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Pavia AT. Clinical Manifestations and Outcomes of SARS-CoV-2 Infection in Children and Adolescents. Infect Dis Clin North Am 2025:S0891-5520(25)00023-6. [PMID: 40187944 DOI: 10.1016/j.idc.2025.02.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2025]
Abstract
Compared to adults, children are more likely to experience asymptomatic infections or mild-to-moderate symptoms of SARS-CoV-2 infection that resemble other viral infections. However, a substantial proportion of children experience severe disease; more than 2000 US children have died of COVID-19, significantly exceeding the death toll from influenza. Risk factors for severe disease include age less than 6 months and 12 to 17 years, as well as the presence of underlying conditions, especially 2 or more conditions. Multisystem inflammatory syndrome in children is a life-threatening post-infectious complication seen in children. Children experience post-acute sequelae of SARS-CoV-2 but at lower rates than adults.
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Affiliation(s)
- Andrew T Pavia
- Division of Pediatric Infectious Diseases, Departments of Pediatrics and Internal Medicine, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT 84112, USA.
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Adler AL, Waghmare A, Lacombe K, Dickerson JA, L. Greninger A, Briggs Hagen M, Pringle K, Fairlie T, Midgely CM, Englund JA. Seroprevalence of SARS-CoV-2 IgG antibodies in children seeking medical care in Seattle, WA June 2020 to December 2022. Microbiol Spectr 2025; 13:e0262524. [PMID: 40062892 PMCID: PMC11960482 DOI: 10.1128/spectrum.02625-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2024] [Accepted: 02/18/2025] [Indexed: 04/03/2025] Open
Abstract
Seroprevalence studies play an important role in estimating the number of children infected with SARS-CoV-2. We report SARS-CoV-2 seroprevalence in children seeking medical care for any reason at a free-standing pediatric hospital in Seattle, WA over a 2.5-year period and four distinct pandemic waves. We randomly selected residual serum samples from children and young adults seeking medical care as inpatients and outpatients at Seattle Children's Hospital between June 2020 and December 2022 to test for the presence of anti-nucleocapsid (N) antibodies. Samples were categorized into four distinct pandemic waves based on Washington State epidemiology: Wave 1 (June 2020-October 2020), Wave 2 (November 2020-June 2021), Wave 3 (July 2021-November 2021), and Wave 4 (December 2021-December 2022). Patient characteristics and COVID-19 vaccine status were obtained, and zip codes were used to ascertain the Social Vulnerability Index (SVI). Multivariable Poisson regression models with robust variance estimates were used to examine the relationship between patient characteristics and anti-N-positivity for each wave. Among 8,040 samples from 7,102 patients included in the analyses, seroprevalence rose from 2.4% (95% CI, 2.0%-3.1%) in Wave 1 to 25.5% (95% CI 23.3%-27.8%) in Wave 4 (following the Omicron surge). High SVI, Hispanic ethnicity, or use of government insurance was associated with increased anti-N positivity in most waves. We observed a steady increase in anti-N seroprevalence followed by a sharp increase after the Omicron surge in early 2022. Our data demonstrate the burden of COVID-19 on specific groups with health disparities within our region throughout the pandemic.IMPORTANCEOur results highlight the importance of seropositivity studies as essential tools to provide information on the incidence and prevalence of SARS-CoV-2 seropositivity. Our results also reinforce other reports demonstrating the inequitable burden of COVID-19 on groups with health disparities and that this inequitable burden continued to persist throughout the pandemic, even in a region with high adherence to COVID-19 mitigation efforts. It also highlights SVI's value in identifying communities that must be part of pandemic research, and public health and vaccination strategies.
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Affiliation(s)
- Amanda L. Adler
- Seattle Children’s Research Institute, Seattle, Washington, USA
| | - Alpana Waghmare
- Seattle Children’s Research Institute, Seattle, Washington, USA
- Department of Pediatrics, University of Washington, Seattle, Washington, USA
| | - Kirsten Lacombe
- Seattle Children’s Research Institute, Seattle, Washington, USA
| | - Jane A. Dickerson
- Seattle Children’s Research Institute, Seattle, Washington, USA
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA
| | - Alexander L. Greninger
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA
| | - Melissa Briggs Hagen
- Coronavirus and Other Respiratory Viruses Division, Centers for Disease Control and Prevention, Atlanta, USA
| | - Kimberly Pringle
- Coronavirus and Other Respiratory Viruses Division, Centers for Disease Control and Prevention, Atlanta, USA
| | - Tarayn Fairlie
- Coronavirus and Other Respiratory Viruses Division, Centers for Disease Control and Prevention, Atlanta, USA
| | - Claire M. Midgely
- Coronavirus and Other Respiratory Viruses Division, Centers for Disease Control and Prevention, Atlanta, USA
| | - Janet A. Englund
- Seattle Children’s Research Institute, Seattle, Washington, USA
- Department of Pediatrics, University of Washington, Seattle, Washington, USA
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Hatabah D, Gupta SL, Mantus G, Sullivan P, Heilman S, Camacho-Gonzalez A, Leake D, Le M, Griffiths M, Norwood C, Shih S, Korman R, Maziashvili G, Rees CA, Benedit L, Wynn BA, Suthar M, Vos MB, Wrammert J, Morris CR. Longitudinal Surveillance of COVID-19 Antibodies in Pediatric Healthcare Workers. Vaccines (Basel) 2025; 13:163. [PMID: 40006710 PMCID: PMC11861628 DOI: 10.3390/vaccines13020163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2024] [Revised: 01/27/2025] [Accepted: 02/05/2025] [Indexed: 02/27/2025] Open
Abstract
Background: Vaccines against COVID-19 target the spike protein. There is minimal information on longitudinal COVID-19 immune profiling in recovered versus naïve and vaccinated versus non-vaccinated healthcare workers (HCWs). Methods: This is a prospective longitudinal observational cohort of pediatric HCWs (pHCWs) conducted during 2020-2022 at an academic center, exploring the impact of COVID-19 vaccination on immunoglobulin G (IgG) antibody titers over time and cross-reactivity with other coronaviruses, including SARS-CoV-1, MERS-CoV, and seasonal coronaviruses (HCoV-HKU1 and HCoV-OC43). Results: A total of 642 pHCWs initially enrolled, and 337 participants had repeat IgG titers measured post-vaccine and post-booster. Most participants were female, median age range of 31-40 years. Anti-spike was higher in all vaccinated individuals versus non-vaccinated (p < 0.0001) and naïve versus infected (p < 0.0001). A single dose of vaccine was sufficient to attain maximum titers in recovered participants versus naïve who received both doses of vaccine. Anti-spike titers dropped significantly at 9 months after the primary series, whereas sustained anti-spike titers were observed at 9 months post-booster. Conclusions: All vaccinated pHCWs developed antibodies to spike. COVID-19 infection and/or vaccination yielded antibodies that cross-reacted to SARS-CoV-1, MERS-CoV, HCoV-HKU1, and HCoV-OC43. Anti-spike titers were more durable post-booster compared to the primary series. Longitudinal immune profiling of COVID-19 responses provides vital data to shape public health policies, optimize vaccine strategies, and strengthen pandemic preparedness.
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Affiliation(s)
- Dunia Hatabah
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA; (D.H.); (S.L.G.); (G.M.); (S.H.); (A.C.-G.); (M.L.); (M.G.); (C.N.); (S.S.); (R.K.); (G.M.); (C.A.R.); (B.A.W.); (M.S.); (M.B.V.); (J.W.)
| | - Sneh Lata Gupta
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA; (D.H.); (S.L.G.); (G.M.); (S.H.); (A.C.-G.); (M.L.); (M.G.); (C.N.); (S.S.); (R.K.); (G.M.); (C.A.R.); (B.A.W.); (M.S.); (M.B.V.); (J.W.)
| | - Grace Mantus
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA; (D.H.); (S.L.G.); (G.M.); (S.H.); (A.C.-G.); (M.L.); (M.G.); (C.N.); (S.S.); (R.K.); (G.M.); (C.A.R.); (B.A.W.); (M.S.); (M.B.V.); (J.W.)
- Center for Childhood Infections and Vaccines of Children’s Healthcare of Atlanta and Emory University, Atlanta, GA 30322, USA
| | - Patrick Sullivan
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30329, USA;
| | - Stacy Heilman
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA; (D.H.); (S.L.G.); (G.M.); (S.H.); (A.C.-G.); (M.L.); (M.G.); (C.N.); (S.S.); (R.K.); (G.M.); (C.A.R.); (B.A.W.); (M.S.); (M.B.V.); (J.W.)
| | - Andres Camacho-Gonzalez
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA; (D.H.); (S.L.G.); (G.M.); (S.H.); (A.C.-G.); (M.L.); (M.G.); (C.N.); (S.S.); (R.K.); (G.M.); (C.A.R.); (B.A.W.); (M.S.); (M.B.V.); (J.W.)
- Center for Childhood Infections and Vaccines of Children’s Healthcare of Atlanta and Emory University, Atlanta, GA 30322, USA
- Children’s Healthcare of Atlanta, Atlanta, GA 30329, USA; (D.L.); (L.B.)
| | - Deborah Leake
- Children’s Healthcare of Atlanta, Atlanta, GA 30329, USA; (D.L.); (L.B.)
| | - Mimi Le
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA; (D.H.); (S.L.G.); (G.M.); (S.H.); (A.C.-G.); (M.L.); (M.G.); (C.N.); (S.S.); (R.K.); (G.M.); (C.A.R.); (B.A.W.); (M.S.); (M.B.V.); (J.W.)
| | - Mark Griffiths
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA; (D.H.); (S.L.G.); (G.M.); (S.H.); (A.C.-G.); (M.L.); (M.G.); (C.N.); (S.S.); (R.K.); (G.M.); (C.A.R.); (B.A.W.); (M.S.); (M.B.V.); (J.W.)
- Children’s Healthcare of Atlanta, Atlanta, GA 30329, USA; (D.L.); (L.B.)
| | - Carson Norwood
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA; (D.H.); (S.L.G.); (G.M.); (S.H.); (A.C.-G.); (M.L.); (M.G.); (C.N.); (S.S.); (R.K.); (G.M.); (C.A.R.); (B.A.W.); (M.S.); (M.B.V.); (J.W.)
- Center for Childhood Infections and Vaccines of Children’s Healthcare of Atlanta and Emory University, Atlanta, GA 30322, USA
| | - Samuel Shih
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA; (D.H.); (S.L.G.); (G.M.); (S.H.); (A.C.-G.); (M.L.); (M.G.); (C.N.); (S.S.); (R.K.); (G.M.); (C.A.R.); (B.A.W.); (M.S.); (M.B.V.); (J.W.)
- Center for Childhood Infections and Vaccines of Children’s Healthcare of Atlanta and Emory University, Atlanta, GA 30322, USA
| | - Rawan Korman
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA; (D.H.); (S.L.G.); (G.M.); (S.H.); (A.C.-G.); (M.L.); (M.G.); (C.N.); (S.S.); (R.K.); (G.M.); (C.A.R.); (B.A.W.); (M.S.); (M.B.V.); (J.W.)
| | - Giorgi Maziashvili
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA; (D.H.); (S.L.G.); (G.M.); (S.H.); (A.C.-G.); (M.L.); (M.G.); (C.N.); (S.S.); (R.K.); (G.M.); (C.A.R.); (B.A.W.); (M.S.); (M.B.V.); (J.W.)
| | - Chris A. Rees
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA; (D.H.); (S.L.G.); (G.M.); (S.H.); (A.C.-G.); (M.L.); (M.G.); (C.N.); (S.S.); (R.K.); (G.M.); (C.A.R.); (B.A.W.); (M.S.); (M.B.V.); (J.W.)
- Children’s Healthcare of Atlanta, Atlanta, GA 30329, USA; (D.L.); (L.B.)
| | - Laura Benedit
- Children’s Healthcare of Atlanta, Atlanta, GA 30329, USA; (D.L.); (L.B.)
| | - Bridget A. Wynn
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA; (D.H.); (S.L.G.); (G.M.); (S.H.); (A.C.-G.); (M.L.); (M.G.); (C.N.); (S.S.); (R.K.); (G.M.); (C.A.R.); (B.A.W.); (M.S.); (M.B.V.); (J.W.)
| | - Mehul Suthar
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA; (D.H.); (S.L.G.); (G.M.); (S.H.); (A.C.-G.); (M.L.); (M.G.); (C.N.); (S.S.); (R.K.); (G.M.); (C.A.R.); (B.A.W.); (M.S.); (M.B.V.); (J.W.)
- Center for Childhood Infections and Vaccines of Children’s Healthcare of Atlanta and Emory University, Atlanta, GA 30322, USA
| | - Miriam B. Vos
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA; (D.H.); (S.L.G.); (G.M.); (S.H.); (A.C.-G.); (M.L.); (M.G.); (C.N.); (S.S.); (R.K.); (G.M.); (C.A.R.); (B.A.W.); (M.S.); (M.B.V.); (J.W.)
- Children’s Healthcare of Atlanta, Atlanta, GA 30329, USA; (D.L.); (L.B.)
- Center for Clinical and Translational Research of Children’s Healthcare of Atlanta and Emory University, Atlanta, GA 30322, USA
| | - Jens Wrammert
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA; (D.H.); (S.L.G.); (G.M.); (S.H.); (A.C.-G.); (M.L.); (M.G.); (C.N.); (S.S.); (R.K.); (G.M.); (C.A.R.); (B.A.W.); (M.S.); (M.B.V.); (J.W.)
- Center for Childhood Infections and Vaccines of Children’s Healthcare of Atlanta and Emory University, Atlanta, GA 30322, USA
| | - Claudia R. Morris
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA; (D.H.); (S.L.G.); (G.M.); (S.H.); (A.C.-G.); (M.L.); (M.G.); (C.N.); (S.S.); (R.K.); (G.M.); (C.A.R.); (B.A.W.); (M.S.); (M.B.V.); (J.W.)
- Children’s Healthcare of Atlanta, Atlanta, GA 30329, USA; (D.L.); (L.B.)
- Center for Clinical and Translational Research of Children’s Healthcare of Atlanta and Emory University, Atlanta, GA 30322, USA
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Wang-Erickson AF, Zhang X, Dauer K, Zerr DM, Adler A, Englund JA, Lee B, Schuster JE, Selvarangan R, Rohlfs C, Staat MA, Sahni LC, Boom JA, Balasubramani GK, Williams JV, Michaels MG. Prevalence of SARS-CoV-2 in Children Identified by Preprocedural Testing at 5 US Children's Hospital Systems. Pediatr Infect Dis J 2025; 44:47-53. [PMID: 39298522 PMCID: PMC11661921 DOI: 10.1097/inf.0000000000004547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/21/2024]
Abstract
BACKGROUND The burden of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in asymptomatic children was initially presumed to be high, which influenced hospital, school and childcare policies. Before vaccines were widely available, some hospitals implemented universal preprocedural SARS-CoV-2 polymerase chain reaction testing on asymptomatic patients. Understanding SARS-CoV-2 prevalence in asymptomatic children is needed to illuminate the diversity of viral characteristics and inform policies implemented during future pandemics. METHODS Data were extracted from patient records of outpatient children who were preprocedurally tested for SARS-CoV-2 from 5 US hospital systems between March 1, 2020, and February 28, 2021. Prevalence was determined from positive test results. Adjusted odds ratios (AORs) were calculated using mixed logistic regression with the site as a random effect. RESULTS This study analyzed 93,760 preprocedural SARS-CoV-2 test results from 74,382 patients and found 2693 infections (3.6%) from 2889 positive tests (3.1%). Site-specific prevalence varied across sites. Factors modestly associated with infection included being uninsured [AOR, 1.76 (95% confidence interval [CI], 1.45-2.13)], publicly insured [AOR, 1.17 (95% CI, 1.05-1.30)], Hispanic [AOR, 1.78 (95% CI, 1.59-1.99)], Black [AOR, 1.22 (95% CI, 1.06-1.39)], elementary school age [5-11 years; AOR, 1.15 (95% CI, 1.03-1.28)], or adolescent [12-17 years; AOR, 1.26 (95% CI, 1.13-1.41)]. CONCLUSIONS SARS-CoV-2 prevalence was low in outpatient children undergoing preprocedural testing, a population that was predominantly asymptomatic at the time of testing. This study contributes evidence that suggests that undetected infection in children likely did not play a predominant role in SARS-CoV-2 transmission during the early prevaccine pandemic period when the general population was naive to the virus.
