Prevention Of Respiratory Virus Infection Research Articles

Prevalence of Respiratory Viral Infections in Deceased Persons during the COVID-19 Pandemic Season 2021-2022: A Population-Based Observational Study.

Although the omicron variant of SARS-CoV-2 circulated intensely during the 2021-2022 season, many patients with severe acute respiratory disease tested negative for COVID-19. The aim of this study was to assess the presence of different respiratory viruses in deceased persons. The proportion of deceased persons with respiratory viral infections in the 2021-2022 season in Navarre, Spain, was estimated considering all deaths caused by confirmed COVID-19 according to the epidemiological surveillance and the results of multiplex PCR tests for respiratory viruses performed in a sample of deceased persons with a cause of death other than COVID-19. Of 3578 deaths, 324 (9.1%) were initially reported as caused by pre-mortem confirmed COVID-19. A sample of 242 persons who died by causes other than COVID-19 were tested post-mortem; 64 (26.4%) of them were positive for any respiratory virus: 11.2% for SARS-CoV-2, 5.8% for rhinovirus, 3.7% for human coronavirus, 2.5% for metapneumovirus, 1.7% for respiratory syncytial virus, 1.7% for parainfluenza, 1.2% for influenza, and less than 1% each for adenovirus and bocavirus. Combining both approaches, we estimated that 34.4% of all deceased persons during the study period had a respiratory viral infection and 19.2% had SARS-CoV-2. Only 33.3% (9/27) of SARS-CoV-2 and 5.0% (2/40) of other viruses detected post-mortem had previously been confirmed pre-mortem. In a period with very intense circulation of SARS-CoV-2 during the pandemic, other respiratory viruses were also frequently present in deceased persons. Some SARS-CoV-2 infections and most other viral infections were not diagnosed pre-mortem. Several respiratory viruses may contribute to excess mortality in winter.

Prevalence and Predictors for Respiratory Viral Infections among Liver Disease Patients.

Respiratory viral infections (RVIs) cause significant hospitalizations every year. Also, RVIs caused by either influenza or noninfluenza group of viruses can have adverse outcomes, especially among immunosuppressed patients. Regular and timely supervision is needed for accurate etiological identification, to prevent inappropriate use of antibiotics in patients with nonbacterial etiology. This study aimed to identify the spectrum of RVIs and clinical characteristics among liver disease patients with influenza-like illness (ILI). In this study, medical records of patients with ILI, whose requests for respiratory viral testing came from September 2016 to December 2022 were retrospectively reviewed. Respiratory viruses were identified using FilmArray 2.0 respiratory panel (BioFire Diagnostics, USA). Of the 1,577 liver disease patients with ILI, the overall prevalence of RVI was 28% (n = 449). Infection by noninfluenza viruses (NIVs) was detected in 329 patients (73%), higher than those infected with influenza viruses. In multivariable logistic regression analysis, female gender [odds ratio (OR): 2.5, 95% confidence interval (CI): 1.5-4.2], infection with influenza B (OR: 3.3, 95% CI: 1.09-9.9) and decompensated cirrhosis (OR: 3.9, 95% CI: 1.7-8.5) were independent risk factors for mortality. Regarding seasonality, influenza peaked in monsoons and winters, whereas NIVs circulated throughout the year. Overall, this study adds new knowledge regarding the incidence of RVI and the distribution of respiratory viral etiologies among liver disease patients with ILI. The findings highlight that female gender, decompensated cirrhosis, and influenza B infection are independently associated with poor clinical outcomes. Early etiological identification of viral causes of ILI could aid in an enhanced understanding of the prevalence of ILI and the timely management of the patients. Respiratory viral infections can cause severe illness in individuals with underlying liver disease. Accurate diagnosis and risk stratification is crucial in mitigating the adverse health effects. Samal J, Prabhakar T, Prasad M, et al. Prevalence and Predictors for Respiratory Viral Infections among Liver Disease Patients. Euroasian J Hepato-Gastroenterol 2023;13(2):108-114.

Revisiting the personal protective equipment components of transmission-based precautions for the prevention of COVID-19 and other respiratory virus infections in healthcare.

