Acute Respiratory Viral Infections Research Articles

Comparative content analysis of biologically active substances in citrus peel

The analysis of the documents of the Ministry of Health of the Russian Federation shows that in 2021, there were 38.44 million cases of acute upper respiratory infections of multiple and unspecified localization, which accounted for 75.8% of all infectious and parasitic diseases. Researchers are interested in the creation of drugs for the treatment and prevention of acute respiratory viral infections using extracts and essential oils of plants with antiviral activity. Among the significant number of essential oil plants with potential antibacterial and antiviral effects, plants of the citrus family are of particular interest. The citrus fruits are widely used by the food industry, and the peel of the fruits is an industrial waste of food production. It is known that the peel of orange, tangerine, and lemon contains such valuable biologically active groups of substances as flavonoids, polyphenolic compounds, and essential oil, which allows considering this product as a potential source of novel medicines and preventive agents. The authors conducted a qualitative analysis of aqueous and aqueous-alcoholic extracts from citrus peel using a complex of pharmacopoeial qualitative reactions. The quantitative determination of the content of extractive substances extracted with 45% and 70% ethyl alcohol and water was carried out, and the quantitative content of essential oil, flavonoids, tannins, and ascorbic acid was established.

A case of development of membranous nephropathy against the background of atypical hemolytic-uremic syndrome activated as a result of acute respiratory viral infection

The article considers a clinical case of atypical hemolytic-uremic syndrome, which was the starting mechanism for the development of membranous nephropathy. Patient X. 23 years after acute respiratory viral infection, signs of nephrotic syndrome, arterial hypertension, and impaired kidney function appeared. Puncture nephrobiopsy was performed and the morphological picture corresponds to immunocomplex glomerulonephritis, most likely membranous nephropathy with the presence of segmental glomerulosclerosis, cellular half-moons. In parallel, the patient had verified signs of thrombotic microangiopathy in the form of microangiopathic anemia, thrombocytopenia, increased lactate dehydrogenase levels as a sign of cytolysis (primarily intravascular hemolysis). During the differential diagnosis, we stopped at the diagnosis of atypical hemolytic-uremic syndrome. The uniqueness of the described clinical case is that cases of glomerulonephritis against the background of atypical hemolytic-uremic syndrome are extremely rare, and membranous nephropathy is described for the first time.

Application of Mathematical Models of the Dynamics of the Epidemic Acute Respiratory Viral Infections to Increase the Efficiency of Epidemiological Surveillance

Uncertainty in the calculations of forecasts of the spread of epidemic acute respiratory infections obtained using mathematical models, associated with data error and uncertainty in the choice of a model, as well as the lack of verification of modeling results by interdisciplinary teams including epidemiology specialists, prevent the correct prediction of the effectiveness of disease control measures. In this paper, we propose a solution to these problems by using a software package consisting of a family of epidemic models, methods for estimating the error of output data depending on the error of the initial morbidity data, as well as a graphical interface with the possibility of manual correction of the results of automatic calibration and generation of epidemic bulletins. The novelty of the presented study is the methodology for integrating epidemic models into software tools used by supervisory authorities, which allows to supplement weekly bulletins and annual epidemiological reports in semi-automatic mode with a quantitative interval estimation of the error of calculated indicators. The ultimate goal is to provide the supervisory authorities with informative and promptly obtained calculated data for decision-making in the field of infection control.