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Affiliation(s)
- Anna F. Wang-Erickson
- Department of Pediatrics, Division of Infectious Diseases, University of Pittsburgh School of Medicine; UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA
- Institute for Infection, Inflammation, and Immunity in Children (i4Kids), Pittsburgh, PA
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA
| | - Xueyan Zhang
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA
| | - Klancie Dauer
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA
| | - Danielle M. Zerr
- Department of Pediatrics, University of Washington and Seattle Children’s Hospital, Seattle, WA
| | - Amanda Adler
- Department of Pediatrics, University of Washington and Seattle Children’s Hospital, Seattle, WA
| | - Janet A. Englund
- Department of Pediatrics, University of Washington and Seattle Children’s Hospital, Seattle, WA
| | - Brian Lee
- Department of Pediatrics, Children’s Mercy Hospital, Kansas City, MO
| | | | - Rangaraj Selvarangan
- Department of Pathology and Laboratory Medicine, Children’s Mercy Hospital, Kansas City, MO
| | - Chelsea Rohlfs
- Department of Pediatrics, University of Cincinnati, Division of Infectious Diseases, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Mary A. Staat
- Department of Pediatrics, University of Cincinnati, Division of Infectious Diseases, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Leila C. Sahni
- Texas Children’s Hospital and Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Julie A. Boom
- Texas Children’s Hospital and Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - G. K. Balasubramani
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA
| | - John V. Williams
- Department of Pediatrics, Division of Infectious Diseases, University of Pittsburgh School of Medicine; UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA
- Institute for Infection, Inflammation, and Immunity in Children (i4Kids), Pittsburgh, PA
| | - Marian G. Michaels
- Department of Pediatrics, Division of Infectious Diseases, University of Pittsburgh School of Medicine; UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA
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Choi WJ, Lee J, Choi K, Kim DM, Han N, Choi JH, Jung J, Lee H, Choi JY, Choi YJ, Eom HS, Chun JY, Lee E. Outcomes of hematopoietic stem cell transplantation in patients with SARS-CoV-2 infection during the Omicron era. Int J Infect Dis 2024; 147:107207. [PMID: 39147195 DOI: 10.1016/j.ijid.2024.107207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2024] [Revised: 08/02/2024] [Accepted: 08/06/2024] [Indexed: 08/17/2024] Open
Abstract
Here, we present the outcomes of four patients with COVID-19 who underwent hematopoietic stem cell transplantation (HSCT) at the National Cancer Center in South Korea. Despite concerns about the unfavorable course of COVID-19 in HSCT recipients, none of our patients experienced severe COVID-19. Moreover, extended viral shedding in case 1, lasting over 100 days, was resolved after successful engraftment. Contracting the virus when the host could not mount enough of an immune reaction might result in a paradoxically favorable course. Vaccination, monoclonal antibodies, and antiviral agent usage against COVID-19 might also be effective. We suggest, if necessary, HSCT should not be deferred in COVID-19 patients.
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Affiliation(s)
- Won Jun Choi
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jinhong Lee
- Infection Control Unit, National Cancer Center, Goyang, Republic of Korea
| | - Kowoon Choi
- Infection Control Unit, National Cancer Center, Goyang, Republic of Korea
| | - Dong Mi Kim
- Infection Control Unit, National Cancer Center, Goyang, Republic of Korea
| | - Nayoung Han
- Department of Pathology, National Cancer Center Hospital, National Cancer Center, Goyang, Republic of Korea
| | - Jin-Ho Choi
- Department of Thoracic Surgery, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea
| | - Jongheon Jung
- Department of Hematology-Oncology, Center for Hematologic Malignancy, National Cancer Center, Goyang, Republic of Korea
| | - Hyewon Lee
- Department of Hematology-Oncology, Center for Hematologic Malignancy, National Cancer Center, Goyang, Republic of Korea
| | - Jun Yong Choi
- Division of Infectious Diseases, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young Ju Choi
- Division of Infectious Disease, Department of Internal Medicine, National Cancer Center, Goyang, Republic of Korea
| | - Hyeon-Seok Eom
- Department of Hematology-Oncology, Center for Hematologic Malignancy, National Cancer Center, Goyang, Republic of Korea
| | - June Young Chun
- Division of Infectious Disease, Department of Internal Medicine, National Cancer Center, Goyang, Republic of Korea
| | - Eunyoung Lee
- Department of Hematology-Oncology, Center for Hematologic Malignancy, National Cancer Center, Goyang, Republic of Korea.
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Silva MFBD, Guaraldo L, Santos HFP, Bastos LS, Pina-Costa AD, Penetra SLS, Moraes ICVD, Calvet GA, Fuller TL, Silva PCR, Siqueira MAMTD, Brasil P. Cohort profile: follow-up of a household cohort throughout five epidemic waves of SARS-CoV-2 in Rio de Janeiro, Brazil. CAD SAUDE PUBLICA 2024; 40:e00152023. [PMID: 39194089 DOI: 10.1590/0102-311xen152023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 04/04/2024] [Indexed: 08/29/2024] Open
Abstract
Since May 2020, we have been conducting a comprehensive study to understand the natural history of SARS-CoV-2 infection in Rio de Janeiro, Brazil. Our focus has been on following families, systematically collecting respiratory tract swabs and blood samples, monitoring symptoms, and gathering data on vaccine status. This paper aims to describe the household cohort across five epidemic waves of SARS-CoV-2, providing an overview of the collected data and a description of the epidemiological, clinical, and immunological characteristics and incidence of SARS-CoV-2 infection. Our cohort includes 691 participants from 189 households. During the five epidemic waves, we detected 606 infections. The incidence density of SARS-CoV-2 infection ranged from 4 (Delta) to 56 (B.1.1.33) per 1,000 person-week, with a peak in wave B.1.1.33 in all age groups. The seroprevalence of SARS-CoV-2 antibodies (IgG anti spike protein) varied from 37%, in the pre-VoC period, to 99%, in the Omicron period, progressively increasing after each wave in a similar manner regardless of age. As we have monitored the cohort continuously since the beginning of the pandemic, we were able to collect data across different scenarios according to the predominant lineage in circulation. Via active monitoring of families, we were able to carry out an epidemiological surveillance on SARS-CoV-2, including its variants, persistence of symptoms, and changes in immunity over time in the population, contributing to knowledge of the natural history of SARS-CoV-2 infection.
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Affiliation(s)
| | - Lusiele Guaraldo
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | | | | | - Anielle de Pina-Costa
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | | | | | - Guilherme Amaral Calvet
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | | | | | | | - Patricia Brasil
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
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Watson LM, Plank MJ, Armstrong BA, Chapman JR, Hewitt J, Morris H, Orsi A, Bunce M, Donnelly CA, Steyn N. Jointly estimating epidemiological dynamics of Covid-19 from case and wastewater data in Aotearoa New Zealand. COMMUNICATIONS MEDICINE 2024; 4:143. [PMID: 39009723 PMCID: PMC11250817 DOI: 10.1038/s43856-024-00570-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 07/04/2024] [Indexed: 07/17/2024] Open
Abstract
BACKGROUND Timely and informed public health responses to infectious diseases such as COVID-19 necessitate reliable information about infection dynamics. The case ascertainment rate (CAR), the proportion of infections that are reported as cases, is typically much less than one and varies with testing practices and behaviours, making reported cases unreliable as the sole source of data. The concentration of viral RNA in wastewater samples provides an alternate measure of infection prevalence that is not affected by clinical testing, healthcare-seeking behaviour or access to care. METHODS We construct a state-space model with observed data of levels of SARS-CoV-2 in wastewater and reported case incidence and estimate the hidden states of the effective reproduction number, R, and CAR using sequential Monte Carlo methods. RESULTS We analyse data from 1 January 2022 to 31 March 2023 from Aotearoa New Zealand. Our model estimates that R peaks at 2.76 (95% CrI 2.20, 3.83) around 18 February 2022 and the CAR peaks around 12 March 2022. We calculate that New Zealand's second Omicron wave in July 2022 is similar in size to the first, despite fewer reported cases. We estimate that the CAR in the BA.5 Omicron wave in July 2022 is approximately 50% lower than in the BA.1/BA.2 Omicron wave in March 2022. CONCLUSIONS Estimating R, CAR, and cumulative number of infections provides useful information for planning public health responses and understanding the state of immunity in the population. This model is a useful disease surveillance tool, improving situational awareness of infectious disease dynamics in real-time.
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Affiliation(s)
- Leighton M Watson
- School of Mathematics and Statistics, University of Canterbury, Christchurch, New Zealand.
| | - Michael J Plank
- School of Mathematics and Statistics, University of Canterbury, Christchurch, New Zealand
| | | | - Joanne R Chapman
- Institute of Environmental Science and Research Ltd, Porirua, New Zealand
| | - Joanne Hewitt
- Institute of Environmental Science and Research Ltd, Porirua, New Zealand
| | - Helen Morris
- Institute of Environmental Science and Research Ltd, Porirua, New Zealand
| | - Alvaro Orsi
- Institute of Environmental Science and Research Ltd, Porirua, New Zealand
| | - Michael Bunce
- Institute of Environmental Science and Research Ltd, Porirua, New Zealand
| | - Christl A Donnelly
- Department of Statistics, University of Oxford, Oxford, United Kingdom
- Pandemic Sciences Institute, University of Oxford, Oxford, United Kingdom
| | - Nicholas Steyn
- Department of Statistics, University of Oxford, Oxford, United Kingdom
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8
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Powell AA, Dowell AC, Moss P, Ladhani SN. Current state of COVID-19 in children: 4 years on. J Infect 2024; 88:106134. [PMID: 38432584 DOI: 10.1016/j.jinf.2024.106134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 02/28/2024] [Indexed: 03/05/2024]
Abstract
Children have been disproportionately affected by the COVID-19 pandemic. Despite evidence of a very low risk of severe disease, children were subjected to extensive lockdown, restriction and mitigation measures, including school closures, to control the rapid spread of SARS-CoV-2 in most parts of the world. In this review we summarise the UK experience of COVID-19 in children four years into the largest and longest pandemic of this century. We address the risks of SARS-CoV-2 infection, immunity, transmission, severity and outcomes in children. We also assess the implementation, uptake, effectiveness and impact of COVID-19 vaccination, as well as the emergence, evolution and near disappearance of PIMS-TS (paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2) and current understanding of long COVID in children. This review consolidates current knowledge on childhood COVID-19 and emphasises the importance of continued research and the need for research-driven public health actions and policy decisions, especially in the context of new variants and future vaccines.
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Affiliation(s)
- Annabel A Powell
- Public Health Programmes, UK Health Security Agency, London, UK.
| | - Alexander C Dowell
- Institute of Immunology & Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Paul Moss
- Institute of Immunology & Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Shamez N Ladhani
- Public Health Programmes, UK Health Security Agency, London, UK; Paediatric Infectious Diseases Research Group, St. George's University of London, London, UK
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9
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Major CG, Rodríguez DM, Sánchez-González L, Rodríguez-Estrada V, Morales-Ortíz T, Torres C, Pérez-Rodríguez NM, Medina-Lópes NA, Alexander N, Mabey D, Ryff K, Tosado-Acevedo R, Muñoz-Jordán J, Adams LE, Rivera-Amill V, Rolfes M, Paz-Bailey G. Investigating SARS-CoV-2 Incidence and Morbidity in Ponce, Puerto Rico: Protocol and Baseline Results From a Community Cohort Study. JMIR Res Protoc 2024; 13:e53837. [PMID: 38640475 PMCID: PMC11034577 DOI: 10.2196/53837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 01/19/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND A better understanding of SARS-CoV-2 infection risk among Hispanic and Latino populations and in low-resource settings in the United States is needed to inform control efforts and strategies to improve health equity. Puerto Rico has a high poverty rate and other population characteristics associated with increased vulnerability to COVID-19, and there are limited data to date to determine community incidence. OBJECTIVE This study describes the protocol and baseline seroprevalence of SARS-CoV-2 in a prospective community-based cohort study (COPA COVID-19 [COCOVID] study) to investigate SARS-CoV-2 infection incidence and morbidity in Ponce, Puerto Rico. METHODS In June 2020, we implemented the COCOVID study within the Communities Organized to Prevent Arboviruses project platform among residents of 15 communities in Ponce, Puerto Rico, aged 1 year or older. Weekly, participants answered questionnaires on acute symptoms and preventive behaviors and provided anterior nasal swab samples for SARS-CoV-2 polymerase chain reaction testing; additional anterior nasal swabs were collected for expedited polymerase chain reaction testing from participants that reported 1 or more COVID-19-like symptoms. At enrollment and every 6 months during follow-up, participants answered more comprehensive questionnaires and provided venous blood samples for multiantigen SARS-CoV-2 immunoglobulin G antibody testing (an indicator of seroprevalence). Weekly follow-up activities concluded in April 2022 and 6-month follow-up visits concluded in August 2022. Primary study outcome measures include SARS-CoV-2 infection incidence and seroprevalence, relative risk of SARS-CoV-2 infection by participant characteristics, SARS-CoV-2 household attack rate, and COVID-19 illness characteristics and outcomes. In this study, we describe the characteristics of COCOVID participants overall and by SARS-CoV-2 seroprevalence status at baseline. RESULTS We enrolled a total of 1030 participants from 388 households. Relative to the general populations of Ponce and Puerto Rico, our cohort overrepresented middle-income households, employed and middle-aged adults, and older children (P<.001). Almost all participants (1021/1025, 99.61%) identified as Latino/a, 17.07% (175/1025) had annual household incomes less than US $10,000, and 45.66% (463/1014) reported 1 or more chronic medical conditions. Baseline SARS-CoV-2 seroprevalence was low (16/1030, 1.55%) overall and increased significantly with later study enrollment time (P=.003). CONCLUSIONS The COCOVID study will provide a valuable opportunity to better estimate the burden of SARS-CoV-2 and associated risk factors in a primarily Hispanic or Latino population, assess the limitations of surveillance, and inform mitigation measures in Puerto Rico and other similar populations. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR1-10.2196/53837.
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Affiliation(s)
- Chelsea G Major
- Division of Vector Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Dania M Rodríguez
- Division of Vector Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Liliana Sánchez-González
- Division of Vector Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | | | | | - Carolina Torres
- Division of Vector Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico
- Kāpili Services, LLC, Alaka`ina Foundation Family of Companies, Orlando, FL, United States
| | - Nicole M Pérez-Rodríguez
- Division of Vector Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Nicole A Medina-Lópes
- Division of Vector Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Neal Alexander
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - David Mabey
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Kyle Ryff
- Division of Vector Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Rafael Tosado-Acevedo
- Division of Vector Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Jorge Muñoz-Jordán
- Division of Vector Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Laura E Adams
- Division of Vector Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | | | - Melissa Rolfes
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Gabriela Paz-Bailey
- Division of Vector Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico
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10
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Klee B, Diexer S, Horn J, Langer S, Wende M, Ortiz D, Bielecka A, Strowig T, Mikolajczyk R, Gottschick C. The impact of non-pharmaceutical interventions on community non-SARS-CoV-2 respiratory infections in preschool children. BMC Pediatr 2024; 24:231. [PMID: 38561704 PMCID: PMC10985994 DOI: 10.1186/s12887-024-04686-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 03/02/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Effects of non-pharmaceutical interventions during the pandemic were mainly studied for severe outcomes. Among children, most of the burden of respiratory infections is related to infections which are not medically attended. The perspective on infections in the community setting is necessary to understand the effects of the pandemic on non-pharmaceutical interventions. METHODS In the unique prospective LoewenKIDS cohort study, we compared the true monthly incidence of self-reported acute respiratory infections (ARI) in about 350 participants (aged 3-4 years old) between October 2019 to March 2020 (pre-pandemic period) and October 2020 to March 2021 (pandemic period). Parents reported children's symptoms using a diary. Parents were asked to take a nasal swab of their child during all respiratory symptoms. We analysed 718 swabs using Multiplex PCR for 25 common respiratory viruses and bacteria. RESULTS During the pre-pandemic period, on average 44.6% (95% CI: 39.5-49.8%) of children acquired at least one ARI per month compared to 19.9% (95% CI: 11.1-28.7%) during the pandemic period (Incidence Rate Ratio = 0.47; 95% CI: 0.41-0.54). The detection of influenza virus decreased absolute by 96%, respiratory syncytial virus by 65%, metapneumovirus by 95%, parainfluenza virus by 100%, human enterovirus by 96% and human bocavirus by 70% when comparing the pre-pandemic to the pandemic period. However, rhinoviruses were nearly unaffected by NPI. Co-detection (detection of more than one virus in a single symptomatic swab) was common in the pre-pandemic period (222 of 390 samples with viral detection; 56.9%) and substantially less common during the pandemic period (46 of 216 samples; 21.3%). CONCLUSION Non-pharmaceutical interventions strongly reduced the incidence of all respiratory infections in preschool children but did not affect rhinovirus.
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Affiliation(s)
- Bianca Klee
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Sophie Diexer
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Johannes Horn
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Susan Langer
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Marie Wende
- Helmholtz Centre for Infection Research, Braunschweig, Germany
- German Centre for Infection Research (DZIF), Partner Site Hannover-Braunschweig, Braunschweig, Germany
| | - Diego Ortiz
- Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Agata Bielecka
- Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Till Strowig
- Helmholtz Centre for Infection Research, Braunschweig, Germany
- German Centre for Infection Research (DZIF), Partner Site Hannover-Braunschweig, Braunschweig, Germany
- Hannover Medical School, Cluster of Excellence RESIST (EXC 2155), Hannover, Germany
| | - Rafael Mikolajczyk
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
- Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Cornelia Gottschick
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
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11
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Emanuels A, Casto AM, Heimonen J, O'Hanlon J, Chow EJ, Ogokeh C, Rolfes MA, Han PD, Hughes JP, Uyeki TM, Frazar C, Chung E, Starita LM, Englund JA, Chu HY. Remote surveillance and detection of SARS-CoV-2 transmission among household members in King County, Washington. BMC Infect Dis 2024; 24:309. [PMID: 38481147 PMCID: PMC10936024 DOI: 10.1186/s12879-024-09160-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 02/21/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Early during the COVID-19 pandemic, it was important to better understand transmission dynamics of SARS-CoV-2, the virus that causes COVID-19. Household contacts of infected individuals are particularly at risk for infection, but delays in contact tracing, delays in testing contacts, and isolation and quarantine posed challenges to accurately capturing secondary household cases. METHODS In this study, 346 households in the Seattle region were provided with respiratory specimen collection kits and remotely monitored using web-based surveys for respiratory illness symptoms weekly between October 1, 2020, and June 20, 2021. Symptomatic participants collected respiratory specimens at symptom onset and mailed specimens to the central laboratory in Seattle. Specimens were tested for SARS-CoV-2 using RT-PCR with whole genome sequencing attempted when positive. SARS-CoV-2-infected individuals were notified, and their household contacts submitted specimens every 2 days for 14 days. RESULTS In total, 1371 participants collected 2029 specimens that were tested; 16 individuals (1.2%) within 6 households tested positive for SARS-CoV-2 during the study period. Full genome sequences were generated from 11 individuals within 4 households. Very little genetic variation was found among SARS-CoV-2 viruses sequenced from different individuals in the same household, supporting transmission within the household. CONCLUSIONS This study indicates web-based surveillance of respiratory symptoms, combined with rapid and longitudinal specimen collection and remote contact tracing, provides a viable strategy to monitor households and detect household transmission of SARS-CoV-2. TRIAL REGISTRATION IDENTIFIER NCT04141930, Date of registration 28/10/2019.
