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Al-Momani H, Aolaymat I. Proton pump inhibitors and gastrointestinal symptoms among patients with COVID-19 infection. Ann Med 2024; 56:2355581. [PMID: 38823421 PMCID: PMC11146260 DOI: 10.1080/07853890.2024.2355581] [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: 01/10/2024] [Accepted: 03/25/2024] [Indexed: 06/03/2024] Open
Abstract
INTRODUCTION The administration of proton pump inhibitors (PPIs) is anticipated to elevate an individual's susceptibility to enteric infections as a result of altering the gut flora. The influence of PPIs on the clinical manifestation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is still uncertain. This study aims to investigate the impact of PPI usage on the clinical manifestation of COVID-19, namely its gastrointestinal symptoms. METHODS This is a cross-sectional cohort study involving COVID-19 patients. Patients were interviewed using a predesigned questionnaire that asked about their demographics, clinical manifestations of COVID-19 infection, and the extent and type of PPIs in use. PPI usage was confirmed by reviewing patients' electronic medical records. The primary outcome was to establish any association between the use of PPI and the symptoms and clinical presentation of COVID-19. RESULTS Out of a total of 254 participants, 69 (27.2%) were considered PPI users. Patients who were on PPI medications reported a significantly lower rate of myalgia (27.5% vs 51.9%; p = 0.0006) and heartburn (5.7% vs 15.6%; p = 0.03) but had a significantly higher rate of abdominal pain (27.5% vs 13.5%; p = 0.001) and diarrhoea (28.9% vs 14.5%, p = 0.02) when compared to those who were not using PPIs. Patients on PPIs were also shown to have significantly higher odds of developing diarrhoea (OR 2.0, 95% CI: 1.08 to 3.93, p = 0.02) and abdominal pain (OR 2.0, 95% CI: 1.22 to 3.93, p = 0.03), but a lower risk of developing myalgia (OR 0.5, 95% CI: 0.3 to 0.9, p = 0.02) when compared to non-PPI users. CONCLUSION This study shows that the use of PPIs could impact COVID-19 clinical presentation toward more gastrointestinal manifestations. Further studies investigating the link between other acid suppression medications and COVID-19 manifestations and severity should be carried out.
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Affiliation(s)
- Hafez Al-Momani
- Department of Microbiology, Pathology and Forensic Medicine, Medical School, The Hashemite University, Zarqa, Jordan
| | - Iman Aolaymat
- Department of Anatomy, Physiology and Biochemistry, Medical School, The Hashemite University, Zarqa, Jordan
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Tang C, Wang S, Fan J. A follow-up study of post-COVID-19 syndrome in hospitalized children with Omicron variant infection in Wuhan. Front Pediatr 2024; 12:1359057. [PMID: 39149538 PMCID: PMC11324477 DOI: 10.3389/fped.2024.1359057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 07/23/2024] [Indexed: 08/17/2024] Open
Abstract
Background Since the Chinese government changed its COVID-19 prevention and control policies, the rapid spread of the omicron variant resulted in a pervasive surge of infections throughout the nation, particularly affecting children. Although the acute symptoms of children infected with COVID-19 are milder compared to adults, the impact of post-COVID-19 syndromes (PCS) on the growth and development of children should not be ignored. The clinical manifestations, treatment methods, and long-term effects of children are significantly different from those of adults, making it necessary to understand the phenotype of children with PCS in order to effectively manage their health. Methods The study focuses on hospitalized children infected with omicron variant in Zhongnan Hospital of Wuhan University from December 7, 2022, to January 5, 2023. Three telephone follow-ups with the guardians was conducted at 4-5 weeks, 12-13 weeks, and 24-25 weeks after the patients' discharge to understand their prevalence, clinical characteristics, and risk factors of PCS. Results The age range of the 112 hospitalized pediatric patients was 0-13 years, with a median age of 19 months. After three follow-ups, 49.1% patients had PCS, while the incidence of PCS persisting 3 month was 21.4%, with a prevalence of PCS persisting 6 month of 10.7%. From the first follow-up phase to the third phase, there was a significant decrease in the incidence of PCS. In infants, the most common persistent symptom was sleep disorder (19.2%), followed by respiratory symptoms, diarrhea (8.2%), and decreased appetite (6.8%). In children and adolescents, decreased appetite was the most common persistent symptom (30.8%), followed by respiratory symptoms, fatigue (15.4%), and mood changes (15.4%). Decreased appetite was more common in the children and adolescents, while diarrhea and sleep disorders were more common in the infants. Binary logistic regression analysis and ordered logistic regression analysis showed that times of illness (OR = 1.671, 95% CI: 1.339-2.086) were positively correlated with the duration of symptoms. Times of illness was positively correlated with cough/expectoration (OR = 1.491, 95% CI: 1.039-2.138). Age (OR = 0.844, 95% CI: 0.755-0.944) and re-hospitalization (OR = 0.146, 95% CI: 0.022-0.969) were positively correlated with sleep disorders. Conclusions Children with Omicron variant may still experience PCS, but the incidence is lower compared to adults and compared to other variants and the incidence of PCS will gradually decrease over time. The symptoms of PCS differ between older children and infants and it is necessary to prevent recurrent illness for at least half a year after COVID-19 recovery. In order to further understand and ameliorate the impact of PCS on the health of children infected with COVID-19, subsequent follow-up studies will expand the scope, combine with objective follow-up contents, and establish an assessment and management system especially for children of different ages.
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Affiliation(s)
- Chunjiao Tang
- Department of Pediatrics, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Shouyi Wang
- Department of Pediatrics, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Jingyi Fan
- Department of Pediatrics, Zhongnan Hospital of Wuhan University, Wuhan, China
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Al-Momani H, Aolymat I, Al Haj Mahmoud S. Critical appraisal of how COVID-19 infection and imposed lockdowns have impacted gastroesophageal reflux: A review. Medicine (Baltimore) 2024; 103:e38074. [PMID: 38728518 PMCID: PMC11081575 DOI: 10.1097/md.0000000000038074] [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: 12/14/2023] [Accepted: 04/10/2024] [Indexed: 05/12/2024] Open
Abstract
Previous literature has demonstrated that COronaVIrus Disease of 2019 (COVID-19) impacts an individual gastrointestinal tract (GIT), causing symptoms like nausea, diarrhea, and loss of appetite. Severe acute respiratory syndrome coronavirus RNA has been discovered in the stool of infected individuals in earlier research. It was discovered that severe acute respiratory syndrome coronavirus was significantly expressed in the GIT, indicating that the virus can also infect the digestive system. Angiotensin-converting enzyme 2 functions as the viral receptor. The chronic illness known as gastroesophageal reflux disease (GERD) is typified by frequent reflux of stomach acid into the esophagus. By triggering the sensitized esophageal-bronchial neuronal circuit or aspirating into the airways (microaspiration), GER exacerbates respiratory diseases. Aspiration is a well-known risk to be considered when treating patients in intensive care units. Strong genetic correlations have been identified between COVID-19 infection and GERD susceptibility, suggesting a shared genetic basis for both conditions. Nonetheless, even though GERD, extraesophageal reflex, and COVID-19 have a number of significant risk factors and exhibit similar symptoms, the relationship between these illnesses has not yet been examined in depth. This review is the first of its kind to critically examine the association between the COVID-19 epidemic and GER and its associated diseases. The key objective of this work is to promote the creation of prevention plans, treatment plans, and guidelines while also enhancing and optimizing our understanding of the relationship between COVID-19 and GERs.
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Affiliation(s)
- Hafez Al-Momani
- Department of Microbiology, Pathology and Forensic Medicine, Faculty of Medicine, The Hashemite University, Zarqa, Jordan
| | - Iman Aolymat
- Department of Anatomy, Physiology & Biochemistry, Faculty of Medicine, The Hashemite University, Zarqa, Jordan
| | - Sameer Al Haj Mahmoud
- Department of Basic Medical Science, Faculty of Medicine, Al-Balqa’ Applied University, Al-Salt, Jordan
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Nasyrov RA, Ivanov DO, Krasnogorskaya OL, Timchenko VN, Fedotova EP, Chepelev AS, Galichina VA, Sidorova NA, Anichkov NM. COVID-19 in Children: Molecular Profile and Pathological Features. Int J Mol Sci 2023; 24:16750. [PMID: 38069078 PMCID: PMC10706827 DOI: 10.3390/ijms242316750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 11/15/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023] Open
Abstract
Although the World Health Organization has declared the end of the COVID-19 pandemic, doctors continue to register new cases of the disease among both adults and children. Unfortunately, the course of COVID-19 in children can have a severe form, with death being a potential outcome. The absence of published works discussing the pathological morphology of COVID-19 in children prevents the objective analysis of the disease's pathogenesis, including among the adult population. In this vein, the objective of our study is to identify the morphological features of the lungs' involvement and evaluate virus-host interactions in the case of COVID-19 in patients at a pediatric medical practice. We present the results of the study of the lungs of three children who died due to COVID-19, highlighting the predominant involvement of their respiratory organs at different stages of the disease (5, 21, and 50 days). This article presents data obtained from histopathological and immunohistochemical investigations, taking into account the results of clinical and laboratory indicators and intravital and postmortem SARS-CoV-2 PCR investigations. The common finding of all of the examined COVID-19 cases is the involvement of the endothelium in microcirculation vessels, which are considered to be a primary target of various pathogenic influencing factors. We also discuss both the significance of apoptosis as a result of virus-host interactions and the most likely cause of endothelium cell destruction. The results of this study could be useful for the development of endothelium-protective therapy to prevent the progression of disseminated intravascular coagulation syndrome.
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Affiliation(s)
- Ruslan A. Nasyrov
- The Prof. D.D. Lohov Department of Pathological Anatomy with Course of Forensic Medicine, Saint Petersburg State Pediatric Medical University Ministry of Public Health Care of the Russian Federation, St. Litovskaya, 2, 194100 St. Petersburg, Russia; (D.O.I.); (O.L.K.); (V.N.T.); (E.P.F.); (A.S.C.); (V.A.G.); (N.A.S.); (N.M.A.)
