Acute Respiratory Viral Infections Research Articles

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.

Incidence of Pediatric Acute Disseminated Encephalomyelitis During the Coronavirus Disease 2019 Pandemic in South Korea

BackgroundAcute disseminated encephalomyelitis (ADEM) is an immune-mediated demyelinating disorder of the central nervous system that is usually triggered by infections. We aimed to determine the temporal trends in the incidence of ADEM before and during the pandemic and their correlation with viral epidemiology. MethodsWe conducted a nationwide, population-based, retrospective, ADEM cohort study by using the Health Insurance Review and Assessment Service database. New-onset ADEM was defined as a patient (age <19 years) who was hospitalized with a diagnostic code of G04.0, G36.8, and G36.9 and a prescription of intravenous methylprednisolone. The National Infectious Disease Surveillance System was used to collect the nationwide viral epidemics. ResultsA total of 185 new-onset pediatric ADEM cases were included. The mean patient age was 7.0 ± 4.9 years. The incidence of ADEM was 0.34 to 0.48 of 100,000 persons per year before the pandemic, which dropped to 0.22 of 100,000 persons per year during the first pandemic year. The risk of ADEM occurrence was approximately 1.74% higher during the prepandemic years compared with the first pandemic year (odds ratio = 1.017, P = 0.009). There was a weak positive correlation between acute respiratory viral infection and ADEM incidence (r = 0.28, P = 0.03). ConclusionThis study demonstrates how infection control during the early coronavirus disease 2019 (COVID-19) pandemic influenced the incidence of ADEM. The low incidence of ADEM in the early COVID-19 pandemic may be related to the decline in acute respiratory viral infections, which are potential triggers of ADEM.

Nonlinear main components of the cytokine profile in children with community-acquired pneumonia

Cytokines are the key mediators which control and regulate immune and inflammatory responses via complex networks and serve as biomarkers of many diseases. Quantitative determination of cytokines is helpful in assessing immune status and adjusting therapy for various inflammatory diseases, such as sepsis and pneumonia. Since community-acquired pneumonia remains a common cause of childhood morbidity and mortality. At the present stage, prognosis of the disease severity in children is an urgent problem. The aim of our study was to identify associations between cytokine levels in healthy children and in children with community-acquired pneumonia (CAP), depending on the age of patients and severity of the pathological process. The work was carried out at the Department of Microbiology, Virology and Immunology, Department of Propaedeutics of Childhood Diseases and Pediatrics, and at the Research Institute of Immunology at the South Ural State Medical University. The study included 117 children aged 1 to 18 years with radiologically confirmed diagnosis of CAP, either severe or mild degree. The comparison group was composed from 28 healthy children who did not have community-acquired pneumonia, as well as other signs of acute respiratory viral infection at the time of examination, being observed for any chronic disorders. The levels of IL-1β, IFNγ, IL-6, IL-4, IL-10, IL-2, TNFα, IFNλ2 (IL-28A), IFNλ3 (IL-28B), IL-8, MCP-1, IL-17AF, GM-CSF were determined in blood serum by means of ELISA test systems (a “sandwich” technique with peroxidase as an indicator enzyme). For statistical analysis, a multidimensional method was used, i.e., non-linear analysis of the principal components using the CATPCA algorithm. Among the children with CAP, our study revealed a consistent increase of IL-1ß, IL-4, IL-10, IL-2, TNFα, IFNλ2 (IL-28A), IFNλ3 (IL-28B), IL-8, MCP-1, IL-17AF, GM-CSF in blood serum. The highest correlation with severity was shown for IFNλ2 (IL-28A), IFNλ3 (IL-28B) and MCP-1, which may be considered additional biomarkers of the CAP severity. There was also a significant variability of the cytokine profile in healthy children and its significant skewing in pneumonia, especially in severe cases.