The COVID-19 pandemic highlighted some potential limitations of transmission-based precautions. The distinction between transmission through large droplets vs aerosols, which have been fundamental concepts guiding infection control measures, has been questioned, leading to considerable variation in expert recommendations on transmission-based precautions for COVID-19. Furthermore, the application of elements of contact precautions, such as the use of gloves and gowns, is based on low-quality and inconclusive evidence and may have unintended consequences, such as increased incidence of healthcare-associated infections and spread of multidrug-resistant organisms. These observations indicate a need for high-quality studies to address the knowledge gaps and a need to revisit the theoretical background regarding various modes of transmission and the definitions of terms related to transmission. Further, we should examine the implications these definitions have on the following components of transmission-based precautions: (i) respiratory protection, (ii) use of gloves and gowns for the prevention of respiratory virus infections, (iii) aerosol-generating procedures and (iv) universal masking in healthcare settings as a control measure especially during seasonal epidemics. Such a review would ensure that transmission-based precautions are consistent and rationally based on available evidence, which would facilitate decision-making, guidance development and training, as well as their application in practice.

Probiotics in treatment of respiratory viral infections

Acute respiratory viral infections (RVI) traditionally lead in frequency of morbidity and frequency of visits to medical institutions. RVI affects people of completely different ages, including children and the elderly, whose diseases occur with more severe symptoms and a higher risk of complications. The study of the pathogenesis, optimization of treatment and prevention of RVI is extremely relevant and has special significance in the time of the COVID-19 pandemic. On the other hand, quite a large number of people on the planet have disorders of the gut microbiota, which negatively affects the metabolic process, the state of immunity and may underlie the development of systemic inflammatory reactions. In situation of gut dysbiosis, a more severe and prolonged duration of RVI is noted, which may be associated with a change in the immunological effects of the gut microbiota, the insufficiency of a number of factors of local and common immunity and a disorder of the functioning of the ‘gut-lungs’ axis. Pathogenetically justified the usage of medications (probiotics) for the correction of gut microbiota disorders in patients with RVI, including those taking antibiotics for bacterial complications. Probiotics have immunomodulatory effects. They can directly inhibit the attachment of the virus to the receptor of the host cell, and also contribute to the improvement of cellular, humoral and local immunity.

Role of Polymerase Chain Reaction-Based Diagnosis of Respiratory Viruses in Febrile Neutropenic Patients.

Background Neutropenic patients are commonly affected by respiratory infections, whereas respiratory viral infections causing high morbidity and mortality are routinely diagnosed in developing countries like India. Our study aimed to investigate the prevalence of respiratory viral infections in pediatric cancer patients with febrile neutropenia. Methods This prospective study was performed on 45 neutropenia patients with hematological malignancies. Nasal swabs were collected and analyzed by real-time multiplex polymerase chain reaction (PCR), covering the following viruses: influenza A virus, influenza B virus, human parainfluenza virus (subtypes 1-4), human respiratory syncytial virus A and B, enterovirus, human-coronavirus (HCoV: HKU1, NL63, 229E, and OC43), human bocavirus, adenovirus, human rhinovirus, human-metapneumovirus A and B, human paraechovirus, and a bacteriumMycoplasma pneumoniae. Patients enrolled in the study since the COVID-19 pandemic was also detected for the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Results Of the 45 cases included in our study, 26 cases showed the presence of at least one positivity by PCR (57.7%): 23 patients had monoinfection with only one virus, two patients were found positive for coinfection with two viruses, and one patient was found positive for three viruses. The most detected viruses were human rhinovirus (26.9%, n=7) and coronavirus 19 (19.2%, n=5). A total of 11.5% of the patients had multiple viral infections. About 19 (42.2%) of the patients enrolled in our study had no viral pathogen detected. Conclusion We found that respiratory viruses contribute significantly to the development of neutropenic fever, as evidenced by the results of our prospective study. Individualizing infection treatment can reduce antibiotic use in immunocompromised patients. Thus, routine screening for viremia may be warranted in this clinical setting.

