Cases Of Acute Respiratory Illness Research Articles

Influenza C virus in U.S. children with acute respiratory infection 2016–2019

Influenza C virus (ICV) is an orthomyxovirus related to influenza A and B, yet due to few commercial assays, epidemiologic studies may underestimate incidence of ICV infection and disease. We describe the epidemiology and characteristics of ICV within the New Vaccine Surveillance Network (NVSN), a Centers for Disease Control and Prevention (CDC)-led network that conducts population-based surveillance for pediatric acute respiratory illness (ARI). Nasal or/combined throat swabs were collected from emergency department (ED) or inpatient ARI cases, or healthy controls, between 12/05/2016–10/31/2019 and tested by molecular assays for ICV and other respiratory viruses. Parent surveys and chart review were used to analyze demographic and clinical characteristics of ICV+ children. Among 19,321 children tested for ICV, 115/17,668 (0.7 %) ARI cases and 8/1653 (0.5 %) healthy controls tested ICV+. Median age of ICV+ patients was 18 months and 88 (71.5 %) were ≤36 months. Among ICV+ ARI patients, 40 % (46/115) were enrolled in the ED, 60 % (69/115) were inpatients, with 15 admitted to intensive care. Most ICV+ ARI patients had fever (67.8 %), cough (94.8 %), or wheezing (60.9 %). Most (60.9 %) ARI cases had ≥1 co-detected viruses including rhinovirus, RSV, and adenovirus. In summary, ICV detection was rarely associated with ARI in children, and most ICV+ patients were ≤3 years old with co-detected respiratory viruses.

Socioeconomic inequality in child health outcomes in India: analyzing trends between 1993 and 2021

BackgroundThe health of India’s children has improved over the past thirty years. Rates of morbidity and anthropometric failure have decreased. What remains unknown, however, is how those patterns have changed when examined by socioeconomic status. We examine changes in 11 indicators of child health by household wealth and maternal education between 1993 and 2021 to fill this critical gap in knowledge. Doing so could lead to policies that better target the most vulnerable children.MethodsWe used data from five rounds of India’s National Family Health Survey conducted in 1993, 1999, 2006, 2016, and 2021 for this repeated cross-sectional analysis. We studied mother-reported cases of acute respiratory illness and diarrhea, hemoglobin measurements for anemia, and height and weight measurements for anthropometric failure. We examined how the prevalence rates of each outcome changed between 1993 and 2021 by household wealth and maternal education. We repeated this analysis for urban and rural communities. ResultsThe socioeconomic gradient in 11 indicators of child health flattened between 1993 and 2021. This was in large part due to large reductions in the prevalence among children in the lowest socioeconomic groups. For most outcomes, the largest reductions occurred before 2016. Yet as of 2021, except for mild anemia, outcome prevalence remained the highest among children in the lowest socioeconomic groups. Furthermore, we show that increases in the prevalence of stunting and wasting between 2016 and 2021 are largely driven by increases in the severe forms of these outcomes among children in the highest socioeconomic groups. This finding underscores the importance of examining child health outcomes by severity.ConclusionsDespite substantial reductions in the socioeconomic gradient in 11 indicators of child health between 1993 and 2021, outcome prevalence remained the highest among children in the lowest socioeconomic groups in most cases. Thus, our findings emphasize the need for a continued focus on India’s most vulnerable children.

Neglected bacterial infections associated to bovine respiratory disease in lactating cows from high-yielding dairy cattle herds.

Bovine respiratory disease (BRD) is a multifactorial and predominantly multietiological disease that affects dairy cattle herds worldwide, being more frequent in young animals. The occurrence of BRD was investigated in lactating cows from two high-yielding dairy herds in southern Brazil. To determine the etiology of the clinical cases of acute respiratory disease, nasal swab samples were collected from cows with clinical signs of BRD and evaluated using PCR and RT-PCR for nucleic acid detection of the main BRD etiological agents, including Mycoplasma bovis, Mannheimia haemolytica, Pasteurella multocida, Histophilus somni, bovine respiratory syncytial virus, bovine coronavirus, bovine viral diarrhea virus, bovine alphaherpesvirus 1, and bovine parainfluenza virus 3. Only three microorganisms (M. bovis, H. somni, and P. multocida) were identified in both single and mixed infections. We concluded that 40.0% of the cows were infected with M. bovis and 75.0% with H. somni in herd A. Considering both single and mixed infections, the analyses performed in herd B showed that 87.5%, 25.0%, and 50.0% of the cows were infected with M. bovis, H. somni, and P. multocida, respectively. M. bovis and H. somni are considered fastidious bacteria and laboratory diagnosis is neglected. Subsequently, most clinical cases of mycoplasmosis and histophilosis in cattle remain undiagnosed. This study demonstrates the importance of M. bovis and H. somni infections in adult cows with BRD. These results highlight the importance of including these bacteria in the group of etiological agents responsible for the occurrence of BRD in cattle, especially in adult cows with unfavorable immunological conditions, such as recent calving and peak lactation.

