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Pediatric Respiratory Viral Infection

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A special issue of Viruses (ISSN 1999-4915). This special issue belongs to the section "Human Virology and Viral Diseases".

Deadline for manuscript submissions: closed (30 April 2023) | Viewed by 22019

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Special Issue Editor

Dr. Renee WY Chan

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Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
Interests: mucosal immunity; rhinovirus; primary respiratory epithelial organoids; age-stratified host response; BSL-3 respiratory viruses; antivirals screening; mucosal diagnostics

Special Issue Information

Dear Colleagues,

We have lived with SARS-CoV-2 for more than two years now. Epidemiological and clinical data suggest that children become less sick than adults with the virus, while only sporadic cases of SARS-CoV-2-associated multisystem inflammatory syndrome in children (MIS-C) would occur. After the Omicron variant's emergence in November 2021, its impact on the paediatric population compared with the other variants of concern is yet to be determined. In addition, the increased proportion of the COVID-19-recovered and -vaccinated population creates a new landscape for the next generation. Moreover, the host response of neonates and infants against SARS-CoV-2 infection, as their first exposed respiratory virus, is understudied.

With the increase in the cumulative number of children recovered from COVID-19, the number of children with long COVID is also increasing and is becoming a concern. Long COVID occurs in one in four COVID-19-infected children and presents with debilitating yet under-recognised symptoms that generally impact everyday functioning. So far, neither the risk factor nor the preventive measures of long COVID in children are known.

We are pleased to invite you to contribute your research to develop the understanding of the immunological profile of these post-SARS-CoV-2 era babies in their development, and their interaction with other prominent paediatric respiratory viruses, such as respiratory syncytial virus and rhinovirus would be essential for us to prepare responses to address these emerging health problems and identify future research and intervention needs.

The aim is to have a collection of at least 10 articles, and the Special Issue may be printed in book form if this number is reached.

In this Special Issue, original research articles and reviews are welcome.

I look forward to receiving your contributions.

Dr. Renee WY Chan
Guest Editor

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Keywords

neonate SARS-CoV-2 infection
vertical SARS-CoV-2 transmission infection and immunity
paediatric long COVID
school-resumption transmission and mitigation measures
mucosal and cellular immunity
cellular regeneration after COVID-19
immunity of children in post-COVID era
viral interference of SARS-CoV-2
SARS-CoV-2 and allergy
vaccine for children

Published Papers (12 papers)

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Editorial

Jump to: Research, Review

2 pages, 124 KiB

Open AccessEditorial

Pediatric Respiratory Viral Infection

by Stacy L. S. Yam, Joan Marie Javillo Baguio and Renee W. Y. Chan

Viruses 2024, 16(5), 733; https://doi.org/10.3390/v16050733 - 6 May 2024

Viewed by 394

Abstract

Reflecting on this Special Issue dedicated to pediatric respiratory viruses, it is evident that the shadow cast by the global SARS-CoV-2 pandemic has profoundly impacted individuals of all ages and backgrounds, neonates and school-aged children being vulnerable cohorts resulting from the evolving immunological [...] Read more.

(This article belongs to the Special Issue Pediatric Respiratory Viral Infection)

Research

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21 pages, 1096 KiB

Open AccessArticle

Disease Burden and Inpatient Management of Children with Acute Respiratory Viral Infections during the Pre-COVID Era in Germany: A Cost-of-Illness Study

by Maren Alchikh, Tim O. F. Conrad, Patrick E. Obermeier, Xiaolin Ma, Brunhilde Schweiger, Onya Opota and Barbara A. Rath