Face Masks and Prevention of Respiratory Viral Infections: An Overview

Airborne transmission of respiratory viruses consists of three sequential steps: (1) release of respiratory fluids in the form of droplets from the nose and mouth of an infected person, (2) transport of the droplets through air, and (3) entry of the droplets into the nose and mouth of an uninfected individual. Talking, coughing, and sneezing emit droplets across a spectrum of sizes. The water in exhaled droplets begins to evaporate in air and, as a result, the droplets are reduced in size shortly after being emitted. Face masks are effective for capturing droplets just released from the nose and mouth. Studies indicate that more than 50% of community transmission of SARS-CoV-2 is from asymptomatic and pre-symptomatic cases. Use of face masks by the public can effectively reduce the chance of infected individuals unknowingly spreading the virus. In addition to being an effective device for source control, face masks can protect the wearers from inhaling virus-laden droplets. Cloth masks and disposable masks provide reasonable protection for the public, while surgical masks and N95 respirators give higher levels of protection as needed in healthcare settings. Made with varied materials, these masks have different structural characteristics. The collection efficiency of a face mask depends on droplet size, face velocity, and the structural characteristics of the mask. For a given mask, capturing droplets is more effective during exhalation than during inhalation. Pressure drop across the mask should be taken into consideration when selecting a face mask. The best face mask is the one that gives the highest collection efficiency with the least pressure drop. For an effective protection, a mask should fit the face properly. While face masks have proven adequate in reducing airborne transmission of SARS-CoV-2 infections, continuous improvement is needed to better prepare for future respiratory viral threats.

Can bacterial lysates be useful in prevention of viral respiratory infections in childhood? The results of experimental OM-85 studies.

Respiratory tract infections (RTI) are mainly viral in origin and among the leading cause of childhood morbidity globally. Associated wheezing illness and asthma are still a clear unmet medical need. Despite the continuous progress in understanding the processes involved in their pathogenesis, preventive measures and treatments failed to demonstrate any significant disease-modifying effect. However, in the last decades it was understood that early-life exposure to microbes, may reduce the risk of infectious and allergic disorders, increasing the immune response efficacy. These results suggested that treatment with bacterial lysates (BLs) acting on gut microbiota, could promote a heterologous immunomodulation useful in the prevention of recurrent RTIs and of wheezing inception and persistence. This hypothesis has been supported by clinical and experimental studies showing the reduction of RTI frequency and severity in childhood after oral BL prophylaxis and elucidating the involved mechanisms. OM-85 is the product whose anti-viral effects have been most extensively studied in vitro, animal, and human cell studies and in translational animal infection/disease models. The results of the latter studies, describing the potential immune training-based activities of such BL, leading to the protection against respiratory viruses, will be reported. In response to human rhinovirus, influenza virus, respiratory syncytial virus and severe acute respiratory coronavirus-2, OM-85 was effective in modulating the structure and the functions of a large numbers of airways epithelial and immune cells, when administered both orally and intranasally.

Studying expression of IL-1β gene under the action of siRNA complexes with anti-influenza effect

Influenza is one of the most urgent global health problems today. The influenza virus has immunosuppressive properties, which can lead to the development of secondary immunodeficiencies, interfering with the functioning of the interferon system activation, thus leading to impaired production of pro-inflammatory cytokines. IL-1 is the most important player in development of antiviral immunity. This cytokine plays an important role in boosting the expression of the MCP-1 and MCP-3 genes and maturation of macrophages and dendritic cells. Induction of IL-1 production occurs due to interaction of the ligand with Toll-like receptors. Currently, there is a lot of drugs aimed at the prevention and treatment of influenza infection. However, their use in some cases is difficult due to high mutational variability of the influenza virus, thus making it resistant to these drugs. Therefore, the issue of developing and creating effective methods to combat such infections is of particular importance. A promising approach to the treatment and prevention of viral respiratory infections may be connected with RNA interference. This process consists of degradation of foreign mRNA by small interfering RNA (siRNA) molecules. The aim of the present study was to evaluate expression of the IL-1 gene upon transfection of miRNA complexes directed to the cellular FLT4, Nup98, Nup205 genes. Evaluation of changed viral reproduction was carried out using titration by CPE virus-containing fluid. Expression level of the IL-1 gene was determined by means of real-time RT-PCR. Assessment of the changes in viral reproduction allowed us to reveal that the use of all the miRNA complexes directed to the cellular genes lead to a significant decrease in viral reproduction on the 1st day after infection. Usage of Nup205 + FLT4 and FLT4 + Nup205 + Nup98 complexes proved to cause a decrease in viral reproduction on the second day as well (p 0.05), as compared with nonspecific and viral controls. When analyzing expression profile of the IL-1 gene, an increase in its expression was observed on the 1st day for all miRNA complexes and on the 2nd and 3rd days for the Nup98 + FLT4 and Nup205 + Nup98 complexes. In the course of the study, it was found that suppression of the cellular genes FLT4, Nup98 and Nup205 activities, which are necessary for viral reproduction, led to a significant decrease in viral activity and an increase in IL-1 expression.

