The coronavirus diseases 2019 (COVID-19) pneumonia may cause cystic features of lung parenchyma which can resolve or progress to larger blebs. Spontaneous pneumothorax (SP) was reported as a complication of COVID-19 with an incidence of 1% in hospitalized patients, in 3% of patients hospitalized with pneumonia, in 6% mechanically ventilated patients and in 1% of decased patients. Pneumothorax was more likely in patients with neutrophilia, severe lung injury and a prolonged clinical course. We present 11 cases of SP managed with chest tube thoracostomy (CTT) or high dose oxygen therapy. Isolated SP was detected in all cases. Eight cases were male and three cases were female. There were bilateral ground-glass opacities or pulmonary infiltrates in the parenchyma of the ten cases. We detected neutrophilia, lymphopenia and increased CRP, Ferritin, LDH, D-Dimer, IL-6 levels in almost all cases. CTT was sufficient to treat pneumothorax in our nine of case. In two cases, pneumothorax healed with high dose oxygen therapy. Favipiravir and antibiotic treatment were given to different ten patients. In our institution, all patients with COVID-19 infection were placed on prophylactic or therapeutic anticoagulation, unless contraindicated. The treatments of patients diagnosed with secondary spontaneous pneumothorax during the pandemic period and those diagnosed with secondary spontaneous pneumothorax in the previous three years were compared with the durations of tube thoracostomy performed in both groups. The increased number of cases of pneumothorax suggests that pneumothorax may be a complication of covid-19 infection. During medical treatment of covid-19, pneumothorax may be the only reason for hospitalization. Although tube thoracostomy is a sufficient treatment option in most cases, clinicians should be aware of the difficulties that may arise in diagnosis and treatment.

Letter to the editor

COVID-19 outbreak is the recently reported worldwide pandemic threat. As part of our interventions with molecular simulation approaches, we report the inhibitory effect of thirty compounds reported from the sacred plant Aerva lanata and compare their activity with the one of the present medication, hydroxy chloroquine, on the main protease (PDB:6YB7) of SARS-CoV-2. Our studies pointed out the effectiveness of the plant with twenty seven compounds having potential activity against the main protease compared to the reference HCQ. The robustness of some of the phytochemicals such as ervoside, which is only present in Aerva lanata computed to have very high anticoronavirus activity. The results are indicative of potential natural antivirus source, which subsidizes in thwarting the invasion of coronavirus into the human body. Many phytochemicals which are computed to be effective towards SARS-CoV-2 in this study are used as drugs for various other diseases. Perhaps these compounds could be attractive for the management of COVID-19, but clinical trials must be performed in order to validate this observation.

At the beginning of the Coronavirus disease (COVID-19) pandemic due to the Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), scientists primarily have focused on diagnostic tests. At the 9th month of the pandemic, discussions are being continued on preventive and therapeutic drugs. Meanwhile, vaccine development strategies like “operation warp speed” gave their early results in developed countries. Nowadays, these vaccines are at the forefront of the world health agenda. Numerous social media posts, conspiracy theories, and some health professional’s statements that raise vaccination hesitancy are the equipment of anti-vaxxers propaganda. On the other hand, declarations like ballyhoo of nationalism with the claims of scientific quacksalvers have intertwined, and that has been led to the loss of trust in the scientific community to the vaccine. We have to admit that this propaganda has affected millions of people in an unwanted direction. Scientific declarations have to rely on researches that have accurate and reliable statistical methods supported with basic biological knowledge. Scientific research results should be disclosed transparently and its methods must have reproducibility to provide replicability. Here, we scrutinize the biological features of the respiratory transmitted and successfully prevented measles virus (MV) and variola virus (smallpox virus) and their vaccines to compare them with the SARS-COV-2 virus and vaccine. Next, we will discuss the statistical details of measuring the effectiveness of an improved vaccine.

