Cases Of Respiratory Infection Research Articles

OP05 Outcome of induction therapy with vedolizumab in children: Results from the prospective, multi-centre VEDOKIDS study

Abstract Background Limited data are available on the use of Vedolizumab (VDZ) in paediatric Crohn’s Disease (CD) and Ulcerative Colitis (UC). We evaluated the effectiveness and safety of VDZ to induce remission at week 14 in the prospective, multicenter VEDOKIDS study. Methods We enrolled children (age 0–18 years) with CD or UC commenced on VDZ with a standardized dosing of 177mg/BSA up to 300mg at 0, 2, 6 and q8 weeks thereafter. Non-responders had their dose escalated to q4wks at the discretion of the local physician. Explicit demographic, clinical and safety data were prospectively recorded via REDcap. Clinical remission was defined as steroid- and EEN-free remission (i.e. wPCDAI<12.5 or PUCAI<10) without the need for new medications. Complete remission was defined as clinical remission with normal CRP and ESR. Predictors of response were explored by Logistic regression. Results 128 children were enrolled, 60 (47%) with CD, and 68 (53%) with UC (58 (45%) males, mean age 13.8±3.6, 93 (73%) failed previous anti-TNF, median disease duration 2.3 years (IQR 0.9–4.7)). Using the ITT principle, clinical and complete remission rates for CD at week 14 were 30% and 20%, respectively, and for UC 50% and 38%, respectively (Fig 1). Clinical remission rates of those receiving VDZ as first line biologics versus second line were 57% and 34%, respectively (p=0.019; Fig 2); the corresponding complete remission rates were 49% and 23% (p=0.004). In the UC group, disease activity at baseline measured by the PUCAI predicted clinical remission at week 14 (OR=0.95, 95%CI 0.93–0.98; median baseline PUCAI 15 (IQR 0–30) in those achieving remission and 45 (20–55) in those who did not; p=0.002). ESR (OR=0.94, 95%CI 0.89–0.98; p=0.009) and a trend towards extensive disease (L3 vs. L1 and L2; OR 0.14, 95%CI 0.18–1.036, p=0.054) predicted clinical remission in CD. During the 14 weeks, 113 adverse events (AE) were recorded in 58 children: 28 AEs were possibly related to VDZ, all of which were mild-moderate and only 3 (11%) led to discontinuation of VDZ (leukocytoclastic vasculitis, myalgia and dyspnea). There were 18 serious AEs, only one was graded as possibly related to VDZ (headache). There were 18 non-serious cases (19%) of upper respiratory infections (pharyngitis, tonsilitis, parotitis, and otitis media) and one Campylobacter jejuni which was graded as serious. Conclusion In this prospective multicenter study, VDZ was safe and effective for inducing remission in a refractory cohort of paediatric IBD, more so in UC. Disease severity and extent at baseline may predict clinical response.

Геоинформационное картографирование избыточной смертности в Европе в 2020–2021 годах на фоне пандемии коронавируса

The first officially recorded case of severe acute respiratory infection caused by SARS-CoV-2 coronavirus (2019-nCoV) was reported in the People’s Republic of China in late 2019. Since then, the virus has spread rapidly across the planet. On 30 January 2020. The World Health Organization (WHO) designated the outbreak as an emergency and as early as 30 March 2020 it declared the disease a pandemic, named COVID-19. At the beginning of April 2022 there were more than 500 million cases and 6 million deaths according to this organization. The latter figure however immediately raised questions—among doctors and scientists alike—as it has not yet been possible to develop a uniform approach to its recording around the world. Therefore, in this paper, the choice of the excess mortality indicator is justified in its mapping presentation, whose main advantage is that it can be used to represent both the losses from COVID-19 itself and the consequences of the increased burden on public health systems. The visualization of such data using modern geo-information technology is relevant both at present, against the background of the ongoing COVID-19 pandemic, and in the future, when dealing with its consequences. The main specificity of the territory under study—Europe (including both countries wholly located in this part of the world and parts of it—including Kazakhstan, Russia and Turkey, as well as Azerbaijan, Armenia, Georgia and Cyprus, geographically located in Asia)—is sufficient similarity of basic demographic indicators of countries with different approaches to pandemic control applied in each of them. This enables us to use maps to highlight whether they have been successful in this area in the most straightforward way. The geo-referenced mapping materials can be used for further, more in-depth analysis and visualization of coronavirus data using cartographic research at the level of individual states and their smaller jurisdictions.