Modulation of Alveolar Macrophages by Postimmunobiotics: Impact on TLR3-Mediated Antiviral Respiratory Immunity.

Beneficial microbes with immunomodulatory capacities (immunobiotics) and their non-viable forms (postimmunobiotics) could be effectively utilized in formulations towards the prevention of respiratory viral infections. In this study, novel immunobiotic strains with the ability to increase antiviral immunity in porcine alveolar macrophages were selected from a library of Lactobacillus gasseri. Postimmunobiotics derived from the most remarkable strains were also evaluated in their capacity to modulate the immune response triggered by Toll-like receptor 3 (TLR3) in alveolar macrophages and to differentially regulate TLR3-mediated antiviral respiratory immunity in infant mice. We provide evidence that porcine alveolar macrophages (3D4/31 cells) are a useful in vitro tool for the screening of new antiviral immunobiotics and postimmunobiotics by assessing their ability to modulate the expression IFN-β, IFN-λ1, RNAseL, Mx2, and IL-6, which can be used as prospective biomarkers. We also demonstrate that the postimmunobiotics derived from the Lactobacillus gasseri TMT36, TMT39 and TMT40 (HK36, HK39 or HK40) strains modulate the innate antiviral immune response of alveolar macrophages and reduce lung inflammatory damage triggered by TLR3 activation in vivo. Although our findings should be deepened and expanded, the results of the present work provide a scientific rationale for the use of nasally administered HK36, HK39 or HK40 to beneficially modulate TLR3-triggerd respiratory innate immune response.

Respiratory Virus infections in symptomatic and asymptomatic children: Results of one year of hospital admission screening

Background: Respiratory viral infections are very common among children. Transmission-based precautions are frequently used with patients who test positive for a respiratory virus in pediatric hospitals to prevent transmission of infections, regardless of whether the patient has symptoms of a respiratory infection or not (asymptomatic). However, few data are available on the prevalence of respiratory viral infections in symptomatic and asymptomatic children who are admitted to a pediatric hospital. The study was conducted in 3 hospitals that combine for a 601-bed pediatric healthcare system in northern Texas. Methods: From July 7, 2020, to the present, all patients admitted to the hospital had a nasopharyngeal swab collected and tested with a multiplex PCR panel including SARS-CoV-2 and 8 other common respiratory viruses. Over a 1-year period from October 1, 2020, to September 30, 2021, the prevalences of infection with each of the 9 respiratory viruses were calculated and stratified by respiratory infection symptom status (determined by the ordering provider in an electronic order set) and age group. Results: During this 1-year period, 28,421 PCR panels were collected on patients admitted to the hospital. The median age was 5 years (IQR, 1–12 years), and 15,105 patients were male (53.2%). Overall, 12,792 panels were positive for at least 1 virus (45.0%). Among 26,688 panels on individuals with known symptom status, 26.3% of asymptomatic patients and 69.4% of symptomatic patients tested positive for at least 1 virus. The most common virus was rhinovirus or enterovirus (17.7% asymptomatic positive and 40.2% symptomatic positive) (Fig. 1). Asymptomatic rhinovirus or enterovirus prevalence varied by age group and was greatest in children aged 1–4 years (31.7%) and those aged 5–9 years (23.1%). It was lowest in adolescents aged 15–21 years (7.1%) (Fig. 2). Over time, the prevalence of asymptomatic infections fluctuated with local outbreaks. For SARS-CoV-2, in the resolution phase of an outbreak the prevalence of asymptomatic infections tended to overlap or surpass symptomatic infections. Conclusions: Asymptomatic respiratory viral infections, and in particular rhinovirus or enterovirus infections, were common among pediatric patients admitted to the hospital during the COVID-19 pandemic and were most common among children aged 1–9 years. However, symptomatic patients were still more likely to test positive for a respiratory virus compared to asymptomatic patients. Prolonged shedding of SARS-CoV-2 may explain why asymptomatic prevalence surpasses symptomatic prevalence in the resolution phase after outbreaks.Funding: NoneDisclosures: None