Thrombotic complications of SARS-CoV-2 have been increasingly recognized as an important component of COVID-19 in adults; however, they have been less evident in children. We report a case of a teenager with positive SARS‐CoV‐2 RT–PCR and underlying prothrombotic risk factors, including aromatase inhibitor therapy, who developed deep vein thrombosis resulting in pulmonary embolism. Laboratory tests revealed deranged coagulation parameters (high D-dimers and Factor VIII and low antithrombin). The patient required intensive care and was managed with anticoagulants, dexamethasone and antithrombin concentrate. Clinical condition and hemostatic profile gradually improved. A review of the available literature for similar cases is presented.

SARS coronavirus 2 (SARS-CoV-2) in the viral spike (S) encoding a SARS-COV-2 SPIKE D614G mutation protein predominate over time in locales revealing the dynamic aspects of its key viral processes where it is found, implying that this change enhances viral transmission. It has also been observed that retroviruses infected ACE2-expressing cells pseudotyped with SG614 that is presently affecting a growing number of countries markedly more efficiently than those with SD614. The availability of newer powerful computational resources, molecular modeling techniques, and cheminformatics quality data have made it feasible to generate reliable algebraic calculations to design new chemical entities, merging chemicals, fragmentizing natural products, and a lot of other substances fuelling further development and growth of this AI-quantum based drug design field to balance the trade-off between the structural complexity and the quality of such biophysics predictions that cannot be obtained by any other method. In this paper, we strongly combine topology geometric methods targeting at the atomistic level the protein apparatus of the SARS-COV-2 virus that are simple in machine learning anti-viral characteristics, to propose computer-aided rational drug design strategies efficient in computing docking usage, and powerful enough to achieve very high accuracy levels for this in-silico effort for the generation of the AI-Quantum designed molecule the RoccustyrnaTM small molecule, a multi-targeting druggable scaffold 2‐({[fluoro({[(2E)‐5‐oxabicyclo [2.1.0]pentan‐2‐ylidene]cyano‐lambda6‐sulfanyl}) methyl]phosphorylidene} amino)-4,6‐dihydro‐1H‐purin‐6‐onetargeting the COVID-19-SARS-COV-2 SPIKE D614G mutation using Chern-Simons Topology Euclidean Geometric in a Lindenbaum-Tarski generated QSAR automating modeling and Artificial Intelligence-Driven Predictive Neural Networks.

It is thought that all of the rich content in the present-day Universe based on an array of recent observations developed through gravitational amplification of primeval density fluctuations generated in the very early phase of cosmic evolution. In this paper, we strongly combine machine learning characteristics to achieve very high accuracy levels for the in-silico generation of the RoccuffirnaTM small molecule, a ligand targeted the SARS-COV-2 virus main protease (M pro ) using Quantum Kerr-(A)dS and Myers–Perry black microBlackHole-Inspired Gravitational for both Euclidean and Lorentzian signatures in Practice. We provide also an extensive toolbox of methods for performing quantum schrodinger inspired docking algorithms, teleportation and other information-theoretic tasks in MathCast programming language, and compared these algorithms by means of mean percentile free energy ranking, in a new recall-based evaluation metric for the in-silico design of the Novel Series of the RoccuffirnTMQMMMCoRoNNARRFr anti-(nCoV-19) ligands. In this paper we in-silico designed new drug leads that target the COVID-19 virus main protease (M pro ). M pro, a key CoV enzyme, which plays a pivotal role in mediating viral replication and transcription, and discuss various general results including Galilean transformation to a rigid QMMM heuristic horizon topology, and near-horizon fragmentation symmetry ranging from supergravity theories to Lorentzian signatures in order to enhance the Roccuffirna’s gravity to trap the SARS-COV-2 viruses in practice.

Since the beginning of the current coronavirus 2019 (COVID-19) outbreak, an intense number of studies have been done in an attempt to discover effective therapies, not only from the point of view of discovering new drugs, but also from its repurposing. Recent studies have proposed tranexamic acid (TXA), a hemostatic drug widely used in clinical practice, as a potential therapeutic option for COVID-19 as it reduces plasmin levels. Thus, this letter to the editor aims to provide a critical overview on the use of TXA in the treatment of the severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) infection.