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Mancino E, Nenna R, Matera L, La Regina DP, Petrarca L, Iovine E, Di Mattia G, Frassanito A, Conti MG, Bonci E, Spatuzzo M, Ialongo S, Zicari AM, Spalice A, Midulla F. A Single Center Observational Study on Clinical Manifestations and Associated Factors of Pediatric Long COVID. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6799. [PMID: 37754658 PMCID: PMC10531477 DOI: 10.3390/ijerph20186799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 09/10/2023] [Accepted: 09/15/2023] [Indexed: 09/28/2023]
Abstract
Children with SARS-CoV-2 are mostly mild symptomatic, but they may develop conditions, such as persisting symptoms, that may put them at greater risk of complications. Our aim was to evaluate the frequency and the presence of risk factors for persisting COVID-19 symptoms in children. We carried out a prospective observational study of the clinical manifestation of Long COVID at the Department of Maternal Infantile Science of a tertiary University hospital in Rome. We included 697 children (0-18 years), with previous SARS-CoV-2 infection. Children and parents were asked questions regarding persistent symptoms of COVID-19. Children with symptoms 30 days after initial diagnosis were 185/697 (26.4%). Moreover, 81/697 (11.6%) patients presented symptoms 90 days after the diagnosis. Thirty-day-persisting symptoms were mostly present in children with anosmia, atopy, asthenia, and cough in the acute phase compared with the asymptomatic children 30 days after infection. After 90 days, symptoms described were mainly neurological (47/697 children, 6.7%), and headache (19/697; 2.7%) was the most frequent manifestation. In conclusion, a relatively large proportion of the patients reported persisting symptoms that seem to be related to the symptom burden and to the atopy. Ninety days after the infection, most of the children had recovered, showing that long-term effects are not frequent. Limitations of the study include the single-center design and the lack of a control group.
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Affiliation(s)
- Enrica Mancino
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00161 Rome, Italy
- Department of Maternal, Infantile and Urological Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Raffaella Nenna
- Department of Maternal, Infantile and Urological Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Luigi Matera
- Department of Maternal, Infantile and Urological Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Domenico Paolo La Regina
- Department of Maternal, Infantile and Urological Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Laura Petrarca
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00161 Rome, Italy
- Department of Maternal, Infantile and Urological Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Elio Iovine
- Department of Maternal, Infantile and Urological Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Greta Di Mattia
- Department of Maternal, Infantile and Urological Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Antonella Frassanito
- Department of Maternal, Infantile and Urological Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Maria Giulia Conti
- Department of Maternal, Infantile and Urological Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Enea Bonci
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Mattia Spatuzzo
- Department of Maternal, Infantile and Urological Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Sara Ialongo
- Department of Maternal, Infantile and Urological Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Anna Maria Zicari
- Department of Maternal, Infantile and Urological Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Alberto Spalice
- Department of Maternal, Infantile and Urological Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Fabio Midulla
- Department of Maternal, Infantile and Urological Sciences, Sapienza University of Rome, 00161 Rome, Italy
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Iovine E, Di Mattia G, Nenna R, La Regina DP, Mancino E, Petrarca L, Conti MG, Matera L, Virgili F, Midulla F. Lung function after SARS-CoV-2 infection: A prospective cohort study in children. Pediatr Pulmonol 2023. [PMID: 37083203 DOI: 10.1002/ppul.26425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 03/29/2023] [Accepted: 04/03/2023] [Indexed: 04/22/2023]
Abstract
INTRODUCTION Although impaired lung function after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been described in adults, it is unclear whether lung function might be altered in children, especially among asymptomatic or mildly symptomatic patients. In this study, we report the results of lung function testing performed after SARS-CoV-2 infection in a large pediatric population. METHODS The study included 589 patients with previous confirmed SARS-CoV-2 infection aged 0-18 years. Both symptomatic and asymptomatic patients during acute infection were enrolled in the study. A spirometry was performed in all cooperating patients. RESULTS The mean age of enrolled patients was 9.6 years and the mean time from infection to enrollment was 171 days. Spirometry was performed and deemed evaluable in 433 patients. No patient had reduced forced vital capacity (FVC) and only 14 patients (3.2%) had a forced expiratory volume in the First second (FEV1) < 80%. The mean spirometry values recorded were in the normal range. There were no statistically significant differences in spirometry values between patients with respiratory symptoms during infection and those without. Similarly, there were no differences in spirometry parameters according to the time elapsed between infection and enrollment. CONCLUSION Lung function, according to spirometry values, does not appear to be impaired long after infection in the pediatric population. The presence of respiratory symptoms during SARS-CoV-2 infection would not represent a risk factor for impaired lung function in this cohort of patients.
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Affiliation(s)
- Elio Iovine
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Greta Di Mattia
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Raffaella Nenna
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Domenico Paolo La Regina
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Enrica Mancino
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Laura Petrarca
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Maria Giulia Conti
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Luigi Matera
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Fabrizio Virgili
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Fabio Midulla
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
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Beyranvand S, Davoodian P, Alizade H, Gouklani H, Nejatizadeh A, Eftekhar E, Nikpoor AR. Study of frequency and inheritance model of ACE1 I/D and ACE2 rs2285666 polymorphisms in COVID-19 patients with varying severity of lung involvement and its effect on serum cytokines levels. Cell Biol Int 2023; 47:731-741. [PMID: 36511187 PMCID: PMC9877702 DOI: 10.1002/cbin.11977] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 11/15/2022] [Accepted: 12/03/2022] [Indexed: 12/15/2022]
Abstract
The angiotensin-converting enzyme (ACE) has been shown to play a role as a receptor for the COVID-19 virus. This virus usually gets into cells and infects them by attaching to their glycoprotein receptors, which are found on the ACE2 receptor. The aim of this study was to evaluate the frequency and inheritance of ACE1 I/D and ACE2 rs2285666 polymorphisms in COVID-19 patients with varying severity of lung involvement and its effect on serum cytokines levels of interleukin (IL)-1 and IL-6 and laboratory parameters. One hundred eighty-five COVID-19 patients were grouped according to the severity of lung involvement. (I/D) polymorphism of the ACE1 gene and rs2285666 polymorphism of the ACE2 gene were determined by single specific primer-polymerase chain reaction and restriction fragment length reaction-polymerase chain reaction methods, respectively. Serum levels of IL-1 and IL-6 were also measured by the enzyme linked immunosorbent assay technique. No statistically significant association of ACE2 rs2285666 polymorphism genotypes and ACE1 I/D with the severity of lung involvement was noted. However, there was a statistically significant association between I/D ACE1 polymorphism genotypes and IL-6, white blood cells (WBC), and neutrophil-to-lymphocyte ratio (NLR) levels. Also, there was no statistically significant association between rs2285666 polymorphism genotypes and patients' blood oxygen saturation level, IL-6, IL-1β, lactate dehydrogenase activity, WBC count, and NLR. In patients with COVID-19, the rs2285666 polymorphism of the ACE2 gene and the I/D polymorphism of the ACE1 gene were not significantly associated with the severity of COVID-19 disease and serum IL-6 and IL-1 cytokine levels.
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Affiliation(s)
- Shirin Beyranvand
- Student Research Committee, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Parivash Davoodian
- Infectious and Tropical Diseases Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Hesam Alizade
- Infectious and Tropical Diseases Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Hamed Gouklani
- Infectious and Tropical Diseases Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Azim Nejatizadeh
- Molecular Medicine Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Ebrahim Eftekhar
- Endocrinology and Metabolism Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Amin Reza Nikpoor
- Molecular Medicine Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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Fraser R, Orta-Resendiz A, Dockrell D, Müller-Trutwin M, Mazein A. Severe COVID-19 versus multisystem inflammatory syndrome: comparing two critical outcomes of SARS-CoV-2 infection. Eur Respir Rev 2023; 32:32/167/220197. [PMID: 36889788 PMCID: PMC10032586 DOI: 10.1183/16000617.0197-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 12/31/2022] [Indexed: 03/10/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with diverse host response immunodynamics and variable inflammatory manifestations. Several immune-modulating risk factors can contribute to a more severe coronavirus disease 2019 (COVID-19) course with increased morbidity and mortality. The comparatively rare post-infectious multisystem inflammatory syndrome (MIS) can develop in formerly healthy individuals, with accelerated progression to life-threatening illness. A common trajectory of immune dysregulation forms a continuum of the COVID-19 spectrum and MIS; however, severity of COVID-19 or the development of MIS is dependent on distinct aetiological factors that produce variable host inflammatory responses to infection with different spatiotemporal manifestations, a comprehensive understanding of which is necessary to set better targeted therapeutic and preventative strategies for both.
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Affiliation(s)
- Rupsha Fraser
- The University of Edinburgh, Queen's Medical Research Institute, Edinburgh, UK
| | - Aurelio Orta-Resendiz
- Institut Pasteur, Université Paris Cité, HIV, Inflammation and Persistence Unit, Paris, France
| | - David Dockrell
- The University of Edinburgh, Queen's Medical Research Institute, Edinburgh, UK
| | - Michaela Müller-Trutwin
- Institut Pasteur, Université Paris Cité, HIV, Inflammation and Persistence Unit, Paris, France
| | - Alexander Mazein
- Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Belvaux, Luxembourg
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Angiotensin-converting Enzyme-2 (ACE2) Expression in Pediatric Liver Disease. Appl Immunohistochem Mol Morphol 2022; 30:647-653. [PMID: 36222506 DOI: 10.1097/pai.0000000000001068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 08/20/2022] [Indexed: 11/25/2022]
Abstract
The membrane protein angiotensin-converting enzyme-2 (ACE2) has gained notoriety as the receptor for severe acute respiratory syndrome coronavirus 2. Prior evidence has shown ACE2 is expressed within the liver but its function has not been fully discerned. Here, we utilized novel methodology to assess ACE2 expression in pediatric immune-mediated liver disease to better understand its presence in liver diseases and its role during infections such as COVID-19. We stained liver tissue with ACE2-specific immunofluorescent antibodies, analyzed via confocal microscopy. Computational deep learning-based segmentation models identified nuclei and cells, allowing the quantification of mean cellular and cytosolic immunofluorescent. Spatial transcriptomics provided high-throughput gene expression analysis in tissue to determine cellular composition for ACE2 expression. ACE2 plasma expression was quantified via enzyme-linked immunosorbent assay. High ACE2 expression was seen at the apical surface of cholangiocytes, with lower expression within hepatocyte cytosol and nonparenchymal cells (P<0.001). Children with liver disease had higher ACE2 hepatic expression than pediatric control tissue (P<0.001). Adult control tissue had higher expression than pediatric control (P<0.001). Plasma ACE2 was not found to be statistically different between samples. Spatial transcriptomics identified cell composition of ACE2-expressing spots containing antibody-secreting cells. Our results show ACE2 expression throughout the liver, with strongest localization to cholangiocyte membranes. Machine learning can be used to rapidly identify hepatic cellular components for histologic analysis. ACE2 expression in the liver may be increased in pediatric liver disease. Future work is needed to better understand the role of ACE2 in chronic disease and acute infections.
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Trivedi P, Abbas A, Lehmann C, Rupasinghe HPV. Antiviral and Anti-Inflammatory Plant-Derived Bioactive Compounds and Their Potential Use in the Treatment of COVID-19-Related Pathologies. J Xenobiot 2022; 12:289-306. [PMID: 36278757 PMCID: PMC9589987 DOI: 10.3390/jox12040020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/15/2022] [Accepted: 09/15/2022] [Indexed: 01/24/2023] Open
Abstract
The highly contagious coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been declared a global pandemic and public health emergency as it has taken the lives of over 5.7 million in more than 180 different countries. This disease is characterized by respiratory tract symptoms, such as dry cough and shortness of breath, as well as other symptoms, including fever, chills, and fatigue. COVID-19 is also characterized by the excessive release of cytokines causing inflammatory injury to the lungs and other organs. It is advised to undergo precautionary measures, such as vaccination, social distancing, use of masks, hygiene, and a healthy diet. This review is aimed at summarizing the pathophysiology of COVID-19 and potential biologically active compounds (bioactive) found in plants and plant food. We conclude that many plant food bioactive compounds exhibit antiviral and anti-inflammatory properties and support in attenuating organ damage due to reduced cytokine release and improving the recovery process from COVID-19 infection.