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Affiliation(s)
- Anne Emanuels
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, UW Medicine Box 358061, Chu Lab Room E630, 750 Republican Street, Seattle, WA, 98109, USA
| | - Amanda M Casto
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, UW Medicine Box 358061, Chu Lab Room E630, 750 Republican Street, Seattle, WA, 98109, USA
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Jessica Heimonen
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, UW Medicine Box 358061, Chu Lab Room E630, 750 Republican Street, Seattle, WA, 98109, USA
| | - Jessica O'Hanlon
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, UW Medicine Box 358061, Chu Lab Room E630, 750 Republican Street, Seattle, WA, 98109, USA
| | - Eric J Chow
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, UW Medicine Box 358061, Chu Lab Room E630, 750 Republican Street, Seattle, WA, 98109, USA
| | - Constance Ogokeh
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Melissa A Rolfes
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Peter D Han
- Brotman Baty Institute for Precision Medicine, Seattle, Washington, USA
- Department of Genome Sciences, University of Washington, Seattle, Washington, USA
| | - James P Hughes
- Department of Biostatistics, University of Washington, Seattle, Washington, USA
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Timothy M Uyeki
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Christian Frazar
- Department of Genome Sciences, University of Washington, Seattle, Washington, USA
| | - Erin Chung
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, UW Medicine Box 358061, Chu Lab Room E630, 750 Republican Street, Seattle, WA, 98109, USA
| | - Lea M Starita
- Brotman Baty Institute for Precision Medicine, Seattle, Washington, USA
- Department of Genome Sciences, University of Washington, Seattle, Washington, USA
| | - Janet A Englund
- Seattle Children's Research Institute, Seattle, Washington, USA
| | - Helen Y Chu
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, UW Medicine Box 358061, Chu Lab Room E630, 750 Republican Street, Seattle, WA, 98109, USA.
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12
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Kulkarni D, Ismail NF, Zhu F, Wang X, del Carmen Morales G, Srivastava A, Allen KE, Spinardi J, Rahman AE, Kyaw MH, Nair H. Epidemiology and clinical features of SARS-CoV-2 infection in children and adolescents in the pre-Omicron era: A global systematic review and meta-analysis. J Glob Health 2024; 14:05003. [PMID: 38419461 PMCID: PMC10902805 DOI: 10.7189/jogh.14.05003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024] Open
Abstract
Methods We searched MEDLINE, Embase, Global Health, CINAHL, China National Knowledge Infrastructure, Wanfang, CQvip, and the World Health Organization (WHO) COVID-19 global literature databases for primary studies recruiting children aged ≤18 years with a diagnosis of SARS-CoV-2 infection confirmed either by molecular or antigen tests. We used the Joanna Briggs Institute critical appraisal tools to appraise the study quality and conducted meta-analyses using the random effects model for all outcomes except for race/ethnicity as risk factors of SARS-CoV-2 infection. Results We included 237 studies, each reporting at least one of the study outcomes. Based on data from 117 studies, the pooled SARS-CoV-2 positivity rate was 9.30% (95% confidence interval (CI) = 7.15-11.73). Having a comorbidity was identified as a risk factor for SARS-CoV-2 infection (risk ratio (RR) = 1.33; 95% CI = 1.04-1.71) based on data from 49 studies. Most cases in this review presented with mild disease (n = 50; 52.47% (95% CI = 44.03-60.84)). However, 20.70% of paediatric SARS-CoV-2 infections were hospitalised (67 studies), 7.19% required oxygen support (57 studies), 4.26% required intensive care (93 studies), and 2.92% required assisted ventilation (63 studies). The case fatality ratio (n = 119) was 0.87% (95% CI = 0.54-1.28), which included in-hospital and out-of-hospital deaths. Conclusions Our data showed that children were at risk for SARS-CoV-2 infections and severe outcomes in the pre-Omicron era. These findings underscore the need for effective vaccination strategies for the paediatric population to protect against the acute and long-term sequelae of COVID-19. Registration PROSPERO: CRD42022327680.
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Affiliation(s)
- Durga Kulkarni
- Centre for Global Health, University of Edinburgh, Edinburgh, United Kingdom
| | - Nabihah Farhana Ismail
- Centre for Global Health, University of Edinburgh, Edinburgh, United Kingdom
- Communicable Disease Control Unit, Public Health Department, Johor State, Malaysia
| | - Fuyu Zhu
- Schol of Public Health, Nanjing Medical University, China
| | - Xin Wang
- Schol of Public Health, Nanjing Medical University, China
| | | | | | | | | | - Ahmed Ehsanur Rahman
- Centre for Global Health, University of Edinburgh, Edinburgh, United Kingdom
- International Centre for Diarrhoeal Diseases Research, Bangladesh
| | | | - Harish Nair
- Centre for Global Health, University of Edinburgh, Edinburgh, United Kingdom
- Schol of Public Health, Nanjing Medical University, China
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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13
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Barry MC, Pathak EB, Swanson J, Cen R, Menard J, Salemi JL, Nembhard WN. Epidemiology of COVID-19 in Infants in the United States: Incidence, Severity, Fatality, and Variants of Concern. Pediatr Infect Dis J 2024; 43:217-225. [PMID: 38134379 DOI: 10.1097/inf.0000000000004201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2023]
Abstract
BACKGROUND The clinical spectrum of infant COVID-19 ranges from asymptomatic infection to life-threatening illness, yet epidemiologic surveillance has been limited for infants. METHODS Using COVID-19 case data (restricted to reporting states) and national mortality data, we calculated incidence, hospitalization, mortality and case fatality rates through March 2022. RESULTS Reported incidence of COVID-19 was 64.1 new cases per 1000 infant years (95% CI: 63.3-64.9). We estimated that 594,012 infants tested positive for COVID-19 nationwide by March 31, 2022. Viral variant comparisons revealed that incidence was 7× higher during the Omicron (January-March 2022) versus the pre-Delta period (June 2020-May 2021). The cumulative case hospitalization rate was 4.1% (95% CI: 4.0%-4.3%). For every 74 hospitalized infants, one infant death occurred, but overall COVID-19-related infant case fatality was low, with 7.0 deaths per 10,000 cases (95% CI: 5.6-8.7). Nationwide, 333 COVID-19 infant deaths were reported. Only 13 infant deaths (3.9%) were the result of usually lethal congenital anomalies. The majority of infant decedents were non-White (28.2% Black, 26.1% Hispanic, 8.1% Asian, Indigenous or multiracial). CONCLUSIONS More than half a million US infants contracted COVID-19 by March 2022. Longitudinal assessment of long-term infant SARS-CoV-2 infection sequelae remains a critical research gap. Extremely low infant vaccination rates (<5%), waning adult immunity and continued viral exposure risks suggest that infant COVID-19 will remain a persistent public health problem. Our study underscores the need to increase vaccination rates for mothers and infants, decrease viral exposure risks and improve health equity.
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Affiliation(s)
- Megan C Barry
- From the College of Public Health, University of South Florida, Tampa, Florida
| | | | - Justin Swanson
- From the College of Public Health, University of South Florida, Tampa, Florida
| | - Ruiqi Cen
- Department of Epidemiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Janelle Menard
- Women's Institute for Independent Social Enquiry, Olney, Maryland
| | - Jason L Salemi
- From the College of Public Health, University of South Florida, Tampa, Florida
| | - Wendy N Nembhard
- Department of Epidemiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
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El-Halaby H, Eid R, Elagamy A, El-Hussiny A, Moustafa F, Hammad A, Zeid M. A retrospective analysis of acute kidney injury in children with post-COVID-19 multisystem inflammatory syndrome: insights into promising outcomes. Ital J Pediatr 2024; 50:23. [PMID: 38317228 PMCID: PMC10845792 DOI: 10.1186/s13052-024-01598-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 01/21/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Acute kidney injury (AKI) in patients with multisystem inflammatory syndrome (MIS), COVID-19 related infection has been increasingly recognized with a paucity of data on AKI incidence, related mortality, and the requirement of renal replacement therapy in children with MIS (MIS-C). METHODS This is a retrospective study evaluating the prevalence, severity, management and outcomes of AKI in a cohort of Egyptian children with MIS-children (MIS-C) post-COVID infection. Patients were included if they met the criteria for MIS-C based on CDC guidelines. All patients were evaluated for AKI diagnosis and staging according to the Kidney Disease Improving Global Outcomes (KDIGO) criteria. RESULTS Between March 2021 and June 2023, a total of 655 confirmed COVID-19 cases were admitted and then followed up in our hospital, of whom 138 (21%) were diagnosed with MIS-C. Fifty-one patients developed AKI associated with MIS-C post-COVID infection, 42 of whom were included in the analysis. Thirty-one patients had AKI in a formerly healthy kidney, of whom 51% (16 patients) were classified as KDIGO stage 3, 5 patients needed hemodialysis and 13 needed mechanical ventilation. Higher WBCs count, and serum ferritin on admission were associated with more severe AKI (KDIGO stage 3) (p = 0.04), while multivariate analysis showed high serum ferritin to be independent predictor of more severe AKI (p = 0.02). Two patients (2/31) died during hospital admission, while no residual renal impairment was reported at the time of discharge of patients with previously normal kidney functions. CONCLUSION More than one-third of patients with MIS-C develop AKI. Avoidance of nephrotoxic drugs, early recognition, and prompt management of AKI, including well-timed commencement of dialysis in MIS-C cases, is associated with favorable outcomes.
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Affiliation(s)
- Hanan El-Halaby
- Pediatric Critical Care Unit, Mansoura University Children's Hospital, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Riham Eid
- Pediatric Nephrology Unit, Mansoura University Children's Hospital, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
| | - Ahmed Elagamy
- Pediatric Critical Care Unit, Mansoura University Children's Hospital, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Ahmed El-Hussiny
- Pediatric Critical Care Unit, Mansoura University Children's Hospital, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Fatma Moustafa
- Department of Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Ayman Hammad
- Pediatric Nephrology Unit, Mansoura University Children's Hospital, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Mayada Zeid
- Pediatric Infectious Diseases Unit, Mansoura University Children's Hospital, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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15
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Tabatabaei SR, Babaie D, Hoseini-Alfatemi SM, Shamshiri A, Karimi A. Determining the coverage and efficacy of the COVID-19 vaccination program at the community level in children aged 12 to 17 in Tehran. GMS HYGIENE AND INFECTION CONTROL 2024; 19:Doc04. [PMID: 38404412 PMCID: PMC10884833 DOI: 10.3205/dgkh000459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
Background The vaccination is one of the acceptable and recomended solution to prevent and control of COVID-19. The aim of this study was to determine the efficacy of sinopharm vaccination in children aged 12-17 in Tehran. Methods The case population study was performed from October 2021 to March 2022 among 1,500 children with positive PCR test reffered in Mofid Children's Hospital in Tehran. 64 children aged 12-17 years were included. The data were collected by the hospital information system (HIS), vaccination information registration systems and questionnaire with their families. The coverage and efficacy of vaccination determined with equels commented by WHO. Results Out of 64 children, 52 children were 12 to 15 years old (13.35±1.08), 12 children were 16 to 17 years old (16.55±0.52). 48.4% had received two doses of vaccine. The highest rate of positive PCR was observed in February 2022. Sinopharm vaccine coverage in this age group was 93.6% for the first dose and 81.1% for the second dose. Based on this information, 48.4% children in this study have received two complete doses of the COVID-19 vaccine. The efficacy of the vaccine was estimated as 94.4% (95% CI 90.2 to 97.7). Conclusion It seems the coverage of Sinopharm vaccination in the age group of 12-17 years in Tehran is favorable and has high efficacy in this age group. In order to obtain more accurate and comprehensive estimation, it is recommended to take a sample on a wider level of the community.
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Affiliation(s)
- Sedigheh Rafiei Tabatabaei
- Pediatric Infections Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Delara Babaie
- Department of Allergy and Clinical Immunology, Mofid Children’s Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyedeh Mahsan Hoseini-Alfatemi
- Pediatric Infections Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ahmadreza Shamshiri
- Research Center for Caries Prevention, Dentistry Research Institute, Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Abdollah Karimi
- Pediatric Infections Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Kao CM. Overview of COVID-19 Infection, Treatment, and Prevention in Children. J Clin Med 2024; 13:424. [PMID: 38256558 PMCID: PMC10817068 DOI: 10.3390/jcm13020424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/02/2024] [Accepted: 01/10/2024] [Indexed: 01/24/2024] Open
Abstract
Coronavirus disease 2019 (COVID-19), caused by the novel respiratory virus-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-was declared a global pandemic by the World Health Organization on 11 March 2020. Since then, substantial gains have been made in our understanding of COVID-19 epidemiology, disease presentation, and management. While children tend to have less severe disease courses compared to adults, children can still develop severe COVID-19 infections, particularly in those with underlying medical conditions such as obesity, chronic lung disease, or prematurity. In addition, children are at risk of severe complications of COVID-19 infection, such as multisystem inflammatory syndrome in children (MIS-C) or long COVID. The case definitions of MIS-C and long COVID have continued to evolve with the increased understanding of these new entities; however, improved methods of diagnosis and determination of the optimal management are still needed. Furthermore, with the continued circulation of SARS-CoV-2 variants, there remains a need for clinicians to remain up-to-date on the latest treatment and prevention options. The purpose of this review is to provide an evidence-based review of what we have learned about COVID-19 in children since the start of the pandemic and how best to counsel children and their families on the best methods of prevention.
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Affiliation(s)
- Carol M Kao
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Washington University School of Medicine, 660 S. Euclid Avenue, St. Louis, MO 63110, USA
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Ajmera H, Lakhawat SS, Malik N, Kumar A, Bhatti JS, Kumar V, Gogoi H, Jaswal SK, Chandel S, Sharma PK. Global Emergence of SARS-CoV2 Infection and Scientific Interventions to Contain its Spread. Curr Protein Pept Sci 2024; 25:307-325. [PMID: 38265408 DOI: 10.2174/0113892037274719231212044235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 10/09/2023] [Accepted: 10/18/2023] [Indexed: 01/25/2024]
Abstract
The global pandemic caused by COVID-19 posed a significant challenge to public health, necessitating rapid scientific interventions to tackle the spread of infection. The review discusses the key areas of research on COVID-19 including viral genomics, epidemiology, pathogenesis, diagnostics, and therapeutics. The genome sequencing of the virus facilitated the tracking of its evolution, transmission dynamics, and identification of variants. Epidemiological studies have provided insights into disease spread, risk factors, and the impact of public health infrastructure and social distancing measures. Investigations of the viral pathogenesis have elucidated the mechanisms underlying immune responses and severe manifestations including the long-term effects of COVID-19. Overall, the article provides an updated overview of the diagnostic methods developed for SARS-CoV-2 and discusses their strengths, limitations, and appropriate utilization in different clinical and public health settings. Furthermore, therapeutic approaches including antiviral drugs, immunomodulatory therapies, and repurposed medications have been investigated to alleviate disease severity and improve patient outcomes. Through a comprehensive analysis of these scientific efforts, the review provides an overview of the advancements made in understanding and tackling SARS-CoV-2, while underscoring the need for continued research to address the evolving challenges posed by this global health crisis.
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Affiliation(s)
- Himanshu Ajmera
- Amity Institute of Biotechnology, Amity University Rajasthan, Jaipur, 303002, India
| | | | - Naveen Malik
- Amity Institute of Biotechnology, Amity University Rajasthan, Jaipur, 303002, India
| | - Akhilesh Kumar
- Amity Institute of Biotechnology, Amity University Rajasthan, Jaipur, 303002, India
| | - Jasvinder Singh Bhatti
- Department of Human Genetics & Molecular Medicine, Central University of Punjab, Bathinda, India
| | - Vikram Kumar
- Amity Institute of Biotechnology, Amity University Rajasthan, Jaipur, 303002, India
| | - Himanshu Gogoi
- Translational Health Science and Technology Institute, NCR Biotech Science Cluster 3rd milestone Faridabad, Haryana, India
| | - Sunil Kumar Jaswal
- Department of Biotechnology, Himachal Pradesh University Summer Hill, Shimla, India
| | - Sanjeev Chandel
- Department of Nursing, GHG College of Nursing Rajkot Road, Ludhiana, Punjab, India
| | - Pushpender Kumar Sharma
- Amity Institute of Biotechnology, Amity University Rajasthan, Jaipur, 303002, India
- Amity Centre for Nanobiotechnology and Nanomedicine, Amity University Rajasthan, Jaipur, 303002, India
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18
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Jafari M, Mahalati Y, Zarei E, Kazemi MM, Irompour A, Sadri A, AzadiYekta H. Clinical Manifestations Laboratory Tests Abdominal Ultrasonic Findings and In-hospital Prognosis of COVID-19 in 185 Pediatric Cases in a Tertiary Center. ARCHIVES OF IRANIAN MEDICINE 2023; 26:679-687. [PMID: 38431948 PMCID: PMC10915921 DOI: 10.34172/aim.2023.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 10/14/2023] [Indexed: 03/05/2024]
Abstract
BACKGROUND Despite the COVID-19 pandemic, there is little information about the different clinical aspects of COVID-19 in children. In this study, we assessed the clinical manifestations, outcome, ultrasound, and laboratory findings of pediatric COVID-19. METHODS This retrospective study was conducted on 185 children with definitive diagnosis of COVID-19 between 2021 and 2022. The patients' information was retrieved from hospital records. RESULTS The average age of the patients was 5.18 ± 4.55 years, and 61.1% were male. The most frequent clinical manifestation was fever (81.1%) followed by cough (31.9%), vomiting (20.0%), and diarrhea (20.0%). Mesenteric lymphadenitis was common on ultrasound and found in 60% of cases. In-hospital death was identified in 3.8% of cases. The mean length of hospital stay was 8.5 days. Mandating intensive care unit (ICU) stay was found in 19.5% and 5.9% of cases were intubated. Acute respiratory distress syndrome (ARDS), lower arterial oxygen saturation, higher white blood cell (WBC) count, and higher C-reactive protein (CRP) were the main determinants of death. Lower age, respiratory distress, early onset of clinical manifestations, lower arterial oxygen saturation, lower serum hemoglobin (Hb) level, and higher CRP level could predict requiring ICU admission. CONCLUSION We recommend close monitoring on CRP, serum Hb level, WBC count, and arterial level of oxygenation as clinical indicators for potential progression to critical illness and severe disease. Mesenteric lymphadenitis is a common sonographic finding in pediatric COVID-19 which can cause abdominal pain. Ultrasound is helpful to avoid unnecessary surgical interventions in COVID-19.