Influenza-associated respiratory illness among five cohorts of pregnant women and their young infants (0-6months), Bangladesh, 2013-2017.

Pregnant women with their infants are considered at higher risk for influenza-associated complications, and the World Health Organization (WHO) recommends influenza vaccination during pregnancy to protect them, including their infants (0-6months). There are limited data on the influenza burden among pregnant women and their infants (0-6months), and there are no routine influenza vaccinations in Bangladesh. Five annual cohorts (2013-2017) of pregnant women were enrolled from the eight sub-districts of Bangladesh before the influenza season (May-September); they were contacted weekly to identify new onset of influenza-like illness (ILI) (subjective or measured fever and cough) and acute respiratory illness (ARI) (at least two of these symptoms: cough, rhinorrhea, or difficulty in breathing) among their infants from birth to 6 months of age. We collected nasopharyngeal swabs from ILI and ARI cases, tested by real-time reverse transcription polymerase chain reaction (rRT-PCR) for influenza virus (including types and subtypes) and estimated influenza incidence (95% CI)/10000 pregnant women-months or infant-months, respectively. We enrolled 9020 pregnant women, followed for 26,709 pregnancy-months, and detected 1241 ILI episodes. We also followed 8963 infants for 51,518 infant-months and identified 5116 ARI episodes. Influenza positivity was 23% for ILI and 3% for ARI cases. The overall incidence (2013-2017) of influenza among pregnant women was 158.5/10000 pregnant women-months (95% CI: 141.4-177.6) and that among infants was 21.9/10000 infant-months (95% CI: 18.2-26.5). Although the data was collected more than 5 years ago, as the only baseline data, our findings illustrate evidence of influenza burden among pregnant women and infants (0-6months), which may support preventive policy decisions in Bangladesh.

Nausea, Vomiting, and Diarrhea Are Common in Community-Acquired Acute Viral Respiratory Illness

BackgroundGastrointestinal (GI) symptoms are recognized sequelae of acute respiratory illness (ARI), but their prevalence is not well documented. Our study aim was to assess the incidence of GI symptoms in community ARI cases for persons of all ages and their association with clinical outcomes.MethodsWe collected mid-nasal swabs, clinical, and symptom data from Seattle-area individuals during the 2018–2019 winter season as part of a large-scale prospective community surveillance study. Swabs were tested by polymerase chain reaction (PCR) for 26 respiratory pathogens. Likelihood of GI symptoms given demographic, clinical, and microbiological covariates were analyzed with Fisher’s exact, Wilcoxon-rank-sum, and t-tests and multivariable logistic regression.ResultsIn 3183 ARI episodes, 29.4% had GI symptoms (n = 937). GI symptoms were significantly associated with pathogen detection, illness interfering with daily life, seeking care for the illness, and greater symptom burden (all p < 0.05). Controlling for age, > 3 symptoms, and month, influenza (p < 0.001), human metapneumovirus (p = 0.004), and enterovirus D68 (p = 0.05) were significantly more likely to be associated with GI symptoms than episodes with no pathogen detected. Seasonal coronaviruses (p = 0.005) and rhinovirus (p = 0.04) were significantly less likely to be associated with GI symptoms.ConclusionIn this community-surveillance study of ARI, GI symptoms were common and associated with illness severity and respiratory pathogen detection. GI symptoms did not track with known GI tropism, suggesting GI symptoms may be nonspecific rather than pathogen-mediated. Patients presenting with GI and respiratory symptoms should have respiratory virus testing, even if the respiratory symptom is not the primary concern.

