Virus Infection In Children Research Articles

Seroprevalence of Epstein-Barr virus infection in children during the COVID-19 pandemic in Zhejiang, China.

We aimed to investigate the seroprevalence of Epstein-Barr virus (EBV) infection in children before and during the COVID-19 pandemic. All children admitted to the Children's Hospital Affiliated to Zhejiang University from January 2019 to December 2021 with suspected EBV-associated disease and EBV antibodies were detected by a two-step indirect method of chemiluminescence technology. A total of 44,943 children were enrolled in this study. The seroprevalence of EBV infections was compared from January 2019 to December 2021. The total seropositive rate of EBV infections was 61.02% between January 2019 and December 2021, and the seropositive trend decreased year by year. The total number of seropositive EBV infections in 2020 was reduced by 30% compared to that in 2019. In particular, nearly 30% and 50% reductions in the number of acute EBV infections and EBV reactivations or late primary infections from 2019 to 2020 were found, respectively. The number of acute EBV infections in children aged 1-3 years and EBV reactivation or late primary infection in children aged 6-9 years in 2020 sharply dropped by approximately 40% and 64% compared to that in 2019. Our study further demonstrated that the prevention and control measures for COVID-19 in China had a certain effect on containing acute EBV infections and EBV reactivations or late primary infections.

Characteristics of immunological events in Epstein-Barr virus infection in children with infectious mononucleosis.

Epstein-Barr virus (EBV) infection occurs commonly in children and may cause acute infectious mononucleosis (AIM) and various malignant diseases. Host immune responses are key players in the resistance to EBV infection. We here assessed the immunological events and laboratory indicators of EBV infection, as well as determined the clinical usefulness of evaluating the severity and efficacy of antiviral therapy in AIM patients. We enrolled 88 children with EBV infection. The immune environment was defined by immunological events such as frequencies of lymphocyte subsets, phenotypes of T cells, and their ability to secrete cytokines, and so on. This environment was analyzed in EBV-infected children with different viral loads and in children in different phases of infectious mononucleosis (IM) from disease onset to convalescence. Children with AIM had higher frequencies of CD3+ T and CD8+ T cells, but lower frequencies of CD4+ T cells and CD19+ B cells. In these children, the expression of CD62L was lower and that of CTLA-4 and PD-1 was higher on T cells. EBV exposure induced granzyme B expression, but reduced IFN-γ secretion, by CD8+ T cells, whereas NK cells exhibited reduced granzyme B expression and increased IFN-γ secretion. The frequency of CD8+ T cells was positively correlated with the EBV DNA load, whereas the frequencies of CD4+ T cells and B cells were negatively correlated. During the convalescent phase of IM, CD8+ T cell frequency and CD62L expression on T cells were restored. Moreover, patient serum levels of IL-4, IL-6, IL-10, and IFN-γ were considerably lower throughout the convalescent phase than throughout the acute phase. Robust expansion of CD8+ T cells, accompanied by CD62L downregulation, PD-1 and CTLA-4 upregulation on T cells, enhanced granzyme B production, and impaired IFN-γ secretion, is a typical characteristic of immunological events in children with AIM. Noncytolytic and cytolytic effector functions of CD8+ T cells are regulated in an oscillatory manner. Furthermore, the AST level, number of CD8+ T cells, and CD62L expression on T cells may act as markers related to IM severity and the effectiveness of antiviral treatment.

424 - Safety and Efficacy of Virus-Specific Cytotoxic T-Lymphocytes Manufactured By the IFN-γ Cytokine Capture System for the Treatment of Refractory Adenovirus, Cytomegalovirus, Epstein Barr Virus, and BK Virus Infections in Children, Adolescents and Young Adults after Allogeneic Hematopoietic Stem Cell Transplantation, Solid Organ Transplantation, or with Primary Immunodeficiency (IND# 17449)

424 - Safety and Efficacy of Virus-Specific Cytotoxic T-Lymphocytes Manufactured By the IFN-γ Cytokine Capture System for the Treatment of Refractory Adenovirus, Cytomegalovirus, Epstein Barr Virus, and BK Virus Infections in Children, Adolescents and Young Adults after Allogeneic Hematopoietic Stem Cell Transplantation, Solid Organ Transplantation, or with Primary Immunodeficiency (IND# 17449)

