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COVID-19 in Immunocompromised Patients: A Systematic Review
Semin Respir Crit Care Med 2021; 42: 839-858 DOI: 10.1055/s-0041-1740110Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) was first identified as a novel coronavirus in Wuhan, Hubei province, central China, in December 2019, and is responsible for the 2019-to-present pandemic. According to the most recent data released by the World Health Organization, more than 200 million people have been infected by SARS-CoV-2 so far, and more than 4 million people died worldwide. Although our knowledge on SARS-CoV-2 and COVID-19 is constantly growing, data on COVID-19 in immunocompromised patients are still limited. The aim ...
Source: Seminars in Respiratory and Critical Care Medicine - December 16, 2021 Category: Respiratory Medicine Authors: Stainer, Anna Amati, Francesco Suigo, Giulia Simonetta, Edoardo Gramegna, Andrea Voza, Antonio Aliberti, Stefano Tags: Review Article Source Type: research

Middle East Respiratory Syndrome Coronavirus
Semin Respir Crit Care Med 2021; 42: 828-838 DOI: 10.1055/s-0041-1733804The past two decades have witnessed the emergence of three zoonotic coronaviruses which have jumped species to cause lethal disease in humans: severe acute respiratory syndrome coronavirus 1 (SARS-CoV-1), Middle East respiratory syndrome coronavirus (MERS-CoV), and SARS-CoV-2. MERS-CoV emerged in Saudi Arabia in 2012 and the origins of MERS-CoV are not fully understood. Genomic analysis indicates it originated in bats and transmitted to camels. Human-to-human transmission occurs in varying frequency, being highest in healthcare environment and to a les...
Source: Seminars in Respiratory and Critical Care Medicine - December 16, 2021 Category: Respiratory Medicine Authors: Al-Tawfiq, Jaffar A. Azhar, Esam I. Memish, Ziad A. Zumla, Alimuddin Tags: Review Article Source Type: research

Hantavirus
Semin Respir Crit Care Med 2021; 42: 822-827 DOI: 10.1055/s-0041-1733803Hantaviruses are tri-segmented lipid-enveloped RNA viruses belonging to the Bunyaviridae family. Human infection corresponds to a zoonosis associated with two different clinical syndromes: hemorrhagic fever with renal syndrome that occurs in Asia and Europe and hantavirus cardiopulmonary syndrome (HCPS) that occurs in the North America, Central America and South America. The major pathogenic mechanisms in HCPS include (1) direct microvascular endothelial injury leading to increased capillary permeability and the development of noncardiogenic pulmonary ...
Source: Seminars in Respiratory and Critical Care Medicine - December 16, 2021 Category: Respiratory Medicine Authors: Riquelme, Ra úl Tags: Review Article Source Type: research

Adenovirus: Epidemiology, Global Spread of Novel Types, and Approach to Treatment
Semin Respir Crit Care Med 2021; 42: 800-821 DOI: 10.1055/s-0041-1733802Adenoviruses (AdVs) are DNA viruses that typically cause mild infections involving the upper or lower respiratory tract, gastrointestinal tract, or conjunctiva. Rare manifestations of AdV infections include hemorrhagic cystitis, hepatitis, hemorrhagic colitis, pancreatitis, nephritis, or meningoencephalitis. AdV infections are more common in young children, due to lack of humoral immunity. Epidemics of AdV infection may occur in healthy children or adults in closed or crowded settings (particularly military recruits). The vast majority of cases are sel...
Source: Seminars in Respiratory and Critical Care Medicine - December 16, 2021 Category: Respiratory Medicine Authors: Lynch, Joseph P. Kajon, Adriana E. Tags: Review Article Source Type: research

Respiratory Syncytial Virus
Semin Respir Crit Care Med 2021; 42: 788-799 DOI: 10.1055/s-0041-1736182Human respiratory syncytial virus (RSV) is a negative sense single-stranded RNA virus that can result in epidemics of seasonal respiratory infections. Generally, one of the two genotypes (A and B) predominates in a single season and alternate annually with regional variation. RSV is a known cause of disease and death at both extremes of ages in the pediatric and elderly, as well as immunocompromised populations. The clinical impact of RSV on the hospitalized adults has been recently clarified with the expanded use of multiplex molecular assays. Among a...
Source: Seminars in Respiratory and Critical Care Medicine - December 16, 2021 Category: Respiratory Medicine Authors: Nam, Hannah H. Ison, Michael G. Tags: Review Article Source Type: research