The burden of RSV-associated illness in children aged < 5 years, South Africa, 2011 to 2016

BackgroundVaccines and monoclonal antibodies to protect the very young infant against the respiratory syncytial virus (RSV)-associated illness are effective for limited time periods. We aimed to estimate age-specific burden to guide implementation strategies and cost-effectiveness analyses.MethodsWe combined case-based surveillance and ecological data to generate a national estimate of the burden of RSV-associated acute respiratory illness (ARI) and severe acute respiratory illness (SARI) in South African children aged < 5 years (2011–2016), including adjustment for attributable fraction. We estimated the RSV burden by month of life in the < 1-year age group, by 3-month intervals until 2 years, and then 12 monthly intervals to < 5 years for medically and non-medically attended illness.ResultsWe estimated a mean annual total (medically and non-medically attended) of 264,112 (95% confidence interval (CI) 134,357–437,187) cases of RSV-associated ARI and 96,220 (95% CI 66,470–132,844) cases of RSV-associated SARI (4.7% and 1.7% of the population aged < 5 years, respectively). RSV-associated ARI incidence was highest in 2-month-old infants (18,361/100,000 population, 95% CI 9336–28,466). The highest incidence of RSV-associated SARI was in the < 1-month age group 14,674/100,000 (95% CI 11,175–19,645). RSV-associated deaths were highest in the first and second month of life (110.8 (95% CI 74.8–144.5) and 111.3 (86.0–135.8), respectively).ConclusionsDue to the high burden of RSV-associated illness, specifically SARI cases in young infants, maternal vaccination and monoclonal antibody products delivered at birth could prevent significant RSV-associated disease burden.

Respiratory virus infections of the lower respiratory tract elevate bronchoalveolar lavage eosinophil fraction: a clinical retrospective study and case review

BackgroundEosinophilic airway inflammation caused by respiratory virus infection has been demonstrated in basic research; however, clinical investigations are lacking. To clarify the extent to which respiratory virus infection induces airway eosinophilic inflammation, we reviewed the results of bronchoalveolar lavage (BAL) and respiratory virus testing performed at our hospital.MethodsAmong the BAL procedures performed at the University of the Ryukyu Hospital from August 2012 to September 2016, we collected cases of acute respiratory disease in which multiplex polymerase chain reaction (PCR) was used to search for respiratory viruses. The effect of respiratory virus detection on BAL eosinophil fraction was analyzed using statistical analysis. A case study was conducted on respiratory virus detection, which showed an elevated BAL eosinophil fraction.ResultsA total of 95 cases were included in this study, of which 17 were PCR-positive. The most common respiratory virus detected was parainfluenza virus (eight cases). The PCR-positive group showed a higher BAL eosinophil fraction than the PCR-negative group (p = 0.030), and more cases had a BAL eosinophil fraction > 3% (p = 0.017). Multivariate analysis revealed that being PCR-positive was significantly associated with BAL eosinophil fraction > 1% and > 3%. There were nine PCR-positive cases with a BAL eosinophil fraction > 1%, of which two cases with parainfluenza virus infection had a marked elevation of BAL eosinophil fraction and were diagnosed with eosinophilic pneumonia.ConclusionsCases of viral infection of the lower respiratory tract showed an elevated BAL eosinophil fraction. The increase in eosinophil fraction due to respiratory virus infection was generally mild, whereas some cases showed marked elevation and were diagnosed with eosinophilic pneumonia. Respiratory virus infection is not a rare cause of elevated BAL eosinophil fraction and should be listed as a differential disease in the practice of eosinophilic pneumonia.

Two novel recombinant human mastadenovirus D genotypes associated with acute respiratory illness.

Two novel genotypes of species human mastadenovirus D designated 109 and 110 were isolated from three epidemiologically unrelated cases of acute respiratory disease detected in January 2018 by surveillance efforts at the California/Mexico border. Both genotypes represent examples of intertypic recombination. Genotype D109 is most closely related to genotype D56 (97.68% genomic similarity) and features a type D22-like penton base, a type D19-like hexon gene, and a type D9-like fiber [P22/H19/F9]. On the other hand, genotype D110 is most closely related to type D22 (96.94% genomic similarity) and features a type D67-like penton base, a novel hexon gene, and a type D9-like fiber [P67/H110/F9]. Importantly, the fibers of both novel genotypes are highly similar to those of genotypes D56 and D59, which have also been isolated from a few cases of respiratory infections. The present report shows data contributing to the understanding of the molecular determinants of the expanded tissue tropism of certain members of species HAdV-D.