Serum 25-Hydroxyvitamin D Was Not Associated with Influenza Virus Infection in Children and Adults in Hong Kong, 2009–201

Background: Some studies have hypothesized that vitamin D may have a role to play in protection against influenza virus infections and illnesses, and that seasonal fluctuation in serum 25-hydroxyvitamin D [25(OH)D] may affect seasonal patterns of influenza virus infections.Objective: We aimed to investigate whether serum 25(OH)D concentrations were associated with the incidence of influenza virus infections and illnesses in children and adults in Hong Kong.Methods: In 2009–2010, 3030 children and adults of all ages from 796 households in Hong Kong were followed up to identify acute respiratory illnesses. Sera from 2694 participants were collected at baseline and after ∼1 mo, 6 mo, and 12 mo. Influenza virus infections were confirmed by reverse transcriptase–polymerase chain reaction performed on nasal and throat swab samples collected during illness episodes. Serologic evidence of influenza virus infection was measured by hemagglutination inhibition assays in unvaccinated participants. The serum 25(OH)D concentrations were measured after collection of all specimens. Each individual’s baseline serum 25(OH)D concentration on 1 January 2010 was predicted by a random-effects linear regression model.Results: We found that, in children and adults who had not received a seasonal influenza vaccine, baseline serum 25(OH)D concentrations (<50 nmol/L compared with ≥50 nmol/L) were not statistically significantly associated with serologic evidence of influenza A(H1N1)pdm09 (RR, 1.18; 95% CI: 0.85, 1.65) or seasonal influenza virus infections [including A(H3N2) and B virus] (RR, 1.13; 95% CI: 0.86, 1.49). In all participants, baseline serum 25(OH)D concentrations were not statistically significantly associated with polymerase chain reaction–confirmed influenza virus infection (RR, 1.15; 95% CI: 0.73, 1.83) and influenza-like illness (RR, 1.18; 95% CI: 0.98, 1.43).Conclusions: These findings indicate that lower serum vitamin D concentrations may not contribute to the seasonality of influenza and are not associated with an increased risk of influenza virus infections in persons of all ages in Hong Kong.

Successful Treatment of Complicated Influenza A(H3N2) Virus Infection and Rhabdomyolysis with Compassionate Use of IV Zanamivir

In 2019, EMA licensed intravenous (IV) zanamivir for severe influenza virus infection in children over 6 months as well as adults. Prior to that, it was possible via a compassionate use program. We present successful compassionate use of IV zanamivir in a 14-year-old female with severe influenza A(H3N2) and multi-organ failure, who had failed oral oseltamivir. Her illness was complicated by acute respiratory distress syndrome and rhabdomyolysis requiring extracorporeal membrane oxygenation and hemofiltration. Considering the broad safety margins with neuraminidase inhibitors, an adult dose of 600 mg IV BID was administered in this 60 kg patient. Influenza virus was cleared rapidly and undetectable on day 13. Creatine kinase (CK) values were dropping from 38,000 to 500 within nine days. Given the recent licensure of IV zanamivir, multi-center prospective observational studies in pediatric Intensive Care Unit patients would be beneficial to guide the most appropriate use of IV zanamivir in this vulnerable age group.

Эффективность нового режима дозирования препарата Виферон® в терапии гриппа и других ОРВИ у детей разного возраста с нарушениями в состоянии здоровья