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Affiliation(s)
- Purvi Trivedi
- Department of Anesthesia, Pain Management and Perioperative Medicine, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 3E2, Canada
| | - Amna Abbas
- Department of Plant, Food, and Environmental Sciences, Faculty of Agriculture, Dalhousie University, Truro, NS B2N 5E3, Canada
- Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON L8S 4M1, Canada
| | - Christian Lehmann
- Department of Anesthesia, Pain Management and Perioperative Medicine, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 3E2, Canada
| | - H. P. Vasantha Rupasinghe
- Department of Plant, Food, and Environmental Sciences, Faculty of Agriculture, Dalhousie University, Truro, NS B2N 5E3, Canada
- Department of Pathology, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 3E2, Canada
- Correspondence:
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A comparison between SARS-CoV-1 and SARS-CoV2: an update on current COVID-19 vaccines. Daru 2022; 30:379-406. [PMID: 36050585 PMCID: PMC9436716 DOI: 10.1007/s40199-022-00446-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 08/05/2022] [Indexed: 10/31/2022] Open
Abstract
Since the outbreak of the novel coronavirus disease 2019 (COVID-19) in Wuhan, China, many health care systems have been heavily engaged in treating and preventing the disease, and the year 2020 may be called as “historic COVID-19 vaccine breakthrough”. Due to the COVID-19 pandemic, many companies have initiated investigations on developing an efficient and safe vaccine against the virus. From Moderna and Pfizer in the United States to PastocoVac in Pasteur Institute of Iran and the University of Oxford in the United Kingdom, different candidates have been introduced to the market. COVID-19 vaccine research has been facilitated based on genome and structural information, bioinformatics predictions, epitope mapping, and data obtained from the previous developments of severe acute respiratory syndrome coronavirus (SARS-CoV or SARS-CoV-1) and middle east respiratory syndrome coronavirus (MERS-CoV) vaccine candidates. SARS-CoV genome sequence is highly homologous to the one in COVID-19 and both viruses use the same receptor, angiotensin-converting enzyme 2 (ACE2). Moreover, the immune system responds to these viruses, partially in the same way. Considering the on-going COVID-19 pandemic and previous attempts to manufacture SARS-CoV vaccines, this paper is going to discuss clinical cases as well as vaccine challenges, including those related to infrastructures, transportation, possible adverse reactions, utilized delivery systems (e.g., nanotechnology and electroporation) and probable vaccine-induced mutations.
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Nenna R, Zeric H, Petrarca L, Mancino E, Midulla F. Weighing policymaking: A narrative review of school closures as COVID-19 pandemic-mitigation strategies. Pediatr Pulmonol 2022; 57:1982-1989. [PMID: 34894111 DOI: 10.1002/ppul.25787] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 11/30/2021] [Accepted: 12/07/2021] [Indexed: 12/23/2022]
Abstract
INTRODUCTION In the era of data-driven decision-making, unacceptable haziness, and inconsistency surrounds the yearlong scientific and public debate on the school closure policy in the coronavirus disease-2019 (COVID-19) pandemic mitigation efforts. AIM The present literature review stems out of the need for a clear scaffold collecting in one place all current evidence, as well as helping to organize incoming future evidence, concerning both the role of schools in driving the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) community spread and the cost-effectiveness of school closure in containing such spread. METHODS References for this review were initially identified through searches of PubMed, Scopus, and Cochrane Library for articles published from March 2020 to March 2021 by the use of key terms "Schools," "COVID-19," "pandemic," "clusters," "outbreak," and "seroprevalence," selecting all articles from 2020 to 2021 with full-text availability. A further search was undertaken by screening citations of articles found in the original search and through Google Scholar and ResearchGate. RESULTS Overall, evidence shows that opening schools and keeping them open in the context of the SARS-CoV-2 pandemic is possible, although behaviorally challenging and unfeasible if educational facilities or testing services are inadequate. Contrary to other respiratory viruses, children are not chief targets of SARS-CoV-2 infection, transmission, and disease. It also appears that the second wave of the SARS-CoV-2 virus spread in the WHO European region has been unrelated to school re-opening. CONCLUSIONS A fact-based understanding of what is currently known on such a consequential policy is required to provide a basis of evidence for advocacy of either school closure or school opening at times of high-intensity community transmission of SARS-CoV-2.
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Affiliation(s)
- Raffaella Nenna
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Hana Zeric
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Laura Petrarca
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Enrica Mancino
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Fabio Midulla
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
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Agarwal S, Cohen CT, Zobeck M, Jacobi PM, Sartain SE. Downregulation of thrombomodulin-thrombin-activated protein C pathway as a mechanism for SARS-CoV-2 induced endotheliopathy and microvascular thrombosis. THROMBOSIS UPDATE 2022; 8:100116. [PMID: 38620965 PMCID: PMC9262652 DOI: 10.1016/j.tru.2022.100116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 06/14/2022] [Accepted: 06/27/2022] [Indexed: 11/30/2022] Open
Abstract
There is emerging evidence of microvascular thrombosis and thrombotic microangiopathy (TMA) induced by COVID-19, presumably from endothelial injury. Thrombomodulin (TM) is an endothelial glycoprotein that plays a dual role in maintaining healthy endothelium-as a natural anticoagulant by binding thrombin to activate protein C (APC) and a negative regulator of the alternate complement pathway (AP). TM is shed into the plasma as soluble TM (sTM) during endothelial injury. We hypothesize that SARS-CoV-2 spike proteins cause direct microvascular endothelial injury, leading to TM shedding, decreased activation of PC, and consequently, microvascular thrombosis in COVID-19. We conducted this study twofold: 1) in vivo, we assessed endothelial injury (by measuring sTM) and AP activation by quantifying Ba (cleavage product of AP component Factor B) in a cohort of critically ill COVID-19 pediatric patients and the implications on clinical outcomes; and 2)in vitro, we investigated endothelial injury (TM shedding) by SARS-COV-2 spike proteins and the subsequent functional consequence in activated PC (APC) levels and Ba levels. sTM and Ba in plasma samples from SARS-CoV-2 positive patients admitted to Texas Children's Hospital Pediatric Intensive Care Unit (n = 33) and from healthy controls (n = 38) were measured by ELISA. In vitro, confluent glomerular microvascular endothelial cells (GMVECs) were incubated for 48 h in the presence or absence (control) of purified SARS-CoV-2 spike proteins, S1 and S2. TM from the cell lysates while Ba and APC from the cell supernatants were measured by ELISA. sTM and Ba levels were significantly higher in the COVID-19 pediatric patients compared to healthy controls (p < 0.01 and p < 0.001, respectively). Among the COVID-19 patients, elevated sTM was associated with increased vasopressor use (p = 0.01) and elevated Ba was associated with increased duration of mechanical ventilation (p = 0.04). In vitro, surface bound TM and soluble APC were significantly lower in GMVECs after addition of spike proteins (p < 0.05), while Ba was undetectable in both control and spike proteins exposed GMVECs. In conclusion, we provide evidence of endothelial injury in COVID-19 pediatric patients and demonstrate a potential pathway of SARS-CoV-2 induced thrombosis. Decreased surface-bound TM results in lower amount of thrombin-TM complex, hence lesser activation of PC, likely leading to a pro-thrombotic state. These findings in GMVECs could explain the vulnerability of kidneys to COVID-19-induced TMA.
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Affiliation(s)
- S Agarwal
- - Texas Children's Hospital, Division of Pediatric Hematology-Oncology, Houston, TX, USA
- - Baylor College of Medicine, Houston, TX, USA
| | - C T Cohen
- - Texas Children's Hospital, Division of Pediatric Hematology-Oncology, Houston, TX, USA
- - Baylor College of Medicine, Houston, TX, USA
| | - M Zobeck
- - Texas Children's Hospital, Division of Pediatric Hematology-Oncology, Houston, TX, USA
- - Baylor College of Medicine, Houston, TX, USA
| | - P M Jacobi
- - Texas Children's Hospital, Division of Pediatric Hematology-Oncology, Houston, TX, USA
- - Baylor College of Medicine, Houston, TX, USA
| | - S E Sartain
- - Texas Children's Hospital, Division of Pediatric Hematology-Oncology, Houston, TX, USA
- - Baylor College of Medicine, Houston, TX, USA
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14
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LEVENTOĞLU E, ÖZDEMİR ATİKEL Y, NALÇACIOĞLU H, DURSUN İ, DURSUN H, YÜRÜK YILDIRIM Z, YILDIZ N, KAYA AKSOY G, TAŞDEMİR M, ÇELAKIL M, DEMİRCİOĞLU KILIÇ B, ZIRHLI SELÇUK Ş, CANPOLAT N, KARGIN ÇAKICI E, ÖZLÜ SG, TÜLPAR S, YÜKSEL S, ATMIŞ B, SÜRMELİ DÖVEN S, TANER S, ERTAN P, KAVAZ A, TORUN BAYRAM M, KALYONCU M, GÜLLEROĞLU K, KABASAKAL C, KASAP DEMİR B, ÇİÇEK RY, BİLGE I, DÖNMEZ O, KARA A, YAVAŞCAN Ö, ÖZÇELİK G, GEZGİN YILDIRIM D, GÜLER MA, SÖNMEZ F, POYRAZOĞLU H, AKMAN S, TOPALOĞLU R, ALPAY H, BAKKALOĞLU SA. COVID-19 in pediatric nephrology centers in Turkey. Turk J Med Sci 2022; 52:1762-1770. [PMID: 36945974 PMCID: PMC10390129 DOI: 10.55730/1300-0144.5521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 12/21/2022] [Accepted: 07/24/2022] [Indexed: 12/24/2022] Open
Abstract
Background/aim There is limited data on COVID-19 disease in children with kidney disease. We aimed to investigate the characteristics and prognosis of COVID-19 in pediatric nephrology patients in Turkey. Materials and methods This was a national, multicenter, retrospective cohort study based on an online survey evaluating the data between 11th March 2020 and 11th March 2021 as an initial step of a detailed pediatric nephrology COVID-19 registry. Results Two hundred and three patients (89 girls and 114 boys) were diagnosed with COVID-19. One-third of these patients (36.9%) were between 10-15 years old. Half of the patients were on kidney replacement therapy: kidney transplant (KTx) recipients (n = 56, 27.5%), patients receiving chronic hemodialysis (n = 33, 16.3%) and those on peritoneal dialysis (PD) (n = 18, 8.9%). Fifty-four (26.6%) children were asymptomatic. Eighty-two (40.3%) patients were hospitalized and 23 (28%) needed intensive care unit admission. Fifty-five percent of the patients were not treated, while the remaining was given favipiravir (20.7%), steroid (16.3%), and hydroxychloroquine (11.3%). Acute kidney injury developed in 19.5% of hospitalized patients. Five (2.4%) had MIS-C. Eighty-three percent of the patients were discharged without any apparent sequelae, while 7 (3.4%) died. One hundred and eight health care staff were infected during the study period. Conclusion COVID-19 was most commonly seen in patients who underwent KTx and received HD. The combined immunosuppressive therapy and frequent exposure to the hospital setting may increase these patients' susceptibility. Staff infections before vaccination era were alarming, various precautions should be taken for infection control, particularly optimal vaccination coverage.
