Respiratory Viral Infections In Children Research Articles

Presence and Significance of Multiple Respiratory Viral Infections in Children Admitted to a Tertiary Pediatric Hospital in Italy

Viral co-infections are frequently observed among children, but whether specific viral interactions enhance or diminish the severity of respiratory disease is still controversial. This study aimed to investigate the type of viral mono- and co-infections by also evaluating viral correlations in 3525 respiratory samples from 3525 pediatric in/outpatients screened by the Allplex Respiratory Panel Assays and with a Severe Acute Respiratory Syndrome-COronaVirus 2 (SARS-CoV-2) test available. Overall, viral co-infections were detected in 37.8% of patients and were more frequently observed in specimens from children with lower respiratory tract infections compared to those with upper respiratory tract infections (47.1% vs. 36.0%, p = 0.003). SARS-CoV-2 and influenza A were more commonly detected in mono-infections, whereas human bocavirus showed the highest co-infection rate (87.8% in co-infection). After analyzing viral pairings using Spearman’s correlation test, it was noted that SARS-CoV-2 was negatively associated with all other respiratory viruses, whereas a markedly significant positive correlation (p < 0.001) was observed for five viral pairings (involving adenovirus/human bocavirus/human enterovirus/metapneumoviruses/rhinovirus). The correlation between co-infection and clinical outcome may be linked to the type of virus(es) involved in the co-infection rather than simple co-presence. Further studies dedicated to this important point are needed, since it has obvious implications from a diagnostic and clinical point of view.

Monocyte Production of C1q Potentiates CD8+ T Cell Function Following Respiratory Viral Infection.

Respiratory viral infections remain a leading cause of morbidity and mortality. Using a murine model of human metapneumovirus (HMPV), we identified recruitment of a C1q-expressing inflammatory monocyte population concomitant with viral clearance by adaptive immune cells. Genetic ablation of C1q led to reduced CD8+ T cell function. Production of C1q by a myeloid lineage was necessary to enhance CD8+ T cell function. Activated and dividing CD8+ T cells expressed a C1q receptor, gC1qR. Perturbation of gC1qR signaling led to altered CD8+ T cell IFN-γ production, metabolic capacity, and cell proliferation. Autopsy specimens from fatal respiratory viral infections in children demonstrated diffuse production of C1q by an interstitial population. Humans with severe COVID-19 infection also demonstrated upregulation of gC1qR on activated and rapidly dividing CD8+ T cells. Collectively, these studies implicate C1q production from monocytes as a critical regulator of CD8+ T cell function following respiratory viral infection. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Effect of pneumococcal conjugate vaccines on viral respiratory infections: a systematic literature review.

In addition to preventing pneumococcal disease, emerging evidence indicates that pneumococcal conjugate vaccines (PCVs) might indirectly reduce viral respiratory tract infections (RTI) by affecting pneumococcal-viral interactions. We performed a systematic review of interventional and observational studies published during 2000-2022 on vaccine efficacy/adjusted effectiveness (VE) and overall effect of PCV7, PCV9, PCV10, or PCV13 against viral RTI. Sixteen of 1671 records identified were included. Thirteen publications described effects of PCVs against viral RTIs in children. VE against influenza ranged between 41-86% (n=4), except for the 2010-2011 influenza season. In a randomized controlled trial, PCV9 displayed efficacy against any viral RTI, human seasonal coronavirus, parainfluenza, and human metapneumovirus. Data in adults were limited (n=3). PCV13 VE ranged between 4-25% against viral lower RTI, 32-35% against COVID-19 outcomes, 24-51% against human seasonal coronavirus, and 13-36% against influenza A lower RTI, with some 95%CI spanning zero. No protection was found against adenovirus or rhinovirus in children or adults. PCVs were associated with protection against some viral RTI, with the strongest evidence for influenza in children. Limited evidence for adults was generally consistent with pediatric data. Restricting public health evaluations to confirmed pneumococcal outcomes may underestimate the full impact of PCVs.

Pre-admission virus detection during the COVID-19 pandemic in children with and without symptoms of infection.