Healthcare-seeking behavior for respiratory illnesses in Kenya: implications for burden of disease estimation

BackgroundUnderstanding healthcare-seeking patterns for respiratory illness can help improve estimation of disease burden and target public health interventions to control acute respiratory disease in Kenya.MethodsWe conducted a cross-sectional survey to determine healthcare utilization patterns for acute respiratory illness (ARI) and severe pneumonia in four diverse counties representing urban, peri-urban, rural mixed farmers, and rural pastoralist communities in Kenya using a two-stage (sub-locations then households) cluster sampling procedure. Healthcare seeking behavior for ARI episodes in the last 14 days, and severe pneumonia in the last 12 months was evaluated. Severe pneumonia was defined as reported cough and difficulty breathing for > 2 days and report of hospitalization or recommendation for hospitalization, or a danger sign (unable to breastfeed/drink, vomiting everything, convulsions, unconscious) for children < 5 years, or report of inability to perform routine chores.ResultsFrom August through September 2018, we interviewed 28,072 individuals from 5,407 households. Of those surveyed, 9.2% (95% Confidence Interval [CI] 7.9–10.7) reported an episode of ARI, and 4.2% (95% CI 3.8–4.6) reported an episode of severe pneumonia. Of the reported ARI cases, 40.0% (95% CI 36.8–43.3) sought care at a health facility. Of the74.2% (95% CI 70.2–77.9) who reported severe pneumonia and visited a medical health facility, 28.9% (95% CI 25.6–32.6) were hospitalized and 7.0% (95% CI 5.4–9.1) were referred by a clinician to the hospital but not hospitalized. 21% (95% CI 18.2–23.6) of self-reported severe pneumonias were hospitalized. Children aged < 5 years and persons in households with a higher socio-economic status were more likely to seek care for respiratory illness at a health facility.ConclusionOur findings suggest that hospital-based surveillance captures less than one quarter of severe pneumonia in the community. Multipliers from community household surveys can account for underutilization of healthcare resources and under-ascertainment of severe pneumonia at hospitals.

Mild and asymptomatic influenza B virus infection among unvaccinated pregnant persons: Implication for effectiveness of non-pharmaceutical intervention and vaccination to prevent influenza.

We estimated symptomatic and asymptomatic influenza infection frequency in community-dwelling unvaccinated pregnant persons to inform risk communication. We collected residue sera from multiple antenatal-care blood draws during October 2016-April 2017. We determined influenza infection as seroconversion with≥4-fold rise in antibody titers between any two serum samples by improved hemagglutinin-inhibition assay including ether-treated B antigens. The serology data were linked to the results of nuclei acid testing (rRT-PCR) based on acute respiratory illness (ARI) surveillance. Among all participants, 43%(602/1384) demonstrated serology and/or rRT-PCR evidenced infection, and 44%(265/602) of all infections were asymptomatic. ARI-associated rRT-PCR testing identified only 10%(61/602) of total infections. Only 1%(5/420) of the B Victoria cases reported ARI and had a rRT-PCR positive result, compared with 33%(54/165) of the H3N2 cases. Among influenza ARI cases with multiple serum samples, 19%(11/58) had seroconversion to a different subtype prior to the illness. The incidence of influenza B infection in unvaccinated pregnant persons is under-estimated substantially. Non-pharmaceutical intervention may have suboptimal effectiveness in preventing influenza B transmission due to the less clinical manifestation compared to influenza A. The findings support maternal influenza vaccination to protect pregnant persons and reduce consequent household transmission.