Purpose. To study the efficacy and safety of a new dosing regimen of Viferon®, rectal suppositories, in the treatment of influenza and other acute respiratory viral infections (ARVI) in children from 1 month of age. up to 18 years of age with deviations in the state of health (related to II–IV health groups). Patients and methods. Conducted a double-blind placebo-controlled study involving 260 children aged 1 month up to 18 years of health groups II–IV, patients with influenza and other acute respiratory viral infections, who were randomized into 2 groups: 129 people group 1 received Viferon®, rectal suppositories, 131 people group 2 – placebo according to one of the three treatment regimens in accordance with the age of the children. All patients received standard therapy: antipyretics, anticongestants, mucolytics, if necessary, antihistamines and antibacterials. Clinical and laboratory observation was carried out within 10 days of therapy and then 1, 3 and 6 months after the start of treatment. Statistical processing was carried out using the statistical software Statistica 13.0. Null hypotheses were rejected at p &lt; 0.05. Results. The inclusion of the drug Viferon®, rectal suppositories, in the complex therapy of influenza and other acute respiratory viral infections in children of II–IV health groups, compared with Placebo, significantly reduces the period of improvement by 2.82 days (p = 0.0001, Tukey's test), by 2.85 days of recovery (p = 0.0001, Tukey's test), contributes to a 3.5-fold decrease in the proportion of patients with complications (p &lt; 0.001), and also allows a significant reduction in the number of episodes of influenza and other acute respiratory viral infections during the follow-up period after 1, 3 and 6 months after therapy. Conclusion. Complex therapy of influenza and other acute respiratory viral infections in children with functional and morphofunctional deviations in health status (II–IV health groups) using the drug Viferon®, rectal suppositories, according to a modified scheme using higher doses and with a longer duration of therapy, can reduce the onset improvement and overall recovery of patients, reduce the number of complications of influenza and other acute respiratory viral infections, reduce the number of recurrent episodes of the disease during the follow-up period 1, 3 and 6 months after treatment. Key words: Viferon®, children, immunity, interferon, influenza, acute respiratory viral infections

Влияние карбоцистеина на выраженность кашля и компоненты местного иммунитета слизистых оболочек на фоне ОРВИ у детей

Aim: To evaluate the effect of carbocysteine on cough and the level of secretory immunoglobulin A (sIgA) in saliva in children with acute respiratory viral infections (ARVI) and the presence of a correlation between the level of sIgA in saliva and the total cough index. Design: Multicentre observational study. Materials and methods. 156 children older than 2 years (4.4 ± 1.2 years) with ARVI were included in the study. All patients received carbocysteine at the age dosage. The total cough index and the concentration of sIgA in saliva were measured on days 1–2 and on days 7–10 from the onset of ARVI. Results. The total cough index significantly decreased in 98.7% of patients by the 7–10th day of illness. The level of sIgA in saliva was initially 26.49 (8.94; 56.51) μg/ml, in dynamics — 30.07 (8.52; 60.40) μg/ml (no significant differences were found). An increase in the level of sIgA in dynamics was noted in 43.6% of patients, and in the vast majority of them the increase was significant — 20% or more. A decrease in the concentration of sIgA in dynamics was noted in 55.8% of patients. A significant correlation was found between sIgA concentrations in saliva at the first and second visits (p &lt; 0,001). There was no significant correlation between the total cough index and sIgA levels. Conclusion. A significant positive dynamic of cough was noted in patients with ARVI during treatment with carbocysteine. The concentration of sIgA in saliva varies within a wide range. A multidirectional change in the level of sIgA in saliva over time was noted in children with ARVI. Further study of the mechanisms of local mucosal immunity can help in the development of new approaches to the treatment and prevention of ARVI. Keywords: carbocysteine, secretory immunoglobulin A in saliva, acute respiratory viral infections in children, cough, mucosal immunity.

Epidemiological and genetic characteristics of respiratory syncytial virus infection in children from Hangzhou after the peak of COVID-19.

Respiratory syncytial virus (RSV) is one of the main pathogens that causes acute lower respiratory tract infection (ARTI) in infants. During the Coronavirus Disease 2019 (COVID-19) pandemic, although strict interventions have been implemented, RSV infection has not decreased. To study the epidemiological and genetic characteristics of RSV circulating in Hangzhou after the peak of COVID-19. A total of 1225 nasopharyngeal swabs were collected from outpatients with ARTIs from July 2021 to January 2022 in The Children's Hospital, Zhejiang University School of Medicine. A total of 267 (21.79%) of the 1225 samples were RSV positive. There was no gender bias. However, an obvious age preference for infection was observed, and children aged 3-6 years were more susceptible, which was very different from previous RSV pandemic seasons. Phylogenetic analysis of 115 sequenced RSV isolates showed that all the RSV-A viruses belong to the ON1 subtype, which could be clustered into three clusters. While all the RSV-B viruses belong to BA9. Further analysis of the mutations highlights the fixation of ten mutations, which should be given extra attention regarding their biological properties. The incidence of RSV infection in preschool children reported in this study is high. Phylogenetic analysis showed that the subtype A ON1 genotype was the dominant strain in Hangzhou from July 2021 to January 2022.

Significance of expression of selected miRNAs in the diagnosis of hepatological complications of Epstein-Barr virus infection in children.

