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Benameur T, Kaliyadan F, Saidi N, Porro C. A Retrospective Chart Review Evaluating Changes in 25-Hydroxyvitamin D Levels among Patients Attending the University Healthcare Centre during the COVID-19 Pandemic. Nutrients 2023; 15:2345. [PMID: 37242228 PMCID: PMC10223421 DOI: 10.3390/nu15102345] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/10/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023] Open
Abstract
COVID-19-pandemic-related home confinement aids in limiting the spread of the virus but restricts exposure to sunlight, thereby possibly affecting 25(OH)D concentrations. This study aimed to investigate the effect of lockdown measures on 25(OH)D levels in outpatients visiting the healthcare centre over a period of two years. In this retrospective chart review, outpatients who visited a university healthcare centre for a health check-up over a period of two years were included. The patients' 25(OH)D serum levels and status were compared before, during, and after the lockdown periods. A total of 7234 patients were included in this study, with a mean age of 34.66 ± 16.78. The overall prevalence of 25(OH)D insufficiency, deficiency and sufficiency was 33.8%, 30.7% and 35.4%, respectively. The proportion of individuals with 25-(OH) D deficiency prior to lockdown was 29% and this proportion increased in the lockdown and post-lockdown periods to 31.1% and 32%, respectively. Although gender was less likely to have an impact on the 25 (OH) D level during the lockdown period (p = 0.630), we found an association between gender and 25 (OH) D status in the pre-lockdown and post-lockdown periods (p < 0.001 and p < 0.001, respectively). Another association between nationality and 25 (OH)D levels was found before, during and after the lockdown periods (p < 0.001). In addition, the youngest population, aged between 1 and 14, was strongly affected by the home confinement. Age had a positive and significant (p < 0.05) effect on 25 (OH) D status regardless of the different periods. Moreover, in the pre-lockdown period, male outpatients had 1.56 chance of having a sufficient level of 25 (OH)D. However, during the lockdown period, this chance decreased to 0.85 and then increased to 0.99 after the lockdown period. We found no statistically significant difference in the mean serum concentrations or in the prevalence of vitamin D insufficiency when we compared values from before, during and immediately after the COVID-19 lockdown period. However, there was a generally increased prevalence of vitamin D insufficiency in our study population. Another association between gender, nationality and age groups with 25(OH) D was found. Regular exposure to UVR is recommended for maintaining adequate vitamin D levels and to prevent vitamin D deficiency. Further research is needed to determine the best indications for vitamin D supplementation if confinement periods are extended and to consider the potential health consequences of prolonged confinement periods not only on vitamin D status but also on overall public health. The findings of this study may be considered by stakeholders for a targeted supplementation approach for risk groups.
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Affiliation(s)
- Tarek Benameur
- Department of Biomedical Sciences, College of Medicine, King Faisal University, Al Ahsa 31982, Saudi Arabia
| | - Feroze Kaliyadan
- Sree Narayana Institute of Medical Sciences, Kerala University of Health Sciences, Thrissur 683594, India
| | - Neji Saidi
- Department of Mathematics and Statistics, College of Sciences, King Faisal University, Al Ahsa 31982, Saudi Arabia
| | - Chiara Porro
- Department of Clinical and Experimental Medicine, University of Foggia, 71121 Foggia, Italy
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2
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Toros K, Falch-Eriksen A. The voices of parents in child protective services: A qualitative analysis of families' struggles with COVID-19. DEVELOPMENTAL CHILD WELFARE 2022; 4:97-113. [PMID: 38603234 PMCID: PMC9047598 DOI: 10.1177/25161032221094045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The pandemic of the Coronavirus disease 2019 (COVID-19) has affected children and families worldwide, disrupting their daily lives and well-being. A small-scale study involving 13 parents in Child Protective Services in Estonia was conducted using in-depth, semi-structured interviews to explore parents' experiences with COVID-19 and its impact on their families' well-being. The findings indicated that one of the areas most impacted by the COVID-19 pandemic was schooling, as the implementation of remote schooling often created tensions and conflicts at home. Parents reported regression in daily functioning, attributing this to the lack of supportive services during lockdown and additional distress resulting from increased workload at home and problems with balancing home and work life. Parents were exhausted by the various problems caused by the pandemic and questioned their ability to provide their children the support they needed. Discontinuation of services intensified existing challenges for both parents and children. Furthermore, a lack of trust in Child Protective Services was identified, serving as a barrier to asking for help in times of crisis.