Viruses 2024, 16(4), 507; https://doi.org/10.3390/v16040507 - 26 Mar 2024

Viewed by 783

Abstract

Respiratory viral infections (RVIs) are common reasons for healthcare consultations. The inpatient management of RVIs consumes significant resources. From 2009 to 2014, we assessed the costs of RVI management in 4776 hospitalized children aged 0–18 years participating in a quality improvement program, where all ILI patients underwent virologic testing at the National Reference Centre followed by detailed recording of their clinical course. The direct (medical or non-medical) and indirect costs of inpatient management outside the ICU (‘non-ICU’) versus management requiring ICU care (‘ICU’) added up to EUR 2767.14 (non-ICU) vs. EUR 29,941.71 (ICU) for influenza, EUR 2713.14 (non-ICU) vs. EUR 16,951.06 (ICU) for RSV infections, and EUR 2767.33 (non-ICU) vs. EUR 14,394.02 (ICU) for human rhinovirus (hRV) infections, respectively. Non-ICU inpatient costs were similar for all eight RVIs studied: influenza, RSV, hRV, adenovirus (hAdV), metapneumovirus (hMPV), parainfluenza virus (hPIV), bocavirus (hBoV), and seasonal coronavirus (hCoV) infections. ICU costs for influenza, however, exceeded all other RVIs. At the time of the study, influenza was the only RVI with antiviral treatment options available for children, but only 9.8% of influenza patients (non-ICU) and 1.5% of ICU patients with influenza received antivirals; only 2.9% were vaccinated. Future studies should investigate the economic impact of treatment and prevention of influenza, COVID-19, and RSV post vaccine introduction. Full article

(This article belongs to the Special Issue Pediatric Respiratory Viral Infection)

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11 pages, 919 KiB

Open AccessArticle

Rapid Triage of Children with Suspected COVID-19 Using Laboratory-Based Machine-Learning Algorithms

by Dejan Dobrijević, Gordana Vilotijević-Dautović, Jasmina Katanić, Mirjana Horvat, Zoltan Horvat and Kristian Pastor

Viruses 2023, 15(7), 1522; https://doi.org/10.3390/v15071522 - 8 Jul 2023

Cited by 3 | Viewed by 1309

Abstract

In order to limit the spread of the novel betacoronavirus (SARS-CoV-2), it is necessary to detect positive cases as soon as possible and isolate them. For this purpose, machine-learning algorithms, as a field of artificial intelligence, have been recognized as a promising tool. The aim of this study was to assess the utility of the most common machine-learning algorithms in the rapid triage of children with suspected COVID-19 using easily accessible and inexpensive laboratory parameters. A cross-sectional study was conducted on 566 children treated for respiratory diseases: 280 children with PCR-confirmed SARS-CoV-2 infection and 286 children with respiratory symptoms who were SARS-CoV-2 PCR-negative (control group). Six machine-learning algorithms, based on the blood laboratory data, were tested: random forest, support vector machine, linear discriminant analysis, artificial neural network, k-nearest neighbors, and decision tree. The training set was validated through stratified cross-validation, while the performance of each algorithm was confirmed by an independent test set. Random forest and support vector machine models demonstrated the highest accuracy of 85% and 82.1%, respectively. The models demonstrated better sensitivity than specificity and better negative predictive value than positive predictive value. The F1 score was higher for the random forest than for the support vector machine model, 85.2% and 82.3%, respectively. This study might have significant clinical applications, helping healthcare providers identify children with COVID-19 in the early stage, prior to PCR and/or antigen testing. Additionally, machine-learning algorithms could improve overall testing efficiency with no extra costs for the healthcare facility. Full article

(This article belongs to the Special Issue Pediatric Respiratory Viral Infection)

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11 pages, 257 KiB

Open AccessArticle

Clinical Features of COVID-19 in Pediatric Rheumatic Diseases: 2020–2022 Survey of the Pediatric Rheumatology Association of Japan

by Hiroyuki Wakiguchi, Utako Kaneko, Satoshi Sato, Tomoyuki Imagawa, Hidehiko Narazaki and Takako Miyamae