Severity and Mortality of Covid-19 in Patients with Diabetes Mellitus

Background: Covid-19 infection appeared as rapidly spreading cases of acute respiratory disease in Wuhan city of China that became pandemic. It was brought to the notice of WHO on December 31, 2019. Diabetes mellitus is one of the biggest health problems and fast growing emergencies of the 21st century. Diabetic patients with who got infected with Covid-19 have more chance of in hospital treatment need, intensive care unit care requirement, intubation and death. Objective: The objective of this study was to know the severity and mortality of covid-19 in patients with diabetes mellitus. Study Design: This was a descriptive case series study. Study Setting: It was done in the Covid-19 isolation and ICU unit of Ayub Teaching Hospital Abbottabad from May 2020 to October 2021. Methods: Using non-probability consecutive sampling, 189 diabetic patients were enrolled. Sample included all covid-19 patients having diabetes that received indoor treatment during this period. All patients from both genders with age &gt; 18 years were included. Patients with malignancy or on immunosuppressants for more than 1 month were excluded. Patients who were maintaining oxygen saturation at room air/facemask/nasal prongs were labelled as having non-severe disease while patient who needed CPAP or assisted ventilation were labelled as having severe covid-19 disease. All patients who died during admission were documented as covid-19 related mortality. Patients were labelled as diabetic who were known diabetic and taking diabetes treatment. Data was collected on a structured pro forma. Statistical program SPSS version 16.0 was used for the analysis of data. Results: In this study, mean age was 61.29 ± 11.73 years. There were 40.2% male and 59.8% female patients. 86.2% patients were not-vaccinated, 3.7% patients were partially vaccinated and 10.1% patients were fully vaccinated. Hypertension was most common comorbidity (42.3%) and only CKD was significantly associated with increased mortality. 43.92%patients had non-severe illness while 56.08% patients had severe illness. The overall mortality of illness was 48.15% while it was 84.9% in patients with severe illness. Practical implication: These published publications provide a variety of various estimations and impact amounts due to the numerous different study designs and demographics. A comprehensive and methodical study is required because of the unpredictability of the situation. So that we conducted this study to assess the severity and mortality of covid-19 in patients with diabetes mellitus Conclusion: Our study concluded that severity and mortality of covid-19 was high in diabetic patients with high fasting &amp; random sugar levels, pack smoking years and low oxygen saturation. Keywords: Covid-19, diabetes mellitus, severity, mortality. Severity and mortality of Corona virus infectious disease-19 in patients with diabetes mellitus

Post‐flood infectious disease prevention and control: Current scenario in Pakistan

Post‐flood infectious disease prevention and control: Current scenario in Pakistan

COVID like illness versus COVID-19 (CLIC STUDY) – Clinical profile and outcome

Background: In December 2019, several cases of acute respiratory illness were detected in Wuhan city of China. This SARS-CoV-2 has been rapidly spreading worldwide ever since. SARS-CoV-2 has the potential to damage the vital organs such as lung, heart, liver, and kidney, and infection poses a considerable risk to patients by the high prevalence of pneumonia. Aims and Objectives: The objectives of the study are as follows: (1) To study clinical profile and biochemical markers in SARI patients. (2) To compare the clinical profile and biochemical markers between SARS-CoV-2 positive and negative patients and their outcomes. Materials and Methods: The present study is a hospital-based prospective cross-sectional study conducted on a total of 350 patients (150 SARI+200 COVID-19) in Bengaluru during the study period from June 2020 to May 2021. Results: Diabetes mellitus was present in 30% of SARI and 42% in COVID-19 patients (P=0.03). Leukocytosis (Total Leukocyte Count [TLC] &gt;11000 cells/mm3) was more common among SARI patients than COVID-19 patients (49.3% vs. 24.3%). Leukopenia (TLC &lt;4000 cells/mm3) was significantly more common in COVID-19 patients than in SARI patients (10.2% vs. 3.6%, P&lt;0.001). Conclusion: COVID-19 infection is more common in patients with comorbidities such as diabetes mellitus and hypertension than SARI. Leukopenia was more common in COVID-19 patients whereas leukocytosis was more common in SARI patients.

Patient-Friendly Summary of the ACR Appropriateness Criteria: Acute Respiratory Illness in Immunocompetent Patients.

Acute respiratory illness (ARI) is one of the most common reasons for individuals to seek medical treatment. A person with ARI will have one or more of the following symptoms: cough, phlegm production, chest pain, or trouble breathing. Most cases of ARI are caused by infection that will clear up without treatment. ARI cases caused by bacterial pneumonia require treatment. Imaging is used to determine if there is pneumonia.