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Affiliation(s)
- Emre LEVENTOĞLU
- Departments of Pediatric Nephrology and Rheumatology, Faculty of Medicine, Gazi University, Ankara,
Turkey
| | - Yeşim ÖZDEMİR ATİKEL
- Department of Pediatric Nephrology, Eskişehir City Training and Research Hospital, Eskişehir,
Turkey
| | - Hülya NALÇACIOĞLU
- Department of Pediatric Nephrology, Faculty of Medicine, Ondokuz Mayıs University, Samsun,
Turkey
| | - İsmail DURSUN
- Department of Pediatric Nephrology, Faculty of Medicine, Erciyes University, Kayseri,
Turkey
| | - Hasan DURSUN
- Department of Pediatric Nephrology, Prof. Dr. Cemil Taşçıoğlu City Hospital, University of Health Sciences, İstanbul,
Turkey
| | - Zeynep YÜRÜK YILDIRIM
- Department of Pediatric Nephrology, İstanbul Faculty of Medicine, İstanbul University, İstanbul,
Turkey
| | - Nurdan YILDIZ
- Department of Pediatric Nephrology, İstanbul Pendik Education and Research Hospital, Marmara University, İstanbul,
Turkey
| | - Gülşah KAYA AKSOY
- Department of Pediatric Nephrology, Faculty of Medicine, Akdeniz University, Antalya,
Turkey
| | - Mehmet TAŞDEMİR
- Departments of Pediatric Nephrology and Rheumatology, Faculty of Medicine, Koç University, İstanbul,
Turkey
| | - Mehtap ÇELAKIL
- Department of Pediatric Nephrology, Hatay State Hospital, Hatay,
Turkey
| | | | - Şenay ZIRHLI SELÇUK
- Department of Pediatric Nephrology, Turgut Özal Medical Center, İnönü University, Malatya,
Turkey
| | - Nur CANPOLAT
- Department of Pediatric Nephrology, Cerrahpaşa Faculty of Medicine, İstanbul University, İstanbul,
Turkey
| | - Evrim KARGIN ÇAKICI
- Department of Pediatric Nephrology, Dr. Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, University of Health Sciences, Ankara,
Turkey
| | - Sare Gülfem ÖZLÜ
- Department of Pediatric Nephrology, Ankara City Training and Research Hospital, Ankara,
Turkey
| | - Sebahat TÜLPAR
- Department of Pediatric Nephrology, İstanbul Bakırköy Dr. Sadi Konuk Research and Training Hospital, University of Health Sciences, İstanbul,
Turkey
| | - Selçuk YÜKSEL
- Department of Pediatric Nephrology, Faculty of Medicine, Pamukkale University, Denizli,
Turkey
| | - Bahriye ATMIŞ
- Department of Pediatric Nephrology, Faculty of Medicine, Çukurova University, Adana,
Turkey
| | - Serra SÜRMELİ DÖVEN
- Department of Pediatric Nephrology, Faculty of Medicine, Mersin University, Mersin,
Turkey
| | - Sevgin TANER
- Department of Pediatric Nephrology, Adana City Training and Research Hospital, University of Health Sciences, Adana,
Turkey
| | - Pelin ERTAN
- Department of Pediatric Nephrology, Faculty of Medicine, Celal Bayar University, Manisa,
Turkey
| | - Aslı KAVAZ
- Department of Pediatric Nephrology, Faculty of Medicine, Osmangazi University, Eskişehir,
Turkey
| | - Meral TORUN BAYRAM
- Department of Pediatric Nephrology, Faculty of Medicine, Dokuz Eylül University, İzmir,
Turkey
| | - Mukaddes KALYONCU
- Departments of Pediatric Nephrology and Rheumatology, Faculty of Medicine, Karadeniz Technical University, Trabzon,
Turkey
| | - Kaan GÜLLEROĞLU
- Department of Pediatric Nephrology, Faculty of Medicine, Başkent University, Ankara,
Turkey
| | - Caner KABASAKAL
- Department of Pediatric Nephrology, Faculty of Medicine, Ege University, İzmir,
Turkey
| | - Belde KASAP DEMİR
- Departments of Pediatric Nephrology and Rheumatology, Faculty of Medicine, İzmir Katip Çelebi University, İzmir,
Turkey
| | - Rümeysa Yasemin ÇİÇEK
- Department of Pediatric Nephrology, Başakşehir Çam and Sakura City Hospital, İstanbul,
Turkey
| | - Ilmay BİLGE
- Departments of Pediatric Nephrology and Rheumatology, Faculty of Medicine, Koç University, İstanbul,
Turkey
| | - Osman DÖNMEZ
- Departments of Pediatric Nephrology and Rheumatology, Faculty of Medicine, Uludağ University, Bursa,
Turkey
| | - Aslıhan KARA
- Departments of Pediatric Nephrology and Rheumatology, Faculty of Medicine, Fırat University, Elazığ,
Turkey
| | - Önder YAVAŞCAN
- Department of Pediatric Nephrology, Faculty of Medicine, Medipol University, İstanbul,
Turkey
| | - Gül ÖZÇELİK
- Department of Pediatric Nephrology, Şisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, İstanbul,
Turkey
| | - Deniz GEZGİN YILDIRIM
- Departments of Pediatric Nephrology and Rheumatology, Faculty of Medicine, Gazi University, Ankara,
Turkey
| | - Muhammet Akif GÜLER
- Department of Pediatric Nephrology, Faculty of Medicine, Atatürk University, Erzurum,
Turkey
| | - Ferah SÖNMEZ
- Department of Pediatric Nephrology, Faculty of Medicine, Adnan Menderes University, Aydın,
Turkey
| | - Hakan POYRAZOĞLU
- Department of Pediatric Nephrology, Faculty of Medicine, Erciyes University, Kayseri,
Turkey
| | - Sema AKMAN
- Department of Pediatric Nephrology, Faculty of Medicine, Akdeniz University, Antalya,
Turkey
| | - Rezan TOPALOĞLU
- Department of Pediatric Nephrology, Faculty of Medicine, Hacettepe University, Ankara,
Turkey
| | - Harika ALPAY
- Department of Pediatric Nephrology, İstanbul Pendik Education and Research Hospital, Marmara University, İstanbul,
Turkey
| | - Sevcan A. BAKKALOĞLU
- Departments of Pediatric Nephrology and Rheumatology, Faculty of Medicine, Gazi University, Ankara,
Turkey
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Pierangeli A, Gentile M, Oliveto G, Frasca F, Sorrentino L, Matera L, Nenna R, Viscido A, Fracella M, Petrarca L, D’Ettorre G, Ceccarelli G, Midulla F, Antonelli G, Scagnolari C. Comparison by Age of the Local Interferon Response to SARS-CoV-2 Suggests a Role for IFN-ε and -ω. Front Immunol 2022; 13:873232. [PMID: 35903094 PMCID: PMC9315386 DOI: 10.3389/fimmu.2022.873232] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 06/15/2022] [Indexed: 12/14/2022] Open
Abstract
Children generally develop a mild disease after SARS-CoV-2 infection whereas older adults are at risk of developing severe COVID-19. Recent transcriptomic analysis showed pre-activated innate immunity in children, resulting in a more effective anti-SARS-CoV-2 response upon infection. To further characterize age-related differences, we studied type I and III interferon (IFN) response in SARS-CoV-2 infected and non-infected individuals of different ages. Specifically, levels of expression of type I (IFN-α, -β, -ε and -ω), type III (IFN-λ1, -λ2 and -λ3) IFNs and of the IFN-stimulated genes, ISG15 and ISG56 were quantified in nasopharyngeal cells from diagnostic swabs. Basal transcription of type I/III IFN genes was highest among children and decreased with age. Among SARS-CoV-2-infected individuals, only IFN-ε and -ω levels were significantly higher in children and young adults whereas ISGs were overexpressed in infected adults. The occurrence of symptoms in children and the need for hospitalization in adults were associated to higher transcription of several IFN genes. Starting from a pre-activated transcription level, the expression of type I and III IFNs was not highly up-regulated in children upon SARS-CoV-2 infection; young adults activated IFNs’ transcription at intermediate levels whereas older adults were characterized by higher ISGs and lower IFN-ε and -ω relative expression levels. Overall, our findings contribute to recognize components of a protective IFN response as a function of age, in the context of SARS-CoV-2 infection.