Epidemic manifestations of coronavirus infection caused by «omicron» genovariant in the Volgograd region

The article is devoted to an urgent problem the study of the epidemic manifestations of the new coronavirus infection COVID-19 during the fourth wave of the rise in the incidence, which began in January 2022 in the Volgograd region.
 Materials and methods: We used the official statistical data of the Office of Rospotrebnadzor for the Volgograd Region on the incidence of COVID-19 and the results of SARS-CoV-2 genomic RNA sequencing. The main research method is epidemiological analysis. We analyzed the period from the beginning of the next increase in the incidence, coinciding with the almost complete replacement of other variants of SARS-CoV-2 by omicron (since January 16, 2022), until the decrease and stabilization of the incidence rates on March 30, 2022. Comparison of the epidemiological process indicators was carried out with the period before the appearance of the omicron genovariant (as of December 30, 2021).
 Results and discussion: Since mid-January 2022, there has been a sharp rise in the incidence of COVID-19 in the region up to 2,222 cases per day by mid-February and a subsequent decrease in incidence rates by the end of March. It has been established that the next wave of coronavirus infection is associated both with an increase in interpersonal contacts on holidays and the subsequent introduction of the infection into work and educational teams, and with the change of the SARS-CoV-2 genovariant to omicron. During 2.5 months of the fourth wave, 76,717 people fell ill with coronavirus, which is 36.6 % of the total number of cases registered over the entire observation period. Moreover, the proportion of cases in the age category up to 18 years has significantly increased (by 13.1 %). During the analyzed period, the proportion of cases with a mild course increased by 18.3 % (up to 88.6 %), and the percentage of cases of moderate severity decreased by 10.1% (up to 10.5 %), a severe course decreased by 4.1% (to 0.7 %), asymptomatic also decreased by 4.06 % and accounted for 0.14 % of the total number of detected cases of COVID-19. The share of pneumonia in the total morbidity for 2.5 months decreased by 16.8 % (to 1.6 %). In most cases, the treatment took place on an outpatient basis. The percentage of patients requiring hospitalization decreased to 18.5 %. There is a downward trend in the mortality rate from 4.3 % before the rise in incidence to 3.2 % as of March 30, 2022.
 Conclusions: In the Volgograd region, from January 14, 2022, another rise in the incidence of COVID-19 was registered with the maximum indicators for the entire observation period in February. The omicron genovariant, which has become dominant, has a higher contagiousness and is actively spreading in childrens groups. The disease is characterized by a milder clinical course in the form of acute respiratory viral infections, bronchitis, and a decrease in the proportion of deaths.

The effectiveness of scientifically based monitoring programs and therapeutic and preventive measures for controlled infectious diseases of animals

The aim of the work was to assess the effectiveness of an improved monitoring program for controlled infectious animal diseases and individual vaccination programs for acute respiratory viral infection in cattle. To fulfill the tasks set, serological studies, PCR diagnostics, bacteriological and coprological methods of examining biological samples from animals were carried out. As a result of the work, the main factors influencing the effectiveness of vaccine prophylaxis of acute respiratory viral infection in cattle populations have been identified. It was found that in three administrative and administrative districts of the Sverdlovsk region, the main factors in 35.1% of cases are violations of the rules of vaccination of acute respiratory viral infection of cattle, in 13.5% of cases - violations of zoo-hygienic and veterinary–sanitary conditions of keeping farm animals. A comprehensive assessment of the effectiveness of individual vaccination programs for cattle against acute respiratory viral infection has been carried out, taking into account the epizootological situation in agricultural organizations. It was shown that vaccination of cattle against acute respiratory viral infection according to individual programs ensured the formation of specific immunity in 92.5-95.0% of animals. The number of immunotolerant individuals and animals with a low level of immunoreactivity in the physiological group of young cattle did not exceed 3.5%, in the physiological group of adult animals – 1.25%. The high efficiency of improved scientifically based programs for monitoring, diagnosis, therapeutic, preventive and health measures to protect animals from epizootically significant infectious diseases of cattle among the populations of farm animals of the Ural Federal District has been confirmed.

