the Pre-COVID Era in Germany: A Cost-of-Illness Study.

Respiratory viral infections (RVIs) are common reasons for healthcare consultations. The inpatient management of RVIs consumes significant resources. From 2009 to 2014, we assessed the costs of RVI management in 4776 hospitalized children aged 0-18 years participating in a quality improvement program, where all ILI patients underwent virologic testing at the National Reference Centre followed by detailed recording of their clinical course. The direct (medical or non-medical) and indirect costs of inpatient management outside the ICU ('non-ICU') versus management requiring ICU care ('ICU') added up to EUR 2767.14 (non-ICU) vs. EUR 29,941.71 (ICU) for influenza, EUR 2713.14 (non-ICU) vs. EUR 16,951.06 (ICU) for RSV infections, and EUR 2767.33 (non-ICU) vs. EUR 14,394.02 (ICU) for human rhinovirus (hRV) infections, respectively. Non-ICU inpatient costs were similar for all eight RVIs studied: influenza, RSV, hRV, adenovirus (hAdV), metapneumovirus (hMPV), parainfluenza virus (hPIV), bocavirus (hBoV), and seasonal coronavirus (hCoV) infections. ICU costs for influenza, however, exceeded all other RVIs. At the time of the study, influenza was the only RVI with antiviral treatment options available for children, but only 9.8% of influenza patients (non-ICU) and 1.5% of ICU patients with influenza received antivirals; only 2.9% were vaccinated. Future studies should investigate the economic impact of treatment and prevention of influenza, COVID-19, and RSV post vaccine introduction.

Assessment Of Purine Catabolism And Morbidity In Miners Depending On Their Work Experience

Objective — The role of end products of purine metabolism as predictors of the development of pathological changes and diseases caused by the impact of dust on the human body in a professional environment vs. the work experience (duration of underground experience in the field). Material and Methods — We analyzed the content of the end products of purine metabolism in the blood plasma of coal miners depending on the length of working in dusty conditions and evaluated the morbidity in the studied individuals via an analysis of the biomarkers. Results — The median levels of xanthine and uric acid exhibited similar significant trends with a decrease in values with underground work experience under 3 years and an increase in values with 5 or more years of experience. When assessing outcomes 1-3 years after the selection of coal miners into the study, we revealed that both acute diseases (acute respiratory viral infection (ARVI), COVID-19, acute bronchitis, and community-acquired pneumonia) and chronic diseases were present in all groups. One coal miner (2.9%) from the group with 7-10 years of underground work experience was diagnosed with an occupational disease. The development of radiological changes in the chest organs (pulmonary fibrosis, symptoms of chronic bronchitis) was detected in the groups with an experience of up to 3 years, 3-5 years, 5-7 years, and 7-10 years in 6.4%, 9.4%, 11.1%, and 5.8% of miners, respectively. Conclusion — According to logistic regression data, underground experience of 7-10 years has led to the reduction in the levels of xanthine and uric acid in the blood, which inflicted a statistically significant effect on the development of diseases in miners. Long-term underground work yielded 8.6-fold increase in the risk of developing diseases in miners.

Characterization of lipid peroxidation processes and antioxidant defense in parturients with COVID-19

