Outbreak of SARS-CoV-2 compared to other respiratory viruses in children with acute respiratory infections

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS), even if a pandemic of coronavirus disease 2019 (COVID-19) occurs worldwide and has a devastating effect on human health, human life, and human economy -CoV-2) seemed to save the children in the early stages. Not only that, other viral infections associated with acute respiratory illness, which are common in children, have also declined sharply.

A new paper compares the infection and hospitalization rates of pediatric patients with acute respiratory illness.

Preface

The era of pandemics began with new terms like social distance. At the same time, regular hand hygiene, face mask use, and shelter-in-place orders have become new and normal as part of public health interventions aimed at stopping or at least delaying the peak of the pandemic. During this time, it was pointed out that patient consultation rates were much lower in primary care clinics and emergency rooms.

This may be due to the fear of COVID-19 avoiding medical centers or the sharp reduction in respiratory infections due to effective containment measures against almost all infectious agents.

With the fall wave of the pandemic, children’s acute respiratory infections (ARIs) rose again, but only about half of the levels observed in the year before the pandemic. Influenza infections were reduced by almost 100% in all age groups during the fall / winter influenza season. In Germany, which has a physician surveillance system, there were only three cases of respiratory syncytial virus (RSV) infection in the 30 weeks after the 40th week of 2020.

These trends have been seen in some countries.Current studies published in the journal Pediatric infectious diseaseBetween the 2nd and 3rd waves, we investigated the incidence of COVID-19 in children with ARI compared to other respiratory viruses.

What did the study show?

This survey was conducted in the city of Würzburg, Germany. All patients who developed symptoms within 14 days prior to presentation were eligible. There were 168 children and adolescents in ARI. About a quarter of them had chronic lung disease such as bronchopulmonary dysplasia and asthma, but less than 10% had heart disease.

Most commonly, children have a runny nose, otitis media, sinusitis, conjunctivitis or laryngitis, and among other symptoms, almost 80% of all acute symptoms compared to bronchitis, pneumonia, and laryngitis. Presented with all upper respiratory tract infections. .. About one-fifth of the cases had both upper and lower respiratory tract infections, with or without fever. Most appeared 3 days after the onset of symptoms, but the median duration of illness was 1 week.

Two in three patients had one or more respiratory viruses, and almost half were due to rhinovirus. One in seven was caused by adenovirus and the same number was caused by coronavirus NL63. SARS-CoV-2 and other seasonal endemic diseases coronavirusInfluenza, and parainfluenza virus were responsible for less than 1% of infections.

Two or more viruses were detected simultaneously in the same child in about one-fifth of the cases. This includes rhinovirus and adenovirus, coronavirus NL63, bocavirus, parainfluenza virus double infections, and adenovirus and NL63 double infections. None of the samples were positive for RSV, enterovirus, or human metapneumovirus.

None of these infections were found to be more common in any age group. Nevertheless, virus detection was lowest during the strict blockade (end of December 2020 to the end of February 2021) and increased as restrictions were relaxed.

What is the impact?

In this study, most ARIs during the study period from November 2020 to April 2021 were due to rhinovirus, seasonal endemic coronavirus, and adenovirus, which are almost three-thirds of children. Shown that it was found in 2. Rhinovirus is notorious for being easily transmitted among children due to poor hand-washing techniques and smear or contact infections.

The virus has over 160 serotypes and circulates throughout the year, allowing the same child to be repeatedly infected without developing durable, type-specific immunity. The other two types can be easily spread by applying an infectious runny nose or contact infection to a surface that the child frequently touches. In addition, adenovirus may be found on the surface despite the use of some disinfectants.

A single SARS-CoV-2 positive sample was found, despite the timing of the study at the peak of the second and third waves. RSV was not specifically seen, and a single influenza sample was observed despite studies conducted during the winter influenza season. The significantly lower incidence of these viruses may be due to the interruption of the virus infection. Still, for new coronaviruses, the role of different susceptibility needs to be further elucidated.

Increased infections with RSV, influenza virus, and SARS-CoV-2 with relaxation of restrictions indicate potential preventative potential with strict containment measures. This is not the case for rhinoviruses, but also for the endemic seasonal human coronavirus. More research may reveal interactions between different viruses, their infectivity, and compatibility in different environments.

As SARS-CoV-2 continues to evolve and generate new, more infectious, and / or immune-avoidance mutants, other older viruses continue to cause a significant number of cases or are severe. May appear during the off-season with mild hygiene relief. Infection control measures. This means that healthcare systems need to respond to the potential surge in ARI in children due to these pathogens. Failure to do so can have a significant impact on the health of the child.