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Heffner AL, Rouault TA. A Comparison of Conserved Features in the Human Coronavirus Family Shows That Studies of Viruses Less Pathogenic than SARS-CoV-2, Such as HCoV-OC43, Are Good Model Systems for Elucidating Basic Mechanisms of Infection and Replication in Standard Laboratories. Viruses 2025; 17:256. [PMID: 40007010 PMCID: PMC11860170 DOI: 10.3390/v17020256] [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: 12/11/2024] [Revised: 02/05/2025] [Accepted: 02/06/2025] [Indexed: 02/27/2025] Open
Abstract
In 2021, at the height of the COVID-19 pandemic, coronavirus research spiked, with over 83,000 original research articles related to the word "coronavirus" added to the online resource PubMed. Just 2 years later, in 2023, only 30,900 original research articles related to the word "coronavirus" were added. While, irrefutably, the funding of coronavirus research drastically decreased, a possible explanation for the decrease in interest in coronavirus research is that projects on SARS-CoV-2, the causative agent of COVID-19, halted due to the challenge of establishing a good cellular or animal model system. Most laboratories do not have the capabilities to culture SARS-CoV-2 'in house' as this requires a Biosafety Level (BSL) 3 laboratory. Until recently, BSL 2 laboratory research on endemic coronaviruses was arduous due to the low cytopathic effect in isolated cell culture infection models and the lack of means to quantify viral loads. The purpose of this review article is to compare the human coronaviruses and provide an assessment of the latest techniques that use the endemic coronaviruses-HCoV-229E, HCoV-OC43, HCoV-NL63, and HCoV-HKU1-as lower-biosafety-risk models for the more pathogenic coronaviruses-SARS-CoV-2, SARS-CoV, and MERS-CoV.
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Affiliation(s)
- Audrey L. Heffner
- Molecular Medicine Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD 20892, USA
- Department of Biology, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Tracey A. Rouault
- Molecular Medicine Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD 20892, USA
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Szczawińska-Popłonyk A, Popłonyk N, Awdi K. Down Syndrome in Children: A Primary Immunodeficiency with Immune Dysregulation. CHILDREN (BASEL, SWITZERLAND) 2024; 11:1251. [PMID: 39457216 PMCID: PMC11506678 DOI: 10.3390/children11101251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2024] [Revised: 10/06/2024] [Accepted: 10/13/2024] [Indexed: 10/28/2024]
Abstract
Background: The multisystemic features of Down syndrome (DS) in children are accompanied by immunodeficiency, making them susceptible to infections and immune dysregulation with autoimmune, allergic, inflammatory, and hematological complications. This study was aimed at a better understanding of the abnormalities within the B and T cell compartments and their correlations with clinical immunophenotypes. Methods: Medical records of 35 DS children were retrospectively reviewed, referring to clinical symptomatology including history of infections, immune dysregulation disorders, and humoral and cellular immune response. Results: While the etiology of respiratory tract infections included typical viral and bacterial pathogens, SARS-CoV2-induced inflammatory disease and syndromic immunodeficiency contributed significantly to the deterioration of the clinical course. Allergic diseases in the form of asthma, allergic rhinitis, and alimentary allergy were the most frequent manifestations of immune dysregulation and were followed by autoimmune disorders, such as Crohn's disease, celiac disease, autoimmune thyroiditis, and alopecia, as well as inflammatory disorders, balanitis xerotica obliterans and lymphadenopathy, and a hematological disorder of myelopoiesis. Deficiency of serum immunoglobulin levels, reduced numbers of naïve B cells, and non-switched memory B cells along with low naïve T helper cells and significantly reduced regulatory T helper cells were the most prominent immune abnormalities. Conclusions: The loss of naïveté in B and T lymphocyte compartments with a deficiency of regulatory T cells may be underpinning pathomechanisms for the skewed immune response. The clinical immunophenotype in DS is complex and represents syndromic primary immunodeficiency with immune dysregulation.
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Affiliation(s)
- Aleksandra Szczawińska-Popłonyk
- Department of Pediatric Pneumonology, Allergy and Clinical Immunology, Institute of Pediatrics, Poznań University of Medical Sciences, Szpitalna 27/33, 60-572 Poznań, Poland
| | - Natalia Popłonyk
- Student Scientific Society, Poznań University of Medical Sciences, 61-701 Poznań, Poland
| | - Karina Awdi
- Student Scientific Society, English Division, Poznań University of Medical Sciences, 61-701 Poznań, Poland
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Park H, Kim KR, Huh HJ, Yoon Y, Park E, Cho J, Lee J, Lee J, Kim JH, Kim YJ. Complications of the Central Nervous System in Pediatric Patients With Common Cold Coronavirus Infection During 2014-2019. J Korean Med Sci 2023; 38:e358. [PMID: 38013644 PMCID: PMC10681840 DOI: 10.3346/jkms.2023.38.e358] [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: 05/02/2023] [Accepted: 08/31/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND In pediatric patients, the common cold coronavirus (ccCoV) usually causes mild respiratory illness. There are reports of coronavirus causing central nervous system (CNS) infection in experimental animal models. Some immunocompromised patients have also been reported to have fatal CNS infections with ccCoV. The aim of this study was to investigate the clinical characteristics of CNS complications related to ccCoV infection. METHODS From January 2014 to December 2019, a retrospective analysis was performed of medical records from hospitalized patients under 19 years of age whose ccCoV was detected through polymerase chain reaction in respiratory specimens. The CNS complications were defined as clinically diagnosed seizure, meningitis, encephalopathy, and encephalitis. RESULTS A total of 436 samples from 420 patients were detected as ccCoV. Among the 420 patients, 269 patients were immunocompetent and 151 patients were immunocompromised. The most common type of ccCoV was OC43 (52% in immunocompetent, 37% in immunocompromised). CNS complications were observed in 9.4% (41/436). The most common type of CNS complication was the fever-provoked seizure under pre-existing neurologic disease (42% in immunocompetent and 60% in immunocompromised patients). Among patients with CNS complications, two immunocompetent patients required intensive care unit admission due to encephalitis. Three patients without underlying neurological disease started anti-seizure medications for the first time at this admission. There was no death related to ccCoV infection. CONCLUSION ccCoV infection may cause severe clinical manifestations such as CNS complications or neurologic sequelae, even in previously healthy children.
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Affiliation(s)
- Hwanhee Park
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyung-Ran Kim
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hee Jae Huh
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yoonsun Yoon
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Esther Park
- Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Joongbum Cho
- Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jiwon Lee
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jeehun Lee
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji Hye Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yae-Jean Kim
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Jamalidoust M, Jalil M, Ashkan Z, Sharifi M, Hemmati R, Dashti AS, Kadivar MR, Pouladfar G, Amanati A, Hamzavi SS, Asaie S, Eskandari M, Aliabadi N, Ziyaeyan M. COVID 19 infection clinical features in pediatric patients in Southwestern Iran: a cross-sectional, multi-center study. BMC Infect Dis 2023; 23:828. [PMID: 38007434 PMCID: PMC10675973 DOI: 10.1186/s12879-023-08720-z] [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: 05/02/2023] [Accepted: 10/17/2023] [Indexed: 11/27/2023] Open
Abstract
With the SARS-CoV-2 pandemic, the impact of recent coronavirus, especially in children, cannot be ignored. In this study, we evaluated the SARS-CoV-2 infection rates and associated features in children less than 18 years of age in "Fars" and "Kohgiluyeh and Boyer Ahmad", provinces, Iran. 5943 children who were suspected cases to SARS-CoV-2 infection were enrolled in this study. Demographic and clinical data of SARS-CoV-2 patients were collected from 16 February 2020 to 20 June 2021. Underlying conditions were considered in this study as well. Among 5943 patients suspected COVID 19 cases, 13.51% were confirmed by real-time PCR assay. The female/male ratio was 1:1.3 with a mean age of 5.71 years. 11.2% of confirmed patients were transferred and admitted in Pediatric ICU. COVID 19 was significantly higher in children with malignancy and diabetes rather than those with other underlying diseases. Children of all ages were susceptible to COVID 19, and there is no significant difference between both sexes. Most of the COVID 19 cases were in 10-18 years old group. Among a number of children with different underlying diseases, children with malignancy had the highest rate of SARS-CoV-2 infection, followed by those with diabetes.
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Affiliation(s)
- Marzieh Jamalidoust
- Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohsen Jalil
- Emergency Medical Service, Yasouj University of Medical Sciences, Yasouj, Iran
| | - Zahra Ashkan
- Department of Biology, Faculty of Basic Science, Shahrekord University, Shahrekord, Iran
| | - Moslem Sharifi
- Emergency Medical Service, Yasouj University of Medical Sciences, Yasouj, Iran
| | - Rouhollah Hemmati
- Department of Biology, Faculty of Basic Science, Shahrekord University, Shahrekord, Iran
| | - Anahita Sanaei Dashti
- Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Departments of Pediatrics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Rahim Kadivar
- Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Departments of Pediatrics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Gholamreza Pouladfar
- Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Departments of Pediatrics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Amanati
- Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Departments of Pediatrics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyeheh Sedigheh Hamzavi
- Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Departments of Pediatrics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sadaf Asaie
- Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Eskandari
- Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nasrin Aliabadi
- Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mazyar Ziyaeyan
- Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Al-Farsi A, Alhinai Z, Alawi FB, Al Maamari K, Al Yazidi LS. The Burden of Human Parechoviruses Among Children in Oman: A retrospective study. Sultan Qaboos Univ Med J 2023; 23:519-525. [PMID: 38090246 PMCID: PMC10712389 DOI: 10.18295/squmj.5.2023.033] [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: 02/14/2023] [Revised: 04/05/2023] [Accepted: 05/03/2023] [Indexed: 12/18/2023] Open
Abstract
Objectives This study aimed to evaluate the burden, clinical and laboratory features and outcomes of human parechoviruses (HPeVs) infection among children in Oman. Methods This retrospective study included children (aged <18 years) with molecularly proven HPeV infection who were managed at Sultan Qaboos University Hospital, Muscat, Oman, between January 2017 and December 2019. Data were obtained from the patients' medical records and analysed to describe their demographics, clinical and laboratory features, management and outcomes. Results HPeV was detected in 61 patients, 44 (72%) of whom were males. The median age of these patients was nine months (interquartile range [IQR]: 6-15 months). HPeV was detected throughout the year without any significant peaks. Majority of the patients (n = 51, 84%) had co-infection with other viruses. Forty-eight (79%) children with HPeV infection required hospitalisation, and their median length of hospital stay was five days (IQR: 3-8 days). Ex-prematurity (n = 10, 16%) was the commonest comorbidity among this group. Fever (n = 41, 67%) and cough (n = 41, 67%) were the commonest presenting symptoms among the children. Two-thirds of the HPeV-infected children in this cohort were managed for lower respiratory tract infection; none was managed for meningitis. Gastroenteritis was not common in this cohort; only eight children had diarrhoea. All children made a full recovery. Conclusion HPeVs infection does not show a clear seasonality in Oman. Most of the children were aged <2 years and had a viral co-infection. The outcomes of HPeV infection were favourable, with no mortalities, but a thorough follow-up for neurological outcomes was lacking.
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Affiliation(s)
- Aws Al-Farsi
- College of Medicine and Health Sciences, Sultan Qaboos University, Sultan Qaboos University Hospital, Muscat, Oman
| | - Zaid Alhinai
- College of Medicine and Health Sciences, Sultan Qaboos University, Sultan Qaboos University Hospital, Muscat, Oman
| | - Fatma Ba Alawi
- Department of Microbiology & Immunology, Sultan Qaboos University Hospital, Muscat, Oman
| | - Khuloud Al Maamari
- Department of Microbiology & Immunology, Sultan Qaboos University Hospital, Muscat, Oman
| | - Laila S. Al Yazidi
- Department of Child Health, Sultan Qaboos University Hospital, Muscat, Oman
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Ramazani SN, Fallon A, Sosa T. Capitalizing on Opportunities: Evaluating an Inpatient COVID-19 Vaccination Program. Hosp Pediatr 2023; 13:e348-e350. [PMID: 37807880 DOI: 10.1542/hpeds.2023-007450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Affiliation(s)
- Suzanne N Ramazani
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York
- Division of Pediatric Hospital Medicine, Golisano Children's Hospital
| | - Anne Fallon
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York
- Division of Pediatric Hospital Medicine, Golisano Children's Hospital
| | - Tina Sosa
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York
- Division of Pediatric Hospital Medicine, Golisano Children's Hospital
- UR Medicine Quality Institute, University of Rochester Medical Center, Rochester, New York
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7
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Abuhammad S, Alhawatmeh H, Al‐Natour A, Hamaideh S, Alrabadi N, Sindiani A, Mehrass AA. Knowledge toward COVID-19 in children among undergraduate students at the beginning of COVID-19 era. Nurs Open 2023; 10:3579-3585. [PMID: 36625197 PMCID: PMC10170903 DOI: 10.1002/nop2.1600] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/11/2022] [Accepted: 12/21/2022] [Indexed: 01/11/2023] Open
Abstract
AIMS To describe the level of knowledge of undergraduate students in Jordan toward COVID-19 in children in respect of the clinical signs of the disease, modes of transmission, protection measures against the disease and satisfaction with governmental measures. DESIGN A cross-section was utilized in this study. METHODS An online survey questionnaire was utilized in this research study. All undergraduate students in Jordan were able to take part. The size of the sample was 799. Knowledge toward COVID-19 among children was used to assess the participants' knowledge about COVID-19. RESULTS The findings indicate that the students had a good understanding of the clinical signs, mode of transmission and protection measures and were satisfied with governmental measures. According to the students' responses, the resource they used the most was social media followed by news channels. Our study also found that medical specialty students had more knowledge toward COVID-19 than non-medical.