Influence of Copper and Zinc Nanoparticles on Genotyping Characterizations of Multi-Drug Resistance Genes for Some Calf Pathogens

Nowadays there is a worldwide problem in the control of animal diseases due to the multidrug resistance of pathogens. Fecal samples, pharyngeal swabs, and rations were examined for cases of respiratory and diarrhea infections in calves. The most predominant species were A. flavus and E. coli pathogens. The drug-resistance against A. flavus and E. coli was tested. Nanotechnology was used and evaluated to overcome the drug resistance to conventional drugs. Herein, ZnONPs and CuNPs were used instead of commercial antibiotics against A. flavus and E. coli pathogens. They suppressed the growth and viability of A. flavus and E. coli sp., and the MIC was (600μg/mL). In addition, the molecular detection of virulent genes such as A. flavus (aflR) and E. coli (stx1) confirmed their conventional identification. In addition, the isolates were PCR tested for multidrug resistance (MDR) genes using primers for the Azole resistance gene (CYP51) in A. flavus and ampicillin resistance gene (CITM) in E. coli. The treated isolates with ZnONPs and CuNPs at high doses, 600μg/mL and 150μg/mL, eliminated the signals of DNA bands of MDR genes, respectively. Whereas the expression of genes was observed with the treatment of E. coli and A. flavus with low doses of 100 and 50μg/mL of ZnONPs and CuNPs, respectively. The exposure of pathogens to high doses of ZnONPs and CuNPs (600 and 150μg/mL) prevents mutation of the azole resistance gene (CYP51) in fungi and ampicillin resistance gene (CITM) in bacteria. Hence, the supplementation of ZnONPs and CuNPs for rations can inhibit the microbial viability and removal of drugs resistant genes.

Three Cases Infected with Avian Influenza A(H5N6) Virus - Chongqing Municipality, China, January-September, 2021.

What is already known about this topic?The World Health Organization (WHO) has reported a total of 48 cases by October 15, 2021. The continuous genomic reassortments of H5N6 and other subtype avian influenza viruses (AIVs) pose a long-term threat to public health and the poultry industry.What is added by this report?Three new cases of H5N6 that occurred from January to September 2021 in Chongqing Municipality, China were reported in this study. Epidemiological information of the three cases showed raising poultry and visiting live poultry market contributed to these infections, and there was no evidence of human-to-human transmission of H5N6 currently but a potential spatial cluster. An increase of H5N6 cases was recorded in the area.What are the implications for public health practice?In case of unexplained pneumonia or severe respiratory infection, the patients’ epidemiological history of contact with poultry or live poultry markets (LPMs) may be an important interrogation to help diagnose. Extensive and long-term surveillance of avian influenza viruses in LPMs is essential.

Complications of Posterior Fusion for Atlantoaxial Instability in Children With Down Syndrome.

ObjectiveTo clarify the complications of posterior fusion for atlantoaxial instability (AAI) in children with Down syndrome and to discuss the significance of surgical intervention.MethodsTwenty pediatric patients with Down syndrome underwent posterior fusion for AAI between February 2000 and September 2018 (age, 6.1±1.9 years). C1–2 or C1–3 fusion and occipitocervical fusion were performed in 14 and 6 patients, respectively. The past medical history, operation time, estimated blood loss (EBL), duration of Halo vest immobilization, postoperative follow-up period, and intra- and perioperative complications were examined. ResultsThe operation time was 257.9±55.6 minutes, and the EBL was 101.6±77.9 mL. Complications related to the operation occurred in 6 patients (30.0%). They included 1 major complication (5.0%): hydrocephalus at 3 months postoperatively, possibly related to an intraoperative dural tear. Other surgery-related complications included 3 cases of superficial infections, 1 case of bone graft donor site deep infection, 1 case of C2 pedicle fracture, 1 case of Halo ring dislocation, 1 case of pseudoarthrosis that required revision surgery, and 1 case of temporary neurological deficit after Halo removal at 2 months postoperatively. Complications unrelated to the operation included 2 cases of respiratory infections and 1 case of implant loosening due to a fall at 9 months postoperatively. ConclusionThe complication rate of upper cervical fusion in patients with Down syndrome remained high; however, major complications decreased substantially. Improved intra- and perioperative management facilitates successful surgical intervention for upper cervical instability in pediatric patients with Down syndrome.