To assess the expression of selected miRNAs as predictive factors of hepatological complications in Epstein-Barr virus (EBV)-infected children. This study included 68 children infected with EBV aged 1 to 18 years hospitalised between 01.12.2018 and 31.12.2020 in the Department of Paediatrics, Infectious Diseases and Hepatology. The expression of 5 miRNAs (miR-122-5p, miR-21-3p, miR-34a-5p, miR-26b-5p, miR-199a-5p) was analysed by real-time PCR using the TaqMan Fast Advanced Master Mix kit. In the group of EBV-infected children, statistically significantly higher expression for miR-21-3p, miR-122-5p, miR-26b-5p and miR-34a-5p was confirmed. In a group of 54 children diagnosed with hepatitis, along with an increase in alanine aminotransferase (ALT) and g-glutamyl transpeptidase (GGTP) activity, an increase in expression of miR-21-3p, miR-122-5p, miR-26b-5p, miR-34a-5p and miR-199a-5p was observed. Increased expression of miR-21-3p, miR-122-5p, miR-26b-5p, miR-34a-5p and miR-199a-5p in EBV-infected children appears to be a risk factor for hepatological complications progressing to biliary pole defects.

Perceptions and challenges among health care providers about HIV-TB co-infected children- A qualitative study

BackgroundHuman immunodeficiency virus – Tuberculosis (HIV-TB) co-infected patients have a greater risk of mortality, treatment failure, and recurrence. The significant morbidity and mortality rates associated with tuberculosis and human immunodeficiency virus infection in children cause concern. India aims to enhance the detection and treatment of HIV-TB cases in children and coordinate TB & HIV care. ObjectiveTo explore the perceptions and challenges of health care providers regarding the diagnosis and treatment of Tuberculosis in HIV-TB co-infected children. Materials and methodIn-depth interviews among 14 health care providers were conducted in ART centers of 5 talukas of Belagavi district to identify health care providers' perceptions and challenges regarding pediatric HIV-TB diagnosis and treatment. Interviews were conducted after receiving informed consent. ResultsChallenges during HIV-TB diagnosis and treatment in children: difficult to get sputum sample for CBNAAT and child was unable to complain about symptoms, caregivers were not able to mention the signs/symptoms correctly, unavailability of a pediatrician in few Taluka ART centers, delay in receiving TB lab report, challenging to feed drugs to an infant, higher loss to follow-up, financial problem, distance from centers, low community awareness, poverty and illiteracy, stigma and death due to TB treatment default. ConclusionEfforts such as expanded health care providers, community education, and a constant supply of HIV rapid test kits are required to ensure successful diagnosis and treatment of HIV-TB co-infected children.

Проблемы и возможности лечения инфекций верхних дыхательных путей у детей на сегодняшний день

This article presents the resolution and materials of the Expert Council meeting held in Saint Petersburg on May 24, 2023. The meeting was devoted to topical issues of treatment of oropharyngeal infections in children. Leading infectious disease specialists, pediatricians and immunologists from Moscow, Saint Petersburg, Kazan, and other cities of Russia took part in the discussion. According to the resolution, today in the Russian Federation there is a high incidence of acute respiratory infections among children with a high frequency of complications, and fatal outcomes are registered. Numerous cases of active herpesvirus infections are recorded, especially among frequently ill children. The current clinical guidelines for the treatment of acute respiratory viral infections lack algorithms for differentiated therapeutic approaches that reduce disease duration, prevent the development of complications and recurrent episodes of respiratory infections. In clinical practice, there is excessive, often unjustified prescription of antimicrobial therapy, which aggravates intestinal disorders, reducing colonization and immune resistance, and provokes oral infections and inflammations caused by opportunistic pathogens. Based on the presented data, it is necessary to correct clinical recommendations for the treatment of acute respiratory viral infections in children with the introduction of indications for prescribing benzydamine in cases of tonsillitis, pharyngitis (tonsillopharyngitis) and stomatitis as a first-choice medication for sore mouth and throat. It also seems necessary to include data on the efficacy of inosine pranobex in symptoms of acute respiratory viral infections of various etiologies, including COVID-19 and active herpesvirus infections. Key words: benzydamine, herpesvirus infections, inosine pranobex, microbiome, acute respiratory viral infections, ARI, tonsillitis, tonsillopharyngitis, pharyngitis, COVID-19, SARS-CoV-2

