scholarly journals Adenovirus viremia may predict adenovirus pneumonia severity in immunocompetent children

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ruimu Zhang ◽  
Hongmei Wang ◽  
Shufeng Tian ◽  
Jikui Deng
Keyword(s):  
Risk Factors ◽  
Viral Load ◽  
Disease Severity ◽  
Mycoplasma Pneumoniae ◽  
Quantitative Polymerase Chain Reaction ◽  
Univariate Analysis ◽  
Clinical Manifestations ◽  
Pneumonia Severity ◽  
Adenovirus Pneumonia ◽  
Blood Viral Load

Abstract Background Previous studies have demonstrated an association between adenovirus viremia and disease severity in immunocompromised children. However, few studies have focused on this association in immunocompetent children. This study explored the association between adenovirus viremia and adenovirus pneumonia severity in immunocompetent children. Methods We performed a retrospective, observational study of immunocompetent children with adenovirus pneumonia admitted to Shenzhen Children’s Hospital in Shenzhen, China. Pneumonia was classified as severe or mild based on the Chinese guideline for the classification of pneumonia severity. Serum samples from all the children included in the study were tested for adenovirus DNA with a quantitative polymerase chain reaction. Clinical manifestations, laboratory examinations, and disease severity were compared between children with severe and mild pneumonia. Results A total of 111 immunocompetent children with adenovirus pneumonia (60 severe, 51 mild) were included. The median age was 40 months, and 64 patients were male. Five patients were admitted to the intensive care unit, and two underwent endotracheal intubation. All patients were discharged after recovery or improvement. Univariate analysis and binary logistic regression analysis showed that leukocytosis (OR = 1.1; 95% CI: 1.0 to 1.2; P = 0.033), co-infection with Mycoplasma pneumoniae (OR = 5.0; 95% CI: 2.1 to 12.3; P <  0.001), and high blood viral load (OR = 1.5; 95% CI: 1.2 to 2.0; P = 0.001) may be risk factors for severe adenovirus pneumonia. Conclusions Leukocytosis, co-infection with Mycoplasma pneumoniae, and high blood viral load may be risk factors for severe adenovirus pneumonia in immunocompetent children. Blood viral load may predict pneumonia severity.

scholarly journals Adenovirus Viremia Predicts Adenovirus Pneumonia Severity in Immunocompetent Children

2020 ◽  
Author(s):  
Ruimu Zhang ◽  
Hongmei Wang ◽  
Shufeng Tian ◽  
Jikui Deng
Keyword(s):  
Risk Factors ◽  
Viral Load ◽  
Disease Severity ◽  
Mycoplasma Pneumoniae ◽  
Quantitative Polymerase Chain Reaction ◽  
Univariate Analysis ◽  
Clinical Manifestations ◽  
Pneumonia Severity ◽  
Adenovirus Pneumonia ◽  
Blood Viral Load

Abstract Background: Previous studies have demonstrated an association between adenovirus viremia and disease severity in immunocompromised children. However, few studies focused on the use of this approach in immunocompetent children. This study explored the association between adenovirus viremia and adenovirus pneumonia severity in immunocompetent children. Methods: We did a retrospective, observational study of immunocompetent children with adenovirus pneumonia admitted in Shenzhen Children’s hospital in Shenzhen, China. Pneumonia was classified as severe or mild, based on the Chinese guideline of pneumonia severity classification. The serum of all the children in the study was tested for adenovirus DNA with quantitative polymerase chain reaction (PCR). Clinical manifestations, laboratory examinations, and disease severity were compared between these two groups. Results: A total of 111 immunocompetent children with adenovirus pneumonia (60 severe, 51 mild) were included. The median age was 40 months and 64 patients were male. Five patients were admitted to intensive care unit and two were endotracheal intubated. All the patients were discharged with recovery or improvement. Univariate analysis and binary logistic regression analysis showed leukocytosis (OR = 1.1; 95% CI: 1.0 to 1.2; P = 0.033), co-infection of mycoplasma pneumoniae (OR = 5.0; 95% CI: 2.1 to 12.3; P < 0.001), and high blood viral load (OR = 1.5; 95% CI: 1.2 to 2.0; P = 0.001) were risk factors for severe adenovirus pneumonia. Conclusions: Leukocytosis, co-infection of mycoplasma pneumoniae, and high blood viral load are risk factors for severe adenovirus pneumonia in immunocompetent children. Blood viral load predicts pneumonia severity.

