|
1
|
Wechsler S, Pitaro J, Shlamkovich N, Kalmovich LM, Gavriel H. Ulcerative supraglottitis - a unique presentation of COVID-19 infection. Eur Arch Otorhinolaryngol 2025:10.1007/s00405-025-09458-x. [PMID: 40380993 DOI: 10.1007/s00405-025-09458-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2024] [Accepted: 03/27/2025] [Indexed: 05/19/2025]
Abstract
OBJECTIVE COVID-19 has been previously considered a lower respiratory tract disease. However, as the disease has evolved, studies have described its upper respiratory involvement. This study's objective was to present, for the first time, a series of patients with supraglottitis with unique characteristics of coronavirus disease. METHODS This retrospective single-center case study included patients who were referred to the Emergency Department (ED) between June 1, 2022, and September 1, 2023, with clinical and endoscopic findings consisting of supraglottitis and positive PCR results for SARS-CoV-2. RESULTS Ten patients met the inclusion criteria. The mean age was 61. Six (60%) patients had comorbidities. Two (20%) patients were not vaccinated, whereas the others were vaccinated between one and five times. All patients presented with odynophagia, and most had fever and hoarseness. Laryngeal findings included epiglottic ulcers in the inner portion of the epiglottis in all patients, with varying degrees of severity. Presentation with a choking sensation, hoarseness, and elevated CRP and WBC levels may indicate a more severe disease course. CONCLUSION The latest COVID-19 variants can manifest with clinical and endoscopic findings of acute supraglottitis, with specific endoscopic characteristics of the larynx. Physicians should be aware of this clinical entity, refer suspected patients to the ED, and perform urgent laryngoscopy, while the otolaryngologist should be aware of the specific endoscopic presentation and manage the patient accordingly. LEVEL OF EVIDENCE 4: This study was approved by the institutional review board. Approval number- 0212-23ASF- 22/09/2023.
Collapse
Affiliation(s)
- Shmuel Wechsler
- Department of Otolaryngology, Head and Neck Surgery, Shamir (Assaf Haroffeh) Medical Center, Tzriffin, Israel.
- Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
| | - Jacob Pitaro
- Department of Otolaryngology, Head and Neck Surgery, Shamir (Assaf Haroffeh) Medical Center, Tzriffin, Israel
- Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Nathan Shlamkovich
- Department of Otolaryngology, Head and Neck Surgery, Shamir (Assaf Haroffeh) Medical Center, Tzriffin, Israel
- Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Limor Muallem Kalmovich
- Department of Otolaryngology, Head and Neck Surgery, Shamir (Assaf Haroffeh) Medical Center, Tzriffin, Israel
- Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Haim Gavriel
- Department of Otolaryngology, Head and Neck Surgery, Shamir (Assaf Haroffeh) Medical Center, Tzriffin, Israel
- Innovation Center, Shamir (Assaf Harofeh) Medical Center, Zerifin, Israel
- Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| |
Collapse
|
|
2
|
Wu Y, Wang M, Lv X, Chen J, Song L. Characteristics of symptoms among outpatients following the discontinuation of the dynamic zero-COVID-19 policy in China: insights from an online nationwide cross-sectional survey in 2022. J Thorac Dis 2025; 17:1593-1604. [PMID: 40223953 PMCID: PMC11986797 DOI: 10.21037/jtd-24-1244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2024] [Accepted: 01/03/2025] [Indexed: 04/15/2025]
Abstract
Background After the cessation of the dynamic zero-coronavirus disease 2019 (COVID-19) policy in China, a large number of people were infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) without being hospitalized, but few studies investigated the symptoms of this population. In this study, we aimed to describe the symptom characteristics of this population and to provide information for further understanding of COVID-19. Methods An online nationwide anonymous survey questionnaire on symptoms was conducted through WeChat to probe participants infected with SARS-CoV-2 between December 2022 and January 2023. In order to guarantee the promptness of data collection while maximizing the coverage of diverse populations, we opted for the convenient sampling method. Demographic information, incidence and severity of main symptoms, and vaccination status were collected in the questionnaire. Descriptive analysis was utilized to elucidate the epidemiological characteristics of the overall population; comparative analysis was conducted to highlight the differences in symptom variations among distinct subgroups. Results A total of 4,836 valid questionnaires were collected, with 64.8% testing positive for COVID-19 and 35.2% exhibiting symptoms but not having undergone testing. Among the COVID-19-positive respondents, 64.3% (n=2,016) were female, with a median age of 39.0 (33.0, 47.0) years, and 95.8% (n=3,002) had received multiple vaccine doses. The prevalent comorbidities included allergic rhinitis (10.1%), hypertension (6.1%), and diabetes (3.5%). The most frequently reported symptoms were fever (n=2,941, 93.9%), fatigue (n=2,871, 91.6%), expectoration (n=2,847, 90.8%), nasal congestion (n=2,735, 87.2%), and myalgia (n=2,712, 86.5%). Vaccinated individuals, non-smokers, and males exhibited significantly higher rates of respiratory symptoms. Myalgia (35.3%), fatigue (31.5%), and sore throat (30.9%) were the symptoms with the highest incidence of severe occurrence, and this varied between age groups. Except for sneezing, age of 60 years or older was negatively correlated with severe manifestations for all symptoms. Conversely, smoking was positively associated with severe symptoms for nearly all conditions. Conclusions The study highlights common systemic and respiratory symptoms among non-hospitalized COVID-19 patients in China, varying by gender, age, and underlying diseases. These findings are clinically important for early identification, diagnosis, treatment evaluation, and global management of COVID-19.
Collapse
Affiliation(s)
- Yunfu Wu
- Department of Pulmonary and Critical Care Medicine, Xijing Hospital, Air Force Medical University, Xi'an, China
| | - Mingming Wang
- Department of Pulmonary and Critical Care Medicine, Xijing Hospital, Air Force Medical University, Xi'an, China
| | - Xing Lv
- Department of Pulmonary and Critical Care Medicine, Xijing Hospital, Air Force Medical University, Xi'an, China
| | - Jie Chen
- Department of Pulmonary and Critical Care Medicine, Xijing Hospital, Air Force Medical University, Xi'an, China
| | - Liqiang Song
- Department of Pulmonary and Critical Care Medicine, Xijing Hospital, Air Force Medical University, Xi'an, China
| |
Collapse
|
|
3
|
Gu Y, Liu M, Niu N, Jia J, Gao F, Sun Y, Zhang Z, Dai Z, Jiao J, Zhu Z, Jia S, Xu J, Zhang Z, Xu B, Lei HM. Integrative network pharmacology and multi-omics to study the potential mechanism of Niuhuang Shangqing Pill on acute pharyngitis. JOURNAL OF ETHNOPHARMACOLOGY 2025; 338:119100. [PMID: 39547363 DOI: 10.1016/j.jep.2024.119100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2024] [Revised: 10/31/2024] [Accepted: 11/11/2024] [Indexed: 11/17/2024]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Niuhuang Shangqing Pill (NSP) is a renowned Chinese medicine prescription listed in the Chinese Pharmacopoeia (Edition, 2020; volume 1) and is utilized in clinical practice for treating headaches and acute pharyngitis (AP) associated with "Shanghuo". Despite its widespread use, the pharmacological mechanism and bioactive components underlying NSP in treating AP remain unclear. AIM OF THE STUDY This study delved into evaluate the alleviation effect of NSP on AP and explore the mechanisms by analyzing multi-omics. MATERIALS AND METHODS UHPLC-Q Exactive Orbitrap HRMS was employed for the chemical ingredients of NSP. Multiple compositions, targets and pathways involved in the treatment of AP with NSP were predicted by network pharmacology. Additionally, wistar rat model of AP induced by capsaicin was established to evaluate the anti-AP activity of NSP in vivo. The potential mechanism of NSP to improve AP was investigated by real-time PCR, pharyngeal transcriptome analysis, non-targeted metabolomics, immunofluorescence and Western blot. RESULTS 119 compounds were identified by UHPLC-Q Exactive Orbitrap HRMS. Both clinical data of Gene Expression Omnibus (GEO) and network pharmacology demonstrated that MAPK signaling pathway and TNF signaling pathway were the critical pathway for AP treatment. In rat model of AP induced by capsaicin, NSP demonstrated the ability to reduce the levels of IL-1β, TNF-α, IL-6, CGRP, SP, PGE2, COX-2 in serum. Moreover, Transcriptomics analysis comprehensively indicated that NSP regulated the MAPK signaling pathway, TNF signaling pathway, biosynthesis of phenylalanine, tyrosine and tryptophan, arachidonic acid metabolism in AP rats. Metabolomics analysis verified that NSP could rebalance arachidonic acid metabolism, biosynthesis of phenylalanine, tyrosine and tryptophan and regulate metabolic profiles. Multi-omics Correlation analysis exhibited that the relative expression of Tnfrsf1b was significantly negatively correlated with 12(S)-HPETE. Immunofluorescence, real-time PCR and Western blot of pharyngeal tissue revealed that NSP inhibited the TNF/p38-MAPK/NF-κB signaling pathway. Additionally, in vitro study on RAW264.7 cells confirmed that NSP counteract LPS-induced inflammatory by inhibiting the TNF/p38-MAPK/NF-κB signaling pathway. Overall, NSP effectively ameliorated capsaicin-induced AP by modulating the arachidonic acid metabolism and TNF/p38-MAPK/NF-κB signaling pathway. CONCLUSION NSP effectively ameliorated capsaicin-induced AP by modulating the arachidonic acid metabolism, biosynthesis of phenylalanine, tyrosine and tryptophan, as well as the TNF/p38-MAPK/NF-κB signaling pathway.