Pre-admission viral screening is used only in exceptional situations such as pandemics. We therefore evaluated pre-admission screening for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), respiratory syncytial virus (RSV) and influenza during the COVID-19 pandemic, comparing epidemiology and clinical features of admitted children. Children were screened at a paediatric emergency department from 1 March 2020 to 30 June 2022 by nasopharyngeal sampling and polymerase chain reaction kit. We retrospectively retrieved positive results from the laboratory and scrutinised charts of admitted children. Out of 15 927 screened children, 522, 127 and 572 were positive and admitted with RSV, influenza A or SARS-CoV-2, respectively. Of these, 29 (5.6%), 26 (24.1%) and 245 (44.8%) were incidental findings, lacking symptoms of infection. RSV and influenza A were initially absent but re-emerged in the autumn of 2021. The rate of COVID-19 rose when the Omicron variant emerged in December 2021. The median age of children with RSV was 0.3 years, of those with influenza A 6.7 years and of those with COVID-19 1.6 years. Major complications were rare. Frequent incidental detections of SARS-CoV-2 likely reflected widespread presence of a mild infection. Clinically, COVID-19 was like other viral respiratory infections in children.

Respiratory virus infection and its influence on outcome in children with septic shock

Objective: To investigate respiratory virus infection in children with septic shock in pediatric care units (PICU) in China and its influence on clinical outcomes. Methods: The clinical data of children with septic shock in children's PICU from January 2018 to December 2019 in 10 Chinese hospitals were retrospectively collected. They were divided into the pre-COVID-19 and post-COVID-19 groups according to the onset of disease, and the characteristics and composition of respiratory virus in the 2 groups were compared. Matching age, malignant underlying diseases, bacteria, fungi and other viruses, a new database was generated using 1∶1 propensity score matching method. The children were divided into the respiratory virus group and non-respiratory virus group according to the presence or absence of respiratory virus infection; their clinical characteristics, diagnosis, and treatment were compared by t-test, rank sum test and Chi-square test. The correlation between respiratory virus infection and the clinical outcomes was analyzed by logistic regression. Results: A total of 1 247 children with septic shock were included in the study, of them 748 were male; the age was 37 (11, 105) months. In the pre-and post-COVID-19 groups, there were 530 and 717 cases of septic shock, respectively; the positive rate of respiratory virus was 14.9% (79 cases) and 9.8% (70 cases); the seasonal distribution of septic shock was 28.9% (153/530) and 25.9% (185/717) in autumn, and 30.3% (161/530) and 28.3% (203/717) in winter, respectively, and the corresponding positive rates of respiratory viruses were 19.6% (30/153) and 15.7% (29/185) in autumn, and 21.1% (34/161) and 15.3% (31/203) in winter, respectively. The positive rates of influenza virus and adenovirus in the post-COVID-19 group were lower than those in the pre-COVID-19 group (2.1% (15/717) vs. 7.5% (40/530), and 0.7% (5/717) vs. 3.2% (17/530), χ2=21.51 and 11.08, respectively; all P<0.05). Rhinovirus virus were higher than those in the pre-Covid-19 group (1.7% (12/717) vs. 0.2% (1/530), χ2=6.51, P=0.011). After propensity score matching, there were 147 cases in both the respiratory virus group and the non-respiratory virus group. Rate of respiratory failure, acute respiratory distress, rate of disseminated coagulation dysfunction, and immunoglobulin usage of the respiratory virus group were higher than those of non-respiratory virus group (77.6% (114/147) vs. 59.2% (87/147), 17.7% (26/147) vs. 4.1% (6/147), 15.6% (25/147) vs. 4.1% (7/147), and 35.4% (52/147) vs. 21.4% (32/147); χ2=11.07, 14.02, 11.06 and 6.67, all P<0.05); and PICU hospitalization of the former was longer than that of the later (7 (3, 16) vs. 3 (1, 7)d, Z=5.01, P<0.001). Univariate logistic regression analysis showed that the presence of respiratory viral infection was associated with respiratory failure, disseminated coagulation dysfunction, the use of mechanical ventilation, and the use of immunoglobulin and anti-respiratory viral drugs (OR=2.42, 0.22, 0.25, 0.56 and 1.12, all P<0.05). Conclusions: The composition of respiratory virus infection in children with septic shock is different between pre and post-COVID-19. Respiratory viral infection is associated with organ dysfunction in children with septic shock. Decreasing respiratory viral infection through respiratory protection may improve the clinical outcome of these children.