Epidemiology of the novel coronavirus infection in the Orenburg Region in the period from 2020 to 2022

The article presents the results of a study of the dynamics and structure of the incidence of a new coronavirus infection (COVID-19) in the Orenburg region for 2020–2022, in view of the circulating genovariant of the SARS-CoV-2 virus. The data of operational monitoring of the Department of Rospotrebnadzor used in the Orenburg region. On the territory of the Orenburg region, the circulating genovariant of the coronavirus infection and its influence on the incidence rate, age, sex of patients and the clinical form of diseases, 3 periods allocated: The 1st period (March 2020 — March 2021) characterized by the circulation of the Wuhan SARS-CoV-2 genovariant; in the 2nd period (April — December 2021), the SARS-CoV-2 Delta genovariant and, along with it, the British SARS-CoV-2 Alpha genovariant became widespread; in 3In the 1st period (January-December 2022), the SARS-CoV-2 Omicron gene variant prevailed. The incidence rate in every subsequent period was significantly higher than in the previous one. In all periods, women have highest morbidity, the age group at risk was people over 65 years old. The clinical variants of the disease was heterogeneous: the dynamics showed an increase in the proportion of acute respiratory viral infections, a decrease in the proportion of pneumonia and asymptomatic forms. The most severe course of the disease and the highest mortality established in the second period, against the background of the intensive dissemination of the most virulent Delta genvariant. The circulation of the contagious Omicron genevariant can be explained the peak values of morbidity at the beginning of the third period. The territorial unevenness of the distribution of morbidity revealed. The correlation established between the circulating genovariants of the SARS-CoV-2 virus and the manifestations of the epidemic process of a new coronavirus infection (COVID-19) in the Orenburg Region in 2020–2022.

Immunomodulating agent Galavit for the prevention of frequent acute respiratory viral infections after COVID-19: A review

Many convalescents of the new coronavirus infection caused by the SARS-CoV-2 virus, including mild and moderate severity, have frequent acute respiratory viral infections (ARVI) and other diseases of the ENT organs during the first 6 months after recovery. A well-known problem of COVID-19 is immune disorders due to the negative impact of the virus on the immune system, which is associated with various consequences described as a post-COVID syndrome. One of the manifestations of post-COVID syndrome is a decrease in infection resistance due to the immunodeficiency state. In particular, exacerbations of bacterial and viral ENT diseases, frequent ARVI, and exacerbation of herpes virus infection were reported. Moreover, the infections tend to be prolonged, cyclic, and often recurrent, significantly reducing patients' physical activity and quality of life. ARVI symptoms, accompanying the post-COVID syndrome, negatively affect the general condition of patients. Immunocorrection can interrupt the vicious circle of recurrent ARVI and restore impaired immunity after COVID-19. The immunomodulatory drug Galavit has a pathogenetic basis for use in the post-COVID period to restore the immune system. It was shown effective in preventing frequent recurrent ARVI and herpes virus infection in patients in the post-COVID period. The article shows the experience of using Galavit in coronavirus infection convalescents with frequent episodes of acute respiratory infections.

Therapy of acute respiratory viral infections in adults in outpatient clinical practice: new opportunities for the prevention of bacterial complications (Results of the observational program RAPORT)

The frequency of routine prescription of systemic antibacterial drugs in outpatient practice is still unreasonably high despite the desire to reduce them. Under the auspices of the Alliance of Clinical Chemotherapists and Microbiologists, the observational program RAPORT was conducted to assess the therapeutic potential (including bacterial complications preventing) of Raphamin in routine clinical practice in adults with acute respiratory viral infection (ARVI). The program included 14,033 patients aged 1897 years with ARVI who received an investigational drug (ID) as monotherapy (93%) or in combination with basic therapy (7%). The frequency of prophylactic prescribing antibacterial drugs was 0.6%. It was shown that fever duration was 2.311.38 days, and the duration of the disease 3.61.52 days. In 99.4% of patients, ID allowed to avoid the development of bacterial complications and prescription of antibacterial drugs. ID showed a stable therapeutic effect in patients who started treatment late, as well as in patients with a moderate course of ARVI, there was no delay in recovery. The results obtained a broad prospect for the use of ID in order to minimize the number of bacterial complications and the frequency of use of antibiotics in ARVI, which may reduce rate of resistance of topical pathogens in the future.