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Affiliation(s)
- Sawsan Abuhammad
- Faculty of NursingJordan University of Science and TechnologyIrbidJordan
| | - Hossam Alhawatmeh
- Faculty of NursingJordan University of Science and TechnologyIrbidJordan
| | - Ahlam Al‐Natour
- Faculty of NursingJordan University of Science and TechnologyIrbidJordan
| | - Shaher Hamaideh
- Department of Community and Mental Health Nursing, Faculty of NursingThe Hashemite UniversityZarqaJordan
| | - Nasr Alrabadi
- Faculty of MedicineJordan University of Science and TechnologyIrbidJordan
| | - Amer Sindiani
- Faculty of MedicineJordan University of Science and TechnologyIrbidJordan
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Balakumar N, Catueno S, Nadiger M, Keshavamurthy PRS, Totapally BR, Sherani F, Mba N, Gist KM, Tripathi S, Gajic O, Deo N, Kumar V, Walkey A, Kashyap R, Bhalala US. Coronavirus Disease 2019 in Pediatric Oncology Patients: A Matched-Cohort Analysis of the SCCM Discovery Viral Infection and Respiratory Illness Universal Study COVID-19 Registry. J Pediatr Hematol Oncol 2023; 45:e309-e314. [PMID: 36729758 PMCID: PMC10038816 DOI: 10.1097/mph.0000000000002588] [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] [Received: 03/14/2022] [Accepted: 10/10/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND There is a paucity of multicenter data describing the impact of coronavirus disease 2019 (COVID-19) on hospitalized pediatric oncology patients. Using a large, multicenter, Society of Critical Care Medicine (SCCM) Discovery Viral Infection and Respiratory Illness University Study (VIRUS) database, we aimed at assessing outcomes of COVID-19 infection in this population. METHOD This is a matched-cohort study involving children below 18 years of age hospitalized with COVID-19 between March 2020 and January 2021. Using the VIRUS; COVID-19 Registry database, children with oncologic diseases were compared with propensity score matched (age groups, sex, race, and ethnicity) cohort of children without oncologic diseases for the prevalence of Multisystem Inflammatory Syndrome in Children (MIS-C), intensive care unit (ICU) admission, interventions, hospital, and ICU length of stay. RESULTS The number of children in the case and control groups was 45 and 180, respectively. ICU admission rate was similar in both groups ([47.7 vs 51.7%], P =0.63). The proportion of children requiring noninvasive and invasive mechanical ventilation, and its duration were similar between groups, same as hospital mortality. Interestingly, MIS-C was significantly lower in the oncology group compared with the control (2.4 vs 24.6%; P =0.0002). CONCLUSIONS In this study using a multicenter VIRUS database, ICU admission rate, interventions, and outcomes of COVID-19 were similar in children with the oncologic disease compared with control patients. The incidence of MIS-C is lower in oncologic patients.
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Affiliation(s)
- Niveditha Balakumar
- Division of Critical Care Medicine, Department of Pediatrics, Children’s Hospital of San Antonio and Baylor College of Medicine, Houston
| | - Samanta Catueno
- Department of Pediatrics, Driscoll Children’s Hospital, Corpus Christi, TX and Texas A&M University, College Station, TX
| | - Meghana Nadiger
- Division of Critical Care Medicine, Department of Pediatrics, Children’s Hospital of Illinois and University of Illinois College of Medicine
| | - Prithvi Raj Sendi Keshavamurthy
- Division of Critical Care Medicine, Department of Pediatrics, Nicklaus Children’s Hospital and Herbert Wertheim College of Medicine, Florida International University, Miami, FL
| | - Balagangadhar R Totapally
- Division of Critical Care Medicine, Department of Pediatrics, Nicklaus Children’s Hospital and Herbert Wertheim College of Medicine, Florida International University, Miami, FL
| | - Farha Sherani
- Division of Hematology-Oncology, Department of Pediatrics, Driscoll Children’s Hospital, Corpus Christi and Texas A and M University, College Station
| | - Nkechi Mba
- Division of Hematology-Oncology, Department of Pediatrics, Driscoll Children’s Hospital, Corpus Christi and Texas A and M University, College Station
| | | | | | | | | | | | | | | | - Utpal S. Bhalala
- Department of Pediatrics, Driscoll Children’s Hospital, Corpus Christi, TX and Texas A&M University, College Station, TX
- Department of Anesthesiology and Critical Care, University of Texas Medical Branch, Galveston, TX
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Šašić M, Bodulić K, Hojsak I, Mašić M, Trivić I, Markić J, Batinić M, Bartulović I, Šurina A, Krajcar N, Tešović G. Parents' attitudes toward childhood COVID-19 immunization in Croatia: a multicenter cross-sectional study. Croat Med J 2023; 64:52-60. [PMID: 36864819 PMCID: PMC10028565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
AIM To assess parents' attitudes toward childhood COVID-19 immunization in Croatia. METHODS In this multicenter cross-sectional study, we collected data from four tertiary care facilities in Zagreb, Split, and Osijek between December 2021 and February 2022. During the visit to the Pediatric Emergency Departments, parents were asked to fill out a highly-structured questionnaire about their attitudes toward COVID-19 immunization in children. RESULTS The sample consisted of 872 respondents. A total of 46.3% of respondents were hesitant about vaccinating their child against COVID-19, 35.2% definitely did not intend to vaccinate their child, and 18.5% definitely intended to vaccinate their child. Parents who were themselves vaccinated against COVID-19 were more likely than unvaccinated parents (29.2% and 3.2%, P<0.001) to vaccinate their children. Parents agreeing with the epidemiological guidelines were more inclined to vaccinate their children, as were parents of older children and parents of children vaccinated according to the national program schedule. Child comorbidities and respondents' history of COVID-19 were not associated with childhood vaccination intention. Ordinal logistic regression revealed that the most important predictors for a positive parents' attitude toward vaccinating their child were parents' vaccination status and regular vaccination of their child according to the national immunization program schedule. CONCLUSION Our results demonstrate Croatian parents' mostly hesitant and negative attitudes toward childhood COVID-19 immunization. Future vaccination campaigns should target unvaccinated parents, parents with younger children, and parents of children with chronic diseases.
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Affiliation(s)
| | - Kristian Bodulić
- Kristian Bodulić, Research Department, Dr. Fran Mihaljević University Hospital for Infectious Diseases, Mirogojska cesta 8, 10000 Zagreb, Croatia,
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10
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Šašić M, Bodulić K, Hojsak I, Mašić M, Trivić I, Markić J, Batinić M, Bartulović I, Šurina A, Krajcar N, Tešović G. Parents' attitudes toward childhood COVID-19 immunization in Croatia: a multicenter cross-sectional study. Croat Med J 2023; 64. [PMID: 36864819 PMCID: PMC10028565 DOI: 10.3325/cmj.2023.64.52] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023] Open
Abstract
AIM To assess parents' attitudes toward childhood COVID-19 immunization in Croatia. METHODS In this multicenter cross-sectional study, we collected data from four tertiary care facilities in Zagreb, Split, and Osijek between December 2021 and February 2022. During the visit to the Pediatric Emergency Departments, parents were asked to fill out a highly-structured questionnaire about their attitudes toward COVID-19 immunization in children. RESULTS The sample consisted of 872 respondents. A total of 46.3% of respondents were hesitant about vaccinating their child against COVID-19, 35.2% definitely did not intend to vaccinate their child, and 18.5% definitely intended to vaccinate their child. Parents who were themselves vaccinated against COVID-19 were more likely than unvaccinated parents (29.2% and 3.2%, P<0.001) to vaccinate their children. Parents agreeing with the epidemiological guidelines were more inclined to vaccinate their children, as were parents of older children and parents of children vaccinated according to the national program schedule. Child comorbidities and respondents' history of COVID-19 were not associated with childhood vaccination intention. Ordinal logistic regression revealed that the most important predictors for a positive parents' attitude toward vaccinating their child were parents' vaccination status and regular vaccination of their child according to the national immunization program schedule. CONCLUSION Our results demonstrate Croatian parents' mostly hesitant and negative attitudes toward childhood COVID-19 immunization. Future vaccination campaigns should target unvaccinated parents, parents with younger children, and parents of children with chronic diseases.
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Affiliation(s)
| | - Kristian Bodulić
- Kristian Bodulić, Research Department, Dr. Fran Mihaljević University Hospital for Infectious Diseases, Mirogojska cesta 8, 10000 Zagreb, Croatia,
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11
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Alsulami AO, Chahine R, Kong M, Kimberlin DW, Whitley RJ, James SH. Impact of human coronavirus infections on paediatric patients at a tertiary paediatric hospital: a retrospective study of the prepandemic era. J Hosp Infect 2023; 134:27-34. [PMID: 36682627 PMCID: PMC9850843 DOI: 10.1016/j.jhin.2022.12.021] [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: 10/06/2022] [Revised: 12/08/2022] [Accepted: 12/22/2022] [Indexed: 01/20/2023]
Abstract
BACKGROUND Human coronaviruses (HCoVs) are important respiratory pathogens in humans and animals. Most HCoVs are emerging pathogens, with five known human pathogens identified in the last two decades. AIM To examine the clinical course of HCoV infection in children to improve understanding of severity and outcomes. METHODS A retrospective review was undertaken of all encounters of children with known HCoV infection at a tertiary paediatric hospital from January 2015 to January 2018. Electronic medical records were reviewed for demographic data, HCoV type, viral co-pathogens, time to testing, need for hospitalization, requirement for higher-level care (HLC) including intensive care unit management and requirement for oxygen support, radiographic findings suggestive of lower respiratory tract (LRT) disease, and length of stay (LOS). FINDINGS In total, 450 encounters for 430 different patients were identified, with the majority (85%) being inpatient. OC43 was the most common HCoV. Younger patients (age <5 years) had higher probability of hospitalization [adjusted odds ratio (aOR) 2.2, 95% confidence interval (CI) 1.2-4.1], requirement for HLC (aOR 1.8, 95% CI 1.0-3.1) and presence of LRT findings on chest radiographs (aOR 1.7, 95% CI 1.01-2.9). Clinical outcomes did not differ between HCoV types, except LOS which was longer for 229E. Fifty-two (11%) encounters were detected after 3 days of hospitalization (median 25.5 days), suggesting possible nosocomial infection. CONCLUSION HCoVs are important respiratory pathogens in the paediatric population, especially among patients aged <5 years who are at increased risk for severe disease. The role of HCoVs as hospital-acquired pathogens may be underappreciated.
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Affiliation(s)
- A O Alsulami
- Division of Pediatric Infectious Disease, Department of Pediatrics, University of Alabama at Birmingham, AL, USA; Department of Paediatrics, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - R Chahine
- Research Triangle Institute International, Raleigh, NC, USA
| | - M Kong
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, AL, USA
| | - D W Kimberlin
- Division of Pediatric Infectious Disease, Department of Pediatrics, University of Alabama at Birmingham, AL, USA
| | - R J Whitley
- Division of Pediatric Infectious Disease, Department of Pediatrics, University of Alabama at Birmingham, AL, USA
| | - S H James
- Division of Pediatric Infectious Disease, Department of Pediatrics, University of Alabama at Birmingham, AL, USA
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Effects of COVID-19 on Pediatric Cancer Care: A Multicenter Study of 11 Middle Eastern Countries. J Pediatr Hematol Oncol 2023; 45:e87-e91. [PMID: 36219708 DOI: 10.1097/mph.0000000000002564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 08/15/2022] [Indexed: 02/03/2023]
Abstract
During the COVID-19 pandemic, major challenges are facing pediatric cancer centers regarding access to cancer centers, continuity of the anti-cancer therapy, hospital admission, and infection protection precautions. Pediatric oncologists actively treating children with cancer from 29 cancer centers at 11 countries were asked to answer a survey from May 2020 to August 2020 either directly or through the internet. COVID-19 pandemic affected the access to pediatric cancer care in the form of difficulty in reaching the center in 22 (75.9%) centers and affection of patients' flow in 21 (72.4%) centers. Health care professionals (HCP) were infected with COVID-19 in 20 (69%) surveyed centers. Eighteen centers (62%) modified the treatment guidelines. Care of follow-up patients was provided in-hospital in 8(27.6%) centers, through telemedicine in 10 (34.5%) centers, and just delayed in 11 (38%) centers. Pediatric oncologists had different expectations about the future effects of COVID-19 on pediatric cancer care. Seventy-six percent of pediatric oncologists think the COVID-19 pandemic will increase the use of telemedicine. Fifty-five percent of pediatric oncologists think if the COVID-19 pandemic persists, we will need to change chemotherapy protocols to less myelosuppressive ones. Collaborative studies are required to prioritize pediatric cancer management during COVID-19 era.
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13
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Frutos AM, Balmaseda A, Vydiswaran N, Patel M, Ojeda S, Brouwer A, Tutino R, Cai S, Bakker K, Sanchez N, Lopez R, Kuan G, Gordon A. Burden and seasonality of primary and secondary symptomatic common cold coronavirus infections in Nicaraguan children. Influenza Other Respir Viruses 2023; 17:e13078. [PMID: 36494188 PMCID: PMC9835451 DOI: 10.1111/irv.13086] [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: 11/15/2022] [Accepted: 11/22/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The current SARS-CoV-2 pandemic highlights the need for an increased understanding of coronavirus epidemiology. In a pediatric cohort in Nicaragua, we evaluate the seasonality and burden of common cold coronavirus (ccCoV) infection and evaluate likelihood of symptoms in reinfections. METHODS Children presenting with symptoms of respiratory illness were tested for each of the four ccCoVs (NL63, 229E, OC43, and HKU1). Annual blood samples collected before ccCoV infection were tested for antibodies against each ccCoV. Seasonality was evaluated using wavelet and generalized additive model (GAM) analyses, and age-period effects were investigated using a Poisson model. We also evaluate the risk of symptom presentation between primary and secondary infections. RESULTS In our cohort of 2576 children from 2011 to 2016, we observed 595 ccCoV infections and 107 cases of ccCoV-associated lower respiratory infection (LRI). The overall incidence rate was 61.1 per 1000 person years (95% confidence interval (CI): 56.3, 66.2). Children under two had the highest incidence of ccCoV infections and associated LRI. ccCoV incidence rapidly decreases until about age 6. Each ccCoV circulated throughout the year and demonstrated annual periodicity. Peaks of NL63 typically occurred 3 months before 229E peaks and 6 months after OC43 peaks. Approximately 69% of symptomatic ccCoV infections were secondary infections. There was slightly lower risk (rate ratio (RR): 0.90, 95% CI: 0.83, 0.97) of LRI between secondary and primary ccCoV infections among participants under the age of 5. CONCLUSIONS ccCoV spreads annually among children with the greatest burden among ages 0-1. Reinfection is common; prior infection is associated with slight protection against LRI among the youngest children.