Collapse
Affiliation(s)
- Yuhao Gu
- School of Chinese Pharmacy, Beijing University of Chinese Medicine, Beijing, 100102, China
| | - Manting Liu
- School of Chinese Pharmacy, Beijing University of Chinese Medicine, Beijing, 100102, China
| | - Nan Niu
- Scientific Research Institute of Beijing Tongrentang Co., Ltd., Beijing, 100079, China
| | - Jun Jia
- Scientific Research Institute of Beijing Tongrentang Co., Ltd., Beijing, 100079, China
| | - Feng Gao
- School of Chinese Pharmacy, Beijing University of Chinese Medicine, Beijing, 100102, China
| | - Yangyang Sun
- Institute of Basic Theory for Chinese Medicine, China Academy of Chinese Medicine Science, Beijing, 100700, China
| | - Zixuan Zhang
- School of Chinese Pharmacy, Beijing University of Chinese Medicine, Beijing, 100102, China
| | - Ziqi Dai
- School of Chinese Pharmacy, Beijing University of Chinese Medicine, Beijing, 100102, China
| | - Jingyi Jiao
- School of Chinese Pharmacy, Beijing University of Chinese Medicine, Beijing, 100102, China
| | - Zhi Zhu
- School of Chinese Pharmacy, Beijing University of Chinese Medicine, Beijing, 100102, China
| | - Shuhe Jia
- School of Chinese Pharmacy, Beijing University of Chinese Medicine, Beijing, 100102, China
| | - Jiyue Xu
- Nanjing Tech University, Nanjing, 211816, China
| | - Zhaohua Zhang
- Scientific Research Institute of Beijing Tongrentang Co., Ltd., Beijing, 100079, China.
| | - Bing Xu
- School of Chinese Pharmacy, Beijing University of Chinese Medicine, Beijing, 100102, China.
| | - Hai Min Lei
- School of Chinese Pharmacy, Beijing University of Chinese Medicine, Beijing, 100102, China.
| |
Collapse
|
|
4
|
Fukuzaki M, Nakatomi C, Kubo S, Shimada T, Tsuji K, Hsu CC, Kawamoto T, Ono K. Effects of loxoprofen on impaired water-evoked swallows in a pharyngitis rat model. Arch Oral Biol 2025; 169:106125. [PMID: 39510027 DOI: 10.1016/j.archoralbio.2024.106125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 10/23/2024] [Accepted: 10/31/2024] [Indexed: 11/15/2024]
Abstract
OBJECTIVE The objective of this study was to investigate the effects of nonsteroidal anti-inflammatory drugs (NSAIDs; e.g., loxoprofen) on pharyngitis-induced dysphagia in rats. DESIGN A pharyngitis rat model was generated by topical application of acetic acid to the laryngopharyngeal region. Changes in water swallowing were evaluated by endoscopic observation over time. A histological analysis of the laryngopharyngeal mucosa was performed. The effects of loxoprofen, antibacterial drugs, and transient receptor potential (TRP) channel inhibitors were investigated in model rats. RESULTS After acetic acid treatment, water-evoked swallowing was impaired on day 1 (prolonging the swallowing latency and interval and decreasing the number of swallows), and recovered until day 6. Administration of loxoprofen significantly alleviated impaired water swallowing. Histologically, loxoprofen significantly improved inflammation of the pharynx, including submucosal edema, but did not affect the loss of taste bud-like structures in the arytenoid. In contrast, the administration of antibacterial drugs or TRP channel inhibitors did not affect the impairment of water swallowing in the model group. CONCLUSION These results demonstrate the efficacy of systemic administration of loxoprofen in improving swallowing impairment in a pharyngitis model rat. This study is the first to provide scientific evidence for the use of NSAIDs in the management of pharyngitis.
Collapse
Affiliation(s)
- Mari Fukuzaki
- Division of Physiology, Kyushu Dental University, 2-6-1 Manazuru, Kokurakita-ku, Kitakyushu, Fukuoka 803-8580, Japan; Division of Orofacial Functions and Orthodontics, Kyushu Dental University, 2-6-1 Manazuru, Kokurakita-ku, Kitakyushu, Fukuoka 803-8580, Japan
| | - Chihiro Nakatomi
- Division of Physiology, Kyushu Dental University, 2-6-1 Manazuru, Kokurakita-ku, Kitakyushu, Fukuoka 803-8580, Japan.
| | - Sayaka Kubo
- Research Department, Daiichi Sankyo Healthcare Co., Ltd., 1-2-58 Hiromachi, Shinagawa-ku, Tokyo 140-0005, Japan
| | - Tomoki Shimada
- Research Department, Daiichi Sankyo Healthcare Co., Ltd., 1-2-58 Hiromachi, Shinagawa-ku, Tokyo 140-0005, Japan
| | - Keiko Tsuji
- Research Department, Daiichi Sankyo Healthcare Co., Ltd., 1-2-58 Hiromachi, Shinagawa-ku, Tokyo 140-0005, Japan
| | - Chia-Chien Hsu
- Division of Physiology, Kyushu Dental University, 2-6-1 Manazuru, Kokurakita-ku, Kitakyushu, Fukuoka 803-8580, Japan
| | - Tatsuo Kawamoto
- Division of Orofacial Functions and Orthodontics, Kyushu Dental University, 2-6-1 Manazuru, Kokurakita-ku, Kitakyushu, Fukuoka 803-8580, Japan
| | - Kentaro Ono
- Division of Physiology, Kyushu Dental University, 2-6-1 Manazuru, Kokurakita-ku, Kitakyushu, Fukuoka 803-8580, Japan
| |
Collapse
|
|
5
|
Chwa JS, Shin Y, Lee Y, Fabrizio T, Congrave-Wilson Z, Cheng WA, Jumarang J, Kim M, Webby R, Bender JM, Pannaraj PS. SARS-CoV-2 Variants May Affect Saliva RT-PCR Assay Sensitivity. J Appl Lab Med 2024; 9:927-937. [PMID: 39246012 PMCID: PMC12001863 DOI: 10.1093/jalm/jfae095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 07/09/2024] [Indexed: 09/10/2024]
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) variants demonstrate predilection for different regions of the respiratory tract. While saliva-based reverse transcription-polymerase chain reaction (RT-PCR) testing is a convenient, cost-effective alternative to nasopharyngeal swabs (NPS), few studies to date have investigated whether saliva sensitivity differs across variants of concern. METHODS SARS-CoV-2 RT-PCR was performed on paired NPS and saliva specimens collected from individuals with acute coronavirus disease 2019 (COVID-19) symptoms or exposure to a COVID-19 household contact. Viral genome sequencing of NPS specimens and Los Angeles County surveillance data were used to determine the variant of infection. Saliva sensitivity was calculated using NPS-positive RT-PCR as the reference standard. Factors contributing to the likelihood of saliva SARS-CoV-2 RT-PCR positivity were evaluated with univariate and multivariable analyses. RESULTS Between June 2020 and December 2022, 548 saliva samples paired with SARS-CoV-2 positive NPS samples were tested by RT-PCR. Overall, saliva sensitivity for SARS-CoV-2 detection was 61.7% (95% CI, 57.6%-65.7%). Sensitivity was highest with Delta infection (79.6%) compared to pre-Delta (58.5%) and Omicron (61.5%) (P = 0.003 and 0.01, respectively). Saliva sensitivity was higher in symptomatic individuals across all variants compared to asymptomatic cases [pre-Delta 80.6% vs 48.3% (P < 0.001), Delta 100% vs 72.5% (P = 0.03), Omicron 78.7% vs 51.2% (P < 0.001)]. Infection with Delta, symptoms, and high NPS viral load were independently associated with 2.99-, 3.45-, and 4.0-fold higher odds of SARS-CoV-2 detection by saliva-based RT-PCR (P = 0.004, <0.001, and <0.001), respectively. CONCLUSIONS As new variants emerge, evaluating saliva-based testing approaches may be crucial to ensure effective virus detection.
Collapse
Affiliation(s)
- Jason S. Chwa
- Keck School of Medicine, University of Southern California, Los Angeles, California, USA
- Division of Infectious Diseases, Children’s Hospital Los Angeles, Los Angeles, California, USA
| | - Yunho Shin
- Division of Infectious Diseases, Children’s Hospital Los Angeles, Los Angeles, California, USA
| | - Yesun Lee
- Division of Infectious Diseases, Department of Pediatrics, University of California, San Diego, California, USA
| | - Thomas Fabrizio
- Department of Infectious Diseases, St Jude Children’s Research Hospital, Memphis, Tennessee, USA
| | - Zion Congrave-Wilson
- Division of Infectious Diseases, Children’s Hospital Los Angeles, Los Angeles, California, USA
| | - Wesley A. Cheng
- Division of Infectious Diseases, Department of Pediatrics, University of California, San Diego, California, USA
| | - Jaycee Jumarang
- Division of Infectious Diseases, Department of Pediatrics, University of California, San Diego, California, USA
| | - Minjun Kim
- Division of Infectious Diseases, Department of Pediatrics, University of California, San Diego, California, USA
| | - Richard Webby
- Department of Infectious Diseases, St Jude Children’s Research Hospital, Memphis, Tennessee, USA
| | - Jeffrey M. Bender
- Department of Pediatrics, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Pia S. Pannaraj
- Division of Infectious Diseases, Department of Pediatrics, University of California, San Diego, California, USA
| |
Collapse
|
|
6
|
Gu Z, Song R, Zhang Y, Hao Y, Sheng S, Chen X, Jin R. Clinical characteristics of COVID-19 clusters in three schools in Beijing, China: A retrospective study. Heliyon 2024; 10:e35425. [PMID: 39165927 PMCID: PMC11334814 DOI: 10.1016/j.heliyon.2024.e35425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 07/27/2024] [Accepted: 07/29/2024] [Indexed: 08/22/2024] Open
Abstract
Background This retrospective analysis aims to investigate the clinical characteristics of students infected with the SARS-CoV-2 Omicron variant in three Beijing schools. Additionally, we explore the dynamic trends of nucleic acid cycle threshold values (Ct values) and serum antibody titers throughout the disease course. Methods Demographic, clinical, nucleic acid Ct values, and antibody titer data were collected from cases in a COVID-19 cluster in Beijing Ditan Hospital, Capital Medical University, spanning from September 6 to October 1, 2022. Results A total of 107 students infected with Omicron (BA.5.2 and BA.2.76) were identified across three schools. Primary clinical manifestations included fever and upper respiratory symptoms (85/107, 79.4 %), with the majority being classified as mild cases (96/107, 89.7 %). Notably, middle school students in the second school exhibited a higher peak body temperature compared to college students in the first and third schools (39.5 °C vs. 38.4 °C, adjusted P = 0.005; 39.5 °C vs. 38.6 °C, adjusted P = 0.002). Analysis of dynamic changes in Ct values revealed the lowest median Ct value in nasopharyngeal swabs on the third day of illness, reaching 35 after 9-11 days. Oropharyngeal swab nucleic acid median Ct value reached 35 approximately 3-5 days post-onset. Serum antibody detection showed continuous negativity of IgM antibody titers from days 1-10, while IgG antibody titers were positive on the first day and increased rapidly after one week. Conclusions The three COVID-19 cluster school outbreaks primarily resulted from Omicron infections, with no severe or fatal cases observed. Clinically, the selection of different types of SARS-CoV-2 nucleic acid swabs for virus detection can be tailored based on the infection's course.