scholarly journals Adenovirus Viremia Predicts Adenovirus Pneumonia Severity in Immunocompetent Children

2020 ◽  
Author(s):  
Ruimu Zhang ◽  
Hongmei Wang ◽  
Shufeng Tian ◽  
Jikui Deng
Keyword(s):  
Risk Factors ◽  
Viral Load ◽  
Disease Severity ◽  
Mycoplasma Pneumoniae ◽  
Quantitative Polymerase Chain Reaction ◽  
Univariate Analysis ◽  
Clinical Manifestations ◽  
Pneumonia Severity ◽  
Adenovirus Pneumonia ◽  
Blood Viral Load

Abstract Background: Previous studies have demonstrated an association between adenovirus viremia and disease severity in immunocompromised children. However, few studies focused on the use of this approach in immunocompetent children. This study explored the association between adenovirus viremia and adenovirus pneumonia severity in immunocompetent children. Methods: We did a retrospective, observational study of immunocompetent children with adenovirus pneumonia admitted in Shenzhen Children’s hospital in Shenzhen, China. Pneumonia was classified as severe or mild, based on the Chinese guideline of pneumonia severity classification. The serum of all the children in the study was tested for adenovirus DNA with quantitative polymerase chain reaction (PCR). Clinical manifestations, laboratory examinations, and disease severity were compared between these two groups. Results: A total of 111 immunocompetent children with adenovirus pneumonia (60 severe, 51 mild) were included. The median age was 40 months and 64 patients were male. Five patients were admitted to intensive care unit and two were endotracheal intubated. All the patients were discharged with recovery or improvement. Univariate analysis and binary logistic regression analysis showed leukocytosis (OR = 1.1; 95% CI: 1.0 to 1.2; P = 0.033), co-infection of mycoplasma pneumoniae (OR = 5.0; 95% CI: 2.1 to 12.3; P < 0.001), and high blood viral load (OR = 1.5; 95% CI: 1.2 to 2.0; P = 0.001) were risk factors for severe adenovirus pneumonia. Conclusions: Leukocytosis, co-infection of mycoplasma pneumoniae, and high blood viral load are risk factors for severe adenovirus pneumonia in immunocompetent children. Blood viral load predicts pneumonia severity.

scholarly journals Evaluation of Risk Factors for Exacerbations in Children with Adenoviral Pneumonia

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Na Xu ◽  
Peng Chen ◽  
Ying Wang
Keyword(s):  
Risk Factors ◽  
Disease Severity ◽  
Clinical Manifestations ◽  
Severe Pneumonia ◽  
Clinical Implications ◽  
Laboratory Findings ◽  
Severe Group ◽  
Adenovirus Pneumonia ◽  
The Difference ◽  
D Dimer

Purpose. The aim of this work was to analyze clinical features and laboratory findings of children with adenovirus pneumonia and guide clinical diagnosis, treatment, and assessment of disease severity. Material and Methods. Retrospective analysis of clinical data of 285 children with adenoviral pneumonia who were hospitalized in Wuhan Children’s Hospital from December 2018 to October 2019. According to the assessment criteria for severe pneumonia, it was divided into the severe group (92 cases) and the nonsevere group (193 cases). Collected clinical manifestations, complications, and laboratory test indicators in two groups of children and conducted all statistical analyses. Results. The risk of fever and wheezing was significantly higher in the severe group than in the nonsevere group. The difference was statistically significant (P<0.05). The risk of complications in the severe group was significantly higher than that in the nonsevere group. The difference was statistically significant (P<0.05). The levels of AST, LDH-L, PCT, ferritin, and D-dimer in the severe group were significantly higher than those in the nonsevere group. The difference was statistically significant (P<0.05). Conclusion. Children with severe adenovirus pneumonia have severe clinical manifestations and many complications. AST, LDH-L, PCT, ferritin, and D-dimer levels have important clinical implications for assessing disease severity.