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Affiliation(s)
- Aaron M. Frutos
- Department of Epidemiology, School of Public HealthUniversity of MichiganAnn ArborMichiganUSA
| | - Angel Balmaseda
- Health Center Sócrates Flores VivasMinistry of HealthManaguaNicaragua
- Laboratorio Nacional de Virología, Centro Nacional de Diagnósticoy ReferenciaMinistry of HealthManaguaNicaragua
| | - Nivea Vydiswaran
- Department of Epidemiology, School of Public HealthUniversity of MichiganAnn ArborMichiganUSA
| | - Mayuri Patel
- Department of Epidemiology, School of Public HealthUniversity of MichiganAnn ArborMichiganUSA
| | | | - Andrew Brouwer
- Department of Epidemiology, School of Public HealthUniversity of MichiganAnn ArborMichiganUSA
| | - Rebecca Tutino
- Department of Epidemiology, School of Public HealthUniversity of MichiganAnn ArborMichiganUSA
| | - Shuwei Cai
- Department of Epidemiology, School of Public HealthUniversity of MichiganAnn ArborMichiganUSA
| | - Kevin Bakker
- Department of Epidemiology, School of Public HealthUniversity of MichiganAnn ArborMichiganUSA
| | | | - Roger Lopez
- Laboratorio Nacional de Virología, Centro Nacional de Diagnósticoy ReferenciaMinistry of HealthManaguaNicaragua
- Sustainable Sciences InstituteManaguaNicaragua
| | - Guillermina Kuan
- Health Center Sócrates Flores VivasMinistry of HealthManaguaNicaragua
- Sustainable Sciences InstituteManaguaNicaragua
| | - Aubree Gordon
- Department of Epidemiology, School of Public HealthUniversity of MichiganAnn ArborMichiganUSA
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14
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McIntosh K, Perlman S, Monto A, Englund JA. A Proposal to Refer to Four Coronaviruses of Limited Human Virulence "Common Cold Coronaviruses". J Infect Dis 2022; 226:2047-2049. [PMID: 36052654 PMCID: PMC9494316 DOI: 10.1093/infdis/jiac355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/17/2022] [Accepted: 08/22/2022] [Indexed: 01/04/2023] Open
Abstract
We propose the term "common cold coronaviruses," or ccCoV, to describe the four human coronaviruses commonly associated with upper respiratory tract disease - coronaviruses 229E, OC43, NL63, and HKU1. This will differentiate these previously described coronaviruses from those causing more severe disease in humans - including the viruses severe acute respiraotry syndrome coronavirus (SARS-CoV), the Middle East respiratory syndrome coronavirus (MERS-CoV) and SARS-CoV-2.
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Affiliation(s)
- Kenneth McIntosh
- Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Stanley Perlman
- Department of Microbiology and Immunology, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
- Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | - Arnold Monto
- Department of Epidemiology and Global Public Health, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Janet A Englund
- Department of Pediatrics, University of Washington School of Medicine, Seattle Children's Research Institute, Seattle, Washington, USA
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15
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Qatawneh MA, Altarawneh M, Alhazaimeh R, Jazazi M, Jarrah O, Shorman A, Alsadah L, Mustafa M. Manifestations of COVID-19 infection in children with malignancy: A single-center experience in Jordan. World J Virol 2022; 11:321-330. [PMID: 36188736 PMCID: PMC9523322 DOI: 10.5501/wjv.v11.i5.321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 06/28/2022] [Accepted: 09/02/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) has been the cause of a global health crisis since the end of 2019. All countries are following the guidelines and re-commendations released by the World Health Organization to decrease the spread of the disease. Children account for only 3%-5% of COVID-19 cases. Few data are available regarding the clinical course, disease severity, and mode of treatment in children with malignancy and COVID-19.
AIM To evaluate the treatment plan and outcome of children with malignancy who contracted COVID-19.
METHODS A retrospective study of the medical files of patients with malignancy who contracted COVID-19 between July 2020 and June 2021 was performed. The following data were reviewed for all patients: primary disease, laboratory data, admission ward, clinical status upon admission, disease course, treatment plan, and outcome. Eligible patients were those with malignancy who tested positive for COVID-19 by reverse transcription polymerase chain reaction.
RESULTS A total of 40 patients who had malignancy contracted COVID-19 from July 1, 2020 to June 1, 2021. Their primary diseases were as follows: 34 patients (85%) had hematological malignancies (30 had acute lymphoblastic leukemia, 2 had acute myeloblastic leukemia, and 2 had Hodgkin lymphoma), whereas 6 patients (15%) had solid tumors (2 had neuroblastoma, 2 had rhabdomyosarcoma, and 2 had central nervous system tumors). Twelve patients (30%) did not need hospitalization and underwent home isolation only, whereas twenty-eight patients (70%) required hospitalization (26 patients were admitted in the COVID-19 ward and 2 were admitted in the pediatric intensive care unit).
CONCLUSION COVID-19 with malignancy in the pediatric age group has a benign course and does not increase the risk of having severe infection compared to other children.
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Affiliation(s)
- Mousa Ahmad Qatawneh
- Department of Hematology and Medical Oncology and Stem Cell Transplantation Unit, Queen Rania Children’s Hospital, Royal Medical Services, Amman 11183, Jordan
| | - Moath Altarawneh
- Department of Hematology and Medical Oncology and Stem Cell Transplantation Unit, Queen Rania Children’s Hospital, Royal Medical Services, Amman 11183, Jordan
| | - Ruba Alhazaimeh
- Department of Hematology and Medical Oncology and Stem Cell Transplantation Unit, Queen Rania Children’s Hospital, Royal Medical Services, Amman 11183, Jordan
| | - Mais Jazazi
- Department of Hematology and Medical Oncology and Stem Cell Transplantation Unit, Queen Rania Children’s Hospital, Royal Medical Services, Amman 11183, Jordan
| | - Omaiema Jarrah
- Department of Hematology and Medical Oncology and Stem Cell Transplantation Unit, Queen Rania Children’s Hospital, Royal Medical Services, Amman 11183, Jordan
| | - Alaa Shorman
- Department of Neonatology, Queen Rania Children’s Hospital, Royal Medical Services, Amman 11183, Jordan
| | - Laila Alsadah
- Department of General Pediatrics, Queen Rania Children’s Hospital, Royal Medical Services, Amman 11183, Jordan
| | - Maher Mustafa
- Department of Hematology and Medical Oncology and Stem Cell Transplantation Unit, Queen Rania Children’s Hospital, Royal Medical Services, Amman 11183, Jordan
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16
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Frutos AM, Kubale J, Kuan G, Ojeda S, Vydiswaran N, Sanchez N, Plazaola M, Patel M, Lopez R, Balmaseda A, Gordon A. SARS-CoV-2 and endemic coronaviruses: Comparing symptom presentation and severity of symptomatic illness among Nicaraguan children. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000414. [PMID: 35785016 PMCID: PMC9245908 DOI: 10.1371/journal.pgph.0000414] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 04/06/2022] [Indexed: 12/24/2022]
Abstract
It has been proposed that as SARS-CoV-2 transitions to endemicity, children will represent the greatest proportion of SARS-Co-V-2 infections as they currently do with endemic coronavirus infections. While SARS-CoV-2 infection severity is low for children, it is unclear if SARS-CoV-2 infections are distinct in symptom presentation, duration, and severity from endemic coronavirus infections in children. We compared symptom risk and duration of endemic human coronavirus (HCoV) infections from 2011-2016 with SARS-CoV-2 infections from March 2020-September 2021 in a Nicaraguan pediatric cohort. Blood samples were collected from study participants annually in February-April. Respiratory samples were collected from participants that met testing criteria. Blood samples collected in were tested for SARS-CoV-2 antibodies and a subset of 2011-2016 blood samples from four-year-old children were tested for endemic HCoV antibodies. Respiratory samples were tested for each of the endemic HCoVs from 2011-2016 and for SARS-CoV-2 from 2020-2021 via rt-PCR. By April 2021, 854 (49%) cohort participants were ELISA positive for SARS-CoV-2 antibodies. Most participants had antibodies against one alpha and one beta coronavirus by age four. We observed 595 symptomatic endemic HCoV infections from 2011-2016 and 121 symptomatic with SARS-CoV-2 infections from March 2020-September 2021. Symptom presentation of SARS-CoV-2 infection and endemic coronavirus infections were very similar, and SARS-CoV-2 symptomatic infections were as or less severe on average than endemic HCoV infections. This suggests that, for children, SARS-CoV-2 may be just another endemic coronavirus. However, questions about the impact of variants and the long-term effects of SARS-CoV-2 remain.
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Affiliation(s)
- Aaron M. Frutos
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, United States of America
| | - John Kubale
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, United States of America
| | - Guillermina Kuan
- Health Center Sócrates Flores Vivas, Ministry of Health, Managua, Nicaragua
| | - Sergio Ojeda
- Laboratorio Nacional de Virología, Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | - Nivea Vydiswaran
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, United States of America
| | - Nery Sanchez
- Laboratorio Nacional de Virología, Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | - Miguel Plazaola
- Laboratorio Nacional de Virología, Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | - May Patel
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, United States of America
| | - Roger Lopez
- Laboratorio Nacional de Virología, Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
- Sustainable Sciences Institute, Managua, Nicaragua
| | - Angel Balmaseda
- Laboratorio Nacional de Virología, Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
- Sustainable Sciences Institute, Managua, Nicaragua
| | - Aubree Gordon
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, United States of America
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17
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Klučka J, Klabusayová E, Kratochvíl M, Musilová T, Vafek V, Skříšovská T, Kosinová M, Havránková P, Štourač P. Critically Ill Pediatric Patient and SARS-CoV-2 Infection. CHILDREN 2022; 9:children9040538. [PMID: 35455582 PMCID: PMC9024430 DOI: 10.3390/children9040538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 03/30/2022] [Accepted: 04/04/2022] [Indexed: 01/08/2023]
Abstract
In December 2019 SARS-CoV-2 initiated a worldwide COVID-19 pandemic, which is still ongoing in 2022. Although adult elderly patients with chronic preexisting diseases had been identified as the most vulnerable group, COVID-19 has also had a significant impact on pediatric intensive care. Early in 2020, a new disease presentation, multisystemic inflammatory syndrome, was described in children. Despite the vaccination that is available for all age categories, due to its selection process, new viral mutations and highly variable vaccination rate, COVID-19 remains a significant clinical challenge in adult and pediatric intensive care in 2022.
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Affiliation(s)
- Jozef Klučka
- Department of Paediatric Anaesthesiology and Intensive Care Medicine, University Hospital Brno and Faculty of Medicine, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic; (J.K.); (E.K.); (M.K.); (T.M.); (V.V.); (T.S.); (P.H.); (P.Š.)
- Department of Simulation Medicine, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic
| | - Eva Klabusayová
- Department of Paediatric Anaesthesiology and Intensive Care Medicine, University Hospital Brno and Faculty of Medicine, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic; (J.K.); (E.K.); (M.K.); (T.M.); (V.V.); (T.S.); (P.H.); (P.Š.)
- Department of Simulation Medicine, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic
| | - Milan Kratochvíl
- Department of Paediatric Anaesthesiology and Intensive Care Medicine, University Hospital Brno and Faculty of Medicine, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic; (J.K.); (E.K.); (M.K.); (T.M.); (V.V.); (T.S.); (P.H.); (P.Š.)
- Department of Simulation Medicine, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic
| | - Tereza Musilová
- Department of Paediatric Anaesthesiology and Intensive Care Medicine, University Hospital Brno and Faculty of Medicine, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic; (J.K.); (E.K.); (M.K.); (T.M.); (V.V.); (T.S.); (P.H.); (P.Š.)
- Department of Simulation Medicine, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic
| | - Václav Vafek
- Department of Paediatric Anaesthesiology and Intensive Care Medicine, University Hospital Brno and Faculty of Medicine, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic; (J.K.); (E.K.); (M.K.); (T.M.); (V.V.); (T.S.); (P.H.); (P.Š.)
- Department of Simulation Medicine, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic
| | - Tamara Skříšovská
- Department of Paediatric Anaesthesiology and Intensive Care Medicine, University Hospital Brno and Faculty of Medicine, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic; (J.K.); (E.K.); (M.K.); (T.M.); (V.V.); (T.S.); (P.H.); (P.Š.)
- Department of Simulation Medicine, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic
| | - Martina Kosinová
- Department of Paediatric Anaesthesiology and Intensive Care Medicine, University Hospital Brno and Faculty of Medicine, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic; (J.K.); (E.K.); (M.K.); (T.M.); (V.V.); (T.S.); (P.H.); (P.Š.)
- Department of Simulation Medicine, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic
- Correspondence: ; Tel.: +420-53223-469
| | - Pavla Havránková
- Department of Paediatric Anaesthesiology and Intensive Care Medicine, University Hospital Brno and Faculty of Medicine, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic; (J.K.); (E.K.); (M.K.); (T.M.); (V.V.); (T.S.); (P.H.); (P.Š.)
- Department of Anaesthesiology and Intensive Care Medicine, The Donaustadt Clinic, Lango Bardenstraße 122, 1220 Vienna, Austria
| | - Petr Štourač
- Department of Paediatric Anaesthesiology and Intensive Care Medicine, University Hospital Brno and Faculty of Medicine, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic; (J.K.); (E.K.); (M.K.); (T.M.); (V.V.); (T.S.); (P.H.); (P.Š.)
- Department of Simulation Medicine, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic
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18
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Morley HL, Shaw DL, Hannant G. Femur fracture in a paediatric patient with hereditary hyaline fibromatosis syndrome. BMJ Case Rep 2022; 15:e248447. [PMID: 35383097 PMCID: PMC8984057 DOI: 10.1136/bcr-2021-248447] [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] [Accepted: 03/29/2022] [Indexed: 11/04/2022] Open
Abstract
An 18-month-old girl with hereditary hyaline fibromatosis syndrome (HHFS) and fixed flexion contractures presented with an oblique femur fracture, following a fall out of her mother's arms. The fracture was abutting intramedullary hyaline lesions. Due to her condition, balanced traction was impossible to apply. The authors report effective treatment of her injury using a non-operative approach in an early hip spica, over a 4-week period. There was no evidence of delayed osseous healing. Early spica application could be used as a definitive management option in children with femur fractures and fixed flexion contractures in future. This case emphasises the need for preventative measures to support bone health in patients with HHFS.
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Affiliation(s)
| | - David L Shaw
- Trauma and Orthopaedics, Bradford Royal Infirmary, Bradford, UK
| | - Gary Hannant
- Trauma and Orthopaedics, Bradford Royal Infirmary, Bradford, UK
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19
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Comparison of Clinical and Diagnostic Features of Pediatric Oncology Patients With or Without COVID-19 Infection: A Retrospective Chart Review. J Pediatr Hematol Oncol 2022; 44:e658-e664. [PMID: 34486542 DOI: 10.1097/mph.0000000000002303] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 07/27/2021] [Indexed: 11/26/2022]
Abstract
There is a scarcity of data summarizing the clinical picture, laboratory, and imaging findings and outcome in children with malignancy and coronavirus disease 2019 (COVID-19) infection. This study characterizes a detailed comparison of pediatric oncology patients with and without COVID infection. A retrospective study was conducted at The Indus Hospital, Karachi, from March 2020 to June 2020. Clinical presentation, laboratory and imaging findings, disease severity, and outcome were compared between cohorts. The mean age of children with and without COVID was 8.0±4.9 and 7.4±4.1 years, respectively. Hematologic malignancy comprised the largest number of patients, followed by solid tumors. Lymphocytosis and low neutrophil-lymphocyte ratio was observed in the COVID positive group. Cardiac dysfunction (1.4% vs. 0%), acute respiratory distress syndrome (8% vs. 0%) and lower peripheral capillary oxygen saturation/fraction of inspired oxygen ratio (473 vs. 486) found to be associated with severe disease in COVID positive group (P<0.05). Overall mortality in children with COVID was 6.8% versus 2.7% in children without COVID. Pediatric patients with malignancy have different clinical features and laboratory parameters as compared with children without malignancy. Acute respiratory distress syndrome, absolute lymphocytosis and low neutrophil-lymphocyte ratio is associated with severe disease in children with malignancy and COVID infection. In contrast to adults, biochemical markers and complete blood count parameters do not help recognize COVID infection in pediatric patients with malignancy.