Aim. The aim of the study was to investigate the functional state of the «lipid peroxidation - antioxidant defense» system in the peripheral blood of parturients with mild and severe COVID-19.Materials and methods. This casecontrol study examined 95 parturients with confirmed COVID-19 diagnosis in the third trimester, divided into two groups based on the severity of the disease. Group 1a included parturients with severe COVID-19 (community-acquired pneumonia, n=48), while group 1b consisted of patients with mild COVID-19 (acute respiratory viral infection, n=47). The control group was composed of 45 parturients without a prior or current diagnosis of COVID-19. The average age of women in the study groups was 23.9±0.50 years, and 24.4±0.60 years in the control group (p&gt;0.05). Peripheral venous blood served as the material for the study. Spectrophotometric methods were used to examine the concentrations of primary (diene conjugates - DC) and final (active thiobarbituric acid products - TBARS) products of lipoperoxidation. The content of 8-isoprostane, total antioxidant capacity of plasma components, and phospholipase A2 were investigated using enzymelinked immunosorbent assay (ELISA).Results. Study showed that parturients with severe COVID-19 had increased levels of phospholipase A2 by 2.1 times (p&lt;0.001), oxidative stress markers: diene conjugate concentrations by 1.94 times (p&gt;&lt;0.001), TBARS by 2.2 times (p&gt;&lt;0.001), and 8-isoprostane by more than 2 times (p&gt;&lt;0.001), along with a simultaneous decrease in the total antioxidant capacity of blood plasma components by 1.7 times (p&gt;&lt;0.001) compared to the control group. In the group of parturients with mild COVID-19, the studied indicators changed less significantly. Conclusion. The study established the pathogenetic role of SARS-CoV-2 in disrupting the functional system of «lipid peroxidation - antioxidant defense» and the development of oxidative stress in parturients who had COVID-19 in the third trimester. A dependency of oxidative stress marker concentrations in peripheral blood on the severity of COVID-19 was identified. It was shown that COVID-19 in the third trimester of pregnancy is associated with high levels of phospholipase A2, an imbalance in the prooxidant-antioxidant system, characterized by a reduction in the level of total antioxidant capacity and an increase in oxidative modification products of biomolecules, expressed by the growth of DC, TBARS, and 8-isoprostane levels, leading to oxidative stress correlated with the severity of lung damage. Key words: COVID-19, parturients, lipid peroxidation, antioxidant defense, oxidative stress&gt; ˂ 0.001), oxidative stress markers: diene conjugate concentrations by 1.94 times (p ˂ 0.001), TBARS by 2.2 times (p ˂ 0.001), and 8-isoprostane by more than 2 times (p ˂ 0.001), along with a simultaneous decrease in the total antioxidant capacity of blood plasma components by 1.7 times (p ˂ 0.001) compared to the control group. In the group of parturients with mild COVID-19, the studied indicators changed less significantly.Conclusion. The study established the pathogenetic role of SARS-CoV-2 in disrupting the functional system of «lipid peroxidation - antioxidant defense» and the development of oxidative stress in parturients who had COVID-19 in the third trimester. A dependency of oxidative stress marker concentrations in peripheral blood on the severity of COVID-19 was identified. It was shown that COVID-19 in the third trimester of pregnancy is associated with high levels of phospholipase A2, an imbalance in the prooxidant-antioxidant system, characterized by a reduction in the level of total antioxidant capacity and an increase in oxidative modification products of biomolecules, expressed by the growth of DC, TBARS, and 8-isoprostane levels, leading to oxidative stress correlated with the severity of lung damage.

Predictors of severity and prolonged hospital stay of viral acute respiratory infections (ARI) among children under five years in Burkina Faso, 2016–2019

BackgroundViruses are the leading etiology of acute respiratory infections (ARI) in children. However, there is limited knowledge on drivers of severe acute respiratory infection (SARI) cases involving viruses. We aimed to identify factors associated with severity and prolonged hospitalization of viral SARI among children < 5 years in Burkina Faso.MethodsData were collected from four SARI sentinel surveillance sites during October 2016 through April 2019. A SARI case was a child < 5 years with an acute respiratory infection with history of fever or measured fever ≥ 38 °C and cough with onset within the last ten days, requiring hospitalization. Very severe ARI cases required intensive care or had at least one danger sign. Oropharyngeal/nasopharyngeal specimens were collected and analyzed by multiplex real-time reverse-transcription polymerase chain reaction (rRT-PCR) using FTD-33 Kit. For this analysis, we included only SARI cases with rRT-PCR positive test results for at least one respiratory virus. We used simple and multilevel logistic regression models to assess factors associated with very severe viral ARI and viral SARI with prolonged hospitalization.ResultsOverall, 1159 viral SARI cases were included in the analysis after excluding exclusively bacterial SARI cases (n = 273)very severe viral ARI cases were common among children living in urban areas (AdjOR = 1.3; 95% CI: 1.1–1.6), those < 3 months old (AdjOR = 1.5; 95% CI: 1.1–2.3), and those coinfected with Klebsiella pneumoniae (AdjOR = 1.9; 95% CI: 1.2–2.2). Malnutrition (AdjOR = 2.2; 95% CI: 1.1–4.2), hospitalization during the rainy season (AdjOR = 1.71; 95% CI: 1.2–2.5), and infection with human CoronavirusOC43 (AdjOR = 3; 95% CI: 1.2-8) were significantly associated with prolonged length of hospital stay (> 7 days).ConclusionYounger age, malnutrition, codetection of Klebsiella pneumoniae, and illness during the rainy season were associated with very severe cases and prolonged hospitalization of SARI involving viruses in children under five years. These findings emphasize the need for preventive actions targeting these factors in young children.

