Respiratory syncytial virus infection: why does disease severity vary among individuals?

Tahamtan, Alireza; Samadizadeh, Saeed; Rastegar, Mostafa; Nakstad, Britt; Salimi, Vahid

doi:10.1080/17476348.2020.1724095

Cited by 23 publications

(19 citation statements)

References 126 publications

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“…Previous studies showed that the mortality of PMV infection among adults is 0-50%, depending on the virus type, immune status of the host, and severity of disease (28)(29)(30), which is consistent with our results. However, most of these studies focused on lower respiratory tract infections or acute respiratory infections affected by these PMVs.…”

Section: Discussionsupporting

confidence: 93%

The Clinical Characteristics and Outcomes of Adult Patients With Pneumonia Related to Three Paramyxoviruses

Chen

Han

et al. 2021

Front. Med.

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Background: Respiratory syncytial virus (RSV), human metapneumovirus (hMPV), and human parainfluenza virus (hPIV) are paramyxoviruses (PMVs) that are important etiologies of community-acquired pneumonia. However, current knowledge about the clinical features and outcomes of PMV-related pneumonia (PMV-p) is limited. We aimed to investigate the clinical characteristics and disease severity in immunocompetent adults hospitalized with hMPV-related pneumonia (hMPV-p), hPIV-related pneumonia (hPIV-p), or RSV-related pneumonia (RSV-p).Methods: We retrospectively recruited 488 patients with PMV-p (153 with RSV-p, 137 with hMPV-p, and 198 with hPIV-p) from five teaching hospitals in China during 2011–2019. Univariate and multivariate analyses were performed to identify predictors to distinguish hMPV-p/hPIV-p from RSV-p and evaluate the effects of virus types on the clinical outcomes.Results: Compared with RSV-p, sputum production [odds ratio (OR) 5.029, 95% confidence interval (CI) 2.452–10.312, P < 0.001] was positively associated with hMPV-p, while solid malignant tumor (OR 0.346, 95% CI 0.126–0.945, P = 0.038), nasal congestion (OR 0.102, 95% CI 0.041–0.251, P < 0.001), and respiratory rate ≥ 30 breaths/min (OR 0.296, 95% CI 0.136–0.640, P = 0.002) were negatively related to hMPV-p. Sputum production (OR 13.418, 95% CI 6.769–26.598, P < 0.001) was positively associated with hPIV-p, while nasal congestion (OR 0.194, 95% CI 0.098–0.387, P < 0.001), dyspnea (OR 0.469, 95% CI 0.272–0.809, P < 0.001), and respiratory rate ≥30 breaths/min (OR 0.090, 95% CI 0.032–0.257, P < 0.001) on admission were negatively related to hPIV-p. After adjustment for confounders, multivariate logistic regression analysis suggested that hMPV-p (OR 0.355, 95% CI 0.135–0.932, P = 0.035) and hPIV-p (OR 0.311, 95% CI 0.121–0.784, P = 0.013) were associated with decreased 30-day mortality compared with RSV-p. RSV infection (OR 4.183, 95% CI 1.709–10.236, P = 0.002) was identified as an independent predictor of 30-day mortality in patients with PMV-p.Conclusion: RSV-p caused more severe disease than hMPV-p and hPIV-p. Although some clinical features are helpful for distinguishing the diseases, etiologic diagnosis is critical in the management of the PMV-p.

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Section: Discussionsupporting

confidence: 93%

The Clinical Characteristics and Outcomes of Adult Patients With Pneumonia Related to Three Paramyxoviruses

Chen

Han

et al. 2021

Front. Med.