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20
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COVID-19 Mortality in Children: A Referral Center Experience from Iran (Mofid Children’s Hospital, Tehran, Iran). CANADIAN JOURNAL OF INFECTIOUS DISEASES AND MEDICAL MICROBIOLOGY 2022; 2022:2737719. [PMID: 35340920 PMCID: PMC8942697 DOI: 10.1155/2022/2737719] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 01/27/2022] [Accepted: 02/09/2022] [Indexed: 01/08/2023]
Abstract
Background. The novel coronavirus disease 2019 (COVID-19) started in Wuhan, China, in December 2019. It spread widely around the world and was described as a pandemic by the World Health Organization (WHO). The knowledge regarding the mortality rate and risk factors of COVID-19 among the pediatric population is lacking. In this regard, we aimed to report the clinical and laboratory characteristics of deceased pediatric patients with SARS-CoV-2 infection. Method. This cross-sectional study was conducted in Mofid Children’s Hospital, Tehran, Iran, from February 2020 to April 2021. Recorded documents of 59 pediatric patients (under 18 years old) assumed to have COVID-19 who had died in the COVID-19 ward and COVID-19 intensive care unit (ICU) were retrospectively evaluated. All statistical analyses were performed using SPSS software (v. 26.0, Chicago, IL). A
value of less than 0.05 was considered statistically significant. Results. From 711 COVID-19 definite and suspected patients, 59 children died. Of these deceased pediatric patients, 34 were boys (57.62%) and 25 were girls (42.37%), with a total mean age of 5.6 years. The median length of stay in the hospital was 10 days (range 1–215). 91.52% had underlying comorbidities of which neurological diseases accounted for the largest share. 54 patients were admitted to the ICU and 83.05% of them had intubation during their hospitalization. In addition, the most common reasons for death in our study were related to respiratory and multiorgan failure. Conclusion. According to our knowledge, we are the first team to report such a thorough study in the field of COVID-19 pediatric mortality in Iran. Mortality was observed in all age groups of children, especially in those with previous comorbidities, specifically neurological disease. Abnormally elevated tests of ESR, CRP, LDH, AST, and ALT as well as the presence of proteinuria and hematuria were found in more than 50% of patients in our investigations, and ICU admission between both definite and suspected groups had significant differences, so monitoring and considering these factors may help to control and reduce the progression of the disease to death.
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21
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Wen C, Sun L, Zhao MC, Duan SX, Wang L, Cui XW. Clinical Study of Human Coronavirus NL63, OC43, 229E, HKU1 Infentions in Hospitalized Children from 2015 to 2020. Infect Drug Resist 2022; 15:1093-1101. [PMID: 35321083 PMCID: PMC8934707 DOI: 10.2147/idr.s357193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 02/22/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Chan Wen
- Department of Medical, Children’s Hospital of Hebei Province, Shijiazhuang, 050031, People’s Republic of China
| | - Ling Sun
- Department of Medical, Children’s Hospital of Hebei Province, Shijiazhuang, 050031, People’s Republic of China
| | - Meng-Chuan Zhao
- Department of Laboratory Medicine, Children’s Hospital of Hebei Province, Shijiazhuang, 050031, People’s Republic of China
| | - Su-Xia Duan
- Department of Laboratory Medicine, Children’s Hospital of Hebei Province, Shijiazhuang, 050031, People’s Republic of China
| | - Le Wang
- Department of Laboratory Medicine, Children’s Hospital of Hebei Province, Shijiazhuang, 050031, People’s Republic of China
| | - Xiao-Wei Cui
- Children’s Hospital of Hebei Province, Shijiazhuang, 050031, People’s Republic of China
- Correspondence: Xiao-Wei Cui, Children’s Hospital of Hebei Province, No. 133 of Jianhua Street, Yuhua District, Shijiazhuang, 050031, People’s Republic of China, Tel +86 18503292016, Fax +86 031185911109, Email
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22
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José RJ, Dickey BF, Sheshadri A. Airway disease in hematologic malignancies. Expert Rev Respir Med 2022; 16:303-313. [PMID: 35176948 PMCID: PMC9067103 DOI: 10.1080/17476348.2022.2043746] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 02/15/2022] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Hematologic malignancies are cancers of the blood, bone marrow and lymph nodes and represent a heterogenous group of diseases that affect people of all ages. Treatment generally involves chemotherapeutic or targeted agents that aim to kill malignant cells. In some cases, hematopoietic stem cell transplantation (HCT) is required to replenish the killed blood and stem cells. Both disease and therapies are associated with pulmonary complications. As survivors live longer with the disease and are treated with novel agents that may result in secondary immunodeficiency, airway diseases and respiratory infections will increasingly be encountered. To prevent airways diseases from adding to the morbidity of survivors or leading to long-term mortality, improved understanding of the pathogenesis and treatment of viral bronchiolitis, BOS, and bronchiectasis is necessary. AREAS COVERED This review focuses on viral bronchitis, BOS and bronchiectasis in people with hematological malignancy. Literature was reviewed from Pubmed for the areas covered. EXPERT OPINION Airway disease impacts significantly on hematologic malignancies. Viral bronchiolitis, BOS and bronchiectasis are common respiratory manifestations in hematological malignancy. Strategies to identify patients early in their disease course may improve the efficacy of treatment and halt progression of lung function decline and improve quality of life.
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Affiliation(s)
- Ricardo J José
- Department of Respiratory Medicine, Host Defence, Royal Brompton Hospital, Chelsea, London, UK
- Centre for Inflammation and Tissue Repair, UCL Respiratory, London, UK
| | - Burton F Dickey
- Department of Pulmonary Medicine, University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Ajay Sheshadri
- Department of Pulmonary Medicine, University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
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Najafinejad M, Cheraghali F, Aghcheli B, Rajabi A, Barati L, Naziri H, Gharib MH, Tabarraei A, Nakstad B, Tahamtan A. COVID-19 in Pediatrics: Demographic, Clinical, Laboratory, and Radiological Characteristics of Infected Patients With SARS-CoV-2. Front Pediatr 2022; 9:808187. [PMID: 35096716 PMCID: PMC8793734 DOI: 10.3389/fped.2021.808187] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 12/21/2021] [Indexed: 12/21/2022] Open
Abstract
The COVID-19 disease usually leads to mild infectious disease in children, but some develop serious complications. Here, we describe the characteristics of children with COVID-19 in northern Iran, the Golestan province. Ninety-one confirmed cases were enrolled in the study, aged 0-18 years. Demographic, clinical, comorbidity, laboratory, and radiological data were compared based on the disease severity (admitted to intensive care unit (ICU) or not) and disease outcome (recovered or deceased). Sixteen (17.5%) cases were hospitalized in ICU, and 8/91 (8.8%) deceased. Fever and cough were the most common clinical symptoms. Among all symptoms notified there were no significant differences between severe and milder cases, or between those who deceased and recovered. Failure to thrive (FTT), malignant disease and neurological disease were significantly more prevalent in severe cases as was frequently reported comorbidities. Laterality, ground-glass opacity, and lung consolidation were the most common findings in chest computed tomography. The data confirms that the COVID-19 disease has various presentations in children, and clinical, laboratory, and radiological findings may help predict the development of severe forms of COVID-19 among children.
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Affiliation(s)
- Maryam Najafinejad
- Department of Pediatrics, School of Medicine, Taleghani Children's Hospital, Golestan University of Medical Sciences, Gorgan, Iran
| | - Fatemeh Cheraghali
- Department of Pediatrics, School of Medicine, Taleghani Children's Hospital, Golestan University of Medical Sciences, Gorgan, Iran
| | - Bahman Aghcheli
- Department of Microbiology, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
| | - Abdolhalim Rajabi
- Department of Biostatistics and Epidemiology, Faculty of Health, Environmental Health Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Leila Barati
- Department of Pediatrics, School of Medicine, Taleghani Children's Hospital, Golestan University of Medical Sciences, Gorgan, Iran
| | - Hamed Naziri
- Department of Microbiology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Mohammad Hadi Gharib
- Department of Radiology, School of Medicine, 5th Azar Hospital, Golestan University of Medical Sciences, Gorgan, Iran
| | - Alijan Tabarraei
- Department of Microbiology, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
| | - Britt Nakstad
- Division of Paediatric and Adolescent Medicine, University of Oslo, Oslo, Norway
- Department of Paediatrics and Adolescent Health, University of Botswana, Gaborone, Botswana
| | - Alireza Tahamtan
- Department of Microbiology, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
- Infectious Diseases Research Centre, Golestan University of Medical Sciences, Gorgan, Iran
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24
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Beight LJ, Helton G, Avery M, Dussel V, Wolfe J. Parent and Adolescent Perspectives on the Impact of COVID on the Care of Seriously Ill Children. J Pain Symptom Manage 2022; 63:52-60. [PMID: 34333095 PMCID: PMC8319041 DOI: 10.1016/j.jpainsymman.2021.07.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 07/07/2021] [Accepted: 07/19/2021] [Indexed: 12/12/2022]
Abstract
CONTEXT Few studies have explored the impact of the Coronavirus Pandemic (COVID-19) on the care of seriously ill children which may be especially affected due to the child's vulnerability, complexity of care, and high reliance on hospital-based care. OBJECTIVE To explore parental and adolescent perspectives on the impact of COVID-19 on care of seriously children. METHODS We recruited a convenience sample of families of seriously ill children between September and December 2020. The study involved a semi-structured interview through Zoom followed by an online sociodemographic survey. Interviews were transcribed and coded using the constant comparison method. The sample intended to represent diversity in child age and diagnoses, and family sociodemographic characteristics. RESULTS Sixty-four families were approached; 29 enrolled (response rate 45%), including 30 parents and three AYAs. Most parents and AYAs identified as white (62%). Some families reported new financial hardships, with 17.2% having difficulty paying bills after March 2020 compared to 6.9% before. Emerging themes from interviews included additional roles parents managed due to cancelled services or shifting to telehealth, increased isolation, high emotional distress due increased in-home demands, uncertainty, and visitor restrictions in medical facilities, and benefits and challenges to telehealth. One positive outcome was the use of a hybrid care model whereby families choose telehealth appointments and in-person services, when necessary. CONCLUSION Families caring for seriously ill children during COVID-19 face increased challenges. Health systems should consider long-term telehealth/in-person hybrid care models that have potential to improve access to and satisfaction with care.
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Affiliation(s)
- Leah J Beight
- Department of Psychosocial Oncology and Palliative Care (L.J.B., G.H., M.A., V.D., J.W.), Dana-Farber Cancer Institute. Boston, MA, USA
| | - Gabrielle Helton
- Department of Psychosocial Oncology and Palliative Care (L.J.B., G.H., M.A., V.D., J.W.), Dana-Farber Cancer Institute. Boston, MA, USA
| | - Madeline Avery
- Department of Psychosocial Oncology and Palliative Care (L.J.B., G.H., M.A., V.D., J.W.), Dana-Farber Cancer Institute. Boston, MA, USA
| | - Veronica Dussel
- Pediatric Palliative Care (V.D.), Dana-Farber Boston Children's Cancer and Blood Disorders Center, Boston, MA, USA; Center for Research and Implementation in Palliative Care (CII-CP) (V.D.), Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires Argentina
| | - Joanne Wolfe
- Department of Psychosocial Oncology and Palliative Care (L.J.B., G.H., M.A., V.D., J.W.), Dana-Farber Cancer Institute. Boston, MA, USA; Department of Pediatrics (J.W.), Boston Children's Hospital. Boston, MA, USA.
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25
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Frutos AM, Kubale J, Kuan G, Ojeda S, Vydiswaran N, Sanchez N, Plazaola M, Patel M, Lopez R, Balmaseda A, Gordon A. SARS-CoV-2 and endemic coronaviruses: Comparing symptom presentation and severity of symptomatic illness among Nicaraguan children.. [PMID: 35075460 PMCID: PMC8786229 DOI: 10.1101/2021.12.09.21267537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
It has been proposed that as SARS-CoV-2 transitions to endemicity, children will represent the greatest proportion of SARS-Co-V-2 infections as they currently do with endemic coronavirus infections. While SARS-CoV-2 infection severity is low for children, it is unclear if SARS-CoV-2 infections are distinct in symptom presentation, duration, and severity from endemic coronavirus infections in children. We compared symptom risk and duration of endemic human coronavirus (HCoV) infections from 2011–2016 with SARS-CoV-2 infections from March 2020-September 2021 in a Nicaraguan pediatric cohort. Blood samples were collected from study participants annually in February-April. Respiratory samples were collected from participants that met testing criteria. Blood samples collected in were tested for SARS-CoV-2 antibodies and a subset of 2011–2016 blood samples from four-year-old children were tested for endemic HCoV antibodies. Respiratory samples were tested for each of the endemic HCoVs from 2011–2016 and for SARS-CoV-2 from 2020–2021 via rt-PCR. By April 2021, 854 (49%) cohort participants were ELISA positive for SARS-CoV-2 antibodies. Most participants had antibodies against one alpha and one beta coronavirus by age four. We observed 595 symptomatic endemic HCoV infections from 2011–2016 and 121 symptomatic with SARS-CoV-2 infections from March 2020-September 2021. Symptom presentation of SARS-CoV-2 infection and endemic coronavirus infections were very similar, and SARS-CoV-2 symptomatic infections were as or less severe on average than endemic HCoV infections. This suggests that, for children, SARS-CoV-2 may be just another endemic coronavirus. However, questions about the impact of variants and the long-term effects of SARS-CoV-2 remain.