scholarly journals Association of Mycoplasma pneumoniae coinfection with adenovirus pneumonia severity in children

2022 ◽  
Vol 50 (1) ◽  
pp. 31-36
Author(s):  
Jinfeng Wei ◽  
Suling Wu ◽  
Xuefeng Jin ◽  
Jie Zhang ◽  
Shanshan Pan
Keyword(s):  
Mycoplasma Pneumoniae ◽  
Southern China ◽  
Clinical Manifestations ◽  
Severe Illness ◽  
Imaging Findings ◽  
Pneumonia Severity ◽  
Number Of Children ◽  
Oxygen Inhalation ◽  
Pulmonary Imaging ◽  
Adenovirus Pneumonia

Between the winter of 2018 and the end of 2019, there has been an epidemic of adenovirus infection in southern China, including Zhejiang Province. The number of children suffering from adenovirus pneumonia (AP) has significantly increased. AP can be accompanied by Mycoplasma pneumoniae in children. This study aimed to investigate the association of M. pneumoniae and identify the risk factors for coinfection on hospitalized patients with AP. The patients were classified into two groups by etiologic analysis (single AP and AP with M. pneumoniae coinfection groups). The clinical manifestations, clinical medication, and laboratory and imaging findings of the two groups were compared and analyzed. The coinfection group (n = 125) had a significantly longer duration of fever than the single AP group (n = 171; P = 0.03). Shortness of breath (P = 0.023) and pulmonary imaging findings, such as pulmonary consolidation, atelectasis, pleural effusion, and multilobe lesions (P < 0.05), were more common in the coinfection group. The patients with coinfection had more severe symptoms, significantly longer hospitalization time and an increased proportion of using glucocorticoids and/or immunoglobulin needing oxygen inhalation (P < 0.05). The incidence of AP with M. pneumoniae coinfection is high. The prolonged fever duration and pulmonary imaging findings could be used as prediction factors to predict M. pneumoniae coinfection in children with AP. Patients with AP coinfected with MP may easily develop severe illness. Hence, a reasonable change in the treatment is necessary.

scholarly journals Analysis of Clinical Characteristics and Risk Factors of Plastic Bronchitis in Children With Mycoplasma pneumoniae Pneumonia

2021 ◽  
Vol 9 ◽  
Author(s):  
Haiqin Zhong ◽  
Rong Yin ◽  
Ran Zhao ◽  
Kun Jiang ◽  
Chao Sun ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Mycoplasma Pneumoniae ◽  
Clinical Characteristics ◽  
Univariate Analysis ◽  
Clinical Manifestations ◽  
Multivariate Logistic Regression Analysis ◽  
Plastic Bronchitis ◽  
Complement 3 ◽  
Strong Inflammatory Response

Objective: To analyze the clinical characteristics of plastic bronchitis (PB) in children with Mycoplasma pneumoniae pneumonia (MPP) in order to explore its risk factors.Methods: A retrospective analysis was performed in MPP children receiving bronchoscopy admitted to department of respiratory medicine in Shanghai Children's Hospital from January 2018 to December 2020. According to the bronchoscopic findings, the patients were divided into PB group and non-PB group. The clinical manifestations, laboratory examination, etiology, treatment methods and outcomes of the children were analyzed. Logistic regression was used to analyze the risk factors for PB in children with MPP.Results: A total of 296 children with MPP were enrolled in the study, including 42 (14.2%) children in the PB group and 254 (85.8%) children in the non-PB group. There was no difference in the ratios of gender, age, proportion of fever, cough, wet rales, and wheezing rales between the two groups (P &gt; 0.05). The univariate analysis showed that there were significant differences between the PB group and the non-PB group in LDH, D-dimer, CD3+CD4+(%), CD3+CD4+/CD3+CD8+, CD3 count, CD4 count, CD8 count, complement 3, IL8, IL-1β, IL-2, IL-10 (P &lt; 0.05). The multivariate logistic regression analysis showed that fever duration &gt; 12 d, IL-8 &gt; 2,721.33 pg/ml, LDH &gt; 482 U/L and complement 3 &lt;1.02 g/L were independent risk factors for PB in children with MPP.Conclusions: Children with PB caused by MPP have protracted fever, a strong inflammatory response and immune function disturbance.