A cross-sectional study to assess impact of COVID-19 infection amongst patients with chronic kidney disease

Background: In December 2019, a series of unknown origin cases of acute respiratory illness occurred in Wuhan, Hubei Province, China. Although diffuse alveolar damage and acute respiratory failure were the main features of COVID-19, the involvement of other organs needed to be explored. After lung infection, the virus may enter the blood, accumulate in the kidney, and cause damage to resident renal cells. Hence, this study was planned to analyze the potential impact of this pandemic of COVID-19 amongst the chronic kidney disease (CKD) patients.Methods: Cross-sectional observational study was conducted at Seven Hills Dedicated Covid-19 hospital, Andheri, Mumbai. Data was collected from hospital records of CKD patients admitted in the study duration.Results: This study was conducted on 310 patients. Mean age was 53.33+14.21 years, and 191 (61.6%) of patients were male while mean duration of hospitalization was 16.78+10.31. Majority of the patients presented with symptoms like fever 80%, breathlessness 61.3%, and co-morbidities like Diabetes Mellitus 65.5% followed by Hypertension 61.8%. Patients (15.5%) over age of 60 years tested swab report positive for more than 5 times. Recovery rate being 76.1% while mortality rate found to be 23.87%.Conclusions: Early detection and effective intervention may help to reduce deaths among CKD patients with COVID-19.

Epidemiology of influenza B infection in the state of Rio Grande do Sul, Brazil, from 2003 to 2019.

Influenza B virus (IBV) causes respiratory tract infections with mild, moderate, or life-threatening symptoms. This study describes the epidemiology of IBV infection in Rio Grande do Sul (RS), Brazil, over 17 years. Nasopharyngeal samples were collected from outpatients presenting acute respiratory illness (ARI) between 2003 and 2019, and from inpatients with severe acute respiratory infection (SARI) from 2009 to 2019. IBV was detected by immunofluorescence assay or quantitative real-time polymerase chain reaction; demographic and clinical data were analyzed.In total, 48,656 cases of respiratory infection were analyzed, of which 20.45% were ARI, and 79.46% were SARI. Respiratory viruses accounted for 22.59% and 37.47% of the cases of ARI and SARI, respectively. Considering respiratory viral infections, 17.10% of ARI and 3.06% of SARI were associated with IBV. IBV circulated year-round in RS, with an increase in autumn and winter, peaking in July (p = .005). IBV infection showed an association with age, and most outpatients positive for IBV were between 10 and 49 years old, whereas IBV infection in SARI affected mainly individuals ≤ 1 year or ≥ 60 years old. No significant association was found between sex and IBV infection. Coryza, sore throat, and myalgia were associated with ARI (p < .001). Moreover, 3.18% of the deaths associated with respiratory virus infection were positive for IBV; notably, cardiopathy (p < .001), metabolic disease (p < .001), and smoking (p = .003) were associated to fatality in IBV infection.IBV is an important cause of severe respiratory infections, and the fatality risk is high in individuals with cardiopathy and metabolic diseases.

English

Coronavirus disease 2019 (COVID-19) emerged in December 2019 in Wuhan, the capital of Hubei province, China. While the outbreak in China is almost over, this highly contagious disease is currently spreading across the world with a daily increase in the number of affected countries, confirmed cases, and infection-related deaths. In January, the World Health Organization (WHO) declared that the outbreak of COVID-19 constituted a Public Health Emergency of International Concern (PHEIC). Based on the high levels of global spread and the severity of COVID-19, on 11 March 2020, the Director-General of the WHO declared the COVID-19 outbreak a pandemic. COVID-19 is an acute respiratory disease caused by a newly emerged zoonotic coronavirus. A positive-sense enveloped single-stranded RNA virus, named Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), has been isolated from a patient with pneumonia and connected to the cluster of acute respiratory illness cases from Wuhan. The virus is transmitted from human to human via droplets coughed or exhaled by infected persons and by touching droplet-contaminated surfaces or objects and then touching the eyes, nose, or mouth. Population groups that have been more frequently reported as having severe disease and a higher mortality rate include people aged over 60 years, males, people with underlying conditions such as hypertension, diabetes, cardiovascular disease, chronic respiratory disease, and cancer. Current estimates suggest a median incubation period of five to six days for COVID-19, with a range of one to 14 days. Disease-specific pharmaceuticals and vaccines are still under research and development. The therapeutic use of convalescent plasma donated by patients recovered from COVID-19 might play a role in the efforts to find a possible treatment for COVID-19. Keywords: Coronavirus, COVID-19, WHO, SARS-Cov-2, Zoonotic.