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Affiliation(s)
- Alessandra Pierangeli
- Virology Laboratory, Department of Molecular Medicine, “Sapienza” University, Rome, Italy
- *Correspondence: Alessandra Pierangeli, ; orcid.org/0000-0003-0633-360X
| | - Massimo Gentile
- Virology Laboratory, Department of Molecular Medicine, “Sapienza” University, Rome, Italy
| | - Giuseppe Oliveto
- Virology Laboratory, Department of Molecular Medicine, “Sapienza” University, Rome, Italy
| | - Federica Frasca
- Virology Laboratory, Department of Molecular Medicine, “Sapienza” University, Rome, Italy
| | - Leonardo Sorrentino
- Virology Laboratory, Department of Molecular Medicine, “Sapienza” University, Rome, Italy
| | - Luigi Matera
- Department of Maternal, Infantile and Urological Sciences, “Sapienza” University, Rome, Italy
| | - Raffaella Nenna
- Department of Maternal, Infantile and Urological Sciences, “Sapienza” University, Rome, Italy
| | - Agnese Viscido
- Virology Laboratory, Department of Molecular Medicine, “Sapienza” University, Rome, Italy
| | - Matteo Fracella
- Virology Laboratory, Department of Molecular Medicine, “Sapienza” University, Rome, Italy
| | - Laura Petrarca
- Department of Maternal, Infantile and Urological Sciences, “Sapienza” University, Rome, Italy
| | - Gabriella D’Ettorre
- Department of Public Health and Infectious Diseases, “Sapienza” University, Rome, Italy
| | - Giancarlo Ceccarelli
- Department of Public Health and Infectious Diseases, “Sapienza” University, Rome, Italy
| | - Fabio Midulla
- Department of Maternal, Infantile and Urological Sciences, “Sapienza” University, Rome, Italy
| | - Guido Antonelli
- Virology Laboratory, Department of Molecular Medicine, “Sapienza” University, Rome, Italy
| | - Carolina Scagnolari
- Virology Laboratory, Department of Molecular Medicine, “Sapienza” University, Rome, Italy
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16
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Nenna R, Matera L, Pierangeli A, Oliveto G, Viscido A, Petrarca L, La Regina DP, Mancino E, Di Mattia G, Villani A, Midulla F. First COVID-19 lockdown resulted in most respiratory viruses disappearing among hospitalised children, with the exception of rhinoviruses. Acta Paediatr 2022; 111:1399-1403. [PMID: 35266576 PMCID: PMC9111239 DOI: 10.1111/apa.16326] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 03/01/2022] [Accepted: 03/08/2022] [Indexed: 12/20/2022]
Abstract
Aim Emergency room admissions have decreased globally during the COVID‐19 pandemic, particularly for respiratory diseases. We evaluated hospital admissions for respiratory diseases in the first year of the Italian pandemic and compared them with the corresponding period in 2016–2017. Methods The study was carried out at the Sapienza University in Rome, Italy, and covered 9 March to 28 February 2020–2021 and 2016–2017. We tested 85 hospitalised children who were negative for the virus that causes COVID‐19 in 2020–2021 and compared them with 476 hospitalised children from 2016–2017, as we had also tested nasal washing samples for 14 respiratory viruses during that period. Results Hospitalisations for acute respiratory tract infections were 82.2% lower in 2020–2021 than 2016–2017. The respiratory syncytial virus (RSV) and several other viruses were detected less frequently during the pandemic. An extraordinary finding was that rhinoviruses remained seasonal. In 2020–2021, we detected a virus in 54.1% of the hospitalised children: rhinoviruses in 41, RSV in 4 and other viruses in 1. This was significantly lower than the 71.6% in 2016–2017: RSV in 130, rhinoviruses in 128 and other viruses in 83. Conclusion Pandemic measures dramatically reduced childhood respiratory infections, particularly RSV, but were less effective at reducing rhinoviruses.
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Affiliation(s)
- Raffaella Nenna
- Department of Maternal Infantile and Urological Sciences Sapienza University of Rome Rome Italy
| | - Luigi Matera
- Department of Maternal Infantile and Urological Sciences Sapienza University of Rome Rome Italy
| | - Alessandra Pierangeli
- Laboratory of Virology Department of Molecular Medicine Affiliated to Istituto Pasteur Italia Sapienza University of Rome Rome Italy
| | - Giuseppe Oliveto
- Laboratory of Virology Department of Molecular Medicine Affiliated to Istituto Pasteur Italia Sapienza University of Rome Rome Italy
| | - Agnese Viscido
- Laboratory of Virology Department of Molecular Medicine Affiliated to Istituto Pasteur Italia Sapienza University of Rome Rome Italy
| | - Laura Petrarca
- Department of Maternal Infantile and Urological Sciences Sapienza University of Rome Rome Italy
| | | | - Enrica Mancino
- Department of Maternal Infantile and Urological Sciences Sapienza University of Rome Rome Italy
| | - Greta Di Mattia
- Department of Maternal Infantile and Urological Sciences Sapienza University of Rome Rome Italy
| | - Alberto Villani
- Department of Maternal Infantile and Urological Sciences Sapienza University of Rome Rome Italy
| | - Fabio Midulla
- Department of Maternal Infantile and Urological Sciences Sapienza University of Rome Rome Italy
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17
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Bloise S, Isoldi S, Marcellino A, De Luca E, Dilillo A, Mallardo S, Martucci V, Sanseviero M, Del Giudice E, Iorfida D, Leone R, Testa A, Frasacco B, Gizzone P, Proietti Ciolli C, Sinceri A, Zuliani F, Zanardi E, Gambarotto A, Lisa Grandinetti A, Ventriglia F, Lubrano R. Clinical picture and long-term symptoms of SARS-CoV-2 infection in an Italian pediatric population. Ital J Pediatr 2022; 48:79. [PMID: 35598023 PMCID: PMC9123625 DOI: 10.1186/s13052-022-01270-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 05/04/2022] [Indexed: 12/15/2022] Open
Abstract
Background SARS-CoV-2 infection in the pediatric age group has a milder course than in adults, but in some cases even children may present with severe forms or develop long-term consequences. The aim of this study was to analyze the clinical features, long-term effects, lifestyle changes and psychological effects of SARS-CoV-2 infection in a pediatric sample of the Italian population. Methods We conducted a telephone survey among 3075 children infected with SARS-CoV-2 in the Latina Local Health Authority. Outcomes included: clinical features of infection, long-term symptoms, lifestyle changes and emotional symptoms during the illness. The information obtained was automatically linked to a spreadsheet and analyzed. Results One thousand four hundred thirteen children agreed to participate in the study; the mean age was 112.8 ± 21.9 months. Children were infected mainly inside familial clusters (59.6%; n = 842); 99% (n = 1399) of children were asymptomatic or exhibited mild symptoms. 20% (n = 259) of children experienced long-term symptoms; risk factors were: older age, higher body mass index and longer duration of infection. Throughout the period of infection, children spent most of the time on devices like tv-video, social media and mobile phone for non-educational activities. 58.8% (n = 620) of parents expressed a negative opinion about distance learning. Finally, we observed that 49,6% (n = 532) of children experienced psychological symptoms during quarantine period. Conclusion Despite a lower susceptibility to COVID-19 in children, it is important to keep the focus high in children, both because of the possible long symptoms after infection and the impact on a children’s mental and physical health due to pandemic. We believe that the return to school or other extracurricular activities are important to correct some of the risk factors for the long COVID syndrome, as obesity, and to limit the cultural damage generated by distance learning and psychological effects related to restrictive measures.
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Affiliation(s)
- Silvia Bloise
- Dipartimento Materno Infantile E Di Scienze Urologiche, Sapienza Università Di Roma, UOC Di Pediatria e NeonatologiaOspedale Santa Maria Goretti, Polo Pontino, Rome, Lazio, Italy.
| | - Sara Isoldi
- Dipartimento Materno Infantile E Di Scienze Urologiche, Sapienza Università Di Roma, UOC Di Pediatria e NeonatologiaOspedale Santa Maria Goretti, Polo Pontino, Rome, Lazio, Italy
| | - Alessia Marcellino
- Dipartimento Materno Infantile E Di Scienze Urologiche, Sapienza Università Di Roma, UOC Di Pediatria e NeonatologiaOspedale Santa Maria Goretti, Polo Pontino, Rome, Lazio, Italy
| | - Enrica De Luca
- Dipartimento Materno Infantile E Di Scienze Urologiche, Sapienza Università Di Roma, UOC Di Pediatria e NeonatologiaOspedale Santa Maria Goretti, Polo Pontino, Rome, Lazio, Italy
| | - Anna Dilillo
- Dipartimento Materno Infantile E Di Scienze Urologiche, Sapienza Università Di Roma, UOC Di Pediatria e NeonatologiaOspedale Santa Maria Goretti, Polo Pontino, Rome, Lazio, Italy
| | - Saverio Mallardo
- Dipartimento Materno Infantile E Di Scienze Urologiche, Sapienza Università Di Roma, UOC Di Pediatria e NeonatologiaOspedale Santa Maria Goretti, Polo Pontino, Rome, Lazio, Italy
| | - Vanessa Martucci
- Dipartimento Materno Infantile E Di Scienze Urologiche, Sapienza Università Di Roma, UOC Di Pediatria e NeonatologiaOspedale Santa Maria Goretti, Polo Pontino, Rome, Lazio, Italy
| | - Mariateresa Sanseviero
- Dipartimento Materno Infantile E Di Scienze Urologiche, Sapienza Università Di Roma, UOC Di Pediatria e NeonatologiaOspedale Santa Maria Goretti, Polo Pontino, Rome, Lazio, Italy
| | - Emanuela Del Giudice
- Dipartimento Materno Infantile E Di Scienze Urologiche, Sapienza Università Di Roma, UOC Di Pediatria e NeonatologiaOspedale Santa Maria Goretti, Polo Pontino, Rome, Lazio, Italy
| | - Donatella Iorfida
- Dipartimento Materno Infantile E Di Scienze Urologiche, Sapienza Università Di Roma, UOC Di Pediatria e NeonatologiaOspedale Santa Maria Goretti, Polo Pontino, Rome, Lazio, Italy
| | - Rita Leone
- Dipartimento Materno Infantile E Di Scienze Urologiche, Sapienza Università Di Roma, UOC Di Pediatria e NeonatologiaOspedale Santa Maria Goretti, Polo Pontino, Rome, Lazio, Italy
| | - Alessia Testa
- Dipartimento Materno Infantile E Di Scienze Urologiche, Sapienza Università Di Roma, UOC Di Pediatria e NeonatologiaOspedale Santa Maria Goretti, Polo Pontino, Rome, Lazio, Italy
| | - Beatrice Frasacco
- Dipartimento Materno Infantile E Di Scienze Urologiche, Sapienza Università Di Roma, UOC Di Pediatria e NeonatologiaOspedale Santa Maria Goretti, Polo Pontino, Rome, Lazio, Italy
| | - Pietro Gizzone
- Dipartimento Materno Infantile E Di Scienze Urologiche, Sapienza Università Di Roma, UOC Di Pediatria e NeonatologiaOspedale Santa Maria Goretti, Polo Pontino, Rome, Lazio, Italy
| | - Claudia Proietti Ciolli
- Dipartimento Materno Infantile E Di Scienze Urologiche, Sapienza Università Di Roma, UOC Di Pediatria e NeonatologiaOspedale Santa Maria Goretti, Polo Pontino, Rome, Lazio, Italy
| | - Alessandro Sinceri
- Dipartimento Materno Infantile E Di Scienze Urologiche, Sapienza Università Di Roma, UOC Di Pediatria e NeonatologiaOspedale Santa Maria Goretti, Polo Pontino, Rome, Lazio, Italy
| | - Francesca Zuliani
- Dipartimento Materno Infantile E Di Scienze Urologiche, Sapienza Università Di Roma, UOC Di Pediatria e NeonatologiaOspedale Santa Maria Goretti, Polo Pontino, Rome, Lazio, Italy
| | - Elena Zanardi
- Dipartimento Materno Infantile E Di Scienze Urologiche, Sapienza Università Di Roma, UOC Di Pediatria e NeonatologiaOspedale Santa Maria Goretti, Polo Pontino, Rome, Lazio, Italy
| | - Anna Gambarotto
- Dipartimento Materno Infantile E Di Scienze Urologiche, Sapienza Università Di Roma, UOC Di Pediatria e NeonatologiaOspedale Santa Maria Goretti, Polo Pontino, Rome, Lazio, Italy
| | | | - Flavia Ventriglia
- Dipartimento Materno Infantile E Di Scienze Urologiche, Sapienza Università Di Roma, UOC Di Pediatria e NeonatologiaOspedale Santa Maria Goretti, Polo Pontino, Rome, Lazio, Italy
| | - Riccardo Lubrano
- Dipartimento Materno Infantile E Di Scienze Urologiche, Sapienza Università Di Roma, UOC Di Pediatria e NeonatologiaOspedale Santa Maria Goretti, Polo Pontino, Rome, Lazio, Italy
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18
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Arslanoglu Aydin E, Baglan E, Bagrul I, Tuncez S, Ozdel S, Bulbul M. Safety of COVID-19 vaccines and disease flares after vaccines in children with rheumatic disease. Postgrad Med 2022; 134:616-621. [PMID: 35535525 DOI: 10.1080/00325481.2022.2074700] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Wide spread availability of safe and effective vaccines for COVID-19 in all countries is the best hope to end the COVID-19 pandemic. However, in developing countries, the hesitancy of the society about vaccination is an important problem in terms of public health. This study aimed to investigate the acceptability and tolerability of COVID-19 vaccines in the pediatric population diagnosed with rheumatic disease, as well as the attitudes towards these vaccines. METHODS This is an observational, cross sectional, single center study. Pediatric patients with at least one diagnosis of rheumatic disease were included in this study to investigate patient and family acceptability and safety of COVID-19 vaccines. RESULTS A total of 228 patients with rheumatic disease were included in this study. Ninety nine (43.4%) of the patients were juvenile idiopathic arthritis. One hundred and five (46%) of the patients were using biological agent treatment for their rheumatic disease, whereas 123 (54%) of the patients were not. No serious adverse effect related to the COVID-19 vaccine were observed in any of the patients. No disease activation was observed in any of them. CONCLUSION There are only a few studies evaluating of the safety and disease flare of COVID-19 vaccines in children with rheumatic disease. Although this study has some limitations, such as the small sample size of patients with different diagnoses, it appears that there is no increase in COVID-19 vaccination-related harms in the patients with rheumatic disease.