Rhinoviruses as critical agents in severe bronchiolitis in infants

ObjectivesTo detect RSV or other thirteen respiratory viruses as possible causer agent of bronchiolitis in infants. MethodThis is an epidemiological analytical study, conducted using a nasopharyngeal aspirate of 173 hospitalized children younger than two years old with severe bronchiolitis in three hospitals in the Campinas Metropolitan Region (CMR) during 2013-14. The data was statically evaluated by Pearson's chi-squared test with statistical significance of 0.05 and 95% confidence level. ResultsAs expected, the most prevalent viruses detected were RSV A and B in 47% and 16% of the samples, respectively. However, almost a third of severe bronchiolitis cases there were no detection of RSV, and the viruses more commonly detected were rhinoviruses, which were identified in almost a quarter of all positive samples for at least a viral agent. ConclusionsAlthough nothing could be concluded from the disease severity and clinical-epidemiological data, the present study's results indicate that severe bronchiolitis is not always related to RSV infections in children younger than two years old, and the rhinoviruses were more prevalent in these cases. These findings reinforce the need to carry out a viral diagnosis in the hospital emergency would be very appropriate for all cases of respiratory infections in children, even for diseases in which the primary etiological agent seems to be well known.

Phylogeography and phylogeny of Rhinoviruses collected from Severe Acute Respiratory Infection (SARI) cases over successive epidemic periods in Tunisia.

Rhinoviruses (RV) are a major cause of Severe Acute Respiratory Infection (SARI) in children, with high genotypic diversity in different regions. However, RV type diversity remains unknown in several regions of the world. In this study, the genetic variability of the frequently circulating RV types in Northern Tunisia was investigated, using phylogenetic and phylogeographic analyses with a specific focus on the most frequent RV types: RV-A101 and RV-C45. This study concerned 13 RV types frequently circulating in Northern Tunisia. They were obtained from respiratory samples collected in 271 pediatric SARI cases, between September 2015 and November 2017. A total of 37 RV VP4-VP2 sequences, selected among a total of 49 generated sequences, was compared to 359 sequences from different regions of the world. Evolutionary analysis of RV-A101 and RV-C45 showed high genetic relationship between different Tunisian strains and Malaysian strains. RV-A101 and C45 progenitor viruses’ dates were estimated in 1981 and 1995, respectively. Since the early 2000s, the two types had a wide spread throughout the world. Phylogenetic analyses of other frequently circulating strains showed significant homology of Tunisian strains from the same epidemic period, in contrast with earlier strains. The genetic relatedness of RV-A101 and RV-C45 might result from an introduction of viruses from different clades followed by local dissemination rather than a local persistence of an endemic clades along seasons. International traffic may play a key role in the spread of RV-A101, RV-C45, and other RVs.

Genome-wide association study of susceptibility to hospitalised respiratory infections

Background: Globally, respiratory infections contribute to significant morbidity and mortality. However, genetic determinants of respiratory infections are understudied and remain poorly understood. Methods: We conducted a genome-wide association study in 19,459 hospitalised respiratory infection cases and 101,438 controls from UK Biobank. We followed-up well-imputed top signals from the UK Biobank discovery analysis in 50,912 respiratory infection cases and 150,442 controls from 11 cohorts. We aggregated effect estimates across studies using inverse variance-weighted meta-analyses. Additionally, we investigated the function of the top signals in order to gain understanding of the underlying biological mechanisms. Results: In the discovery analysis, we report 56 signals at P<5×10-6, one of which was genome-wide significant (P<5×10-8). The genome-wide significant signal was in an intron of PBX3, a gene that encodes pre-B-cell leukaemia transcription factor 3, a homeodomain-containing transcription factor. Further, the genome-wide significant signal was found to colocalise with gene-specific expression quantitative trait loci (eQTLs) affecting expression of PBX3 in lung tissue, where the respiratory infection risk alleles were associated with decreased PBX3 expression in lung tissue, highlighting a possible biological mechanism. Of the 56 signals, 40 were well-imputed in UK Biobank and were investigated in the 11 follow-up cohorts. None of the 40 signals replicated, with effect estimates attenuated. Conclusions: Our discovery analysis implicated PBX3 as a candidate causal gene and suggests a possible role of transcription factor binding activity in respiratory infection susceptibility. However, the PBX3 signal, and the other well-imputed signals, did not replicate when aggregating effect estimates across 11 independent cohorts. Significant phenotypic heterogeneity and differences in study ascertainment may have contributed to this lack of statistical replication. Overall, our study highlighted putative associations and possible biological mechanisms that may provide insight into respiratory infection susceptibility.