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Affiliation(s)
- Maryam Jafari
- Department of Radiology Aliasghar Children’s Hospital School of Medicine Iran University of Medical Science Tehran Iran
| | - Yasaman Mahalati
- Department of Radiology Aliasghar Children’s Hospital School of Medicine Iran University of Medical Science Tehran Iran
| | - Elham Zarei
- Department of Radiology Aliasghar Children’s Hospital School of Medicine Iran University of Medical Science Tehran Iran
| | - Mohammad Mahdi Kazemi
- Department of Radiology Aliasghar Children’s Hospital School of Medicine Iran University of Medical Science Tehran Iran
| | - Arsalan Irompour
- Department of Radiology Aliasghar Children’s Hospital School of Medicine Iran University of Medical Science Tehran Iran
| | - Amirhoessein Sadri
- Department of Radiology Aliasghar Children’s Hospital School of Medicine Iran University of Medical Science Tehran Iran
| | - Hamed AzadiYekta
- Department of Radiology Aliasghar Children’s Hospital School of Medicine Iran University of Medical Science Tehran Iran
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Pillay A, Yeola A, Tea F, Denkova M, Houston S, Burrell R, Merheb V, Lee FXZ, Lopez JA, Moran L, Jadhav A, Sterling K, Lai CL, Vitagliano TL, Aggarwal A, Catchpoole D, Wood N, Phan TG, Nanan R, Hsu P, Turville SG, Britton PN, Brilot F. Infection and Vaccine Induced Spike Antibody Responses Against SARS-CoV-2 Variants of Concern in COVID-19-Naïve Children and Adults. J Clin Immunol 2023; 43:1706-1723. [PMID: 37405544 PMCID: PMC10661752 DOI: 10.1007/s10875-023-01540-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 06/19/2023] [Indexed: 07/06/2023]
Abstract
Although a more efficient adaptive humoral immune response has been proposed to underlie the usually favorable outcome of pediatric COVID-19, the breadth of viral and vaccine cross-reactivity toward the ever-mutating Spike protein among variants of concern (VOCs) has not yet been compared between children and adults. We assessed antibodies to conformational Spike in COVID-19-naïve children and adults vaccinated by BNT162b2 and ChAdOx1, and naturally infected with SARS-CoV-2 Early Clade, Delta, and Omicron. Sera were analyzed against Spike including naturally occurring VOCs Alpha, Beta, Gamma, Delta, and Omicron BA.1, BA.2, BA.5, BQ.1.1, BA2.75.2, and XBB.1, and variants of interest Epsilon, Kappa, Eta, D.2, and artificial mutant Spikes. There was no notable difference between breadth and longevity of antibody against VOCs in children and adults. Vaccinated individuals displayed similar immunoreactivity profiles across variants compared with naturally infected individuals. Delta-infected patients had an enhanced cross-reactivity toward Delta and earlier VOCs compared to patients infected by Early Clade SARS-CoV-2. Although Omicron BA.1, BA.2, BA.5, BQ.1.1, BA2.75.2, and XBB.1 antibody titers were generated after Omicron infection, cross-reactive binding against Omicron subvariants was reduced across all infection, immunization, and age groups. Some mutations, such as 498R and 501Y, epistatically combined to enhance cross-reactive binding, but could not fully compensate for antibody-evasive mutations within the Omicron subvariants tested. Our results reveal important molecular features central to the generation of high antibody titers and broad immunoreactivity that should be considered in future vaccine design and global serosurveillance in the context of limited vaccine boosters available to the pediatric population.
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Affiliation(s)
- Aleha Pillay
- Brain Autoimmunity Group, Kids Neuroscience Centre, Kids Research at the Children's Hospital at Westmead, Sydney, New South Wales, Australia
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Avani Yeola
- Brain Autoimmunity Group, Kids Neuroscience Centre, Kids Research at the Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Fiona Tea
- Brain Autoimmunity Group, Kids Neuroscience Centre, Kids Research at the Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Martina Denkova
- Brain Autoimmunity Group, Kids Neuroscience Centre, Kids Research at the Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Samuel Houston
- Brain Autoimmunity Group, Kids Neuroscience Centre, Kids Research at the Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Rebecca Burrell
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Kids Research at the Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Vera Merheb
- Brain Autoimmunity Group, Kids Neuroscience Centre, Kids Research at the Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Fiona X Z Lee
- Brain Autoimmunity Group, Kids Neuroscience Centre, Kids Research at the Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Joseph A Lopez
- Brain Autoimmunity Group, Kids Neuroscience Centre, Kids Research at the Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Lilly Moran
- Kids Research at the Children's Hospital at Westmead, Sydney, New South Wales, Australia
- National Center for Immunisation Research and Surveillance, the Sydney Children's Hospitals Network, Sydney, New South Wales, Australia
| | - Ajay Jadhav
- Kids Research at the Children's Hospital at Westmead, Sydney, New South Wales, Australia
- National Center for Immunisation Research and Surveillance, the Sydney Children's Hospitals Network, Sydney, New South Wales, Australia
| | - Katrina Sterling
- Kids Research at the Children's Hospital at Westmead, Sydney, New South Wales, Australia
- National Center for Immunisation Research and Surveillance, the Sydney Children's Hospitals Network, Sydney, New South Wales, Australia
| | - Catherine L Lai
- Kids Research at the Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Tennille L Vitagliano
- Kids Research at the Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Anupriya Aggarwal
- The Kirby Institute, The University of New South Wales, Sydney, New South Wales, Australia
| | - Dan Catchpoole
- Kids Research at the Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Nicholas Wood
- Kids Research at the Children's Hospital at Westmead, Sydney, New South Wales, Australia
- National Center for Immunisation Research and Surveillance, the Sydney Children's Hospitals Network, Sydney, New South Wales, Australia
| | - Tri Giang Phan
- Garvan Institute of Medical Research, Sydney, New South Wales, Australia
- St Vincent's Healthcare Clinical Campus, School of Clinical Medicine, Faculty of Medicine and Health, The University of New South Wales, Sydney, New South Wales, Australia
| | - Ralph Nanan
- Charles Perkins Center and Sydney Medical School Nepean, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Peter Hsu
- Kids Research at the Children's Hospital at Westmead, Sydney, New South Wales, Australia
- Department of Allergy and Immunology, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Stuart G Turville
- The Kirby Institute, The University of New South Wales, Sydney, New South Wales, Australia
| | - Philip N Britton
- Kids Research at the Children's Hospital at Westmead, Sydney, New South Wales, Australia
- Sydney Institute for Infectious Disease, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Fabienne Brilot
- Brain Autoimmunity Group, Kids Neuroscience Centre, Kids Research at the Children's Hospital at Westmead, Sydney, New South Wales, Australia.
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
- Sydney Institute for Infectious Disease, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia.
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20
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Dahleh A, Bean AJ, Johnson TJ. Racial, socioeconomic, and neighborhood characteristics in relation to COVID-19 severity of illness for adolescents and young adults. PNAS NEXUS 2023; 2:pgad396. [PMID: 38034092 PMCID: PMC10682970 DOI: 10.1093/pnasnexus/pgad396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 11/07/2023] [Indexed: 12/02/2023]
Abstract
This study tests the hypotheses that insurance status, race and ethnicity, and neighborhood characteristics are associated with hospital admission and severe health outcomes (Intensive Care Unit [ICU] admission and oxygen assistance) for youth and young adults who present to the emergency department (ED) with COVID-19 in a single, academic health system in Illinois, Rush University System for Health (RUSH). Demographic and clinical data from the electronic health record were collected for all 13- to 24-y-old patients seen at RUSH who tested positive for COVID-19 between March 2020 and 2021. Individual-level and neighborhood characteristics were analyzed to determine their association with hospital admission and severe health outcomes through generalized estimating equations. As of March 2021, 1,057 patients were seen in the ED within RUSH in which non-Hispanic White (odds ratio [OR], 2.96; 95% CI, 1.61-5.46; P = 0.001) and Hispanic (OR, 3.34; 95% CI, 1.84-6.10; P < 0.001) adolescents and youth were more likely to be admitted to the hospital compared with non-Hispanic Black/other adolescents and youth. Patients with public insurance or who were uninsured were less likely to be admitted to the ICU compared with those with private insurance (OR, 0.24; 95% CI, 0.09-0.64; P = 0.004). None of the neighborhood characteristics were significantly associated with hospital admission or severe health outcomes after adjusting for covariates. Our findings demonstrated that race and ethnicity were related to hospitalization, while insurance was associated with presentation severity due to COVID-19 for adolescents and young adults. These findings can aid public health investigators in understanding COVID-19 disparities among adolescents and young adults.
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Affiliation(s)
- Ayaat Dahleh
- The Graduate College, Rush University, Chicago, IL 60612, USA
| | - Andrew J Bean
- The Graduate College, Rush University, Chicago, IL 60612, USA
| | - Tricia J Johnson
- Department of Health Systems Management, Rush University College of Health Sciences, Chicago, IL 60612, USA
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21
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Jung J, Lee J, Lee JH. Kidney involvement in children during the SARS-CoV-2 Omicron variant pandemic. BMC Pediatr 2023; 23:491. [PMID: 37770841 PMCID: PMC10538237 DOI: 10.1186/s12887-023-04322-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 09/20/2023] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND As the coronavirus disease-2019 (COVID-19) pandemic continues, driven by the Omicron variant, infection rates in children have recently rapidly surged compared with previous years. We aimed to investigate the presentation of kidney involvement in children after Omicron variant severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. METHODS We retrospectively reviewed the medical records of pediatric patients who presented with kidney disease with a temporal relationship with COVID-19 between January and August 2022 in a single tertiary center in Korea. RESULTS Fifteen children presented with kidney involvement after Omicron variant infection, with a median age of 10.6 (6.8-18.3) years. None of the patients exhibited severe respiratory symptoms apart from cough and sore throat. The median time from infection to renal symptom onset was 3 (0-49) days. Among 10 patients with underlying kidney disease, six had previously been diagnosed with nephrotic syndrome (NS) that relapsed after COVID-19 infection, two with immunoglobulin A nephropathy (IgAN) experienced transient gross hematuria (GHU) with or without acute kidney injury (AKI), and two with kidney transplantation presented with AKI. Of the five patients without underlying kidney disease, one patient had NS, and the other four patients had GHU and proteinuria (PU), of whom one was eventually diagnosed with Henoch Shönlein Purpura nephritis (HSPN), and one with rhabdomyolysis. The seven patients with NS (1 new-onset, 6 relapsed) had uneventful remission with corticosteroid therapy. Apart from one patient with new-onset HSPN, GHU and PU resolved spontaneously in all affected patients, and AKI also resolved with supportive care. CONCLUSIONS Kidney involvement subsequent to Omicron variant COVID-19 exhibited various, but mostly mild manifestations in children.
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Affiliation(s)
- Jiwon Jung
- Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Republic of Korea
| | - Jina Lee
- Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Republic of Korea
| | - Joo Hoon Lee
- Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Republic of Korea.
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22
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de Lima TM, Martins RB, Miura CS, Souza MVO, Cassiano MHA, Rodrigues TS, Veras FP, Sousa JDF, Gomes R, de Almeida GM, Melo SR, da Silva GC, Dias M, Capato CF, Silva ML, Luiz VEDDB, Carenzi LR, Zamboni DS, Jorge DMDM, Cunha FDQ, Tamashiro E, Anselmo-Lima WT, Valera FCP, Arruda E. Tonsils are major sites of persistence of SARS-CoV-2 in children. Microbiol Spectr 2023; 11:e0134723. [PMID: 37737615 PMCID: PMC10581087 DOI: 10.1128/spectrum.01347-23] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 08/01/2023] [Indexed: 09/23/2023] Open
Abstract
In the present study, we show that SARS-CoV-2 can infect palatine tonsils, adenoids, and secretions in children without symptoms of COVID-19, with no history of recent upper airway infection. We studied 48 children undergoing tonsillectomy due to snoring/OSA or recurrent tonsillitis between October 2020 and September 2021. Nasal cytobrushes, nasal washes, and tonsillar tissue fragments obtained at surgery were tested by RT-qPCR, immunohistochemistry (IHC), flow cytometry, and neutralization assay. We detected the presence of SARS-CoV-2 in at least one specimen tested in 27% of patients. IHC revealed the presence of the viral nucleoprotein in epithelial surface and in lymphoid cells in both extrafollicular and follicular regions, in adenoids and palatine tonsils. Also, IHC for the SARS-CoV-2 non-structural protein NSP-16 indicated the presence of viral replication in 53.8% of the SARS-CoV-2-infected tissues. Flow cytometry showed that CD20+ B lymphocytes were the most infected phenotypes, followed by CD4+ lymphocytes and CD123 dendritic cells, CD8+ T lymphocytes, and CD14+ macrophages. Additionally, IF indicated that infected tonsillar tissues had increased expression of ACE2 and TMPRSS2. NGS sequencing demonstrated the presence of different SARS-CoV-2 variants in tonsils from different tissues. SARS-CoV-2 antigen detection was not restricted to tonsils but was also detected in nasal cells from the olfactory region. Palatine tonsils and adenoids are sites of prolonged RNA presence by SARS-CoV-2 in children, even without COVID-19 symptoms. IMPORTANCE This study shows that SRS-CoV-2 of different lineages can infect tonsils and adenoids in one quarter of children undergoing tonsillectomy. These findings bring advancement to the area of SARS-CoV-2 pathogenesis, by showing that tonsils may be sites of prolonged infection, even without evidence of recent COVID-19 symptoms. SARS-CoV-2 infection of B and T lymphocytes, macrophages, and dendritic cells may interfere with the mounting of immune responses in these secondary lymphoid organs. Moreover, the shedding of SARS-CoV-2 RNA in respiratory secretions from silently infected children raises concern about possible diagnostic confusion in the presence of symptoms of acute respiratory infections caused by other etiologies.
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Affiliation(s)
- Thais Melquiades de Lima
- Department of Cellular and Molecular Biology and Pathogenic Bioagents, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Ronaldo Bragança Martins
- Department of Cellular and Molecular Biology and Pathogenic Bioagents, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
- Department of Clinical, Toxicological and Bromatological Analysis, University of São Paulo School of Pharmaceutical Sciences, Ribeirão Preto, São Paulo, Brazil
| | - Carolina Sponchiado Miura
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Maria Vitória Oliveira Souza
- Department of Cellular and Molecular Biology and Pathogenic Bioagents, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Murilo Henrique Anzolini Cassiano
- Department of Cellular and Molecular Biology and Pathogenic Bioagents, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Tamara Silva Rodrigues
- Department of Biochemistry and Immunology, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Flávio Protásio Veras
- Department of BioMolecular Sciences, University of São Paulo School of Pharmaceutical Sciences, Ribeirão Preto, São Paulo, Brazil
| | - Josane de Freitas Sousa
- Department of Cellular and Molecular Biology and Pathogenic Bioagents, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Rogério Gomes
- Department of Cellular and Molecular Biology and Pathogenic Bioagents, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Glaucia Maria de Almeida
- Department of Biochemistry and Immunology, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Stella Rezende Melo
- Department of Cellular and Molecular Biology and Pathogenic Bioagents, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Gabriela Condé da Silva
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Matheus Dias
- Department of Cellular and Molecular Biology and Pathogenic Bioagents, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Carlos Fabiano Capato
- Department of Cellular and Molecular Biology and Pathogenic Bioagents, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Maria Lúcia Silva
- Department of Cellular and Molecular Biology and Pathogenic Bioagents, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Veridiana Ester Dias de Barros Luiz
- Department of Cellular and Molecular Biology and Pathogenic Bioagents, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Lucas Rodrigues Carenzi
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Dario Simões Zamboni
- Department of Cellular and Molecular Biology and Pathogenic Bioagents, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
- Department of Biochemistry and Immunology, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Daniel Macedo de Melo Jorge
- Department of Cellular and Molecular Biology and Pathogenic Bioagents, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Fernando de Queiroz Cunha
- Department of Pharmacology, University of Sao Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Edwin Tamashiro
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Wilma Terezinha Anselmo-Lima
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Fabiana Cardoso Pereira Valera
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Eurico Arruda
- Department of Cellular and Molecular Biology and Pathogenic Bioagents, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
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23
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Galmiche S, Charmet T, Rakover A, Schaeffer L, Chény O, von Platen C, Omar F, David C, Mailles A, Carrat F, Fontanet A. Risk of SARS-CoV-2 Infection Among Households With Children in France, 2020-2022. JAMA Netw Open 2023; 6:e2334084. [PMID: 37713194 PMCID: PMC10504612 DOI: 10.1001/jamanetworkopen.2023.34084] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 07/18/2023] [Indexed: 09/16/2023] Open
Abstract
Importance Understanding the contribution of children to SARS-CoV-2 circulation in households is critical for designing public health policies and mitigation strategies. Objective To identify temporal changes in the risk of SARS-CoV-2 infection in people living with children. Design, Setting, and Participants This case-control study included online questionnaire responses from French adults between October 2020 and October 2022. Eligible cases were adults with ongoing SARS-CoV-2 infection with an email address on record with the national health insurance system, which centralized all new diagnoses in France. Eligible controls were adults who had never tested positive for SARS-CoV-2 until February 2021, when eligibility was extended to all adults without ongoing SARS-CoV-2 infection. Exposure Transmission of SARS-CoV-2 from a child (aged under 18 years) within the household in the descriptive analysis, as reported by the participating case. Sharing household with a child (of any age or broken down by school level) in the case-control analysis. Main Outcome and Measures Ongoing SARS-CoV-2 infection diagnosed by reverse transcription-polymerase chain reaction or supervised rapid antigen test (ie, not self-tests). Results A total of 682 952 cases were included for the descriptive analysis (68.8% female, median [IQR] age, 44 [34-55] years). Among those, 45 108 (6.6%) identified a household child as the source case; this proportion peaked at 10.4% during the Omicron BA.1 wave (December 20, 2021, to April 8, 2022). For the case-control analysis, we matched 175 688 cases (with a 4:1 ratio) for demographic characteristics with 43 922 controls. In multivariable logistic regression analysis, household exposure to children was associated with an increased risk of infection mainly at the end of summer 2021 (receding Delta wave) and during winter 2022 (Omicron BA.1 wave). In subgroup analysis by school level of the child, living with children under the age of 6 was associated with increased odds of infection throughout the study period, peaking at an odds ratio (OR) 1.8 (95% CI, 1.6-2.1) for children looked after by professional in-home caregivers, 1.7 (95% CI, 1.5-1.7) for children in day care facilities, and 1.6 (95% CI, 1.4-1.8) for children in preschool. The ORs associated with household exposure to children aged 6 to 14 years increased during the Delta (August 14, 2021, to December 19, 2021) and Omicron BA.1 waves, reaching 1.6 (95% CI, 1.5-1.7) for primary school children and 1.4 (95% CI, 1.3-1.5) for middle school children. Exposure to older children aged 15 to 17 years was associated with a moderate risk until April 2021, with an OR of 1.2 (95% CI, 1.2-1.3) during curfew in early 2021 (December 4, 2020, to April 8, 2021). Conclusions and Relevance The presence of children, notably very young ones, was associated with an increased risk of SARS-CoV-2 infection in other household members, especially during the Delta and Omicron BA.1 waves. These results should help to guide policies targeting children and immunocompromised members of their household.