To the 55th аnniversary of the Department of Virus Ecology with the Scientific and Practical Center for the Ecology and Epidemiology of Influenza (D.I. Ivanovsky Institute of Virology of the N.F. Gamaleya National Research Center for Epidemiology and Microbiology of the Ministry of Health of Russian Federation)

The article presents historical aspects and key achievements of the Department of Virus Ecology (DVE) with the Scientific and Practical Center for Influenza Ecology and Epidemiology, which was established in 1969 at the D.I. Ivanovsky Institute of Virology of Academy of Medical Sciences of the USSR. For over 50 years, the DVE has been devoted to addressing fundamental issues in virus ecology, including the formation of viral populations in nature, and conducting comprehensive large-scale studies in the interest of the state’s biosecurity. The department’s primary focus is on particularly dangerous (arboviral) and socially significant (influenza and other acute respiratory viral infections, parenteral hepatitis) viral infections. As a result of this extensive work in the Northern Eurasia region, over 2,000 strains of zoonotic viruses (17 genera, 8 families), ecologically linked to various arthropod vectors and vertebrate hosts, have been isolated. Many of them have been registered in international catalogs as new species. The role of these isolated viruses in human pathology has been studied, new viral infections have been described, and diagnostic preparations have been developed. The scientific results obtained by the department are of high priority and internationally recognized.

Properties of influenza viruses that caused epidemic increases in morbidity in Russia and countries of the world during 2022–2023. The effectiveness of vaccine prophylaxis

The purpose of this work was to determine the characteristics of the circulation of various viral respiratory pathogens during the epidemic season 2022–2023 against the background of the ongoing evolutionary variability of SARS-CoV-2.&#x0D; Materials and methods. The article uses methods used in «traditional» and «hospital» epidemiological surveillance of acute respiratory viral infections.&#x0D; Results and discussion. The period from October 2022 to September 2023 was characterized by early and high activity of influenza A(H1N1)pdm09 virus, which was replaced by influenza B virus. The antigenic and genetic properties of strains were closely related to influenza vaccines viruses recommended by WHO experts for the current season. The effectiveness of influenza vaccines was confirmed (75.0%). All of the studied influenza A(H1N1)pdm09, A(H3N2) and B epidemic strais retained sensitivity to drugs with antineuraminidase activity. The structure and share of other ARVI pathogens have changed somewhat compared to the previous season: There was a tendency to increase the activity of HAdV and HMPV; almost equivalent activity of HRsV, HRV, HCoV and HBoV; and a decrease in HPIV activity. At the same time, the frequency of other ARVI pathogens did not reach the indicators of the pre-pandemic COVID-19 period. The rationale for updating the composition of influenza vaccines for the countries of the Northern Hemisphere in the 2023–2024 season is given.

Analysis of the course and treatment of COVID-19: the experience of the Morozov Children’s City Clinical Hospital