Enhanced national surveillance of severe acute respiratory infections (SARI) within COVID-19 surveillance, Slovenia, weeks 13 to 37 2021.

We monitored trends of severe COVID-19 morbidity in Slovenia during weeks 13 to 37 2021. National weekly rates of severe acute respiratory infections (SARI) cases testing positive for SARS-CoV-2 at admission in all hospitals varied between 0.2 and 16.3 cases per 100,000 population. Of those without previous COVID-19 diagnosis, SARI COVID-19 admission rates ranged between 0.3 and 17.5 per 100,000 unvaccinated, and 0.0 and 7.3 per 100,000 fully vaccinated individuals. National SARI COVID-19 surveillance is essential in informing COVID-19 response.

Experimental Intranasal Immunization against Respiratory Viruses

The most common method of influenza prevention is intramuscular administration of vaccines, which causes a higher antibody response than subcutaneous. However, such routes of antigens administration result in the predominant formation of serum IgG against influenza viruses, while intranasal administration promotes higher titers of both IgG and IgA than intramuscular vaccination. Based on the fact that this infectious agent enters the body through the mucous membranes of the respiratory tract, we developed the concept of local etiologically adequate vaccination, based on the statement that the vaccine should be administered in the same way as the infection, i.e. in cases of respiratory infections it should be intranasal or oral administration of vaccine material. So, the aim of this work was to demonstrate the benefits of local vaccination against respiratory viruses, as well as the use of nanocarriers in such vaccination and possible cross-antigen reactions by hemagglutinin between antigens of influenza virus and severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2). Methods. The study was performed using Wistar rats in 3 series of experiments. At first series we investigated the comparative immune response to influenza Influvac® vaccine (Abbott, The Netherlands) against A and B type influenza viruses, which was administered intranasally, per os and subcutaneously once at a dose of 1.5 μg of hemagglutinin. Animals from group 2were similarly administered with the same amount of vaccine with and without cerium dioxide nanoparticles (CeO2). Animals of group 3 intranasally received an identical volume of sodium chloride solution (placebo control). Rats were removed from the experiment by decapitation one week after the immunization. Tissue homogenates were prepared from the trachea of animals of all groups by homogenization at the rate of 100 mg/mL of 0.9% sodium chloride solution. The homogenates were kept at 2°C for 18 hours and then centrifuged at 120 g for 20 minutes (cold centrifuge NF800R, Turkey). The obtained extracts and sera were stored at a temperature of -20°C until the determination of antibodies titers to hemagglutinins of A and B influenza viruses in the reaction of hemagglutination inhibition and titers of interferons (IFN) -α and -γ and using enzyme-linked immunosorbent assay using Elabscience (USA) reagents and Stat Fax 2100 Microplate Reader (USA). In the 3rd series of experiments, the content of antihemagglutinins in the trachea and serum after immunization of animals with nucleocapsid antigen of SARS-Cov-2 coronavirus (recombinant antigen produced by PJSC SPC “Diaproph-Med”, Ukraine) at a dose of 2.5 μg in 0.2 mL of Hanks’ solution was determined. The antigen was administered intranasally or subcutaneously and then all other steps of the experiments were similar to those described below for the 1st series of experiments. Results. Conducted experimental studies aimed to develop new approaches and technologies for vaccination against respiratory viruses, which enter mainly through the upper respiratory tract, confirm the concept of the feasibility of local intranasal vaccination against influenza and other respiratory viruses. The data obtained during the research confirm more effective appearance of protective local immunity both in terms of humoral immune response and interferon protection of the respiratory tract during intranasal vaccination. The use of cerium dioxide nanoparticles in local vaccination may increase the effectiveness of this approach to stimulate the production of antibodies to influenza virus antigens in the upper respiratory tract. Finally, the advantages of local intranasal immunization with SARS-CoV-2 N-antigens over their systemic administration suggest that local intranasal vaccination against coronavirus antigens may also be more effective than systemic administration of antigens of this virus, which requires further research for clinical trials. Conclusions. Intranasal immunization of animals with influenza A and B virus antigens and N-antigen of SARS CoV-2 is more effective for creating local protective immunity in the respiratory system compared to parenteral administration of the antigen. The use of cerium dioxide nanoparticles together with the vaccine resulted in more effective local immune response to respiratory virus antigens.