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

ObjectivesViruses are the main infectious agents of acute respiratory infections (ARIs) in children. We aim to describe the changes in epidemic characteristics of viral ARIs in outpatient children before and during the COVID-19 pandemic. Patients and methodsFrom 2017 to 2022, the results of viral detection in oral pharyngeal swabs in 479,236 children with ARIs in the outpatient department of Children’s Hospital, Zhejiang University School of Medicine, were retrospectively analyzed. Viral antigens, including adenovirus (ADV), influenza A (FLUA), influenza B (FLUB) and respiratory syncytial virus (RSV) were detected by the colloidal gold method. ResultsThe median age was 3.4 (1.6–5.6) years. Among all the children, 159,895 cases (33.4 %) were positive for at least one virus. The total positive rate for ADV, FLUA and FLUB during the pandemic period was lower than during the pre-pandemic period in every season (pre-pandemic period vs. pandemic period11.7 % vs. 4.7 %, 13.9 % vs. 9.2 %, 7.0 % vs. 5.2 %, respectively, with overall p value < 0.001). However, the positive rate fir RSV was not significantly different between the pre-pandemic period and the pandemic period (5.6 % vs. 5.8 %, p = 0.117). Atypical timing of RSV (summer-autumn 2021) and FLUA (summer 2022) was noted. ConclusionsPublic health interventions for different pathogens are maximally effective. While positive rates for ADV, FLUA and FLUB decreased during the COVID-19 pandemic period, positive rates for RSV remained similar. In RSV and FLUA, off-season outbreaks were observed. Measures need to be taken to protect children from possible infection surges due to immunity debt having accrued over the last three years.

Enteroviruses in the etiology of acute respiratory viral infections in children, Novosibirsk, Russia

Aim. To assess the contribution of human enteroviruses to the overall structure of acute respiratory viral infections in children in Novosibirsk during the epidemic season 2022–2023. Material and Methods. 1132 samples collected from children aged 0–15 years with symptoms of ARVI were analyzed by real–time PCR for the presence of genetic material of respiratory viruses, including enteroviruses. Results. 65.2 % of the examined children were positive for at least one virus, including enteroviruses. Respiratory syncytial virus was most often found in children during this period, which accounted for 17.2 % of the total number of samples studied. Influenza virus was detected in 14.2 % of the examined children. Enteroviruses were detected in 9.2 % of cases and rhinovirus was detected in 10.8 % of the examined children. Conclusions. Respiratory enteroviruses, along with rhinovirus, occupy a significant place in the etiology of acute respiratory viral infections in children. The study of the epidemiology of enteroviruses is necessary to understand the clinical manifestations and outcomes of enterovirus infection, and to assess the burden of diseases caused by enteroviruses, which is important for optimizing prevention and therapy strategies.

Retrospective analysis of the prevalence of acute respiratory infections in children of the Ivano-Frankivsk region

