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  • 1
    In: Frontiers in Public Health, Frontiers Media SA, Vol. 10 ( 2022-9-2)
    Abstract: This study aimed to determine the prevalence, viral profile, and clinical features of coinfections with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and other respiratory viruses. Methods Nasopharyngeal samples and clinical data of 221 hospitalized patients and 21 outpatients were collected and analyzed. Real-time reverse transcription-polymerase chain reaction was used to detect SARS-CoV-2, influenza virus, respiratory syncytial virus (RSV), human metapneumovirus (HMPV), parainfluenza virus (PIV) 1,2,3, rhinovirus (RV), adenovirus (AdV), bocaviruses (BoV), and seasonal coronaviruses (OC43, 229E, NL63, and HKU1). Viral load was determined by capillary electrophoresis. Results From November 2020 to mid-March 2022, 242 SARS-CoV-2 positive patients were tested for seasonal respiratory viruses, and 24 (9.9%) cases of coinfections were detected. The distribution of viruses involved in cases of coinfections were as follows: HMPV ( n = 6; 25%), RSV ( n = 4;16.7%), AdV ( n = 4; 16.7%), BoV ( n = 4; 16.7%), PIV3 ( n = 2; 8.3%), influenza A (H3N2; n = 2; 8.3%), RV ( n = 1; 4.62%), and RV+BoV ( n = 1; 4.62%). The proportion of detected coinfections with SARS-CoV-2 was highest in children aged 0–5 years (59%), followed by those & gt;65 years (33%). In specimens with detected coinfection, the viral load of influenza was higher than that of SARS-CoV-2, and the mean viral load of SARS-CoV-2 was higher than that of the other respiratory viruses. C-reactive protein (CRP) and lymphocytes count in co-infected patients & gt;65 years of age were on average higher than in children & lt;16 years of age (mean CRP of 161.8 ± 133.1 mg/L; 19.7 ± 3.09% vs. mean 6.9 ± 8.9 mg/L, 0.9 ± 3.1%; p & lt; 0.01). Patients & gt;65 years of age co-infected with SARS-CoV-2 and other respiratory viruses had longer hospital stays than those & lt;16 years of age (mean 9 ± 3.96 days vs. 5.44 ± 1.89 days; p = 0.025). The combination of AdV and SARS-CoV-2 is fatal for patients aged & gt;65 years. Conclusion In patients aged & gt;65 years, coinfection with SARS CoV-2 and other respiratory viruses, together with concomitant diseases, causes worsening of the clinical picture and complications, and can be fatal. Screening of patients with SARS CoV-2 for other respiratory viruses is needed to select appropriate treatments and prevent a fatal outcome of the disease.
    Type of Medium: Online Resource
    ISSN: 2296-2565
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2022
    detail.hit.zdb_id: 2711781-9
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  • 2
    In: Journal of Medical Virology, Wiley, Vol. 95, No. 2 ( 2023-02)
    Abstract: Social distancing, mask‐wearing, and travel restrictions during the COVID‐19 pandemic have significantly impacted the spread of influenza viruses. The objectives of this study were to analyze the pattern of influenza virus circulation with respect to that of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) in Bulgaria during the 2021–2022 season and to perform a phylogenetic/molecular analysis of the hemagglutinin ( HA ) and neuraminidase ( NA ) sequences of representative influenza strains. Influenza infection was confirmed using real‐time reverse transcription polymerase chain reaction in 93 (4.2%) of the 2193 patients with acute respiratory illness tested wherein all detected viruses were subtyped as A(H3N2). SARS‐CoV‐2 was identified in 377 (24.3%) of the 1552 patients tested. Significant differences in the incidence of influenza viruses and SARS‐CoV‐2 were found between individual age groups, outpatients/inpatients, and in the seasonal distribution of cases. Two cases of coinfections were identified. In hospitalized patients, the C t values of influenza viruses at admission were lower in adults aged ≥65 years (indicating higher viral load) than in children aged 0–14 years ( p   〈  0.05). In SARS‐CoV‐2‐positive inpatients, this association was not statistically significant. HA genes of all A(H3N2) viruses analyzed belonged to subclade 3C.2a1b.2a. The sequenced viruses carried 11 substitutions in HA and 5 in NA , in comparison to the vaccine virus A/Cambodia/e0826360/2020, including several substitutions in the HA antigenic sites B and C. This study revealed extensive changes in the typical epidemiology of influenza infection, including a dramatic reduction in the number of cases, diminished genetic diversity of circulating viruses, changes in age, and seasonal distribution of cases.
    Type of Medium: Online Resource
    ISSN: 0146-6615 , 1096-9071
    URL: Issue
    RVK:
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 752392-0
    detail.hit.zdb_id: 1475090-9
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  • 3
    Online Resource
    Online Resource
    National Center of Infectious and Parasitic Diseases ; 2023
    In:  PROBLEMS of Infectious and Parasitic Diseases Vol. 51, No. 1 ( 2023-08-14), p. 5-10
    In: PROBLEMS of Infectious and Parasitic Diseases, National Center of Infectious and Parasitic Diseases, Vol. 51, No. 1 ( 2023-08-14), p. 5-10
    Abstract: The COVID-19 pandemic is associated with high morbidity and significant mortality worldwide. The objective of this study was to track the circulation pattern of SARS-CoV-2 in Bulgaria over three consecutive years (2020-2022) and to analyze the involvement of SARS-CoV-2 in cases of co-infections. A total of 98 247 clinical samples were tested for SARS-CoV-2 using a Real-Time RT-PCR method and 25.2% of them were positive. The positive rate for SARS-CoV-2 was greater among hospitalized patients compared to outpatients (p 〈 0.05). Approximately 48.3% of all SARS-CoV-2-positive cases were male and 51.7% were female (p 〈 0.05). SARS-CoV-2 positivity was highest in the group of oldest adults (≥65 years) (average 40.6%), and lowest in the group of youngest children (0-5 years) (average 9.4%). Several peaks in the spread of SARS-CoV-2 infections were observed. Among the 1 463 SARS-CoV-2 positive clinical samples examined for the presence of other respiratory viruses, 109 (7.5%) cases of co-infections were found. The greatest variety of co-infections with SARS-CoV-2 and other respiratory viruses was detected during the Omicron wave. Surveillance of SARS-CoV-2 is important to continue in the future in order not to miss the emergence of new genetic variants with increased infectivity, virulence or immune escape.
