Clinical impact of respiratory virus in pulmonary exacerbations of children with Cystic Fibrosis

Abstract

Backgrounds Cystic Fibrosis (CF) is a genetic, multisystemic, progressive illness that causes chronic suppurative lung disease. A major cause of morbimortality in this condition are pulmonary exacerbations. Although classically attributed to bacterial infections, respiratory virus have been increasingly recognized in its ethiopathogeny. Methods Nasopharyngeal swab samples were collected from children < 18 years old with CF in Rio de Janeiro, Brazil, with pulmonary exacerbation criteria. Samples were submitted to RT-PCR for Adenovirus, Influenza A and B, Parainfluenza Virus, Respiratory Syncytial Virus (RSV), Metapneumovirus and Rhinovirus. Virus positive and virus negative groups were compared in regards to clinical presentation, severity of exacerbation and bacterial colonization. Results Out of 70 samples collected from 48 patients, 35.7% were positive for respiratory viruses. Rhinovirus were the most common (28% of all positive samples), followed by RSV. The virus positive group was associated with change in sinus discharge (p = 0.03). Considering only patients younger than five years old, positive virus detection was also associated with fever (p = 0.01). There was no significant difference in clinical severity or in bacterial colonization between virus positive and negative groups. Conclusions Prospective studies are still needed to assess the long term impact of viral infections in patients with CF, and their interaction with the bacterial microbiome in these patients.

Reduction of pulmonary exacerbations in young children with cystic fibrosis during the COVID‐19 pandemic

“…1 The impact of these measures on cystic fibrosis (CF) pulmonary exacerbations (PEx) has not been described. Respiratory viral infections are a common trigger for PEx, 2,3 and COVID-19 restrictions might lead to fewer PEx by reducing exposure to viruses in general, not just SARS-CoV2. To test the hypothesis that the COVID-19 lockdown would be associated with a lower PEx incidence we compared PEx data at our CF Center from the time with the most stringent restrictions in Indiana to the same time interval in 2019.…”

Rhinovirus remains prevalent in school teenagers during fight against COVID‐19 pandemic

“…An investigation of 452 children with acute respiratory infection reported that acute respiratory infection in children was mainly infected by HRV (11.28%), and most of the HRV infection occurred was in winter 7 . Respiratory virus surveillance studies showed that the positive rate of HRV was 16.4%–35.1% 8–13 . During the COVID‐19 pandemic, the government had taken all possible means to stop the pandemic, and successfully stopped the COVID‐19 pandemic in Guangzhou, and the common respiratory infectious diseases, such as influenza and pneumonia as well 3 .…”

Pediatric asthma symptom control during lockdown for the COVID‐19 pandemic in Spring 2020: A prospective community‐based study in Cyprus and Greece

“…During the same period, reduced respiratory morbidity was demonstrated in other pediatric chronic lung diseases, where respiratory viral infections are a common trigger of pulmonary exacerbations, suggesting that COVID‐19 restrictions might have led to reduced exposure to viruses in general, not just SARS‐CoV2 24,25 . Unfortunately, laboratory testing for respiratory viruses was not part of our study protocol and data on viral infections pre‐ and during the lockdown measures period were only available through questionnaire responses.…”