Collapse
Affiliation(s)
- Zhixia Gu
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, China
- Beijing Key Laboratory of Emerging Infectious Diseases, Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, China
- Beijing Institute of Infectious Diseases, Beijing, 100015, China
- National Center for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, China
| | - Rui Song
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, China
- Beijing Key Laboratory of Emerging Infectious Diseases, Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, China
- National Center for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, China
| | - Yuanyuan Zhang
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, China
- Beijing Key Laboratory of Emerging Infectious Diseases, Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, China
- Beijing Institute of Infectious Diseases, Beijing, 100015, China
- National Center for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, China
| | - Yiwei Hao
- Department of Medical Record, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, China
| | - Shugui Sheng
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, China
- Beijing Key Laboratory of Emerging Infectious Diseases, Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, China
- Beijing Institute of Infectious Diseases, Beijing, 100015, China
- National Center for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, China
| | - Xiaoyou Chen
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, China
- Beijing Key Laboratory of Emerging Infectious Diseases, Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, China
- National Center for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, China
| | - Ronghua Jin
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, China
- Beijing Key Laboratory of Emerging Infectious Diseases, Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, China
- Beijing Institute of Infectious Diseases, Beijing, 100015, China
- National Center for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, China
| |
Collapse
|
|
7
|
Tsiouma GK, Oikonomou AA, Nikitopoulos SN, Stavridopoulos MT. COVID-19-Induced Acute Laryngitis: A Case Series. J Voice 2024:S0892-1997(24)00210-8. [PMID: 39048460 DOI: 10.1016/j.jvoice.2024.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 06/29/2024] [Accepted: 07/01/2024] [Indexed: 07/27/2024]
Abstract
OBJECTIVES The objective of this study is to present a novel clinical manifestation of COVID-19 with characteristic endoscopic laryngeal findings. A group of patients who reported similar symptoms, displayed akin laryngoscopic features, and received appropriate treatment is analyzed. Endoscopic images are provided and the pattern of this entity is discussed. STUDY DESIGN This single-center descriptive analysis of a case series was performed in the General Hospital of Volos (Greece), during a 6-month period (from April 2022 to September 2022). Twenty-three patients who suffered from COVID-19 and were simultaneously diagnosed with acute laryngitis were enrolled. METHODS Demographic data, clinical and endoscopic findings, laboratory results, and treatment courses were recorded. Descriptive statistics were performed with the statistical package SPSS (IBM Corp. Released 2017. IBM SPSS Statistics for Windows, Version 25.0. Armonk, NY: IBM Corp.). RESULTS The majority of the patients were male and fully vaccinated, as defined by Greek legislation at the time. None of them was a smoker. All patients were infected with Severe Acute Respiratory Syndrome Coronavirus 2 for the first time and presented with acute odynophagia. The characteristic endoscopic finding was an erythematous larynx with white undetachable lesions mainly in the supraglottic area. Pooling of saliva in the pyriform fossae was an independent predicting factor for patients' hospitalization (P < 0.001). None of the patients required intubation or tracheostomy and all responded to the systemic treatment with corticosteroids and antibiotics. CONCLUSIONS COVID-19-induced laryngitis should be considered in any patient with positive COVID-19 who complains of acute odynophagia. Fiberoptic laryngoscopy is necessary to confirm the diagnosis. In our series, timely initiation of treatment minimized the need to secure the airway and ensured a favorable prognosis.
Collapse
Affiliation(s)
- Georgia K Tsiouma
- ENT Department of General Hospital of Volos "Achillopouleio", Volos, Thessaly, Greece.
| | - Anastasia A Oikonomou
- ENT Department of General Hospital of Volos "Achillopouleio", Volos, Thessaly, Greece.
| | | | | |
Collapse
|
|
8
|
Dai B, Ji W, Zhu P, Han S, Chen Y, Jin Y. Update on Omicron variant and its threat to vulnerable populations. PUBLIC HEALTH IN PRACTICE 2024; 7:100494. [PMID: 38584806 PMCID: PMC10998192 DOI: 10.1016/j.puhip.2024.100494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 02/20/2024] [Accepted: 03/15/2024] [Indexed: 04/09/2024] Open
Abstract
Objective To reduce the incidence of severe illness and fatalities, and promote the awareness of protection and precaution, increased vaccination, strengthen the physical fitness, frequent ventilation, and health education should be enhanced among vulnerable populations as essential measures for the future control of COVID-19. Study design Systematic review. Method The search was done using PubMed, EMBASE and Web of Science for studies without language restrictions, published up through March 2023, since their authoritative and comprehensive literature search database. Eighty articles were included. Extraction of articles and quality assessment of included reviews was performed independently by two authors using the AMSTAR 2 score. Results The articles in the final data set included research on epidemiological characteristics, pathogenicity, available vaccines, treatments and epidemiological features in special populations including the elders, pregnant women, kids, people with chronic diseases concerning Omicron. Conclusion Although less pathogenic potential is found in Omicron, highly mutated forms have enhanced the ability of immune evasion and resistance to existing vaccines compared with former variants. Severe complications and outcomes may occur in vulnerable populations. Infected pregnant women are more likely to give birth prematurely, and fatal implications in children infected with Omicron are hyperimmune response and severe neurological disorders. In immunocompromised patients, there is a greater reported mortality and complication compared to patients with normal immune systems. Therefore, maintain social distancing, wear masks, and receive vaccinations are effective long-term measures.
Collapse
Affiliation(s)
- Bowen Dai
- Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou, China
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, 450001, China
| | - Wangquan Ji
- Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou, China
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, 450001, China
| | - Peiyu Zhu
- Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou, China
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, 450001, China
| | - Shujie Han
- Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou, China
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, 450001, China
| | - Yu Chen
- Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou, China
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, 450001, China
| | - Yuefei Jin
- Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou, China
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, 450001, China
| |
Collapse
|
|
9
|
Sun J, Zhang H, Yang Z. A retrospective analysis of children with mild and asymptomatic Omicron infections under 14: A single-center study. Medicine (Baltimore) 2024; 103:e37149. [PMID: 38363889 PMCID: PMC10869072 DOI: 10.1097/md.0000000000037149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 01/11/2024] [Indexed: 02/18/2024] Open
Abstract
Omicron BA.5 subvariant has been proven to be more transmissible than other Omicron subvariants. But the studies on the spread of the Omicron BA.5 subvariant in children are still limited. This study aimed to analyze the clinical features of children infected with Omicron BA.5.2 variant in the mobile cabin hospital and the influence factors of the infections. Children with mild and asymptomatic Omicron infections under 14 years old who were admitted to the mobile cabin hospital from October 30 to December 7, 2022 were retrospectively collected. A total of 741 children, 424 boys (57.2%) and 317 girls (42.8%) were enrolled, including 145 asymptomatic cases (22.7%) and 493 (77.3%) mild cases. Upper respiratory tract infection was the dominant manifestation. Fever was the most common presenting symptom (80.7%), followed by cough (52.5%). The average time to symptom disappearance was 3.76 days, and the average negative conversion time of nucleic acid was 12.3 days. Univariate analysis showed that the negative conversion time of nucleic acid differed significantly across the age groups. The multivariate analysis showed that the older the age, the longer the negative conversion time of nucleic acid. Among those with the negative conversion time of nucleic acid longer than 12 days, age was positively correlated to the negative conversion time of nucleic acid, while the number of vaccine doses received was negatively correlated to the negative conversion time of nucleic acid. Omicron infection occurred in children of any age group, with good prospect for recovery. Age and number of vaccine doses received were risk factors influencing the negative conversion time of nucleic acid.
Collapse
Affiliation(s)
- Jing Sun
- Department of Pediatrics, Lanzhou Chengguan District People’s Hospital, Lanzhou City, China
| | - Haiyan Zhang
- Department of Pediatrics, Lanzhou Chengguan District People’s Hospital, Lanzhou City, China
| | - Zhen Yang
- Department of Pediatrics, Lanzhou Maternal and Child Health Care Hospital, Lanzhou City, China
| |
Collapse
|
|
10
|
He Y, Henley J, Sell P, Comai L. Differential Outcomes of Infection by Wild-Type SARS-CoV-2 and the B.1.617.2 and B.1.1.529 Variants of Concern in K18-hACE2 Transgenic Mice. Viruses 2023; 16:60. [PMID: 38257760 PMCID: PMC10820160 DOI: 10.3390/v16010060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 12/22/2023] [Accepted: 12/23/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND SARS-CoV-2 is a respiratory virus with neurological complications including the loss of smell and taste, headache, and confusion that can persist for months or longer. Severe neuronal cell damage has also been reported in some cases. The objective of this study was to compare the infectivity of the wild-type virus, Delta (B.1.617.2) and Omicron (B.1.1.529) variants in transgenic mice that express the human angiotensin-converting enzyme 2 (hACE2) receptor under the control of the keratin 18 promoter (K18) and characterize the progression of infection and inflammatory response in the lungs, brain, medulla oblongata, and olfactory bulbs of these animals. We hypothesized that wild type, Delta and Omicron differentially infect K18-hACE2 mice, thereby inducing distinct cellular responses. METHODS K18-hACE2 female mice were intranasally infected with wild-type, Delta, or Omicron variants and euthanized either at 3 days post-infection (dpi) or at the humane endpoint. None of the animals infected with the Omicron variant reached the humane endpoint and were euthanized at day 8 dpi. Virological and immunological analyses were performed in the lungs, brains, medulla oblongata and olfactory bulbs isolated from infected mice. RESULTS At 3 dpi, mice infected with wild type and Delta displayed significantly higher levels of viral RNA in the lungs than mice infected with Omicron, while in the brain, Delta and Omicron resulted in higher levels of viral RNA than with the wild type. Viral RNA was also detected in the medulla oblongata of mice infected by all these virus strains. At this time point, the mice infected with wild type and Delta displayed a marked upregulation of many inflammatory markers in the lungs. On the other hand, the upregulation of inflammatory markers was observed only in the brains of mice infected with Delta and Omicron. At the humane endpoint, we observed a significant increase in the levels of viral RNA in the lungs and brains of mice infected with wild type and Delta, which was accompanied by the elevated expression of many inflammatory markers. In contrast, mice which survived infection with the Omicron variant showed high levels of viral RNA and the upregulation of cytokine and chemokine expression only in the lungs at 8 dpi, suggesting that infection and inflammatory response by this variant is attenuated in the brain. Reduced RNA levels and the downregulation of inflammatory markers was also observed in the medulla oblongata and olfactory bulbs of mice infected with Omicron at 8 dpi as compared with mice infected with wild-type and Delta at the humane end point. Collectively, these data demonstrate that wild-type, Delta, and Omicron SARS-CoV-2 induce distinct levels of infection and inflammatory responses in K18-hACE2 mice. Notably, sustained brain infection accompanied by the upregulation of inflammatory markers is a critical outcome in mice infected with wild type and Delta but not Omicron.