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26
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Wong BLH, Ramsay ME, Ladhani SN. Should children be vaccinated against COVID-19 now? Arch Dis Child 2021; 106:1147-1148. [PMID: 33402324 DOI: 10.1136/archdischild-2020-321225] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/10/2020] [Accepted: 12/11/2020] [Indexed: 02/02/2023]
Affiliation(s)
- Brian Li Han Wong
- Immunisation and Countermeasures Division, Public Health England, Colindale, London, UK
| | - Mary Elizabeth Ramsay
- Immunisation and Countermeasures Division, Public Health England, Colindale, London, UK
| | - Shamez N Ladhani
- Immunisation and Countermeasures Division, Public Health England, Colindale, London, UK
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27
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Yuksel M, Akturk H, Mizikoglu O, Toroslu E, Arikan C. A single-center report of COVID-19 disease course and management in liver transplanted pediatric patients. Pediatr Transplant 2021; 25:e14061. [PMID: 34076953 PMCID: PMC8237072 DOI: 10.1111/petr.14061] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 04/20/2021] [Accepted: 05/09/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND In 2019, SARS-CoV-2 causing COVID-19 emerged. Severe COVID-19 symptoms may evolve by virtue of hyperactivation of the immune system. Equally, immunocompromised patients may be at increased risk to develop COVID-19. However, treatment guidelines for children following liver transplantation are elusive. METHODS As a liver transplantation center, we diagnosed and followed up 10 children (male/female: 8/2) with a median age of 8.5 years (IQR: 5.2-11.0), with COVID-19 post-liver transplant between March 2019 and December 2020. COVID-19 diagnosis was based on PCR test and or florid X-ray findings compatible with COVID-19 in the absence of other cause. We retrospectively collected clinical and laboratory data from electronic patient records following written consent from patients/parents. RESULTS Nine patients were diagnosed as definitive (PCR positive) with one patient being diagnosed as probable COVID-19. Seven patients recovered without any support whereas three were admitted for non-invasive oxygenation. Lymphopenia and/or high levels of serum IL-6 were detected in four patients. Six patients mounted anti-SARS-CoV-2 antibodies at median 30 days (IQR: 26.5-119.0) following COVID-19 diagnosis. Antibiotic therapy, favipiravir, anakinra, and IVIG were used as treatment in 4,1,1 and 2 patients, respectively. Furthermore, we kept the tacrolimus with or without everolimus but stopped MMF in 2 patients. Importantly, liver allograft function was retained in all patients. CONCLUSIONS We found that being immunocompromised did not affect disease severity nor survival. Stopping MMF yet continuing with tacrolimus was an apt treatment modality in these patients.
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Affiliation(s)
- Muhammed Yuksel
- Pediatric Gastroenterology‐HepatologyLiver Transplantation CenterKoç University HospitalIstanbulTurkey,Koç University Research Center for Translational Medicine (KUTTAM)‐Liver Immunology LabIstanbulTurkey
| | - Hacer Akturk
- Koç University Pediatric infectious diseasesIstanbulTurkey
| | - Ozlem Mizikoglu
- Pediatric Gastroenterology‐HepatologyLiver Transplantation CenterKoç University HospitalIstanbulTurkey
| | - Ertug Toroslu
- Pediatric Gastroenterology‐HepatologyLiver Transplantation CenterKoç University HospitalIstanbulTurkey
| | - Cigdem Arikan
- Pediatric Gastroenterology‐HepatologyLiver Transplantation CenterKoç University HospitalIstanbulTurkey,Koç University Research Center for Translational Medicine (KUTTAM)‐Liver Immunology LabIstanbulTurkey
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28
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Ebeid FSE, Ragab IA, Elsherif NHK, Makkeyah S, Mostafa S, Eltonbary K, Matbouly S, Mostafa A, Goma H, Agwa SH, Hafez HM, Girgis S, El Gendy YG, El-Sayed MH. COVID-19 in Children With Cancer: A Single Low-Middle Income Center Experience. J Pediatr Hematol Oncol 2021; 43:e1077-e1081. [PMID: 33290293 DOI: 10.1097/mph.0000000000002025] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 10/29/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Coronavirus disease-2019 (COVID-19) could be associated with morbidity and mortality in immunocompromised children. OBJECTIVE The objective of this study was to measure the frequency of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among hospitalized children with cancer and to detect the associated clinical manifestations and outcomes. METHODOLOGY A prospective noninterventional study including all hospitalized children with cancer conducted between mid-April and mid-June 2020 in Ain Shams University Hospital, Egypt. Clinical, laboratory, and radiologic data were collected. SARS-CoV-2 infection was diagnosed by reverse transcription polymerase chain reaction tests in nasopharyngeal swabs. RESULTS Fifteen of 61 hospitalized children with cancer were diagnosed with SARS-CoV-2. Their mean age was 8.3±3.5 years. Initially, 10 (66.7%) were asymptomatic and 5 (33.3%) were symptomatic with fever and/or cough. Baseline laboratory tests other than SARS-CoV-2 reverse transcription polymerase chain reaction were not diagnostic; the mean absolute lymphocyte count was 8.7±2.4×109/L. C-reactive protein was mildly elevated in most of the patients. Imaging was performed in 10 (66.7%) patients with significant radiologic findings detected in 4 (40%) patients. Treatment was mainly supportive with antibiotics as per the febrile neutropenia protocol and local Children Hospital guidance for management of COVID-19 in children. CONCLUSIONS Pediatric cancer patients with COVID-19 were mainly asymptomatic or with mild symptoms. A high index of suspicion and regular screening with nasopharyngeal swab in asymptomatic hospitalized cancer patients is recommended.
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Affiliation(s)
- Fatma S E Ebeid
- Pediatric Hematology Oncology Department
- Faculty of Medicine, Ain Shams University Research Institute-Clinical Research Center (MASRI-CRC)
| | | | | | | | | | | | | | - Aya Mostafa
- Community, Environmental, and Occupational Medicine
| | - Heba Goma
- Pediatric Hematology Oncology Department
| | | | | | | | | | - Manal H El-Sayed
- Pediatric Hematology Oncology Department
- Faculty of Medicine, Ain Shams University Research Institute-Clinical Research Center (MASRI-CRC)
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29
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Bitterman R, Kumar D. Respiratory Viruses in Solid Organ Transplant Recipients. Viruses 2021; 13:2146. [PMID: 34834953 PMCID: PMC8622983 DOI: 10.3390/v13112146] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/15/2021] [Accepted: 10/22/2021] [Indexed: 12/02/2022] Open
Abstract
Solid organ transplantation is often lifesaving, but does carry an increased risk of infection. Respiratory viral infections are one of the most prevalent infections, and are a cause of significant morbidity and mortality, especially among lung transplant recipients. There is also data to suggest an association with acute rejection and chronic lung allograft dysfunction in lung transplant recipients. Respiratory viral infections can appear at any time post-transplant and are usually acquired in the community. All respiratory viral infections share similar clinical manifestations and are all currently diagnosed using nucleic acid testing. Influenza has good treatment options and prevention strategies, although these are hampered by resistance to neuraminidase inhibitors and lower vaccine immunogenicity in the transplant population. Other respiratory viruses, unfortunately, have limited treatments and preventive methods. This review summarizes the epidemiology, clinical manifestations, therapies and preventive measures for clinically significant RNA and DNA respiratory viruses, with the exception of SARS-CoV-2. This area is fast evolving and hopefully the coming decades will bring us new antivirals, immunologic treatments and vaccines.
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Affiliation(s)
| | - Deepali Kumar
- Ajmera Transplant Centre, University Health Network, Toronto, ON M5G 2N2, Canada;
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30
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Chinawa AT, Chinawa JM, Ossai EN, Obinna N, Onukwuli V, Aronu AE, Manyike CP. Maternal level of awareness and predictors of willingness to vaccinate children against COVID 19; A multi-center study. Hum Vaccin Immunother 2021; 17:3982-3988. [PMID: 34613862 DOI: 10.1080/21645515.2021.1963172] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Several controversies surround mothers' willingness to vaccinate against the COVID-19 pandemic especially when mortality is not frequently reported in children.Objectives: This study aimed to ascertain the willingness of mothers of children attending two institutions in Southeast Nigeria to accept the COVID-19 vaccine and factors that may be associated with their choices. METHODOLOGY This was a cross-sectional study carried out among 577 mothers who presented with their children in two tertiary health institutions in southeast Nigeria. RESULTS Majority of the respondents (93.9%) were aware of the COVID-19 vaccine. Majority of the respondents, 89.4%, noted that children were not in high priority groups for COVID-19 vaccination in Nigeria. Only 6.9% of the respondents intend to receive the COVID-19 vaccination. Also, a minor proportion of the respondents (4.9%) were willing to vaccinate their children with the COVID-19 vaccine. The odds of receiving the Covid-19 vaccine were four times greater in those who believed that they could be infected than in those who believed that they could not be infected (AOR = 4.0. 95% CI:1.8-8.7). The odds of receiving the Covid-19 vaccine were six times greater in those who were aware of someone that died from COVID-19 than in those who did not know anyone who died from COVID-19 (AOR = 5.7, 95% CI: 2.1-15.8). CONCLUSION A high level of awareness but low acceptance level for COVID-19 vaccination for mothers and their children was noted. Socioeconomic class, maternal age, and level of education did not influence the willingness of the mother to receive COVID vaccination. Having a belief of possibility of infection with the COVID-19 as well as being aware of someone who died from the disease were important positive variables that could predict vaccine acceptance from this study.
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Affiliation(s)
- Awoere T Chinawa
- Department of Community medicine, ESUCOM Parkalane, Enugu State University Teaching Hospital, Enugu, Nigeria
| | - Josephat M Chinawa
- Department of Paediatrics, College of Medicine, University of Nigeria Enugu Campus, Enugu, Nigeria
| | - Edmund N Ossai
- Department of Community Medicine, College of Health Sciences, Ebonyi State University Abakaliki, Abakiliki, Nigeria
| | - Nduagubam Obinna
- Department of Paediatrics, Enugu State University Teaching Hospital, Enugu
| | - Vivian Onukwuli
- Department of Paediatrics, College of Medicine, University of Nigeria Enugu Campus, Enugu, Nigeria
| | - Ann E Aronu
- Department of Paediatrics, College of Medicine, University of Nigeria Enugu Campus, Enugu, Nigeria
| | - Chuka P Manyike
- Department of Paediatrics, College of Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Abakiliki
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31
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Yadav A, Thakkar D, Wadhwa T, Sarma S, Upasana K, Rastogi N, Yadav SP. COVID-19 in children with blood and cancer disorders: An experience from India. PEDIATRIC HEMATOLOGY ONCOLOGY JOURNAL 2021. [PMCID: PMC8517390 DOI: 10.1016/j.phoj.2021.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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33
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Mukkada S, Bhakta N, Chantada GL, Chen Y, Vedaraju Y, Faughnan L, Homsi MR, Muniz-Talavera H, Ranadive R, Metzger M, Friedrich P, Agulnik A, Jeha S, Lam C, Dalvi R, Hessissen L, Moreira DC, Santana VM, Sullivan M, Bouffet E, Caniza MA, Devidas M, Pritchard-Jones K, Rodriguez-Galindo C. Global characteristics and outcomes of SARS-CoV-2 infection in children and adolescents with cancer (GRCCC): a cohort study. Lancet Oncol 2021; 22:1416-1426. [PMID: 34454651 PMCID: PMC8389979 DOI: 10.1016/s1470-2045(21)00454-x] [Citation(s) in RCA: 94] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 07/23/2021] [Accepted: 07/26/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Previous studies have shown that children and adolescents with COVID-19 generally have mild disease. Children and adolescents with cancer, however, can have severe disease when infected with respiratory viruses. In this study, we aimed to understand the clinical course and outcomes of SARS-CoV-2 infection in children and adolescents with cancer. METHODS We did a cohort study with data from 131 institutions in 45 countries. We created the Global Registry of COVID-19 in Childhood Cancer to capture de-identified data pertaining to laboratory-confirmed SARS-CoV-2 infections in children and adolescents (<19 years) with cancer or having received a haematopoietic stem-cell transplantation. There were no centre-specific exclusion criteria. The registry was disseminated through professional networks through email and conferences and health-care providers were invited to submit all qualifying cases. Data for demographics, oncological diagnosis, clinical course, and cancer therapy details were collected. Primary outcomes were disease severity and modification to cancer-directed therapy. The registry remains open to data collection. FINDINGS Of 1520 submitted episodes, 1500 patients were included in the study between April 15, 2020, and Feb 1, 2021. 1319 patients had complete 30-day follow-up. 259 (19·9%) of 1301 patients had a severe or critical infection, and 50 (3·8%) of 1319 died with the cause attributed to COVID-19 infection. Modifications to cancer-directed therapy occurred in 609 (55·8%) of 1092 patients receiving active oncological treatment. Multivariable analysis revealed several factors associated with severe or critical illness, including World Bank low-income or lower-middle-income (odds ratio [OR] 5·8 [95% CI 3·8-8·8]; p<0·0001) and upper-middle-income (1·6 [1·2-2·2]; p=0·0024) country status; age 15-18 years (1·6 [1·1-2·2]; p=0·013); absolute lymphocyte count of 300 or less cells per mm3 (2·5 [1·8-3·4]; p<0·0001), absolute neutrophil count of 500 or less cells per mm3 (1·8 [1·3-2·4]; p=0·0001), and intensive treatment (1·8 [1·3-2·3]; p=0·0005). Factors associated with treatment modification included upper-middle-income country status (OR 0·5 [95% CI 0·3-0·7]; p=0·0004), primary diagnosis of other haematological malignancies (0·5 [0·3-0·8]; p=0·0088), the presence of one of more COVID-19 symptoms at the time of presentation (1·8 [1·3-2·4]; p=0·0002), and the presence of one or more comorbidities (1·6 [1·1-2·3]; p=0·020). INTERPRETATION In this global cohort of children and adolescents with cancer and COVID-19, severe and critical illness occurred in one fifth of patients and deaths occurred in a higher proportion than is reported in the literature in the general paediatric population. Additionally, we found that variables associated with treatment modification were not the same as those associated with greater disease severity. These data could inform clinical practice guidelines and raise awareness globally that children and adolescents with cancer are at high-risk of developing severe COVID-19 illness. FUNDING American Lebanese Syrian Associated Charities and the National Cancer Institute.