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Serra M, Presicci A, Quaranta L, Urbano MRE, Marzulli L, Matera E, Margari F, Margari L. Depressive risk among Italian socioeconomically disadvantaged children and adolescents during COVID-19 pandemic: a cross-sectional online survey. Ital J Pediatr 2022; 48:68. [PMID: 35526021 PMCID: PMC9077638 DOI: 10.1186/s13052-022-01266-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 04/27/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Children and adolescents and low-income individuals are considered particularly vulnerable for mental health implications during the current COVID-19 pandemic. Depression is a frequent negative emotional response during an epidemic outbreak and is also prone importantly to environmental risk like stressors derived from income inequality. We aimed to assess depressive symptomatology in a sample of Italian low-income minors during the COVID-19 outbreak. We hypothesized that the stronger were the negative effects of the pandemic on socioeconomic conditions, the higher would have been the risk for showing depressive symptoms. METHODS We performed a cross-sectional study during July 2020, at the end of the Italian first wave of COVID-19 pandemic. We recruited 109 Italian socioeconomically disadvantaged children and adolescents from 7 to 17 years. We used an online survey to collect socio-demographic and clinical data and information about pandemic-related stressors and to assess depressive symptoms with the Children's Depression Inventory 2 (CDI 2), Parent Version (Emotional Problems subscale) and Self-Report Short Form. We performed logistic regression analysis to assess the association between depressive symptoms and potential risk factors for mental health. RESULTS 22% and 14% of participants showed depressive symptoms at the CDI 2 Parent Version and Self-Report, respectively. Participants coming from families experiencing a lack of basic supplies during the pandemic (34.9%) were more expected to show depressive symptoms at CDI 2 Parent Version. Participants with a pre-existing neuropsychiatric diagnosis (26.6%) were more likely to exhibit depressive symptoms measured by CDI 2 Parent Version. CONCLUSIONS The results of our study showed that a group of Italian socioeconomically disadvantaged children and adolescents were more vulnerable to depressive symptoms if they suffered from a paucity of essential supplies during the pandemic or had pre-existing neurodevelopmental disorders. The promotion of educational and child-care programs and activities could be crucial in sustaining the prevention of mental distress in those frail subjects who particularly need support outside the family. Further studies are needed to detect effective preventive and therapeutic strategies to adopt promptly in the case of another pandemic wave.
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Affiliation(s)
- Maria Serra
- Department of Pharmacy-Pharmaceutical Sciences, University of Bari "Aldo Moro", Via Edoardo Orabona 4, Bari, Italy
| | - Anna Presicci
- Department of Neuroscience, Sense Organs and Locomotor System, University Hospital "Policlinico", Piazza Giulio Cesare 11, 70124, Bari, Italy
| | - Luigi Quaranta
- Department of Computer Science, University of Bari "Aldo Moro", Via Edoardo Orabona 4, Bari, Italy
| | - Maria Rosaria Erminia Urbano
- Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro", Piazza Giulio Cesare 11, 70124, Bari, Italy
| | - Lucia Marzulli
- Department of Basic Medical Science, Neuroscience and Sensory Organs, University of Bari "Aldo Moro", Piazza Giulio Cesare 11, 70124, Bari, Italy
| | - Emilia Matera
- Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro", Piazza Giulio Cesare 11, 70124, Bari, Italy
| | - Francesco Margari
- Department of Basic Medical Science, Neuroscience and Sensory Organs, University of Bari "Aldo Moro", Piazza Giulio Cesare 11, 70124, Bari, Italy
| | - Lucia Margari
- Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro", Piazza Giulio Cesare 11, 70124, Bari, Italy.
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Buonsenso D, Valentini P, Macchi M, Folino F, Pensabene C, Patria MF, Agostoni C, Castaldi S, Lecce M, Giannì ML, Marchisio P, Milani GP. Caregivers' Attitudes Toward COVID-19 Vaccination in Children and Adolescents With a History of SARS-CoV-2 Infection. Front Pediatr 2022; 10:867968. [PMID: 35463893 PMCID: PMC9021633 DOI: 10.3389/fped.2022.867968] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 03/03/2022] [Indexed: 12/28/2022] Open
Abstract
Background Limited data are available on the attitudes of caregivers toward COVID-19 vaccination in children and adolescents with a history of SARS-CoV-2 infection or Long Covid symptoms. The aim of this study was to investigate the vaccine hesitancy among caregivers of children and adolescents with a documented history of SARS-CoV-2 infection and to explore the possible associations between COVID-19 manifestations and the acceptance of the vaccine. Methods Caregivers of children or adolescents with a microbiologically confirmed diagnosis of SARS-CoV-2 infection evaluated in two University Hospitals were interviewed. Results We were able to contact 132 caregivers and 9 declined to participate. 68 caregivers (56%) were in favor of COVID-19 vaccination for their child. In the multiple logistic regression, child's age (OR 1.17, 95%CI 1.06-1.28) and hospitalization due to COVID-19 (OR 3.25, 95%CI 1.06-9.95) were positively associated with being in favor of COVID-19 vaccination. On the contrary, the occurrence of child's Long Covid was associated with a higher likelihood of being against the vaccination (OR 0.28, 95%CI 0.10-0.80). Conclusions This preliminary study shows that only about half of the interviewed parents of children and adolescents with a previous SARS-CoV-2 infection are willing to vaccinate them to prevent a repeated COVID-19 infection. These findings might help healthcare workers to provide tailored information to caregivers of children with a previous SARS-CoV-2 infection.