Collapse
Affiliation(s)
- Yicheng He
- Department of Molecular Microbiology and Immunology, 2011 Zonal Avenue, Los Angeles, CA 90089, USA
| | - Jill Henley
- Hastings Foundation and Wright Foundation BSL3 Laboratory, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA
| | - Philip Sell
- Department of Molecular Microbiology and Immunology, 2011 Zonal Avenue, Los Angeles, CA 90089, USA
- Hastings Foundation and Wright Foundation BSL3 Laboratory, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA
| | - Lucio Comai
- Department of Molecular Microbiology and Immunology, 2011 Zonal Avenue, Los Angeles, CA 90089, USA
- Hastings Foundation and Wright Foundation BSL3 Laboratory, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA
| |
Collapse
|
|
11
|
Xia W, Jiang T, Tan Y, Li C, Wu S, Mei B. Characteristics of hematological parameters on admission in COVID-19 Omicron variant infected in Chinese population: a large-scale retrospective study. BMC Infect Dis 2023; 23:835. [PMID: 38012548 PMCID: PMC10683119 DOI: 10.1186/s12879-023-08771-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 10/30/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND The Omicron variant of SARS-CoV-2, currently the most prevalent strain, has rapidly spread in Jingzhou, China, due to changes in the country's epidemic prevention policy, resulting in an unprecedented increase in cases. Previous studies reported hematological parameters' predictive value in COVID-19 severity and prognosis, but their relevance for early diagnosis in patients infected by the Omicron variant, particularly in high-risk pneumonia cases, remains unclear. Our study aimed to evaluate these parameters as early warning indicators for Omicron-infected patients in fever clinics and those with pulmonary infections (PI). METHODS A total of 2,021 COVID-19 patients admitted to the fever clinic and infectious disease department of Jingzhou Hospital Affiliated to Yangtze University from November 1, 2022, to December 31, 2022, were retrospectively recruited. Demographic and hematological parameters were obtained from the electronic medical records of eligible patients. These hematological parameters were analyzed by receiver operating characteristic (ROC) curves to determine whether they can be used for early diagnosis of COVID-19 patients in fever clinics and the presence of PI in COVID-19 patients. RESULTS Statistical differences in hematological parameters were observed between COVID-19 patients with fever and PI and control groups (P < 0.01). The ROC curve further demonstrated that lymphocyte (LYM) counts, neutrophil (NEU) counts, monocyte-to-lymphocyte ratios (MLR), platelet-to-lymphocyte ratios (PLR), white blood cell counts (WBC), and mean corpuscular hemoglobin concentration (MCHC) were the top 6 indicators in diagnosing Omicron infection with fever, with area under the curve (AUC) values of 0.738, 0.718, 0.713, 0.702, 0.700, and 0.687, respectively (P < 0.01). Furthermore, the mean platelet volume (MPV) with an AUC of 0.764, red blood cell count (RBC) with 0.753, hematocrit (HCT) with 0.698, MLR with 0.694, mean corpuscular hemoglobin (MCH) with 0.676, and systemic inflammation response indexes (SIRI) with 0.673 were the top 6 indicators for the diagnosis of COVID-19 patients with PI (P < 0.01). CONCLUSIONS LYM, NEU, MLR, PLR, WBC, and MCHC can serve as potential prescreening indicators for Omicron infection in fever clinics. Additionally, MPV, RBC, HCT, MLR, MCH, and SIRI can predict the presence of PI in COVID-19 patients infected by the Omicron variant.
Collapse
Affiliation(s)
- Wei Xia
- Department of Laboratory Medicine, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, Hubei, 434020, China
| | - Tao Jiang
- Department of Laboratory Medicine, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, Hubei, 434020, China
| | - Yafeng Tan
- Department of Laboratory Medicine, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, Hubei, 434020, China
| | - Chengbin Li
- Department of Laboratory Medicine, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, Hubei, 434020, China
| | - Song Wu
- Department of Laboratory Medicine, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, Hubei, 434020, China
| | - Bing Mei
- Department of Laboratory Medicine, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, Hubei, 434020, China.
| |
Collapse
|
|
12
|
Huang Y, Su S, Xu Z, Chen W. Clinical Features and Outcomes of Omicron-Associated Croup in Children. EAR, NOSE & THROAT JOURNAL 2023:1455613231211311. [PMID: 37970829 DOI: 10.1177/01455613231211311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023] Open
Abstract
Objective: This study was aimed to describe the clinical features and outcomes of Omicron-associated croup in children. Methods: A total of 105 children aged 3-60 months (median age 11 months) with coronavirus disease 2019 (COVID-19) and cough were admitted to our hospital from December 16, 2022, to December 31, 2022. Their clinical features, treatment, and outcomes were reviewed. These children were followed up for 8 months. Results: Among the cases, 5 had complex medical histories, while the other children were generally healthy. Out of the cases, 41 (38.3%), 57 (54.4%), and 7 (6.7%) had mild, moderate, and severe laryngeal obstruction, respectively. They developed croup after 1-5 days of fever (median 2 days). The majority (90.5%) of COVID-19 children with croup did not have pneumonia, and most of them (64.8%) had decreased eosinophil counts. Additionally, most other blood routine indicators were normal. Five other viral infections (chlamydia pneumoniae, respiratory syncytial virus, adenovirus, coxsackie virus, and mycoplasma pneumoniae) were tested in 51 cases, and all results were negative. All cases recovered from croup after receiving prompt nebulization therapy and/or intravenous drip of hormone. The hospitalization rate was 6.7%. During the 8-month follow-up period, 71 cases experienced repeated fever due to various infections, but only 4 cases (4/105, 3.8%) had repeated croup. Conclusion: Omicron is a risk factor for croup, with most cases presenting mild to moderate laryngeal obstructions. Co-viral infection testing is unnecessary for such cases. The symptoms of Omicron-associated croup may be more severe than croup associated with other viruses; however, unnecessary hospitalizations can be avoided, leading to reduced healthcare expenses.
Collapse
Affiliation(s)
- Yue Huang
- Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Fudan University, Shanghai, China
| | - Shuhua Su
- Department of Otolaryngology, Qinzhou Maternity and Child Health Care Hospital, Qinzhou City, Guangxi Province, China
| | - Zhengmin Xu
- Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Fudan University, Shanghai, China
| | - Wenxia Chen
- Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Fudan University, Shanghai, China
| |
Collapse
|
|
13
|
Reyes-Ruiz JM, Bastida-González F, Del Ángel RM. Response to Letter to the Editor from Finsterer: "Encephalitis Associated With SARS-CoV-2 Infection in a Child With Chiari Malformation Type I". In Vivo 2023; 37:2859-2862. [PMID: 37905639 PMCID: PMC10621447 DOI: 10.21873/invivo.13403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 08/26/2023] [Accepted: 08/30/2023] [Indexed: 11/02/2023]
Affiliation(s)
- José Manuel Reyes-Ruiz
- Unidad Médica de Alta Especialidad, Hospital de Especialidades No. 14, Centro Médico Nacional Adolfo Ruiz Cortines, Instituto Mexicano del Seguro Social (IMSS), Veracruz, Mexico;
- Facultad de Medicina, Región Veracruz, Universidad Veracruzana (UV), Veracruz, Mexico
| | - Fernando Bastida-González
- Laboratorio de Biología Molecular, Laboratorio Estatal de Salud Pública del Estado de México, Toluca de Lerdo, Mexico
| | - Rosa María Del Ángel
- Department of Infectomics and Molecular Pathogenesis, Center for Research and Advanced Studies (CINVESTAV-IPN), Mexico City, Mexico
| |
Collapse
|
|
14
|
Kimura H, Hayashi Y, Kitagawa M, Yoshizaki M, Saito K, Harada K, Okayama K, Miura Y, Kimura R, Shirai T, Fujita K, Machida S, Ito K, Kurosawa I. Pathogen Profiles in Outpatients with Non-COVID-19 during the 7th Prevalent Period of COVID-19 in Gunma, Japan. Microorganisms 2023; 11:2142. [PMID: 37763986 PMCID: PMC10536078 DOI: 10.3390/microorganisms11092142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 08/17/2023] [Accepted: 08/19/2023] [Indexed: 09/29/2023] Open
Abstract
The identification of pathogens associated with respiratory symptoms other than the novel coronavirus disease 2019 (COVID-19) can be challenging. However, the diagnosis of pathogens is crucial for assessing the clinical outcome of patients. We comprehensively profiled pathogens causing non-COVID-19 respiratory symptoms during the 7th prevalent period in Gunma, Japan, using deep sequencing combined with a next-generation sequencer (NGS) and advanced bioinformatics technologies. The study included nasopharyngeal swabs from 40 patients who tested negative for severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) using immuno-chromatography and/or quantitative reverse transcription polymerase chain reaction (qRT-PCR) methods. Comprehensive pathogen sequencing was conducted through deep sequencing using NGS. Additionally, short reads obtained from NGS were analyzed for comprehensive pathogen estimation using MePIC (Metagenomic Pathogen Identification Pipeline for Clinical Specimens) and/or VirusTap. The results revealed the presence of various pathogens, including respiratory viruses and bacteria, in the present subjects. Notably, human adenovirus (HAdV) was the most frequently detected virus in 16 of the 40 cases (40.0%), followed by coryneforms, which were the most frequently detected bacteria in 21 of the 40 cases (52.5%). Seasonal human coronaviruses (NL63 type, 229E type, HKU1 type, and OC43 type), human bocaviruses, and human herpesviruses (human herpesvirus types 1-7) were not detected. Moreover, multiple pathogens were detected in 50% of the subjects. These results suggest that various respiratory pathogens may be associated with non-COVID-19 patients during the 7th prevalent period in Gunma Prefecture, Japan. Consequently, for an accurate diagnosis of pathogens causing respiratory infections, detailed pathogen analyses may be necessary. Furthermore, it is possible that various pathogens, excluding SARS-CoV-2, may be linked to fever and/or respiratory infections even during the COVID-19 pandemic.