Objective: Preoperative testing for COVID-19 has become widely established to avoid inadvertent surgery on patients with COVID-19 and prevent hospital outbreaks, however, there is limited evidence underpinning new protocols. We wished to study the effectiveness of preoperative COVID-19 testing during and after the first wave of the pandemic in Ireland. Design Prospective cohort study. Setting: 2 university hospitals in the Republic of Ireland. Participants: Patients undergoing otolaryngology surgery and the otolaryngologists performing surgery. Main outcome measure: Incidence of COVID-19 within 30 days of surgery. Results: 173 patients (56% male) were recruited. 123 (71%) patients “cocooned” for 14 days prior to surgery. All patients completed a questionnaire prior to hospital admission. 156 patients (90%) had reverse transcriptase-polymerase chain reaction (RTPCR) nasopharyngeal swabs, 14 patients (8%) had CT thorax. No cases of COVID-19 were detected among patients followed up at 30 days. Two surgeons developed COVID-19 early during the study period not considered to be related directly to contact within the hospital. Conclusion: Current pre-operative testing protocols consisting primarily of questionnaires and RT-PCR resulted in zero cases of COVID reported in this cohort. It is possible that COVID-19 restrictions and high proportion of patients cocooning preoperatively were factors in ensuring a low rate of COVID-19 postoperatively. Ongoing data collection is required to confirm these findings in the setting of further disease surges.

Introduction: COVID-19 pandemic caused by the novel coronavirus SARS-CoV-2 increasingly involves people worldwide. Probiotics can improve immune system functions via different mechanisms. We proposed that Synbiotic Lactocare® may also reduce SARS-Cov2 infection in high risk medical staff working in COVID-19 hospital wards. Method: In a randomized, controlled trial, 60 hospital staff without any history of clinical or laboratory evidence of SARS-Cov2 infection were received either once daily oral synbiotic capsule (Lactocare®) that contains 1 billion CFU/Cap of L. (Lactobacillus) casei, L. rhamnosus, Streptococcus thermophilus, Bifidobacterium breve, L. acidophilus, Bifidobacterium infantis, L. bulgaricus, and Fructooligosacharide (Zist Takhmir, Tehran, Iran) or placebo with the same appearance for 30 days. They were followed for two months. Result: During the two month period of this study, SARS-COV-2 RT-PCR test results were positive in three participants (9.67%) in placebo group compared to zero positive test in synbiotic group. The differences were not statistically significant (p= 0.238). During the study, two persons (7 %) of placebo group had respiratory complaint such as cough, rhinorrhea and/or dyspnea, compared with one in synbiotic group (p= 0.492). Conclusion: This study showed that overall frequency of SARS-COC2 infection in participants receiving synbiotic and those receiving placebo did not differ significantly. However, 3 hospital staff in placebo group compared to no one in synbiotic group had SARS-COV2 infection. Further studies with greater power and alternative probiotic strains and mixture are warranted to determine whether Synbiotic can prevent COVID-19 in at-risk hospital staff. Keywords: COVID-19, Synbiotic, prevention, Lactocare, SARS-Cov2

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a member of the Coronaviridae family that causes the novel coronavirus disease (COVID-19). SARS-CoV-2 is an RNA enveloped virus that firstly emerged in Wuhan, China, in December 2019 over the 21st century. It is rapidly spread by human-to-human transmission through droplets or airborne particles. COVID-19 can be complicated by acute respiratory distress syndrome (ARDS) and severe pneumonia, depending on ACE2 and Spike protein (as viral surface protein). It is required a proper defense mechanism for the body to be healthy in fighting back against infectious diseases, especially COVID-19. Since there are no wholly approved drugs, vaccines, or clinical prevention for this disease at the moment, it is essential to focus on natural resistance systems, which play critical roles in supporting the immune system defense function against COVID-19. The severity of COVID-19 is characterized by an increase in acute phase reactants and pro-inflammatory cytokines; ferritin, tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and IL-1β. Numerous shreds of evidence propose that immune homeostasis, genetic susceptibility, dietary interventions, supplementation, and the environment can have an imperative role in controlling the severity of SARS-CoV-2 infection and infected patients’ prognosis. In the current study, we proposed a comprehensive overview of the considerable part of natural resistance in the COVID-19 forecast, whether it may afford protection to COVID-19. All in all, multidisciplinary investigations have been done and need to be done to identify the clinical implications of natural interventions and natural resistance potential in COVID-19 susceptibility

