Report of death in children with SARS‐CoV‐2 and human metapneumovirus (hMPV) coinfection: Is hMPV the trigger?

Hashemi, Seyed Ahmad; Safamanesh, Saghar; Ghasemzadeh‐Moghaddam, Hamed; Ghafouri, Majid; Mohajerzadeh‐Heydari, Mina‐sadat; Namdar-Ahmadabad, Hasan; Azimian, Amir

doi:10.1002/jmv.26401

Cited by 18 publications

(22 citation statements)

References 16 publications

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“…Besides, numerous studies have shown viral co-infections being associated with disease severity, acute respiratory distress syndrome (ARDS) and even death. These studies show higher intensive care admission rates in patients presenting with co-infections [ 5 , 28 , 32 ]. In this study, influenza A H1N1‐COVID‐19 co-infected cases were more severe and required ICU admission.…”

Section: Discussionmentioning

confidence: 99%

Influenza co-infection associated with severity and mortality in COVID-19 patients

Alosaimi

Naeem

Hamed

et al. 2021

Virol J

121

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Background In COVID-19 patients, undetected co-infections may have severe clinical implications associated with increased hospitalization, varied treatment approaches and mortality. Therefore, we investigated the implications of viral and bacterial co-infection in COVID-19 clinical outcomes. Methods Nasopharyngeal samples were obtained from 48 COVID-19 patients (29% ICU and 71% non-ICU) and screened for the presence of 24 respiratory pathogens using six multiplex PCR panels. Results We found evidence of co-infection in 34 COVID-19 patients (71%). Influenza A H1N1 (n = 17), Chlamydia pneumoniae (n = 13) and human adenovirus (n = 10) were the most commonly detected pathogens. Viral co-infection was associated with increased ICU admission (r = 0.1) and higher mortality (OR 1.78, CI = 0.38–8.28) compared to bacterial co-infections (OR 0.44, CI = 0.08–2.45). Two thirds of COVID-19 critically ill patients who died, had a co-infection; and Influenza A H1N1 was the only pathogen for which a direct relationship with mortality was seen (r = 0.2). Conclusions Our study highlights the importance of screening for co-infecting viruses in COVID-19 patients, that could be the leading cause of disease severity and death. Given the high prevalence of Influenza co-infection in our study, increased coverage of flu vaccination is encouraged to mitigate the transmission of influenza virus during the on-going COVID-19 pandemic and reduce the risk of severe outcome and mortality.

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Section: Discussionmentioning

confidence: 99%

Influenza co-infection associated with severity and mortality in COVID-19 patients

Alosaimi

Naeem

Hamed

et al. 2021

Virol J

121

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“…Symptoms and severity of COVID-19 lower airways infection in children seem no more severe than those in children with other viral infections (178). Despite this, it was recommended to check SARS-CoV-2 positive children for other viral pathogens, namely influenza A virus and metapneumovirus, as the identification of co-infections may lead to modify the diagnostic and therapeutic protocols (179). Indeed, public health measures during the COVID-19 pandemic have potential to impact transmission of other respiratory viruses, such as RSV and influenza, indicating a decline in respiratory virus detection and related hospital admissions following the implementation of COVID-19 restrictions.…”