Collapse
Affiliation(s)
- Hirokazu Kimura
- Department of Health Science, Gunma Paz University Graduate School of Health Sciences, Takasaki-shi 370-0006, Gunma, Japan; (Y.H.); (K.H.); (K.O.); (Y.M.); (K.F.)
- Advanced Medical Science Research Center, Gunma Paz University Research Institute, Shibukawa-shi 377-0008, Gunma, Japan; (R.K.); (T.S.); (K.I.)
| | - Yuriko Hayashi
- Department of Health Science, Gunma Paz University Graduate School of Health Sciences, Takasaki-shi 370-0006, Gunma, Japan; (Y.H.); (K.H.); (K.O.); (Y.M.); (K.F.)
| | - Masanari Kitagawa
- Project Department, Takara Bio Inc., Kusatsu-shi 525-0058, Shiga, Japan; (M.K.); (M.Y.); (K.S.)
| | - Miwa Yoshizaki
- Project Department, Takara Bio Inc., Kusatsu-shi 525-0058, Shiga, Japan; (M.K.); (M.Y.); (K.S.)
| | - Kensuke Saito
- Project Department, Takara Bio Inc., Kusatsu-shi 525-0058, Shiga, Japan; (M.K.); (M.Y.); (K.S.)
| | - Kazuhiko Harada
- Department of Health Science, Gunma Paz University Graduate School of Health Sciences, Takasaki-shi 370-0006, Gunma, Japan; (Y.H.); (K.H.); (K.O.); (Y.M.); (K.F.)
- Kurosawa Hospital, Takasaki-shi 370-1203, Gunma, Japan; (S.M.); (I.K.)
| | - Kaori Okayama
- Department of Health Science, Gunma Paz University Graduate School of Health Sciences, Takasaki-shi 370-0006, Gunma, Japan; (Y.H.); (K.H.); (K.O.); (Y.M.); (K.F.)
| | - Yusuke Miura
- Department of Health Science, Gunma Paz University Graduate School of Health Sciences, Takasaki-shi 370-0006, Gunma, Japan; (Y.H.); (K.H.); (K.O.); (Y.M.); (K.F.)
| | - Ryusuke Kimura
- Advanced Medical Science Research Center, Gunma Paz University Research Institute, Shibukawa-shi 377-0008, Gunma, Japan; (R.K.); (T.S.); (K.I.)
- Department of Bacteriology, Graduate School of Medicine, Gunma University, Maebashi-shi 371-8514, Gunma, Japan
| | - Tatsuya Shirai
- Advanced Medical Science Research Center, Gunma Paz University Research Institute, Shibukawa-shi 377-0008, Gunma, Japan; (R.K.); (T.S.); (K.I.)
| | - Kiyotaka Fujita
- Department of Health Science, Gunma Paz University Graduate School of Health Sciences, Takasaki-shi 370-0006, Gunma, Japan; (Y.H.); (K.H.); (K.O.); (Y.M.); (K.F.)
| | - Suguru Machida
- Kurosawa Hospital, Takasaki-shi 370-1203, Gunma, Japan; (S.M.); (I.K.)
| | - Kazuto Ito
- Advanced Medical Science Research Center, Gunma Paz University Research Institute, Shibukawa-shi 377-0008, Gunma, Japan; (R.K.); (T.S.); (K.I.)
- Kurosawa Hospital, Takasaki-shi 370-1203, Gunma, Japan; (S.M.); (I.K.)
| | - Isao Kurosawa
- Kurosawa Hospital, Takasaki-shi 370-1203, Gunma, Japan; (S.M.); (I.K.)
| |
Collapse
|
|
15
|
Inui G, Tomita K, Yamasaki A. Cobblestone Throat in a Younger Patient Infected with the Omicron Variant of the SARS-CoV-2 Virus. Am J Trop Med Hyg 2023; 109:221-222. [PMID: 37364864 PMCID: PMC10397436 DOI: 10.4269/ajtmh.22-0747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 05/13/2023] [Indexed: 06/28/2023] Open
Affiliation(s)
- Genki Inui
- Division of Respiratory Medicine and Rheumatology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Tottori, Japan
- Department of Respiratory Medicine, National Hospital Organization Yonago Medical Centre, Tottori, Japan
| | - Katsuyuki Tomita
- Department of Respiratory Medicine, National Hospital Organization Yonago Medical Centre, Tottori, Japan
| | - Akira Yamasaki
- Division of Respiratory Medicine and Rheumatology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Tottori, Japan
| |
Collapse
|
|
16
|
Kimura Y, Hirabayashi E, Yano M, Fujitani S, Shioiri S. COVID-19 Omicron variant-induced laryngitis. Auris Nasus Larynx 2023; 50:637-640. [PMID: 36114072 PMCID: PMC9395289 DOI: 10.1016/j.anl.2022.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 07/20/2022] [Accepted: 08/17/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The COVID-19 omicron variant has a low affinity for the lower respiratory tract. However, upper respiratory tract symptoms, such as nasal discharge and sore throat, characterize the infection with this variant. Therefore, in laryngeal stenosis, disease severity assessment through blood oxygen saturation has not been useful. METHODS We report the case of "omicron laryngitis" in a 59-year-old male who visited the ear, nose, and throat (ENT) clinic with complaints of a sore throat and difficulty in swallowing saliva that persisted for a day. RESULTS Laryngoscopy revealed severe swelling of the transglottic region and exudates on the larynx. He was then diagnosed with COVID-19 and subjected to emergency tracheostomy for airway management. Until the emergence of the omicron variant, COVID-19 showed mainly lower airway and mild upper airway inflammatory features. However, upper airway stenosis should be suspected in cases presenting with "muffled speech," "dysphagia," "severe pain on swallowing," and "inspiratory dyspnea or stridor." CONCLUSION Therefore, laryngeal and pharyngeal evaluation using a flexible laryngoscope under appropriate infection control measures is necessary, considering the possibility of progression to fatal laryngeal stenosis, as noted in this case.
Collapse
Affiliation(s)
- Yurika Kimura
- Department of Otolaryngology, Tokyo Metropolitan Ebara Hospital, 4-5-10, Higashi Yukigaya, Ohta-ku, Tokyo, 145-0065, Japan.
| | - Eiko Hirabayashi
- Department of Otolaryngology, Tokyo Metropolitan Ebara Hospital, 4-5-10, Higashi Yukigaya, Ohta-ku, Tokyo, 145-0065, Japan
| | - Mai Yano
- Department of Otolaryngology, Tokyo Metropolitan Ebara Hospital, 4-5-10, Higashi Yukigaya, Ohta-ku, Tokyo, 145-0065, Japan
| | | | - Sadaaki Shioiri
- Department of Palliative Care, Ebara Hospital, Tokyo Metropolitan Ebara Hospital, 4-5-10, Higashi Yukigaya, Ohta-ku, Tokyo, 145-0065, Japan
| |
Collapse
|
|
17
|
Lin Y, Ge XH, Liu P, Zhang J, Jiang LP. A retrospective analysis of coping competence among community health centers during the COVID-19 pandemic in Shanghai, China: Coping strategies for future public health emergency events. Glob Health Med 2023; 5:151-157. [PMID: 37397943 PMCID: PMC10311669 DOI: 10.35772/ghm.2023.01042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 05/29/2023] [Accepted: 06/08/2023] [Indexed: 07/04/2023]
Abstract
This study aims to investigate the coping competence of 12 community health centers through nursing workforce, emergency preparation, emergency response training, and emergency support in a district of Shanghai during the coronavirus disease 2019 (COVID-19) pandemic in 2022 to propose coping strategies and implication for Future Public Health Emergency Events for community health centers. A cross-sectional survey was conducted on June 2022, and 12 community health centers (servicing a population of 104,472.67 ± 41,421.18, with 125 ± 36 health care providers per center) were then divided into group A (n = 5, medical care ratio ≥ 1:1) and group B (n = 7, medical care ratio < 1:1) according to collected data, and the nursing human resources management and coping competence of the centers with COVID-19 of both groups were retrospectively analyzed. Nursing shortages were obvious across all 12 centers. Certain deficiencies in the coping competence of community health centers with emergencies must be addressed (possession rate < 70% in both groups, p > 0.05). Community health centers need to enhance hospital-to-hospital collaboration and the ability to transport emergency staff to the post promptly during outbreaks. Emergency coping assessments, emergency drills at different levels, and mental health support need to be implemented regularly among community health centers, and effective donation management should be pursued as well. We expect that this study could support efforts by leaders of community health centers to conclude coping strategies including increasing nursing workforce, optimizing human recourse management, and identifying areas of improvement of centers for emergency coping during public health events.
Collapse
Affiliation(s)
- Yan Lin
- Department of Nursing, Xinhua Hospital affiliated with Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xiao-Hua Ge
- Department of Nursing, Xinhua Hospital affiliated with Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Ping Liu
- Department of Nursing, Xinhua Hospital affiliated with Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jie Zhang
- Department of Nursing, Xinhua Hospital affiliated with Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Li-Ping Jiang
- Department of Nursing, Xinhua Hospital affiliated with Shanghai Jiaotong University School of Medicine, Shanghai, China
| |
Collapse
|
|
18
|
Tsuchiya H. COVID-19 Oral Sequelae: Persistent Gustatory and Saliva Secretory Dysfunctions after Recovery from COVID-19. Med Princ Pract 2023; 32:166-177. [PMID: 37271130 PMCID: PMC10601698 DOI: 10.1159/000531373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 05/21/2023] [Indexed: 06/06/2023] Open
Abstract
Diverse manifestations have been recognized to last for a long time in patients infected with SARS-CoV-2. However, understanding of oral sequelae after recovery from COVID-19 is relatively poor compared to that of oral symptoms in the acute phase of COVID-19 and other COVID-19 sequelae. The aim of the present study was to characterize persistent gustatory and saliva secretory dysfunctions and to speculate on their pathogenic mechanisms. Articles were retrieved by searching scientific databases with a cutoff date of September 30, 2022. The literature search indicated that ageusia/dysgeusia and xerostomia/dry mouth are reported by 1-45% of COVID-19 survivors at follow-ups of 21-365 days and by 2-40% of COVID-19 survivors at follow-ups of 28-230 days, respectively. The prevalence of gustatory sequelae partly depends on difference in ethnicity, gender, age, and disease severity of subjects. Co-occurring gustatory and saliva secretory sequelae are pathogenically related to either or both of the following: expression of SARS-CoV-2 cellular entry-relevant receptors in taste buds and salivary glands, and SARS-CoV-2 infection-induced deficiency in zinc that is essential for normality of taste perception and saliva secretion. Given the long-term oral sequelae, hospital discharge is not the end of the disease; therefore, careful attention should be continuously paid to oral conditions of post-COVID-19 patients.