Chronic cough and refractory chronic cough: An important distinction

Cough is the most common concern for which patients in the United States seek medical attention. Cough is typically classified according to its duration: acute cough (<3 weeks), subacute cough (3‐8 weeks), and chronic cough (>8 weeks). The vast majority of cases of acute cough in patients are due to an acute viral upper respiratory tract infection (common cold) and are self limited. Subacute cough is often due to a prolonged postviral cough. Once a cough meets the definition of chronic, it becomes likely that the cough is due to one or more treatable underlying etiologies: upper airway cough syndrome (formerly, postnasal drip syndrome), asthma and non-asthmatic eosinophilic bronchitis, and gastroesophageal reflux disease. Refractory chronic cough (RCC) refers to chronic cough that persists despite adequate therapeutic trials aimed at the known causes of chronic cough. The term cough hypersensitivity syndrome has recently been introduced to stress the concept that RCC is a distinct disease entity due to vagal hyperactivity causing hypersensitivity of the cough reflex. No medications have ever been approved for chronic cough or RCC in the United States and most of the world. Thus, physicians are limited to the use of off-label medications for their patients with this chronic and often debilitating condition. However, recent insights into the mechanisms of cough have resulted in multiple molecules currently being evaluated as potential antitussives. Among these, furthest along in the drug development pipeline are the P2X3-antagonists, of which, gefapixant has completed phase III trials, and camlipixant is currently in phase III studies.

Time trend of respiratory viruses before and during the COVID-19 pandemic in severe acute respiratory virus infection in the Sultanate of Oman between 2017 and 2022.

Severe acute respiratory illness (SARI) is a potentially lethal condition, necessitating thorough medical care. COVID-19 underscored the SARI threat, but other high-risk pathogens require monitoring alongside SARS-CoV-2. Oman instituted a comprehensive testing system to gauge the prevalence of these pathogens between 2017 and 2021, aiding resource allocation and public health responses to potential respiratory pathogen outbreaks. Samples from SARI cases admitted to ICU were tested for pathogens using the Fast-Track Diagnostic (FTD) molecular assay, a respiratory virus panel (RVP) that tests for 21 pathogens, including 20 viruses, by qPCR. Between 2017 and 2022, ~30 000 samples were analysed using the RVP panel. Among SARI patients, 8%-42% tested positive for respiratory pathogens, with 4% showing multiple infectious agents, especially in children under 10. A drop in positivity during 2020-2021 can be attributed to SARS-CoV-2 control measures, followed by a rebound in infections in early 2022. The COVID-19 pandemic heightened awareness of respiratory pathogens' spread without adequate control measures. Influenza A/B, human rhinoviruses and respiratory syncytial virus constituted over 50% of severe acute respiratory illness cases in Oman over the past 5years. During the pandemic, the incidence of these infections significantly declined, demonstrating the efficacy of COVID-19 prevention measures in reducing spread of other pathogens.

Epidemiology and Etiology of Viral Acute Respiratory Infections Among Children in Al-Ahsa Province - Saudi Arabia

Epidemiology and Etiology of Viral Acute Respiratory Infections Among Children in Al-Ahsa Province - Saudi Arabia

2077. Utility of a Real-Time Spatiotemporal Mapping Surveillance System in Detection of Healthcare-Associated Acute Respiratory Viral Infection Clusters in a Tertiary Healthcare Institution