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Affiliation(s)
- Sheena Mukkada
- Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN, USA.
| | - Nickhill Bhakta
- Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Guillermo L Chantada
- Department of Pediatric Hematology and Oncology, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Yichen Chen
- Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Yuvanesh Vedaraju
- Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Lane Faughnan
- Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Maysam R Homsi
- Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Hilmarie Muniz-Talavera
- Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Radhikesh Ranadive
- Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Monika Metzger
- Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Paola Friedrich
- Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Asya Agulnik
- Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Sima Jeha
- Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Catherine Lam
- Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Rashmi Dalvi
- Department of Pediatrics, Bombay Hospital Institute of Medical Sciences, Mumbai, India
| | - Laila Hessissen
- Department of Pediatric Hematology and Oncology, Mohammed V University, Rabat, Morocco
| | - Daniel C Moreira
- Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Victor M Santana
- Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Michael Sullivan
- Children's Cancer Centre, Royal Children's Hospital, Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Eric Bouffet
- Division of Haematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada
| | - Miguela A Caniza
- Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Meenakshi Devidas
- Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Kathy Pritchard-Jones
- Developmental Biology and Cancer Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
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Malcangi G, Inchingolo AD, Inchingolo AM, Santacroce L, Marinelli G, Mancini A, Vimercati L, Maggiore ME, D’Oria MT, Hazballa D, Bordea IR, Xhajanka E, Scarano A, Farronato M, Tartaglia GM, Giovanniello D, Nucci L, Serpico R, Sammartino G, Capozzi L, Parisi A, Di Domenico M, Lorusso F, Contaldo M, Inchingolo F, Dipalma G. COVID-19 Infection in Children, Infants and Pregnant Subjects: An Overview of Recent Insights and Therapies. Microorganisms 2021; 9:1964. [PMID: 34576859 PMCID: PMC8469368 DOI: 10.3390/microorganisms9091964] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 09/07/2021] [Accepted: 09/09/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The SARS-CoV-2 pandemic has involved a severe increase of cases worldwide in a wide range of populations. The aim of the present investigation was to evaluate recent insights about COVID-19 infection in children, infants and pregnant subjects. METHODS a literature overview was performed including clinical trials, in vitro studies, reviews and published guidelines regarding the present paper topic. A descriptive synthesis was performed to evaluate recent insights and the effectiveness of therapies for SARS-CoV-2 infection in children, infants and pregnant subjects. RESULTS Insufficient data are available regarding the relationship between COVID-19 and the clinical risk of spontaneous abortion and premature foetus death. A decrease in the incidence of COVID-19 could be correlated to a minor expression of ACE2 in childrens' lungs. At present, a modulation of the dose-effect posology for children and infants is necessary. CONCLUSIONS Pregnant vertical transmission has been hypothesised for SARS-CoV-2 infection. Vaccines are necessary to achieve mass immunity for children and also pregnant subjects.
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Affiliation(s)
- Giuseppina Malcangi
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (L.S.); (G.M.); (A.M.); (L.V.); (M.E.M.); (M.T.D.); (D.H.); (F.I.); (G.D.)
| | - Alessio Danilo Inchingolo
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (L.S.); (G.M.); (A.M.); (L.V.); (M.E.M.); (M.T.D.); (D.H.); (F.I.); (G.D.)
| | - Angelo Michele Inchingolo
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (L.S.); (G.M.); (A.M.); (L.V.); (M.E.M.); (M.T.D.); (D.H.); (F.I.); (G.D.)
| | - Luigi Santacroce
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (L.S.); (G.M.); (A.M.); (L.V.); (M.E.M.); (M.T.D.); (D.H.); (F.I.); (G.D.)
| | - Grazia Marinelli
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (L.S.); (G.M.); (A.M.); (L.V.); (M.E.M.); (M.T.D.); (D.H.); (F.I.); (G.D.)
| | - Antonio Mancini
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (L.S.); (G.M.); (A.M.); (L.V.); (M.E.M.); (M.T.D.); (D.H.); (F.I.); (G.D.)
| | - Luigi Vimercati
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (L.S.); (G.M.); (A.M.); (L.V.); (M.E.M.); (M.T.D.); (D.H.); (F.I.); (G.D.)
| | - Maria Elena Maggiore
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (L.S.); (G.M.); (A.M.); (L.V.); (M.E.M.); (M.T.D.); (D.H.); (F.I.); (G.D.)
| | - Maria Teresa D’Oria
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (L.S.); (G.M.); (A.M.); (L.V.); (M.E.M.); (M.T.D.); (D.H.); (F.I.); (G.D.)
- Department of Medical and Biological Sciences, University of Udine, Via delle Scienze, 206, 33100 Udine, Italy
| | - Denisa Hazballa
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (L.S.); (G.M.); (A.M.); (L.V.); (M.E.M.); (M.T.D.); (D.H.); (F.I.); (G.D.)
- Kongresi Elbasanit, Rruga: Aqif Pasha, 3001 Elbasan, Albania
| | - Ioana Roxana Bordea
- Department of Oral Rehabilitation, Faculty of Dentistry, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Edit Xhajanka
- Department of Dental Prosthesis, Medical University of Tirana, Rruga e Dibrës, U.M.T., 1001 Tirana, Albania;
| | - Antonio Scarano
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy;
| | - Marco Farronato
- UOC Maxillo-Facial Surgery and Dentistry, Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, Fondazione IRCCS Ca Granda, Ospedale Maggiore Policlinico, University of Milan, 20100 Milan, Italy; (M.F.); (G.M.T.)
| | - Gianluca Martino Tartaglia
- UOC Maxillo-Facial Surgery and Dentistry, Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, Fondazione IRCCS Ca Granda, Ospedale Maggiore Policlinico, University of Milan, 20100 Milan, Italy; (M.F.); (G.M.T.)
| | | | - Ludovica Nucci
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via Luigi de Crecchio, 6, 80138 Naples, Italy; (L.N.); (R.S.); (M.C.)
| | - Rosario Serpico
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via Luigi de Crecchio, 6, 80138 Naples, Italy; (L.N.); (R.S.); (M.C.)
| | - Gilberto Sammartino
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, 80131 Naples, Italy;
| | - Loredana Capozzi
- Istituto Zooprofilattico Sperimentale Della Puglia e Della Basilicata, 71121 Foggia, Italy; (L.C.); (A.P.)
| | - Antonio Parisi
- Istituto Zooprofilattico Sperimentale Della Puglia e Della Basilicata, 71121 Foggia, Italy; (L.C.); (A.P.)
| | - Marina Di Domenico
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, 80138 Naples, Italy;
| | - Felice Lorusso
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy;
| | - Maria Contaldo
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via Luigi de Crecchio, 6, 80138 Naples, Italy; (L.N.); (R.S.); (M.C.)
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (L.S.); (G.M.); (A.M.); (L.V.); (M.E.M.); (M.T.D.); (D.H.); (F.I.); (G.D.)
| | - Gianna Dipalma
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (L.S.); (G.M.); (A.M.); (L.V.); (M.E.M.); (M.T.D.); (D.H.); (F.I.); (G.D.)
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Saleh M, Alkofide A, Alshammari A, Siddiqui K, Owaidah T. Changes in Hematological, Clinical and Laboratory Parameters for Children with COVID-19: Single-Center Experience. J Blood Med 2021; 12:819-826. [PMID: 34512062 PMCID: PMC8427837 DOI: 10.2147/jbm.s321372] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 08/06/2021] [Indexed: 12/23/2022] Open
Abstract
Background COVID-19 wreaked havoc on the healthcare system, with more than 36 million cases reported globally. Although the pediatric population makes up a lesser proportion of total COVID-19 patients than adults, the clinical status, age and comorbidities warrant identifying possible prognostic factors associated with disease severity in this group. The current study aimed to explore the incidence of thrombosis, overall outcome, and different hematological and coagulation markers in children with COVID-19. Methods This is a single-center prospective study of 43 patients (age < 14 years) with confirmed COVID-19 diagnosis recruited from April to August 2020. Data for clinical presentation were collected and analyzed. The samples were tested for different hematological and coagulation markers. Results Twenty-nine (67.4%) were symptomatic at presentation, with fever being the most common symptom (n = 23, 53.5%), followed by respiratory (n = 5, 11.6%) and gastrointestinal symptoms (n = 3, 7%). Co-morbid conditions were recorded in 26 (60.5%) patients, with malignancy being the commonest (n = 9, 20.9%). In this cohort of patients with age <14 years, hypertension, respiratory symptoms and ABO group-A were significantly associated with pediatric intensive care unit (PICU) admission during the course of treatment. Patients with elevated FVIII and fibrinogen levels at presentation were more likely to have an extended length of hospital stay (LOS) (P-value =0.036 and 0.032 respectively). No thrombotic event was observed in our cohort. D-dimer values were higher (above 0.5 µg/mL) in 24 (55.8%) patients at admission. We found an association between high D-dimer and PICU admission and LOS. Conclusion Although we did not observe thrombosis in our cohort, serial measurements of D-dimer and elevated FVIII bear a prognostic value in predicting the need for critical care in children with COVID-19. Further studies with larger sample size can aid in the establishment of prognostic factors for the pediatric COVID-19 population.
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Affiliation(s)
- Mahasen Saleh
- Department of Pediatric Hematology Oncology, King Faisal Specialist Hospital and Research Center, Riyadh, 11533, Kingdom of Saudi Arabia
| | - Amani Alkofide
- Department of Pediatric Hematology Oncology, King Faisal Specialist Hospital and Research Center, Riyadh, 11533, Kingdom of Saudi Arabia
| | - Anfal Alshammari
- Department of Pediatric Hematology Oncology, King Faisal Specialist Hospital and Research Center, Riyadh, 11533, Kingdom of Saudi Arabia
| | - Khawar Siddiqui
- Department of Pediatric Hematology Oncology, King Faisal Specialist Hospital and Research Center, Riyadh, 11533, Kingdom of Saudi Arabia
| | - Tarek Owaidah
- Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, 11211, Kingdom of Saudi Arabia.,Department of Pathology, Alfaisal University, Riyadh, 11533, Kingdom of Saudi Arabia
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36
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Lapp SA, Edara VV, Lu A, Lai L, Hussaini L, Chahroudi A, Anderson LJ, Suthar MS, Anderson EJ, Rostad CA. Original antigenic sin responses to Betacoronavirus spike proteins are observed in a mouse model, but are not apparent in children following SARS-CoV-2 infection. PLoS One 2021; 16:e0256482. [PMID: 34449792 PMCID: PMC8396729 DOI: 10.1371/journal.pone.0256482] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 08/06/2021] [Indexed: 11/19/2022] Open
Abstract
Background The effects of pre-existing endemic human coronavirus (HCoV) immunity on SARS-CoV-2 serologic and clinical responses are incompletely understood. Objectives We sought to determine the effects of prior exposure to HCoV Betacoronavirus HKU1 spike protein on serologic responses to SARS-CoV-2 spike protein after intramuscular administration in mice. We also sought to understand the baseline seroprevalence of HKU1 spike antibodies in healthy children and to measure their correlation with SARS-CoV-2 binding and neutralizing antibodies in children hospitalized with acute coronavirus disease 2019 (COVID-19) or multisystem inflammatory syndrome (MIS-C). Methods Groups of 5 mice were injected intramuscularly with two doses of alum-adjuvanted HKU1 spike followed by SARS-CoV-2 spike; or the reciprocal regimen of SARS-Cov-2 spike followed by HKU1 spike. Sera collected 21 days following each injection was analyzed for IgG antibodies to HKU1 spike, SARS-CoV-2 spike, and SARS-CoV-2 neutralization. Sera from children hospitalized with acute COVID-19, MIS-C or healthy controls (n = 14 per group) were analyzed for these same antibodies. Results Mice primed with SARS-CoV-2 spike and boosted with HKU1 spike developed high titers of SARS-CoV-2 binding and neutralizing antibodies; however, mice primed with HKU1 spike and boosted with SARS-CoV-2 spike were unable to mount neutralizing antibodies to SARS-CoV-2. HKU1 spike antibodies were detected in all children with acute COVID-19, MIS-C, and healthy controls. Although children with MIS-C had significantly higher HKU1 spike titers than healthy children (GMT 37239 vs. 7551, P = 0.012), these titers correlated positively with both SARS-CoV-2 binding (r = 0.7577, P<0.001) and neutralizing (r = 0.6201, P = 0.001) antibodies. Conclusions Prior murine exposure to HKU1 spike protein completely impeded the development of neutralizing antibodies to SARS-CoV-2, consistent with original antigenic sin. In contrast, the presence of HKU1 spike IgG antibodies in children with acute COVID-19 or MIS-C was not associated with diminished neutralizing antibody responses to SARS-CoV-2.
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Affiliation(s)
- Stacey A. Lapp
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States of America
- Center for Childhood Infections and Vaccines, Children’s Healthcare of Atlanta and Emory University School of Medicine, Atlanta, GA, United States of America
| | - Venkata Viswanadh Edara
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States of America
- Center for Childhood Infections and Vaccines, Children’s Healthcare of Atlanta and Emory University School of Medicine, Atlanta, GA, United States of America
- Yerkes Primate Center, Emory University, Atlanta, GA, United States of America
| | - Austin Lu
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States of America
- Center for Childhood Infections and Vaccines, Children’s Healthcare of Atlanta and Emory University School of Medicine, Atlanta, GA, United States of America
| | - Lilin Lai
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States of America
- Center for Childhood Infections and Vaccines, Children’s Healthcare of Atlanta and Emory University School of Medicine, Atlanta, GA, United States of America
- Yerkes Primate Center, Emory University, Atlanta, GA, United States of America
| | - Laila Hussaini
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States of America
- Center for Childhood Infections and Vaccines, Children’s Healthcare of Atlanta and Emory University School of Medicine, Atlanta, GA, United States of America
| | - Ann Chahroudi
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States of America
- Center for Childhood Infections and Vaccines, Children’s Healthcare of Atlanta and Emory University School of Medicine, Atlanta, GA, United States of America
| | - Larry J. Anderson
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States of America
- Center for Childhood Infections and Vaccines, Children’s Healthcare of Atlanta and Emory University School of Medicine, Atlanta, GA, United States of America
| | - Mehul S. Suthar
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States of America
- Center for Childhood Infections and Vaccines, Children’s Healthcare of Atlanta and Emory University School of Medicine, Atlanta, GA, United States of America
- Yerkes Primate Center, Emory University, Atlanta, GA, United States of America
| | - Evan J. Anderson
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States of America
- Center for Childhood Infections and Vaccines, Children’s Healthcare of Atlanta and Emory University School of Medicine, Atlanta, GA, United States of America
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, United States of America
| | - Christina A. Rostad
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States of America
- Center for Childhood Infections and Vaccines, Children’s Healthcare of Atlanta and Emory University School of Medicine, Atlanta, GA, United States of America
- * E-mail:
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Deyà-Martínez A, García-García A, Gonzalez-Navarro EA, Yiyi L, Vlagea A, Jordan I, Fumadó V, Fortuny C, Español M, Launes C, Esteve-Solé A, Juan M, Pascal M, Alsina L. COVID-19 in children and young adults with moderate/severe inborn errors of immunity in a high burden area in pre-vaccine era. Clin Immunol 2021; 230:108821. [PMID: 34391937 PMCID: PMC8359496 DOI: 10.1016/j.clim.2021.108821] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 08/02/2021] [Accepted: 08/06/2021] [Indexed: 12/24/2022]
Abstract
Background Information regarding inborn error of immunity (IEI) as a risk factor for severe COVID-19 is scarce. We aimed to determine if paediatric patients with moderate/severe IEI got COVID-19 at the same level as the general population, and to describe COVID-19 expression. Material and methods We included patients with moderate/severe IEI aged 0–21 years old: cross-sectional study (June2020) to determine the prevalence of COVID-19; prospective study (January2020-January2021) including IEI patients with COVID-19. Assays used: nasopharyngeal swab SARS-CoV-2 PCR and SARS-CoV-2-specific immunoglobulins. Results Seven from sixty-five patients tested positive (prevalence: 10.7% (7%–13%)) after the first SARS-COV-2 wave and 13/15 patients diagnosed with COVID-19 had an asymptomatic/mild course. Conclusions In our area, prevalence of COVID-19 in moderate/severe IEI paediatric patients after the first wave was slightly higher than in the general population. The majority of patients presented a benign course, suggesting a possible protective factor related with age despite IEI.