Collapse
Affiliation(s)
- Hironori Tsuchiya
- Department of Dental Basic Education, Asahi University School of Dentistry, Mizuho, Japan
| |
Collapse
|
|
19
|
Suzuki H, Muramatsu H, Hayashi K. Causes of death of forensic autopsy cases tested positive for COVID-19 in Tokyo Metropolis, Japan. Leg Med (Tokyo) 2023; 62:102222. [PMID: 36842226 PMCID: PMC9940469 DOI: 10.1016/j.legalmed.2023.102222] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 02/18/2023] [Indexed: 02/22/2023]
Abstract
BACKGROUND The profile of deaths related to coronavirus disease of 2019 (COVID-19) that occurred outside the hospital in Japan remains unclear because of cautious stance on performing autopsies of COVID-19 positive cases. METHODS Autopsy cases that tested positive for COVID-19 in the Tokyo Metropolis from April 2020 to July 2022 were handled by medical examiners (n = 41). Age, sex, medical history, autopsy findings, cause of death, postmortem computed tomography (PMCT) findings, and the causal relationship between death and COVID-19 were examined. RESULTS The mean age of the deceased was 58.0 years (range: 28-96 years), and the study sample consisted of 33 males (80.5%) and 8 females (19.5%). The most frequent medical histories were hypertension (n = 7) and diabetes (n = 7), followed by mental disorders (n = 5). Nineteen cases showed a body mass index ≧25.0 (46.3%). The leading cause of death was pneumonia (n = 17), in which diffuse ground-glass opacification and/or consolidation was noted on PMCT. There were 26 deaths directly related to COVID-19 (63.4%), including pneumonia, myocarditis, laryngotracheobronchitis, and emaciation. The proportion of deaths directly related to COVID-19 was lower after 2022 (42.1%) than prior to 2022 (81.8%). CONCLUSION Pneumonia was the leading cause of death in this study sample; however, the causes of death in COVID-19 positive cases varied, especially after 2022, when the omicron variant was dominant. Mortality statistics may be affected by viral mutations, and the results of this study further emphasize the need for autopsy because more differential diagnoses should be considered in the phase of the omicron variant.
Collapse
Affiliation(s)
- Hideto Suzuki
- Tokyo Medical Examiner's Office, Tokyo Metropolitan Government, Japan. hideto-@qk9.so-net.ne.jp
| | | | - Kino Hayashi
- Tokyo Medical Examiner's Office, Tokyo Metropolitan Government, Japan
| |
Collapse
|
|
20
|
Bao Y, He L, Miao B, Zhong Z, Lu G, Bai Y, Liang Q, Ling Y, Ji P, Su B, Zhao GP, Wu H, Zhang W, Wang Y, Chen Y, Xu J. BBIBP-CorV vaccination accelerates anti-viral antibody responses in heterologous Omicron infection: A retrospective observation study in Shanghai. Vaccine 2023; 41:3258-3265. [PMID: 37085449 DOI: 10.1016/j.vaccine.2023.03.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 03/29/2023] [Accepted: 03/31/2023] [Indexed: 04/23/2023]
Abstract
OBJECTIVES To investigate how BBIBP-CorV vaccination affecting antibody responses upon heterologous Omicron infection. METHODS 440 Omicron-infected patients were recruited in this study. Antibodies targeting SARS-CoV-2 spike protein receptor binding domain (RBD) and nucleoprotein of both wild-type (WT) and Omicron were detected by ELISA. The clinical relevance was further analyzed. RESULTS BBIBP-CorV vaccinated patients exhibited higher anti-RBD IgG levels targeting both WT and Omicron than non-vaccinated patients at different stages. By using a 3-day moving average analysis, we found that BBIBP-CorV vaccinated patients exhibited the increases in both anti-WT and Omicron RBD IgG from the onset and reached the plateau at Day 8 whereas those in non-vaccinated patients remained low during the disease. Significant increase in anti-WT RBD IgA was observed only in vaccinated patients. anti-Omicron RBD IgA levels remained low in both vaccinated and non-vaccinated patients. Clinically, severe COVID-19 only occurred in non-vaccinated group. anti-RBD IgG and IgA targeting both WT and Omicron were negatively correlated with virus load, hospitalization days and virus elimination in vaccinated patients. CONCLUSIONS BBIBP-CorV vaccination effectively reduces the severity of Omicron infected patients. The existence of humoral memory responses established through BBIBP-CorV vaccination facilitates to induce rapid recall antibody responses when encountering SARS-CoV-2 variant infection.
Collapse
Affiliation(s)
- Yujie Bao
- Department of Infectious Diseases, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Liheng He
- Shanghai Institute of Immunology, Department of Microbiology and Immunology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Benjie Miao
- Bio-Med Big Data Center, Key Laboratory of Computational Biology, CAS-MPG Partner Institute for Computational Biology, Shanghai Institute of Nutrition and Health, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai 200032, China
| | - Zhengrong Zhong
- Department of Clinical Diagnosis, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Guanzhu Lu
- Department of Infectious Diseases, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Yupan Bai
- Department of Infectious Diseases, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Qiming Liang
- Shanghai Institute of Immunology, Department of Microbiology and Immunology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Yunchao Ling
- Bio-Med Big Data Center, Key Laboratory of Computational Biology, CAS-MPG Partner Institute for Computational Biology, Shanghai Institute of Nutrition and Health, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai 200032, China
| | - Ping Ji
- Shanghai Institute of Immunology, Department of Microbiology and Immunology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Bing Su
- Shanghai Institute of Immunology, Department of Microbiology and Immunology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Guo-Ping Zhao
- Bio-Med Big Data Center, Key Laboratory of Computational Biology, CAS-MPG Partner Institute for Computational Biology, Shanghai Institute of Nutrition and Health, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai 200032, China
| | - Hao Wu
- Department of Otorhinolaryngology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Wenhong Zhang
- Department of Infectious Diseases, National Medical Center for Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Huashan Hospital, Fudan University, Shanghai China
| | - Ying Wang
- Shanghai Institute of Immunology, Department of Microbiology and Immunology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; Shanghai Key Laboratory of Emergency Prevention, Diagnosis and Treatment of Respiratory Infectious Diseases (20dz2261100), Shanghai 200025, China; Key Laboratory of Parasite and Vector Biology, Ministry of Health, School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Institute of Virology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| | - Yingying Chen
- Shanghai Institute of Immunology, Department of Microbiology and Immunology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; Key Laboratory of Parasite and Vector Biology, Ministry of Health, School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Jie Xu
- Department of Infectious Diseases, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China.
| |
Collapse
|
|
21
|
Abdel-Aty Y, Sulica L. Increased Incidence of Ulcerative Laryngitis During Spring 2022 Omicron-Variant Wave of COVID19. J Voice 2023:S0892-1997(23)00125-X. [PMID: 37156683 PMCID: PMC10083210 DOI: 10.1016/j.jvoice.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 04/05/2023] [Accepted: 04/06/2023] [Indexed: 05/10/2023]
Abstract
OBJECTIVES Ulcerative laryngitis is a distinctive condition which typically follows illness with severe cough, and is characterized by dysphonia, ulcerative lesions of the vocal folds, and a prolonged clinical course. We present four patients with ulcerative laryngitis who presented in close succession amid the surge in omicron-variant COVID19 cases. STUDY DESIGN Retrospective review. METHODS Patient records for patients with ulcerative laryngitis from April and May 2022 were reviewed and compared with patients who presented with the same diagnosis from January 2017 through March 2022. Incidence, patient demographics, occupation, vaccination status, disease history, and treatment were obtained and compared. RESULTS Four patients presented with ulcerative laryngitis over six weeks. Compared to the previous 4 years, this represented an eight-fold increase in monthly incidence. Average time from symptom onset to presentation was 15 days. All patients presented with dysphonia, with an average VHI10 of 23 and SVHI10 of 28. Two patients were COVID positive, one negative, and one had unknown COVID status. Three patients were fully vaccinated while one patient had only received one dose. Treatments included voice rest, steroids, antibiotics, antireflux medicine, and cough suppressants. Clinical course tended to be shorter and outcomes similar to the comparison group. CONCLUSION The incidence of ulcerative laryngitis appeared to increase markedly with the prevalence of omicron-variant COVID19. Potential explanations include the apparent upper airway focus of omicron infection in contrast with prior variants and/or change in COVID19 infection characteristics in a vaccinated population.