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Affiliation(s)
- Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario “A. Gemelli”, Rome, Italy
- Center for Global Health Research and Studies, Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Piero Valentini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario “A. Gemelli”, Rome, Italy
- Center for Global Health Research and Studies, Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Marina Macchi
- Department of Clinical Science and Community Health, University of Milan, Milan, Italy
| | - Francesco Folino
- Department of Clinical Science and Community Health, University of Milan, Milan, Italy
| | - Carola Pensabene
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Unit, Milan, Italy
| | | | - Carlo Agostoni
- Department of Clinical Science and Community Health, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Unit, Milan, Italy
| | - Silvana Castaldi
- Department of Biomedical Sciences for Health, Postgraduate School of Public Health, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Maurizio Lecce
- Department of Biomedical Sciences for Health, Postgraduate School of Public Health, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Maria Lorella Giannì
- Department of Clinical Science and Community Health, University of Milan, Milan, Italy
- Neonatal Intensive Care Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paola Marchisio
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Unit, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Gregorio P. Milani
- Department of Clinical Science and Community Health, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Unit, Milan, Italy
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5
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Toros K. 'The Pandemic Affected My Life in a Negative Way': The Experiences of Estonian Children in Child Protective Services During the Coronavirus Disease 2019 Pandemic. CHILDREN & SOCIETY 2021; 37:CHSO12517. [PMID: 34898856 PMCID: PMC8653028 DOI: 10.1111/chso.12517] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 10/04/2021] [Accepted: 10/07/2021] [Indexed: 05/07/2023]
Abstract
This study investigates children's experiences concerning the effect of the containment measures associated with coronavirus disease 2019 (COVID-19) on their daily lives. A small-scale study using in-depth, semi-structured interviews was conducted in Estonia with 10 children registered with Child Protective Services (CPS) as in need of assistance. The COVID-19 pandemic generally negatively affected the children, who struggled with e-schooling, social relationships and emotional well-being. Most of the children reported struggling with their emotional well-being, using words such as anxiety, tension, fear, sadness, and depressing. Not all of the children received the necessary support or assistance from the CPS. The children reported a few positive experiences during the COVID-19 pandemic, such as attaining a more personalised method and schedule for studying and receiving parental support during e-schooling.
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Affiliation(s)
- Karmen Toros
- School of Governance, Law and SocietyTallinn UniversityTallinnEstonia
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6
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Picca M, Manzoni P, Milani GP, Mantovani S, Cravidi C, Mariani D, Mezzopane A, Marinello R, Bove C, Ferri P, Macchi M, Agostoni C. Distance learning, technological devices, lifestyle and behavior of children and their family during the COVID-19 lockdown in Lombardy: a survey. Ital J Pediatr 2021; 47:203. [PMID: 34635133 PMCID: PMC8503704 DOI: 10.1186/s13052-021-01156-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 09/15/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic and the subsequent national lockdowns, school closures and distance learning may have had both negative and positive effects on physical and mental health of children. METHODS A cross-sectional study was conducted on a large group of children between 1 and 10 years old in Lombardy, Italy (n = 3392). Their parents filled in a survey answering single or multiple-choice questions about their offspring's behavior changes (including sleep, dietary habits, emotional disturbances), relationship with siblings, parents and peers, the use of digital technologies, and distance learning experience during the lockdown. RESULTS Parents reported lifestyles and emotional alterations during the lockdown. The modifications of family relationships, parents' remote working, and screen time were associated with sleep, emotional and behavioral modifications. Distance learning was overall considered adequate. CONCLUSIONS This study reported the most updated data on the effects of COVID-19 pandemic lockdown on children between 1 and 10 years of age in a large sample of Italian schoolchildren. The results of this study point out that pediatricians and authorities should support relationships within families during the COVID-19 pandemic. Parents' remote working might play an important role for this purpose.