Epidemiology of human parainfluenza virus infection in patients with acute respiratory tract infection in Beijing, 2015–2020

Objective To understand the epidemiological characteristics of human parainfluenza virus (HPIV) infection in patients with acute respiratory tract infections (ARIs) in Beijing, and provide support for the development of prevention and control strategies for respiratory infectious diseases. Methods The throat swabs, sputum, bronchoalveolar lavage fluid, tracheal aspirates and other pathogenic samples were collected from the patients with ARIs in 35 sentinel hospitals in Beijing from 2015 to 2020. Multiple real-time PCR was used to detect HPIV-1, HPIV-2, HPIV-3, HPIV-4 and other common respiratory tract viruses. The results were analyzed with SPSS 20.0 and χ2 test was used to compare the rates between groups. Results During 2015–2020, the positive rate of HPIV was 3.90% (1622/41557). HPIV-3 was the mostly detected pathogen, accounting for 58.45%, followed by HPIV-1 (19.17%), HPIV-2 (12.70%) and HPIV-4 (10.79%). The positive rate of HPIV in 2020 (1.65%, 70/4 234) was significantly lower than that during 2015–2019 (4.52%, 1569/37 323). The HPIV infection arte showed a peak every other year. The infection peak of HPIV was from May to July. The incidence trend of HPIV-3 infection was the similar to other HPIVs. The positive rate of HPIV-1 during summer-autumn was higher than that in other seasons. There was no obvious seasonality of HPIV-2 infection. The positive rate of HPIV-4 in autumn was higher than that in other seasons. The positive rate of HPIV in men was lower than that in women. The positive rate in 0–5 years old group was highest (8.81%, 685/7 776), followed by 6–15 years old group (4.07%, 173/4 247), and ≥ 60 years old group (3.25%, 442/13 582). There was significant differences in the positive rate of HPIV-1 and HPIV-3 between upper and lower respiratory tract infection cases ( χ2=4.449, P=0.039; χ2=17.513, P Conclusion HPIV is a common respiratory pathogens in Beijing. The main affecting population of HPIV infection is children under 15 years old. In 2020, the prevention and control of COVID-19 significantly reduced the incidence of HPIV infection.

A Comprehensive Review on Covid-19

: During the past two decades, multiple viral epidemics have emerged, including the epidemics of H1N1 influenza in 2009 and the acute respiratory syndrome coronavirus (SARS-CoV) in 2002 - 2003. Moreover, the middle east respiratory syndrome coronavirus (MERS-CoV) was initially recognized in Saudi Arabia in 2012. Recently, cases of another lower respiratory tract infection (LRTI) were discovered in Wuhan, Hubei province, China, on December 31st 2019, and reported to the WHO country office in the country. Studies in the field have referred to the identification of first symptomatic people in early December 2019. Since experts in the field could not determine the causative agent of the disease, they mistakenly categorized the first reported cases as pneumonia of unknown etiology (PUE). Therefore, the Chinese Center for Disease Control and Prevention (China CDC), as well as local CDCs, arranged a full outbreak investigation plan, ascribing the etiology to a newly discovered virus of the coronavirus (CoV) family (i.e., the causative agent of COVID-19).