2165. Surveillance of Severe Viral Respiratory Infections among Children Presenting to Hôpital Saint Damien in Haiti

Abstract Background Learning the burden and seasonality of respiratory viral infections in children in resource-limited settings is critical for hospital infection care and prevention and national public health programs. We built a prospective surveillance program of severe acute respiratory illness (SARI) in hospitalized children at Hôpital Saint Damien - Nos Petits Frères et Soeurs to gather local evidence and support informed clinical and policy decision-making. The COVID-19 pandemic erupted as we were launching our project, requiring the use of available point-of-care diagnostics. Methods Children &amp;lt; 18 years of age with cough, history of fever ≥ 38 C°, of &amp;lt; 10 days evolution, and requiring hospitalization were included in the study. We obtained a nasopharyngeal swab and collected demographic and clinical data for eligible patients. Samples were tested using antigen test on-site for influenza A (Flu A) and B (Flu B), respiratory syncytial virus (RSV), and SARS-CoV-2. Afterwards, all specimens (both negative and positive) were stored and shipped for molecular studies. Results We obtained and tested 167 samples from patients since April 30, 2021, through January 31, 2022. Single isolates were detected in 88 samples (53%), multiple isolates in 20 samples (12%), and no isolates in 59 samples (35%). Positive cases for RSV, Flu A, and Flu B peaked between November and January. Rhinovirus 1A (RhV) was detected throughout the study period, with peaks around August-September and was the most often detected viral isolate (49, 38%), followed by RSV (37, 29%). Co-infections were seen with RSV, Flu A, RhV, and SARS-CoV-2. Molecular studies detected 7 isolates of Flu A not detected by rapid test, 1 isolate of Flu B, and 1 isolate of SARS-CoV-2. However, it failed to detect 2 isolates of Flu A detected by rapid test, 1 isolate of Flu B, and 1 isolate of SARS-CoV-2. Conclusion Our study captured circulating respiratory viruses in children with SARI in Haiti during the COVID-19 pandemic. Preliminary data suggest an increase in respiratory viruses between August and January. Improving point-of-care diagnostics can better inform providers of the local epidemiology of respiratory viruses and support clinical decision-making, such as good use of antibiotics. However, we confirmed the sensitivity of molecular testing. Disclosures All Authors: No reported disclosures.

The Impact of Multiple Viral Infection in Children with Severe Lower Respiratory Tract Infections

The Impact of Multiple Viral Infection in Children with Severe Lower Respiratory Tract Infections

Duration of clinical symptoms in children with acute respiratory infection.

To investigate duration of clinical symptoms associated with various respiratory viruses and with the co-detection of respiratory viral and bacterial pathogens. This prospective cohort study included 737 acutely ill children treated in a paediatric emergency department prior to the COVID-19 pandemic. Nasal swab samples were analysed with multiplex PCR panels for 16 viral and 7 bacterial respiratory pathogens. Parents filled in a questionnaire about the symptoms at the time of the visit and 14 days afterwards. Persistent symptoms 2 weeks after the onset of acute illness were common: 32% of the patients with a coronavirus 229 E, NL63 or OC43 finding, 31% of those with human metapneumovirus and 25% of those with rhinovirus reported ongoing symptoms. At least one symptom lasting more than 4 weeks was observed in 3-4% of the children. Children with viral and bacterial co-detection had a longer duration of fever than those with only viral detection (3.3 days [SD 2.8] vs. 1.6 days [SD 2.4], p < 0.001). Symptoms lasting for more than 2 to 4 weeks appear to be relatively frequent in all respiratory viral infections in children. Viral and bacterial co-detection may increase the duration of illness.

Predictors of first-line antiretroviral treatment failure among children on antiretroviral therapy at the University of Gondar comprehensive specialised hospital, North-west, Ethiopia: a 14-year long-term follow-up study

ObjectiveTo determine the incidence and predictors of first-line human immune deficiency virus treatment failure among human immune deficiency virus-infected children at the University of Gondar comprehensive specialised hospital in Ethiopia.DesignA...