Viruses 2023, 15(5), 1205; https://doi.org/10.3390/v15051205 - 20 May 2023

Cited by 2 | Viewed by 1768

Abstract

Coronavirus disease 2019 (COVID-19) in children can be compounded by concurrent diseases and immunosuppressants. For the first time, we aimed to report the clinical features of concurrent COVID-19 and pediatric rheumatic disease (PRD) in Japan. Pediatric Rheumatology Association of Japan members were surveyed between 1 April 2020 and 31 August 2022. Outcome measurements included the clinical features of concurrent PRD and COVID-19. Questionnaire responses were obtained from 38 hospitals. Thirty-one hospitals (82%) had children with PRD and COVID-19. The female-to-male ratio in these children (n = 156) was 7:3, with half aged 11–15 years. The highest proportion of children with PRD and COVID-19 was accounted for by juvenile idiopathic arthritis (52%), followed by systemic lupus erythematosus (24%), juvenile dermatomyositis (5%), scleroderma (4%), and Takayasu arteritis (3%). Of children with PRD, a significant majority (97%) were found to be asymptomatic (10%) or presented with mild symptoms (87%) of the COVID-19 infection. No severe cases or deaths were observed. Regarding the use of glucocorticoids, immunosuppressants, or biologics for PRD treatment before COVID-19, no significant difference was found between asymptomatic/mild and moderate COVID-19 in children with PRD. Therefore, COVID-19 is not a threat to children with PRD in Japan. Full article

(This article belongs to the Special Issue Pediatric Respiratory Viral Infection)

10 pages, 386 KiB

Open AccessArticle

Acute Bronchitis and Bronchiolitis Infection in Children with Asthma and Allergic Rhinitis: A Retrospective Cohort Study Based on 5,027,486 Children in Taiwan

by Fung-Chang Sung, Chang-Ching Wei, Chih-Hsin Muo, Shan P. Tsai, Chao W. Chen, Dennis P. H. Hsieh, Pei-Chun Chen and Chung-Yen Lu

Viruses 2023, 15(3), 810; https://doi.org/10.3390/v15030810 - 22 Mar 2023

Viewed by 2108

Abstract

This study evaluated the risks of childhood acute bronchitis and bronchiolitis (CABs) for children with asthma or allergic rhinitis (AR). Using insurance claims data of Taiwan, we identified, from children of ≤12 years old in 2000–2016, cohorts with and without asthma (N = 192,126, each) and cohorts with and without AR (N = 1,062,903, each) matched by sex and age. By the end of 2016, the asthma cohort had the highest bronchitis incidence, AR and non-asthma cohorts followed, and the lowest in the non-AR cohort (525.1, 322.4, 236.0 and 169.9 per 1000 person-years, respectively). The Cox method estimated adjusted hazard ratios (aHRs) of bronchitis were 1.82 (95% confidence interval (CI), 1.80–1.83) for the asthma cohort and 1.68 (95% CI, 1.68–1.69) for the AR cohort, relative to the respective comparisons. The bronchiolitis incidence rates for these cohorts were 42.7, 29.5, 28.5 and 20.1 per 1000 person-years, respectively. The aHRs of bronchiolitis were 1.50 (95% CI, 1.48–1.52) for the asthma cohort and 1.46 (95% CI, 1.45–1.47) for the AR cohort relative to their comparisons. The CABs incidence rates decreased substantially with increasing age, but were relatively similar for boys and girls. In conclusion, children with asthma are more likely to develop CABs than are children with AR. Full article

(This article belongs to the Special Issue Pediatric Respiratory Viral Infection)

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12 pages, 989 KiB

Open AccessArticle

Clinical Presentation and Severity of SARS-CoV-2 Infection Compared to Respiratory Syncytial Virus and Other Viral Respiratory Infections in Children Less than Two Years of Age

by Francesco Nunziata, Simona Salomone, Andrea Catzola, Marco Poeta, Federica Pagano, Liana Punzi, Andrea Lo Vecchio, Alfredo Guarino and Eugenia Bruzzese