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Affiliation(s)
- Marina Picca
- SICuPP-Lombardia: Società Italiana delle Cure Primarie Pediatriche - Lombardia (Italian Primary Care Paediatrics Society-Lombardy), Milan, Italy
| | - Paola Manzoni
- SICuPP-Lombardia: Società Italiana delle Cure Primarie Pediatriche - Lombardia (Italian Primary Care Paediatrics Society-Lombardy), Milan, Italy
| | - Gregorio Paolo Milani
- Fondazione IRCCS Ca’ Granda - Ospedale Maggiore Policlinico, Pediatric Area, Via della Commenda 9, 20121 Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | | | - Claudio Cravidi
- SICuPP-Lombardia: Società Italiana delle Cure Primarie Pediatriche - Lombardia (Italian Primary Care Paediatrics Society-Lombardy), Milan, Italy
| | - Danila Mariani
- SICuPP-Lombardia: Società Italiana delle Cure Primarie Pediatriche - Lombardia (Italian Primary Care Paediatrics Society-Lombardy), Milan, Italy
| | - Angela Mezzopane
- SICuPP-Lombardia: Società Italiana delle Cure Primarie Pediatriche - Lombardia (Italian Primary Care Paediatrics Society-Lombardy), Milan, Italy
| | - Roberto Marinello
- SICuPP-Lombardia: Società Italiana delle Cure Primarie Pediatriche - Lombardia (Italian Primary Care Paediatrics Society-Lombardy), Milan, Italy
| | - Chiara Bove
- Department of Human Sciences for Education, University of Milan-Bicocca, Milan, Italy
| | - Paolo Ferri
- Department of Human Sciences for Education, University of Milan-Bicocca, Milan, Italy
| | - Marina Macchi
- Fondazione IRCCS Ca’ Granda - Ospedale Maggiore Policlinico, Pediatric Area, Via della Commenda 9, 20121 Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Carlo Agostoni
- Fondazione IRCCS Ca’ Granda - Ospedale Maggiore Policlinico, Pediatric Area, Via della Commenda 9, 20121 Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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7
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Bagateli LE, Saeki EY, Fadda M, Agostoni C, Marchisio P, Milani GP. COVID-19 Vaccine Hesitancy among Parents of Children and Adolescents Living in Brazil. Vaccines (Basel) 2021; 9:1115. [PMID: 34696223 PMCID: PMC8540804 DOI: 10.3390/vaccines9101115] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 09/24/2021] [Accepted: 09/27/2021] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND The immunization of large portions of populations in low/middle-income countries is considered one of the key measures to limit the development of new SARS-CoV-2 variants. However, parental vaccine hesitancy might be an important obstacle to pediatric vaccination. The aim of this survey was to study the prevalence and extent of COVID-19 vaccine hesitancy among parents of children and adolescents living in Brazil. METHODS Caregivers of children and adolescents referred to the emergency department of Hospital Estadual de Bauru, São Paulo (Brazil) were invited to fill in a validated questionnaire on vaccine hesitancy and to report their willingness for themselves and their offspring to receive a COVID-19 vaccine. RESULTS A total of 501 consecutive caregivers filled in the survey. Response rate was 100%. A minority (N = 14, 2.8%) of caregivers were hesitant about vaccines. Despite this, half of them declared they were willing to vaccinate their offspring against COVID-19. CONCLUSIONS This survey identifies that vaccine hesitancy is very low among caregivers living in Brazil and that even many of the hesitant caregivers are willing to vaccinate their offspring against COVID-19. This study highlights the importance of offering the COVID-19 vaccination to the whole population, including subjects that present uncertainty about other vaccines.
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Affiliation(s)
- Leonardo Evangelista Bagateli
- Department of Clinical Science and Community Health, Universita’ Degli Studi di Milano, 20122 Milan, Italy; (L.E.B.); (P.M.); (G.P.M.)
| | - Edna Yayoi Saeki
- Pediatrics, Hospital Estadual de Bauru, Bauru 17033-360, Brazil;
| | - Marta Fadda
- Facoltà di Scienze Biomediche, Università della Svizzera Italiana, 6900 Lugano, Switzerland;
| | - Carlo Agostoni
- Department of Clinical Science and Community Health, Universita’ Degli Studi di Milano, 20122 Milan, Italy; (L.E.B.); (P.M.); (G.P.M.)
- Pediatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Polcilinico, 20122 Milan, Italy
| | - Paola Marchisio
- Department of Clinical Science and Community Health, Universita’ Degli Studi di Milano, 20122 Milan, Italy; (L.E.B.); (P.M.); (G.P.M.)
- Pediatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Polcilinico, 20122 Milan, Italy
| | - Gregorio Paolo Milani
- Department of Clinical Science and Community Health, Universita’ Degli Studi di Milano, 20122 Milan, Italy; (L.E.B.); (P.M.); (G.P.M.)
- Pediatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Polcilinico, 20122 Milan, Italy
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8
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Milani GP, Casazza G, Corsello A, Marchisio P, Rocchi A, Colombo G, Agostoni C, Costantino G. Early evidence of SARS-CoV-2 in Milan, Jan-Feb 2020. Ital J Pediatr 2021; 47:145. [PMID: 34193222 PMCID: PMC8243623 DOI: 10.1186/s13052-021-01095-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 05/30/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A few studies have suggested that the Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) was present in Northern Italy several weeks before its official detection on February 21, 2020. On the other hand, no clinical data have been provided so far to support such hypothesis. We investigated clinical-epidemiological evidence of SARS-CoV-2 infection among children and adults referring to emergency department (ED) in the main hospital of the center of Milan (Italy) before February 21, 2020. METHODS A retrospective analysis of medical records of ED visits at the Fondazione Ca' Granda Policlinico, Milan between January 11 and February 15 in 2017, 2018, 2019 and in 2020 was performed. The number of subjects referring with fever, cough or dyspnea was compared between the studied period of 2020 and the previous 3 years, by calculating a standardized referral ratio (SRR, number of observed cases in 2020 divided by the number of expected cases according to 2017-2019) and the corresponding 95% confidence interval (CI). RESULTS In the pediatric ED, 7709 (average 2570/year) and 2736 patients were visited during the period 2017-2019 and in the 2020, respectively. Among adults, 13,465 (average 4488/year) and 4787 were visited during the period 2017-2019 and in the 2020, respectively. The SRR was 1.16 (95% CI 1.10-1.23) in children and 1.25 (95% CI 1.16-1.35) in adults. The ratio for the two (children and adults) SRRs was 0.93 (0.84-1.02), suggesting a trend towards a higher frequency in adults compared to children. CONCLUSIONS This study suggests that SARS-CoV-2 might have spread in Milan before February 21, 2020 with a minor trend among children.
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Affiliation(s)
- Gregorio P Milani
- Pediatric Emergency Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Clinical Science and Community Health, University of Milan, Milan, Italy
| | - Giovanni Casazza
- Dipartimento di Scienze Biomediche e Cliniche "L. Sacco", Università degli Studi di Milano, Milan, Italy
| | - Antonio Corsello
- Department of Clinical Science and Community Health, University of Milan, Milan, Italy
| | - Paola Marchisio
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,Pediatric Highly Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Alessia Rocchi
- Pediatric Emergency Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giulia Colombo
- Department of Clinical Science and Community Health, University of Milan, Milan, Italy
| | - Carlo Agostoni
- Department of Clinical Science and Community Health, University of Milan, Milan, Italy. .,Pediatric Intermediate Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via della Commenda 9, 20122, Milan, Italy.
| | - Giorgio Costantino
- Department of Clinical Science and Community Health, University of Milan, Milan, Italy.,Emergency Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Van Brusselen D, De Troeyer K, Ter Haar E, Vander Auwera A, Poschet K, Van Nuijs S, Bael A, Stobbelaar K, Verhulst S, Van Herendael B, Willems P, Vermeulen M, De Man J, Bossuyt N, Vanden Driessche K. Bronchiolitis in COVID-19 times: a nearly absent disease? Eur J Pediatr 2021; 180:1969-1973. [PMID: 33517482 PMCID: PMC7847293 DOI: 10.1007/s00431-021-03968-6] [Citation(s) in RCA: 126] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/21/2021] [Accepted: 01/26/2021] [Indexed: 12/04/2022]
Abstract
Stay-at-home orders, physical distancing, face masks and other non-pharmaceutical interventions (NPIs) do not only impact COVID-19, but also the dynamics of various other infectious diseases. Bronchiolitis is a clinically diagnosed viral infection of the lower respiratory tract, and causes a yearly seasonal wave of admissions in paediatric wards worldwide. We counted 92,5% less bronchiolitis hospitalisations in Antwerp before the expected end of the peak this year (of which only 1 RSV positive), as compared to the last 3 years. Furthermore, there was a >99% reduction in the number of registered RSV cases in Belgium.Conslusion: The 2020 winter bronchiolitis peak is hitherto nonexistent, but we fear a 'delayed' spring/summer bronchiolitis peak when most NPIs will be relaxed and pre-pandemic life restarts. What is known? • Bronchiolitis causes a yearly seasonal wave of admissions in paediatric departments worldwide. • Non-pharmaceutical interventions (NPIs) do not only impact COVID-19, but also the dynamics of various other infectious diseases. What is new? • The 2020 winter bronchiolitis peak is hitherto nonexistent. • A 'delayed' spring or summer bronchiolitis peak could happen when most NPIs will be relaxed and pre-pandemic life restarts.