RESPIRATORY VIRAL INFECTION IN NEONATES CLINICALLY DIAGNOSED AS BACTERIAL SEPSIS

Respiratory viral infections in neonatal intensive care units (NICUs) can cause significant morbidity and mortality. Testing for viral pathogens is not routinely done in many NICUs. Their clinical presentations are unpredictable and on infant sepsis evaluation, bacterial cultures are frequently sterile. The study aimed to estimate the prevalence of respiratory viral infections among neonates clinically diagnosed with sepsis using multiplex polymerase chain reaction (PCR).

The use of interferons in the treatment of viral infections

The article presents an analysis of current information on approaches, pathogenetic features and the use of interferons in the treatment of viral infections. the types and biological characteristics of interferons, which are an integral part of the antiviral defense of the body, are described. The validity of the use of interferon preparations for the treatment and prevention of respiratory viral infections has been analyzed, taking into account information about the mechanisms of their action.

Prevalence of Respiratory Viral Infections in Children with Asthma in Kermanshah

Background: Asthma is a chronic inflammatory disorder of lung airways, affecting about 300 million people worldwide. Several risk factors are involved in asthma development, such as environmental allergens, genetic susceptibility, and respiratory viral infections. Viral infections induce NF-kB and inflammatory pathways that lead to the production of cytokines, chemokines, and inflammatory proteins and, finally, a reduction of lung volume and function. Objectives: The aim of this study was to evaluate viral infections’ prevalence in children with asthma from 2016 to 2017. Methods: One hundred throat swab samples were collected from asthmatic children. Extraction of RNA and cDNA synthesis were performed to recognize parainfluenza viruses, rhinoviruses, influenza viruses, and respiratory syncytial virus (RSV) using real-time PCR. Also, the associations of age, sex, and other studied factors with asthmatic attacks were evaluated. Results: In this study, 41 viruses were detected, including 21 cases of rhinoviruses (51.22%), 10 cases of parainfluenza (24.39%), seven cases of respiratory syncytial virus (17.07%), and three cases of the influenza virus (7.32%). Regarding seasonal incidence, the prevalence of the viruses was high in autumn and winter, and there was a significant relationship between seasonal incidence and gender. However, there were no statistically significant relationships between the prevalence of the viruses and age or gender. Conclusions: The most important viral causes of childhood asthma in this study were found to be rhinoviruses, followed by parainfluenza. The lowest prevalence was related to the RSV and influenza virus, which the two viruses also showed the lowest seasonal outbreaks. Therefore, it can be said that with an increase in the seasonal incidence of respiratory viruses, the effects of these viruses will be greater on asthma.

Update Alert 5: Masks for Prevention of Respiratory Virus Infections, Including SARS-CoV-2, in Health Care and Community Settings.