   Morozov Children’s City Clinical Hospital, almost in the first months of the development of the COVID-19 epidemic, began to admit not only patients with acute infection, but mainly with combined comorbid pathology. Based on a retrospective analysis of 290 medical records of children hospitalized with COVID-19 at the Children’s City Clinical Hospital, an analysis of children admitted to the hospital with predominantly comorbid pathology was carried out between April 2020 and September 2020. Six of these children had a fatal outcome. Most children were in the first 3 years of life (38,4 %) and puberty (37,3 %). The diagnoses of hospitalized patients were varied: pneumonia — 41 (14,4 %), surgical pathology and trauma — 69 (24,3 %), somatic pathology — 120 (42,3 %), including: diseases of the gastrointestinal tract, kidneys and urinary tract pathways, hematological diseases, neurological, type I diabetes mellitus, joint diseases, diseases of the newborn period, oncological diseases, diseases of the cardiovascular system. To diagnose covid pneumonia, along with rapid methods of SARS-COV2, computed tomography of the lungs was used. Analyzing the course of diseases in surgical children, it can be noted that coronavirus infection did not affect the course of the underlying disease. At the same time, COVID-19 infection in hematological patients provoked a worsening of the condition with symptoms of an acute respiratory viral infection (hyperthermia, weakness, cough, rhinitis). In patients with symptomatic focal epilepsy and in patients with increased intracranial pressure, SARS-COV-2 caused activation of seizures. It should be noted that the onset of type 1 diabetes was observed in 5 out of 6 admitted children. In these cases, COVID-19 infection was a provoking factor; it also caused an exacerbation in 1 child who had “long-term” diabetes. The article presents case histories and diagnoses of 6 children aged 3 years 9 months to 17 years with deaths, severe comorbid pathology (leukemia, brain stem tumor, immunodeficiency state), in whom COVID-19 infection aggravated the course of the underlying disease with the development of generalized combined bacterial infection, sepsis, bleeding.

Cytokines in influenza in children (literature review)

This literature review was compiled according to the data of search engines PubMed, eLIBRARY.RU, Google Scholar using key words influenza, cytokines, children. The article highlights the participation of pro-inflammatory and antiinflammatory cytokines in the pathogenesis of influenza, compares the cytokine profile in different strains of the virus, with concomitant pathology, as well as attempts to find an answer to the question: “Why are young children more susceptible to this infection?” The article contains information about the creation of express systems for diagnosing cytokine storm in patients with influenza and other acute respiratory viral infections, taking into account a complex of clinical and laboratory data that comes to the aid of a practicing physician. It should be noted that there are different opinions among authors regarding the early markers of severe and complicated influenza in childhood. This information makes the topic of studying the significance of cytokines in influenza in children relevant, but it requires continuation and clarification of knowledge on this issue.

A case of a combined course of typhoid fever and leptospirosis

Coinfections are becoming increasingly relevant and urgently require research. The development of international tourism has caused the rapid spread of infectious diseases from countries with unfavorable sanitary and hygienic conditions. This article analyzes the clinical case of a patient who recently returned from India and developed a combined course of typhoid fever and leptospirosis due to astrovirus infection and blastocystosis. The disease was characterized by symptoms of enteritis, low-grade fever, and mild intoxication. The patient repeatedly sought medical help. Diagnoses of “acute respiratory viral infection” and “intestinal infection of unknown etiology” were established. Symptomatic therapy was performed without a positive effect; fever and severe asthenic syndrome persisted. The patient was hospitalized on the 18th day of illness with moderate severity. Taking into account clinical, anamnestic, and epidemiological data and laboratory examination results, typhoid fever was diagnosed. A polymerase chain reaction (PCR) test identified astrovirus RNA in the stool, and Blastocystis hominis was detected during stool examination. Despite the ongoing pathogenetic and antibacterial therapy, considering the determination of the pathogen’s sensitivity to antibiotics, the patient’s condition worsened. On day 23 of the illness, jaundice, hemorrhagic syndrome, and signs of acute renal failure were noted. Through in-depth analysis of changes in the clinical and laboratory findings, considering epidemiological history data (stay in a region endemic for leptospirosis), leptospirosis was diagnosed and treated with antibacterial therapy. Complex intensive therapy using extracorporeal treatment methods helped prevent the development of unfavorable outcomes of combined pathology. This clinical case emphasizes that doctors must be wary of imported infections and conduct additional comprehensive investigations of suspected cases.