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Affiliation(s)
- Daan Van Brusselen
- Department of Paediatric Infectious Diseases, GZA Hospitals, Antwerp, Belgium. .,Multidisciplinary Unit of Infectious Diseases, GZA Hospitals, Antwerp, Belgium. .,Department of Public Health & Primary Care, Ghent University, Ghent, Belgium.
| | - Katrien De Troeyer
- Department of Public Health and Primary Care, University of Leuven, Ghent, Belgium
| | - Eva Ter Haar
- Division of Paediatric Pulmonology, ZNA Jan Palfijn Hospital, Antwerp, Belgium
| | - Ann Vander Auwera
- Department of Paediatric Infectious Diseases, GZA Hospitals, Antwerp, Belgium
| | - Katleen Poschet
- Department of Paediatric Infectious Diseases, GZA Hospitals, Antwerp, Belgium
| | - Sascha Van Nuijs
- Department of Paediatric Infectious Diseases, GZA Hospitals, Antwerp, Belgium
| | - An Bael
- Department of Paediatrics, ZNA Queen Paola Children's Hospital, Antwerp, Belgium.,Faculty of Medicine, Antwerp University, Antwerp, Belgium
| | - Kim Stobbelaar
- Division of Paediatric Pulmonology, Department of Paediatrics, University Hospital Antwerp, Edegem, Belgium.,Lab of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Stijn Verhulst
- Division of Paediatric Pulmonology, Department of Paediatrics, University Hospital Antwerp, Edegem, Belgium.,Lab of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Bruno Van Herendael
- Multidisciplinary Unit of Infectious Diseases, GZA Hospitals, Antwerp, Belgium.,Department of Microbiology, GZA Hospitals, Antwerp, Belgium
| | - Philippe Willems
- Multidisciplinary Unit of Infectious Diseases, GZA Hospitals, Antwerp, Belgium.,Department of Microbiology, GZA Hospitals, Antwerp, Belgium
| | - Melissa Vermeulen
- Scientific Directorate of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Jeroen De Man
- Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium
| | - Nathalie Bossuyt
- Scientific Directorate of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Koen Vanden Driessche
- Division of Paediatric Pulmonology, Department of Paediatrics, University Hospital Antwerp, Edegem, Belgium.,Section Paediatric Infectious Diseases, Laboratory of Medical Immunology, Radboud Centre for Infectious Diseases, Radboud Institute for Life Sciences, Nijmegen, The Netherlands
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10
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Vitamin D Status in Adolescents during COVID-19 Pandemic: A Cross-Sectional Comparative Study. Nutrients 2021; 13:nu13051467. [PMID: 33925932 PMCID: PMC8146895 DOI: 10.3390/nu13051467] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/18/2021] [Accepted: 04/23/2021] [Indexed: 01/08/2023] Open
Abstract
Vitamin D has been claimed to be effective in the response to infections, including the respiratory syndrome coronavirus 2 (SARS-CoV-2). It is supposed that lockdown measures and fear of SARS-CoV-2 infection might reduce vitamin D levels through the modification of lifestyle. However, very few data exist on the association between lockdown measures and vitamin D status in humans. For this cross-sectional comparative study, adolescents (n = 298) aged 18 to 19 years were enrolled during the compulsory military fitness-for-duty evaluation between July and December 2020 in Southern Switzerland. Beyond anthropometric measurements, participants filled in a structured questionnaire about their lifestyle and a blood specimen was sampled for the determination of total 25-hydroxy-vitamin D. The obtained data were compared with those of 437 adolescents enrolled at the military fitness-for-duty evaluation during the same period of the year in the context of the CENERI study (2014–2016). The anthropometric measures were similar between the two study groups. The levels of vitamin D were also comparable (77 (64–91) vs. 74 (60–92) nmol/L, p = 0.50; median and interquartile range). A total of 38 (13%) and 43 (9.8%) subjects presented insufficient (<50 nmol/L) levels of vitamin D (p = 0.42) during the current pandemic and in the CENERI study, respectively. These data do not support the hypothesis that during the SARS-CoV-2 pandemic, late adolescents are at higher risk of vitamin insufficiency.
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11
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Vogel M, Meigen C, Sobek C, Ober P, Igel U, Körner A, Kiess W, Poulain T. Well-being and COVID-19-related worries of German children and adolescents: A longitudinal study from pre-COVID to the end of lockdown in Spring 2020. JCPP ADVANCES 2021; 1:e12004. [PMID: 34485984 PMCID: PMC8250267 DOI: 10.1111/jcv2.12004] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 01/25/2021] [Indexed: 01/26/2023] Open
Abstract
Background There is concern that pandemic measures put a strain on the health and well‐being of children. We investigated the effects of the COVID‐19 pandemic, the lockdown, and social distancing on the well‐being, media use, and emotions of children and adolescents between 9 and 18 years. Methods We used linear and proportional odds logistic regression correcting for age, sex, and socioeconomic status (SES) and to compare media use, peers/social support, physical, and psychological well‐being between 2019 (pre‐COVID baseline) and two time points shortly after the start of the lockdown (last week of March and April 2020, respectively) in 391 9–19‐year‐old healthy children and adolescents of the LIFE Child cohort. COVID‐19‐related feelings and their relationship to age, sex, and SES were assessed at two time points during lockdown. Results We found significantly lower scores in physical and psychological well‐being during lockdown compared to baseline. The effect was significantly stronger in children with medium/low SES. Perceived social support scores were also significantly lower during the lockdown. The percentage of children who had no contact with their peers (in‐person or online) increased from 3% pre‐COVID to 14% and 13% in April and March 2020, respectively. About 80% of the children missed in‐person contacts with friends. Most of the children worried more about the health of their families than their own. Sixty percent worried about the international situation at least moderately, whereas only 20% were afraid of COVID‐19 itself. The percentage of children who believed it would never be as before COVID‐19 rose from 7.4% at the beginning lockdown end of March to 16.2% a month later. In contrast, all other COVID‐19‐related worries, showed a (nonsignificant) decline during the same period. Conclusion Our study supports the notion that pandemic measures have to be balanced against adverse public health effects. Especially vulnerable groups have to be protected.
