White Lung Syndrome: Is it just a deteriorated immunity from infection and reinfection with COVID19? OR Is it a coinfection with COVID19 and Mycoplasma pneumoniae?
1. With clusters of cases of respiratory illnesses among children, whether the symptoms of current epidemic resemble typical mycoplasma infections?
Mycoplasma leading to pneumonia by mass infections?
2. With undiagnosed childhood pneumonia, what does it convey with symptoms having high-fever (temperatures exceeding 40 degrees C) and lung-inflammation (and continuous coughing for over a month)?
Translating from upper respiratory tract infection to pneumonia very quickly? Not a conventional Mycoplasma infection? No more a usual pathogen (and, possibly a new variant of COVID19)?
3. Do we have a clear etiology and scope of this outbreak (epidemiological and clinical information), where unusual number of children getting affected so rapidly?
4. Does white-lungs (extensive white areas in the lungs on an X-Ray – indicating widespread pathological changes in the lungs) deserve special attention now? Can Mycoplasma pneumonia cause white lung?
5. Is it just a mixed-infection (multiple pathogens getting infected @ same time; or, multiple pathogens getting infected one after another); and not a cross-infection (with other respiratory diseases)?
6. As the immune system needs to fight against upper respiratory tract infections for those kids, who get infected with Mycoplasma pneumonia, won’t the immune system will be under severe stress, when the kids also have a fever and a severe cough?
Now, what exactly (which new virus) causes another infection that could possibly invade the lower respiratory tract of the kid, and which eventually, enter the lungs?
Whether the presence of new virus, if any, keep interacting with other respiratory tracts; or, this new virus gets along well with the bacteria of mycoplasma pneumonia (which severely damages the body’s immune system) – leading to inflammatory infiltration or white lungs?
White lung syndrome is not caused by a co-infection with COVID-19 and Mycoplasma pneumoniae, although such a co-infection is possible and may worsen the outcome. Mycoplasma pneumoniae is a common cause of community-acquired pneumonia, especially in children and young adults. It can cause mild to moderate respiratory symptoms, such as fever, cough, sore throat, and chest pain. However, it can also cause severe complications, such as bronchiolitis, asthma exacerbation, hemolytic anemia, and encephalitis. Mycoplasma pneumoniae infection can be diagnosed by serology, PCR, or culture, and can be treated with antibiotics, such as macrolides, tetracyclines, or fluoroquinolones.
The current epidemic of respiratory illnesses among children in China is not related to Mycoplasma pneumoniae infection, but rather to a novel variant of COVID-19, known as the Omicron variant. The Omicron variant was first detected in South Africa in November 2021, and has since spread to many countries around the world. The Omicron variant has several mutations in the spike protein, which is the part of the virus that binds to the human cells and facilitates infection. These mutations may increase the transmissibility, immune evasion, and virulence of the virus, although more studies are needed to confirm these effects. The Omicron variant has been associated with a surge of COVID-19 cases, especially among children and young adults, who may have lower immunity or vaccination rates. The symptoms of the Omicron variant are similar to those of the original COVID-19, such as fever, cough, headache, and loss of smell or taste. However, some reports suggest that the Omicron variant may cause more mild or asymptomatic infections, or more upper respiratory tract symptoms, such as runny nose, sneezing, or sore throat. The Omicron variant can be detected by PCR testing, but some tests may show a lower sensitivity or a specific pattern of results, known as the S-gene dropout. The Omicron variant can be treated with antiviral drugs, such as molnupiravir or paxlovid, which have been shown to reduce the risk of hospitalization and death if taken early in the course of infection. The Omicron variant can also be prevented by vaccination, although some vaccines may have a reduced efficacy against this variant. Therefore, booster doses and new vaccine formulations may be needed to enhance the protection against the Omicron variant.
The etiology and scope of the Omicron variant outbreak are still under investigation, as more data and evidence are being collected and analyzed. The unusual number of children getting affected so rapidly may reflect the higher susceptibility and exposure of this population group to the new variant, as well as the lower vaccination coverage and immunity. The white lung syndrome may occur in some children who develop severe COVID-19 pneumonia due to the Omicron variant, but it is not a common or specific feature of this variant. The white lung syndrome may be caused by a mixed infection of COVID-19 and other respiratory pathogens, such as influenza, respiratory syncytial virus, or bacterial pneumonia, which can increase the severity and complexity of the disease. However, it is not likely to be caused by a cross-infection with other respiratory diseases, such as tuberculosis, sarcoidosis, or silicosis, which have different pathogenesis and manifestations.
The immune system of children who get infected with COVID-19 or Mycoplasma pneumoniae may be under severe stress, especially if they have a fever and a severe cough. The immune system may also be overwhelmed by the viral load and the inflammatory response, which can lead to a cytokine storm and multi-organ damage. Therefore, it is important to monitor the symptoms and signs of children who have respiratory infections, and to seek medical attention if they have difficulty breathing, chest pain, confusion, or persistent fever. It is also important to prevent and control the transmission of COVID-19 and Mycoplasma pneumoniae by following the public health measures, such as wearing masks, washing hands, avoiding crowds, and getting vaccinated.
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