Viruses 2023, 15(3), 717; https://doi.org/10.3390/v15030717 - 9 Mar 2023

Cited by 5 | Viewed by 1574

Abstract

The spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the implementation of restrictive measures led to a dramatic reduction in respiratory syncytial virus (RSV) occurrence together with rare and mild bronchiolitis induced by SARS-CoV-2. We described the respiratory picture of SARS-CoV-2 infection and evaluated the frequency and the severity of SARS-CoV-2 bronchiolitis comparing it with other respiratory viral infections in children less than two years of age. The severity of respiratory involvement was evaluated based on the need for oxygen therapy, intravenous hydration, and the length of hospital stay. A total of 138 children hospitalized for respiratory symptoms were enrolled: 60 with SARS-CoV-2 and 78 with RSV. In the group of SARS-CoV-2-infected children, 13/60 (21%) received a diagnosis of co-infection. Among the enrolled children, 87/138 (63%) received a diagnosis of bronchiolitis. The comparative evaluation showed a higher risk of the need for oxygen therapy and intravenous hydration in children with RSV infection and co-infection compared to children with SARS-CoV-2 infection. In the children with a diagnosis of bronchiolitis, no differences in the main outcomes among the groups were observed. Although children with SARS-CoV-2 infection have less severe respiratory effects than adults, the pediatrician should pay attention to bronchiolitis due to SARS-CoV-2, which could have a severe clinical course in younger children. Full article

(This article belongs to the Special Issue Pediatric Respiratory Viral Infection)

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19 pages, 1504 KiB

Open AccessArticle

Metagenomic Analysis of Respiratory RNA Virome of Children with and without Severe Acute Respiratory Infection from the Free State, South Africa during COVID-19 Pandemic Reveals Higher Diversity and Abundance in Summer Compared with Winter Period

by Ayodeji E. Ogunbayo, Milton T. Mogotsi, Hlengiwe Sondlane, Kelebogile R. Nkwadipo, Saheed Sabiu and Martin M. Nyaga

Viruses 2022, 14(11), 2516; https://doi.org/10.3390/v14112516 - 14 Nov 2022

Cited by 1 | Viewed by 2107

Abstract

Viral respiratory infections contribute to significant morbidity and mortality in children. Currently, there are limited reports on the composition and abundance of the normal commensal respiratory virome in comparison to those in severe acute respiratory infections (SARIs) state. This study characterised the respiratory RNA virome in children ≤ 5 years with (n = 149) and without (n = 139) SARI during the summer and winter of 2020/2021 seasons in South Africa. Nasopharyngeal swabs were, collected, pooled, enriched for viral RNA detection, sequenced using Illumina MiSeq, and analysed using the Genome Detective bioinformatic tool. Overall, Picornaviridae, Paramoxyviridae, Pneumoviridae, Picobirnaviridae, Totiviridae, and Retroviridae families were the most abundant viral population in both groups across both seasons. Human rhinovirus and endogenous retrovirus K113 were detected in most pools, with exclusive detection of Pneumoviridae in SARI pools. Generally, higher viral diversity/abundance was seen in children with SARI and in the summer pools. Several plant/animal viruses, eukaryotic viruses with unclear pathogenicity including a distinct rhinovirus A type, were detected. This study provides remarkable data on the respiratory RNA virome in children with and without SARI with a degree of heterogeneity of known viruses colonizing their respiratory tract. The implication of the detected viruses in the dynamics/progression of SARI requires further investigations. Full article

(This article belongs to the Special Issue Pediatric Respiratory Viral Infection)

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12 pages, 1148 KiB

Open AccessArticle

COVID-19 in Infants Less than 3 Months: Severe or Not Severe Disease?

by Daniele Dona’, Carlotta Montagnani, Costanza Di Chiara, Elisabetta Venturini, Luisa Galli, Andrea Lo Vecchio, Marco Denina, Nicole Olivini, Eugenia Bruzzese, Andrea Campana, Roberta Giacchero, Filippo Salvini, Antonella Meini, Matteo Ponzoni, Sandra Trapani, Elena Rossi, Mary Haywood Lombardi, Raffaele Badolato, Luca Pierri, Giulia Pruccoli, Sara Rossin, Claudia Colomba, Salvatore Cazzato, Ilaria Pacati, Giangiacomo Nicolini, Luca Pierantoni, Sonia Bianchini, Andrzej Krzysztofiak, Silvia Garazzino, Carlo Giaquinto, Guido Castelli Gattinara and on behalf of The Italian SITIP-SIP Pediatric SARS-CoV-2 Infection Study Group Show full author list Hide full author list