Management of Severe Influenza
Semin Respir Crit Care Med 2021; 42: 771-787 DOI: 10.1055/s-0041-1735491Influenza infection causes severe illness in 3 to 5 million people annually, with up to an estimated 650,000 deaths per annum. As such, it represents an ongoing burden to health care systems and human health. Severe acute respiratory infection can occur, resulting in respiratory failure requiring intensive care support. Herein we discuss diagnostic approaches, including development of CLIA-waived point of care tests that allow rapid diagnosis and treatment of influenza. Bacterial and fungal coinfections in severe influenza pneumonia are associated with...
Source: Seminars in Respiratory and Critical Care Medicine - December 16, 2021 Category: Respiratory Medicine Authors: O'Driscoll, Liam S. Martin-Loeches, Ignacio Tags: Review Article Source Type: research

The Immune Response to Respiratory Viruses: From Start to Memory
Semin Respir Crit Care Med 2021; 42: 759-770 DOI: 10.1055/s-0041-1736459Biomedical research has long strived to improve our understanding of the immune response to respiratory viral infections, an effort that has become all the more important as we live through the consequences of a pandemic. The disease course of these infections is shaped in large part by the actions of various cells of the innate and adaptive immune systems. While these cells are crucial in clearing viral pathogens and establishing long-term immunity, their effector mechanisms may also escalate into excessive, tissue-destructive inflammation detrimental...
Source: Seminars in Respiratory and Critical Care Medicine - December 16, 2021 Category: Respiratory Medicine Authors: Reijnders, Tom D.Y. Schuurman, Alex R. van der Poll, Tom Tags: Review Article Source Type: research

Viral Respiratory Infections: New Tools for a Rapid Diagnosis
Semin Respir Crit Care Med 2021; 42: 747-758 DOI: 10.1055/s-0041-1739306Respiratory tract infection is one of the most common diseases in human worldwide. Many viruses are implicated in these infections, including emerging viruses, such as the novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Identification of the causative viral pathogens of respiratory tract infections is important to select a correct management of patients, choose an appropriate treatment, and avoid unnecessary antibiotics use. Different diagnostic approaches present variable performance in terms of accuracy, sensitivity, ...
Source: Seminars in Respiratory and Critical Care Medicine - December 16, 2021 Category: Respiratory Medicine Authors: Colagrossi, Luna Mattana, Giordana Piccioni, Livia Cento, Valeria Perno, Carlo Federico Tags: Review Article Source Type: research

COVID-19 in Children: Update on Diagnosis and Management
Semin Respir Crit Care Med 2021; 42: 737-746 DOI: 10.1055/s-0041-1741371In December 2019, a new infectious disease called coronavirus disease 2019 (COVID-19) attributed to the new virus named severe scute respiratory syndrome coronavirus 2 (SARS-CoV-2) was detected. The gold standard for the diagnosis of SARS-CoV-2 infection is the viral identification in nasopharyngeal swab by real-time polymerase chain reaction. Few data on the role of imaging are available in the pediatric population. Similarly, considering that symptomatic therapy is adequate in most of the pediatric patients with COVID-19, few pediatric pharmacologica...
Source: Seminars in Respiratory and Critical Care Medicine - December 16, 2021 Category: Respiratory Medicine Authors: Esposito, Susanna Abate, Luciana Laudisio, Serena Rosa Ciuni, Andrea Cella, Simone Sverzellati, Nicola Principi, Nicola Tags: Review Article Source Type: research

Viral Respiratory Infections: From Bench to Bedside
Semin Respir Crit Care Med 2021; 42: 735-736 DOI: 10.1055/s-0041-1740169 Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAArticle in Thieme eJournals: Table of contents  |  Full text (Source: Seminars in Respiratory and Critical Care Medicine)
Source: Seminars in Respiratory and Critical Care Medicine - December 16, 2021 Category: Respiratory Medicine Authors: Blasi, Francesco Ramirez, Julio Tags: Preface Source Type: research

