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Abstract Background Respiratory symptoms are associated with coronavirus disease 2019 (COVID-19) outcomes. However, the impacts of upper and lower respiratory symptoms on COVID-19 outcomes in the same population have not been compared. The objective of this study was to characterize upper and lower respiratory symptoms and compare their impacts on outcomes of hospitalized COVID-19 patients. Methods This was a multicenter, retrospective cohort study; the database from the Japan COVID-19 Task Force was used. A total of 3314 COVID-19 patients were included in the study, and the data on respiratory symptoms were collected. The participants were classified according to their respiratory symptoms (Group 1: no respiratory symptoms, Group 2: only upper respiratory symptoms, Group 3: only lower respiratory symptoms, and Group 4: both upper and lower respiratory symptoms). The impacts of upper and lower respiratory symptoms on the clinical outcomes were compared. The primary outcome was the percentage of patients with poor clinical outcomes, including the need for oxygen supplementation via high-flow oxygen therapy, mechanical ventilation, and extracorporeal membrane oxygenation or death. Results Of the 3314 COVID-19 patients, 605, 1331, 1229, and 1149 were classified as Group 1, Group 2, Group 3, and Group 4, respectively. In univariate analysis, patients in Group 2 had the best clinical outcomes among all groups (odds ratio [OR]: 0.21, 95% confidence interval [CI]: 0.11–0.39), while patients in Group 3 had the worst outcomes (OR: 3.27, 95% CI: 2.43–4.40). Group 3 patients had the highest incidence of pneumonia, other complications due to secondary infections, and thrombosis during the clinical course. Conclusions Upper and lower respiratory tract symptoms had vastly different impacts on the clinical outcomes of COVID-19.

ABSTRACT Rapid and reliable diagnosis is important for the management of individuals infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The rapid antigen detection test (RADT) is a rapid, inexpensive, and easy method. Several studies have reported that RADTs performed well in many countries; however, very few studies have been reported in China. In this study, we assessed the performance of the RADT (Ediagnosis COVID-19 antigen test kit). This study was conducted in a centralized isolation site in Shanghai and enrolled 716 patients with COVID-19 and 203 noninfected participants. Nasopharyngeal swabs from all participants were collected on the same day and tested using the RADT and real-time reverse transcription-PCR (RT-PCR). The performance of the RADT was evaluated in different scenarios, such as threshold cycle (CT) values, symptomatic phase, and symptoms on the day of testing. The results demonstrated that the sensitivity for patients with CT values lower than 20 was 96.55% (95% confidence interval [CI], 87.05 to 99.4). The sensitivities were 78.4% (95% CI, 69.96 to 85.05) for participants within 5 days after the first RT-PCR-positive result and 90.77% (95% CI, 80.34 to 96.19) within 5 days after symptom onset. Moreover, the sensitivity of the RADT was more than 80% for patients with symptoms on the day of testing, including fever (89.29%), cough (86.84%), stuffy nose (92.59%), runny nose (92%), sore throat (81.25%), and muscle pain (80.77%), especially for those with upper respiratory tract symptoms. The specificity of the RADT was good in all scenarios. During the SARS-CoV-2 epidemic, Ediagnosis performed excellently in individuals with a higher viral load (evidenced by lower CT values), individuals in the early symptomatic phase, and especially those with upper respiratory tract symptoms. IMPORTANCE RADTs have demonstrated excellent performance in many counties for screening SARS-CoV-2 infection, but very few studies have been conducted in China. The performance of RADTs is largely related to different real-life scenarios. In our study, the performance of the RADT was evaluated in different scenarios, such as CT values, symptomatic phase, and symptoms on the day of testing. The results demonstrated that Ediagnosis (an RADT made in China) performed excellently for individuals with a higher viral load (evidenced by lower CT values), individuals in the early symptomatic phase, and especially those with upper respiratory tract symptoms.

The present study investigated the effects of a 12-week endurance-training intervention on salivary proteins and upper respiratory tract symptoms (URS) in 25 young men. Saliva samples of 25 recreational male endurance runners (age 34.6 years, body mass index = 23.8 kg·m−2, peak aerobic capacity = 47.2 mL·kg−1·min−1) were collected before (PRE) and after (POST) the training intervention, in a fasting state, as well as both before and after a maximal incremental treadmill run. The training consisted of both continuous and interval training sessions, 4-6 times per week based on the polarized training approach. Participants filled in Wisconsin Upper Respiratory Symptom Survey-21 and were retrospectively divided into 2 groups according to whether they reported URS (URS group, n = 13) or not (HEALTHY group, n = 12). Basal salivary immunoglobulin A (sa-sIgA) levels were significantly higher (+70%, p < 0.05) in the HEALTHY group both at PRE and POST whereas no significant differences were observed in salivary immunoglobulin M, salivary immunoglobulin G, lysozyme, or salivary α-amylase activity (sAA). Sa-sIgA concentration at PRE significantly correlated with the number of sick-days ( R = -0.755, p < 0.001) in all subjects. The incremental treadmill run acutely increased sAA significantly ( p < 0.05) at PRE (200%) and POST (166%) in the HEALTHY group but not in the URS group. This study demonstrated that subjects, who experienced URS during the 12 weeks of progressive endurance training intervention, had significantly lower basal sa-sIgA levels both before and after the experimental endurance training period. In addition to sa-sIgA, acute sAA response to exercise might be a possible determinant of susceptibility to URS in endurance runners. [ABSTRACT FROM AUTHOR]