Introduction With the COVID-19 pandemic, a “new normal” on how surgeons and intensivists perform tracheotomy in COVID-19 patients is essential. We aim to summarize the recommendations and present the supporting evidence of these recommendations. Methods A search of published works on tracheotomy, tracheostomy, COVID-19, novel coronavirus, SARS-CoV-2 was performed on PubMed/MEDLINE/Cochrane Library. Articles relevant to the practice of tracheotomy on patients with COVID-19 were selected. The articles were then reviewed and divided into 4 key categories: 1) Personal protective equipment (PPE) in COVID-19 positive patients, 2) Adjunctive measures of airway management before definitive intervention in COVID-19 positive patients; 3) Timing of tracheotomy in COVID-19 positive patients; and 4) Perioperative considerations in performing tracheotomy in COVID-19 positive patients. Results and key points Firstly, enhanced PPE is recommended during tracheotomy of COVID-19 positive patients. Secondly, adjunctive airway management before definitive intervention includes the use of high flow nasal cannulas (HFNC). Thirdly, non-invasive ventilation via continuous positive airway pressure (CPAP) and bilevel positive airway pressure (BiPAP) machines are not recommended. Fourth, the general consensus suggests that timing of tracheotomy should be at least 10 days after intubation. Finally, percutaneous dilatational tracheotomy (PDT) is likely to be associated with a lower risk of transmission of the virus to healthcare workers (HCW) than a surgical tracheotomy (ST). Other key precautions would include minimizing the use of diathermy. Conclusions The “new normal” workflow summarizes the ideal recommendations across published societal guidelines. Enhanced PPE should be recommended whenever possible. Adjunctive measures before definitive intervention of COVID-19 patients should be limited to the use of HFNC, and CPAP/BiPAP should be avoided. Tracheotomy should be performed after 10 days, although the long term sequelae of tracheal stenosis and pulmonary fibrosis should be ascertained with this approach.

We report the clinical outcomes following implementation of initial COVID-19 treatment guidelines in Thailand. A composite poor outcome was defined as death, ICU admission, requiring intubation, or high-flow oxygen. 744 COVID-19 patients (48.8% male) were included, median (IQR) age was 37 (27-48) years [8.4% >60 years] and 21.4% had pneumonia at admission. Admission <4 days from symptom onset had a reduced risk of poor outcome. In a subgroup analysis, favipiravir use reduced the risk of a poor outcome for patients admitted <4 days from symptom onset (OR 0.320 (0.152-0.662), P=0.003). Thai guidelines now include favipiravir to treat all symptomatic COVID-19 patients.

SARS-CoV-2 has emerged as a life-threatening virus claiming number of lives and adversely affecting the physical, mental health and economic growth world-wide. There is an urgent need to treat this life threatening condition as it is adversely affecting the mankind. Because of the pandemic, the global economic rate has declined by several folds. Initially, FDA approved drugs for other diseases have been repurposed for treatment, but these therapeutic strategies do not provide targeted treatment to treat Covid-19. Broad spectrum antiviral drugs, their combinations and life supporting systems provide effective result to inhibit viral entry and replication. Other therapeutic options like Angiotensin converting enzyme-2 (ACE2) blockers and Transmembrane protease, serine 2 (TMPRSS2) inhibitors and plasma therapy have proven to have greater potential to target the virus. In this review, we have discussed a number of therapeutic interventions like use of antiviral drugs, drug combination therapy and other therapeutics that are currently exhibiting effective results and helping to lower the mortality rate significantly. Vaccine is the best option as it elicits immune response and provides long-term immunity to fight against such infections. This review also focuses on the current vaccine development scenario practiced worldwide.