Abstract Background Transition to endemic COVID-19 has been associated with a rise in community respiratory viral infections (ARIs) with a corresponding increase in healthcare-associated ARIs (HA-ARIs) (Figure 1). 4D-Disease Outbreak Surveillance System (4D-DOSS) is a real-time spatiotemporal mapping surveillance system being developed to detect healthcare-associated infection clusters. We aimed to assess 4D-DOSS’s utility in detection of HA-ARI clusters. Methods 4D-DOSS is a system that integrates and maps clinical, laboratory and patient movement data onto a digital twin of the hospital’s physical space. In addition to a virtual mapping replica of Singapore General Hospital, a 2000-bedded tertiary hospital in Singapore, it constitutes detailed healthcare cloud architecture and surveillance algorithms. Respiratory specimens from inpatients with ARI symptoms are tested for 16 human respiratory viral pathogens via a respiratory virus multiplex PCR (RV16) panel. HA-ARI constitutes first positive sample beyond the maximum incubation period of the corresponding virus (from admission date). Earlier positive test is categorized as community-associated ARI (CA-ARI). Two or more patients with spatial temporal overlap of three-days or less, during the infectious period (7-days) of an index patient are deemed a HA-ARI cluster. Results Incidence of HA-ARI, as per 10,000 patient-days was 7.4 pre-COVID-19 pandemic (Jan 2018 to Dec 2019), 1.5 during pandemic (Jan 2020 to Dec 2022) and 6.4 during transition to endemicity (Jan 2023 – April 2023). Between September 2018 and December 2018, one influenza cluster of ten inpatients (Nov 2018) was identified in the proof-of-concept version of 4D-DOSS. There were four HA-ARI clusters during the Jan 2020-Dec 2022 COVID-19 pandemic phase. 19 HA-ARI clusters were identified between Jan 2023-April 2023. Conclusion 4D-DOSS can detect HA-ARI clusters and has potential to trigger an alert-response process for more effective infection prevention. It enables study of infectious disease transmission kinetics in real-time. Disclosures Sean Whiteley, BSc (IT), Axomem: Board Member|Axomem: Fees received for service and software licenses Maybelle Auw, MBBS, Axomem: Work for company that received fees for service and licensing

The economic burden of viral severe acute respiratory infections in the Kingdom of Saudi Arabia: A nationwide cost-of-illness study

ObjectivesThe authors conducted a study to estimate the rising disease and economic burden of viral severe acute respiratory infections and their management, including COVID-19, respiratory syncytial virus, and influenza types A and B, in early and delayed diagnosis scenarios in the Kingdom of Saudi Arabia from a national perspective. MethodsThis cross-sectional study was conducted in May 2022 using a de novo Excel-based universal cost-of-illness calculator model. The study used primary data, such as expert interviews, as well as secondary data from a thorough literature search. ResultsThe total economic burden of viral severe acute respiratory infections in patients with an early diagnosis was lower than those with a delayed diagnosis among patients with complications, both from the payer's (United States dollar [USD] 3846 million vs USD 4726 million) and societal (USD 4048 million vs USD 5020 million, respectively) perspectives. The major cost driver of the total economic burden for both early and delayed diagnosis was disease management costs: 49% (USD 1880 million) and 58% (USD 2730 million), respectively. ConclusionsIn the Kingdom of Saudi Arabia, the total economic burden for COVID-19, influenza (epidemic phase), and respiratory syncytial virus was higher with a delayed diagnosis vs an early diagnosis, emphasizing the importance of using a broader diagnostic method.

Monitoring of respiratory viral infections in Moscow during 2011–2022

Introduction. Respiratory viruses (RV) circulate throughout the world and in all seasons of the year. Long-term monitoring of the distribution of respiratory pathogens is necessary to analyze the relevance of diagnostic systems to current viral isolates, to assess the risks of infection and the need for vaccine development and use, as well as to investigate the interdependence of RV reproduction in mixed infections.
 Objective — to study the causative agents of acute respiratory viral infections (ARVI) in Moscow during 2011–2022 by reverse transcription with subsequent polymerase chain reaction with fluorescent hydrolysis probes detection in real-time (RT2-PCR).
 Materials and Methods. Nasopharyngeal swabs from 3908 patients with acute respiratory infections were examined by the RT2-PCR.
 Results. Monitoring of RV spread in Moscow showed cyclical changes in frequencies with three dominant species: influenza A virus (up to 31.3%), respiratory syncytial virus (up to 24.8%) and human rhinoviruses (up to 21.3%) in 2011–2020. The increase in the portion of unidentified clinical specimens from 1.2 to 28.5% in 2022 indicated incomplete accordance of diagnostic systems to modern RV isolates or the emergence of new species or strains of pathogens. Unidirectional changes in dynamics were registered for 5 out of 9 studied RVs with correlation coefficients of 0.43–0.79. High frequencies of mixed acute respiratory viral infections (up to 33.4%) along with unidentified samples do not allow us to accurately assess the risks of infection with various RV in Moscow, but prove the necessity of preventing infectious diseases with the most common RV.
 Conclusion. Analysis of the dynamics of RV frequencies in Moscow showed the preservation of the dominant species: influenza A virus, respiratory syncytial virus and human rhinoviruses. During the period of vaccination against COVID-19, the proportion of seasonal coronaviruses increased.