scholarly journals Correlation of Cytomegalovirus (CMV) Disease Severity and Mortality With CMV Viral Burden in CMV-Seropositive Donor and CMV-Seronegative Solid Organ Transplant Recipients

2019 ◽  
Vol 6 (2) ◽  
Author(s):  
Jacqueline M McBride ◽  
Daniel Sheinson ◽  
Jenny Jiang ◽  
Nicholas Lewin-Koh ◽  
Barbara G Werner ◽  
...  
Keyword(s):  
Viral Load ◽  
Disease Severity ◽  
Quantitative Polymerase Chain Reaction ◽  
Solid Organ Transplantation ◽  
Area Under The Curve ◽  
World Health ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Viral Burden ◽  
Cmv Disease

Abstract Background The rate of cytomegalovirus (CMV) viral load increase and peak viral loads are associated with CMV disease in kidney and liver transplant recipients, but relationships to disease severity or mortality have not been shown. Methods Using stored serial serum specimens from renal (n = 59) and liver (n = 35) transplant recipients (D+R-; CMV-seropositive donors, CMV-seronegative recipients) from 2 prospective, randomized, controlled, interventional prophylaxis trials of CMV immune globulin (CMVIG), CMV viral load was measured using the COBAS quantitative polymerase chain reaction assay and the World Health Organization CMV standard. Patients with severe CMV-associated disease were classified according to trial definitions. Pairwise comparisons of mean viral load among deceased, surviving diseased, and nondiseased patients were analyzed by 2-way analysis of variance. To determine if viral load could predict mortality, receiver operating characteristic (ROC) curves were constructed using area under the curve (AUC) of the viral load and peak viral concentration (Vmax). Results Viral load (mean log10 [AUC], peak viral load [Vmax]) for patients with severe CMV disease was significantly higher compared with nondiseased patients (P &lt; .001). Similarly, higher viral burden was significantly associated with mortality (P &lt; .001). Viral load AUC and Vmax AUROCs for predicting mortality were 0.796 and 0.824, respectively, for renal patients, and 0.769 and 0.807, respectively, for liver patients. Conclusions Using specimens from studies preceding the antiviral prophylaxis era, CMV viral load was associated with severe CMV disease and death, supporting CMV viral load quantification as a proxy for CMV disease severity and disease-associated mortality end points in solid organ transplantation.

scholarly journals Biodistribution and serologic response in SARS-CoV-2 induced ARDS: A cohort study

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242917
Author(s):  
Tobias Schlesinger ◽  
Benedikt Weißbrich ◽  
Florian Wedekink ◽  
Quirin Notz ◽  
Johannes Herrmann ◽  
...  
Keyword(s):  
Intensive Care ◽  
Viral Load ◽  
Disease Severity ◽  
Quantitative Polymerase Chain Reaction ◽  
Antiviral Treatment ◽  
Antibody Detection ◽  
Enzyme Linked Immunosorbent Assay ◽  
Intensive Care Treatment ◽  
Blood Samples ◽  
Tracheal Aspirates

Background The viral load and tissue distribution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remain important questions. The current study investigated SARS-CoV-2 viral load, biodistribution and anti-SARS-CoV-2 antibody formation in patients suffering from severe corona virus disease 2019 (COVID-19) induced acute respiratory distress syndrome (ARDS). Methods This is a retrospective single-center study in 23 patients with COVID-19-induced ARDS. Data were collected within routine intensive care. SARS-CoV-2 viral load was assessed via reverse transcription quantitative polymerase chain reaction (RT-qPCR). Overall, 478 virology samples were taken. Anti-SARS-CoV-2-Spike-receptor binding domain (RBD) antibody detection of blood samples was performed with an enzyme-linked immunosorbent assay. Results Most patients (91%) suffered from severe ARDS during ICU treatment with a 30-day mortality of 30%. None of the patients received antiviral treatment. Tracheal aspirates tested positive for SARS-CoV-2 in 100% of the cases, oropharyngeal swabs only in 77%. Blood samples were positive in 26% of the patients. No difference of viral load was found in tracheal or blood samples with regard to 30-day survival or disease severity. SARS-CoV-2 was never found in dialysate. Serologic testing revealed significantly lower concentrations of SARS-CoV-2 neutralizing IgM and IgA antibodies in survivors compared to non-survivors (p = 0.009). Conclusions COVID-19 induced ARDS is accompanied by a high viral load of SARS-CoV-2 in tracheal aspirates, which remained detectable in the majority throughout intensive care treatment. Remarkably, SARS-CoV-2 RNA was never detected in dialysate even in patients with RNAemia. Viral load or the buildup of neutralizing antibodies was not associated with 30-day survival or disease severity.

