Recently, the immune system has been identified as one of the possible main bridges which connect the gut–brain axis. This review aims to examine available evidence on the microbiota–immunity–cognitive relationship and its possible effects on human health early in life. This review was assembled by compiling and analyzing various literature and publications that document the gut microbiota–immune system–cognition interaction and its implications in the pediatric population. This review shows that the gut microbiota is a pivotal component of gut physiology, with its development being influenced by a variety of factors and, in return, supports the development of overall health. Findings from current research focus on the complex relationship between the central nervous system, gut (along with gut microbiota), and immune cells, highlighting the importance of maintaining a balanced interaction among these systems for preserving homeostasis, and demonstrating the influence of gut microbes on neurogenesis, myelin formation, the potential for dysbiosis, and alterations in immune and cognitive functions. While limited, evidence shows how gut microbiota affects innate and adaptive immunity as well as cognition (through HPA axis, metabolites, vagal nerve, neurotransmitter, and myelination).

IntroductionIn rural and difficult-to-access settings, early and accurate recognition of febrile children at risk of progressing to serious illness could contribute to improved patient outcomes and better resource allocation. This study aims to develop a prognostic clinical prediction tool to assist community healthcare providers identify febrile children who might benefit from referral or admission for facility-based medical care.Methods and analysisThis prospective observational study will recruit at least 4900 paediatric inpatients and outpatients under the age of 5 years presenting with an acute febrile illness to seven hospitals in six countries across Asia. A venous blood sample and nasopharyngeal swab is collected from each participant and detailed clinical data recorded at presentation, and each day for the first 48 hours of admission for inpatients. Multianalyte assays are performed at reference laboratories to measure a panel of host biomarkers, as well as targeted aetiological investigations for common bacterial and viral pathogens. Clinical outcome is ascertained on day 2 and day 28.Presenting syndromes, clinical outcomes and aetiology of acute febrile illness will be described and compared across sites. Following the latest guidance in prediction model building, a prognostic clinical prediction model, combining simple clinical features and measurements of host biomarkers, will be derived and geographically externally validated. The performance of the model will be evaluated in specific presenting clinical syndromes and fever aetiologies.

The number of confirmed Coronavirus Disease-2019 (COVID-19) cases in Indonesia had reached 1.4 million cases from a total population of 270 million. Smell and/or taste disturbances are frequently found as early symptoms of COVID-19 patients. Our study aimed to investigate the proportion and characteristics of anosmia and/or ageusia in COVID-19. This cross-sectional study identifies the proportion and severity of smell and taste disturbances in COVID-19 patients. Subjects were recruited by consecutive sampling. All subjects were required to fill in the questionnaire modified from the American Academy of Otolaryngology-Head and Neck Surgery Anosmia Reporting Tool (AAO-HNS ART). Symptoms severity was measured with a numerical rating scale of 0–10; 0–3 is defined as mild, 4–6 as moderate, and 7–10 as severe. Out of 51 subjects, 34 (66.7%) suffered from smell and/or taste disturbances. Twenty-nine of 34 subjects (85.3%) suffered from smell disturbance, and 24 of 34 subjects (70.5%) suffered from taste disturbance. Severe smell disturbance occurred in 68.9% of subjects, while severe taste disturbance occurred in 50%. The median onset was three days for smell disturbance and four days for taste disturbance after any symptoms of COVID-19. Smell and/or taste disturbances were early symptoms of COVID-19. These symptoms commonly occurred within the first four days of clinical onset and frequently manifested in severe conditions.