Background. The article presents modern data about the prevalence and peculiarities of the course of acute respiratory viral infections in a childhood based on retrospective analysis of medical records. The purpose of this article was to analyze the epidemiology and features of acute respiratory viral infections in children based on the retrospective analysis of medical records, and reports of the Public Health Center. Materials and methods. Extracts from the medical charts of inpatients with acute respiratory pathology and statistical reports of the work of the ENT department of Ivano-Frankivsk Regional Children’s Clinical Hospital for 2017–2022, which included 1,177 patients, were carefully studied. Results. The clinical features of acute respiratory infections in children hospitalized to the ENT department were as follows: age over 3 years (89 %), frequent admissions to the hospital (&gt; 4 times a year) at the age of 4–5 years, nasal congestion (87.0 %), headache (72.0 %), body temperature above 37.9 °С (37 %), purulent nasal discharge (20 %), cough (15.6 %), general weakness (12.3 %). The average duration of the disease before hospitalization was 8.0 ± 0.2 days, and after hospitalization, it was 7.0 ± 0.1 days. It was found that those hospitalized had mostly ENT pathology, which initially was more likely to be viral (75.0 %); moreover, predominantly girls were affected (45 %), χ2 = 15.7, p &lt; 0.05. At the same time, the proportion of combined forms of ENT diseases with a complicated course was 25 %, and boys were more likely to be affected (60 %), χ2 = 18.9, p &lt; 0.05. Pansinusitis, on the other hand, occurred more often against the background of secondary chronic pathology (70.0 and 30.0 %, p &lt; 0.05), χ2 = 32, p &lt; 0.05. During all years of observation, the age group of 3 years and older prevailed among hospitalized children with acute respiratory infections. Most patients were admitted to the hospital in a condition of moderate severity. In all children hospitalized during the reporting period, we have found signs of respiratory syndrome such as nasal congestion and anosmia, sore throat, cough, purulent nasal discharge, as well as symptoms of intoxication: general weakness, headache, fever. ­Conclusions. The obtained data require further study and observation in the dynamics in order to stratify risk factors for the development of IgA-vasculitis in a childhood.

Urgent Hospitalizations Related to Viral Respiratory Disease in Children during Autumn and Winter Seasons 2022/2023.

The loosening of social distancing measures over the past two years has led to a resurgence of seasonal epidemics associated with respiratory viral infections in children. We aim to describe the impact of such infections through urgent hospitalizations in a pediatric emergency department. We performed a retrospective review of medical records of all children and adolescents with a positive nasal swab admitted at the children's hospital IRCCS Burlo Garofolo of Trieste, in Italy, from September 2021 to March 2022, and September 2022 to March 2023. Respiratory Syncytial Virus and Influenza viruses accounted for up to 55% of hospitalizations for respiratory infections during the study periods. During the last season, the number of hospitalizations related to the Influenza virus was five times higher than those related to SARS-CoV-2 (25% vs. 5%). Respiratory Syncytial Virus was associated with a greater need for respiratory support, mostly HFNC (High Flow Nasal Cannula). Respiratory Syncytial Virus and Influenza virus had a more significant impact on urgent hospitalizations during the past wintery seasons than SARS-CoV-2.

Experience of using an interferon inducer in the prevention of influenza and acute respiratory viral infections in children

Introduction. Taking into account the changeable viral landscape of pathogens, the persistence of seasonal morbidity at a high level, and the refusal of a number of parents to be vaccinated against influenza, the interest of scientists and practitioners in the use of endogenous interferon inducers is increasing. Studies by domestic authors have proven that Kagocel® is highly effective in the prevention and treatment of influenza and other ARIs.Aim. Evaluation of the efficacy and safety of Kagocel® for the prevention of influenza and ARIs in children aged 3–18 years old on an outpatient basis during the epidemic rise of respiratory viral infections in 2022–2023.Materials and methods. A prospective comparative analysis of cases of prevention of influenza and ARIs by Kagocel® in children was carried out: group 1 – main (n = 32). Kagocel® was prescribed according to the scheme for a month. The comparison group consisted of patients vaccinated against influenza, who did not receive drugs for the prevention of acute respiratory viral infections: group 2 – comparison (n = 28).Results and discussion. The index of preventive efficacy of Kagocel® was 3.0, the efficiency ratio was quite high – 66.7%. The elimination of the main clinical symptoms of the disease was noted on average by the 2nd–3rd day of illness. Prophylactic administration of the drug allowed to reduce the incidence of influenza and ARIs by 3 times; reduce the number of complications from these diseases by 4 times. The economic feasibility of prophylaxis with Kagocel® has been proven, direct costs for the treatment of one patient have decreased by 3.6 times. The interferon inducer was well tolerated, no side effects of the drug were detected.Conclusion. Endogenous interferon inducer Kagocel® can be used for prophylactic purposes during the seasonal rise in the incidence of influenza and ARIs.