Возможности перераспределения функций городской поликлиники при открытии подразделения – Дистанционный консультативный центр

Goal. To evaluate the interim results of a pilot project on the organization of an independent unit of a city clinic that provides remote support to citizens – the Distant Consultation Center of the Government Autonomous Organization Healthcare “City Clinic No. 8” (hereinafter referred to as the DCC). M e t h o d s o f w o r k . To assess the effectiveness of the pilot project, a number of indicators of the work of the medical organization were analyzed before the start of the project and 12 months after the start of its implementation. The analysis was carried out in two way of work of the Distant Consultation Center: 1. the process of providing medical care to patients with acute respiratory viral infections / Influenza / COVID‑19; 2. the process of providing medicines to the Subsidized category of citizens. The volumes of work that can be transferred to the Distant Consultation Center from the department of primary care physicians care and from the emergency medical care are analyzed. The source of the data was the medical information system of the medical organization “URMO TO” (modules Registry, Control of realization, doctor’s ARM, Disability sheets, Additional processing). The period of work of the medical organization from 01.01.2022 to 31.12.2022 is analyzed. Statistical processing of the results was carried out using the Statistica 6.0 application software package. Distance consultation was carried out via IP telephony, as well as using specialized Telemedicine software. R e s u l t s o f t h e w o r k . Before the organization of the DCC, the median indicator of the actual workload per hour of the covid team was 2,5 [2,3–2,7] patients, p&lt;0,07. While the doctor of DCC carried out an average of 56,9 [44–68] remote consultations, which is an average of 8,8 patients per hour, p&lt; 0,07. The median value of patients for prescriptions for Subsidized medicines before the start of the project was 4 [3–6] patients per day (p&lt;0,07), on average 22.2% time of the initial consultation falls on patients requiring a Subsidized medicine. The median value of applications for the purpose of providing Subsidized categories of citizens with medicines when discharged by a medical assistant at the DCC was 1 [0–3] (p&lt;0,08). Thus, this section began to occupy 0,06% in the structure of reasons for the initial appointment to the primary care physician. C o n c l u s i o n s . The organization of the work of the DCC allowed us to develop approaches, approve and adapt them to the processes of filling out the schedule of primary care doctors in order to increase accessibility to the primary consultations of the primary care physician’s department. Scaling up the organizational model and processes of the Distance consultation center of the Municipal Polyclinic No. 8 can serve as an effective tool in achieving the goals announced within the framework of the pilot project of the Ministry of Health of the Russian Federation “Incident 38” launched in 2022. T h e s c o p e o f t h e r e s u l t s . The presented experience shows the possibility of managing patients with respiratory viral diseases in outpatient polyclinic conditions on an ongoing basis, as well as the telemedicine format of care can be extended and adapted to non-infectious nosologies.

Epidemic season 2021–2022: Frequency of co-infection by respiratory viral pathogens

BACKGROUND: This study was conducted to determine the characteristics of various viral respiratory pathogens spreading during the epidemic season 20212022 and the frequency of co-infection with SARS-CoV-2 and influenza.&#x0D; AIM: To assess the development of the influenza epidemic and frequency of cases of co-infection with respiratory pathogens in patients with acute respiratory viral infections between 2021 and 2022.&#x0D; MATERIALS AND METHODS: Traditional and hospital epidemiological surveillance methods for acute respiratory viral infections were used.&#x0D; RESULTS: The epidemic season of 20212022 was characterized by the early activity of the influenza A(H3N2) virus and the emergence and rapid spread of the omicron variant of SARS-CoV-2. The distribution of different respiratory pathogens during the epidemic season 20212022 was clearly traced: SARS-CoV-2 (18.8%) was predominant, followed by influenza viruses (10.6%) and pathogens of other acute respiratory viral infections (0.43.7%). With respect to influenza A (H3N2) and B viruses, the heterogeneity of their populations and drift variability in relation to vaccine strains were noted.&#x0D; DISCUSSION: The frequency of co-infection with various respiratory pathogens was low, i.e., it was no more than 0.1%according to traditional surveillance, and no more than 9.2% in the hospital surveillance. The rationale for updating the composition of influenza vaccines for the countries in the Northern Hemisphere for 20222023 season was identified.&#x0D; CONCLUSION: At present, early diagnosis of influenza is important given the availability of effective drugs with a direct mechanism of action for the prevention and treatment of this pathogen. Timely use of anti-influenza drugs will reduce the risks of a severe course, complications, and death, including co-infection with SARS-CoV-2.

MODERN APPROACHES TO DIAGNOSTIC AND TREATMENT OF ADENOIDITIS IN CHILDREN

Diseases of adenoids are one of the most frequent types of ENT pathology in childhood. They often occur against the background of frequent episodes of acute respiratory viral infections (ARVI), bacterial rhinosinusitis, allergic rhinitis. Infectious agent

Lipid mediators in the regulation of innate and adaptive immunity.