Rapid and reliable diagnosis is important for the management of individuals infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The rapid antigen detection test (RADT) is a rapid, inexpensive, and easy method. Several studies have reported that RADTs performed well in many countries; however, very few studies have been reported in China. In this study, we assessed the performance of the RADT (Ediagnosis COVID-19 antigen test kit). This study was conducted in a centralized isolation site in Shanghai and enrolled 716 patients with COVID-19 and 203 noninfected participants. Nasopharyngeal swabs from all participants were collected on the same day and tested using the RADT and real-time reverse transcription-PCR (RT-PCR). The performance of the RADT was evaluated in different scenarios, such as threshold cycle ( C T ) values, symptomatic phase, and symptoms on the day of testing. The results demonstrated that the sensitivity for patients with C T values lower than 20 was 96.55% (95% confidence interval [CI], 87.05 to 99.4). The sensitivities were 78.4% (95% CI, 69.96 to 85.05) for participants within 5 days after the first RT-PCR-positive result and 90.77% (95% CI, 80.34 to 96.19) within 5 days after symptom onset. Moreover, the sensitivity of the RADT was more than 80% for patients with symptoms on the day of testing, including fever (89.29%), cough (86.84%), stuffy nose (92.59%), runny nose (92%), sore throat (81.25%), and muscle pain (80.77%), especially for those with upper respiratory tract symptoms. The specificity of the RADT was good in all scenarios. During the SARS-CoV-2 epidemic, Ediagnosis performed excellently in individuals with a higher viral load (evidenced by lower C T values), individuals in the early symptomatic phase, and especially those with upper respiratory tract symptoms. IMPORTANCE RADTs have demonstrated excellent performance in many counties for screening SARS-CoV-2 infection, but very few studies have been conducted in China. The performance of RADTs is largely related to different real-life scenarios. In our study, the performance of the RADT was evaluated in different scenarios, such as C T values, symptomatic phase, and symptoms on the day of testing. The results demonstrated that Ediagnosis (an RADT made in China) performed excellently for individuals with a higher viral load (evidenced by lower C T values), individuals in the early symptomatic phase, and especially those with upper respiratory tract symptoms.

It has been proposed that high exercise loads increase the risk of infection, most frequently reported as upper respiratory tract infections, by suppressing the immune system. Most athletes will not train when experiencing sickness due to the fear of health complications. However, high training volumes are incompatible with high rates of non-training days, regardless of the cause. The purpose of this observational study was to examine the relationship between self-reported, exercise-constraining days of sickness (days when the athlete decided not to train due to symptoms of disease, either self-reported or by a physician) and the volumes of exercise training in elite endurance athletes by analyzing data from training logs kept for several years. The subjects included 11 elite endurance athletes (8 male, 3 female) competing at national and international levels in cross-country skiing, biathlon and long-distance running. Training logs available from these 11 subjects added to a total of 61 training years. The number of training hours per year (462, 79-856; median, range) was significantly and negatively correlated to the reported number of days not training due to sickness (15, 0-164) by a 3rd degree polynomial regression (R2 = 0.48, F ratio = 18, p < 0.0001). We conclude that elite endurance athletes can achieve high training volumes only if they also experience few sickdays. [ABSTRACT FROM AUTHOR]