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Affiliation(s)
- A Deyà-Martínez
- Study Group for Immune Dysfunction Diseases in Children (GEMDIP), Institut de Recerca Sant Joan de Déu, Barcelona, Spain; Clinical Immunology and Primary Immunodeficiencies Unit, Pediatric Allergy and Clinical Immunology Department, Hospital Sant Joan de Déu, Barcelona, Spain; Universitat de Barcelona, Spain; Clinical Immunology Program, Hospital Sant Joan de Déu-Hospital Clínic Barcelona, Barcelona, Spain.
| | - A García-García
- Study Group for Immune Dysfunction Diseases in Children (GEMDIP), Institut de Recerca Sant Joan de Déu, Barcelona, Spain; Clinical Immunology and Primary Immunodeficiencies Unit, Pediatric Allergy and Clinical Immunology Department, Hospital Sant Joan de Déu, Barcelona, Spain; Universitat de Barcelona, Spain; Clinical Immunology Program, Hospital Sant Joan de Déu-Hospital Clínic Barcelona, Barcelona, Spain
| | - E A Gonzalez-Navarro
- Clinical Immunology Program, Hospital Sant Joan de Déu-Hospital Clínic Barcelona, Barcelona, Spain; Department of Immunology-CDB, Hospital Clínic-IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - L Yiyi
- Clinical Immunology and Primary Immunodeficiencies Unit, Pediatric Allergy and Clinical Immunology Department, Hospital Sant Joan de Déu, Barcelona, Spain; Clinical Immunology Program, Hospital Sant Joan de Déu-Hospital Clínic Barcelona, Barcelona, Spain
| | - A Vlagea
- Clinical Immunology Program, Hospital Sant Joan de Déu-Hospital Clínic Barcelona, Barcelona, Spain; Department of Immunology-CDB, Hospital Clínic-IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - I Jordan
- Universitat de Barcelona, Spain; Paediatric Intensive Care Unit, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain; Institut de Recerca Sant Joan de Deu, Barcelona, Spain; CIBER of Epidemiology and Public Health, Madrid, Spain
| | - V Fumadó
- Universitat de Barcelona, Spain; Paediatric Infectious Diseases Unit, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain; Institut de Recerca Sant Joan de Deu, Barcelona, Spain
| | - C Fortuny
- Universitat de Barcelona, Spain; Paediatric Infectious Diseases Unit, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain; Institut de Recerca Sant Joan de Deu, Barcelona, Spain; CIBER of Epidemiology and Public Health, Madrid, Spain; Translational Research Network in Paediatric Infectious Diseases (RITIP), Madrid, Spain
| | - M Español
- Clinical Immunology Program, Hospital Sant Joan de Déu-Hospital Clínic Barcelona, Barcelona, Spain; Department of Immunology-CDB, Hospital Clínic-IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - C Launes
- Universitat de Barcelona, Spain; Institut de Recerca Sant Joan de Deu, Barcelona, Spain; Paediatrics Department, Hospital Sant Joan de Déu, Barcelona, Spain; CIBER of Epidemiology and Public Health, Madrid, Spain
| | - A Esteve-Solé
- Study Group for Immune Dysfunction Diseases in Children (GEMDIP), Institut de Recerca Sant Joan de Déu, Barcelona, Spain; Clinical Immunology and Primary Immunodeficiencies Unit, Pediatric Allergy and Clinical Immunology Department, Hospital Sant Joan de Déu, Barcelona, Spain; Clinical Immunology Program, Hospital Sant Joan de Déu-Hospital Clínic Barcelona, Barcelona, Spain
| | - M Juan
- Clinical Immunology Program, Hospital Sant Joan de Déu-Hospital Clínic Barcelona, Barcelona, Spain; Immunotherapy Platform, Hospital Sant Joan de Déu-Hospital Clínic, Universitat de Barcelona, Barcelona, Spain; Department of Immunology-CDB, Hospital Clínic-IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - M Pascal
- Clinical Immunology Program, Hospital Sant Joan de Déu-Hospital Clínic Barcelona, Barcelona, Spain; Department of Immunology-CDB, Hospital Clínic-IDIBAPS, Universitat de Barcelona, Barcelona, Spain; Spanish Network for Allergy - RETIC de Asma, Reacciones adversas y Alérgicas (ARADYAL), Madrid, Spain.
| | - L Alsina
- Study Group for Immune Dysfunction Diseases in Children (GEMDIP), Institut de Recerca Sant Joan de Déu, Barcelona, Spain; Clinical Immunology and Primary Immunodeficiencies Unit, Pediatric Allergy and Clinical Immunology Department, Hospital Sant Joan de Déu, Barcelona, Spain; Universitat de Barcelona, Spain; Clinical Immunology Program, Hospital Sant Joan de Déu-Hospital Clínic Barcelona, Barcelona, Spain; Immunotherapy Platform, Hospital Sant Joan de Déu-Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.
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Chowdhoury SR, Biswas HS, Raut S, Bhakta S, Roy A, Banerjee S, Nandi M. Pediatric Oncology Patients and COVID-19: An Experience from the Tertiary COVID Care Facility in Eastern India: A Prospective Observational Study. Indian J Med Paediatr Oncol 2021. [DOI: 10.1055/s-0041-1732814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Abstract
Introduction Pediatric oncology patients presumably are one of the most vulnerable groups during this ongoing coronavirus disease 2019 (COVID-19) pandemic. Not only they are immunocompromised thanks to their inherent disease and treatment regimens, but delay in initiation and maintenance of their treatment in this pandemic era also poses great concern. But the magnitude of this effect on pediatric oncology patients has not been well established due to paucity of data.
Objective This study was proposed to assess clinicoepidemiological profile and outcome of the pediatric oncology patients who were infected with severe acute respiratory syndrome coronavirus 2 virus attending a COVID-19 care facility.
Materials and Methods This was a prospective observational study conducted in a tertiary care hospital. All confirmed oncology patients up to age 12 years who either attended the oncology outpatient department or referred to COVID-19 care center from other cancer treatment facility were included in the study from May 2020 to September 2020. Data on demography, clinical features, investigations, treatment, complications, and outcome were collected. Descriptive statistical analysis was performed and common relevant investigations were compared between non-intensive care unit (ICU) and ICU group.
Results The rate of COVID-19 positivity among the pediatric oncology patient attending oncology clinic of the hospital is 8.21%. Total 28 patients (12 from oncology clinic of our hospital and 16 from other hospitals referred to our COVID-19 unit) were included in our study. The most common malignancy was acute lymphoblastic leukemia (64.28%). The most common symptom was fever (64.28%). Oxygen therapy was needed for 42.85% patients. Eight patients required ICU admission (two required invasive ventilation and one required noninvasive ventilation). Positive C-reactive protein value was associated with severe disease requiring ICU admission. Mean delay in starting chemotherapy in newly diagnosed cases was 28.77 days (standard deviation = 9.67). One newly diagnosed patient expired due to preexisting disease.
Conclusion Though vulnerable, most of the pediatric oncology patients suffered a mild COVID-19 infection without any significant COVID-19-related morbidity and mortality. There is a significant delay in starting specific oncology therapy, that is, chemotherapy as a result of the ongoing COVID-19 pandemic in newly diagnosed pediatric oncology patients, which can increase morbidities and mortality related to malignancy.
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Affiliation(s)
| | - Himanshu Sekhar Biswas
- Department of Pediatric Medicine, Medical College and Hospital, Kolkata, West Bengal, India
| | - Sumantra Raut
- Department of Pediatric Medicine, Medical College and Hospital, Kolkata, West Bengal, India
| | - Subhajit Bhakta
- Department of Pediatric Medicine, Medical College and Hospital, Kolkata, West Bengal, India
| | - Atanu Roy
- Department of Pediatric Medicine, Medical College and Hospital, Kolkata, West Bengal, India
| | - Swarnabindu Banerjee
- Department of Medical Oncology, Medical College and Hospital, Kolkata, West Bengal, India
| | - Mousumi Nandi
- Department of Pediatric Medicine, Medical College and Hospital, Kolkata, West Bengal, India
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Corvol H, Alimi A, Prevost B, Schnuriger A, Le Pointe HD, Rambaud J, Tabone MD. Atypical severe organizing pneumonia following COVID-19 in an immunocompromised teenager. Clin Infect Dis 2021; 74:938-939. [PMID: 34309637 DOI: 10.1093/cid/ciab657] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
- Harriet Corvol
- Pediatric Pulmonology Department, Trousseau Hospital, AP-HP, Sorbonne Université, Paris, France
| | - Aurelia Alimi
- Pediatric Hematology Department, Trousseau Hospital, AP-HP, Sorbonne Université, Paris, France
| | - Blandine Prevost
- Pediatric Pulmonology Department, Trousseau Hospital, AP-HP, Sorbonne Université, Paris, France
| | - Aurélie Schnuriger
- Virology Department, Trousseau Hospital, AP-HP, Sorbonne Université, Paris, France
| | | | - Jérome Rambaud
- Pediatric Intensive care Unit, Trousseau Hospital, AP-HP, Sorbonne Université, Paris, France
| | - Marie-Dominique Tabone
- Pediatric Hematology Department, Trousseau Hospital, AP-HP, Sorbonne Université, Paris, France
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Shahid S, Raza M, Junejo S, Maqsood S. Clinical features and outcome of COVID-19 positive children from a tertiary healthcare hospital in Karachi. J Med Virol 2021; 93:5988-5997. [PMID: 34228363 PMCID: PMC8427002 DOI: 10.1002/jmv.27178] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 06/22/2021] [Accepted: 07/01/2021] [Indexed: 12/28/2022]
Abstract
As the coronavirus disease 2019 (COVID‐19) pandemic continues to evolve, differences in epidemiological and clinical features among pediatrics have been noticed across different countries. We describe the spectrum of COVID‐19 in pediatric patients treated in tertiary health care. We conducted a retrospective chart review of pediatric patients admitted to Indus Hospital & Health care network, Korangi campus, Karachi; from April 1st, 2020 to July 31st, 2020. A total of 141 COVID‐19 cases were reported, males were 81 (57%) and the median age was 8 (0.3–17) years. Moderate and severe infections were noted in 36(26%), and 17(12%) children respectively. Fever (50%) was the most common clinical feature. The SF ratio less than 264 was significantly associated with severe disease (p < .05). Lab investigations that differed significantly across disease severity groups included IL‐6 levels (p < .01) and Prothrombin time (p < .05). Majority of children were advised home isolation 89 (63%), 29 (20.5%) were admitted while mortality was observed in 10 (7%) children. No significant difference was observed between children with and without malignancy. Pre‐existing comorbidities are significantly associated with COVID‐19 infections among children. Reduced SF ratio, elevated Prothrombin time, and interleukin‐6 levels are associated with greater disease severity.
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Affiliation(s)
- Saba Shahid
- Department of Pediatrics, The Indus Hospital & Health network, Karachi, Pakistan
| | - Mohammad Raza
- Department of Pediatrics, The Indus Hospital & Health network, Karachi, Pakistan
| | - Samina Junejo
- Department of Pediatrics, The Indus Hospital & Health network, Karachi, Pakistan
| | - Sidra Maqsood
- Indus hospital Research Centre, Indus Hospital and Health network, Karachi, Pakistan
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Reche A, Nandanwar A, Hedaoo A, Chhbra KG, Fulzele P, Nimbulkar G. The Novel Coronavirus in Pediatric and Geriatric Population- What We Know. Open Dent J 2021. [DOI: 10.2174/1874210602115010300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)is a virus responsible for the coronavirus infection that is currently causing a severe outbreak of the disease in the world, infecting and killing thousands to lacs of people. The pediatric and geriatric population is no exception to this. Children and older adults have less immunity, which makes them more susceptible to infection than other populations. But still the number of cases of Children where less as compared to adults and those having underlying pulmonary pathology or immunocompromising conditions are more vulnerable to infection. Some studies have shown that this virus causes more death in the older age population as compared to adults or children. Patients having any systemic conditions like diabetes, raised blood pressure, heart diseases, lung diseases and chronic renal diseases were more vulnerable to this infection. In this article, we will outline the epidemiology, symptoms, diagnosis, and treatment modalities of the novel coronavirus-2019(COVID 19) infection in humans, with more focusing on infection in children as well as in older adults.
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Navaeian A, Mahmoudi S, Pourakbari B, Bakhtiari M, Khodabandeh M, Abdolsalehi MR, Sharari AS, Mamishi S. COVID-19 infection in children with underlying malignancies in Iran. J Basic Clin Physiol Pharmacol 2021; 33:79-84. [PMID: 34192829 DOI: 10.1515/jbcpp-2021-0057] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 05/04/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Although coronavirus disease 2019 (COVID-19) prognosis is mostly good in pediatric patients with no underlying diseases, there are a few reports on children with oncological underlying malignancies. This study aimed to describe the clinical and laboratory features of 20 children with COVID-19 who had underlying malignancies in an Iranian referral pediatrics hospital. METHODS All children under 15-year-old of age with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive real-time polymerase chain reaction (PCR) and presence of an underlying malignancy were included in the study. RESULTS In this study, among 20 patients, 11 were male (55%). The mean age of the patients was 6.0 ± 4.1 years. Twelve patients (60%) had acute lymphocytic leukemia, two had acute myeloid leukemia (10%), and six had solid organ tumors (30%). The most common symptoms were fever (65%) and cough (65%). We reported severe pneumonia in seven hospitalized patients (35%) and three patients (20%) required intensive care unit admission and mechanical ventilation. Procalcitonin was normal in 73% of the cases (11 out of 15), but it was highly elevated in four cases (27%). Five patients (25%) had positive blood cultures and a mortality of 20% was reported. CONCLUSIONS This is the largest study on SARS-CoV-2 infected pediatric patients with underlying malignancies in Iran. Since the risk of exposure to SARS-CoV-2 and even death in children with malignancy, either in the hospital or community setting during the pandemic is high, special precautions to reduce the risk of transmission are highly suggested.