LettersApril 2021Update Alert 5: Masks for Prevention of Respiratory Virus Infections, Including SARS-CoV-2, in Health Care and Community SettingsFREERoger Chou, MD, Tracy Dana, MLS, Rebecca Jungbauer, DrPH, and Chandler Weeks, MPHRoger Chou, MDPacific Northwest Evidence-based Practice Center and Oregon Health & Science University, Portland, OregonSearch for more papers by this author, Tracy Dana, MLSPacific Northwest Evidence-based Practice Center and Oregon Health & Science University, Portland, OregonSearch for more papers by this author, Rebecca Jungbauer, DrPHPacific Northwest Evidence-based Practice Center and Oregon Health & Science University, Portland, OregonSearch for more papers by this author, and Chandler Weeks, MPHPacific Northwest Evidence-based Practice Center and Oregon Health & Science University, Portland, OregonSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L21-0116 SectionsSupplemental MaterialAboutVisual AbstractPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail This is the fifth update alert for a living rapid review on the use of masks for prevention of respiratory virus infections, including SARS-CoV-2, in health care and community settings (1). The first 3 updates were monthly, and the interval was switched to bimonthly for subsequent updates. Update searches were done from 3 December 2020 to 2 February 2021, using the same search strategies as the original review. The update searches identified 613 citations. Two studies (2, 3) on the use of masks and the prevention of SARS-CoV-2 were added for this update: 1 study (2) was done in a community setting, and the other (3) was done in a health care setting (Supplement Tables 1 to 3).On the basis of evidence from 1 randomized controlled trial (4) and 2 observational studies (5, 6), the strength of evidence for mask use versus nonuse for the prevention of SARS-CoV-2 in community settings was previously assessed as low for a small reduction in risk for infection with any mask use (Supplement Table 4). One new cross-sectional study done in Vermont reported an imprecise estimate for the association between wearing a mask (type unspecified) outside of a work environment or not wearing a mask and SARS-CoV-2 infection risk (odds ratio, 2.35 [95% CI, 0.67 to 8.25]) (Supplement Table 3) (2). Mask use was not included in multivariable models; in addition, the study had methodological limitations, including potential selection and recall bias and low participation and SARS-CoV-2 testing rates among eligible participants. Therefore, the strength of evidence for any mask use versus nonuse in community settings remains low (Supplement Table 4). Other strength-of-evidence ratings related to mask use in community settings were unchanged because of no new evidence.The evidence on various comparisons of mask use in health care settings and risk for SARS-CoV-2 infection was previously assessed as insufficient on the basis of 5 observational studies with methodological limitations (Supplement Table 4) (7–11). One new study done in 500 U.S. hospital workers in a high-prevalence area (SARS-CoV-2 seropositivity, 27%) was added for this update (3). In this study, only 2 hospital workers reported no mask use. Although the study evaluated N95 use only, surgical mask use only, or N95 and surgical mask use, analyses were of limited usefulness because the comparison group was any other mask use, including other types of masks or nonuse (for example, N95 only was compared with the combination of surgical mask only, N95 and surgical mask, or no mask use). In addition, estimates were imprecise, except for N95 and surgical mask use (odds ratio, 0.63 [CI, 0.41 to 1.0]). The comparison of N95 only versus surgical mask only favored the N95, but the difference was not statistically significant (odds ratio, 0.60 [CI, 0.31 to 1.15]). The study had methodological limitations, including no adjustment for confounders and potential recall and selection bias. On the basis of these limitations and because of inconsistent results across studies, evidence for N95 versus surgical mask use and other comparisons involving mask use and risk for SARS-CoV-2 infection in health care settings remains insufficient (Supplement Table 4).No new studies evaluated the effects of mask use and risk for SARS-CoV-1 infection, Middle East respiratory syndrome–CoV infection, or influenza or influenza-like illness. As with prior updates, there were no new studies on the effectiveness and safety of mask reuse or extended use.

Role of “NAFLAN” Immune (Nasal/ Oral) Spray in Prevention of Respiratory Virus Infections (Including COVID 19) in Indian Volunteers: The Preliminary Report of a Phase 1 Clinical Trial