In southwest Florida, Karenia brevis (K. brevis) blooms occur frequently, can be very intense and persist over several years. Individuals living in coastal communities around the Gulf of Mexico are particularly vulnerable to brevetoxins released by K. brevis in seawater and carried inland within marine aerosol. Exposure to K. brevis occurs during residential, recreational, and occupational activities and has been associated with upper respiratory tract (URT) symptoms in healthy and medically vulnerable individuals. Additionally, ingestion of brevetoxin-contaminated seafood causes neurotoxic shellfish poisoning (NSP), and severe headaches prompting emergency department visits which occur in excess during K. brevis blooms. The current study examined a dose-response relationship between K. brevis in coastal waters and URT and NSP-like symptoms and headaches among southwest Florida residents. Data on past medical history (PMH) and medical symptoms were collected from the participants (n = 258) in five southwest Florida counties between June 2019 to August 2021. A dose-response relationship was observed between K. brevis blooms and reporting of URT and NSP-like symptoms and headaches. Reporting of NSP-like symptoms was higher among participants with a PMH of migraines, chronic fatigue syndrome (CFS) and mild memory loss, while the association of headaches with K. brevis blooms was accentuated among individuals with a PMH of migraines. These results suggest further investigations into the threshold of aerosolized brevetoxin dose required to elicit URT, headaches and/or NSP-like symptoms. These symptoms ultimately cause significant public health safety concerns, primarily among vulnerable populations with preexisting neurological conditions. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the occupational exposure and sensitization to storage mites (SM) in sales staff working in a moisture-damaged and three healthy reference buildings. Methods: The study population consisted of the entire personnel ( n=12) in the moisture-damaged grocery store. They all suffered from persistent upper respiratory tract symptoms. Twelve (in results 11) symptom-free controls working in three healthy reference groceries were matched with age, sex and occupation. Dust samples from each building were examined for mites. The clinical study consisted of otorhinolaryngological examination and determination of IgE reactivity. Specific serum IgE antibodies were measured against three SMs and two house dust mites (HDM). Skin prick tests (SPT) were made to the same five mites and to five common aeroallergens. If sensitization to any of the SMs was detected, a nasal provocation test (NPT) was performed. Results: SMs were found in all buildings. In all, seven cases and four control subjects showed IgE-mediated reactivity. Sensitization to mites was detected in six cases and in three controls and in 2/12 and 3/11 this was the only IgE antibody response observed. In addition, one case and one control subject were sensitized to common aeroallergens. NPT with SMs was positive in four cases and in one control. Conclusions: In grocery stores, the personnel are exposed to SMs. The risk of sensitization to mites is obvious and an IgE response can occur without any reactivity to common aeroallergens. SM allergy may in some cases explain the chronic rhinitis related to moisture-damaged buildings. [ABSTRACT FROM AUTHOR]

Objective --To ascertain whether a daily nasal spray with physiological saline could prevent symptoms of common cold in a population of otherwise healthy adults. Material and Methods --This was study involving 10 weeks of daily use of a nasal saline spray and 10 weeks of only recording symptoms. Young adults eligible for military service at an army barrack in Boden, Sweden were invited to participate in the study and 108 healthy conscripts aged ≈ 20 years agreed to do so. Data were recorded by the participants in a diary at home. In the diary the participants noted symptoms such as rhinitis, blocked nose, cough, fever and sore throat (pharyngeal pain). They also recorded inability to perform their duties due to the symptoms, and any medication or antibiotics necessitated by upper respiratory tract infection. Results --A total of 69 subjects completed the 20-week diary period. For 60 of them, compliance during the spray period exceeded 60% and their data were used in the statistical calculations. During the spray period the number of days with nasal secretion and/or blocked nose (mean 6.4 days) was significantly ( p= 0.027) lower than that during the observation period (mean 11 days). Furthermore, the participants had a mean of 0.7 episodes of upper respiratory tract infection during the spray period, compared with 1.0 episodes during the observation period ( p= 0.05). Conclusion --A daily nasal spray with saline can prevent nasal symptoms of common cold in a population of otherwise healthy adults. [ABSTRACT FROM AUTHOR]

A substantial proportion of airway disease's global burden is attributable to exposure to air pollution. This study aimed to investigate the association between air pollution, assessed as concentrations of particulate matter PM2.5 and PM10 on the upper respiratory tract symptoms (URTS) in children. A nation-wide, questionnaire-based study was conducted in Poland in winter 2018/2019 in a population of 1475 children, comparing URTS throughout the study period with publicly available data on airborne particulate matter. A general regression model was used to evaluate the lag effects between daily changes in PM10 and PM2.5 and the number of children reporting URTS and their severity. PM10 and PM2.5 in the single-pollutant models had significant effects on the number of children reporting URTS. The prevalence of URTS: "runny nose", "sneezing" and "cough" was positively associated with 12-week mean PM2.5 and PM10 concentrations. In the locations with the highest average concentration of PM, the symptoms of runny nose, cough and sneezing were increased by 10%, 9% and 11%, respectively, compared to the cities with the lowest PM concentrations. This study showed that moderate-term exposure (12 week observation period) to air pollution was associated with an increased risk of URTS among children aged 3–12 years in Poland. These findings may influence public debate and future policy at the national and international levels to improve air quality in cities and improve children's health. [ABSTRACT FROM AUTHOR]