The extracellular cyclophilin A-integrin β2 complex as a therapeutic target of viral pneumonia

The acute respiratory virus infection can induce uncontrolled inflammatory responses, such as cytokine storm and viral pneumonia, which are the major cause of deaths in clinical cases. Cyclophilin A (CypA) is mainly distributed in the cytoplasm of resting cells and released into the extracellular space in response to inflammatory stimuli. Extracellular CypA (eCypA) is upregulated and promotes inflammatory response in severe COVID-19 patients. However, how eCypA promotes virus-induced inflammatory response remains elusive. Here, we observe that eCypA is induced by influenza A and B viruses and SARS-CoV-2 in cells, mice, or patients. Anti-CypA mAb reduces pro-inflammatory cytokines production, leukocytes infiltration, and lung injury in virus-infected mice. Mechanistically, eCypA binding to integrin β2 triggers integrin activation, thereby facilitating leukocyte trafficking and cytokines production via the FAK/GTPase and FAK/ERK/P65 pathways respectively. These functions are suppressed by the anti-CypA mAb that specifically blocks eCypA-integrin β2 interaction. Overall, our findings reveal that eCypA-integrin β2 signaling mediates virus-induced inflammatory response, indicating that eCypA is a potential target for antibody therapy against viral pneumonia.

Modern Treatment of Dry Post-viral Cough. Focus on Efficiency and Safety

Cough is the most common symptom of bronchopulmonary diseases, about which patients consult the doctors of both primary and secondary care. Cough can be caused by diseases of the respiratory tract, digestive tract, and cardiovascular diseases. However, cough most often develops during acute respiratory viral infections (ARVI), which disrupts the patient’s normal activities and limits his work capacity. Since most respiratory infections are viral in nature, the use of antibacterial drugs will not only be of no benefit, but will also significantly worsen the patient’s condition. The objective: to analyze the effectiveness and tolerability of a combined antitussive agent, which includes codeine, thermopsis extract, licorice root and sodium bicarbonate, in the treatment of dry post-viral cough. Materials and methods. The study included 60 patients with a dry cough that caused by ARVI, namely: 49 (82%) men and 11 (18%) women. The average age of the patients was 46±4.7 years. Most of the subjects (90%) had smoking experience of more than 20 years. The research participants were divided into two groups of 30 people each. The groups were comparable by age, duration and severity of symptoms, as well as clinical manifestations of respiratory disease. The patients of the first group took a combined antitussive drug containing codeine, thermopsis extract, licorice root, and sodium bicarbonate for 5 days. Patients of the second group received alternative antitussive drugs. At the beginning and at the end of treatment, the severity of cough was determined on a visual analog scale and the physical, psychological and social conditions of patients in both groups were assessed using the Leicester Acute Cough Questionnaire. Results. As a result of the research, it was found that the patients of the first group, who received the combined antitussive drug, have achieved the desired treatment result much earlier and more effectively than the patients of the second group. The intensity of their cough decreased by 2.5 times during the treatment period. The patients of the first group also had better results of treatment, comparing indicators of physical, psychological and social conditions. In the control group, positive results of treatment were determined, although a less significant effect was found. Conclusions. The conducted study confirmed the high efficiency of the combined antitussive agent, which includes codeine, thermopsis extract, licorice root and sodium bicarbonate, in the treatment of dry debilitating cough caused by ARVI. Thanks to the use of this drug, the severity of cough significantly decreased, which led to a significant improvement in the general condition and quality of life of patients.

Genetic Diversity of the Human Adenovirus C Isolated from Hospitalized Children in Russia (2019-2022).

The human adenovirus (HAdV) is a common pathogen in children that can cause acute respiratory virus infection (ARVI). However, the molecular epidemiological and clinical information relating to HAdV among hospitalized children with ARVI is rarely reported in Russia. A 4-year longitudinal (2019-2022) study among hospitalized children (0-17 years old) with ARVI in Novosibirsk, Russia, was conducted to evaluate the epidemiological and molecular characteristics of HAdV. Statistically significant differences in the detection rates of epidemiological and virological data of all positive viral detections of HAdV were analyzed using a two-tailed Chi-square test. The incidence of HAdV and other respiratory viruses such as human influenza A and B viruses, respiratory syncytial virus, coronavirus, parainfluenza virus, metapneumovirus, rhinovirus, bocavirus, and SARS-CoV-2 was investigated among 3190 hospitalized children using real-time polymerase chain reaction. At least one of these respiratory viruses was detected in 74.4% of hospitalized cases, among which HAdV accounted for 4%. A total of 1.3% co-infections with HAdV were also registered. We obtained full-genome sequences of 12 HAdVs, which were isolated in cell cultures. Genetic analysis revealed the circulation of adenovirus of genotypes C1, C2, C5, C89, and 108 among hospitalized children in the period from 2019-2022.