Background & Object൴ves: The Immune-modulat൴ng Nutr൴t൴onal Supplements based on Grapeseeds r൴ch ൴n Sterols and V൴tam൴ns can be useful ൴n Management of Resp൴ratory V൴ral ൴nfect൴ons ൴nclud൴ng COVID 19, but stud൴es reveal൴ng the൴r comb൴ned eff ects are lack൴ng ൴n l൴terature. Therefore the German manufactured Oro-Nasal Immune spray (NAFLAN- A Nutr൴t൴onal Supplements Product) based on comb൴nat൴on of Plant Sterols & V൴tam൴n, B, D, E needs urgent explorat൴on ൴n context of Preva൴l൴ng COVID 19 Pandem൴c across the world ൴nclud൴ng Ind൴a. Methods: Th൴s cl൴n൴cal tr൴al was done on 40 healthy Volunteers, as part of a Phase 1 tr൴al Project of Pure Derm GmBH, Germany for ൴ts evaluat൴on ൴n Management of Resp൴ratory Infect൴ons ൴nclud൴ng COVID 19. The volunteers were selected from an NGO Hosp൴tal and th൴s tr൴al was enrolled at CTRI ICMR Ind൴a and conducted accord൴ng to WHO, PATH & CONSORT gu൴del൴nes . Tr൴al was done from 15th March 2021- 15th June 2021 ൴n wh൴ch th൴s Immune spray was used for 1 month (1st May 2021- 31st May). Th൴s Cl൴n൴cal tr൴al ൴ncluded all types of COVID 19 ൴nclud൴ng Ind൴an Mutat൴on Delta Var൴ant. Results: Symptoms such as Cough and D൴arrhoea were reduced s൴gn൴f൴cantly after use of Immune( Nafl an Spray) [χ2 =9.25 (Yates Correct൴on), P <0.05, RR Adjusted=1.8, 95% C.I=1.5-2.1], but no eff ect on h൴gh fever, headache, and Common cold were seen. Interpretation & Conclusions: Nafalan Spray can be useful in Prevention of Cough in Respiratory Infections (possibly also COVID 19). However Large scale Multicentric trial is however advocated by authors before reaching a more defi nite conclusion of role of Nafalan Spray in Prevention of COVID 19 Infection.

Respiratory syndrome coronavirus-2 response: Microbiotaas lactobacilli could make the difference.

Coronavirus disease 2019 (COVID-19) is caused by respiratory syndrome coronavirus qualified as SARS-CoV-2. Viral penetration requires binding of the viral spike (S) protein to a specific cellular receptor (ACE2) highly expressed in a nasal goblet and ciliated cells. In several countries, the COVID-19 evolution was relatively benign compared to others and despite noncompliance with health recommendations on several occasions. In this overview, we attempt to define the criteria that could explain such a difference. Among these criteria, the specificity of Lactobacillus genus strains, as a part of nasal microbiota, could play a role of a barrier against viral penetration and could strengthen the host's immune system in some populations rather than others. In fact, several studies have shown the role of lactic acid bacteria, including lactobacilli, in the prevention of viral respiratory infections. This could provide important information on a possible mechanism of the virus spreading.

Knowledge, Practices, and Attitude of University Students towards the Prevention of Viral Respiratory Infection (COVID-19)

Background: COVID-19 has affected the educational system, particularly students of higher educational institutions. Accurate knowledge about the disease, its transmission, and preventive measures are critical for containing an outbreak. University students, the next generation of professionals, may play an imperative role in propagating key health information to society.
 Objectives: The study aims to assess the level of knowledge, the attitude of concern, and prevention practices among university students towards COVID-19 prevention.
 Methods: This descriptive study was conducted at a private higher educational institution in Central Luzon, Holy Angel University. 357 university students were recruited as study participants from the university's different departments using the purposive sampling method, and data were collected using an online self-administered questionnaire.
 Results: Among the 357 university students who completed the questionnaires, most were females (58.5%). The results show a good level of attitude of concern and good knowledge of clinical manifestations of COVID-19. The students' most frequently stated source of transmission is exposure to coughing and sneezing via droplets. Additionally, wearing face masks was the most reported method of protection against the infection.
 Conclusion: The study revealed that university students have adequate knowledge, practices, and attitude of concern towards COVID-19. To bridge the gap between current and required knowledge, it is essential to establish further professional educational campaigns to increase university students' awareness of the pandemic.