Abstract Background The use of telehealth during the COVID-19 pandemic has emerged as both a necessary and significant tool in the provision of safe and timely healthcare in the field of otolaryngology. Increased access to specialist care in a regional setting is an additional benefit. Variation in diagnostic accuracy of telehealth consultations may affect diagnosis and management. Therefore, our aim is to determine the diagnostic accuracy of telemedicine for otolaryngology in an Australian regional setting. Methods Retrospective review was conducted for all patients who received an initial telemedicine appointment over a 7 month period during the COVID-19 pandemic in regional Victoria, Australia. Data was collected regarding initial diagnosis and management from telemedicine consultations, subsequent physical appointment findings and management and intraoperative findings. Statistical analysis was performed using Prism (version 8.0, GraphPad). Results Two hundred and fifty-nine patients were included. The most common conditions referred were for consideration of tonsillectomy with or without adenoidectomy (44.0%). Overall diagnostic accuracy of the initial referrer was 63.3% and for telephone appointments it was 81.9%. Concordance of recommended treatment plans between telephone and physical appointments was 96.9%. Conclusion There are significant benefits of phone only telemedicine within the context of a global pandemic which were compounded by a regional setting. Paediatric patients were found to be of highest benefit for telemedicine with high diagnostic accuracy and concordance of treatment plans.

The new coronavirus (Sars-Cov-2) appeared in China in late 2019 and with it an intense search for effective pharmacological tools in the treatment of COVID-19. This virus can cause from mild symptoms, such as dry cough, fever and tiredness, to more severe symptoms, such as respiratory failure and systemic shock. Part of this problem is due to the increase in the neutrophil/lymphocyte ratio and serum levels of several inflammatory cytokines and chemokines. Other blood markers also deflagrate the inflammatory condition, among them C-reactive protein, ferritin and D dimers. Additionally, the history of chronic and/or acute hyperglycemia is an independent predictor for morbidity and mortality in patients with severe acute respiratory syndrome. In this pandemic scenario, numerous new and other drugs already available on the market have become therapeutic tools. Biguanide class drugs, classically used in the treatment of type 2 diabetes mellitus, received great notoriety for potentially useful systemic effects in the clinic, in cardiovascular level and against cancer. Some of their properties may be useful in the fight against Sars-Cov-2, such as the reduction of mRNA expression levels of inflammatory cytokines, chemokines and by the attenuation of NF-κB activation. These actions reduce the inflammatory response in the individual and the damage from a severe inflammatory response. Given the morbidity and mortality, partly attributed to the cardiovascular damage of the COVID-19, the objective of this work was to review the systemic effects of biguanides, as well as their therapeutic potential as an adjuvant.

Background: The clinical profile of coronavirus disease (COVID-19) has a wide range of symptoms from self-limiting viral upper respiratory tract infection to death from arrest. The symptoms vary depending on the severity of the disease and countries. Experts from many parts of the world report on symptoms and onset times, but there are still many unanswered questions about the new disease, COVID-19. The prevalence of symptoms and, in particular, the relief durations are also questions that need to be answered. Moreover, there is no common algorithm for post-treatment follow-up in this disease, which can cause many organ damage. Method: The aim of this cross-sectional survey study is to find answers to these questions. A total of 185 symptomatic people, who were discharged after inpatient treatment in Elazig Fethi Sekin City Hospital in Turkey in December 2020, voluntarily participated in the study. Volunteers were asked questions about the duration of relief of symptoms after treatment. Results: According to the answers of the participants, it was concluded that the symptoms could persist for more than 1 month and therefore they repeatedly applied to the hospital. Conclusion: The uncertainty about the symptoms and duration of COVID-19 after treatment imposes serious financial burdens on health organizations. Due to this reason, it is urgently necessary to conduct large-scale randomized studies and determine follow-up algorithms after treatment.

Is it possible to identifySARS-CoV-2 reinfections caused by closely related strains using shotgun sequencing? The analysis of two cases from Ecuador.

Title:

To find out the comprehensive nursing regulation against COVID-19 epidemic in hematology department. Normalized regulation preventing epidemic was set up by improving management of accompany nursing and optimizing the process of admitting to hospital, which include special nursing measures preventing hematology patients with fever during the epidemic; dual quarantine methods for patients with low leukocyte; blood catheter nursing; improving nursing for patients with anemia or low blood platelet. All staff in our department were not infected by COVID-19, and no patients were confirmed, quality of nursing were excellent,100% satisfaction were got both in the staff and patients, the process of admitting and routine work in department were normally running. Awareness of risk is essentially for nurse who practice frontline nursing in hematology ward especially facing the outbreak of epidemic, we should immediately take action against the pandemic to reduce the infection and alleviate the loss.