Incidence and predictors of tuberculosis among children on antiretroviral therapy at northeast Ethiopia comprehensive specialized hospitals, 2022; A multicenter retrospective follow-up study

IntroductionAround the world, tuberculosis (TB) is the most common cause of mortality and morbidity in both adults and children. The incidence of tuberculosis (TB) is increased worldwide by co-infection with the human immunodeficiency virus (HIV), particularly in Sub-Saharan Africa. As a result, the study aimed to determine the incidence and predictors of tuberculosis among children on antiretroviral therapy at northeast Ethiopia Comprehensive Specialized Hospitals. MethodsAn institution-based retrospective follow-up study was carried out in northeast Ethiopia’s Comprehensive Specialized Hospitals, among 362 children on antiretroviral therapy from January 1, 2007, to September 30, 2021. The data were entered into Epi Data version 4.6.1 and then exported to STATA version 16 for analysis. Bivariate and multivariable Cox proportional hazards model was used to discover tuberculosis predictors. Variables with a p-value of <0.05 at 95% confidence intervals in the multivariable Cox proportional hazard model were considered statistically significant. ResultsAmong the 358 Human Immunodeficiency Virus-infected children, two-thirds (69.3%) were over ten years old. The overall tuberculosis incidence rate was 2.0 (95%CI: 1.5–2.6) per 100 person-years with a total of 2452 years of observations. WHO clinical stages III and IV [AHR: 3.2 (95% CI 1.8–5.5)], being severely stunted [AHR = 2.1 (95% CI, 1.5–358)], and “Fair” and “poor” adherence levels to antiretroviral therapy [AHR = 4.0 (95% CI 1.5–10.8)] were independent predictors of tuberculosis. ConclusionThe incidence of tuberculosis in children infected with HIV/AIDS was high in this study. The risk of tuberculosis (TB) in HIV/AIDS-infected children has been linked to WHO stages III and IV, severe stunting, and "Fair" and "Poor" ART adherence. As a result, children with HIV/ADIS should be evaluated on a regular basis in order to improve the quality of ART services and reduce the incidence rate of tuberculosis among children.

XiaoEr LianHuaQinqGan alleviates viral pneumonia in mice infected by influenza A and respiratory syncytial viruses

Context Xiaoer lianhuaqinqgan (XELH), developed based on Lianhua Qingwen (LHQW) prescription, contains 13 traditional Chinese medicines. It has completed the investigational new drug application to treat respiratory viral infections in children in China. Objective This study demonstrates the pharmacological effects of XELH against viral pneumonia. Materials and methods The antiviral and anti-inflammatory effects of XELH were investigated in vitro using H3N2-infected A549 and LPS-stimulated RAW264.7 cells and in vivo using BALB/c mice models of influenza A virus (H3N2) and respiratory syncytial virus (RSV)-infection. Mice were divided into 7 groups (n = 20): Control, Model, LHQW (0.5 g/kg), XELH-low (2 g/kg), XELH-medium (4 g/kg), XELH-high (8 g/kg), and positive drug (20 mg/kg oseltamivir or 60 mg/kg ribavirin) groups. The anti-inflammatory effects of XELH were tested in a rat model of LPS-induced fever and a mouse model of xylene-induced ear edoema. Results In vitro, XELH inhibited the pro-inflammatory cytokines and replication of H1N1, H3N2, H1N1, FluB, H9N2, H6N2, H7N3, RSV, and HCoV-229E viruses, with (IC50 47.4, 114, 79, 250, 99.2, 170, 79, 62.5, and 93 μg/mL, respectively). In vivo, XELH reduced weight loss and lung index, inhibited viral replication and macrophage M1 polarization, ameliorated lung damage, decreased inflammatory cell infiltration and pro-inflammatory cytokines expression in lung tissues, and increased the CD4+/CD8+ ratio. XELH inhibited LPS-induced fever in rats and xylene-induced ear edoema in mice. Conclusion XELH efficacy partially depends on integrated immunoregulatory effects. XELH is a promising therapeutic option against childhood respiratory viral infections.