scholarly journals Clinical characteristics and risk factors of Fulminant Mycoplasma pneumoniae pneumonia in children

2020 ◽  
Author(s):  
yaoyao ling ◽  
Tongqiang Zhang ◽  
Zhenli Zhu ◽  
Jiao Tian ◽  
yongsheng xu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pleural Effusion ◽  
Mycoplasma Pneumoniae ◽  
Clinical Characteristics ◽  
Laboratory Data ◽  
Clinical Manifestations ◽  
Multivariate Logistic Regression Analysis ◽  
Radiological Findings ◽  
Mycoplasma Pneumoniae Pneumonia ◽  
D Dimer

Abstract BACKGROUND: Analyze the clinical characteristics of Fulminant Mycoplasma pneumoniae pneumonia (FMPP), and explore the related factors predicting FMPP. METHODS: A retrospective case-control study was performed on 345 children with Mycoplasma pneumoniae pneumonia (MPP) hospitalized in our Hospital from January 2017 to June 2019. The clinical features, laboratory data and radiological findings were compared between the FMPP group, refractory Mycoplasma pneumoniae pneumonia (RMPP)group and general Mycoplasma pneumoniae pneumonia (GMPP) group. RESULTS: FMPP patients (n=69) had more severe presentations, higher incidence of extra-pulmonary complications and more serious radiological findings(P<0.05). And the days of fever and the days in hospital were longer, and FMPP patients also need more complicated treatments(P<0.05). Meanwhile, the levels of white blood cell count(WBC) ,C-reactive protein(CRP), lactic dehydrogenase (LDH), interleukin (IL)-6,ferritin, D-dimer, fibrinogen(FG),alanine aminotransferase(ALT) and the percentage of neutrophils in the FMPP group were significantly higher than those in the RMPP group and the GMPP group (both P<0.05). In ROC curve analysis, the percentage of neutrophils, WBC, CRP, LDH, IL-6, ferritin, D-dimer and ALT were contributed to identify FMPP patients. Multivariate logistic regression analysis showed that ferritin>174.15 ng/mL, IL-6>25.475pg/ml and pleural effusion had significant predictive effects on the early diagnosis of FMPP (P<0.01). Conclusion: FMPP patients presented more serious clinical manifestations. Ferritin>174.15 ng/mL, IL-6>25.475pg/ml and pleural effusion were high risk factors for FMPP.

scholarly journals 77. Long Term Care Facility Residents Hospitalized with COVID-19 Infection Present with Atypical Symptoms

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S169-S170
Author(s):  
Aurora E Pop-Vicas ◽  
Ambar Haleem ◽  
Fauzia Osman ◽  
Daniel Shirley ◽  
Robert Striker ◽  
...  
Keyword(s):  
Risk Factors ◽  
Long Term Care ◽  
Univariate Analysis ◽  
Clinical Manifestations ◽  
Care Facility ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Atypical Presentations