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Affiliation(s)
- Elif Arslanoglu Aydin
- Department of Pediatric Rheumatology, Dr. Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Esra Baglan
- Department of Pediatric Rheumatology, Dr. Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Ilknur Bagrul
- Department of Pediatric Rheumatology, Dr. Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Serife Tuncez
- Department of Pediatric Rheumatology, Dr. Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Semanur Ozdel
- Department of Pediatric Rheumatology, Dr. Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Mehmet Bulbul
- Department of Pediatric Nephrology and Rheumatology, Dr. Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey
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19
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D’Auria E, Calcaterra V, Verduci E, Ghezzi M, Lamberti R, Vizzuso S, Baldassarre P, Pendezza E, Perico V, Bosetti A, Zuccotti GV. Immunonutrition and SARS-CoV-2 Infection in Children with Obesity. Nutrients 2022; 14:nu14091701. [PMID: 35565668 PMCID: PMC9101404 DOI: 10.3390/nu14091701] [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: 03/07/2022] [Revised: 04/14/2022] [Accepted: 04/18/2022] [Indexed: 11/16/2022] Open
Abstract
Since the beginning of the SARS-CoV-2 pandemic, there has been much discussion about the role of diet and antiviral immunity in the context of SARS-CoV-2 infection. Intake levels of vitamins D, C, B12, and iron have been demonstrated to be correlated with lower COVID-19 incidence and mortality. Obesity has been demonstrated to be an independent risk for the severity of COVID-19 infection in adults and also in children. This may be due to different mechanisms, mainly including the gut dysbiosis status observed in obese children. Moreover, the existence of a gut-lung axis added new knowledge to on the potential mechanisms by which diet and dietary substances may affect immune function. The aim of this narrative review is to address the intricate inter-relationship between COVID-19, immune function, and obesity-related inflammation and to describe the role of nutrients and dietary patterns in enhancing the immune system. Two ways to fight against COVID-19 disease exist: one with an antiviral response through immune system boosting and another with antioxidants with an anti-inflammatory effect. In the current pandemic situation, the intake of a varied and balanced diet, rich in micronutrients and bioactive compounds including fibers, should be recommended. However, clinical studies conducted on children affected by SARS-CoV-2 infection and comorbidity are warranted.
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Affiliation(s)
- Enza D’Auria
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.D.); (V.C.); (M.G.); (R.L.); (S.V.); (P.B.); (E.P.); (V.P.); (A.B.); (G.V.Z.)
| | - Valeria Calcaterra
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.D.); (V.C.); (M.G.); (R.L.); (S.V.); (P.B.); (E.P.); (V.P.); (A.B.); (G.V.Z.)
- Pediatric and Adolescent Unit, Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy
| | - Elvira Verduci
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.D.); (V.C.); (M.G.); (R.L.); (S.V.); (P.B.); (E.P.); (V.P.); (A.B.); (G.V.Z.)
- Department of Health Sciences, University of Milan, 20142 Milan, Italy
- Correspondence:
| | - Michele Ghezzi
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.D.); (V.C.); (M.G.); (R.L.); (S.V.); (P.B.); (E.P.); (V.P.); (A.B.); (G.V.Z.)
| | - Rossella Lamberti
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.D.); (V.C.); (M.G.); (R.L.); (S.V.); (P.B.); (E.P.); (V.P.); (A.B.); (G.V.Z.)
| | - Sara Vizzuso
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.D.); (V.C.); (M.G.); (R.L.); (S.V.); (P.B.); (E.P.); (V.P.); (A.B.); (G.V.Z.)
| | - Paola Baldassarre
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.D.); (V.C.); (M.G.); (R.L.); (S.V.); (P.B.); (E.P.); (V.P.); (A.B.); (G.V.Z.)
| | - Erica Pendezza
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.D.); (V.C.); (M.G.); (R.L.); (S.V.); (P.B.); (E.P.); (V.P.); (A.B.); (G.V.Z.)
| | - Veronica Perico
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.D.); (V.C.); (M.G.); (R.L.); (S.V.); (P.B.); (E.P.); (V.P.); (A.B.); (G.V.Z.)
| | - Alessandra Bosetti
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.D.); (V.C.); (M.G.); (R.L.); (S.V.); (P.B.); (E.P.); (V.P.); (A.B.); (G.V.Z.)
| | - Gian Vincenzo Zuccotti
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (E.D.); (V.C.); (M.G.); (R.L.); (S.V.); (P.B.); (E.P.); (V.P.); (A.B.); (G.V.Z.)
- Department of Biomedical and Clinical Science “L. Sacco”, University of Milan, 20157 Milan, Italy
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20
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Silvestri P, Clemente A, Spalice A, Febbo A, Matera L, Accardo F, Barbieri MA, Villani A, Midulla F. Case Report: Cerebral Venous Sinus Thrombosis in a Young Child With SARS-CoV-2 Infection: The Italian Experience. Front Neurol 2022; 13:861345. [PMID: 35432183 PMCID: PMC9009147 DOI: 10.3389/fneur.2022.861345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 03/02/2022] [Indexed: 12/23/2022] Open
Abstract
Introduction Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in pediatric patients is usually characterized by fever, dry cough, and fatigue, or is asymptomatic and rarely presents with pneumonia. On the other hand, cerebral venous sinus thrombosis (CVST) could be a neurological sequela of the prothrombotic state triggered by coronavirus disease 2019 (COVID-19) both in adults and children. Case Report We present a case of a 15-year-old male child who was obese and had mild neurocognitive impairment. He was admitted to the pediatric emergency department and then diagnosed with CVST during SARS-CoV-2 infection. Conclusion During the COVID-19 pandemic, in patients presenting with neurological manifestations of CVST (headache, alteration of consciousness, focal deficit, or signs of endocranial hypertension), it is advisable to look for a current or recent infection of SARS-CoV-2, regardless of the presence of respiratory symptoms. In our patient, ongoing SARS-CoV-2 infection represents the only prothrombotic risk factor underlying the neurological disease.
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Affiliation(s)
- Paola Silvestri
- Maternal-Infantile and Urological Science Department, Sapienza University of Rome, Rome, Italy
- *Correspondence: Paola Silvestri
| | - Anna Clemente
- Maternal-Infantile and Urological Science Department, Sapienza University of Rome, Rome, Italy
- Anna Clemente
| | - Alberto Spalice
- Maternal-Infantile and Urological Science Department, Sapienza University of Rome, Rome, Italy
| | - Alessandra Febbo
- Maternal-Infantile and Urological Science Department, Sapienza University of Rome, Rome, Italy
| | - Luigi Matera
- Maternal-Infantile and Urological Science Department, Sapienza University of Rome, Rome, Italy
| | - Fabiana Accardo
- Maternal-Infantile and Urological Science Department, Sapienza University of Rome, Rome, Italy
| | | | - Alberto Villani
- Academic Department of Pediatrics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Fabio Midulla
- Maternal-Infantile and Urological Science Department, Sapienza University of Rome, Rome, Italy
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21
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Amin S, Aktar S, Rahman MM, Chowdhury MMH. NLRP3 inflammasome activation in COVID-19: an interlink between risk factors and disease severity. Microbes Infect 2022; 24:104913. [PMID: 34838941 PMCID: PMC8613976 DOI: 10.1016/j.micinf.2021.104913] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 11/18/2021] [Accepted: 11/19/2021] [Indexed: 02/08/2023]
Abstract
NLRP3 inflammasome is a critical immune component that plays a crucial role in mounting innate immune responses. The deleterious effects of inflammasome activation have been correlated with the COVID-19 disease severity. In the presence of several underlying disorders, the immune components of our bodies are dysregulated, creating conditions that could adversely affect us other than providing a required level of protection. In this review, we focused on the occurrence of NLRP3 inflammasome activation in response to SARS-COV-2 infection, dysregulation of NLRP3 activation events in the presence of several comorbidities, the contribution of activated NLRP3 inflammasome to the severity of COVID-19, and available therapeutics for the treatment of such NLRP3 inflammasome related diseases based on current knowledge. The primed state of immunity in individuals with comorbidities (risk factors) could accelerate many deaths and severe COVID-19 cases via activation of NLRP3 inflammasome and the release of downstream inflammatory molecules. Therefore, a detailed understanding of the host-pathogen interaction is needed to clarify the pathophysiology and select a potential therapeutic approach.