Collapse
Affiliation(s)
- Yassmeen Abdel-Aty
- Department of Otolaryngology-Head and Neck Surgery, The Sean Parker Institute for the Voice, Weill Cornell Medical College/New York-Presbyterian Hospital, New York, New York
| | - Lucian Sulica
- Department of Otolaryngology-Head and Neck Surgery, The Sean Parker Institute for the Voice, Weill Cornell Medical College/New York-Presbyterian Hospital, New York, New York.
| |
Collapse
|
|
22
|
Narayanan N, Langer S, Acker KP, Rosenblatt SD, Simmons W, Wu A, Han JY, Abramson EL, Grinspan ZM, Levine DA. COVID-19 is Observed in Older Children During the Omicron Wave in New York City. J Emerg Med 2023; 64:195-199. [PMID: 36803448 PMCID: PMC9482840 DOI: 10.1016/j.jemermed.2022.09.036] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/16/2022] [Accepted: 09/04/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND The Omicron variant of SARS-CoV-2 has a predilection for the upper airways, causing symptoms such as sore throat, hoarse voice, and stridor. OBJECTIVE We describe a series of children with COVID-19-associated croup in an urban multicenter hospital system. METHODS We conducted a cross-sectional study of children ≤18 years of age presenting to the emergency department during the COVID-19 pandemic. Data were extracted from an institutional data repository comprised of all patients who were tested for SARS-CoV-2. We included patients with a croup diagnosis by International Classification of Diseases, 10th revision code and a positive SARS-CoV-2 test within 3 days of presentation. We compared demographics, clinical characteristics, and outcomes for patients presenting during a pre-Omicron period (March 1, 2020-December 1, 2021) to the Omicron wave (December 2, 2021-February 15, 2022). RESULTS We identified 67 children with croup, 10 (15%) pre-Omicron and 57 (85%) during the Omicron wave. The prevalence of croup among SARS-CoV-2-positive children increased by a factor of 5.8 (95% confidence interval 3.0-11.4) during the Omicron wave compared to prior. More patients were ≥6 years of age in the Omicron wave than prior (19% vs. 0%). The majority were not hospitalized (77%). More patients ≥6 years of age received epinephrine therapy for croup during the Omicron wave (73% vs. 35%). Most patients ≥6 years of age had no croup history (64%) and only 45% were vaccinated against SARS-CoV-2. CONCLUSION Croup was prevalent during the Omicron wave, atypically affecting patients ≥6 years of age. COVID-19-associated croup should be added to the differential diagnosis of children with stridor, regardless of age. © 2022 Elsevier Inc.
Collapse
Affiliation(s)
| | | | | | - Steven D Rosenblatt
- Department of Otolaryngology, NewYork-Presbyterian/Weill Cornell Medicine, New York
| | - Will Simmons
- Department of Population Health Sciences, Weill Cornell Medicine, New York, New York
| | - Alan Wu
- Department of Population Health Sciences, Weill Cornell Medicine, New York, New York
| | | | - Erika L Abramson
- Department of Pediatrics; Department of Population Health Sciences, Weill Cornell Medicine, New York, New York
| | - Zachary M Grinspan
- Department of Pediatrics; Department of Population Health Sciences, Weill Cornell Medicine, New York, New York
| | | |
Collapse
|
|
23
|
Chen X, Li H, Song H, Wang J, Zhang X, Han P, Wang X. Meet changes with constancy: Defence, antagonism, recovery, and immunity roles of extracellular vesicles in confronting SARS-CoV-2. J Extracell Vesicles 2022; 11:e12288. [PMID: 36450704 PMCID: PMC9712136 DOI: 10.1002/jev2.12288] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 11/12/2022] [Accepted: 11/16/2022] [Indexed: 12/03/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has wrought havoc on the world economy and people's daily lives. The inability to comprehensively control COVID-19 is due to the difficulty of early and timely diagnosis, the lack of effective therapeutic drugs, and the limited effectiveness of vaccines. The body contains billions of extracellular vesicles (EVs), which have shown remarkable potential in disease diagnosis, drug development, and vaccine carriers. Recently, increasing evidence has indicated that EVs may participate or assist the body in defence, antagonism, recovery and acquired immunity against SARS-CoV-2. On the one hand, intercepting and decrypting the general intelligence carried in circulating EVs from COVID-19 patients will provide an important hint for diagnosis and treatment; on the other hand, engineered EVs modified by gene editing in the laboratory will amplify the effectiveness of inhibiting infection, replication and destruction of ever-mutating SARS-CoV-2, facilitating tissue repair and making a better vaccine. To comprehensively understand the interaction between EVs and SARS-CoV-2, providing new insights to overcome some difficulties in the diagnosis, prevention and treatment of COVID-19, we conducted a rounded review in this area. We also explain numerous critical challenges that these tactics face before they enter the clinic, and this work will provide previous 'meet change with constancy' lessons for responding to future similar public health disasters. Extracellular vesicles (EVs) provide a 'meet changes with constancy' strategy to combat SARS-CoV-2 that spans defence, antagonism, recovery, and acquired immunity. Targets for COVID-19 diagnosis, therapy, and prevention of progression may be found by capture of the message decoding in circulating EVs. Engineered and biomimetic EVs can boost effects of the natural EVs, especially anti-SARS-CoV-2, targeted repair of damaged tissue, and improvement of vaccine efficacy.
Collapse
Affiliation(s)
- Xiaohang Chen
- Shanxi Medical University School and Hospital of StomatologyTaiyuanChina
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New MaterialsTaiyuanChina
- Fujian Key Laboratory of Oral Diseases, School and Hospital of StomatologyFujian Medical UniversityFuzhouChina
| | - Huifei Li
- Shanxi Medical University School and Hospital of StomatologyTaiyuanChina
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New MaterialsTaiyuanChina
| | - Haoyue Song
- Shanxi Medical University School and Hospital of StomatologyTaiyuanChina
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New MaterialsTaiyuanChina
| | - Jie Wang
- Shanxi Medical University School and Hospital of StomatologyTaiyuanChina
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New MaterialsTaiyuanChina
| | - Xiaoxuan Zhang
- Shanxi Medical University School and Hospital of StomatologyTaiyuanChina
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New MaterialsTaiyuanChina
| | - Pengcheng Han
- CAS Key Laboratory of Pathogen Microbiology and ImmunologyInstitute of Microbiology, Chinese Academy of SciencesBeijingChina
- School of MedicineZhongda Hospital, Southeast UniversityNanjingChina
| | - Xing Wang
- Shanxi Medical University School and Hospital of StomatologyTaiyuanChina
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New MaterialsTaiyuanChina
| |
Collapse
|
|
24
|
Nori W, Ghani Zghair MA. Omicron targets upper airways in pediatrics, elderly and unvaccinated population. World J Clin Cases 2022; 10:12062-12065. [PMID: 36405264 PMCID: PMC9669854 DOI: 10.12998/wjcc.v10.i32.12062] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/12/2022] [Accepted: 10/19/2022] [Indexed: 11/08/2022] Open
Abstract
Omicron, a severe acute respiratory syndrome coronavirus-2 variant, has spread around the globe, causing dramatic increases in infection rates. Viral mutant antigens were responsible for the strong infectivity, fast replication, and high reinfection rates reported from all ages. Omicron causes clinical symptoms mostly related to the upper respiratory tract with minimal symptoms from the lower respiratory tract besides an urgent presentation of cases that resembled a fatal illness, epiglottitis. Not to mention the long coronavirus disease 2019, which rises exponentially in the Omicrons era. Apparently, the disease has a less aggressive course than earlier variants with lower death rates; however, the infection is not trivial. Severe infection was raised among pediatrics, unvaccinated, and the elderly. Complete vaccine protection is urgently needed to protect the most vulnerable community members. Additionally, self-protective strategies such as wearing a mask and safe social distancing cannot be omitted.
Collapse
Affiliation(s)
- Wassan Nori
- Department of Obstetrics and Gynecology, Mustansiriyah University, Baghdad 10052, Al Saydyia, Iraq
| | | |
Collapse
|
|
25
|
Yamashita T, Fukuchi T, Sugawara H. Appearance of a sore throat caused by the SARS-CoV-2 Omicron variant. J Gen Fam Med 2022; 24:JGF2589. [PMID: 36718285 PMCID: PMC9877946 DOI: 10.1002/jgf2.589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 09/25/2022] [Accepted: 10/04/2022] [Indexed: 11/09/2022] Open
Abstract
A 37year old Japanese man experienced severe sore throat. He was infected by the Omicron variant of SARSCoV2. The posterior pharyngeal wall in the left showed closely aggregated multiple milletsized white spots with surrounding redness.
Collapse
Affiliation(s)
- Takeshi Yamashita
- Division of General Medicine, Department of Comprehensive Medicine 1, Saitama Medical CenterJichi Medical UniversitySaitama CityJapan
| | - Takahiko Fukuchi
- Division of General Medicine, Department of Comprehensive Medicine 1, Saitama Medical CenterJichi Medical UniversitySaitama CityJapan
| | - Hitoshi Sugawara
- Division of General Medicine, Department of Comprehensive Medicine 1, Saitama Medical CenterJichi Medical UniversitySaitama CityJapan
| |
Collapse
|
|
26
|
Iijima H, Tomita K, Okamoto R, Ogimi C. Epiglottitis-Like Symptoms of COVID-19 in the Omicron Wave. Indian J Pediatr 2022; 89:1152-1153. [PMID: 36125612 PMCID: PMC9486768 DOI: 10.1007/s12098-022-04371-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 09/08/2022] [Indexed: 11/05/2022]
Affiliation(s)
- Hiroyuki Iijima
- Department of General Pediatrics and Interdisciplinary Medicine, National Center for Child Health and Development, Tokyo, 157-8535, Japan.
| | - Keiichi Tomita
- Division of Pediatric Emergency and Transport Services, National Center for Child Health and Development, Tokyo, Japan
| | - Reiko Okamoto
- Division of Diagnostic Imaging, Department of Radiology, National Center for Child Health and Development, Tokyo, Japan
| | - Chikara Ogimi
- Division of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan
| |
Collapse
|
|
27
|
Microbiological and Clinical Findings of SARS-CoV-2 Infection after 2 Years of Pandemic: From Lung to Gut Microbiota. Diagnostics (Basel) 2022; 12:diagnostics12092143. [PMID: 36140544 PMCID: PMC9498253 DOI: 10.3390/diagnostics12092143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/29/2022] [Accepted: 09/02/2022] [Indexed: 01/08/2023] Open
Abstract
Early recognition and prompt management are crucial for improving survival in COVID-19 patients, and after 2 years of the pandemic, many efforts have been made to obtain an early diagnosis. A key factor is the use of fast microbiological techniques, considering also that COVID-19 patients may show no peculiar signs and symptoms that may differentiate COVID-19 from other infective or non-infective diseases. These techniques were developed to promptly identify SARS-CoV-2 infection and to prevent viral spread and transmission. However, recent data about clinical, radiological and laboratory features of COVID-19 at time of hospitalization could help physicians in early suspicion of SARS-CoV-2 infection and distinguishing it from other etiologies. The knowledge of clinical features and microbiological techniques will be crucial in the next years when the endemic circulation of SARS-CoV-2 will be probably associated with clusters of infection. In this review we provide a state of the art about new advances in microbiological and clinical findings of SARS-CoV-2 infection in hospitalized patients with a focus on pulmonary and extrapulmonary characteristics, including the role of gut microbiota.