Prevention of acute respiratory viral infections in children with chronic exudative otitis media in the postoperative period

Introduction. Chronic otitis media vis effusion (COME) is a disease characterized by the presence of exudate in the cavities of the middle ear and hearing loss. Predisposing factors to the development of COME can be recurrent upper respiratory tract infections.Aim. To study the effectiveness of the drug Sinupret® in children who have undergone surgical treatment for COMEMaterials and methods. A clinical study was conducted at the Department of Otorhinolaryngology of TMU and GBUZ TO OKB No. 2 in 2020–2021. This study involved 30 children (15 boys and 15 girls) with HESO. The mean age of all patients was 6.33 ± 0.31 years. In the 1st group of children, consisting of 15 people (10 boys and 5 girls), Sinupret® was prescribed in the postoperative period, in the 2nd group of children, consisting of 15 people (5 boys and 10 girls), Sinupret® was not prescribed. Diagnosis of chronic POE was carried out on the basis of clinical and instrumental examination and integral indices of peripheral blood. Conservative treatment consisted of topical decongestant therapy and rifamycin 2.6% ear drops for a week. The observation period included 12 months.Results. ARVI episodes during the year in group I were observed in 20%, in group II in 60% of children, the average duration of the disease in group I was 5 ± 0.71 days, in group II 7.8 ± 0.42 days (p = 0.01), stable hearing recovery in children of the 1st group was recorded in 100%. POE recurrence in children of group II was registered in 27% (4 people), which required repeated shunting to restore hearing.Conclusions. Prophylactic use of the drug Sinupret® in children who have undergone surgical treatment for chronic OME allows you to achieve a stable restoration of hearing and contributes to complete recovery.

Questions of systemic and topical antibacterial therapy of acute rhinosinusitis in a child

Background. Acute otitis media is the most common complication of acute respiratory viral infection in children under 6 years of age. More than 90% of children suffer from acute otitis media in the first 5 years of life. Ear pain is one of the main symptoms of acute otitis media and determines the patient's well-being.&#x0D; Aim. To evaluate the efficacy and tolerability of the use of ear drops based on the combination of phenazone and lidocaine in the local therapy of acute otitis media in the preperforative stage in children.&#x0D; Materials and methods. A retrospective analysis of the outpatient records of 50 patients with complaints of symptoms of acute otitis media was performed.&#x0D; Results. Based on the analysis of medical records, it was found that the use of ear drops based on a combination of phenazone and lidocaine can significantly reduce the severity of ear pain in acute otitis media within 3 minutes. The use of ear drops based on the combination of phenazone and lidocaine for a course of 7 days allows most patients to abandon the use of systemic forms of analgesics. No patient has been reported to have developed adverse events associated with the use of phenazone-lidocaine combination ear drops.&#x0D; Conclusion. The use of ear drops based on a fixed combination of lidocaine + phenazone is not only a highly effective and safe drug for the treatment of acute otitis media in the preperforative stage in children, but also a fast symptomatic therapy, which physicians after otoscopy can use as the method of choice to reduce patients' ear pain already during the initial examination.

Pyomyositis following respiratory viral infections in children: A case series

Pyomyositis following respiratory viral infections in children: A case series

Concomitant infections in children with allergic pathology in the Kaliningrad region