The Impact of Maternal Human Immunodeficiency Virus Infection on the Burden of Respiratory Syncytial Virus Among Pregnant Women and Their Infants, Western Kenya.

BackgroundRespiratory syncytial virus (RSV) is an important cause of respiratory illness worldwide; however, burden data on mother–infant pairs remain sparse in sub-Saharan Africa, where human immunodeficiency virus (HIV) is prevalent. We evaluated the impact of maternal HIV infection on the burden of RSV among mothers and their infants in western Kenya.MethodsWe enrolled pregnant women (≤20 weeks’ gestation) and followed them and their newborns weekly for up to 3–6 months postpartum, to document cases of acute respiratory illness (ARI). Nasal/oropharyngeal swabs were collected and tested for RSV using polymerase chain reaction. Analyses were stratified by maternal HIV status and incidence was computed per 1000 person-months.ResultsCompared to RSV-negative ARI cases, RSV-positive cases were associated with cough, apnea, and hospitalization among infants. RSV incidence per 1000 person-months among mothers was 4.0 (95% confidence interval [CI], 3.2–4.4), and was twice that among the HIV-infected mothers (8.4 [95% CI, 5.7–12.0]) compared to the HIV-uninfected mothers (3.1 [95% CI, 2.3–4.0]). Among infants, incidence per 1000 person-months was 15.4 (95% CI, 12.5–18.8); incidence did not differ by HIV exposure or prematurity.ConclusionsHIV infection may increase the risk of RSV illness among pregnant women. Future maternal RSV vaccines may have added benefit in areas with high HIV prevalence.

The Potential Transmission of SARS-CoV-2 from Patients with Negative RT-PCR Swab Tests to Others: Two Related Clusters of COVID-19 Outbreak

In December 2019, a cluster of cases of acute respiratory illness, novel coronavirus-infected pneumonia, occurred in Wuhan, Hubei Province, China. The false-negative nasopharyngeal swabs for SARS-CoV-2 caused delayed diagnosis of COVID-19, which hindered the prevention and control of the pandemic. The transmission risk of SARS-CoV-2 in negative nasopharyngeal swabs cases has rarely been addressed previously. This study evaluated two clusters of COVID-19 in six patients, four of whom (66.7%) tested negative for RNA of SARS-CoV-2 on RT-PCR of nasopharyngeal swabs. All epidemiological, clinical, and laboratory data were collected. The first cluster was a nosocomial infection of four health care providers in early January. One case resulted in a sequential familial cluster of infection. All patients either self-quarantined at home or were admitted to hospital for isolated treatment. All recovered and were anti-SARS-CoV-2 IgG- and/or IgM-positive (100%) for serological detection of SARS-CoV-2 at the recovery stage. Our study provides a cautionary warning that negative results for nasopharyngeal swabs of suspected SARS-CoV-2 infection can increase the risk of nosocomial infection among health care providers. Serologic detection for anti-SARS-CoV-2 IgG and/or IgM is an important test in the diagnosis of COVID-19.

Covid-19 and kidney; a mini-review on current concepts and new data

In late December 2019, some cases of acute respiratory illness occurred in Wuhan, Hubei province, China that caused by a virus named "severe acute respiratory syndrome 2" (SARS-Cov2). More susceptible patients to this disease are elderly male patients since these patients with comorbid diseases are disposed to severe infection and more death. The most important comorbid diseases with COVID-19 pneumonia are hypertension, diabetes mellitus, cerebrovascular disease, chronic obstructive pulmonary disease, coronary heart disease. The most common symptoms of SARS-Cov2 infection are dyspnea, cough, fatigue, diarrhea and vomiting. High number of kidney disease in hospitalized patients with COVID-19 has been reported. Furthermore, a large group of patients with COVID-19 pneumonia had signs of kidney disease, with a high level of serum creatinine and blood urea nitrogen that could be justified with different pathophysiologies happened in COVID-19 pneumonia. However, massive differences were found in the prevalence of acute kidney injury (AKI) in patients with acute respiratory distress syndrome (ARDS) secondary to COVID-19 pneumonia, since various studies have shown that AKI correlates with higher mortality rate, upper morbidity and more severe cases of illness. Therefore, we should be informed about the pathophysiology of AKI in COVID-19 pneumonia to find the modalities to decrease the incidence of AKI and subsequent decrease mortality and morbidity of this disease.