Lipid mediators in the regulation of innate and adaptive immunity.

ANALYSIS OF COVID-19 IMPACT ON THE STATE OF HEALTH AND CARDIOVASCULAR FUNCTION OF CHILDREN 7-9 YEARS OLD

Influenza and acute respiratory viral infections pose significant challenges in paediatrics, given their high prevalence among children and the potential for severe and complicated cases, particularly in young age groups. Over the past 20 years, there have been three coronavirus epidemics that have caused a substantial number of severe cases, high mortality rates, and global transmission. This review aims to provide a comparative analysis of clinical and epidemiological features of coronavirus infections in children, drawing from the examples of SARS and MERS, and offers essential approaches and recommendations for the diagnosis and treatment of COVID-19. The review covers the etiology, epidemiology, laboratory diagnosis, clinical presentation, and treatment of severe acute respiratory syndrome. It also provides a brief historical overview of the epidemiology, diagnosis, and treatment of this disease. Unlike other respiratory viral infections, COVID-19 can result in persistent symptoms following the acute phase, known as post-infection COVID-19 syndrome, which can last for weeks or even months. The long-term effects of COVID-19 in children are not yet fully understood, and further research is needed to explore its true prevalence, pathogenesis, and lasting impacts. The management of paediatric post-infection COVID-19 syndrome requires a multidisciplinary approach, international collaboration, and consensus to ensure early detection and effective treatment in children.&#x0D; The article presents current scientific insights into the factors contributing to the development of a prolonged post-COVID period, including chronic systemic inflammation, endothelial dysfunction, coagulation disorders, autoimmune reactions, and other immunological changes. The COVID-19 outbreak serves as a reminder of the ongoing threat posed by infectious diseases caused by pathogenic viruses, highlighting the need for global cooperation and preparedness to effectively mitigate their spread.

Virus-inhibitory activity of the antigen complex of opportunistic pathogenic bacteria against SARS-CoV-2

Introduction. The antigen complex of opportunistic pathogenic bacteria (ACOPB) has a protective effect against avian influenza viruses, herpes virus type 2, and other viruses that cause acute respiratory viral infections. In the context of the COVID-19 pandemic, an important task is to find out whether ACOPB has a protective effect against SARS-CoV-2.&#x0D; The purpose of the study was to evaluate in vitro the ACOPB virus-inhibitory activity against the Dubrovka laboratory strain of SARS-CoV-2.&#x0D; Materials and methods. The study was performed using Vero cell line CCL-81, human peripheral blood mononuclear cells (PBMCs), mouse monoclonal anti-idiotypic antibodies structurally mimicking biological effects of human interferons (IFNs), the Dubrovka laboratory strain of SARS-CoV-2. The infectivity of the virus was assessed by two methods: by virus titration using cell cultures and the limiting dilution method when the results are assessed by a cytopathic effect; the second method was a plaque assay. The in vitro virus inhibition test was performed using the cell culture susceptible to SARS-CoV-2; the mixture containing a specific dose of the virus and a two-fold dilution of ACOPB was transferred to the cell culture after the ACOPB medication had interacted with the virus at 4C for 2 hours. The ACOPB virus-inhibitory activity against SARS-CoV-2 was assessed by the functional activity of / and IFN receptors (RIFN) in human PBMCs induced in vitro by ACOPB and the ACOPB mixture with the specific dose of SARS-CoV-2. The RIFN expression level was measured by the indirect membrane immunofluorescence test.&#x0D; Results. Hemagglutination assay using chicken, mouse, guinea pig, and human red blood cells was performed for detection of the SARS-CoV-2 inhibitory protein. The lysate of Vero CCL-81 cells infected with SARS-CoV-2 Dubrovka demonstrated the highest hemagglutination activity with guinea pig red blood cells and low titers of hemagglutination in the virus-containing fluid. The virus inhibition test in the Vero CCL-81 cell culture demonstrated that ACOPB inhibited 10 doses of SARS-CoV-2 Dubrovka with the titer 1 : 32, providing 100% protection of the cell culture for 8 days (the monitoring period). ACOPB induced / and RIFN expression on membranes of human PBMCs in in vitro cultures and decreased RIFN / and expression after its interaction with SARS-CoV-2 Dubrovka.&#x0D; Conclusion. The experimental studies including the virus inhibition test in the cell culture susceptible to SARS-CoV-2 Dubrovka and the indirect membrane immunofluorescence assay using monoclonal anti-idiotypic antibodies mimicking IFN-like properties demonstrated that ACOPB had both an immunomodulatory and a virus-inhibitory effect.