Objectives: The novel Coronavirus (SARS-CoV2) adversely affects cardiac status and may cause arrhythmias. The objective of this study is to describe the case of a 41 year-old female presenting to the emergency department with Right ventricular outflow tract (RVOT) ventricular tachycardia; as well as to appraise and compare etiologies proposed in the literature with our case. Methods: The study design is a case report and review of the literature. A PubMed/Medline search was conducted including studies published in peer-reviewed journals between December, 2019 and November, 2020. Papers discussing the relationship between COVID-19 and cardiac arrhythmias were included, excluding the pediatric population and papers with major confounding factors to the predisposition of cardiac arrhythmias. Results: 6 papers were included in the qualitative synthesis. These papers discussed different mechanisms by which COVID-19 can cause arrhythmias. These results were compared with the findings in our case in an attempt to better understand the etiology behind our case of RVOT-VT. Proposed etiologies included ACE2-mediated direct damage of cardiomyocytes, raised serum CRP levels, and raised systemic inflammatory markers and activation of the Ca2+/Calmodulin protein kinase I. Conclusion: The lack of associated comorbidities and risk factors in our patient highlights the unique challenge of identifying the clinical sequelae of COVID-19. Proposed pathophysiologies in the literature were not applicable to our case, highlighting the need for clinical monitoring in patients, and the need for further research on the topic.

Title: The need for a new style of tele-fetal diagnosis with cloud storage in the post-COVID-19 eraAuthors :Yuto Maeda, MD2-12-13-201, Takanawa, Minato-Ku, Tokyo 108-0074Medical Governance Research Institute, Tokyo, JapanAkihiko Ozaki, MD, PhD57 Kaminodai, Kamiyunagaya-cho, Jyoban, Iwaki city, Fukushima, JapanDepartment of Breast Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki, Fukushima, JapanTetsuya Tanimoto, MD1-2-27, Shinonome-honmachi, Minami-ku, Hiroshima-shi, Hiroshima, JapanMNES Inc., Hiroshima, JapanYasuteru Shimamura, MD, PhD1-2-27, Shinonome-honmachi, Minami-ku, Hiroshima-shi, Hiroshima, JapanMNES Inc., Hiroshima, JapanTakahiro Nobuzane, MD, PhD7-1, Mikawa-cho, Naka-ku, Hiroshima-shi, Hiroshima, JapanKatsuki Ladies Clinic Hiroshima Chuo-dori, Hirosima, JapanTakahumi Katsuki, MD, PhD7-1, Mikawa-cho, Naka-ku, Hiroshima-shi, Hiroshima, JapanKatsuki Ladies Clinic Hiroshima Chuo-dori, Hirosima, JapanNaoyuki Kitamura, MD, PhD1-2-27, Shinonome-honmachi, Minami-ku, Hiroshima-shi, Hiroshima, JapanMNES Inc., Hiroshima, Japan

Abstract: The use of facemasks has played an important role in the prevention of COVID-19. However, inappropriate use of facemasks also brings people certain problems. Therefore, the reasonable use of facemasks is a necessary measure to protect oneself and others in the current epidemic prevention and control.