The aim of our work was to study the structure and prevalence of the infectious syndrome in children from Kaliningrad Region with moderate-to-severe allergic pathology, with a complex manifestations of allergic reactions, both on skin and on the mucous membranes of the digestive and respiratory tract.&#x0D; Ninety children from 0 to 18 years old with various symptoms of allergic pathology were examined and included in the study group using standard clinical, objective and laboratory criteria. The severity of clinical course was associated with the severe and long-lasting symptoms, as well as with frequent bacterial and bacterial-fungal complications, with impaired quality of life and night sleep. The children were consulted by the specialists in otorhinolaryngology, hematology, pulmonology, surgery, ophthalmology, infectology, endocrinology, cardiology. Diagnoses according to nosological forms were made in accordance with the current clinical recommendations of Russian Ministry of Health. Our article presents data on concomitant infectious diseases and their impact on general condition and severity of hypersensitive responses. The average age of allergic manifestations in the group of children was 3.12±2.72 years. The average duration of the disease in the observed group was 7.5±0.88 years. The number of boys in our group prevailed (n = 56) by 1.6 times. Complicated heredity factors were reported by 15% of the patients’ parents. However, with careful collection of medical history taking, upon dynamic observation, the aggravated heredity on the mother’s side was detected in 45.56% (n = 41), and on the father’s side, in 31.1% of cases (n = 28). In eight families, both parents suffered from allergic pathology, in siblings, 21.1% (n = 19) of the examined children had allergies. In the families, including grandparents, allergic pathology was reported in 56 cases (62.2%).&#x0D; Almost all patients had problems with nasal breathing, 77 (85.6%) children with adenoid hypertrophy had a habit of breathing through the mouth. Postnasal drip syndrome was found in 78 cases. Allergic rhinitis with adenoid hypertrophy is, generally, accompanied by postnasal leakage, which can provoke aspiration bronchitis and pneumonia, especially if pathogenic or opportunistic flora is transferred to the nasal cavity and/or to the pharynx.&#x0D; Conclusions: 1. Identification and rehabilitation of chronic foci of infection, bacterial, fungal, should be a necessary component of the personalized therapy of allergic pathology in children. 2. In cases of recurrent sowing or finding of pathogenic flora (iodophilic flora, fungi, coccal flora) in the coprogram, one should exclude not only transient lactase deficiency, but also congenital lactase deficiency, thus preventing development of enterocolitis in the future like as worsening of skin status and respiratory manifestations. 3. In case of severe respiratory viral infections in children during the period of adaptation for pre-school institutions, one should exclude sensitization to allergens of house dust mites and epidermal allergens of domestic animals. 4. A comprehensive and personalized approach to the diagnosis of allergic disorders and comorbid conditions enables us to create conditions for stable remission, making it possible to conduct allergen-specific immunotherapy, which may provide a disease-modifying effect upon the hyperreactive states in our patients.

Seasonal Prevalence of Respiratory Pathogens Among Children in the United Arab Emirates: A Multicenter Cross-Sectional Study in the Pre-COVID-19 Era.

Background Viral respiratory infections in children pose a significant burden on healthcare facilities globally. In the United Arab Emirates (UAE) these account for 15% of all healthcare encounters among children. However, the seasonal prevalence and molecular epidemiology of respiratory viral infections in the UAE remains unknown. We sought to determine trends in seasonal viral prevalence in order to monitor disease activity and optimize the timing of Respiratory Syncytial Virus (RSV) prophylaxis among high-risk infants in the UAE. Methods This cross-sectional multicenter study included children 0-18 years of age who presented to a large private healthcare group in Dubai, UAE, and had upper respiratory samples collected for multiplex polymerase chain reaction (mPCR) testing between January 1st and December 31st, 2019. Sociodemographic, clinical, and molecular data were examined for children who tested positive for any pathogen on the mPCR panel. Results A total of three thousand and ninety-eight infants and children had mPCR assays performed during the study period, of which 2427 (78.3%) were positive for any respiratory pathogen. The median age of our sample population was 39 months and 56.8% were male. Emergency room was the most common site (34.7%) of sample collection and the vast majority of children presented with fever (85.3%). Rhinovirus/enterovirus was the most prevalent viral infection (45%) throughout the year and peaked in September, followed by Influenza (20.2%), and RSV (17.1%). RSV season, defined as an infection prevalence of >10%, occurred from August to December with a peak in October. Adenovirus (15.6%) infections peaked in June and accounted for 43% of hospitalizations in our study (p<0.05). Viral co-infections with RSV and rhinovirus/enterovirus were most common and observed in 19.9 % of children. Conclusion Rhinovirus/enterovirus is the most prevalent viral pathogen throughout the calendar year among the pediatric population in the UAE. RSV season begins earlier than reported in other countries regionally, hence RSV prophylaxis should be initiated in August to optimize protection among high-risk infants.

Epidemiological Changes in Respiratory Viral Infections in Children: The Influence of the COVID-19 Pandemic.