Acute bronchitis: place, role and effectiveness of phytotherapy

Introduction. An urgent issue of modern medicine is still early diagnosis and treatment of virus-associated respiratory infections. In this context, infectious lesions of the tracheobronchial tree, associated with a high incidence and limited use of drug therapy, are of particular relevance. Analysis of individual mechanisms for the development of acute bronchitis will allow you to choose the addition of course treatment with herbal remedies with high efficiency and safety.Aim. Based on the clinical and epidemiological analysis of the incidence of acute bronchitis and the study of the pathogenetic mechanisms of the development of the disease, to determine the effectiveness of the use of herbal preparations in the course of preventive treatment.Materials and methods. An open, controlled, comparative clinical study was conducted on 63 patients with a diagnosis of acute bronchitis of viral etiology of preventive use in the complex therapy of a phytopreparation containing an extract of common ivy leaves and to evaluate its clinical efficacy and safety.Results. Analysis of the literature showed a high incidence of acute bronchitis during the outbreak of acute respiratory viral infections, the variability of the clinical course and the need to use additional methods of treatment. An early positive trend was noted in people who, in addition to standard therapy, used a phytopreparation containing an extract of ordinary ivy leaves in comparison with preparations of the amino acid derivative of cysteine relief of all symptoms already on the 5th day. The drug was easily tolerated by patients; no side effects were observed.Conclusions. Preventive use in the complex therapy of acute bronchitis, herbal preparations with mucolytic action, which facilitate sputum discharge, allows for a faster recovery.

Prevention of the Seasonal Spread of Arvi Among Early Children

Acute respiratory viral infections (ARVI) are widespread infectious diseases, cause significant economic damage and therefore are not only a serious medical, but also the most important socio-economic problem for humanity. This group of diseases accounts for up to 90% of all infectious morbidity. Mostly children and people over 60 years of age fall ill - the so-called risk groups for the incidence of ARVI. Every adult suffers from influenza or other acute respiratory viral infections on average 2-4 times a year, a schoolchild - 4-5 times, a preschool child - 6 times, a child of the first year of life has from 2 to 12 episodes of acute respiratory viral infections. The polyetiology of ARVI pathogens and the variability of viruses involved in the epidemic process, complications after an illness, necessitate the search for new diagnostic methods and optimization of treatment and preventive measures. Modern approaches to the treatment of influenza and acute respiratory viral infections of other etiologies are reduced to the use of complex drugs that combine antiviral, immunomodulatory, symptomatic and pathogenetic effects.

PD-1 Impairs CD8+ T Cell Granzyme B Production in Aged Mice during Acute Viral Respiratory Infection.

CD8+ T cell dysfunction contributes to severe respiratory viral infection outcomes in older adults. CD8+ T cells are the primary cell type responsible for viral clearance. With increasing age, CD8+ T cell function declines in conjunction with an accumulation of cytotoxic tissue-resident memory (TRM) CD8+ T cells. We sought to elucidate the role of PD-1 signaling on aged CD8+ T cell function and accumulation of CD8+ TRM cells during acute viral respiratory tract infection, given the importance of PD-1 regulating CD8+ T cells during acute and chronic infections. PD-1 blockade or genetic ablation in aged mice yielded improved CD8+ T cell granzyme B production comparable to that in young mice during human metapneumovirus and influenza viral infections. Syngeneic transplant and adoptive transfer strategies revealed that improved granzyme B production in aged Pdcd1-/- CD8+ T cells was primarily cell intrinsic because aged wild-type CD8+ T cells did not have increased granzyme B production when transplanted into a young host. PD-1 signaling promoted accumulation of cytotoxic CD8+ TRM cells in aged mice. PD-1 blockade of aged mice during rechallenge infection resulted in improved clinical outcomes that paralleled reduced accumulation of CD8+ TRM cells. These findings suggest that PD-1 signaling impaired CD8+ T cell granzyme B production and contributed to CD8+ TRM cell accumulation in the aged lung. These findings have implications for future research investigating PD-1 checkpoint inhibitors as a potential therapeutic option for elderly patients with severe respiratory viral infections.