Seasonality of Respiratory Viruses at Northern Latitudes

Every year, respiratory viruses exact a heavy burden on Canadian hospitals during winter months. Generalizable seasonal patterns of respiratory virus transmission may estimate the evolution of SARS-CoV-2 or other emerging pathogens. To describe the annual and biennial variation in respiratory virus seasonality in a northern climate. This cohort study is an epidemiological assessment using population-based surveillance of patients with medically attended respiratory tract infection from 2005 through 2017 in Alberta, Canada. Incident cases of respiratory virus infection and infant respiratory syncytial virus (RSV) hospitalizations in Alberta were extracted from the Data Integration for Alberta Laboratories platform and Alberta Health Services Discharge Abstract Database, respectively. A deterministic susceptible-infected-recovered-susceptible mathematical model with seasonal forcing function was fitted to the data for each virus. The possible future seasonal course of SARS-CoV-2 in northern latitudes was modeled on the basis of these observations. The analysis was conducted between December 15, 2020, and February 10, 2021. Seasonal respiratory pathogens. Incidence (temporal pattern) of respiratory virus infections and RSV hospitalizations. A total of 37 719 incident infections with RSV, human metapneumovirus, or human coronaviruses 229E, NL63, OC43, or HKU1 among 35 375 patients (18 069 [51.1%] male; median [interquartile range], 1.29 [0.42-12.2] years) were documented. A susceptible-infected-recovered-susceptible model mirrored the epidemiological data, including a striking biennial variation with alternating severe and mild winter peaks. Qualitative description of the model and numerical simulations showed that strong seasonal contact rate and temporary immunity lasting 6 to 12 months were sufficient to explain biennial seasonality in these various respiratory viruses. The seasonality of 10 212 hospitalizations among children younger than 5 years with RSV was also explored. The median (interquartile range) rate of hospitalizations per 1000 live births was 18.6 (17.6-19.9) and 11.0 (10.4-11.7) in alternating even (severe) and odd (less-severe) seasons, respectively (P = .001). The hazard of admission was higher for children born in severe (even) seasons compared with those born in less-severe (odd) seasons (hazard ratio, 1.68; 95% CI, 1.61-1.75; P < .001). In this modeling study of respiratory viruses in Alberta, Canada, the seasonality followed a pattern estimated by simple mathematical models, which may be informative for anticipating future waves of pandemic SARS-CoV-2.

Analysis of comprehensive surveillance results of respiratory tract infectious diseases in Taizhou, 2012-2019

Objective To understand the epidemiological characteristics of influenza-like illness (ILI) cases and severe acute respiratory infection (SARI) cases in Taizhou, so as to provide a basis for scientific prevention and control strategies. Methods The basic information of ILI and SARI cases and throat swab specimens were collected from the sentinel hospital and 13 respiratory pathogens were detected by RT-PCR method.χ2 test was used as statistical analysis method. Results From April 2012 to December 2019, with epidemic peaks in autumn and winter, the percentages of ILI visits (ILI%) and SARI visits (SARI%) were 7.27% and 2.44%, respectively. Finally, 956 ILI case specimens and 557 SARI case specimens were detected. The positive detection rates of the two types of cases were 50.84% (486/956) and 39.14% (218/557), separately. Streptococcus pneumoniae (SP), influenza virus (Flu), Haemophilus influenzae (HI) and Human rhinovirus (HRV) were the dominant pathogens in Taizhou city from April 2012 to December 2019, and their detection rates were 14.81%, 9.25%, 9.39% and 7.73%, respectively. The total mixed infection rate was 30.11% (212/704), which was mainly caused by SP complicated with other pathogenic infections. The positive rate of pathogen detection in the low-age group was higher than that in the high-age group, and the detection rate of children under 5 years old was 34.83% (χ2=54.47, P Conclusions The incidence of comprehensive respiratory tract surveillance in sentinel hospitals in Taizhou City showed that the peak of the epidemic was in autumn and winter, and SP, Flu, HI, and HRV were main pathogens in this area. In the age group under 15 years old, the detection rate was higher. Comprehensive respiratory disease prevention and control measures should be taken for key populations.

Acute pancreatitis associated with severe acute respiratory syndrome coronavirus-2 infection: a case report and review of the literature