Viruses 2022, 14(10), 2256; https://doi.org/10.3390/v14102256 - 14 Oct 2022

Cited by 10 | Viewed by 2166

Abstract

Compared to adults, severe or fatal COVID-19 disease is much less common in children. However, a higher risk for progression has been reported in infants. Different pediatric COVID-19 severity scores are reported in the literature. Methods: Subjects under 90 days of age admitted to 35 Italian institutions for COVID-19 were included. The severity of COVID-19 was scored as mild/moderate or severe/critical following the classification reported in the literature by Venturini, Dong, Kanburoglu, and Gale. To assess the diagnostic accuracy of each classification system, we stratified all enrolled patients developing a posteriori severity score based on clinical presentation and outcomes and then compared all different scores analyzed. Results: We included 216 infants below 90 days of age. The most common symptom was fever, followed by coryza, poor feeding, cough, and gastrointestinal manifestations. According to Venturini, Dong, Kanburoglu, and Gale’s severity scores, 18%, 6%, 4.2%, and 29.6% of infants presented with severe/critical disease, respectively. A correlation analysis between these four scores and the a posteriori severity score assigned to all enrolled subjects was performed, and a crescent strength of correlation from Gale (R = 0.355, p < 0.001) to Venturini (R = 0.425, p < 0.001), Dong (R = 0.734, p < 0.001), and Kanburoglu (R = 0.859, p < 0.001) was observed. Conclusions: The percentage of infants with severe COVID-19 varies widely according to the score systems. A unique clinical score should be designed for neonates and infants with COVID-19. Full article

(This article belongs to the Special Issue Pediatric Respiratory Viral Infection)

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23 pages, 1680 KiB

Open AccessArticle

The Relative Roles of Ambient Temperature and Mobility Patterns in Shaping the Transmission Heterogeneity of SARS-CoV-2 in Japan

by Keita Wagatsuma, Iain S. Koolhof and Reiko Saito

Viruses 2022, 14(10), 2232; https://doi.org/10.3390/v14102232 - 11 Oct 2022

Cited by 3 | Viewed by 2468

Abstract

We assess the effects of ambient temperature and mobility patterns on the transmissibility of COVID-19 during the epidemiological years of the pandemic in Japan. The prefecture-specific daily time-series of confirmed coronavirus disease 2019 (COVID-19) cases, meteorological variables, levels of retail and recreation mobility (e.g., activities, going to restaurants, cafes, and shopping centers), and the number of vaccinations were collected for six prefectures in Japan from 1 May 2020 to 31 March 2022. We combined standard time-series generalized additive models (GAMs) with a distributed lag non-linear model (DLNM) to determine the exposure–lag–response association between the time-varying effective reproductive number (R_t), ambient temperature, and retail and recreation mobility, while controlling for a wide range of potential confounders. Utilizing a statistical model, the first distribution of the mean ambient temperature (i.e., −4.9 °C) was associated with an 11.6% (95% confidence interval [CI]: 5.9–17.7%) increase in R_t compared to the optimum ambient temperature (i.e., 18.5 °C). A retail and recreation mobility of 10.0% (99th percentile) was associated with a 19.6% (95% CI: 12.6–27.1%) increase in R_t over the optimal level (i.e., −16.0%). Our findings provide a better understanding of how ambient temperature and mobility patterns shape severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission. These findings provide valuable epidemiological insights for public health policies in controlling disease transmission. Full article

(This article belongs to the Special Issue Pediatric Respiratory Viral Infection)

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Review

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14 pages, 820 KiB

Open AccessReview

Rhinovirus—A True Respiratory Threat or a Common Inconvenience of Childhood?