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Affiliation(s)
- Simon Galmiche
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris Cité, Paris, France
- Sorbonne Université, Ecole Doctorale Pierre Louis de Santé Publique, Paris, France
| | - Tiffany Charmet
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris Cité, Paris, France
| | - Arthur Rakover
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris Cité, Paris, France
| | - Laura Schaeffer
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris Cité, Paris, France
| | - Olivia Chény
- Center for Translational Research, Institut Pasteur, Université Paris Cité, Paris, France
| | - Cassandre von Platen
- Center for Translational Research, Institut Pasteur, Université Paris Cité, Paris, France
| | - Faïza Omar
- Department of Public Affairs—Public Statistics, Institut Ipsos, Paris, France
| | - Christophe David
- Department of Public Affairs—Public Statistics, Institut Ipsos, Paris, France
| | | | - Fabrice Carrat
- Sorbonne Université, Inserm, IPLESP, Hôpital Saint-Antoine, AP-HP, Paris, France
| | - Arnaud Fontanet
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris Cité, Paris, France
- Unité PACRI, Conservatoire National des Arts et Métiers, Paris, France
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Bohn MK, Steele S, Adeli K. SARS-CoV-2 serology in pediatrics: Seroprevalence studies in unvaccinated children and humoral antibody response post vaccination. Clin Biochem 2023; 119:110630. [PMID: 37549823 DOI: 10.1016/j.clinbiochem.2023.110630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 08/02/2023] [Accepted: 08/04/2023] [Indexed: 08/09/2023]
Abstract
BACKGROUND Humoral response against SARS-CoV-2 is increasingly accepted as the central correlate of immune protection. Recent pediatric seroprevalence data are extremely limited. Significant knowledge gaps also exist in immune response to mRNA SARS-CoV-2 vaccination in children. As children demonstrate distinct response to naïve infection relative to adults, it is essential to investigate age-specific differences in seroprevalence and antibody response to SARS-CoV-2 vaccination. METHODS Seroprevalence was assessed through two cross-sectional serosurveys prior to COVID-19 vaccination approval in children <5 years using residual patient specimens (n = 2902). To assess antibody response post-vaccination, 842 participants (580 children, 262 adults) were prospectively recruited with informed consent. Participation required completion of a health questionnaire and blood donation. Samples were collected at varying times post-vaccination and assayed using the Abbott AdviseDx SARS-CoV-2 IgG II and DiaSorin LIAISON SARS-CoV-2 TrimericS IgG assays. RESULTS Significant increases in seroprevalence were observed between the first and second serosurveys in unvaccinated children <6 months to 5 years (38-75%). In the prospective vaccination cohort, serokinetic response decreased with time post-dose of an mRNA vaccine. Measured IgG titres were significantly higher in children relative to adults across all time points. CONCLUSIONS This is the largest evaluation of quantitative SARS-CoV-2 antibody assays in a cohort of Canadian children, adolescents, and adults. Findings suggest high rates of SARS-CoV-2 exposure among unvaccinated young children in the Toronto community. Additional data supports children have higher antibody titres relative to adults post-vaccination.
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Affiliation(s)
- Mary Kathryn Bohn
- CALIPER Program, Department of Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, ON, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Shannon Steele
- CALIPER Program, Department of Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, ON, Canada
| | - Khosrow Adeli
- CALIPER Program, Department of Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, ON, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada.
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Yang X, Fox A, DeCarlo C, Pineda N, Powell RL. The Secretory IgA Response in Human Milk Against the SARS-CoV-2 Spike Is Highly Durable and Neutralizing for At Least 1 Year of Lactation Postinfection. Breastfeed Med 2023; 18:602-611. [PMID: 37615565 PMCID: PMC10460685 DOI: 10.1089/bfm.2023.0117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
Background: Although in the early pandemic period COVID-19 pathology among young children and infants was typically less severe compared with that observed among adults, this has not remained entirely consistent as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants have emerged. There is an enormous body of evidence demonstrating the benefits of human milk antibodies (Abs) in protecting infants against a wide range of enteric and respiratory infections. It is highly plausible that the same holds true for protection against SARS-CoV-2 as this virus infects cells of the gastrointestinal and respiratory mucosae. Understanding the durability of a human milk Ab response over time after infection is critical. Objective: Previously, we examined the Abs present in milk of those recently infected with SARS-CoV-2 and concluded that the response was secretory immunoglobulin A (sIgA) dominant and that these titers were highly correlated with neutralization potency. The present study aimed to monitor the durability of the SARS-CoV-2 IgA and secretory Ab (sAb) response in milk from COVID-19-recovered lactating individuals over 12 months in the absence of vaccination or reinfection. Results: This analysis revealed a robust and durable spike-specific milk sIgA response, and at 9-12 months after infection, 88% of the samples exhibited titers above the positive cutoff for IgA and 94% were above the cutoff for sAb. Fifty percent of participants exhibited less than twofold reduction of spike-specific IgA through 12 months. A strong, significant positive correlation between IgA and sAb against spike persisted throughout the study period. Nucleocapsid-specific Abs were also assessed, which revealed significant background or cross-reactivity of milk IgA against this immunogen, as well as limited/inconsistent durability compared with Spike titers. Conclusion: These data suggest that lactating individuals are likely to continue producing spike-specific Abs in their milk for 1 year or more, which may provide critical passive immunity to infants against SARS-CoV-2 throughout the lactation period.
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Affiliation(s)
- Xiaoqi Yang
- Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Alisa Fox
- Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Claire DeCarlo
- Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Nicole Pineda
- Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Rebecca L.R. Powell
- Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Ailioaie LM, Ailioaie C, Litscher G. Infection, Dysbiosis and Inflammation Interplay in the COVID Era in Children. Int J Mol Sci 2023; 24:10874. [PMID: 37446047 DOI: 10.3390/ijms241310874] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 06/19/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023] Open
Abstract
For over three years, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in children and adolescents has generated repercussions, especially a few weeks after infection, for symptomatic patients who tested positive, for asymptomatic ones, or even just the contacts of an infected person, and evolved from severe forms such as multisystem inflammatory syndrome in children (MIS-C) to multifarious clinical manifestations in long COVID (LC). Referred to under the umbrella term LC, the onset of persistent and highly heterogeneous symptoms such as fatigue, post-exertion malaise, cognitive dysfunction, and others have a major impact on the child's daily quality of life for months. The first aim of this review was to highlight the circumstances of the pathophysiological changes produced by COVID-19 in children and to better understand the hyperinflammation in COVID-19 and how MIS-C, as a life-threatening condition, could have been avoided in some patients. Another goal was to better identify the interplay between infection, dysbiosis, and inflammation at a molecular and cellular level, to better guide scientists, physicians, and pediatricians to advance new lines of medical action to avoid the post-acute sequelae of SARS-CoV-2 infection. The third objective was to identify symptoms and their connection to molecular pathways to recognize LC more easily. The fourth purpose was to connect the triggering factors of LC with related sequelae following acute SARS-CoV-2 injuries to systems and organs, the persistence of the virus, and some of its components in hidden reservoirs, including the gut and the central nervous system. The reactivation of other latent infectious agents in the host's immune environments, the interaction of this virus with the microbiome, immune hyperactivation, and autoimmunity generated by molecular mimicry between viral agents and host proteins, could initiate a targeted and individualized management. New high-tech solutions, molecules, probiotics, and others should be discovered to innovatively solve the interplay between RNA persistent viruses, microbiota, and our immune system.
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Affiliation(s)
- Laura Marinela Ailioaie
- Department of Medical Physics, Alexandru Ioan Cuza University, 11 Carol I Boulevard, 700506 Iasi, Romania
| | - Constantin Ailioaie
- Department of Medical Physics, Alexandru Ioan Cuza University, 11 Carol I Boulevard, 700506 Iasi, Romania
| | - Gerhard Litscher
- President of the International Society for Medical Laser Applications (ISLA Transcontinental), German Vice President of the German-Chinese Research Foundation (DCFG) for TCM, Honorary President of the European Federation of Acupuncture and Moxibustion Societies, 8053 Graz, Austria
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Galmiche S, Charmet T, Madec Y, Rakover A, Schaeffer L, Chény O, Omar F, Martin S, Mailles A, Carrat F, Fontanet A. Reduction of SARS-CoV-2 intra-household child-to-parent transmission associated with ventilation: results from a case-control study. BMC Public Health 2023; 23:1240. [PMID: 37365557 DOI: 10.1186/s12889-023-16144-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 06/18/2023] [Indexed: 06/28/2023] Open
Abstract
PURPOSE Our objective was to describe circumstances of SARS-CoV-2 household transmission and to identify factors associated with a lower risk of transmission in a nationwide case-control study in France. METHODS In a descriptive analysis, we analysed cases reporting transmission from someone in the household (source case). Index cases could invite a non-infected household member to participate as a related control. In such situations, we compared the exposures of the index case and related control to the source case by conditional logistic regression matched for household, restricted to households in which the source case was a child, and the index case and related control were the infected child's parents. RESULTS From October 27, 2020 to May 16, 2022, we included 104 373 cases for the descriptive analysis with a documented infection from another household member. The source case was mostly the index case's child (46.9%) or partner (45.7%). In total, 1026 index cases invited a related control to participate in the study. In the case-control analysis, we included 611 parental pairs of cases and controls exposed to the same infected child. COVID-19 vaccination with 3 + doses versus no vaccination (OR 0.1, 95%CI: 0.04-0.4), isolation from the source case (OR 0.6, 95%CI: 0.4-0.97) and the ventilation of indoor areas (OR 0.6, 95%CI: 0.4-0.9) were associated with lower risk of infection. CONCLUSION Household transmission was common during the SARS-CoV-2 pandemic in France. Mitigation strategies, including isolation and ventilation, decreased the risk of secondary transmission within the household. TRIAL REGISTRATION ClinicalTrials.gov registration number: NCT04607941.
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Affiliation(s)
- Simon Galmiche
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris Cité, 25 rue du Docteur Roux, Paris, 75015, France
- Sorbonne Université, Ecole Doctorale Pierre Louis de Santé Publique, Paris, France
| | - Tiffany Charmet
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris Cité, 25 rue du Docteur Roux, Paris, 75015, France
| | - Yoann Madec
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris Cité, 25 rue du Docteur Roux, Paris, 75015, France
| | - Arthur Rakover
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris Cité, 25 rue du Docteur Roux, Paris, 75015, France
| | - Laura Schaeffer
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris Cité, 25 rue du Docteur Roux, Paris, 75015, France
| | - Olivia Chény
- Institut Pasteur, Université Paris Cité, Centre for Translational Research, Paris, France
| | | | - Sophie Martin
- Caisse Nationale de L'Assurance Maladie, Paris, France
| | | | - Fabrice Carrat
- Sorbonne Université, Inserm, IPLESP, Hôpital Saint-Antoine, AP-HP, Paris, France
| | - Arnaud Fontanet
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris Cité, 25 rue du Docteur Roux, Paris, 75015, France.
- Conservatoire National Des Arts Et Métiers, Unité PACRI, Paris, France.
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Berg SK, Palm P, Nielsen SD, Nygaard U, Bundgaard H, Rosenkilde S, Thorsted AB, Ersbøll AK, Thygesen LC, Petersen MNS, Christensen AV. Symptoms in the acute phase of SARS-CoV-2 infection among Danish children aged 0-14 years. IJID REGIONS 2023; 7:262-267. [PMID: 37200560 PMCID: PMC10133019 DOI: 10.1016/j.ijregi.2023.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 04/19/2023] [Accepted: 04/20/2023] [Indexed: 05/20/2023]
Abstract
Objectives To investigate the prevalence and burden of proxy-reported acute symptoms in children in the first 4 weeks after detection of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, and factors associated with symptom burden. Methods Nationwide cross-sectional survey using parental proxy reporting of symptoms associated with SARS-CoV-2 infection. In July 2021, a survey was sent to the mothers of all Danish children aged 0-14 years with a positive SARS-CoV-2 polymerase chain reaction (PCR) test between January 2020 and July 2021. The survey included 17 symptoms associated with acute SARS-CoV-2 infection and questions about comorbidities. Results Of 38,152 children with a positive SARS-CoV-2 PCR test, 10,994 (28.8%) mothers responded. The median age was 10.2 (range 0.2-16.0) years and 51.8% were male. Among participants, 54.2% (n=5957) reported no symptoms, 43.7% (n=4807) reported mild symptoms, and 2.1% (n=230) reported severe symptoms. The most common symptoms were fever (25.0%), headache (22.5%) and sore throat (18.4%). Asthma {odds ratio (OR) 1.91 [95% confidence interval (CI) 1.57-2.32) and OR 2.11 (95% CI 1.36-3.28)}, allergy [OR 1.31 (95% CI 1.14-1.52) and OR 1.70 (95% CI 1.18-2.46], eczema [OR 1.43 (95% CI 1.20-1.71) and OR 2.03 (95% CI 1.38-2.97)] and OCD/anxiety/depression [OR 2.06 (95% CI 1.39-3.06) and OR 3.79 (95% CI 1.80-7.97)] were associated with reporting a higher symptom burden [values indicate outcomes reporting three or more acute symptoms (upper quartile) and reporting a severe symptom burden, respectively]. The highest prevalence of symptoms was found among children aged 0-2 and 12-14 years. Conclusions Among SARS-CoV-2-positive children aged 0-14 years, approximately half reported no acute symptoms within the first 4 weeks after a positive PCR test. Most symptomatic children reported mild symptoms. Several comorbidities were associated with reporting a higher symptom burden.
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Affiliation(s)
- Selina Kikkenborg Berg
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Pernille Palm
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Susanne Dam Nielsen
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Paediatric and Adolescent Medicine, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Ulrikka Nygaard
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Infectious Disease, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Henning Bundgaard
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Siri Rosenkilde
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Anne Bonde Thorsted
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Annette Kjær Ersbøll
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Lau Casper Thygesen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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Tseng YJ, Olson KL, Bloch D, Mandl KD. Smart Thermometer-Based Participatory Surveillance to Discern the Role of Children in Household Viral Transmission During the COVID-19 Pandemic. JAMA Netw Open 2023; 6:e2316190. [PMID: 37261828 PMCID: PMC10236238 DOI: 10.1001/jamanetworkopen.2023.16190] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 04/18/2023] [Indexed: 06/02/2023] Open
Abstract
Importance Children's role in spreading virus during the COVID-19 pandemic is yet to be elucidated, and measuring household transmission traditionally requires contact tracing. Objective To discern children's role in household viral transmission during the pandemic when enveloped viruses were at historic lows and the predominance of viral illnesses were attributed to COVID-19. Design, Setting, and Participants This cohort study of a voluntary US cohort tracked data from participatory surveillance using commercially available thermometers with a companion smartphone app from October 2019 to October 2022. Eligible participants were individuals with temperature measurements in households with multiple members between October 2019 and October 2022 who opted into data sharing. Main Outcomes and Measures Proportion of household transmissions with a pediatric index case and changes in transmissions during school breaks were assessed using app and thermometer data. Results A total of 862 577 individuals from 320 073 households with multiple participants (462 000 female [53.6%] and 463 368 adults [53.7%]) were included. The number of febrile episodes forecast new COVID-19 cases. Within-household transmission was inferred in 54 506 (15.4%) febrile episodes and increased from the fourth pandemic period, March to July 2021 (3263 of 32 294 [10.1%]) to the Omicron BA.1/BA.2 wave (16 516 of 94 316 [17.5%]; P < .001). Among 38 787 transmissions in 166 170 households with adults and children, a median (IQR) 70.4% (61.4%-77.6%) had a pediatric index case; proportions fluctuated weekly from 36.9% to 84.6%. A pediatric index case was 0.6 to 0.8 times less frequent during typical school breaks. The winter break decrease was from 68.4% (95% CI, 57.1%-77.8%) to 41.7% (95% CI, 34.3%-49.5%) at the end of 2020 (P < .001). At the beginning of 2022, it dropped from 80.3% (95% CI, 75.1%-84.6%) to 54.5% (95% CI, 51.3%-57.7%) (P < .001). During summer breaks, rates dropped from 81.4% (95% CI, 74.0%-87.1%) to 62.5% (95% CI, 56.3%-68.3%) by August 2021 (P = .02) and from 83.8% (95% CI, 79.2%-87.5) to 62.8% (95% CI, 57.1%-68.1%) by July 2022 (P < .001). These patterns persisted over 2 school years. Conclusions and Relevance In this cohort study using participatory surveillance to measure within-household transmission at a national scale, we discerned an important role for children in the spread of viral infection within households during the COVID-19 pandemic, heightened when schools were in session, supporting a role for school attendance in COVID-19 spread.