Local antibacterial therapy in patients with diseases of the nasal cavity and paranasal sinuses, including against the background of cystic fibrosis

Acute respiratory viral infection is one of the most common infectious diseases. Clinical manifestations vary from time to time and from person to person and, as a rule, include intoxication and catarrhal syndromes. ARVI is more often caused by such causative agents as pneumoviruses, human metapneumovirus, coronaviruses, rhinoviruses, adenoviruses and bocaviruses. Among diseases of the ENT organs, ARVI can cause rhinosinusitis and pharyngitis. The inflammation that occurs in the mucosa causes its dystrophy and necrosis, which leads to the dysfunction of mucociliary clearance. As a result, an optimal environment for the development of bacterial flora is created. Bacterial rhinosinusitis needs antibiotic therapy. These drugs can act locally and systemically. It is well known that topical drugs have fewer side effects and result in a greater active substance concentration directly at a site of inflammation. Currently, a nasal framycetin spray is used as a topical antibacterial therapy to treat bacterial rhinosinusitis and in the early postoperative period. Topical drugs have a good evidence base, fewer side effects, and are safe, even for patients with cystic fibrosis. Given the significant antibiotics load in patients with cystic fibrosis, any opportunity to delay re-administration of antibiotics is a positive thing. In this aspect, topical antibiotics that have no systemic adverse events, including negative effects on the normal human microbiome, and can be used to overcome the resistance of microorganisms in a varying degree due to the achievement of high active substance concentration directly in a focus of infection may have a certain therapeutic value. The article addresses issues of epidemiology, pathogenesis, clinical manifestations of acute respiratory viral infection, i. e. acute rhinosinusitis. In addition, the article describes the use of topical antibiotic therapy for the treatment of diseases of the nasal cavities and paranasal sinuses.

Identification of Acute Respiratory Infection Patients Using RP2 Nested Multiplex PCR Test in Jakarta, Indonesia

Acute Respiratory Infection (ARI) is an acute respiratory disease caused by infectious organisms transmitted between humans. Viruses and bacteria generally cause the cause of ARI infection. Other viruses that can also cause ARI are Influenza, Adenovirus, Enterovirus, and Respiratory Syncytial Virus. This study aims to determine the causes of bacterial or viral ARI infection with RP2 Nested Multiplex RT-PCR. The research methodology is cross-sectional. The sample used was 50 people with purposive sampling technique in patients with ARI who examined bacteria and viruses using RP2 Nested Multiplex RT-PCR. The research was located at the Laboratory of the United States Embassy in Jakarta, Indonesia. The results showed that 26 (52%) men suffered more from ARI patients than 24 women (46%), with the most age group being children, 28 people (56%). The three symptoms that many patients in this study felt were that 40 patients (80%) experienced nasal congestion, 38 patients (76%) experienced fever, and 32 patients (64%) coughed. The results of the organisms in the RP2 nested multiplex RT-PCR examination showed that 100% of the causes of ARI were viruses with the highest prevalence (40%) originating from the Human Rhinovirus/Enterovirus. The reason for ARI in this research is from a virus (100%), so antibiotics are not needed for this patient.

Curtailing virus-induced inflammation in respiratory infections: emerging strategies for therapeutic interventions.

Acute respiratory viral infections (ARVI) are the most common illnesses worldwide. In some instances, mild cases of ARVI progress to hyperinflammatory responses, which are damaging to pulmonary tissue and requiring intensive care. Here we summarize available information on preclinical and clinical effects of XC221GI (1-[2-(1-methyl imidazole-4-yl)-ethyl]perhydroazin-2,6-dione), an oral drug with a favorable safety profile that has been tested in animal models of influenza, respiratory syncytial virus, highly pathogenic coronavirus strains and other acute viral upper respiratory infections. XC221GI is capable of controlling IFN-gamma-driven inflammation as it is evident from the suppression of the production of soluble cytokines and chemokines, including IL-6, IL-8, CXCL10, CXCL9 and CXCL11 as well as a decrease in migration of neutrophils into the pulmonary tissue. An excellent safety profile of XC221GI, which is not metabolized by the liver, and its significant anti-inflammatory effects indicate utility of this compound in abating conversion of ambulatory cases of respiratory infections into the cases with aggravated presentation that require hospitalization. This drug is especially useful when rapid molecular assays determining viral species are impractical, or when direct antiviral drugs are not available. Moreover, XC221GI may be combined with direct antiviral drugs to enhance their therapeutic effects.

