Search

In children, the factors that influence COVID-19 disease and its medium- and long-term effects are little known. Our investigation sought to evaluate the presence of comorbidity factors associated with respiratory long COVID manifestations in children and to study ultrasound abnormalities following SARS-CoV-2 infection. Children, who arrived at the 'Respiratory Diseases of Pediatric Interest Unit' at the Department of Woman, Child, and General and Specialized Surgery of the University of Campania 'Luigi Vanvitelli', were selected during the timeframe from September 2021 to October 2022. The children were diagnosed with a SARS-CoV-2 infection that occurred at least one month before the visit. All patients followed a COVID-19 follow-up protocol, developed by the Italian Society of Pediatric Respiratory Diseases (SIMRI), which included: collection of data regarding SARS-CoV-2 illness and history of known respiratory and allergic diseases; physical examination; BMI assessment; baseline spirometry and after bronchodilation test; six-minute walking test; and lung ultrasound (LUS). In a cohort of 104 participants with respiratory long COVID symptoms (64.7% male, average age 8.92 years), 46.1% had fever with other symptoms, and 1% required hospitalization. BMI analysis showed 58.4% of the cohort was overweight. The LUS was positive in 27.0% of cases. A significant BMI association was observed with COVID-19 symptoms and LUS score (p-value < 0.05). No associations were found with asthma or atopy. [ABSTRACT FROM AUTHOR]

Pidotimod is a synthetic dipeptide that exerts immunomodulatory activity, modifying innate and adaptive immunity. Pidotimod firstly acts on Toll-like receptors, then on antigen-presenting cells and other immunocompetent cells. Pidotimod also affects immunoglobulin production and their switching. Evidence shows that pidotimod effectively and safely prevents respiratory infections, mainly in children with recurrent and frequent infectious episodes. In addition, pidotimod may be helpful as an add-on strategy in managing children with infections. Finally, there is evidence that pidotimod, thanks to its immunomodulatory activity and preventing respiratory infections (the main trigger for asthma exacerbation), may be beneficial in managing subjects with asthma and allergic diseases. The present review presents and discusses the most recent studies conducted in children with asthma, allergic rhinitis, recurrent respiratory infections and acute infections. Lastly, pidotimod is safe and well-tolerated in children. [ABSTRACT FROM AUTHOR]

Topical nasal therapy represents a widespread opportunity to treat upper airway diseases. As a result, specialists in different areas (mainly ENT, pediatrics, and allergology) and general practitioners prescribe intranasal compounds. However, a myriad of products and devices are available, as well as respiratory disorders. Consequently, this matter is debatable, and no guideline organically addresses this issue. Considering these premises, a restricted panel of qualified experts promoted an initial multidisciplinary survey involving only Fellows of some Scientific Societies belonging to ENT, pediatrics, and allergology areas. The survey included a series of queries concerning practical aspects of topical nasal therapy (treated disease, devices, and agents). A web platform served to participate in this survey. Each participant anonymously completed the questionnaire. Four hundred and forty-five doctors participated in the survey. There was a homogeneous distribution in Italy. Most participants were pediatricians (37%), followed by allergologists (31%) and ENT specialists (24%). Almost all doctors (95%) used topical nasal therapy. The most common diseases topically treated were allergic rhinitis (79%), chronic rhinosinusitis (73%), and non-allergic rhinitis. The most popular devices were pre-dosed spray both for nasal irrigation (67%) and nebulization (66%). Corticosteroids (67%), isotonic saline (63%), hyaluronic acid, hypertonic saline, and antihistamines (39%) were the most common agents used for intranasal therapy. Combined antihistamine/corticosteroids were also commonly used (38%). The most frequent schedule was the cyclic treatment. Most doctors (89%) claim they adequately spend time educating patients on this matter. In conclusion, topical nasal therapy is commonly used to manage upper respiratory diseases. However, the disagreement about some issues requires greater knowledge of the topics and the need to develop new studies, including pragmatic ones. [ABSTRACT FROM AUTHOR]

Topical nasal therapy is widely used in clinical practice by different specialists. However, it is multifaceted and still controversial. Namely, there is no consensus about the many aspects, and there needs to be specific guidelines. Four independent experts involved 14 Italian scientific societies (concerning ENT, allergy, and pediatrics areas) to participate in generating an Intersocietal Delphi Consensus on this matter. Three iterative rounds collected experts (4 in the first round, 20 in the second round, and 45 in the third round) designed by the scientific societies based on their clinical expertise and documented scientific value. Thirty-four statements were discussed and voted on. At the second round, all statements accomplished a very high consensus grade (>95%). At the third round, many statements reached a high or very high grade of consensus (>70%). However, some statements did not obtain sufficient agreement. Consequently, there is a need to implement knowledge about this issue through educational initiatives and new studies conducted with a robust methodology. In conclusion, topical nasal therapy deserves adequate knowledge as it is widespread and fruitful in managing upper respiratory diseases. [ABSTRACT FROM AUTHOR]