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Affiliation(s)
- Yi-Ju Tseng
- Computational Health Informatics Program, Boston Children’s Hospital, Boston, Massachusetts
- Department of Computer Science, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Karen L. Olson
- Computational Health Informatics Program, Boston Children’s Hospital, Boston, Massachusetts
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | | | - Kenneth D. Mandl
- Computational Health Informatics Program, Boston Children’s Hospital, Boston, Massachusetts
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts
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30
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Yang X, Fox A, DeCarlo C, Pineda N, Powell RL. The secretory IgA (sIgA) response in human milk against the SARS-CoV-2 Spike is highly durable and neutralizing for at least 1 year of lactation post-infection. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.05.19.23290192. [PMID: 37293109 PMCID: PMC10246141 DOI: 10.1101/2023.05.19.23290192] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Although in the early pandemic period, COVID-19 pathology among young children and infants was typically less severe compared to that observed among adults, this has not remained entirely consistent as SARS-CoV-2 variants have emerged. There is an enormous body of evidence demonstrating the benefits of human milk antibodies (Abs) in protecting infants against a wide range of enteric and respiratory infections. It is highly plausible that the same holds true for protection against SARS-CoV-2, as this virus infects cells of the gastrointestinal and respiratory mucosae. Understanding the durability of a human milk Ab response over time after infection is critical. Previously, we examined the Abs present in milk of those recently infected with SARS-CoV-2, and concluded that the response was secretory IgA (sIgA)-dominant and that these titers were highly correlated with neutralization potency. The present study aimed to monitor the durability of the SARS-CoV-2 IgA and secretory Ab (sAb) response in milk from COVID-19-recovered lactating individuals over 12 months, in the absence of vaccination or re-infection. This analysis revealed a robust and durable Spike-specific milk sIgA response, that at 9-12 months after infection, 88% of the samples exhibited titers above the positive cutoff for IgA and 94% were above cutoff for sAb. Fifty percent of participants exhibited less than a 2-fold reduction of Spike-specific IgA through 12 months. A strong significant positive correlation between IgA and sAb against Spike persisted throughout the study period. Nucleocapsid-specific Abs were also assessed, which revealed significant background or cross reactivity of milk IgA against this immunogen, as well as limited/inconsistent durability compared to Spike titers. These data suggests that lactating individuals are likely to continue producing Spike-specific Abs in their milk for 1 year or more, which may provide critical passive immunity to infants against SARS-CoV-2 throughout the lactation period.
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Affiliation(s)
- Xiaoqi Yang
- Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, New York, USA
| | - Alisa Fox
- Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, New York, USA
| | - Claire DeCarlo
- Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, New York, USA
| | - Nicole Pineda
- Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, New York, USA
| | - Rebecca L.R. Powell
- Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, New York, USA
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31
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Morris DR, Qu Y, Thomason KS, de Mello AH, Preble R, Menachery VD, Casola A, Garofalo RP. The impact of RSV/SARS-CoV-2 co-infection on clinical disease and viral replication: insights from a BALB/c mouse model. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.05.24.542043. [PMID: 37292863 PMCID: PMC10245946 DOI: 10.1101/2023.05.24.542043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
RSV and SARS-CoV-2 are prone to co-infection with other respiratory viruses. In this study, we use RSV/SARS-CoV-2 co-infection to evaluate changes to clinical disease and viral replication in vivo. To consider the severity of RSV infection, effect of sequential infection, and the impact of infection timing, mice were co-infected with varying doses and timing. Compared with a single infection of RSV or SARS-CoV-2, the co-infection of RSV/SARS-CoV-2 and the primary infection of RSV followed by SARS-CoV-2 results in protection from SARS-CoV-2-induced clinical disease and reduces SARS-CoV-2 replication. Co-infection also augmented RSV replication at early timepoints with only the low dose. Additionally, the sequential infection of RSV followed by SARS-CoV-2 led to improved RSV clearance regardless of viral load. However, SARS-CoV-2 infection followed by RSV results in enhanced SARS-CoV-2-induced disease while protecting from RSV-induced disease. SARS-CoV-2/RSV sequential infection also reduced RSV replication in the lung tissue, regardless of viral load. Collectively, these data suggest that RSV and SARS-CoV-2 co-infection may afford protection from or enhancement of disease based on variation in infection timing, viral infection order, and/or viral dose. In the pediatric population, understanding these infection dynamics will be critical to treat patients and mitigate disease outcomes.
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Affiliation(s)
- Dorothea R. Morris
- Department of Microbiology & Immunology, The University of Texas Medical Branch, Galveston, TX
- School of Public & Population Health, The University of Texas Medical Branch, Galveston, TX
- Department of Pediatrics, The University of Texas Medical Branch, Galveston, TX
| | - Yue Qu
- Department of Pediatrics, The University of Texas Medical Branch, Galveston, TX
| | - Kerrie S. Thomason
- Department of Pediatrics, The University of Texas Medical Branch, Galveston, TX
| | - Aline Haas de Mello
- Department of Pediatrics, The University of Texas Medical Branch, Galveston, TX
| | - Richard Preble
- John Sealy School of Medicine, The University of Texas Medical Branch, Galveston, TX
| | - Vineet D. Menachery
- Department of Microbiology & Immunology, The University of Texas Medical Branch, Galveston, TX
| | - Antonella Casola
- Department of Microbiology & Immunology, The University of Texas Medical Branch, Galveston, TX
- Department of Pediatrics, The University of Texas Medical Branch, Galveston, TX
| | - Roberto P. Garofalo
- Department of Microbiology & Immunology, The University of Texas Medical Branch, Galveston, TX
- Department of Pediatrics, The University of Texas Medical Branch, Galveston, TX
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Dawood FS, Couture A, Zhang X, Stockwell MS, Porucznik CA, Stanford JB, Hetrich M, Veguilla V, Thornburg N, Heaney CD, Wang J, Duque J, Jeddy Z, Deloria Knoll M, Karron R. Severe Acute Respiratory Syndrome Coronavirus 2 Neutralizing Antibody Responses After Community Infections in Children and Adults. Open Forum Infect Dis 2023; 10:ofad168. [PMID: 37213425 PMCID: PMC10199115 DOI: 10.1093/ofid/ofad168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 03/24/2023] [Indexed: 04/01/2024] Open
Abstract
Background We compared postinfection severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) neutralizing antibody (nAb) responses among children and adults while the D614G-like strain and Alpha, Iota, and Delta variants circulated. Methods During August 2020-October 2021, households with adults and children were enrolled and followed in Utah, New York City, and Maryland. Participants collected weekly respiratory swabs that were tested for SARS-CoV-2 and had sera collected during enrollment and follow-up. Sera were tested for SARS-CoV-2 nAb by pseudovirus assay. Postinfection titers were characterized with biexponential decay models. Results Eighty participants had SARS-CoV-2 infection during the study (47 with D614G-like virus, 17 with B.1.1.7, and 8 each with B.1.617.2 and B.1.526 virus). Homologous nAb geometric mean titers (GMTs) trended higher in adults (GMT = 2320) versus children 0-4 (GMT = 425, P = .33) and 5-17 years (GMT = 396, P = .31) at 1-5 weeks postinfection but were similar from 6 weeks. Timing of peak titers was similar by age. Results were consistent when participants with self-reported infection before enrollment were included (n = 178). Conclusions The SARS-CoV-2 nAb titers differed in children compared to adults early after infection but were similar by 6 weeks postinfection. If postvaccination nAb kinetics have similar trends, vaccine immunobridging studies may need to compare nAb responses in adults and children 6 weeks or more after vaccination.
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Affiliation(s)
- Fatimah S Dawood
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Alexia Couture
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Xueyan Zhang
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Melissa S Stockwell
- Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Irving Medical Center, New York, New York, USA
- Department of Population and Family Health, Mailman School of Public Health, Columbia University Irving Medical Center, New York, New York, USA
| | - Christina A Porucznik
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Joseph B Stanford
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Marissa Hetrich
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Vic Veguilla
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Natalie Thornburg
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Christopher D Heaney
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jing Wang
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Zuha Jeddy
- Abt Associates, Cambridge, Massachusetts, USA
| | - Maria Deloria Knoll
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Ruth Karron
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Park E, Choi SY, Lee S, Kim M, Lee K, Lee S, Yoon S, Kim N, Oh WS, Kim E, Kim BI, Song JS. Widespread Household Transmission of SARS-CoV-2 B.1.1.529 (Omicron) Variant from Children, South Korea, 2022. Yonsei Med J 2023; 64:344-348. [PMID: 37114638 PMCID: PMC10151225 DOI: 10.3349/ymj.2022.0608] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/26/2023] [Accepted: 03/03/2023] [Indexed: 04/29/2023] Open
Abstract
The role that children play in the transmission of the omicron variant is unclear. Here we report an outbreak that started in young children attending various pediatric facilities, leading to extensive household transmission that affected 75 families with 88 confirmed case-patients in 3 weeks. Tailored social and public health measures directed towards children and pediatric facilities are warranted with the emergence of highly transmissible omicron variant to mitigate the impact of coronavirus diseases 2019 (COVID-19).
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Affiliation(s)
- Eunkyung Park
- Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - So Young Choi
- Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Shinyoung Lee
- Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Miyoung Kim
- Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Kyusug Lee
- Wonju Public Health Center, Wonju, Korea
| | - Seonju Lee
- Wonju Public Health Center, Wonju, Korea
| | | | | | - Won Sup Oh
- Gangwon Center for Infectious Diseases, Chuncheon, Korea
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Eunmi Kim
- Gangwon Center for Infectious Diseases, Chuncheon, Korea
| | - Bryan Inho Kim
- Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Jin Su Song
- Korea Disease Control and Prevention Agency, Cheongju, Korea
- Graduate School of Global Development and Entrepreneurship, Handong Global University, Pohang, Korea.
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Liu Y, Xu L, Piao X, Li H, Shi L, Huang Y, Zhou H, Yang Y, Liu X, Wu M, He Y, Yin Y, Wang L, Yu J, Zhou W, Zheng J, Zhong VW, Xue Z, Zhong L. Epidemiological, clinical, and household transmission characteristics of children and adolescents infected with SARS-CoV-2 Omicron variant in Shanghai, China: a retrospective, multicenter observational study. Int J Infect Dis 2023; 129:1-9. [PMID: 36724865 PMCID: PMC9884399 DOI: 10.1016/j.ijid.2023.01.030] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 01/20/2023] [Accepted: 01/23/2023] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVES To describe the epidemiological, clinical, and household transmission characteristics of pediatric COVID-19 cases in Shanghai, China. METHODS Pediatric patients with COVID-19 hospitalized in Shanghai from March-May 2022 were enrolled in this retrospective, multicenter cohort study. The symptoms and the risk factors associated with disease severity were analyzed. RESULTS In total, 2620 cases (age range, 24 days-17 years) were enrolled in this study. Of these, 1011 (38.6%) were asymptomatic, whereas 1415 (54.0%), 190 (7.3%), and 4 (0.2%) patients developed mild, moderate, and severe illnesses, respectively. Household infection rate was negatively correlated with household vaccination coverage. Children aged 0-3 years, those who are unvaccinated, those with underlying diseases, and overweight/obese children had a higher risk of developing moderate to severe disease than children aged 12-17 years, those who were vaccinated, those without any underlying disease, and those with normal weight, respectively (all P <0.05). A prolonged duration of viral shedding was associated with disease severity, presence of underlying diseases, vaccination status, and younger age (all P <0.05). CONCLUSION Children aged younger than 3 years who were not eligible for vaccination had a high risk of developing moderate to severe COVID-19 with a prolonged duration of viral shedding. Vaccination could protect children from COVID-19 at the household level.
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Affiliation(s)
- Yazun Liu
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Lan Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiang Piao
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Han Li
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Li Shi
- Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yue Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huan Zhou
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yan Yang
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiao Liu
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Mingyun Wu
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yuanyuan He
- Children's Hospital of Fudan University, Shanghai, China
| | - Yong Yin
- Department of Respiratory, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Libo Wang
- Children's Hospital of Fudan University, Shanghai, China.
| | - Jian Yu
- Children's Hospital of Fudan University, Shanghai, China.
| | - Wenhao Zhou
- Children's Hospital of Fudan University, Shanghai, China.
| | - Junhua Zheng
- Department of Urology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Victor W Zhong
- Department of Epidemiology and Biostatistics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Zheng Xue
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
| | - Liwei Zhong
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
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Rich C, Hanson L, Daniel L, Davis A. Temperature screening and detection of Covid‐19 in school‐aged children: A retrospective cohort study assessing the efficacy of temperature screening in schools. WORLD MEDICAL & HEALTH POLICY 2023. [DOI: 10.1002/wmh3.567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Affiliation(s)
- Courtney Rich
- Magnolia Regional Health Center Emergency Medicine Residency Corinth Mississippi USA
| | - Laura Hanson
- Magnolia Regional Health Center Emergency Medicine Residency Corinth Mississippi USA
| | - Luther Daniel
- Debusk College of Osteopathic Medicine Lincoln Memorial University Harrogate Tennessee USA
| | - Amy Davis
- Magnolia Regional Health Center Emergency Medicine Residency Corinth Mississippi USA
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Michalska-Smith M, Enns EA, White LA, Gilbertson MLJ, Craft ME. The illusion of personal health decisions for infectious disease management: disease spread in social contact networks. ROYAL SOCIETY OPEN SCIENCE 2023; 10:221122. [PMID: 36998767 PMCID: PMC10049757 DOI: 10.1098/rsos.221122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 03/06/2023] [Indexed: 06/19/2023]
Abstract
Close contacts between individuals provide opportunities for the transmission of diseases, including COVID-19. While individuals take part in many different types of interactions, including those with classmates, co-workers and household members, it is the conglomeration of all of these interactions that produces the complex social contact network interconnecting individuals across the population. Thus, while an individual might decide their own risk tolerance in response to a threat of infection, the consequences of such decisions are rarely so confined, propagating far beyond any one person. We assess the effect of different population-level risk-tolerance regimes, population structure in the form of age and household-size distributions, and different interaction types on epidemic spread in plausible human contact networks to gain insight into how contact network structure affects pathogen spread through a population. In particular, we find that behavioural changes by vulnerable individuals in isolation are insufficient to reduce those individuals' infection risk and that population structure can have varied and counteracting effects on epidemic outcomes. The relative impact of each interaction type was contingent on assumptions underlying contact network construction, stressing the importance of empirical validation. Taken together, these results promote a nuanced understanding of disease spread on contact networks, with implications for public health strategies.
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Affiliation(s)
- Matthew Michalska-Smith
- Department of Ecology, Evolution and behavior, University of Minnesota, Minneapolis, MN, USA
- Department of Plant Pathology, University of Minnesota, Minneapolis, MN, USA
| | - Eva A. Enns
- School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Lauren A. White
- National Socio-Environmental Synthesis Center, University of Maryland, Annapolis, MD, USA
| | - Marie L. J. Gilbertson
- Department of Veterinary Population Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Meggan E. Craft
- Department of Ecology, Evolution and behavior, University of Minnesota, Minneapolis, MN, USA
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Thind P, Vargas CY, Reed C, Wang L, Alba LR, Larson EL, Saiman L, Stockwell MS. Acceptability, Feasibility, and Validity of Detecting Respiratory Pathogens During Acute Respiratory Illness in Participant-Collected Swabs in a Low-Income, Community Sample. Open Forum Infect Dis 2023; 10:ofad068. [PMID: 36879622 PMCID: PMC9985149 DOI: 10.1093/ofid/ofad068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Indexed: 02/18/2023] Open
Abstract
Background Community surveillance for acute respiratory illness (ARI) can include unsupervised participant-collected nasal swabs. Little is known about use of self-swabs in low-income populations or among households including extended family members and the validity of self-collected swabs. We assessed the acceptability, feasibility, and validity of unsupervised participant-collected nasal swabs in a low-income, community sample. Methods This was a substudy of a larger prospective community-based ARI surveillance study in 405 households in New York City. Participating household members self-collected swabs on the day of a research home visit for an index case, and for 3-6 subsequent days. Demographics associated with agreement to participate and swab collection were assessed, and index case self-collected versus research staff-collected swab results were compared. Results Most households (n = 292 [89.6%]) agreed to participate, including 1310 members. Being <18 years old, female, and the household reporter or member of the nuclear family (parents and children) were associated with both agreement to participate and self-swab collection. Being born in the United States or immigrating ≥10 years ago was associated with participation, and being Spanish-speaking and having less than a high school education were associated with swab collection. In all, 84.4% collected at least 1 self-swabbed specimen; self-swabbing rates were highest during the first 4 collection days. Concordance between research staff-collected swabs and self-swabs was 88.4% for negative swabs, 75.0% for influenza, and 69.4% for noninfluenza pathogens. Conclusions Self-swabbing was acceptable, feasible, and valid in this low-income, minoritized population. Some differences in participation and swab collection were identified that could be noted by future researchers and modelers.