IntroductionWe report a case of Severe acute respiratory syndrome coronavirus-2 infection with acute pancreatitis as the only presenting symptom. To the best of our knowledge, there are few case reports of the same presentation.Case presentationAn otherwise healthy 44-year-old white male from Egypt presented to the hospital with severe epigastric pain and over ten attacks of nonprojectile vomiting (first, gastric content, then bilious). Acute pancreatitis was suspected and confirmed by serum amylase, serum lipase, and computed tomography scan that showed mild diffuse enlargement of the pancreas. The patient did not have any risk factor for acute pancreatitis, and extensive investigations did not reveal a clear etiology. Given a potential occupational exposure, a nasopharyngeal swab for polymerase chain reaction testing for severe acute respiratory syndrome coronavirus 2 was done, which was positive despite the absence of the typical symptoms of severe acute respiratory syndrome coronavirus 2 such as fever and respiratory symptoms. The patient was managed conservatively. For pancreatitis, he was kept nil per os for 2 days and received intravenous lactated Ringer’s (10 ml per kg per hour), nalbuphine, alpha chymotrypsin, omeprazole, and cyclizine lactate. For severe acute respiratory syndrome coronavirus 2, he received a 5-day course of intravenous azithromycin (500 mg per day). He improved quickly and was discharged by the fifth day. We know that abdominal pain is not a rare symptom of severe acute respiratory syndrome coronavirus 2, and we also know that elevated levels of serum amylase and lipase were reported in severe acute respiratory syndrome coronavirus-2 patients, especially those with severe symptoms. However, the association between severe acute respiratory syndrome coronavirus-2 infection and idiopathic acute pancreatitis is rare and has been reported only a few times.ConclusionWe believe further studies should be conducted to determine the extent of pancreatic involvement in severe acute respiratory syndrome coronavirus-2 patients and the possible causality between severe acute respiratory syndrome coronavirus 2 and acute pancreatitis. We reviewed the literature regarding the association between severe acute respiratory syndrome coronavirus 2 and acute pancreatitis patients. Published data suggest that severe acute respiratory syndrome coronavirus 2 possibly could be a risk factor for acute pancreatitis.

POT-003 - Clinical characteristic and outcome of Severe Acute Respiratory Infection (SARI) cases in a tertiary hospital, Malaysia: A descriptive study

POT-003 - Clinical characteristic and outcome of Severe Acute Respiratory Infection (SARI) cases in a tertiary hospital, Malaysia: A descriptive study

Immunogenicity, safety and efficacy of 23-valent pneumococcal polysaccharide vaccine in patients with inflammatory joint diseases (preliminary data)

Intoduction.Currently, for the treatment of patients with rheumatoid arthritis (RA) and spondyloarthritis (SpA), basic anti-inflammatory drugs and biological drugs are widely used to effectively control the activity of the disease. However, the use of these drugs is associated with an increased risk of developing comorbid infections, some of which can be prevented by vaccination. Objective. To evaluate the immunogenicity, safety, and clinical efficacy of the 23-valent pneumococcal polysaccharide vaccine (PPV-23) in patients with RA and SpA.Materials and methods. The study included 122 patients: 79 - with RA, 43-with SpA. Most patients had a history of two or more cases of lower respiratory tract infections, 2 patients reported a monthly exacerbation of chronic sinusitis, one patient reported the development of otitis media every 2-3 months. At the time of inclusion in the study, most patients received immunosuppressive therapy. PPV-23 was administered in an amount of 1 dose (0.5 ml) subcutaneously against the background of anti-rheumatic therapy. The level of antibodies to pneumococcal capsular polysaccharide was determined using the EIA PCP IgG kit (TestLine Clin-ical Diagnostics s.r.o., Czech Republic) before vaccination, 1, 3 and 12 months after vaccination. In addition, the tolerance of PPV-23, the frequency of pneumonia, and the effect on the activity of RA and SpA were evaluated (according to the dynamics of DAS28 and BASDAI).Results.At 1, 3, and 12 months after vaccination, the concentration of antibodies to pneumococcal capsular polysaccharide was significantly higher than the baseline values, which indicates sufficient immunogenicity of PPV-23. There was no negative effect of vaccination on the activity of the underlying disease and the occurrence of new autoimmune disorders. In the majority of patients (67% - RA, 81.4% - SpA), the tolerance of the vaccine was good. During the follow-up period, none of the patients developed pneumonia. Patients suffering from frequent sinusitis and otitis media reported the absence of these infections after vaccination.Conclusion.Preliminary results of the study indicate sufficient immunogenicity, safety, and clinical efficacy of PPV-23 in patients with RA and SpA.

Viral pathogenic spectrum analysis of severe acute respiratory infection cases in Luohe City, Henan province from 2017 to 2019