Клінічне значення деблокади носового дихання в дітей грудного і раннього віку на тлі гострих респіраторних вірусних інфекцій: переваги ізотонічного розчину морської води

Acute respiratory viral infections (ARVI) are an urgent problem in young children, which is due to their significant prevalence, they have a constant tendency to increase and occupy the first places in the structure of infectious diseases. Damage to the mucous membranes of the upper respiratory tract in children with ARVI lead to numerous problems that require adequate replacement of the main functions of the child’s body, which determined the relevance of our study. Purpose - to analyze the effectiveness of the use of isotonic dilution of sea water (Pshyk Mini medicine) for irrigation therapy in nasal congestion in infants and young children caused by acute respiratory infections. Materials and methods. A comprehensive examination of 100 infants and young children with influenza and other ARVI was conducted in the infectious diseases department of the Chernivtsi Regional Children’s Clinical Hospital. The children were randomly divided into 2 clinical groups: the Group I included 55 children (average age - 1.09±0.3 years, the proportion of boys - 58.1%), who, as part of complex standard therapy, received nasal irrigation using 2-3 drops of Pshyk mini medicine in each nostril 3 times/day. The Group II included 45 patients (average age - 1.15±0.2 years (p&gt;0.05), the proportion of boys - 59.1% (p&gt;0.05)), in whom isotonic sodium chloride solution was used for the purpose of the nasal sanitation. Results. The conducted studies showed that starting from the 3-4th day of hospitalization, a statistically significant decrease in catarrhal manifestations and the severity of nasal obstruction was noted in patients of the Group I who received Pshyk Mini in complex treatment. In particular, in relation to the results of the Group II, in the children of the Group I, on the 4th day of inpatient treatment, the chances of reducing the severity of catarrhal manifestations (estimated ≤2 points) increased: the absolute risk increase - 53.0%, the relative risk increase - 67.9% (95% CI: 57.8-76.9) with the minimum number of patients who need to be treated to obtain a positive result - 1.5. We also established that compared to the representatives of the Group II, children of the Group I had almost a 4-fold increase in the chances of restoring tolerance to feeding (estimation of feeding difficulties ≤2 points): attributive risk - 30.5%, relative risk - 1.6 (95% CI: 0.6-4.8), odds ratio - 3.9 (95% CI: 1.2-12.3). Conclusions. For the purpose of unblocking of nasal breathing in infants and children of early age at the background of acute respiratory viral infections, the use of an isotonic solution of sea water (Pshyk Mini medicine) has a number of significant advantages compared to the use of an isotonic solution of sodium chloride for this purpose. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

Potential of topical therapy for acute rhinitis in paediatric practice

Rhinitis is an inflammation of the nasal mucosa with rhinorrhea, nasal congestion, sneezing and nasal itching. Rhinitis can be acute or chronic (allergic rhinitis, non-infectious rhinitis, infectious rhinitis) with nasal symptoms, ophthalmological symptoms, ear congestion, sore throat, postnasal drip, cough. Up to 98% of cases of acute infectious rhinitis develop against the background of an acute respiratory viral infection. The pathogenesis of acute viral rhinitis and acute viral sinusitis is based on nasal congestion, difficulty in mucociliary transport and blockage of the paranasal sinuses. When prescribing treatment for children with acute viral rhinitis and acute rhinosinusitis, it is necessary to take into account the age and weight of the child, use elimination therapy and improve drainage of the paranasal sinuses. The use in pediatric clinical practice of the combined decongestant, which includes α2-adrenomimetic and dexpanthenol, is effective and safe in the treatment of almost all conditions accompanied by nasal congestion, promotes rapid restoration of nasal breathing.