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Affiliation(s)
- Priyam Thind
- Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
| | - Celibell Y Vargas
- Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
| | - Carrie Reed
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Liqun Wang
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
| | - Luis R Alba
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
| | - Elaine L Larson
- School of Nursing, Columbia University Irving Medical Center, New York, New York, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, New York, New York, USA
| | - Lisa Saiman
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
- Department of Infection Prevention and Control, New York–Presbyterian Hospital, New York, New York, USA
| | - Melissa S Stockwell
- Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
- Department of Population and Family Health, Mailman School of Public Health, Columbia University Irving Medical Center, New York, New York, USA
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Habet V, Oliveira CR. Clinical Epidemiology of Pediatric Coronavirus Disease 2019 and its Postacute Sequelae. Semin Respir Crit Care Med 2023; 44:66-74. [PMID: 36646086 PMCID: PMC9926930 DOI: 10.1055/s-0042-1759566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has affected individuals of all ages across. Although children generally experience a benign illness from COVID-19, the emergence of novel variants of the virus has resulted in significant changes in the morbidity and mortality rates for this age group. Currently, COVID-19 is the eighth leading cause of pediatric deaths in the United States. In addition to acute respiratory illness, some children can develop a severe postinfectious condition known as a multisystem inflammatory syndrome in children, which can progress to rapid-onset cardiogenic shock. Recovery from COVID-19 can also be slow for some children, resulting in persistent or reoccurring symptoms for months, commonly referred to as long COVID. These postinfectious sequelae are often distressing for children and their parents, can negatively impact the quality of life, and impose a considerable burden on the health care system. In this article, we review the clinical epidemiology of pediatric COVID-19 and outline the management considerations for its acute and postacute manifestations.
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Affiliation(s)
- Victoria Habet
- Section of Critical Care, Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut
| | - Carlos R. Oliveira
- Section of Infectious Diseases and Global Health, Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut
- Section of Health Informatics, Department of Biostatistics, Yale University School of Public Health, New Haven, Connecticut
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Haile SR, Raineri A, Rueegg S, Radtke T, Ulyte A, Puhan MA, Kriemler S. Heterogeneous evolution of SARS-CoV-2 seroprevalence in school-age children: Results from the school-based cohort study Ciao Corona in November-December 2021 in the canton of Zurich. Swiss Med Wkly 2023; 153:40035. [PMID: 36787493 DOI: 10.57187/smw.2023.40035] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Much remains unknown regarding the evolution of SARS-CoV-2 seroprevalence and variability in seropositive children in districts, schools and classes as only a few school-based cohort studies exist. Vaccination of children, initiated at different times for different age groups, adds additional complexity to the understanding of how seroprevalence developed in the school aged population. AIM We investigated the evolution of SARS-CoV-2 seroprevalence in children and its variability in districts, schools and classes in Switzerland from June/July 2020 to November/December 2021. METHODS In this school-based cohort study, SARS-CoV-2 antibodies were measured in primary and secondary school children from randomly selected schools in the canton of Zurich in October/November 2020, March/April 2021 and November/December 2021. Seroprevalence was estimated using Bayesian logistic regression to adjust for test sensitivity and specificity. Variability of seroprevalence between school classes was expressed as maximum minus minimum seroprevalence in a class and summarised as median (interquartile range). RESULTS 1875 children from 287 classes in 43 schools were tested, with median age 12 years (range 6-17), 51% 12+ vaccinated. Seroprevalence increased from 5.6% (95% credible interval [CrI] 3.5-7.6%) to 31.1% (95% CrI 27.0-36.1%) in unvaccinated children, and 46.4% (95% CrI 42.6-50.9%) in all children (including vaccinated). Earlier in the pandemic, seropositivity rates in primary schools were similar to or slightly higher (<5%) than those in secondary schools, but by late 2021, primary schools had 12.3% (44.3%) lower seroprevalence for unvaccinated (all) subjects. Variability in seroprevalence among districts and schools increased more than two-fold over time, and in classes from 11% (95% CrI 7-17%) to 40% (95% CrI 22-49%). CONCLUSIONS Seroprevalence in children increased greatly, especially in 2021 following introduction of vaccines. Variability in seroprevalence was high and increased substantially over time, suggesting complex transmission chains.
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Affiliation(s)
- Sarah R Haile
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
| | - Alessia Raineri
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
| | - Sonja Rueegg
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
| | - Thomas Radtke
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
| | - Agne Ulyte
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
| | - Milo A Puhan
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
| | - Susi Kriemler
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
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Dipasquale V, Deganello Saccomani M, Di Giorgio A, Oliva S, Salvatore S, Strisciuglio C, Tambucci R, Lionetti P, Romano C. Pediatric Gastroenterology and Hepatology in Italy before and after the COVID-19: Lessons learned and management changes by SIGENP. Ital J Pediatr 2023; 49:15. [PMID: 36698148 PMCID: PMC9877500 DOI: 10.1186/s13052-023-01418-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 01/21/2023] [Indexed: 01/27/2023] Open
Abstract
Around the world, the 2019 Coronavirus disease (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has raised serious public health problems and major medical challenges. The Italian Society of Pediatric Gastroenterology, Hepatology and Nutrition (SIGENP) published several papers on the impact of COVID-19 on the current management, diagnosis, and treatment of acute and chronic gastrointestinal, hepatic, immune-mediated, and functional disorders. The present article summarizes the most relevant SIGENP reports and consensus during and after the peak of the COVID-19 outbreak, including the diagnosis and treatment of inflammatory bowel disease (IBD), indications and timing of digestive endoscopy, and insights into the novel hepatitis.
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Affiliation(s)
- Valeria Dipasquale
- Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, Messina, Italy
| | | | - Angelo Di Giorgio
- Pediatric Hepatology, Gastroenterology and Transplantation, Hospital Papa Giovanni XXIII, Bergamo, Italy
| | - Salvatore Oliva
- Pediatric Gastroenterology and Liver Unit, Maternal and Child Health Department, Sapienza University of Rome, Rome, Italy
| | - Silvia Salvatore
- Department of Pediatrics, "F. Del Ponte" Hospital, University of Insubria, Varese, Italy
| | - Caterina Strisciuglio
- Department of Woman, Child and General and Specialistic Surgery, University of Campania "Vanvitelli", Naples, Italy
| | - Renato Tambucci
- Digestive Endoscopy Unit, Department of Gastroenterology, Hepatology and Nutrition, Bambino Gesù Children's Hospital, Rome, Italy
| | - Paolo Lionetti
- Department NEUROFARBA, University of Florence, Gastroenterology and Nutrition Unit, Meyer Children's Hospital, Florence, Italy
| | - Claudio Romano
- Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, Messina, Italy
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Morello W, Vianello FA, Bulgaro C, Montini G. Epidemiology, severity, and risk of SARS-CoV-2-related relapse in children and young adults affected by idiopathic nephrotic syndrome: a retrospective observational cohort study. Pediatr Nephrol 2023; 38:1159-1166. [PMID: 36136155 PMCID: PMC9510541 DOI: 10.1007/s00467-022-05736-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 09/04/2022] [Accepted: 09/05/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Children with underlying kidney diseases display a mild course of SARS-CoV-2 infection, but they only accounted for a minority of cases until the spread of the Omicron variant. Nonetheless, idiopathic nephrotic syndrome (INS) has been advocated as a predictor of worse outcome. METHODS We investigated the spread, severity, and risk of relapse related to SARS-CoV-2 infection among children with INS. The incidence and characteristics of SARS-CoV-2 infections, immunosuppression, and vaccination status were retrospectively collected from the beginning of the pandemic to May 31, 2022. RESULTS We enrolled 176 patients (73 females, median age 10.22 years); 28 had a steroid-resistant disease, and 108 (61.4%) were on immunosuppressive therapy. Sixty-one (34.7%) patients reported a SARS-CoV-2 infection, with incidence peaking between December 2021 and January 2022. No hospitalization or deaths were reported, and symptoms were absent or mild. The rate of SARS-CoV-2 infection was similar in children with and without immunosuppression (33.8% vs 35.2%; p = 0.85). None of the 38 immunosuppressed patients discontinued the therapy, but they had a longer time to negativization (13.31 vs. 10.04 days; p = 0.03). Proteinuria was detected in 7 patients, but only one had a relapse requiring steroid therapy, with prompt remission and a mild course. CONCLUSIONS After the spread of the Omicron variant, the rate of SARS-CoV-2 infection in children with INS was much higher than previously reported. In this large cohort, symptoms were mild, even in immunosuppressed patients and those with proteinuria. During the infection, transient proteinuria was common with a low rate of relapses. A higher resolution version of the Graphical abstract is available as Supplementary information.
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Affiliation(s)
- William Morello
- Pediatric Nephrology, Dialysis and Transplant Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, via della Commenda 9, 20122, Milano, Italy.
| | - Federica Alessandra Vianello
- Pediatric Nephrology, Dialysis and Transplant Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, via della Commenda 9, 20122 Milano, Italy
| | - Chiara Bulgaro
- Pediatric Nephrology, Dialysis and Transplant Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, via della Commenda 9, 20122 Milano, Italy
| | - Giovanni Montini
- Pediatric Nephrology, Dialysis and Transplant Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, via della Commenda 9, 20122 Milano, Italy ,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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Dimopoulou D, Kyritsi M, Dadouli K, Vergadi E, Tsiligianni E, Papadimitriou E, Mavridi A, Giannakopoulos S, Tsiourvopoulou G, Palyvou M, Angeli E, Brikos N, Eleftheriou I, Spoulou V, Michos A, Gkentzi D, Siomou E, Papaevangelou V, Grivea I, Syrogiannopoulos G, Galanakis E, Hadjichristodoulou C, Tsolia M. Seroprevalence of anti-SARS-CoV-2 antibodies among children and their parents in Greece. Eur J Pediatr 2023; 182:439-449. [PMID: 36383284 PMCID: PMC9666986 DOI: 10.1007/s00431-022-04681-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 10/21/2022] [Accepted: 10/26/2022] [Indexed: 11/17/2022]
Abstract
UNLABELLED School closures were enforced as measures to restrain the COVID-19 pandemic, based on the assumption that young children may play a key role in SARS-CoV-2 spread. This study aims to determine the prevalence of SARS-CoV-2 IgG antibodies in children and corresponding parents, in order to improve surveillance and estimate the prevalence of asymptomatic or subclinical COVID-19 cases. A prospective multicenter study was conducted between March and June 2021 in Greece. Children admitted to the hospital or examined in outpatient clinics for reasons other than COVID-19 and their parents were tested for anti-Spike SARS-CoV-2 IgG in serum. A questionnaire about clinical and demographic data was completed. The study included 823 participants: 427 children and 396 corresponding parents. The overall seroprevalence was 16.4% in parents and 13.8% in children. Among families with ≥ 1 seropositive child or parent, the combination of a seropositive parent and a corresponding seronegative child was 29.6%, a seronegative parent and a corresponding seropositive child was 24.7%, and a seropositive child with a corresponding seropositive parent was 45.7%. Age, level of education, and school or work attendance were not significantly associated with increased seropositivity. On the contrary, ethnic minority of Roma, close contact with known COVID-19 case, previous symptoms consistent with COVID-19, and mass gatherings were risk factors for seropositivity. CONCLUSION The spread of SARS-CoV-2 during a period of lockdown in Greece was low in children and comparable to adults most likely due to intrafamilial transmission. Accordingly, it is unlikely that children have boosted virus transmission. WHAT IS KNOWN • In the earliest months of the pandemic, it was demonstrated that children had significantly lower seroprevalence rates than the older age groups, due to the fact that children had decreased exposure to the virus, because of early public health interventions, such as school and day care closure. • Later, further studies reported that children have similar incidence rate of SARS-CoV-2 infection compared to adults in households and community settings. WHAT IS NEW • In this seroprevalence study, the spread of SARS-CoV-2 infection during a period of lockdown in Greece with the predominance of the Alpha-variant was particularly low in children and comparable to adults, most likely due to intrafamilial transmission. • These study findings will be useful for decisions regarding non-pharmaceutical interventions during the pandemic, and especially, to guide in designing and implementing appropriate containment measures for schools and social gatherings.
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Affiliation(s)
- Dimitra Dimopoulou
- Second Department of Pediatrics, "P. & A. Kyriakou" Children's Hospital, National and Kapodistrian University of Athens, Second Department of Paediatrics, Thivon and Leivadias Str, 11526, Athens, Greece.
| | - Maria Kyritsi
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Katerina Dadouli
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Eleni Vergadi
- School of Medicine, Department of Paediatrics, University of Crete, University General Hospital of Heraklion, Heraklion, Greece
| | | | - Eleni Papadimitriou
- School of Health Sciences, Faculty of Medicine, Department of Paediatrics, University General Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - Artemis Mavridi
- Third Department of Paediatrics, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | | | | | - Maria Palyvou
- Medical School, Department of Paediatrics, University of Patras, Patras, Greece
| | - Evangelia Angeli
- Medical School, Department of Paediatrics, University of Patras, Patras, Greece
| | - Nikitas Brikos
- First Department of Paediatrics, “Aghia Sophia” Children’s Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Irini Eleftheriou
- Second Department of Pediatrics, “P. & A. Kyriakou” Children’s Hospital, National and Kapodistrian University of Athens, Second Department of Paediatrics, Thivon and Leivadias Str, 11526 Athens, Greece
| | - Vassiliki Spoulou
- First Department of Paediatrics, “Aghia Sophia” Children’s Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Athanasios Michos
- First Department of Paediatrics, “Aghia Sophia” Children’s Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Despoina Gkentzi
- Medical School, Department of Paediatrics, University of Patras, Patras, Greece
| | - Ekaterini Siomou
- Department of Pediatrics, University Hospital of Ioannina, Ioannina, Greece
| | - Vassiliki Papaevangelou
- Third Department of Paediatrics, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioanna Grivea
- School of Health Sciences, Faculty of Medicine, Department of Paediatrics, University General Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - George Syrogiannopoulos
- School of Health Sciences, Faculty of Medicine, Department of Paediatrics, University General Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - Emmanouil Galanakis
- School of Medicine, Department of Paediatrics, University of Crete, University General Hospital of Heraklion, Heraklion, Greece
| | | | - Maria Tsolia
- Second Department of Pediatrics, “P. & A. Kyriakou” Children’s Hospital, National and Kapodistrian University of Athens, Second Department of Paediatrics, Thivon and Leivadias Str, 11526 Athens, Greece
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Branch-Elliman W, Fisher L, Doron S. The next 'pandemic playbook' needs to prioritize the needs of children-and a clear roadmap for opening schools. ANTIMICROBIAL STEWARDSHIP & HEALTHCARE EPIDEMIOLOGY : ASHE 2023; 3:e82. [PMID: 37179759 PMCID: PMC10173290 DOI: 10.1017/ash.2023.154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/15/2023] [Accepted: 03/15/2023] [Indexed: 05/15/2023]
Abstract
The national influenza pandemic response plan includes short-term school closures as an infection mitigation measure, based on modeling data regarding the role of pediatric populations and schools as drivers of disease spread. Modeled estimates regarding the role of children and their in-school contacts as drivers of community transmission of endemic respiratory viruses were used in part to justify prolonged school closures throughout the United States. However, disease transmission models extrapolated from endemic pathogens to novel ones may underestimate the degree to which spread is driven by population immunity and overestimate the impact of school closures as a means of reducing child contacts, particularly in the longer-term. These errors, in turn, may have caused incorrect estimations about the potential benefits of closing schools on a society level while simultaneously failing to account for the significant harms of long-term educational disruption. Pandemic response plans need to be updated to include nuances regarding drivers of transmission such as pathogen type, population immunity, and contact patterns, and disease severity in different groups. Expected duration of impact also needs to be considered, recognizing that effectiveness of different interventions, particularly those focused on limiting social interactions, are short-lived. Additionally, future iterations should include risk-benefit assessments. Interventions that are particularly harmful to certain groups, such as school closures are on children, should be de-emphasized and time limited. Finally, pandemic responses should include ongoing and continuous policy re-evaluation and should include a clear plan for de-implementation and de-escalation.
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Affiliation(s)
- Westyn Branch-Elliman
- Department of Medicine, VA Boston Healthcare System, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
- Corresponding author: Westyn Branch-Elliman MD, West Roxbury VA Medical Center, 1400 VFW Parkway. West Roxbury, MA02132.
| | - Lloyd Fisher
- Reliant Medical Group, Worcester, Massachusetts
- Department of Pediatrics, University of Massachusetts Medical Center, Worcester, Massachusetts
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Schumm L, Blankenburg J, Kahre E, Armann J, Dalpke AH, Lück C, Berner R, Czyborra P. Lower SARS-CoV-2 household transmission in children and adolescents compared to adults. Sci Rep 2022; 12:22453. [PMID: 36575230 PMCID: PMC9794106 DOI: 10.1038/s41598-022-24643-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 11/17/2022] [Indexed: 12/28/2022] Open
Abstract
In the COVID-19 pandemic, children were considered to play a major role in SARS-CoV-2 transmission similar to influenza. Thus, mitigation measures have been focused on children, impacting their everyday life severely. Despite this, infectivity in this age group regarding SARS-CoV-2 is not yet clarified. We performed a serology study in households with confirmed SARS-CoV-2 infection to evaluate virus transmission with focus on children and adolescents. Between January and July 2021, 341 minors and 650 adults from 300 households with a confirmed index case participated in the FamilyCoviDD19-study including serological assessment for SARS-CoV-2 antibodies and a questionnaire on demographics, recent and ongoing symptoms, hygiene measures and comorbidities. 45 (16.3%) of all index cases were < 18 years old. Thereof, 55.6% reported COVID-19 associated symptoms, while nearly all adult index cases were symptomatic (94.8%). There was significantly less virus transmission by children and adolescents compared to adult index cases with a secondary attack rate of 0.29 vs. 0.54. With the caveat that the results do not necessarily apply to the Delta and Omicron variants, we conclude that children and adolescents are less susceptible for SARS-CoV-2 infection, more frequently show an asymptomatic course of disease and are less infective than adults.