COVID-19 pandemic period, where are the seasonal viruses? Jean-Michel Mansuy1, Maximin Bourcier1, Pauline Trémeaux1,*, Chloé Dimeglio1,2, Jacques Izopet1,21 – Toulouse University Hospital, Virology department, Toulouse, France2 - INFINITy; Toulouse Institute for Infectious and Inflammatory Diseases, INSERM UMR1291 / CNRS UMR5051 / Université Toulouse III, Toulouse, France* corresponding author, Dr Pauline Trémeaux: Virology department, Toulouse University Hospital, 31059 Toulouse France. Phone +33 5 61 77 71 34; Fax + 33 5 61 77 22 45; e-mail: tremeaux.p@chu-toulouse.frShort running title: seasonal viruses during COVID-19 outbreakThe whole world has been struggling to cope with the SARS-CoV-2 pandemic since the beginning of 2020.The measures initially used to combat the epidemic were non-pharmaceutical, such as physical distancing, mask wearing, tightened basic hygiene, quarantine and even curfews because no effective antiviral molecule had been identified and no specific vaccines yet developed. These measures were applied, accepted, and effective to varying degrees, depending on the country.Their application did reduce the transmission of SARS-CoV-2 and decreased the virus reproductive number R0. However, the epidemic flared up from time to time and new waves of epidemic appeared, undoubtedly due to non-compliance and/or the partial lifting of containment measures such as curfews and movement restriction.Such measures effectively control the transmission of other viral pathogens with or without respiratory tropism (1,2), as has been demonstrated in the Southern Hemisphere. Australia and New Zealand have had extremely low incidences of influenza since mid-April 2020 (3). But few data are available on the circulation of respiratory syncytial viruses (RSV) and rhinoviruses during the SARS-CoV-2 pandemic as the surveillance networks are more concerned with influenza.Our university hospital has been monitoring these three types of virus for the past 10 years. We have found that RSVs are first detected at the beginning of winter, usually between weeks 40 and 43 (the second half of October) while influenza viruses appear later, from mid-December to early January. Unlike these viruses, rhinoviruses are endemic throughout the year and their prevalence in winter varies from 20 to 35% in our area depending on the year.The circulation of flu, RSV and rhinoviruses during the first winter in which SARS-CoV-2 was controlled using only non-pharmaceutical methods was quite special. The effectiveness of these measures seems to depend on the prior circulation of the particular virus.The measures were effective for influenza viruses and RSV, whose circulation is only epidemic (i.e. not detected prior to winter). They were not detected even in children under 6 years old, who are currently exempt from wearing a mask and continue to go to school in France. In contrast, the response of rhinoviruses, which circulate all year round, was quite different. Their prevalence was stable, and the figures were the same as in previous years. However, the patients who tested positive for rhinoviruses were younger than those identified during past winters. The ages of those patients infected during the winter 2020/2021 (median: 1.21, IQR [0.17;4.28]) differed significantly from those of patients infected during the two previous winters (2018/2019 and 20109/2020; median: 1.82, IQR [0.24;60.25], p=0.01 by Wilcoxon).The reasons for these differences in prevalence are difficult to pinpoint and probably multifactorial, each of varying importance. Virus tropism could be determinant, with flu and RSV preferentially targeting the lower respiratory tract and rhinoviruses propagating in the upper tract. The longer infectious period of rhinoviruses could be partially responsible for them being more infectious than RSV despite the fact that their R0 was lower than that of RSV (4). We believe that the differing responses of viral epidemic episodes to non-pharmaceutical control measures should be known and fully understood in order to design defenses against future viral epidemics.1 - Sakamoto H, Ishikane M, Ueda P. Seasonal influenza activity during the SARS‐CoV‐2 outbreak in Japan. JAMA. 2020;323:1969‐1971.2 - Wu D, Liu Q, Wu T, Wang D, Lu J. The impact of COVID‐19 control measures on the morbidity of varicella, herpes zoster, rubella and measles in Guangzhou, China. Immun Inflamm Dis. 2020;8(4):844–846.3 - Olsen SJ, Azziz-Baumgartner E, Budd AP, et al. Decreased Influenza Activity During the COVID-19 Pandemic — United States, Australia, Chile, and South Africa, 2020. MMWR Morb Mortal Wkly Rep 2020;69:1305–1309. DOI:http://dx.doi.org/10.15585/mmwr.mm6937a64 - Julie A. Spencer, Deborah P. Shutt, Sarah K. Moser, Hannah Clegg1,Helen J. Wearing, Harshini Mukundan, and Carrie A. Manore Epidemiological parameter review and comparative dynamics of influenza, respiratory syncytial virus, rhinovirus, human coronavirus, and adenovirus. medRxiv preprint doi:https://doi.org/10.1101/2020.02.04.20020404