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Affiliation(s)
- Mandy Vogel
- LIFE Child Leipzig University Hospital for Children and Adolescents Leipzig University Leipzig Germany.,Department of Women and Child Health Center for Pediatric Research Leipzig University Leipzig Germany
| | - Christof Meigen
- LIFE Child Leipzig University Hospital for Children and Adolescents Leipzig University Leipzig Germany.,Department of Women and Child Health Center for Pediatric Research Leipzig University Leipzig Germany
| | - Carolin Sobek
- LIFE Child Leipzig University Hospital for Children and Adolescents Leipzig University Leipzig Germany.,Department of Women and Child Health Center for Pediatric Research Leipzig University Leipzig Germany
| | - Peggy Ober
- LIFE Child Leipzig University Hospital for Children and Adolescents Leipzig University Leipzig Germany.,Department of Women and Child Health Center for Pediatric Research Leipzig University Leipzig Germany
| | - Ulrike Igel
- LIFE Child Leipzig University Hospital for Children and Adolescents Leipzig University Leipzig Germany.,Department of Women and Child Health Center for Pediatric Research Leipzig University Leipzig Germany.,Center for Research and Transfer (FTZ) at the Leipzig University of Applied Sciences (HTWK) Research Field Health and Social Affairs Leipzig Germany
| | - Antje Körner
- LIFE Child Leipzig University Hospital for Children and Adolescents Leipzig University Leipzig Germany.,Department of Women and Child Health Center for Pediatric Research Leipzig University Leipzig Germany
| | - Wieland Kiess
- LIFE Child Leipzig University Hospital for Children and Adolescents Leipzig University Leipzig Germany.,Department of Women and Child Health Center for Pediatric Research Leipzig University Leipzig Germany
| | - Tanja Poulain
- LIFE Child Leipzig University Hospital for Children and Adolescents Leipzig University Leipzig Germany.,Department of Women and Child Health Center for Pediatric Research Leipzig University Leipzig Germany
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12
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Milani GP, Marchisio P, Rocchi A, Bertolozzi G, Furlan L, La Vecchia A, Agostoni C, Costantino G. Frequency of asymptomatic carriers of SARS-CoV-2 among children and adults after school reopening. Ital J Pediatr 2021; 47:65. [PMID: 33712061 PMCID: PMC7953180 DOI: 10.1186/s13052-021-01016-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 03/02/2021] [Indexed: 11/30/2022] Open
Abstract
Background Children often develop an asymptomatic form of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), but it is debated if children are at higher risk than adults to be asymptomatic carriers of SARS-CoV-2, especially during the school reopening. The main aim of this study was to investigate the frequency of SARS-CoV-2 asymptomatic carriers in children and adults during the reopening of the schools in Milan, Italy. Methods We conducted a cross-sectional study at the pediatric and adult Emergency Department (ED) of the Ca' Granda Ospedale Maggiore Policlinico (Milan) between October 1 and 31, 2020, i.e. 3 weeks after the reopening of schools. Patients admitted to the ED short stay observation and without any sign or symptom consistent with a SARS-CoV-2 were eligible. These patients underwent a nasopharyngeal swab specimen for the detection of SARS-CoV-2. The odds ratio and its 95% confidence interval (CI) was calculated to assess the risk of asymptomatically carrying the SARS-CoV-2 infection in children and adults. Results A total of 69 (27 females, median age 8.7 years) children and 251 (107 females, median age 71 years) adults were enrolled. Pediatric and adult subjects tested positive for SARS-CoV-2 with a similar frequency (1/69 [1.4%] vs 4/251 [1.6%]). Children had an odds ratio to be a carrier of 0.91 (CI 0.02– 9.38) compared to adults. Conclusions The frequency of asymptomatic SARS-CoV-2 carriers was similar among children and adults. Considering the emerging diffusion of new SARS-CoV-2 variants, the asymptomatic spread of SARS-CoV-2 infection among children and adults should be monitored.