by Sunčanica Ljubin-Sternak and Tomislav Meštrović

Viruses 2023, 15(4), 825; https://doi.org/10.3390/v15040825 - 24 Mar 2023

Cited by 7 | Viewed by 2340

Abstract

A decade-long neglect of rhinovirus as an important agent of disease in humans was primarily due to the fact that they were seen as less virulent and capable of causing only mild respiratory infections such as common cold. However, with an advent of molecular diagnostic methods, an increasing number of reports placed them among the pathogens found in the lower respiratory tract and recognized them as important risk factors for asthma-related pathology in childhood. As the spread of rhinovirus was not severely affected by the implementation of social distancing and other measures during the coronavirus disease 2019 (COVID-19) pandemic, its putative pathogenic role has become even more evident in recent years. By concentrating on children as the most vulnerable group, in this narrative review we first present classification and main traits of rhinovirus, followed by epidemiology and clinical presentation, risk factors for severe forms of the disease, long-term complications and the pathogenesis of asthma, as well as a snapshot of treatment trials and studies. Recent evidence suggests that the rhinovirus is a significant contributor to respiratory illness in both high-risk and low-risk populations of children. Full article

(This article belongs to the Special Issue Pediatric Respiratory Viral Infection)

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12 pages, 291 KiB

Open AccessReview

Pediatric Systemic Lupus Erythematous in COVID-19 Era

by Ancuta Lupu, Ingrith Crenguta Miron, Cristina Gavrilovici, Anca Adam Raileanu, Iuliana Magdalena Starcea, Ileana Ioniuc, Alice Azoicai, Adriana Mocanu, Lacramioara Ionela Butnariu, Felicia Dragan and Vasile Valeriu Lupu

Viruses 2023, 15(2), 272; https://doi.org/10.3390/v15020272 - 18 Jan 2023

Cited by 9 | Viewed by 1857

Abstract

Pediatric systemic lupus erythematosus is a chronic autoimmune disorder with a highly variable course and prognosis. It results in functional abnormalities in the immune system due to intrinsic factors and the use of immunosuppressive therapies associated with underlying comorbidities seem to increase the risk of severe COVID-19 and poor outcomes of the disease in pediatric systemic lupus erythematosus (SLE) patients. The aim of this review is to obtain a better understanding of the existing link between this new viral infection and pediatric lupus. We have analyzed the characteristics of newly diagnosed cases of pediatric SLE following COVID-19 which have been reported in the literature and which describe the impact that COVID-19 has on patients already suffering with pediatric SLE. Full article

(This article belongs to the Special Issue Pediatric Respiratory Viral Infection)

14 pages, 278 KiB

Open AccessReview

The Impact of the COVID-19 Pandemic on Otitis Media

by Soo-Young Choi, Dong-Keon Yon, Yong-Sung Choi, Jinseok Lee, Ki-Ho Park, Young-Ju Lee, Sung-Soo Kim, Sang-Hoon Kim and Seung-Geun Yeo

Viruses 2022, 14(11), 2457; https://doi.org/10.3390/v14112457 - 6 Nov 2022

Cited by 7 | Viewed by 1943

Abstract

Otitis media is one of the most common diseases in children, with 80% of children experiencing it by the age of three years. Therefore, the resulting social burden is enormous. In addition, many countries still suffer from complications due to otitis media. Meanwhile, COVID-19 has affected many diseases, with otitis media being one of the most strongly affected. This review aims to find out how COVID-19 has affected otitis media and its significance. A series of measures brought about by COVID-19, including emphasis on personal hygiene and social distancing, had many unexpected positive effects on otitis media. These can be broadly classified into four categories: first, the incidence of otitis media was drastically reduced. Second, antibiotic prescriptions for otitis media decreased. Third, the incidence of complications of otitis media was reduced. Fourth, the number of patients visiting the emergency room due to otitis media decreased. The quarantine measures put in place due to COVID-19 suppressed the onset and exacerbation of otitis media. This has great implications for the treatment and prevention of otitis media. Full article

(This article belongs to the Special Issue Pediatric Respiratory Viral Infection)

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