Virus detection in critically ill children with acute respiratory disease: a new profile in view of new technology

Kawaguchi, Atsushı; Bates, Angela; Lee, Bonita E.; Drews, Steven J.; Garros, Daniel

doi:10.1111/apa.14148

Cited by 5 publications

(10 citation statements)

References 26 publications

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“…The age distribution of the infected children we observed also conforms to this feature, and most of them are asymptomatic or mildly febrile and or symptoms of ARI. 3,21 However, the changes of chest CT are more typical of viral pneumonia, 16 which is consistent with the results of other relevant reports. Also,from the 2019-nCoV cases with coinfection we excluded, they all had fever and symptoms of ARI, chest CT findings of viral pneumonia were also typical.…”

Section: Discussionsupporting

confidence: 88%

“…The clinical picture of these different pneumonias can be very similar, but viral infection is more common in the pediatric populations.Despite great advances in virus detection and pneumonia imaging, 4-5 the identification and differential diagnosis of viral infections has been facing enormous challenges because laboratory detections and radiographic images are not always in agreement with clinical features and contact histories of patients. [15][16][17] RT-PCR methods based on spike gene and N gene were widely used for detecting viral RNA,and were considered a gold standard. [18][19] However, this method had its limitations, such as false positive or false negative results,time consuming,false sampling,inconsistence of sample collections and preparations.…”

Section: Discussionmentioning

confidence: 99%

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The role of procalcitonin in early differential diagnosis of suspected children with COVID-19

Peng

Zhang

et al. 2020

Preprint

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Background: Early differential diagnosis of suspected pediatric patients is difficult during the 2019-nCoV epidemic.Objective: To identify clinical characteristics and key points of early differential diagnosis.Methods: A retrospective analysis was performed on suspected pediatric cases. Results:A total of 77 suspected cases were admitted from Jan 22nd to Mar 1st. Compared with non-2019-nCoV group (n=33),2019-nCoV confirmed group (n=35) had fewer fever (OR[95% CI] 0.39[0.242-0.628];P<.001) and symptoms of ARI (0.454[0.287-0.719];P<.001),more asymptomatic (15.086[2.117-107.475];P<.001), and more family cluster infections (5.469[2.405-12.433]; P<.001),while chest CT had more positive findings of viral pneumonia (1.813[1.131-2.908];P=.014).There were significant statistical differences between the two groups in age (7.2[3.9-11.4] vs 5[2.1-7.8];P=.031),body temperature (36.7[36.2-36.9] vs 37[36.7-37.9];P=.001), heart rate ([97.1±16.8] vs [109.7±15.6];P=.002),percentage ([39.4±14.9] vs [52.5±17.5]; P=.001) and count (2.25[1.43-3.53] vs 3.33[2.8-5.18];P=.007) of neutrophil, percentage (45.3[39.2-56.6] vs 33.2[22.7-42.5];P=.001) of lymphocyte,hs-CRP (5.52[1.1-9.04] vs 9.04[7.35-9.54];P=.002) and PCT (0.05[0.03-0.08] vs 0.1[0.05-0.21];P<.001),while gender (42.9% vs 57.6%;P=.332),respiratory rate (22[20-22] vs 22[20-24];P=.092),WBC (5.37[4.67-8.08] vs 6.94[5.72-8.87];P=.198), lymphocyte count (2.68[1.99-4.01] vs 2.26[1.66-2.92];P=.096),Hb (128[124-142] vs 130[119-137];P=.572) and PLT ([279.1±77.5] vs [263.4±65.1];P=.37) were statistically insignificant.Conclusions: Asymptoms or mild symptoms,positive CT findings and family cluster infection are the main clinical characteristics of infected pediatric patients. The CBC, hs-CRP and PCT can provide an important basis for early differential diagnosis.Compared with other non-bacterial infections,hs-CRP and PCT in 2019-nCoV infection are reduced,but further evidence is needed to support whether their reduction is specific.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

The role of procalcitonin in early differential diagnosis of suspected children with COVID-19

Peng

Zhang

et al. 2020

Preprint

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“…In a 10-year study, over 85% of acute respiratory viral infections in critically ill children admitted to a pediatric intensive care unit were caused by either a picornavirus, RSV, PIV, or HMPV (see Figure 1). 4 Other DNA viruses such as adenovirus can be the source of respiratory infections but will not be discussed here.…”

Section: Introduction To Respiratory Infections Caused By Rna Virusesmentioning

confidence: 99%

Nucleosides for the treatment of respiratory RNA virus infections

Jordan

Stevens

Deval

2018

Antivir Chem Chemother

120

105

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Influenza virus, respiratory syncytial virus, human metapneumovirus, parainfluenza virus, coronaviruses, and rhinoviruses are among the most common viruses causing mild seasonal colds. These RNA viruses can also cause lower respiratory tract infections leading to bronchiolitis and pneumonia. Young children, the elderly, and patients with compromised cardiac, pulmonary, or immune systems are at greatest risk for serious disease associated with these RNA virus respiratory infections. In addition, swine and avian influenza viruses, together with severe acute respiratory syndrome-associated and Middle Eastern respiratory syndrome coronaviruses, represent significant pandemic threats to the general population. In this review, we describe the current medical need resulting from respiratory infections caused by RNA viruses, which justifies drug discovery efforts to identify new therapeutic agents. The RNA polymerase of respiratory viruses represents an attractive target for nucleoside and nucleotide analogs acting as inhibitors of RNA chain synthesis. Here, we present the molecular, biochemical, and structural fundamentals of the polymerase of the four major families of RNA respiratory viruses: Orthomyxoviridae, Pneumoviridae/Paramyxoviridae, Coronaviridae, and Picornaviridae. We summarize past and current efforts to develop nucleoside and nucleotide analogs as antiviral agents against respiratory virus infections. This includes molecules with very broad antiviral spectrum such as ribavirin and T-705 (favipiravir), and others targeting more specifically one or a few virus families. Recent advances in our understanding of the structure(s) and function(s) of respiratory virus polymerases will likely support the discovery and development of novel nucleoside analogs.

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“…However, these factors do not explain the changing annual prevalence in the same location, as these weather factors remain essentially unchanged locally [ 18 ]. By contrast, the potential change in clinical practices, and enhanced utilization of viral diagnostics could be other possible explanations for the increasing detection in developed countries [ [19] , [20] , [21] ]. While commercially available viral testing is constantly improving and advancing, we are not aware of any major advances or changes during the study period.…”

Section: Discussionmentioning

confidence: 99%

The burden of viral infections in pediatric intensive care unit between endemic and pandemic coronavirus infections: A tertiary care center experience

Al‐Eyadhy

Almazyad

Hasan

et al. 2023

Journal of Infection and Chemotherapy

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Virus detection in critically ill children with acute respiratory disease: a new profile in view of new technology

Abstract: Higher risk of intubation was found in patients with parainfluenza as compared to RSV. The risk of intubation comparing parainfluenza virus to other viruses and for patients with multiple versus single virus needs to be further studied.

Cited by 5 publications

References 26 publications

The role of procalcitonin in early differential diagnosis of suspected children with COVID-19

The role of procalcitonin in early differential diagnosis of suspected children with COVID-19

Nucleosides for the treatment of respiratory RNA virus infections

The burden of viral infections in pediatric intensive care unit between endemic and pandemic coronavirus infections: A tertiary care center experience

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