Viruses are the major cause of acute respiratory infections in children, causing important morbimortality. Before the COVID-19 pandemic, in temperate regions, respiratory viruses displayed a typical seasonality in transmission. A disruption in this pattern was observed in several countries during the pandemic, with low prevalence during the typical season, and an interseasonal rise. We evaluated the effects of the COVID-19 pandemic in the epidemiology of non-COVID viral respiratory infections in children, in a tertiary care hospital in Portugal. Between March 2020 and August 2022, nasopharyngeal samples from children with respiratory symptoms in the Emergency Department (ED) and the Pediatric Ward were tested for RSV, influenza and other respiratory viruses, by real-time reverse transcriptase PCR (RT-PCR). A seasonal variation was observed from 2018 to 2020, with prevalence increasing in winter (mainly RSV and influenza). In the winter of 2020/21, when measures to mitigate SARS-CoV-2 transmission were stricter, there was a disruption of the seasonal pattern, with unusually low numbers. In the summer of 2021, when measures were being relaxed, there was an atypical rise. In June 2021, RSV was first detected and peaked in October. Influenza (Influenza A H3) was detected for the first time in February 2022, peaking in March/April. These findings show a disruption of the seasonality of viral respiratory infections in children during the pandemic, with a virtual elimination during the months of usually higher prevalence, and a subsequent out-of-season increase, coinciding with variations in the measures implemented to control the SARS-CoV-2 transmission, and confirming their efficacy.

Overnutrition as a risk factor for more serious respiratory viral infections in children: A retrospective study in hospitalized patients

BackgroundThe prevalence of obesity has increased dramatically in children worldwide. Obesity has been recognized as a risk factor for more serious viral respiratory infections, mainly in adults. ObjectiveTo study the relationship between overnutrition (obesity and overweight) and clinical severity in children hospitalized with acute respiratory infections of viral origin. MethodsOne hundred and forty-three clinical records of children between 2 and 18 years old hospitalized for acute respiratory infection at Clínica Dávila (2014–2018) were analyzed, recording the respiratory viruses detected at the time of hospitalization, weight, and height. Nutritional status was estimated using Z score or body mass index, according to age. ResultsEighty-tree3 children (58%) were positive for more than one respiratory virus. The main virus detected in monoinfection was adenovirus (9.8%), followed by respiratory syncytial virus (7.7%) and parainfluenza virus (7.7%). There were no deaths. Patients with obesity presented more days of hospitalization (P = .04), oxygen therapy (P = .03) and mechanical ventilation (P < .001), as well as a higher probability of requiring mechanical ventilation (P = .001) and of ICU admission (P = .003) compared with children with normal weight. Patients with overweight presented more days of mechanical ventilation (P < .001) than patients with normal weight. No significant differences were found between the presence of viral coinfection and nutritional status. ConclusionOvernutrition is associated with greater severity of viral respiratory infection in hospitalized children.

Influence of a combined interferon-alpha-containing drug on the course of respiratory diseases in frequently ill children

Introduction. Acute respiratory viral infections hold a dominant place in the infectious diseases pattern. There are many drugs that can affect separate arms of the immune response.Aim. To analyze the effectiveness of the systemic use of a combined drug containing interferon-α-2b and a complex immunoglobulin preparation in the treatment of respiratory diseases in frequently ill children.Material and methods. We examined 103 children aged 2-12 years. Upon admission, the children were treated with a combined drug containing interferon a-2b and a complex immunoglobulin preparation (CIP) (Kipferon®) rectally. Children in the control group received standard therapy.Results. Children were admitted to the hospital in the first days of the disease (66.02%), mainly in the moderate form of the disease (96.12%). 81.55% had symptoms of intoxication, catarrhal phenomena and respiratory syndrome. Comparing the time from the onset of the disease when prescribing IFN-α-2b to children, their significantly significant differences were established. Introduction in the early stages of the disease contributes to a faster elimination of all symptoms: fever stopped on average (M ± SD) after 1.76 ± 0.33 and 2.05 ± 0.29 days, respectively, from the moment of admission to the hospital, which was on average 2 days less than in the control group. The transition to a productive cough in the main group occurred on average (M ± SD) after 3.25 ± 0.27 days, in the comparative group - after 5.23 ± 0.31, in the control group - after 8.19 ± 0.42 days. In patients of the main and comparative groups, the length of stay in the hospital was significantly shorter - on average (M ± SD) 8.04 ± 0.81 days than in the control group - 10.56 ± 1.42 days. Hematological parameters returned to normal at an earlier time.Discussion. Rectal route of recombinant IFNi-a2b delivery as suppositories is substantiated with regard to etiopathogenesis and immunology.Conclusion. The article presents the outcomes of the clinical use of Kipferon® as part of the combination therapy and prevention of complications of acute respiratory viral infections in children: reduced duration of intoxication, fever, faster improvement of the auscultatory status of the lungs, improvement of immune status indicators.