Prevalence of respiratory viral infections in Ukraine in the context of global warming

The International Panel on Climate Change and the World Meteorological Organization confirms risks of global warming. There is a growing interest in the prevalence of respiratory viral infections due to the current climate change. The aim of the research was to study and analyze the dynamics of prevalence of acute respiratory viral infections/influenza for 2006–2018 in Ukraine in relation to global warming. Materials and methods. In the course of the research, information and analytical reports provided by the Ternopil Regional Laboratory Center of the Ministry of Health of Ukraine on the incidence of respiratory viral infections in 24 regions of Ukraine and the Autonomous Republic of Crimea were used. Results. In Kyiv, Vinnytsia, Rivne, Sumy, Volyn, Zhytomyr, Kirovohrad, Zaporizhia, Zakarpattia, Khmelnytsky, Cherkasy, Odesa, Kherson, and Mykolayiv regions, there was an annual grow of morbidity, with varying degree, compared to 2006. In Poltava, Ternopil and Chernihiv regions level of viral infection was lower than in 2006 only in two or three years of the 12-year research period. In Ivano-Frankivsk, Chernivtsi and Dnipropetrovsk regions, about half of the studied years were characterized by the grow of morbidity from influenza compared to 2006, and in other years after the decrease there was a tendency to increase of morbidity from influenza. Only in Lviv and Kharkiv regions the level of morbidity from respiratory viral infection was higher only in 2007 and 2009 compared to 2006. In Luhansk, Donetsk regions and the Autonomous Republic of Crimea, in the period 2007–2013 the grow of influenza prevalence was observed compared to 2006. Conclusion. Thus, in the context of increasing global warming in Ukraine from 2006 to 2018, there was a higher level of influenza/acute respiratory viral infections, compared to the period up to 2006. Keywords: respiratory viral infections, global warming.

Bioregulatory therapy in the treatment and prevention of upper respiratory tract diseases in children

Influenza and other acute respiratory viral infections (ARVI) are among the most widespread infectious diseases, accounting for up to 90—95% annually in the structure of the registered infectious morbidity. According to the World Health Organization (WHO), every adult on average a year suffers from respiratory infections 2 times, a schoolchild — 3 times, a preschool child - 6 times. Currently, among this group of infections, only influenza is controlled by annual immunoprophylaxis. According to the results of numerous studies, it has been found that with timely vaccination, flu can be prevented in 80–90% of children and adults. It should also be noted that in the vaccinated, the disease proceeds in a milder form and without complications. Therefore, specific immunoprophylaxis against influenza is the most effective means of protecting a susceptible organism, helping to reduce the circulation of influenza viruses among the population, which makes it possible to recommend it for the general population. However, most of the viruses belonging to the ARVI group do not lend themselves to specific immunoprophylaxis, therefore, it is necessary to use non-specific means of preventing infections caused by respiratory viruses. In recent years, there has been a tendency for the widespread use of natural products, which include complex preparations of bioregulatory medicine. This approach is based on the concept of the complexity of diseases and is aimed at eliminating those dysregulation in biological networks that underlie diseases. The goal of bioregulatory medicine is to improve patient outcomes by maintaining the body’s ability to self-regulate. Drugs related to bioregulatory medicine have antiviral, immunomodulatory and cytoprotective effects. This group of drugs has practically no side effects and toxic effects, they do not create a pharmacological load on the organs of detoxification and excretion, therefore they can be recommended among the child population. This group of funds includes the drug Engystol®; Euphorbium compositum®, which is used for rhinitis, sinusitis and rhinosinusitis; Girel®, used as a symptomatic remedy for ARVI, including influenza. The article presents data on the effective use of bioregulatory medicine in the complex therapy and prevention of respiratory viral infections.

Vitamin D deficiency as a factor for immunity stimulation and lower risk of acute respiratory infections and COVID-19

During the COVID-19 pandemic, the efforts of many researchers around the world are aimed at finding preventive and prophylactic measures as well as therapeutic agents against SARS-CoV-2. Recent studies have showed that vitamin D deficiency could be one of many factors associated with the development and severity of acute respiratory infections, and vitamin D could be used for prevention and treatment of these patients. This review summarizes data about the role of vitamin D in the pathogenesis and prevention of respiratory viral infections, including new coronavirus infection as well as mechanisms for reducing the risk of infection with vitamin D therapy. Probably, this review will be of interest for endocrinologists and other specialists.