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      Dynamic Patterns and Predominance of Respiratory Pathogens Post-COVID-19: Insights from a Two-Year Analysis

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          Abstract

          Introduction

          Respiratory tract infections (RTIs) stand out as the most frequent causes leading to visits to the emergency department and hospitalizations. This study aims to assess the types and prevalence of respiratory infections across two years following the end of the COVID-19 pandemic.

          Methods

          Patients presenting with an influenza-like illness (ILI) were tested using multiplex RT-PCR (QIAstat-Dx, Qiagen). The multiplexed RT- PCR test detects 21 respiratory viruses and bacteria.

          Results

          During the study period, PCR test was done on a total of 1,790 samples were tested, and 712 (40%) were positive for a total of 796 pathogens. The mean age (± SD) of the participants was 20.1 ± 28.4 years in 2022 and 21.9 ± 27.6 years in 2023. Among the detected pathogens, the most prevalent were Rhinovirus/Enterovirus 222 (12.4%), followed by RSV A&B (103 cases, 5.7%), and H1N1 Influenza (77 cases, 4.3%). Additionally,  Influenza A/B constituted 172 (9.6%) while parainfluenza constituted (58, 3.2%). SARS-CoV-2 was identified in 3.97% of the samples. Over the two-year period, the monthly pattern of the identified pathogens exhibited fluctuations in the prevalence. Furthermore, variations were observed in the detected pathogens across different age groups.

          Conclusion

          In addition to adding significant knowledge to the field of respiratory viral infections, this study emphasizes the necessity of ongoing research and surveillance for the detection and characterization of respiratory viruses, particularly those with the potential for emergence. Such studies would also require setting up a strategy for genotyping and/or sequencing of viruses.

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          Most cited references26

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          Coronavirus Infections—More Than Just the Common Cold

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            Seasonality of Respiratory Viral Infections

            The seasonal cycle of respiratory viral diseases has been widely recognized for thousands of years, as annual epidemics of the common cold and influenza disease hit the human population like clockwork in the winter season in temperate regions. Moreover, epidemics caused by viruses such as severe acute respiratory syndrome coronavirus (SARS-CoV) and the newly emerging SARS-CoV-2 occur during the winter months. The mechanisms underlying the seasonal nature of respiratory viral infections have been examined and debated for many years. The two major contributing factors are the changes in environmental parameters and human behavior. Studies have revealed the effect of temperature and humidity on respiratory virus stability and transmission rates. More recent research highlights the importance of the environmental factors, especially temperature and humidity, in modulating host intrinsic, innate, and adaptive immune responses to viral infections in the respiratory tract. Here we review evidence of how outdoor and indoor climates are linked to the seasonality of viral respiratory infections. We further discuss determinants of host response in the seasonality of respiratory viruses by highlighting recent studies in the field.
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              Respiratory Syncytial Virus—A Comprehensive Review

              Respiratory syncytial virus (RSV) is amongst the most important pathogenic infections of childhood and is associated with significant morbidity and mortality. Although there have been extensive studies of epidemiology, clinical manifestations, diagnostic techniques, animal models and the immunobiology of infection, there is not yet a convincing and safe vaccine available. The major histopathologic characteristics of RSV infection are acute bronchiolitis, mucosal and submucosal edema, and luminal occlusion by cellular debris of sloughed epithelial cells mixed with macrophages, strands of fibrin, and some mucin. There is a single RSV serotype with two major antigenic subgroups, A and B. Strains of both subtypes often co-circulate, but usually one subtype predominates. In temperate climates, RSV infections reflect a distinct seasonality with onset in late fall or early winter. It is believed that most children will experience at least one RSV infection by the age of 2 years. There are several key animal models of RSV. These include a model in mice and, more importantly, a bovine model; the latter reflects distinct similarity to the human disease. Importantly, the prevalence of asthma is significantly higher amongst children who are hospitalized with RSV in infancy or early childhood. However, there have been only limited investigations of candidate genes that have the potential to explain this increase in susceptibility. An atopic predisposition appears to predispose to subsequent development of asthma and it is likely that subsequent development of asthma is secondary to the pathogenic inflammatory response involving cytokines, chemokines and their cognate receptors. Numerous approaches to the development of RSV vaccines are being evaluated, as are the use of newer antiviral agents to mitigate disease. There is also significant attention being placed on the potential impact of co-infection and defining the natural history of RSV. Clearly, more research is required to define the relationships between RSV bronchiolitis, other viral induced inflammatory responses, and asthma.
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                Author and article information

                Contributors
                jaffar.tawfiq@jhah.com , jaltawfi@yahoo.com
                Journal
                J Epidemiol Glob Health
                J Epidemiol Glob Health
                Journal of Epidemiology and Global Health
                Springer Netherlands (Dordrecht )
                2210-6006
                2210-6014
                8 April 2024
                8 April 2024
                June 2024
                : 14
                : 2
                : 311-318
                Affiliations
                [1 ]Infectious Disease Unit, Specialty Internal Medicine, King Fahd Military Medical Complex, ( https://ror.org/01c524129) Dhahran, Saudi Arabia
                [2 ]College of medicine-Imam Abdulrahaman Bin Faisal University, ( https://ror.org/038cy8j79) Dammam, Saudi Arabia
                [3 ]Molecular laboratory department, King Fahd Military Medical Complex, ( https://ror.org/01c524129) Dhahran, Saudi Arabia
                [4 ]Department of Clinical laboratory Science, Prince Sultan Military College of health science, ( https://ror.org/01k7e4s32) Dammam, Saudi Arabia
                [5 ]Radiology Department, Armed Forces Hospital Najran, ( https://ror.org/024eyyq66) Najran, Saudi Arabia
                [6 ]Department of pharmacy, King Fahd Military Medical Complex, ( https://ror.org/01c524129) Dhahran, Saudi Arabia
                [7 ]Infectious Disease Unit, Specialty Internal Medicine, Johns Hopkins Aramco Healthcare, ( https://ror.org/04k820v98) Dhahran, 31311 Saudi Arabia
                [8 ]Infectious Disease Division, Department of Medicine, Indiana University School of Medicine, ( https://ror.org/02ets8c94) Indianapolis, IN USA
                [9 ]GRID grid.21107.35, ISNI 0000 0001 2171 9311, Infectious Disease Division, Department of Medicine, , Johns Hopkins University School of Medicine, ; Baltimore, MD USA
                Article
                213
                10.1007/s44197-024-00213-9
                11176149
                38589755
                d094597f-37aa-4441-bb14-a553fbab0de8
                © The Author(s) 2024

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 5 January 2024
                : 22 February 2024
                Categories
                Research Article
                Custom metadata
                © Springer Nature B.V 2024

                covid-19,respiratory pathogens,rsv,influenza,sars-cov-2
                covid-19, respiratory pathogens, rsv, influenza, sars-cov-2

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