Children with Asthma Exposed to COVID-19 Show a Decrease in Severity from Baseline: A Systematic Review from March 2020 to September 2022

Introduction: During the COVID-19 pandemic, children have been affected by SARS- CoV-2 infection, primarily affecting the respiratory system. Children with chronic respiratory diseases such as asthma, emphysema, and chronic bronchitis can experience an exacerbation of the preexisting conditions. The study's primary aim was to identify the severity of asthma in COVID-19-exposed children aged 4-12 years. Methods: We extracted the data from the PubMed database between March 2020 and September 2022. During the COVID-19 pandemic, PubMed-published articles involving children living with asthma aged 4-12 years were identified. The study included children who had tested positive for SARS-CoV-2 and excluded children with any other comorbidities. Results:We identified 169 PubMed- published articles and filtered 28 articles. Seven articles met the inclusion criteria and were included in the study. The children with asthma hospitalized owing to COVID-19 worldwide was 1% to 2.7%. Incidence was 12.8 times less frequent in children than in adults. Increased expression of the angiotensin-converting enzyme-2 gene in the bronchial epithelium of patients with type 2-low or T1-high asthma tended to have higher known risk factors for COVID-19. Among school-age children (N=277,285), 1.2% were hospitalized, 0.1% had intensive care unit admissions, and &lt;0.1% died. Of those patients (hospitalized, ICU admissions, and those who died from COVID-19), all had at least one underlying medical condition, and 55% had chronic lung disease, including asthma. Conclusion: Most children with recurrent wheezing and asthma were well-controlled by their underlying asthma and did not require significant changes to their maintenance treatments. It concludes that children who tested positive for SARS-CoV-2 had fewer pediatric hospital admissions and attendance at urgent care settings. The reduction in asthma morbidities is due to improved adherence and decreased exposure to allergens and viral infections in children.

A modern view on the clinical value of the study of oral fluid in the practice of a pediatrician

Currently, the attention of the medical community to a non-invasive method of laboratory diagnostics - the study of oral fluid (oral, saliva, saliva test) in various fields of clinical medicine and mainly in adult patients has been updated. Saliva testing has shown good results, especially in the areas of genomics, microbiomics, proteomics, metabolomics, and transcriptomics. The review presents the possibilities of using a non-invasive method for infectious and non-infectious diseases in children. Saliva contains a wide range of protein DNA and RNA biomarkers that help detect many viral infections in children. Oral fluid tests for human immunodeficiency virus, hepatitis B virus have improved access to diagnostics for infants. Both serological and molecular analyzes of the oral fluid are suitable for routine examination and early detection of measles virus RNA, polyomaviruses. Angiotensin-converting enzyme-2 receptor expression was found in the saliva of children with COVID-19, which can be used to diagnose SARS-CoV-2. The saliva test is as effective as the standard test at identifying asymptomatic individuals in contact tracing. The possibilities of saliva diagnostics are positively assessed in transplantology. New biomarkers in saliva have been identified for the diagnosis of many somatic diseases in children. The role of oral fluid as an alternative to blood serum in patients with terminal renal failure, chronic kidney disease (determination of creatinine, urea) in both adults and children is shown. The data obtained may influence the recommendations for the treatment of patients. As a non-invasive method, the study of oral fluid is promising for the diagnosis, prognosis, monitoring of diseases, large-scale typing of children, and the search for new biomarkers.

Viral infections in pediatric brain tumor patients treated with targeted therapies.

Brain tumors are the most common solid malignancies and the leading cause of cancer-related mortality in children. While numerous studies report on viral infections in children with hematologic malignancies and solid organ transplantation, epidemiologic data on the incidence and outcome of viral infections in pediatric patients with brain tumors treated with targeted therapies are still lacking. We retrospectively reviewed all children with brain tumors receiving targeted therapies in a primary or recurrent setting at the Medical University of Vienna from 2006 to 2021. Demographic variables, quantitative and qualitative parameters of possible infections, and treatment outcomes were recorded. In our cohort (n=117), 36% of the patients developed at least one PCR-proven viral infection. Respiratory and gastrointestinal tract infections were most common, with 31% and 25%, respectively. Central nervous system (CNS) infections occurred in approximately 10%, with an almost equal distribution of varicella-zoster virus, John Cunningham virus (JCV), and enterovirus. Two patients tested PCR-positive for SARS-CoV-2 infection, with one virus-related death caused by a SARS-CoV-2-related acute respiratory distress syndrome. Patients receiving bevacizumab or mTOR inhibitors seem to have a greater susceptibility to viral infections. Pediatric patients with brain tumors receiving targeted therapies have a higher risk of viral infections when compared to children receiving conventional chemotherapy or the general population, and life-threatening infections can occur. Fast detection and upfront treatment are paramount to prevent life-threatening infections in immunocompromised children suffering from brain tumors receiving targeted therapies.