Section: Comparison Of Sars-cov-2 With Other Respiratory Virusesmentioning

confidence: 99%

Coronavirus Disease 2019 in Children

et al. 2021

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Since its appearance in Wuhan in mid-December 2019, acute respiratory syndrome coronavirus 2 (SARS-CoV-2) related 19 coronavirus disease (COVID-19) has spread dramatically worldwide. It soon became apparent that the incidence of pediatric COVID-19 was much lower than the adult form. Morbidity in children is characterized by a variable clinical presentation and course. Symptoms are similar to those of other acute respiratory viral infections, the upper airways being more affected than the lower airways. Thus far, over 90% of children who tested positive for the virus presented mild or moderate symptoms and signs. Most children were asymptomatic, and only a few cases were severe, unlike in the adult population. Deaths have been rare and occurred mainly in children with underlying morbidity. Factors as reduced angiotensin-converting enzyme receptor expression, increased activation of the interferon-related innate immune response, and trained immunity have been implicated in the relative resistance to COVID-19 in children, however the underlying pathogenesis and mechanism of action remain to be established. While at the pandemic outbreak, mild respiratory manifestations were the most frequently described symptoms in children, subsequent reports suggested that the clinical course of COVID-19 is more complex than initially thought. Thanks to the experience acquired in adults, the diagnosis of pediatric SARS-CoV-2 infection has improved with time. Data on the treatment of children are sparse, however, several antiviral trials are ongoing. The purpose of this narrative review is to summarize current understanding of pediatric SARS-CoV-2 infection and provide more accurate information for healthcare workers and improve the care of patients.

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“…2 , 3 The severe forms of the disease are accompanied by an aggressive inflammatory response with the typical characteristics of an uncontrolled systemic inflammatory response resulting from the release of large amounts of pro‐inflammatory cytokines by immune cells known as “cytokine storm.” 4 It has been reported that the severity of COVID‐19 can be influenced by various factors such as age, sex, race, current health issue, and nutritional status. 3 , 5 …”

Section: Introductionmentioning

confidence: 99%

“…4 It has been reported that the severity of COVID-19 can be influenced by various factors such as age, sex, race, current health issue, and nutritional status. 3,5 Micronutrients include vitamins (e.g., A, B, and D) and minerals (e.g., Ca, P, and Mg), as well as trace elements (Zn, CU, and Fe) involved in initiating, maintaining, and regulating host immune reactions to the virus infections through the effect on frequency and function of innate and adaptive immune cells, production and development of virus-specific antibodies, production of pro-, and antiinflammatory cytokines, oxidative burst reaction, and so forth. 6,7 Zinc is an essential micronutrient with potent immunoregulatory and antiviral properties that is involved in the growth and the maturation of immune cells, development and activation of lymphoid cells, regulation of inflammatory cytokines, and controlling oxidative stress.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the relationship between serum levels of zinc, vitamin B12, vitamin D, and clinical outcomes in patients with COVID‐19

Shakeri

Azimian

Ghasemzadeh‐Moghaddam

et al. 2021

Journal of Medical Virology

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Due to the known anti‐inflammatory and antiviral effects of zinc, 25(OH)D, and vitamin B12, in this study, we explored the association between serum levels of these micronutrients in coronavirus disease 2019 (COVID‐19) patients at the time of admission and the clinical outcomes. This study was carried out on 293 patients with COVID‐19, who were hospitalized at Imam Hassan hospital (Bojnourd, Iran). We collected demographic data, clinical characteristics, values of serum biochemical parameters in the first week of admission, and clinical outcomes from electronic medical records. We also measured serum levels of zinc, 25(OH)D, and vitamin B12 within 3 days of admission. Of the 293 hospitalized, the median age was 53 years, and 147 (50.17%) were female. Thirty‐seven patients (12.62%) were admitted to the intensive care unit (ICU), and forty‐two (14.32%) died. We found that the serum levels of zinc, vitamin B12, and 25(OH)D were lower in patients who died than those who were admitted to ICU or non‐ICU and survived; however, these differences were not statistically significant for vitamin B12 and 25(OH)D ( p > 0.05). The serum concentrations of zinc, vitamin B12, and 25(OH)D at the time of admission did not affect the length of hospital stay in patients with COVID‐19. In general, it seems that serum levels of 25(OH)D, vitamin B12, and especially zinc at the time of admission can affect clinical outcomes in COVID‐19 patients.

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Report of death in children with SARS‐CoV‐2 and human metapneumovirus (hMPV) coinfection: Is hMPV the trigger?

Cited by 18 publications

References 16 publications

Influenza co-infection associated with severity and mortality in COVID-19 patients

Influenza co-infection associated with severity and mortality in COVID-19 patients

Coronavirus Disease 2019 in Children

Evaluation of the relationship between serum levels of zinc, vitamin B12, vitamin D, and clinical outcomes in patients with COVID‐19

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