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.

Acute sore throat in frequently ill children: potential of topical therapy

Sore throat is the most common reason for visiting primary care doctors, pediatricians, and ENT doctors. Acute sore throat, as a rule, is not an independent disease and most often accompanies tonsillopharyngitis caused by respiratory viral infections. In childhood, the share of acute respiratory viral infections among other infectious diseases can reach up to 90%, and the proportion of frequently ill children ranges from 30 to 50%. A feature of frequently ill children is a high incidence of illness, regardless of seasonality, and a tendency to a protracted course of the inflammatory process. Uncontrolled systemic antibiotic therapy for acute sore throat in frequently ill children leads to the development of dysbacteriosis and a decrease in mucosal immunity. The use of the topical antibacterial drug Faringazon for sore throat in children reduces inflammation in both viral and bacterial infections and reduces the need for systemic antibiotic therapy. The active substance of Ambazon has a bacteriostatic effect when is kept in the mouth until it resorbs and is effective against Streptococcus haemolyticus, Streptococcus pneumoniae, Streptococcus viridans, and also has antifungal effects against Candida albicans yeast fungus, which is a saprophyte, but exhibits pathogenic properties in decreased body’s immune defence and dysbiosis. The use of topical antimicrobial therapy helps reduce inflammation and speed up the recovery of patients without prescription of systemic antibiotics, and also ensures the preservation of microbiome, reducing the probability of emergence of antibiotic resistant strains to the minimum.

Functional state of the cardiovascular system in children after COVID-19

Introduction. The new coronavirus infection (COVID-19) in children often occurs in a mild, moderate, or asymptomatic. After experiencing COVID-19, some children, as well as adults, had persistent symptoms over more than 12 weeks and could not be explained by alternative diagnoses. These changes are called Post-acute COVID-19 Syndrome (PACS, post-COVID-19 syndrome or post-covid syndrome). Clinical manifestations of post-covid syndrome in children are very diverse, there are combinations of autonomic, psycho-emotional, cognitive and somatic disorders, including disorders of the cardiovascular system. 
 Aim: analysis of changes in the functional state of the cardiovascular system in children in the post-covid period.
 Materials and methods. The study included one hundred thirty one child aged of 5 to 17 years 11 months 29 days (mean age 12 years [9.5; 15]). The observed children were divided into 2 groups: group 1 (main) — children who had a mild new coronavirus infection (n = 76). The comparison group consisted of children who did not have COVID-19, suffered from acute respiratory viral infections of unspecified etiology of a mild course (n = 55). All children were analyzed for medical history, underwent clinical examination, electrocardiographic examination (ECG), echocardiographic examination (ECHO-KG), 24-hour Holter ECG monitoring and 24-hour blood pressure (BP) monitoring.
 Results. Children who have had COVID-19 are significantly more often showed sinus tachycardia (p = 0.025), extrasystole (supraventricular, ventricular) (p = 0.046), atrioventricular blockade of the 2nd degree (p = 0.027) compared with children with ARVI. After undergoing COVID-19, in 19.7% of children an increase in blood pressure was detected, in 15.8% of children there was a significant decrease in blood pressure at night (p = 0.008). In 38.2% of children after COVID-19, there was a decrease in the activity of the parasympathetic division of the nervous system.
 Conclusion. Children who have had a new mild coronavirus infection were shown to undergo a clinical examination with a mandatory assessment of blood pressure, heart rate and an ECG 3 and 6 months after the illness.