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Affiliation(s)
- Gregorio P Milani
- Pediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Clinical Science and Community Health, University of Milan, Milan, Italy
| | - Paola Marchisio
- Pediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Alessia Rocchi
- Pediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppe Bertolozzi
- Pediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Ludovico Furlan
- Department of Clinical Science and Community Health, University of Milan, Milan, Italy
| | - Adriano La Vecchia
- Department of Clinical Science and Community Health, University of Milan, Milan, Italy
| | - Carlo Agostoni
- Pediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. .,Department of Clinical Science and Community Health, University of Milan, Milan, Italy. .,Dipartimento di Emergenza e Urgenza, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Giorgio Costantino
- Department of Clinical Science and Community Health, University of Milan, Milan, Italy.,Dipartimento di Emergenza e Urgenza, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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13
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Collateral impact of COVID-19: why should children continue to suffer? Eur J Pediatr 2021; 180:1975-1979. [PMID: 33580826 PMCID: PMC7881307 DOI: 10.1007/s00431-021-03963-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/19/2021] [Accepted: 01/22/2021] [Indexed: 12/04/2022]
Abstract
The COVID-19 pandemic caused by SARS-COV-2 virus fortunately resulted in few children suffering from severe disease. However, the collateral effects on the COVID-19 pandemic appear to have had significant detrimental effects on children affected and young people. There are also some positive impacts in the form of reduced prevalence of viral bronchiolitis. The new strain of SARS-COV-2 identified recently in the UK appears to have increased transmissibility to children. However, there are no large vaccine trials set up in children to evaluate safety and efficacy. In this short communication, we review the collateral effects of COVID-19 pandemic in children and young people. We highlight the need for urgent strategies to mitigate the risks to children due to the COVID-19 pandemic. What is Known: • Children and young people account for <2% of all COVID-19 hospital admissions • The collateral impact of COVID-19 pandemic on children and young people is devastating • Significant reduction in influenza and respiratory syncytial virus (RSV) infection in the southern hemisphere What is New: • The public health measures to reduce COVID-19 infection may have also resulted in near elimination of influenza and RSV infections across the globe • A COVID-19 vaccine has been licensed for adults. However, large scale vaccine studies are yet to be initiated although there is emerging evidence of the new SARS-COV-2 strain spreading more rapidly though young people. • Children and young people continue to bear the collateral effects of COVID-19 pandemic.
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Schaffert M, Zimmermann F, Bauer L, Kastner S, Schwarz A, Strenger V, Metzger R, Thun‐Hohenstein L, Sperl W, Weghuber D, Wortmann SB. Austrian study shows that delays in accessing acute paediatric health care outweighed the risks of COVID-19. Acta Paediatr 2020; 109:2309-2310. [PMID: 32734708 PMCID: PMC7693207 DOI: 10.1111/apa.15507] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Matthias Schaffert
- Paediatric Surgery University Children’s Hospital Paracelsus Medical University (PMU) Salzburg Austria
| | - Franz Zimmermann
- General Paediatrics University Children’s Hospital Paracelsus Medical University (PMU) Salzburg Austria
| | - Leopold Bauer
- Paediatric Surgery University Children’s Hospital Paracelsus Medical University (PMU) Salzburg Austria
| | - Simon Kastner
- General Paediatrics University Children’s Hospital Paracelsus Medical University (PMU) Salzburg Austria
- Paediatric and Adolescent Psychiatry University Children’s Hospital Paracelsus Medical University (PMU) Salzburg Austria
| | - Astrid Schwarz
- General Paediatrics University Children’s Hospital Paracelsus Medical University (PMU) Salzburg Austria
| | - Volker Strenger
- Department of Pediatric Pulmonology and Allergology Medical University Graz Graz Austria
| | - Roman Metzger
- Paediatric Surgery University Children’s Hospital Paracelsus Medical University (PMU) Salzburg Austria
- General Paediatrics University Children’s Hospital Paracelsus Medical University (PMU) Salzburg Austria
| | - Leonhard Thun‐Hohenstein
- Paediatric and Adolescent Psychiatry University Children’s Hospital Paracelsus Medical University (PMU) Salzburg Austria
| | - Wolfgang Sperl
- General Paediatrics University Children’s Hospital Paracelsus Medical University (PMU) Salzburg Austria
| | - Daniel Weghuber
- General Paediatrics University Children’s Hospital Paracelsus Medical University (PMU) Salzburg Austria
| | - Saskia B. Wortmann
- General Paediatrics University Children’s Hospital Paracelsus Medical University (PMU) Salzburg Austria
- Amalia Children’s Hospital RadboudUMC Nijmegen the Netherlands
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15
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Children and the Use of Emergency Departments During the COVID-19 Pandemic: Where Did the Pain End Up? Pediatr Emerg Care 2020; 36:e670-e671. [PMID: 32947562 DOI: 10.1097/pec.0000000000002256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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