What Is the Role of Steroids for Septic Shock in 2021?
Semin Respir Crit Care Med 2021; 42: 726-734 DOI: 10.1055/s-0041-1733900Corticosteroids have been used for decades in the adjunctive treatment of severe infections in intensive care. The most frequent scenario in intensive care is in septic shock, where low doses of glucocorticoids appear to restore vascular responsiveness to norepinephrine. There is a strong body of evidence suggesting that hydrocortisone reduces time on vasopressor, and may modulate the immune response. In this review, we explore the current evidence supporting the use of corticosteroids in septic shock, its benefits, and potential harms. In addition to ...
Source: Seminars in Respiratory and Critical Care Medicine - September 20, 2021 Category: Respiratory Medicine Authors: Nedel, Wagner Lisboa, Thiago Salluh, Jorge I.F. Tags: Review Article Source Type: research

Survival Outcome of Sepsis in Recipients of Solid Organ Transplant
Semin Respir Crit Care Med 2021; 42: 717-725 DOI: 10.1055/s-0041-1735150Sepsis is a complex disease stemming from a dysregulated immune response toward an infectious agent. In transplantation, sepsis remains one of the leading causes of morbidity and mortality. Solid organ transplant recipients have impaired adaptive immunity due to immunosuppression required to prevent rejection. Immunosuppression has unintended consequences, such as increasing the risk of infections and sepsis. Due to its high morbidity and mortality, early detection of sepsis is paramount to start aggressive treatment. Several biomarkers or combination ...
Source: Seminars in Respiratory and Critical Care Medicine - September 20, 2021 Category: Respiratory Medicine Authors: Florescu, Diana F. Kalil, Andre C. Tags: Review Article Source Type: research

Evidence for the Application of Sepsis Bundles in 2021
Semin Respir Crit Care Med 2021; 42: 706-716 DOI: 10.1055/s-0041-1733899Sepsis represents a severe condition that predisposes patients to a high risk of death if its progression is not ended. As with other time-dependent conditions, the performance of determinant interventions has led to significant survival benefits and quality-of-care improvements in acute emergency care. Thus, the initial interventions in sepsis are a cornerstone for prognosis in most patients. Even though the evidence supporting the hour-1 bundle is perfectible, real-life application of thoughtful and organized sepsis care has improved survival and qua...
Source: Seminars in Respiratory and Critical Care Medicine - September 20, 2021 Category: Respiratory Medicine Authors: Plata-Menchaca, Erika P. Ruiz-Rodr íguez, Juan Carlos Ferrer, Ricard Tags: Review Article Source Type: research

Optimizing Fluid Resuscitation and Preventing Fluid Overload in Patients with Septic Shock
Semin Respir Crit Care Med 2021; 42: 698-705 DOI: 10.1055/s-0041-1733898Intravenous fluid administration remains an important component in the care of patients with septic shock. A common error in the treatment of septic shock is the use of excessive fluid in an effort to overcome both hypovolemia and vasoplegia. While fluids are necessary to help correct the intravascular depletion, vasopressors should be concomitantly administered to address vasoplegia. Excessive fluid administration is associated with worse outcomes in septic shock, so great care should be taken when deciding how much fluid to give these vulnerable pati...
Source: Seminars in Respiratory and Critical Care Medicine - September 20, 2021 Category: Respiratory Medicine Authors: Ravi, Chandni Johnson, Daniel W. Tags: Review Article Source Type: research

How Antibiotics Stewardship Can Be Safely Implemented in Patients with Septic Shock?
Semin Respir Crit Care Med 2021; 42: 689-697 DOI: 10.1055/s-0041-1733987In critically ill patients with sepsis and septic shock, the need for prompt and adequate antibiotic therapy is balanced by the risk of excessive antibiotic exposure that leads to emergence of multidrug-resistant pathogens. As such, antibiotic stewardship programs propose a set of operating rules from antibiotic treatment initiation to de-escalation and finally cessation. In this review, we will describe the rationale for early antibiotic treatment in septic patients, how to optimize initial antibiotic treatment, rules for early treatment discontinuati...
Source: Seminars in Respiratory and Critical Care Medicine - September 20, 2021 Category: Respiratory Medicine Authors: de Montmollin, Etienne Timsit, Jean-Fran çois Tags: Review Article Source Type: research