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Affiliation(s)
- Saiful Amin
- Chittagong Medical University, Chattogram, Bangladesh
| | - Salma Aktar
- Department of Microbiology, Noakhali Science and Technology University, Sonapur, Noakhali 3814, Bangladesh.
| | - Md Mijanur Rahman
- Department of Microbiology, Noakhali Science and Technology University, Sonapur, Noakhali 3814, Bangladesh
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22
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Kopanja S, Gattinger P, Schmidthaler K, Sieber J, Niepodziana K, Schlederer T, Weseslindtner L, Stiasny K, Götzinger F, Pickl WF, Frischer T, Valenta R, Szépfalusi Z. Characterization of the antibody response to SARS-CoV-2 in a mildly affected pediatric population. Pediatr Allergy Immunol 2022; 33:e13737. [PMID: 35212039 PMCID: PMC9115525 DOI: 10.1111/pai.13737] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 01/21/2022] [Accepted: 01/24/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND While children usually experience a mild course of COVID-19, and a severe disease is more common in adults, the features, specificities, and functionality of the SARS-CoV-2-specific antibody response in the pediatric population are of interest. METHODS We performed a detailed analysis of IgG antibodies specific for SARS-CoV-2-derived antigens S and RBD by ELISA in 26 SARS-CoV-2 seropositive schoolchildren with mild or asymptomatic disease course, and in an equally sized, age- and gender-matched control group. Furthermore, a detailed mapping of IgG reactivity to a panel of microarrayed SARS-CoV-2 proteins and S-derived peptides was performed by microarray technology. The capacity of the antibody response to block RBD-ACE2 binding and virus neutralization were assessed. Results were compared with those obtained in an adult COVID-19 convalescent population. RESULTS After mild COVID-19, anti-S and RBD-specific IgG antibodies were developed by 100% and 84.6% of pediatric subjects, respectively. No difference was observed in regards to symptoms and gender. Mounted antibodies recognized conformational epitopes of the spike protein and were capable to neutralize the virus up to a titer of ≥80 and to inhibit the ACE2-RBD interaction by up to 65%. SARS-CoV-2-specific IgG responses in children were comparable to mildly affected adult patients. CONCLUSION SARS-CoV-2 asymptomatic and mildly affected pediatric patients develop a SARS-CoV-2-specific antibody response, which is comparable regarding antigen, epitope recognition, and the ability to inhibit the RBD-ACE2 interaction to that observed in adult patients after mild COVID-19.
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Affiliation(s)
- Sonja Kopanja
- Division of Pediatric Pulmonology, Allergy and EndocrinologyDepartment of Pediatrics and Adolescent MedicineComprehensive Centre of PediatricsMedical University of ViennaViennaAustria
| | - Pia Gattinger
- Department of Pathophysiology and Allergy ResearchDivision of ImmunopathologyCentre for Pathophysiology, Infectiology and ImmunologyMedical University of ViennaViennaAustria
| | - Klara Schmidthaler
- Division of Pediatric Pulmonology, Allergy and EndocrinologyDepartment of Pediatrics and Adolescent MedicineComprehensive Centre of PediatricsMedical University of ViennaViennaAustria
| | - Justyna Sieber
- Division of Pediatric Pulmonology, Allergy and EndocrinologyDepartment of Pediatrics and Adolescent MedicineComprehensive Centre of PediatricsMedical University of ViennaViennaAustria
- Department of Clinical ImmunologyWroclaw Medical UniversityWroclawPoland
| | - Katarzyna Niepodziana
- Department of Pathophysiology and Allergy ResearchDivision of ImmunopathologyCentre for Pathophysiology, Infectiology and ImmunologyMedical University of ViennaViennaAustria
| | - Thomas Schlederer
- Department of Pathophysiology and Allergy ResearchDivision of ImmunopathologyCentre for Pathophysiology, Infectiology and ImmunologyMedical University of ViennaViennaAustria
| | | | - Karin Stiasny
- Centre for VirologyMedical University of ViennaViennaAustria
| | - Florian Götzinger
- Department of Pediatrics and Adolescent MedicineKlinik OttakringViennaAustria
| | - Winfried F. Pickl
- Institute of ImmunologyCenter for Pathophysiology, Infectiology and ImmunologyMedical University of ViennaViennaAustria
- Karl Landsteiner University of Health SciencesKremsAustria
| | - Thomas Frischer
- Department of Pediatrics and Adolescent MedicineKlinik OttakringViennaAustria
- Sigmund Freud Private UniversityViennaAustria
| | - Rudolf Valenta
- Department of Pathophysiology and Allergy ResearchDivision of ImmunopathologyCentre for Pathophysiology, Infectiology and ImmunologyMedical University of ViennaViennaAustria
- Karl Landsteiner University of Health SciencesKremsAustria
- Laboratory for ImmunopathologyDepartment of Clinical Immunology and AllergologySechenov First Moscow State Medical UniversityMoscowRussia
- NRC Institute of Immunology FMBA of RussiaMoscowRussia
| | - Zsolt Szépfalusi
- Division of Pediatric Pulmonology, Allergy and EndocrinologyDepartment of Pediatrics and Adolescent MedicineComprehensive Centre of PediatricsMedical University of ViennaViennaAustria
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23
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Petrarca L, Manganelli V, Nenna R, Frassanito A, Ben David S, Mancino E, Garofalo T, Sorice M, Misasi R, Midulla F. HMGB1 in Pediatric COVID-19 Infection and MIS-C: A Pilot Study. Front Pediatr 2022; 10:868269. [PMID: 35558368 PMCID: PMC9087838 DOI: 10.3389/fped.2022.868269] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 03/24/2022] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE Since the beginning of the coronavirus disease 2019 (COVID-19) pandemic, a novel syndrome known as a multisystem inflammatory syndrome in children (MIS-C) was reported in previously healthy children. A possible pro-inflammatory molecule, high-mobility group box 1 (HMGB1), may be assumed to play an important role in the pathogenesis and clinical presentation of MIS-C. We described the clinical picture of patients with MIS-C and we also aimed to test and compare HMGB1 serum levels of MIS-C patients with those of patients with previous SARS-CoV2 infection and healthy children. STUDY DESIGN We determined HMGB1 levels by Western blot in 46 patients and divided them into three groups, namely, five patients with MIS-C (median age: 8.36 years), 20 children with a history of SARS-CoV-2 infection (median age: 10.45 years), and 21 healthy children (controls) (median age: 4.84 years), without evidence of respiratory infection in the last 3 months. RESULTS The median level of HMGB1 in the serum of five patients with MIS-C was found to be significantly higher compared with both patients with a recent history of COVID-19 (1,151.38 vs. 545.90 densitometric units (DU), p = 0.001) and control (1,151.38 vs. 320.33 DU, p = 0.001) groups. The HMGB1 level in MIS-C patients with coronary involvement had a slightly higher value with respect to patients without coronary dilatation (1,225.36 vs. 1,030.49 DU, p = 0.248). In two of the five children with MIS-C that performed a follow-up, the HMGB1 value decreased to levels that were superimposable to the ones of the control group. CONCLUSION The significantly high level of HMGB1 protein found in the serum of COVID-19 and patients with MIS-C supports its involvement in inflammatory manifestations, suggesting HMGB1 as a potential biomarker and therapeutic target in patients with severe illness.
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Affiliation(s)
- Laura Petrarca
- Maternal Infantile and Urological Sciences Department, Sapienza University of Rome, Rome, Italy.,Translational and Precision Medicine Department, Sapienza University of Rome, Rome, Italy
| | - Valeria Manganelli
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Raffaella Nenna
- Maternal Infantile and Urological Sciences Department, Sapienza University of Rome, Rome, Italy
| | | | - Shira Ben David
- Maternal Infantile and Urological Sciences Department, Sapienza University of Rome, Rome, Italy
| | - Enrica Mancino
- Maternal Infantile and Urological Sciences Department, Sapienza University of Rome, Rome, Italy.,Translational and Precision Medicine Department, Sapienza University of Rome, Rome, Italy
| | - Tina Garofalo
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Maurizio Sorice
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Roberta Misasi
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Fabio Midulla
- Maternal Infantile and Urological Sciences Department, Sapienza University of Rome, Rome, Italy
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24
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Armin S, Mirkarimi M, Pourmoghaddas Z, Tariverdi M, Shamsizadeh A, Alisamir M, Mohammadian M, Rahmati MB, Rafiei Tabatabaei S, Mansour Ghanaiee R, Fahimzad SA, Yaraghi A, Hoseini-Alfatemi SM, Marhamati N, Esmaeili Tarki F, Shirvani A, Karimi A. Evidence-Based Prediction of COVID-19 Severity in Hospitalized Children. Int J Clin Pract 2022; 2022:1918177. [PMID: 35685588 PMCID: PMC9159143 DOI: 10.1155/2022/1918177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 03/18/2022] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE In this study, by using clinical and paraclinical characteristics, we have aimed to predict the severity of the disease in hospitalized COVID-19 children. METHOD This cross-sectional study was conducted on medical records about epidemiologic data, underlying diseases, symptoms, and laboratory tests from March to October, 2020, on 238 hospitalized confirmed COVID-19 paediatric cases in several children's hospitals of Tehran, Ahwaz, Isfahan, and Bandar Abbas. RESULTS From 238 patients, 140 (59%) were male and most of them were in the age group of 1 to 5 years (34.6%). Among all hospitalized patients, 38% had an underlying disease and in total, 5% of cases were expired. CONCLUSION Determining patient severity is essential for appropriate clinical decision making; our results showed that in hospitalized pediatric patients, by using several variables such as SGOT, CRP, ALC, LDH, WBC, O2sat, and ferritin, we can use clinical and paraclinical characteristics for predicting the severity of COVID-19.
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Affiliation(s)
- Shahnaz Armin
- Pediatric Infections Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Mirkarimi
- Aboozar Children's Medical Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Zahra Pourmoghaddas
- Pediatrics Infectious Disease Department, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Marjan Tariverdi
- Department of Pediatric, Clinical Research Development Center of Children Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Ahmad Shamsizadeh
- Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohsen Alisamir
- Aboozar Children's Medical Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maryam Mohammadian
- Department of Pediatric, Clinical Research Development Center of Children Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Mohammad Bagher Rahmati
- Department of Pediatric Infectious Diseases, Children's Clinical Research Development Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Sedigheh Rafiei Tabatabaei
- Pediatric Infections Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Roxana Mansour Ghanaiee
- Pediatric Infections Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Alireza Fahimzad
- Pediatric Infections Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ayeh Yaraghi
- Pediatric Infections Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyedeh Mahsan Hoseini-Alfatemi
- Pediatric Infections Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Noushin Marhamati
- Pediatric Infections Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Esmaeili Tarki
- Pediatric Infections Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Armin Shirvani
- Virtual School of Medical Education and Management, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abdollah Karimi
- Pediatric Infections Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Sharma R, Agarwal A, Ranjan A, Jayashree M, Kumar P. Mortality audit of COVID-19 infection among children. Indian J Med Res 2022; 155:505-509. [PMID: 36124499 PMCID: PMC9807188 DOI: 10.4103/ijmr.ijmr_2500_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Background & objectives As severe COVID-19 and mortality are not common in children, there is a scarcity of data regarding the cause of mortality in children infected with SARS-CoV-2. This study was aimed to describe the all-cause mortality and COVID-19 death (disease-specific mortality) in children with SARS-CoV-2 infection admitted to a paediatric COVID facility in a tertiary care centre. Methods Data with respect to clinical, epidemiological profile and causes of death in non-survivors (0-12 yr old) of SARS-CoV-2 infection admitted to a dedicated tertiary care COVID hospital in north India between April 2020 and June 2021 were retrieved and analyzed retrospectively. Results A total of 475 SARS-CoV-2-positive children were admitted during the study period, of whom 47 died [18 neonates, 14 post-neonatal infants and 15 children (1-12 yr of age)]. The all-cause mortality and COVID-19 death (disease-specific mortality) were 9.9 per cent (47 of 475) and 1.9 per cent (9 of 475), respectively. Underlying comorbidities were present in 35 (74.5%) children, the most common being prematurity and perinatal complications (n=11, 24%) followed by congenital heart disease (n=6, 13%). The common causes of death included septic shock in 10 (21%), COVID pneumonia/severe acute respiratory distress syndrome in nine (19%), neonatal illnesses in eight (17%), primary central nervous system disease in seven (15%) and congenital heart disease with complication in six (13%) children. Interpretation & conclusions Our results showed a high prevalence of underlying comorbidities and a low COVID-19 death (disease-specific mortality). Our findings highlight that mortality due to COVID-19 can be overestimated if COVID-19 death and all-cause mortality in children infected with SARS-CoV-2 are not separated. Standardized recording of cause of death in children with SARS-CoV-2 infection is important.