Collapse
|
|
28
|
Re-Admission of COVID-19 Patients Hospitalized with Omicron Variant-A Retrospective Cohort Study. J Clin Med 2022; 11:jcm11175202. [PMID: 36079138 PMCID: PMC9457250 DOI: 10.3390/jcm11175202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/22/2022] [Accepted: 08/30/2022] [Indexed: 11/17/2022] Open
Abstract
In accordance with previous publications, re-admission rates following hospitalization of patients with COVID-19 is 10%. The aim of the current study was to describe the rates and risk factors of hospital re-admissions two months following discharge from hospitalization during the fifth wave due to the dominant Omicron variant. A retrospective cohort study was performed in Rabin Medical Center, Israel, from November 2021 to February 2022. The primary outcome was re-admissions with any diagnosis; the secondary outcome was mortality within two months of discharge. Overall, 660 patients were hospitalized with a diagnosis of COVID-19. Of the 528 patients discharged from a primary hospitalization, 150 (28%) were re-admitted. A total of 164 patients (25%) died throughout the follow-up period. A multi-variable analysis determined that elevated creatinine was associated with a higher risk of re-admissions. Rates of re-admissions after discharge during the Omicron wave were considerably higher compared to previous waves. A discharge plan for surveillance and treatment following hospitalization is of great importance in the management of pandemics.
Collapse
|
|
29
|
A severe presentation of breakthrough infection caused by the Omicron variant with radiological findings of COVID-19 pneumonia in an elderly woman. Radiol Case Rep 2022; 17:3326-3330. [PMID: 35846507 PMCID: PMC9275445 DOI: 10.1016/j.radcr.2022.06.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 06/09/2022] [Accepted: 06/11/2022] [Indexed: 12/17/2022] Open
Abstract
Omicron variant of COVID-19 is characterized by exceptional transmissibility and by immune evasion with the ability infect people with naturally acquired or vaccine-induced immunity. However, lung involvement is poorly reported in patients who resulted positive by this new COVID-19 variant. COVID-19 breakthrough infections are defined as COVID-19 infection in fully vaccinated patients. Herein, we present a case of breakthrough infection in an elderly woman who came in emergency with dyspnea and with findings of COVID-19 pneumonia on chest computed tomography. The patient was vaccinated with a booster dose of an mRNA vaccine some months earlier and the Omicron variant was detected on real-time reverse-transcription polymerase chain reaction. However, the patient's condition remained stable. For our knowledge we report the first case with lung involvement due to Omicron variant in an elderly after the booster dose of mRNA vaccine. This case highlights as COVID-19 breakthrough infections may represent some concerns in the elderly patients in presence of virus variants.
Collapse
|
|
30
|
Akaishi T, Kushimoto S, Katori Y, Sugawara N, Egusa H, Igarashi K, Fujita M, Kure S, Takayama S, Abe M, Kikuchi A, Ohsawa M, Ishizawa K, Abe Y, Imai H, Inaba Y, Iwamatsu-Kobayashi Y, Nishioka T, Onodera K, Ishii T. COVID-19-Related Symptoms during the SARS-CoV-2 Omicron (B.1.1.529) Variant Surge in Japan. TOHOKU J EXP MED 2022; 258:103-110. [PMID: 36002251 DOI: 10.1620/tjem.2022.j067] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Tetsuya Akaishi
- Department of Education and Support for Regional Medicine, Tohoku University Hospital
| | - Shigeki Kushimoto
- Division of Emergency and Critical Care Medicine, Tohoku University Graduate School of Medicine
| | - Yukio Katori
- Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine
| | - Noriko Sugawara
- Department of Pediatrics, Tohoku University Graduate School of Medicine
| | - Hiroshi Egusa
- Division of Molecular and Regenerative Prosthodontics, Tohoku University Graduate School of Dentistry
| | - Kaoru Igarashi
- Division of Craniofacial Anomalies, Tohoku University Graduate School of Dentistry
| | - Motoo Fujita
- Department of Emergency and Critical Care Medicine, Tohoku University Hospital
| | - Shigeo Kure
- Department of Pediatrics, Tohoku University Graduate School of Medicine
| | - Shin Takayama
- Department of Education and Support for Regional Medicine, Tohoku University Hospital
| | - Michiaki Abe
- Department of Education and Support for Regional Medicine, Tohoku University Hospital
| | - Akiko Kikuchi
- Department of Education and Support for Regional Medicine, Tohoku University Hospital
| | - Minoru Ohsawa
- Department of Education and Support for Regional Medicine, Tohoku University Hospital
| | - Kota Ishizawa
- Department of Education and Support for Regional Medicine, Tohoku University Hospital
| | - Yoshiko Abe
- Department of Education and Support for Regional Medicine, Tohoku University Hospital
| | - Hiroyuki Imai
- Clinical Skills Laboratory, Tohoku University School of Medicine
| | - Yohei Inaba
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine
| | | | - Takashi Nishioka
- Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry
| | - Ko Onodera
- Department of Education and Support for Regional Medicine, Tohoku University Hospital
| | - Tadashi Ishii
- Department of Education and Support for Regional Medicine, Tohoku University Hospital
| |
Collapse
|
|
31
|
Clinical Characteristics of Pediatric Patients With COVID-19 between Omicron era vs. Pre-Omicron era. J Infect Chemother 2022; 28:1501-1505. [PMID: 35933077 PMCID: PMC9349025 DOI: 10.1016/j.jiac.2022.07.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 07/09/2022] [Accepted: 07/24/2022] [Indexed: 12/16/2022]
Abstract
Introduction Detailed data on clinical characteristics in children with the omicron strain of SARS-COV-2 are limited. Methods We conducted a retrospective observational study of children with COVID-19 at the National Center for Child Health and Development to evaluate the clinical manifestations during and before the emergence of the omicron variant. Only symptomatic patients without underlying diseases were included. Participants were divided into two temporal groups: the “omicron era” (1/2022–2/2022) and the “pre-omicron era,” where the delta variant predominated (7/2021–11/2021). The patients were subclassified into an older vaccine-eligible group (aged 12–17 years), a younger vaccine-eligible group (aged 5–11 years), and a vaccine-ineligible group (aged 0–4 years). Results We compared 113 patients in the omicron era with 106 in the pre-omicron era. Most patients in both eras had non-severe disease, and no patients required mechanical ventilation or died. Among patients aged 0–4 years, sore throat and hoarseness were more common during the omicron era than the pre-omicron era (11.1% vs. 0.0% and 11.1% vs. 1.5%, respectively). Croup syndrome was diagnosed in all patients with hoarseness. Among patients aged 5–11 years, vomiting was more frequent during the omicron era (47.2%) than during the pre-omicron era (21.7%). Cough and rhinorrhea were less common during the omicron era in patients aged 0–4 and 5–11 years, respectively, than during the pre-omicron era. Conclusions In children with COVID-19, clinical manifestations differed between the omicron and pre-omicron eras. In the Omicron era, croup syndrome was more frequent in vaccine-ineligible children.
Collapse
|
|
32
|
Orendáčová M, Kvašňák E. Effects of vaccination, new SARS-CoV-2 variants and reinfections on post-COVID-19 complications. Front Public Health 2022; 10:903568. [PMID: 35968477 PMCID: PMC9372538 DOI: 10.3389/fpubh.2022.903568] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 07/04/2022] [Indexed: 11/13/2022] Open
Abstract
Post-COVID-19 complications involve a variety of long-lasting health complications emerging in various body systems. Since the prevalence of post-COVID-19 complications ranges from 8-47% in COVID-19 survivors, it represents a formidable challenge to COVID-19 survivors and the health care system. Post-COVID-19 complications have already been studied in the connection to risk factors linked to their higher probability of occurrence and higher severity, potential mechanisms underlying the pathogenesis of post-COVID-19 complications, and their functional and structural correlates. Vaccination status has been recently revealed to represent efficient prevention from long-term and severe post-COVID-19 complications. However, the exact mechanisms responsible for vaccine-induced protection against severe and long-lasting post-COVID-19 complications remain elusive. Also, to the best of our knowledge, the effects of new SARS-CoV-2 variants and SARS-CoV-2 reinfections on post-COVID-19 complications and their underlying pathogenesis remain to be investigated. This hypothesis article will be dedicated to the potential effects of vaccination status, SARS-CoV-2 reinfections, and new SARS-CoV-2 variants on post-COVID-19 complications and their underlying mechanisms Also, potential prevention strategies against post-COVID complications will be discussed.
Collapse
Affiliation(s)
- Mária Orendáčová
- Department of Medical Biophysics and Medical Informatics, Third Faculty of Medicine, Charles University in Prague, Prague, Czechia
| | | |
Collapse
|
|
33
|
Acute infectious supraglottitis in adult population: epidemiology, management, outcomes and predictors of airway intervention. Eur Arch Otorhinolaryngol 2022; 279:4033-4041. [PMID: 35396955 PMCID: PMC8994090 DOI: 10.1007/s00405-022-07365-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 03/20/2022] [Indexed: 11/05/2022]
Abstract
Purpose The purpose is to analyze the incidence of acute infectious supraglottitis in our center between 2010 and 2020, define the characteristics and trends of those patients and identify factors associated with the need of airway intervention. Methods A retrospective single-center observational study of a cohort of patients diagnosed with acute infectious supraglottitis between January 2010 and December 2020. Patients were stratified according to airway management. Results Eighty eight patients were included: 59 men (67%) and 29 women (33%). A significant upward trend of 9% in the annual incidence rate of supraglottitis was seen during 2010–2020, with an important increase in cases during 2019. Muffled voice (41%) and respiratory distress (38%) were the most common presenting symptoms; and the median duration of symptoms before hospital admission was 2 days [IQR 1; 3]. Airway intervention was performed in fifteen patients (17%). Nine patients (10%) were intubated and six required tracheotomy (7%). Comparing the patients who required airway intervention with those who received a conservative treatment, younger patients (p < 0.01) were more likely to need airway intervention. In logistic regression analysis, we found that epiglottic abscess (p = 0.015), hypersalivation (p = 0.027) and smoking (p = 0.036) were independent factors with a significant association with airway intervention. Conclusion There was an important increase in cases and its severity in 2019, but due to COVID-19 pandemic, it was not possible to define if it was an isolate event or an upward trend. Epiglottic abscess, hypersalivation and smoking could be possible risk factors for airway intervention.
Collapse
|