The effectiveness of a polyvalent antigenic complex including bacterial lysates in the treatment and prevention of rhinosinusitis against the background of acute respiratory viral infections and COVID-19 (clinical description)

One of the urgent tasks of the Ministry of Health of the Russian Federation, noted in the State report on the state of sanitary and epidemiological welfare of the population, is the improvement and implementation of diagnostic and treatment and prevention technologies. First of all, this concerns the continued growth of respiratory viral infections, seasonal influenza epidemics, where SARS-CoV-2 coronavirus infection occupies a special place, which often cause various otorhinolaryngological complications – acute and exacerbations of chronic tonsillopharyngitis, rhinosinusitis, tubotitis, purulent otitis media. In the treatment of bacterial sinusitis, in accordance with clinical recommendations, intranasal corticosteroids, elimination therapy, herbal remedies, and antibacterial drugs are used. Due to the period of the SARS-CoV-2 pandemic, a significant proportion of patients took large doses of antibacterial drugs, which caused an increase in the resistance of microorganisms to them. In this regard, it is possible to use immunostimulating drugs that stimulate cellular and humoral immunity, promote the development of a specific immune response and activate nonspecific defense factors such as lysozyme, mucin, lactoferrin and normalize mucociliary clearance. As a rule, the identification of a viral agent is carried out in case of a severe clinical course of the disease or complications from the ORL and other organs, and the use of immunostimulating agents in complex therapy is necessary at the earliest possible time of the disease. In this context, the use of immunostimulants containing polyvalent antigenic complexes, including bacterial lysates, the most common pathogens of respiratory infections, is justified. It is preferable in these cases to use lysates of bacteria obtained by mechanical destruction of bacterial cells, since they have a more pronounced non-specific immunostimulatory and specific vaccinating effect.

Modern Approaches to the Management of Children with Acute Respiratory Viral Infection

Experts of the Union of Pediatricians of Russia have developed modern guidelines on management of children with acute respiratory viral infection. The term “acute respiratory viral infection” (ARVI) combines following nosological forms: acute nasopharyngitis, acute pharyngitis, acute laryngitis, acute tracheitis, acute laryngopharyngitis, upper respiration tract infection (unspecified). The issues of epidemiology, diagnosis, treatment, and prevention have been considered in detail.

The effectiveness of essential oils in the treatment of acute viral rhinosinusitis

Introduction. Acute respiratory viral infections are the most widespread diseases, accounting for up to 90% of all infectious pathology, which supports the relevance of optimizing the treatment of acute viral rhinosinusitis.Aim. Evaluate the dynamics of clinical symptoms of acute viral rhinosinusitis, which arose as part of an acute respiratory infection, when supplementing therapy with the drug Respero Myrtol (Pol-Boskamp GmbH and Co.KG, Germany), the active ingredient of which is myrtol standardized 120 mg in 1 capsule.Materials and methods. The dynamics of clinical symptoms of 20 cases of acute viral rhinosinusitis in comparison groups was analyzed. Traditional treatment of patients included taking propionic acid derivatives, ascorbic acid, intranasal use of decongestants and irrigation of the nasal cavity with isotonic saline solutions. Patients who have received traditional treatment are defined as a “standard therapy group”. To assess the effectiveness of therapy using standardized myrtol, 20 cases of acute viral rhinosinusitis against the background of acute respiratory viral infections with a similar severity were analyzed, in which patients received outpatient therapy with Respero Myrtol 2 capsules 3 times a day for 7 days in addition to the above treatment (the “myrtol therapy” group). The dynamics of the disease assessed: the number of days of disability before recovery, the period of normalization of body temperature in feverish patients, the need for vasoconstrictive intranasal agents after the seventh day of therapy, the period of complete relief of pain syndrome, the period of normalization of night sleep, the number of cases of bacterial superinfection and the need for systemic antibacterial therapy.The results. In the observed patients, the quality of sleep was restored faster, the pain syndrome was stopped earlier, less often there was a need for systemic antibiotics and prolonged use of intranasal decongestants. The disease proceeded with fewer days of disability.Conclusion. The study results have been shown to report the clinical efficacy of Respero Myrtol essential oils in the outpatient treatment of patients with acute rhinosinusitis.