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Affiliation(s)
- L. Schumm
- grid.4488.00000 0001 2111 7257Department of Paediatrics, University Hospital and Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - J. Blankenburg
- grid.4488.00000 0001 2111 7257Department of Paediatrics, University Hospital and Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - E. Kahre
- grid.4488.00000 0001 2111 7257Department of Paediatrics, University Hospital and Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - J. Armann
- grid.4488.00000 0001 2111 7257Department of Paediatrics, University Hospital and Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - A. H. Dalpke
- grid.4488.00000 0001 2111 7257Institute of Medical Microbiology and Virology, University Hospital and Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - C. Lück
- grid.4488.00000 0001 2111 7257Institute of Medical Microbiology and Virology, University Hospital and Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - R. Berner
- grid.4488.00000 0001 2111 7257Department of Paediatrics, University Hospital and Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - P. Czyborra
- grid.4488.00000 0001 2111 7257Department of Paediatrics, University Hospital and Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
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Bendall EE, Paz-Bailey G, Santiago GA, Porucznik CA, Stanford JB, Stockwell MS, Duque J, Jeddy Z, Veguilla V, Major C, Rivera-Amill V, Rolfes MA, Dawood FS, Lauring AS. SARS-CoV-2 Genomic Diversity in Households Highlights the Challenges of Sequence-Based Transmission Inference. mSphere 2022; 7:e0040022. [PMID: 36377913 PMCID: PMC9769559 DOI: 10.1128/msphere.00400-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 10/24/2022] [Indexed: 11/16/2022] Open
Abstract
The reliability of sequence-based inference of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission is not clear. Sequence data from infections among household members can define the expected genomic diversity of a virus along a defined transmission chain. SARS-CoV-2 cases were identified prospectively among 2,369 participants in 706 households. Specimens with a reverse transcription-PCR cycle threshold of ≤30 underwent whole-genome sequencing. Intrahost single-nucleotide variants (iSNV) were identified at a ≥5% frequency. Phylogenetic trees were used to evaluate the relationship of household and community sequences. There were 178 SARS-CoV-2 cases in 706 households. Among 147 specimens sequenced, 106 yielded a whole-genome consensus with coverage suitable for identifying iSNV. Twenty-six households had sequences from multiple cases within 14 days. Consensus sequences were indistinguishable among cases in 15 households, while 11 had ≥1 consensus sequence that differed by 1 to 2 mutations. Sequences from households and the community were often interspersed on phylogenetic trees. Identification of iSNV improved inference in 2 of 15 households with indistinguishable consensus sequences and in 6 of 11 with distinct ones. In multiple-infection households, whole-genome consensus sequences differed by 0 to 1 mutations. Identification of shared iSNV occasionally resolved linkage, but the low genomic diversity of SARS-CoV-2 limits the utility of "sequence-only" transmission inference. IMPORTANCE We performed whole-genome sequencing of SARS-CoV-2 from prospectively identified cases in three longitudinal household cohorts. In a majority of multi-infection households, SARS-CoV-2 consensus sequences were indistinguishable, and they differed by 1 to 2 mutations in the rest. Importantly, even with modest genomic surveillance of the community (3 to 5% of cases sequenced), it was not uncommon to find community sequences interspersed with household sequences on phylogenetic trees. Identification of shared minority variants only occasionally resolved these ambiguities in transmission linkage. Overall, the low genomic diversity of SARS-CoV-2 limits the utility of "sequence-only" transmission inference. Our work highlights the need to carefully consider both epidemiologic linkage and sequence data to define transmission chains in households, hospitals, and other transmission settings.
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Affiliation(s)
- Emily E. Bendall
- Department of Microbiology and Immunology, University of Michigan, Ann Arbor, Michigan, USA
| | | | | | - Christina A. Porucznik
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Joseph B. Stanford
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Melissa S. Stockwell
- Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA
- Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, New York, USA
| | | | - Zuha Jeddy
- Abt Associates, Rockville, Maryland, USA
| | - Vic Veguilla
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Chelsea Major
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Vanessa Rivera-Amill
- Ponce Research Institute, Ponce Health Sciences University, Ponce, Puerto Rico, USA
| | | | | | - Adam S. Lauring
- Department of Microbiology and Immunology, University of Michigan, Ann Arbor, Michigan, USA
- Division of Infectious Diseases, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
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High Seroprevalence of Anti-SARS-CoV-2 Antibodies in Children in Vietnam: An Observational, Hospital-Based Study. Pathogens 2022; 11:pathogens11121442. [PMID: 36558776 PMCID: PMC9784013 DOI: 10.3390/pathogens11121442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 11/27/2022] [Accepted: 11/28/2022] [Indexed: 12/04/2022] Open
Abstract
Background: The robustness of sero-surveillance has delineated the high burden of SARS-CoV-2 infection in children; however, these existing data showed wide variation. This study aimed to identify the serostatus of antibodies against SARS-CoV-2 and associated factors among children following the fourth pandemic wave in Vietnam. Methods: A cross-sectional study was conducted at Vietnam National Children’s Hospital (VNCH) between March 13 and April 3, 2022. Thus, 4032 eligible children seeking medical care for any medical condition not related to acute COVID-19 infection were tested for IgG SARS-CoV-2 antibodies by ADVIA Centaur® SARS-CoV-2 IgG (sCOVG) assay using the residuals of routine blood samples. Results: The median age of enrolled children was 39 (IQR = 14−82) months. The overall seropositive prevalence was 59.2% (95%CI = 57.6−60.7) and the median antibody titer was 4.78 (IQR 2.38−9.57) UI/mL. The risk of seropositivity and the median antibody titer were not related to gender (58.6% versus 60.1%, 4.9 versus 4.6 UI/mL, all p > 0.05). Children aged ≤12 months were likely to be seropositive compared to children aged 36 to <60 months (59.2% versus 57.5%, p = 0.49) and those aged ≥144 months (59.2% versus 65.5%, p = 0.16). Children aged ≥144 months exhibited a significantly higher titer of protective COVID-19 antibodies than other age groups (p < 0.001). In multivariate logistic regression, we observed independent factors associated with SARS-CoV-2 seropositivity, including the age 13 to <36 months (OR = 1.29, 95%CI = 1.06−1.56, p = 0.01), 60 to <144 months (OR = 0.79, 95%CI = 0.67−0.95, p = 0.01), ≥144 months (OR = 1.84, 95%CI = 1.21−2.8, p = 0.005), the presence of infected household members (OR = 2.36, 95%CI = 2.06−2.70, p < 0.001), participants from Hanoi (OR = 1.54, 95%CI = 1.34−1.77, p < 0.001), underlying conditions (OR = 0.71, 95%CI = 0.60−0.85, p ≤ 0.001), and using corticosteroids or immunosuppressants (OR = 0.64, 95%CI = 0.48−0.86, p = 0.003). Conclusions: This study highlights a high seroprevalence of antibodies against SARS-CoV-2 among children seeking medical care for non-acute COVID-19-related conditions in a tertiary children’s hospital in Hanoi, Vietnam. In the context of reopening in-person schools and future emerging COVID-19 variants, this point will also be a key message about the necessity of “rush-out” immunization coverage for children, especially those under the age of five years.
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Chun JY, Jeong H, Kim Y. Identifying susceptibility of children and adolescents to the Omicron variant (B.1.1.529). BMC Med 2022; 20:451. [PMID: 36419108 PMCID: PMC9684890 DOI: 10.1186/s12916-022-02655-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 11/08/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The Omicron variant (B.1.1.529) is estimated to be more transmissible than previous strains of SARS-CoV-2 especially among children, potentially resulting in croup which is a characteristic disease in children. Current coronavirus disease 2019 (COVID-19) cases among children might be higher because (i) school-aged children have higher contact rates and (ii) the COVID-19 vaccination strategy prioritizes the elderly in most countries. However, there have been no reports confirming the age-varying susceptibility to the Omicron variant to date. METHODS We developed an age-structured compartmental model, combining age-specific contact matrix in South Korea and observed distribution of periods between each stage of infection in the national epidemiological investigation. A Bayesian inference method was used to estimate the age-specific force of infection and, accordingly, age-specific susceptibility, given epidemic data during the third (pre-Delta), fourth (Delta driven), and fifth (Omicron driven) waves in South Korea. As vaccine uptake increased, individuals who were vaccinated were excluded from the susceptible population in accordance with vaccine effectiveness against the Delta and Omicron variants, respectively. RESULTS A significant difference between the age-specific susceptibility to the Omicron and that to the pre-Omicron variants was found in the younger age group. The rise in susceptibility to the Omicron/pre-Delta variant was highest in the 10-15 years age group (5.28 times [95% CI, 4.94-5.60]), and the rise in susceptibility to the Omicron/Delta variant was highest in the 15-19 years age group (3.21 times [95% CI, 3.12-3.31]), whereas in those aged 50 years or more, the susceptibility to the Omicron/pre-Omicron remained stable at approximately twofold. CONCLUSIONS Even after adjusting for contact pattern, vaccination status, and waning of vaccine effectiveness, the Omicron variant of SARS-CoV-2 tends to propagate more easily among children than the pre-Omicron strains.
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Affiliation(s)
- June Young Chun
- Department of Internal Medicine, National Cancer Center, Goyang, South Korea.
| | - Hwichang Jeong
- Department of Statistics, Seoul National University, 56-1 Mountain, Sillim-dong, Gwanak-gu, Seoul, 08826, South Korea
| | - Yongdai Kim
- Department of Statistics, Seoul National University, 56-1 Mountain, Sillim-dong, Gwanak-gu, Seoul, 08826, South Korea.
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Sava CN, Bodog TM, Niulas LR, Iuhas AR, Marinau CP, Negrut N, Balmos AB, Pasca B, Roman NA, Delia Nistor-Cseppento C. Biomarker Changes in Pediatric Patients With COVID-19: A Retrospective Study from a Single Center Database. In Vivo 2022; 36:2813-2822. [PMID: 36309348 PMCID: PMC9677791 DOI: 10.21873/invivo.13019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/07/2022] [Accepted: 10/11/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND/AIM The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for generating a global pandemic with deadly consequences and life changes worldwide. With the appearance of the new variants of the virus, clinical manifestations have been reported in the pediatric population, some with severe evolution. The aim of this study was to identify the laboratory parameters necessary to establish an effective therapy. PATIENTS AND METHODS In the period from August 2020 to September 2021, 234 pediatric patients met the inclusion criteria and were selected for the study. After confirming the COVID-19 diagnosis, laboratory parameters were analyzed and compared to the severity of the illness. RESULTS Thrombocytopenia (p<0.001), leukocytosis (p<0.001), and lymphopenia (p<0.001) correlated with the severity of the disease. Also, D-dimer values were closely monitored due to the high association of this parameter with an unsatisfactory prognosis and a severe form of the disease. CONCLUSION The D-dimer values and complete blood count are useful parameters in COVID-19 evaluation in children.
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Affiliation(s)
- Cristian Nicolae Sava
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Romania
- Department of Pediatrics, County Clinical Emergency Hospital of Oradea, Oradea, Romania
| | | | - Larisa Roxana Niulas
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Romania
- Department of Pediatrics, County Clinical Emergency Hospital of Oradea, Oradea, Romania
| | - Alin Remus Iuhas
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Romania
- Department of Pediatrics, County Clinical Emergency Hospital of Oradea, Oradea, Romania
| | - Cristian Phillip Marinau
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Romania
- Department of Pediatrics, County Clinical Emergency Hospital of Oradea, Oradea, Romania
| | - Nicoleta Negrut
- Department of Psycho-neuroscience and Recovery, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Romania;
| | - Andreea Bianca Balmos
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Romania;
- Department of Pediatrics, County Clinical Emergency Hospital of Oradea, Oradea, Romania
| | - Bianca Pasca
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Romania
| | | | - Carmen Delia Nistor-Cseppento
- Department of Psycho-neuroscience and Recovery, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Romania
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Garnett L, Tse C, Funk D, Dust K, Tran KN, Hedley A, Poliquin G, Bullard J, Strong JE. Differential Infectivity of Original and Delta Variants of SARS-CoV-2 in Children Compared to Adults. Microbiol Spectr 2022; 10:e0039522. [PMID: 35972128 PMCID: PMC9602606 DOI: 10.1128/spectrum.00395-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 08/01/2022] [Indexed: 11/20/2022] Open
Abstract
Although children of all ages are susceptible to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, they have not been implicated as major drivers of transmission thus far. However, it is still unknown if this finding holds true with new variants of concern (VOC), such as Delta (B.1.617.2). This study aimed to examine differences in both viral RNA (as measured by cycle threshold [CT]) and viable-virus levels from children infected with Delta and those infected with original variants (OV). Furthermore, we aimed to compare the pediatric population infection trends to those in adults. We obtained 690 SARS-CoV-2 RT-PCR positive nasopharyngeal swabs from across Manitoba, Canada, which were further screened for mutations characteristic of VOC. Aliquots of sample were then provided for TCID50 (50% tissue culture infective dose) assays to determine infectious titers. Using a variety of statistical analyses we compared CT and infectivity of VOC in different age demographics. Comparing 122 Delta- to 175 OV-positive nasopharyngeal swab samples from children, we found that those infected with Delta are 2.7 times more likely to produce viable SARS-CoV-2 with higher titers (in TCID50 per milliliter), regardless of viral RNA levels. Moreover, comparing the pediatric samples to 130 OV- and 263 Delta-positive samples from adults, we found only that the Delta pediatric culture-positive samples had titers (TCID50 per milliliter) similar to those of culture-positive adult samples. IMPORTANCE These important findings show that children may play a larger role in viral transmission of Delta than for previously circulating SARS-CoV-2 variants. Additionally, they may suggest a mechanism for why Delta has evolved to be the predominant circulating variant.
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Affiliation(s)
- Lauren Garnett
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Carmen Tse
- Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Duane Funk
- Departments of Anaesthesiology and Medicine, Section of Critical Care, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Kerry Dust
- Cadham Provincial Laboratory, Manitoba Health, Winnipeg, Manitoba, Canada
| | - Kaylie N. Tran
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Adam Hedley
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada
- Cadham Provincial Laboratory, Manitoba Health, Winnipeg, Manitoba, Canada
| | - Guillaume Poliquin
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
- Department of Pediatrics & Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Jared Bullard
- Cadham Provincial Laboratory, Manitoba Health, Winnipeg, Manitoba, Canada
- Department of Pediatrics & Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - James E. Strong
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Pediatrics & Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
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Clarke KEN, Kim Y, Jones J, Lee A, Deng Y, Nycz E, Iachan R, Gundlapalli AV, MacNeil A, Hall A. Pediatric Infection-Induced SARS-CoV-2 Seroprevalence Increases and Seroprevalence by Type of Clinical CareSeptember 2021 to February 2022. J Infect Dis 2022; 227:364-370. [PMID: 36281757 PMCID: PMC9620360 DOI: 10.1093/infdis/jiac423] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 10/18/2022] [Accepted: 10/23/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Trends in estimates of US pediatric SARS-CoV-2 infection-induced seroprevalence from commercial laboratory specimens may overrepresent children with frequent health care needs. We examined seroprevalence trends and compared seroprevalence estimates by testing type and diagnostic coding. METHODS Cross-sectional convenience samples of residual sera September 2021-February 2022 from 52 US jurisdictions were assayed for infection-induced SARS-CoV-2 antibodies; monthly seroprevalence estimates were calculated by age group. Multivariate logistic analyses compared seroprevalence estimates for specimens associated with International Classification of Diseases-Tenth Revision (ICD-10) codes and laboratory orders indicating well-child care with estimates for other pediatric specimens. RESULTS Infection-induced SARS-CoV-2 seroprevalence increased in each age group, from 30 to 68 (14 years), 38 to 77 (511 years), and 40 to 74 (1217 years). On multivariate analysis, patients with well-child ICD-10 codes were seropositive more often than other patients aged 117 years (adjusted prevalence ratio [aPR] 1.04; 95 confidence interval [CI], 1.021.07); children aged 911 years receiving standard lipid screening were seropositive more often than those receiving other laboratory tests (aPR, 1.05; 95 CI, 1.021.08). CONCLUSIONS Infection-induced seroprevalence more than doubled among children younger than 12 years between September 2021 and February 2022, and increased 85 in adolescents. Differences in seroprevalence by care type did not substantially impact US pediatric seroprevalence estimates.
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Affiliation(s)
- Kristie E N Clarke
- Address Correspondence to: Kristie E N Clarke, CDC/CSELS/OD/PHIO, 2400 Century Center Mailstop V24-6, Atlanta, GA 30345, USA, [], (843) 209-0829
| | - Yun Kim
- ICF, Rockville, Maryland, USA
| | - Jefferson Jones
- Alternate Corresponding Author: Jefferson Jones, CDC/NCIRD/CORVD, 1600 Clifton Rd NE, Mailstop H24-8, Atlanta GA 30333, USA, [], (404) 718-5517
| | | | | | - Elise Nycz
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA,Abt Associates, Rockville, Maryland, USA
| | | | | | - Adam MacNeil
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Aron Hall
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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