    Type of Medium: Online Resource
    ISSN: 2815-2808 , 0204-9155
    Language: Unknown
    Publisher: National Center of Infectious and Parasitic Diseases
    Publication Date: 2023
    detail.hit.zdb_id: 3159082-2
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  • 4
    Online Resource
    Online Resource
    Frontiers Media SA ; 2024
    In:  Frontiers in Microbiology Vol. 15 ( 2024-4-2)
    In: Frontiers in Microbiology, Frontiers Media SA, Vol. 15 ( 2024-4-2)
    Abstract: Respiratory syncytial virus (RSV) is a common cause of upper and lower respiratory tract infections. This study aimed to explore the prevalence of respiratory syncytial virus (RSV) and other respiratory viruses in Bulgaria, characterize the genetic diversity of RSV strains, and perform amino acid sequence analyses of RSV surface and internal proteins. Methods Clinical and epidemiological data and nasopharyngeal swabs were prospectively collected from patients with acute respiratory infections between October 2020 and May 2023. Real-time PCR for 13 respiratory viruses, whole-genome sequencing, phylogenetic, and amino acid analyses were performed. Results This study included three epidemic seasons (2020–2021, 2021–2022, and 2022–2023) from week 40 of the previous year to week 20 of the following year. Of the 3,047 patients examined, 1,813 (59.5%) tested positive for at least one viral respiratory pathogen. RSV was the second most detected virus (10.9%) after SARS-CoV-2 (22%). Coinfections between RSV and other respiratory viruses were detected in 68 cases, including 14 with SARS-CoV-2. After two seasons of low circulation, RSV activity increased significantly during the 2022–2023 season. The detection rates of RSV were 3.2, 6.6, and 13.7% in the first, second, and third seasons, respectively. RSV was the most common virus found in children under 5 years old with bronchiolitis (40%) and pneumonia (24.5%). RSV-B drove the 2022–2023 epidemic. Phylogenetic analysis indicated that the sequenced RSV-B strains belonged to the GB5.0.5a and GB5.0.6a genotypes. Amino acid substitutions in the surface and internal proteins, including the F protein antigenic sites were identified compared to the BA prototype strain. Conclusion This study revealed a strong resurgence of RSV in the autumn of 2022 after the lifting of anti-COVID-19 measures, the leading role of RSV as a causative agent of serious respiratory illnesses in early childhood, and relatively low genetic diversity in circulating RSV strains.
    Type of Medium: Online Resource
    ISSN: 1664-302X
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2024
    detail.hit.zdb_id: 2587354-4
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  • 5
    In: Viruses, MDPI AG, Vol. 16, No. 6 ( 2024-06-13), p. 958-
    Abstract: This study aimed to determine the incidence and etiological, seasonal, and genetic characteristics of respiratory viral coinfections involving severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Between October 2020 and January 2024, nasopharyngeal samples were collected from 2277 SARS-CoV-2-positive patients. Two multiplex approaches were used to detect and sequence SARS-CoV-2, influenza A/B viruses, and other seasonal respiratory viruses: multiplex real-time polymerase chain reaction (PCR) and multiplex next-generation sequencing. Coinfections of SARS-CoV-2 with other respiratory viruses were detected in 164 (7.2%) patients. The most common co-infecting virus was respiratory syncytial virus (RSV) (38 cases, 1.7%), followed by bocavirus (BoV) (1.2%) and rhinovirus (RV) (1.1%). Patients ≤ 16 years of age had the highest rate (15%) of mixed infections. Whole-genome sequencing produced 19 complete genomes of seasonal respiratory viral co-pathogens, which were subjected to phylogenetic and amino acid analyses. The detected influenza viruses were classified into the genetic groups 6B.1A.5a.2a and 6B.1A.5a.2a.1 for A(H1N1)pdm09, 3C.2a1b.2a.2a.1 and 3C.2a.2b for A(H3N2), and V1A.3a.2 for the B/Victoria lineage. The RSV-B sequences belonged to the genetic group GB5.0.5a, with HAdV-C belonging to type 1, BoV to genotype VP1, and PIV3 to lineage 1a(i). Multiple amino acid substitutions were identified, including at the antibody-binding sites. This study provides insights into respiratory viral coinfections involving SARS-CoV-2 and reinforces the importance of genetic characterization of co-pathogens in the development of therapeutic and preventive strategies.
    Type of Medium: Online Resource
    ISSN: 1999-4915
    Language: English
    Publisher: MDPI AG
    Publication Date: 2024
    detail.hit.zdb_id: 2516098-9
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