Time Course scRNAseq Analysis Reveals Mechanisms of Impaired Lung Recovery Post Influenza Infection during Aging: Zooming into Macrophages

Abstract Aging is considered to be a major risk factor for host morbidity and mortality upon acute respiratory virus infections. To better elucidate the immune determinants of viral pathogenesis during aging, we chronological characterized lung cellular and molecular profiles following influenza virus (PR8) infection in young or aged mice till 60 days post infection. Time-course scRNAseq coupled with high dimensional flow cytometry enabled the description of changes in both immune and stromal compartment between young and aged hosts. We further zoomed into the myeloid compartment and focused on the dynamic responses of lung macrophages given their complex roles in viral pathogenesis, tissue repair and lung fibrosis. Enlarged Monocyte-derived Macrophage (MoM) population as well as decreased resident-Alveolar Macrophage (AM) population were observed in the aged mice when compared to those of the young mice. Despite the self-sustain nature of AMs during homeostasis, it has been reported that Ly6C himonocytes can gain AM identity following severe lung damage like influenza virus infection. We found that the gain of AM identity from monocytes was abrogated in the aged hosts, which likely contributed to the age-associated impairment in lung recovery after influenzas virus infection. Additionally, trajectory analysis with scRNAseq allowed us to identify IFNα/γ signaling to be potential pathways contributing to such defect. This notion is also supported by elevated IFNγ level in BAL from the aged host during lung recovery. Our results thus have improved our understanding on the cellular and molecular mechanisms by which aged hosts exhibit severe diseases and delayed recovery after respiratory viral infection.

Особливості маніфестації неврологічних симптомів гострих полінейропатій та їх диференційна діагностика в дітей при коронавірусній хворобі (COVID-19)

The relevance of the problem of diagnosis and treatment of polyneuropathy in children is due to the diverse clinical manifestations of this pathology, which are often acute and can lead to severe, life-threatening complications. Guillain-Barré syndrome (GBS) refers to acute or subacute, often post-infectious, immune-mediated polyneuropathies accompanied by axonal damage to nerve trunks and peripheral nerves. The present study is devoted to the assessment of neurological symptoms in the acute course of GBS, including its differential diagnosis with musculoskeletal lesions in coronavirus disease (COVID-19) in childhood. Purpose - to determine the features of the debut and characterize the neurological symptoms of acute polyneuropathies in children, including GBS in COVID-19. Materials and methods. We examined 10 children with confirmed GBS. Clinical-anamnestic, general clinical, clinical-neurological, clinical-instrumental and clinical-laboratory methods of examination were used. Results. In 1 of the examined patients aged 6 years, GBS developed in the acute period of COVID-19 and manifested as acute flaccid paresis in the distal, and after 4 days - severe weakness of the thigh muscles in combination with leg pain. In 8 of the examined patients, the debut of GBS occurred within 7-21 days after an acute respiratory viral infection. Of these, 6 children had the acute phase of COVID-19 14-21 days before the onset of GBS, which was confirmed by the results of an oropharyngeal PCR-test. The acute phase of COVID-19 in these patients was manifested by fever up to 38.0º, ague, hyposmia, lasting from 3 to 5 days. Severe pain in the legs was noted in all patients with GBS. The absence of elevated levels of creatine phosphokinase, alanine aminotransferase, aspartate aminotransferase according to biochemical blood tests in patients and the absence of myoglobin in the urine excluded rhabdomyolysis of skeletal muscles. Electroneuromyography (ENMG) confirmed the neural type of lesion in the legs. Conclusions. In most patients, the debut of GBS occurred 3 weeks after the acute phase of COVID-19. Pain syndrome and symmetrical flaccid paresis were the leading symptoms of the course of GBS in children. Reduced excitation conduction velocity along the motor fibres of the tibial and peroneal nerves, according to the results of ENMG, allowed confirming the diagnosis of GBS. Differential diagnosis of GBS with musculoskeletal lesions, in particular, the exclusion of the diagnosis of rhabdomyolysis in COVID-19 in children, allowed for timely prescription of adequate therapy. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institutions. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.