The use of antibacterial drugs in the treatment of coronavirus infection in children in real outpatient clinic practice

Introduction. In light of the available data on the unjustified use of antibiotics in children with acute respiratory viral infections, the frequency of prescribing antibacterial drugs to children with a new coronavirus infection in real clinical practice is of great practical and scientific interest.The aim of the study was to study the frequency of antibiotic therapy and identify factors that increase the risk of needing antibiotics in children with coronavirus infection at the outpatient stage.Materials and methods. A retrospective cross-sectional study was conducted on the basis of children's polyclinics in Samara from November 2021 to July 2022, which included a survey of parents and an analysis of outpatient records of 100 children who were under outpatient observation and treatment for COVID-19. An analysis was made of the frequency of prescribing antibiotics to them and potential factors predisposing to their prescribing to children with COVID-19. The obtained data were subjected to statistical processing using the IBM SPSS Statistics 25 program and a comparative analysis.Results. The frequency of use of antibiotic therapy according to the results of the study was 11 % and did not exceed the Russian average data (14.3 %). When analyzing the factors influencing the doctor's decision to prescribe an antibiotic to a child with coronavirus infection, the most important were a history of recurrent respiratory infections (children from the FIC group), as well as the presence of concomitant diseases and background conditions in children, primarily chronic bronchopulmonary diseases. and nervous system.Discussion. The prescription of antibiotics for children with a new coronavirus infection at the outpatient stage remains empirical due to the limitations of the use of laboratory and instrumental methods for additional examination of the child, which objectifies the likelihood of a secondary bacterial infection. Despite this, the frequency of antibiotic use according to the results of the study was 11 % and did not exceed the Russian average data (14.3 %), as well as the average frequency of antibiotic use for acute respiratory viral infections in children in the Russian Federation (21.5-23.3 %).

A cute respiratory viral infections in children: how to improve the quality of treatment

The issues of improving the quality of treatment of children with acute respiratory infections combined with minimization of the adverse effects and reduction of polypragmasy are high on the agenda. The safety and efficacy of therapy are the key quality criteria, which allows to use complex bioregulatory drugs with antiviral, anti-inflammatory and immunomodulatory effects in the combination therapy of acute respiratory infections in children. The article presents clinical cases of effective treatment of acute respiratory infections using bioregulatory therapy. Clinical case 1: a 3-year-old child, general condition of moderate severity during initial presentation, rise of body temperature up to 38.4 ºС, catarrhal manifestations. Diagnosis: J00 – ARVI, acute nasopharyngitis. Clinical case 2: a 5-year-old child, complaints of fever up to 38.3 ºС, nasal breathing difficulty (especially at night) reported, nasal discharge, wet cough with difficulty in expectoration of sputum. Diagnosis: J00, J35.2, J35.8 – ARVI, grade 2 pharyngeal tonsil hypertrophy, adenoiditis. Clinical case 3: a 12-year-old child, complaints of fever for 3 days (temperature 38.3–38.7 ºС). General condition of moderate severity due to intoxication syndrome, hyperthermia. Complaints of sore throat that was exacerbated by eating. Pharyngoscopy showed hyperemic, enlarged, edematous palatine tonsils, yellowish overlays located in lacunae. Diagnosis: J03.9 Acute tonsillitis, unspecified? All patients were prescribed combination bioregulatory therapy with a high compliance profile, good tolerance and absence of side effects. This therapy contributed to the reduction of polypragmasy and the prevention of recurrent upper respiratory infections.