Objective: The purpose of this study was to investigate the characteristics of viral pathogen spectrum and the epidemiological characteristics of each viral pathogen in hospitalized cases associated with severe acute respiratory infection (SARI) in Luohe City, Henan Province from 2017 to 2019. Methods: Based the SARI Case Surveillance Platform, SARI cases were collected in Central Hospital of Luohe City, Henan Province from November 2017 to February 2019. In the end, 783 SARI cases were included, whose throat swabs were taken within 24 h of admission, as well as their demographic characteristics, onset time, clinical characteristics and other information recorded. At the same time, viral identification was performed, and the age and time distribution of each virus were analyzed. Results: The age of 783 SARI cases shown as M (P25, P75) was 3 (1, 5) years old, ranging from 1 month to 95 years old. Children under 5 years old were the majority (71.01%). The males (61.81%) were more than females (38.18%). Among the 783 SARI cases, a total of 9 kind of viruses were identified with 64.88% (508/783) of the throat swabs tested positive for at least one virus. The positive rate of influenza virus and human respiratory syncytial virus were both 20.18% (158 cases), which was the highest among all the detected respiratory virus. The co-infection rate was 15.84% (124/783), among which double infection was the most common, accounting for 85.48% (106/124) of the co-infected cases. And human respiratory syncytial virus, human rhinovirus and influenza virus were the most common pathogen in co-infection cases. Moreover, the viral positive rate was 68.71% in children aged 5 years and 63.27% in people aged 60-95 years. Influenza and human respiratory syncytial virus dominated in winter and spring, while human parainfluenza virus was the main infection in summer. Conclusion: Influenza virus and human respiratory syncytial virus were the main viruses in throat swabs of SARI cases from 2017 to 2019 in Luohe City, Henan Province. There were differences in the age and seasonal epidemiological characteristics of each virus.

Coronavirus 2019-like illness and public adherence to preventive measures, Sudan 2020.

SummaryIntroductionIn December 2019, a novel corona virus disease was identified and was responsible for the new cases of respiratory tract infections in Wuhan, China. This virus was responsible for the pandemic with more than 84 million cases and 1.82 million deaths worldwide. In Sudan till now the reported cases exceed 23,000 with 1.400 deaths. This study aims to determine the prevalence of COVID-19 suspected cases, health seeking behavior and public adherence to protective measures.MethodsDescriptive community based cross-sectional study using nonprobability snowball sampling technique, conducted in Khartoum state 2020. 3499 respondents with diverse socio-demographic backgrounds were finally enrolled in the study. Data was collected through Manitoba Coronavirus 2019 screening form which distributed through online anonymous Google forms. Data was entered and analyzed by Statistical Package of Social Sciences version 23.ResultsThe study revealed that 26.5% of the respondents were clinically suspected with headache or fatigability being the most common symptom followed by pharyngitis and then dry cough. Asthma and chronic respiratory disease as the commonest comorbidities. Wearing facial masks and regular hand washing were found to be the most used protective measures with only 39.4% implicates social distancing in their daily life. Health seeking behavior was significantly different among suspected respondents the majority tend to use antibiotics than to isolate themselves or undergo testing.ConclusionCOVID-19 suspected cases were prevalent among Sudanese population; screening capacity has to be increased with more strong policies for implications of personal protective measures in the daily life.

Study to determine the correlation of platelet-lymphocyte ratio in COVID 19 positive and negative severe acute respiratory infections cases

Background: Severity of COVID 19 disease is related to the systemic inflammatory response triggered by the respiratory virus. Hematological alterations triggered by inflammation can be used as a marker to predict the severity of COVID 19 infection.Methods: 155 patients of severe acute respiratory infections (SARI) defined by World Health Organization (WHO) criteria of which 65 were COVID positive and 90 COVID negative were taken for the study. Demographic profile of the population and platelet count, lymphocyte count and platelet lymphocyte ratio was compared between COVID 19 positive and negative SARI cases using appropriate descriptive statistics. Correlation analysis done for the same parameters between severe and moderate COVID 19 SARI cases.Results: Median platelet count in COVID positive group (2.47 L) was lower than that of COVID negative group (2.65 L) and was not statistically significant between 2 groups. Median lymphocyte count in COVID positive group (651) was lower compared to the negative group (1250) and difference was statistically significant. PLR in COVID positive group was higher (353) than COVID negative group (198) and was statistically significant (p value 0.00). PLR was higher in severe COVID disease compare to moderate disease but difference was not statistically significant. No significant correlation was found in platelet count, lymphocyte count in moderate and severe COVID positive SARI cases.Conclusions: Lower lymphocyte counts was observed in SARI caused by COVID 19 infection than other causes of SARI. No significant correlation was found in platelet count between COVID positive and negative SARI cases. PLR was significantly higher in COVID positive SARI cases as compared to COVID negative SARI cases. Platelet lymphocyte ratio (PLR) was higher in severe COVID disease when compared to moderate disease but levels did not reach statistical significance.