Abstract Background Fever and cough are frequently reported in COVID-19 infections, although little is known about the subgroup of symptomatic patients who do not manifest these classic symptoms. We aimed to compare clinical manifestations and outcomes for hospitalized COVID-19 patients with typical vs. atypical presentations and identify risk factors for atypical COVID-19 presentations. Methods We conducted a retrospective cohort of all patients hospitalized with laboratory-confirmed COVID-19 infections during 3/13- 5/13/2020 at UW Health, a network of 3 acute-care hospitals in Midwest. We defined atypical cases as patients hospitalized for COVID-19 related reasons presenting without fever and cough and compared them in univariate analysis with patients manifesting both symptoms (controls). We identified independent risk factors for atypical COVID-19 presentations by logistic regression. Results Among the 163 patients hospitalized during the 60-day study frame, 39 (24%) had atypical presentations. Table 1 shows demographic, clinical manifestations, and outcomes of atypical vs. typical cases. On univariate analysis, atypical cases were more likely to be older, reside in a long-term-care facility (LTCF), have underlying diabetes mellitus, stroke, cardiac disease, and deny myalgias or dyspnea, despite having no significant difference in the prevalence of hypoxia or radiological lung infiltrates. Atypical cases also had a significantly higher Beta-Natriuretic-Peptide and lower C-Reactive-Protein, although other inflammatory markers were not significantly different. They were less likely to be admitted to the ICU, and more likely to die within 30 days, as older patients with respiratory failure and multiple comorbidities opted for comfort measures and less aggressive care. On multivariate analysis, LTCF residence was the only independent predictor for atypical status (Table 2). Conclusion LTCF residents are more likely to experience COVID-19 respiratory illness (hypoxia, pneumonia) without classic symptoms (fever, cough, myalgias, dyspnea). Given the excessive pandemic burden in the LTCF setting, timely recognition and diagnosis of these atypical, more subtle presentations is critical. Disclosures All Authors: No reported disclosures

scholarly journals 483. Disease Severity and Clinical Manifestations of SARS-CoV-2 Infection Among Infants Over the First Year of the Pandemic in Canada

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S342-S343
Author(s):  
Pierre-Philippe Piché-Renaud ◽  
Luc Panetta ◽  
Daniel Farrar ◽  
Charlotte Moore Hepburn ◽  
Olivier Drouin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Disease Severity ◽  
Disease Risk ◽  
Severe Disease ◽  
Clinical Manifestations ◽  
Significant Risk ◽  
Age Group ◽  
Younger Age ◽  
The Impact ◽  
Research Grant

Abstract Background There is limited data on outcomes of SARS-CoV-2 infection among infants (&lt; 1 year of age). In the absence of any approved vaccines for infants, understanding the risk factors for hospitalization and severe disease from COVID-19 in this age group will help inform clinical management and targeted public health interventions. The objective of this study was to describe the clinical manifestations, disease severity, and risk factors for hospitalization among infants with SARS-CoV-2 infection in Canada. Methods This is a nationwide prospective observational study using the infrastructure of the Canadian Paediatric Surveillance Program. All cases of infants aged &lt; 1 year of age with microbiologically confirmed SARS-CoV-2 infection were reported from April 8th 2020 to May 11th 2021, and classified by disease severity, and primary cause of hospitalization. Logistic regression was performed to identify risk factors for hospitalization and severe disease. Results A total of 393 cases were reported, including 229 (58.3%) non-hospitalized and 164 (41.7%) hospitalized infants. The most common symptoms included fever (63.4%), runny nose (45.0%), cough (35.1%) and decreased oral intake (24.9%). Significant risk factors for hospitalization included younger age and presence of comorbid conditions (excluding prematurity), as shown in the Table. Among hospitalized infants, 108 (65.9%) were admitted because of COVID-19-related illness, and 52 (31.7%) were admitted for reasons other than COVID-19. A total of 31 (7.9%) infants developed severe or critical disease. Risk factors for severe disease included prematurity and younger age (Table). Conclusion We describe one of the largest cohort of infants with SARS-CoV-2 infection. Severe disease in this age group is uncommon, with younger age and prematurity being significant risk factors for severe COVID-19. Disclosures Pierre-Philippe Piché-Renaud, MD, Pfizer Global Medical Grants (Competitive grant program) (Research Grant or Support, Investigator-led project on the impact of COVID-19 on routine childhood immunizations) Olivier Drouin, MDCM MsC MPH, Covis Pharma (Research Grant or Support) Shaun Morris, MD, MPH, DTM&H, FRCPC, FAAP, GSK (Speaker’s Bureau)Pfizer (Advisor or Review Panel member)Pfizer (Grant/Research Support)

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