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“…Furthermore, studies considering the correlation between RSV titers and disease severity are contradictory, although evidence is accumulating that disease severity does not correlate to viral titers (Thwaites et al, 2018; Uusitupa, Waris, & Heikkinen, 2020). It seems that the severity of infection mostly depends on the magnitude and timing of the innate immune and inflammatory response in the airways (Tahamtan, Samadizadeh, Rastegar, Nakstad, & Salimi, 2020).…”

Section: Introductionmentioning

confidence: 99%

Neutrophils in respiratory syncytial virus infection: From harmful effects to therapeutic opportunities

Tahamtan

Besteman

Samadizadeh

et al. 2020

British J Pharmacology

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Respiratory syncytial virus (RSV) is an important infectious agent in infants and young children. In most cases, RSV infection only causes mild disease, but in some, it requires invasive ventilation. Although antiviral drugs are obvious candidates to treat viral illness, and some have shown antiviral effects in humans, antivirals such as GS-5806, ALX-0171 and ALS-8176 have not yet met their expectations. Since the inappropriate or dysregulated immune response against RSV leads to harmful immune pathology, a robust immune cascade is probably underway by the time patients reach the hospital. RSV infection is associated with a strong neutrophil influx into the airway. It not clear if these cells contribute to antiviral defence or to lung pathology. This article discusses the protective and harmful roles of neutrophils during RSV infection and provides an overview of mechanisms by which neutrophil function could be targeted to prevent tissue injury and preserve homeostasis.

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“…However, these viruses were less prevalent than in the Congolese children. Many factors may influence regional differences in viral detection rates such as seasonal variations, outbreaks, environmental factors and genetics [ 28 ]. Rhinovirus was found to be equally common in pneumonia cases as in control children in the Pneumonia Etiology Research and Child Health (PERCH) multi-center study performed in seven countries in Africa and Asia [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

High bacterial and viral load in the upper respiratory tract of children in the Democratic Republic of the Congo

et al. 2020

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Background Respiratory pathogens including Streptococcus pneumoniae and Haemophilus influenzae , are implicated in the pathogenicity of acute lower respiratory infection (ALRI). These are also commonly found in both healthy and sick children. In this study, we describe the first data on the most frequent bacteria and viruses detected in the nasopharynx of children from the general population in the Eastern DR Congo. Methods From January 2014 to June 2015, nasopharyngeal samples from 375 children aged from 2 to 60 months attending health centres for immunisation or growth monitoring were included in the study. Multiplex real-time PCR assays were used for detection of 15 different viruses and 5 bacterial species and for determination of pneumococcal serotypes/serogroups in the nasopharyngeal secretions. Results High levels of S. pneumonia e were detected in 77% of cases, and H . influenzae in 51%. Rhinovirus and enterovirus were the most commonly found viruses, while respiratory syncytial virus (RSV) was rare (1%). Co-occurrence of both bacteria and viruses at high levels was detected in 33% of the children. The pneumococcal load was higher in those children who lived in a dwelling with an indoor kitchen area with an open fire, i.e. a kitchen with an open fire for cooking located inside the dwelling with the resultant smoke passing to the living room and/or bedrooms; this was also higher in children from rural areas as compared to children from urban areas or children not living in a dwelling with an indoor kitchen area with an open fire/not living in this type of dwelling. Immunization with 2–3 doses of PCV13 was associated with lower rates of pneumococcal detection. Half of the identified serotypes were non-PCV13 serotypes. The most common non-PCV13 serotypes/serogroups were 15BC, 10A, and 12F, while 5, 6, and 19F were the most prevalent PCV13 serotypes/serogroups. Conclusions The burden of respiratory pathogens including S. pneumonia e in Congolese children was high but relatively few children had RSV. Non-PCV13 serotypes/serogroups became predominant soon after PCV13 was introduced in DR Congo.

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Respiratory syncytial virus infection: why does disease severity vary among individuals?

Cited by 23 publications

References 126 publications

The Clinical Characteristics and Outcomes of Adult Patients With Pneumonia Related to Three Paramyxoviruses

The Clinical Characteristics and Outcomes of Adult Patients With Pneumonia Related to Three Paramyxoviruses

Neutrophils in respiratory syncytial virus infection: From harmful effects to therapeutic opportunities

High bacterial and viral load in the upper respiratory tract of children in the Democratic Republic of the Congo

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