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Affiliation(s)
- Amene Navaeian
- Department of Infectious Diseases, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Shima Mahmoudi
- Pediatric Infectious Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Babak Pourakbari
- Pediatric Infectious Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Bakhtiari
- Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahmoud Khodabandeh
- Department of Infectious Diseases, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Abdolsalehi
- Department of Infectious Diseases, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Alieh Safari Sharari
- Department of Pediatrics, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Setareh Mamishi
- Department of Infectious Diseases, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.,Department of Pediatrics, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
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Singh A, Gera A, Misra A, Mehndiratta S. SARS-CoV-2 infection in a pediatric acute leukemia patient on chemotherapy and concurrent sofosbuvir/velpatasvir for HCV. AMERICAN JOURNAL OF BLOOD RESEARCH 2021; 11:286-289. [PMID: 34322293 PMCID: PMC8303012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 05/05/2021] [Indexed: 06/13/2023]
Abstract
There are new targets identified by experimental and animal research for treatment of SARS-COV-2 (Severe acute respiratory syndrome-Corona Virus-2) infection. Out of many clinical trials registered, there are ongoing human studies highlighting Sofosbuvir's possible role in the treatment of Covid-19 (Coronavirus Disease 2019). Here we present a case of acute leukemia on directly acting antiviral therapy (DAAs) for HCV infection mitigating SARS-COV-2 infection in a patient undergoing chemotherapy. The child was undergoing chemotherapy, along with directly acting antiviral for acute hepatitis C infection. He initially had features of hypoxia and radiological evidence of covid-19. He had an uneventful course and tested negative ten days after onset of illness. With ongoing trials on Sofosbuvir in covid 19 treatment, our finding, albeit coincidental, points to the possible role even in immune-compromised children.
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Affiliation(s)
- Amitabh Singh
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, VMMC and Safdarjung HospitalNew Delhi 110029, India
| | - Akriti Gera
- Department of Pediatrics, VMMC and Safdarjung HospitalNew Delhi 110029, India
| | - Aroonima Misra
- Department of Health Research, National Institute of PathologyNew Delhi 110029, India
| | - Sumit Mehndiratta
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, VMMC and Safdarjung HospitalNew Delhi 110029, India
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Liu S, Li Q, Chu X, Zeng M, Liu M, He X, Zou H, Zheng J, Corpe C, Zhang X, Xu J, Wang J. Monitoring Coronavirus Disease 2019: A Review of Available Diagnostic Tools. Front Public Health 2021; 9:672215. [PMID: 34164371 PMCID: PMC8215441 DOI: 10.3389/fpubh.2021.672215] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 04/23/2021] [Indexed: 01/08/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) pneumonia is caused by the virus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and has rapidly become a global public health concern. As the new type of betacoronavirus, SARS-CoV-2 can spread across species and between populations and has a greater risk of transmission than other coronaviruses. To control the spread of SARS-CoV-2, it is vital to have a rapid and effective means of diagnosing asymptomatic SARS-CoV-2-positive individuals and patients with COVID-19, an early isolation protocol for infected individuals, and effective treatments for patients with COVID-19 pneumonia. In this review, we will summarize the novel diagnostic tools that are currently available for coronavirus, including imaging examinations and laboratory medicine by next-generation sequencing (NGS), real-time reverse transcriptase-polymerase chain reaction (rRT-PCR) analysis, immunoassay for COVID-19, cytokine and T cell immunoassays, biochemistry and microbiology laboratory parameters in the blood of the patients with COVID-19, and a field-effect transistor-based biosensor of COVID-19. Specifically, we will discuss the effective detection rate and assay time for the rRT-PCR analysis of SARS-CoV-2 and the sensitivity and specificity of different antibody detection methods, such as colloidal gold and ELISA using specimen sources obtained from the respiratory tract, peripheral serum or plasma, and other bodily fluids. Such diagnostics will help scientists and clinicians develop appropriate strategies to combat COVID-19.
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Affiliation(s)
- Shanshan Liu
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Qiuyue Li
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Xuntao Chu
- Zhuhai Livzon Diagnostics Inc., Guangdong, China
| | - Minxia Zeng
- Zhuhai Livzon Diagnostics Inc., Guangdong, China
| | - Mingbin Liu
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
- School of Pharmacy, Gannan Medical University, Jiangxi, China
| | - Xiaomeng He
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Heng Zou
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Jianghua Zheng
- Department of Laboratory Medicine, Zhoupu Hospital Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Christopher Corpe
- Nutritional Science Department, King's College London, London, United Kingdom
| | - Xiaoyan Zhang
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Jianqing Xu
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Jin Wang
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
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Paediatric Contacts of Adult COVID-19 Patients: Clinical Parameters, Risk Factors, and Outcome. Int J Pediatr 2021; 2021:2141128. [PMID: 34188687 PMCID: PMC8192208 DOI: 10.1155/2021/2141128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 05/18/2021] [Indexed: 01/19/2023] Open
Abstract
Background There is insufficient data in Pakistan and in South Asia regarding paediatric COVID-19 demographics and related parameters. The main aim of this study was to assess the paediatric population exposed to SARS-CoV-2 infection, their clinical parameters, risk factors, and outcome. Methods This was a descriptive retrospective study conducted at the Pakistan Institute of Medical Sciences and Federal General Hospital Islamabad from 23rd July 2020 to 22nd August 2020. All paediatric contacts (≤13 years) of one hundred adult COVID-19 patients were included. Data of the index cases was taken from the medical records. Paediatric data was collected on the phone using a predesigned proforma. Results There were 137 paediatric contacts of 100 adult COVID-19 index cases. The index cases were predominantly males (67%) and belonged to the middle socioeconomic class (89%), and 14% succumbed to the disease. Females had more paediatric contacts. The mean age of contacts was 6.6 years, and the majority (80%) developed no symptoms. Among the symptomatic contacts, fever and cough were the most common symptoms. None of the contacts developed dyspnoea or required hospitalization. Majority of the contacts had been vaccinated with the BCG vaccine. Testing for COVID-19 was done in only 77 (56%) contacts, 25 (32%) by the government team, and 52 (67%) privately. A higher number of symptomatic contacts were positive (15/17 (88%)) as compared to that of the asymptomatic contacts (6/60 (10%)) (p = 0.002). Development of symptoms in the contacts was associated with the history of respiratory illnesses, recurrent infections, use of hematinics, a positive COVID-test result, and health professionals being index cases (p ≤ 0.01). Parents with higher education and in the health profession and the families of symptomatic contacts reported better compliance with quarantine regulations. Conclusion A significant number of children were exposed to adult COVID-19 patients. Most paediatric contacts remained asymptomatic. Children with preexisting medical conditions and with parents in health profession were susceptible to infection.
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Toptan T, Ciesek S, Hoehl S. Pediatrics and COVID-19. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1318:197-208. [PMID: 33973180 DOI: 10.1007/978-3-030-63761-3_12] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Viral respiratory tract infections are prevalent in children. They have substantial effects on childhood morbidity throughout the world, especially in developing countries. In this chapter, we describe the preliminary characteristics of pediatric COVID-19 and discover that severe and critical disease in children is rare. Many children remain asymptomatic. The reason why severity increases with progressing age and largely spares children is not yet known. In the search for possible explanations, we explore key differences between the pediatric and adult immune responses to new pathogens, and in host factors, such as ACE2 abundance.
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Affiliation(s)
- Tuna Toptan
- Institute of Medical Virology, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Sandra Ciesek
- Institute of Medical Virology, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Sebastian Hoehl
- Institute of Medical Virology, University Hospital Frankfurt, Goethe University, Frankfurt, Germany.
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Risk factors for seasonal human coronavirus lower respiratory tract infection after hematopoietic cell transplantation. Blood Adv 2021; 5:1903-1914. [PMID: 33792629 PMCID: PMC8015796 DOI: 10.1182/bloodadvances.2020003865] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 03/08/2021] [Indexed: 12/25/2022] Open
Abstract
We demonstrate risk factors for HCoV LRTI in allogeneic HCT recipients and significance of virologic documentation by BAL on mortality. Hyperglycemia associated with steroid use appears to be a strong predictor of HCoV disease progression.
Data are limited regarding risk factors for lower respiratory tract infection (LRTI) caused by seasonal human coronaviruses (HCoVs) and the significance of virologic documentation by bronchoalveolar lavage (BAL) on outcomes in hematopoietic cell transplant (HCT) recipients. We retrospectively analyzed patients undergoing allogeneic HCT (4/2008-9/2018) with HCoV (OC43/NL63/HKU1/229E) detected by polymerase chain reaction during conditioning or post-HCT. Risk factors for all manifestations of LRTI and progression to LRTI among those presenting with HCoV upper respiratory tract infection (URTI) were analyzed by logistic regression and Cox proportional hazard models, respectively. Mortality rates following HCoV LRTI were compared according to virologic documentation by BAL. A total of 297 patients (61 children and 236 adults) developed HCoV infection as follows: 254 had URTI alone, 18 presented with LRTI, and 25 progressed from URTI to LRTI (median, 16 days; range, 2-62 days). Multivariable logistic regression analyses showed that male sex, higher immunodeficiency scoring index, albumin <3 g/dL, glucose >150 mg/dL, and presence of respiratory copathogens were associated with occurrence of LRTI. Hyperglycemia with steroid use was associated with progression to LRTI (P < .01) in Cox models. LRTI with HCoV detected in BAL was associated with higher mortality than LRTI without documented detection in BAL (P < .01). In conclusion, we identified factors associated with HCoV LRTI, some of which are less commonly appreciated to be risk factors for LRTI with other respiratory viruses in HCT recipients. The association of hyperglycemia with LRTI might provide an intervention opportunity to reduce the risk of LRTI.
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Guo Q, Xu W, Wang PF, Ji HY, Zhang XL, Wang K, Li J. Facing coronavirus disease 2019: What do we know so far? (Review). Exp Ther Med 2021; 21:658. [PMID: 33968188 PMCID: PMC8097225 DOI: 10.3892/etm.2021.10090] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 03/22/2021] [Indexed: 01/08/2023] Open
Abstract
Although the World Health Organization declared the outbreak of coronavirus disease 2019 (COVID-19), which originated in China, as a public health emergency of international concern as early as January 30, 2020, the current COVID-19 epidemic is spreading rapidly. As of April 19, 2020, total of 2,392,165 confirmed cases had been reported in 211 countries and regions, with 614,421 (25.68%) cured cases and 164,391 (6.87%) deaths. Scientists and clinicians have made great efforts to learn much about COVID-19 so that it can be controlled as soon as possible. Herein, this review will discuss the epidemiology, pathology, clinical features, diagnosis and treatment of COVID-19 based on the current evidence.
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Affiliation(s)
- Qie Guo
- Department of Pharmacy, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Wen Xu
- Department of Pharmacy, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Pan-Feng Wang
- Department of Pharmacy, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Hong-Yan Ji
- Department of Pharmacy, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Xiao-Lei Zhang
- Department of Pharmacy, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Kai Wang
- Department of Pharmacy, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Jing Li
- Department of Pharmacy, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
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Raza MR, Maqsood S, Rana ZA, Hamid H, Yasmeen N, Rehman MFU, Iqbal R, Ashraf MS. Impact of COVID-19 on the Children with Cancer in 6 Pediatric Oncology Units (POU's) of Pakistan-a Multi-Center Study. Cancer Invest 2021; 40:401-405. [PMID: 33866889 DOI: 10.1080/07357907.2021.1916027] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
The study is to evaluate the impact of COVID-19 in Pediatric Oncology Units of Pakistan. Data from (1 April-30 June) 2019 and (1April-30 June) 2020 for 1st and 2nd cohort respectively in order to compare the registration, abandonment rate and delay in treatment. 634 were registered cases, 379 and 255 in 1st and 2nd cohort respectively which was significant different <0.005. 77 were abandoned, 45 and 32 in 1st and 2nd cohort respectively. 59 COVID-19 positive cases, 24, 4, 27 and 4 were admitted, referred, home isolated and LAMA respectively. Delayed in treatment and reduction in new cases were observed.
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Affiliation(s)
| | - Sidra Maqsood
- Pediatric Hematology-Oncology Department, The Indus Hospital, Karachi, Pakistan
| | - Zulfiqar Ali Rana
- Pediatric Hematology-Oncology, Children hospital and institute of child health, Multan, Pakistan
| | - Haroon Hamid
- Pediatric Oncology Department, Mayo Hospital, Lahore, Pakistan
| | - Nuzhat Yasmeen
- Pediatric Hematology-Oncology Department, Pakistan Institute of Medical Sciences, Islamabad, Pakistan
| | - Mohammad Fahim Ur Rehman
- Pediatric Hematology-Oncology Department, Children Hospital and Institute of Child Health, Faisalabad, Pakistan
| | - Rabia Iqbal
- Pediatric Hematology-Oncology, Lahore General Hospital, Lahore, Pakistan
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Sarman A, Tuncay S. Principles of approach to suspected or infected patients related Covid-19 in newborn intensive care unit and pediatric intensive care unit. Perspect Psychiatr Care 2021; 57:957-964. [PMID: 33184910 DOI: 10.1111/ppc.12643] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 09/08/2020] [Accepted: 09/30/2020] [Indexed: 12/17/2022] Open
Abstract
PURPOSE In this study, it was aimed to evaluate physical and mental health (MH) effects of children and their parents in newborn intensive care unit and pediatric intensive care unit due to Covid-19. CONCLUSIONS Children are less likely to develop severe illness than adults. It may benefit from medical and psychological/behavioral interventions. Prevent negative MH outcomes for babies/children/caregivers affected by Covid-19. PRACTICE IMPLICATIONS It is useful to clarify the clinical course of children (treatment, care procedures, psychosocial effects, etc.). The establishment of mental health expert nursing teams, psychological counseling (synchronous telemedicine services for support purposes, telepsychiatry for parents, etc.) may have helped prevent negative mental health of Covid-19 outcomes. Continuous updating of medical staff's knowledge and skills for the prevention of Covid-19 is expected to slow the spread of the disease.
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Affiliation(s)
- Abdullah Sarman
- Department of Medical Services and Techniques, Vocational School of Health Services, Bingol University, Bingol, Turkey
| | - Suat Tuncay
- Department of Pediatric Nursing, Bingol University, Bingol, Turkey
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