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.

The upregulation of peripheral CD3-CD56+CD16+ natural killer cells correlates with Th1/Th2 imbalance in asthma patients during acute upper respiratory viral infections

PurposeThe aim of this study is to clarify the changes of peripheral CD3−CD56+CD16+ NK cells and their correlation with Th1/Th2 immunity profiles in asthma during the phase of acute upper respiratory viral infections (AURVIs).MethodsPeripheral venous blood and induced sputum samples were collected from 56 mild asthma patients, 49 asthma patients with AURVIs and 50 healthy subjects. Peripheral CD3−CD56+CD16+ NK cells were monitored by flow cytometry during the course of acute viral infections. Meanwhile, the induced sputum Th2 cytokines IL-4 and IL-5, and Th1 cytokine IFN-γ were also detected by ELISA assay.ResultsThe asthmatics had lower levels of peripheral CD3−CD56+CD16+ NK cells populations as well as higher induced sputum cytokines (IL-4, IL-5 and IFN-γ) compared to healthy controls at baseline. Upon upper respiratory viral infections, peripheral CD3−CD56+CD16+ NK cells numbers in asthma patients sharply elevated on day 3 and slowly decreased by day 14, in accordance with induced sputum IFN-γ changes. IL-4 and IL-5 levels spiked much later (day 8) and lasted until day 14. Compared with asthma alone group, the IFN-γ/IL-4 and IFN-γ/IL-5 ratios of the asthma patients with AURVIs on day 1 were higher and peaked on day 3. The changes of peripheral CD3−CD56+CD16+ NK cells proportions positively correlated with the IFN-γ/IL-4 and IFN-γ/IL-5 ratios on day 1 to day 3 in asthma subsequent to upper respiratory viral infections.ConclusionsOur findings showed an imbalanced Th1/Th2 immunity in airways of asthma with acute upper respiratory viral infections. Upregulated peripheral CD3−CD56+CD16+ NK cells play a crucial role in biased Th1 immunity of airways in asthma during the acute phase of viral infections. The anti-viral Th1 immunity by targeting NK cells may be a possible therapeutic option for virus-induced asthma exacerbation.

Listeriosis in the third trimester of pregnancy: the course of the disease and outcomes for the mother and fetus

Listeriosis mainly affects immunocompromised people, including pregnant women. Listeriosis is 17 times more common in pregnancy than in the population and lead to severe complications for the fetus or newborn. In Russia 644 cases of listeriosis were registered from 2005 to 2017. Every case of listeriosis in pregnant women requires a special analysis. This will increase the alertness of doctors and their awareness of the features of this disease and its treatment in pregnant women.Aims – to study the features of listeriosis in the third trimester of pregnancy, the outcomes of the disease for the pregnant woman and the fetus.Materials and methods. We studied 4 cases of listeriosis in the third trimester of pregnancy, identified in the Clinical Infectious Hospital named after S.P. Botkin in the period from 2020 to 2021.Results. All patients were admitted to the hospital in the third trimester of pregnancy with suspected acute respiratory viral infection, from 1 to 4 days after the onset of the disease. The leading symptom was fever. Leukocytosis was in a clinical blood test, and the value of C-reactive protein and procalcitonin were increased. L. monocytogenes was identified after childbirth during bacteriological examination of mothers and newborns. All the women gave birth during the first day after admission to the hospital. Two women had vaginal deliveries, and two women delivered by cesarean section. All children were born alive, but they all were transferred to the children’s hospital for additional treatment. Finally, one child died, and the other three recovered.Conclusions. Listeriosis of pregnant women is a severe infectious disease that leads to perinatal losses. The search for laboratory techniques that could be widely and routinely used in pregnant women with fever for early identification of L. monocytogenes is relevant. Early identification of this pathogen will make it possible to reasonably choose antibiotics and their dosages, improve prognoses for mother and child.