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Affiliation(s)
- Raman Sharma
- Division of Paediatric Emergency & Critical Care, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Ashish Agarwal
- Division of Paediatric Emergency & Critical Care, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Ankit Ranjan
- Division of Neonatology, Department of Paediatrics, Advanced Paediatrics Centre, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Muralidharan Jayashree
- Division of Paediatric Emergency & Critical Care, Postgraduate Institute of Medical Education & Research, Chandigarh, India,For correspondence: Dr Muralidharan Jayashree, Division of Paediatric Emergency & Critical Care, Department of Paediatrics, Advanced Paediatrics Centre, Postgraduate Institute of Medical Education & Research, Chandigarh 160 012, India e-mail:
| | - Praveen Kumar
- Division of Neonatology, Department of Paediatrics, Advanced Paediatrics Centre, Postgraduate Institute of Medical Education & Research, Chandigarh, India
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Nikolopoulou GB, Maltezou HC. COVID-19 in Children: Where do we Stand? Arch Med Res 2022; 53:1-8. [PMID: 34311990 PMCID: PMC8257427 DOI: 10.1016/j.arcmed.2021.07.002] [Citation(s) in RCA: 121] [Impact Index Per Article: 60.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 06/26/2021] [Accepted: 07/01/2021] [Indexed: 01/05/2023]
Abstract
From the beginning of the coronavirus disease 2019 (COVID-19) pandemic it became evident that children infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remain mostly asymptomatic or mildly symptomatic. We reviewed the epidemiologic and clinical features of children with SARS-CoV-2 infection. The true prevalence of asymptomatic SARS-CoV-2 infection is most likely underestimated, as asymptomatic children are less frequently tested. Serologic surveys indicate that half of children tested positive for SARS-CoV-2 report no symptoms. Anosmia/ageusia is not frequent in children but it is the strongest predictor of a positive SARS-CoV-2 test. In general, children with COVID-19 are at lower risk of hospitalization and life-threatening complications. Nevertheless, cases of severe disease or a post-infectious multisystem hyperinflammatory syndrome named multisystem inflammatory syndrome in children (MIS-C) have been described. Rarely children with severe COVID-19 develop neurologic complications. In addition, studies indicate that school closures have a limited impact on SARS-CoV-2 transmission, much less than other social distancing measures. The past months new SARS-CoV-2 variants emerged with higher transmissibility and an increased impact on morbidity and deaths. The role of children in the transmission dynamics of these variants must be elucidated. Lastly, preliminary results from COVID-19 vaccine trials indicate very good efficacy and tolerability in children. Very recently the United States Centers for Disease Control and Prevention and other public health authorities recommend vaccination of children 12 years or older to protect them but mostly to contribute to the achievement of herd immunity.
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Affiliation(s)
| | - Helena C. Maltezou
- Directorate of Research, Studies and Documentation, National Public Health Organization, Athens, Greece,Address reprint requests to: Helena C. Maltezou, Dr. Directorate of Research, Studies and Documentation, National Public Health Organization, 3-5 Agrafon Street, Marousi, 15123 Athens, Greece; Phone: 0030-210-5212175
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Jafarpour R, Pashangzadeh S, Dowran R. Host factors: Implications in immunopathogenesis of COVID-19. Pathol Res Pract 2021; 228:153647. [PMID: 34749207 PMCID: PMC8505027 DOI: 10.1016/j.prp.2021.153647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 10/03/2021] [Accepted: 10/04/2021] [Indexed: 02/07/2023]
Abstract
Coronavirus disease 2019 (COVID-19) is a viral disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 is more serious in people with underlying diseases, but the cause of healthy people with progressive disease is largely unknown. Host genetic factors such as ACE2 variants, IFITM-3, HLA, TMRSS2, and furin polymorphisms appear to be one of the agents involved in the progression of the COVID-19 and outcome of the disease. This review discusses the general characteristics of SARS-CoV-2, including viral features, receptors, cell entry, clinical findings, and the main human genetic factors that may contribute to the pathogenesis of COVID-19 and get the patients' situation more complex. Further knowledge in this context may help to find a way to prevent and treat this viral pneumonia.
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Affiliation(s)
- Roghayeh Jafarpour
- Department of Immunology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Salar Pashangzadeh
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran,Immunology Today, Universal Scientific Education and Research Network (USERN), Tehan, Iran
| | - Razieh Dowran
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran,Research Center for Clinical Virology, Tehran University of Medical Sciences, Tehran, Iran,Corresponding author at: Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Charla Y, Kalra M, Chopra N, Choudhury S. COVID-19 vaccination in pediatric cancer patients: A high priority. Pediatr Blood Cancer 2021; 68:e29397. [PMID: 34636133 PMCID: PMC8661652 DOI: 10.1002/pbc.29397] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 09/21/2021] [Indexed: 12/18/2022]
Affiliation(s)
- Yashika Charla
- Department of ResearchSir Ganga Ram HospitalNew DelhiIndia
| | - Manas Kalra
- Department of Pediatric Hematology, Oncology and BMT, Sir Ganga Ram HospitalNew DelhiIndia
| | - Neha Chopra
- Department of ResearchSir Ganga Ram HospitalNew DelhiIndia,Spine Labs, St. George and Southerland Clinical SchoolUniversity of New South WalesKogarahNew South WalesAustralia
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Soleimani G, Akbarirad F, Shafighi Shahri E, Sajjadi SM. Demographic, clinical, and paraclinical characteristics of COVID-19 pediatric cases in southeast Iran. Antimicrob Resist Infect Control 2021; 10:165. [PMID: 34838145 PMCID: PMC8626734 DOI: 10.1186/s13756-021-01020-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 10/04/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Even though children seem to be less vulnerable to the Coronavirus disease 2019 (COVID-19) infection, still a diverse range of clinical presentations and symptoms have been reported in children. Few studies assessed the clinical presentations of COVID-19 among Iranian children. We aimed to evaluate the clinical and paraclinical characteristics of COVID-19 infected children. METHODS All COVID-19 suspected and confirmed children were referred to the Ali-ibn-Abitaleb Hospital, Zahedan, Iran. Patients were included in this longitudinal study. Patients were evaluated at admission and during hospitalization. Patients with some of the main COVID symptoms with positive PCR test were defined as confirmed cases. Clinical, imaging and laboratory results were collected for all patients. RESULTS A total of 62 patients participated in this study. The male:female ratio was 1:1.03. There was a significant difference in fatigue prevalence between age groups (P = 0.002). There was no significant difference between groups in terms of fever duration (P = 0.624) and maximum temperature (P = 0.629). There was a significant difference between PCR positive and negative patients in terms of neurologic signs (P = 0.003), Intensive care unit admission (P = 0.001), white blood cell (P = 0.047). CONCLUSIONS Even though our population was small, most of the findings matched other studies conducted on pediatric cases in Iran or other countries. It was also found that some clinical features such as pneumonia, cough, diarrhea, and tachycardia at admission time were statistically different among age groups.
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Affiliation(s)
- Gholamreza Soleimani
- Department of Pediatrics, School of Medicine, Children and Adolescents Health Research Center, Ali-Ibn-Abitaleb Hospital, Zahedan, Iran
| | - Fatemeh Akbarirad
- Department of Pediatrics, Ali-ebne-Abitaleb Hospital, Zehedan University of Medical Sciences, Zahedan, Iran
| | - Elham Shafighi Shahri
- Department of Pediatrics, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Seyyed Masoud Sajjadi
- Department of Cardiovascular Disease, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
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Di Cicco M, Tozzi MG, Ragazzo V, Peroni D, Kantar A. Chronic respiratory diseases other than asthma in children: the COVID-19 tsunami. Ital J Pediatr 2021; 47:220. [PMID: 34742332 PMCID: PMC8571868 DOI: 10.1186/s13052-021-01155-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 09/02/2021] [Indexed: 01/07/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) affects all components of the respiratory system, including the neuromuscular breathing apparatus, conducting and respiratory airways, pulmonary vascular endothelium, and pulmonary blood flow. In contrast to other respiratory viruses, children have less severe symptoms when infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A minority of children experience a post-infectious inflammatory syndrome, the pathology and long-term outcomes of which are poorly understood. The reason for the lower burden of symptomatic disease in children is not yet clear, but several pathophysiological characteristics are postulated. The SARS-CoV-2 pandemic has brought distinct challenges to the care of children globally. Proper recommendations have been proposed for a range of non-asthmatic respiratory disorders in children, including primary ciliary dyskinesia and cystic fibrosis. These recommendations involve the continuation of the treatment during this period and ways to maintain stability. School closures, loss of follow-up visit attendance, and loss of other protective systems for children are the indirect outcomes of measures to mitigate the COVID-19 pandemic. Moreover, COVID-19 has reshaped the delivery of respiratory care in children, with non-urgent and elective procedures being postponed, and distancing imperatives have led to rapid scaling of telemedicine. The pandemic has seen an unprecedented reorientation in clinical trial research towards COVID-19 and a disruption in other trials worldwide, which will have long-lasting effects on medical science. In this narrative review, we sought to outline the most recent findings on the direct and indirect effects of SARS-CoV-2 pandemic on pediatric respiratory chronic diseases other than asthma, by critically revising the most recent literature on the subject.
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Affiliation(s)
- Maria Di Cicco
- Allergology Section, Paediatrics Unit, Pisa University Hospital, Via Roma n. 67, 56126, Pisa, Italy.
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma n. 55, 56126, Pisa, Italy.
| | - Maria Giulia Tozzi
- Allergology Section, Paediatrics Unit, Pisa University Hospital, Via Roma n. 67, 56126, Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma n. 55, 56126, Pisa, Italy
| | - Vincenzo Ragazzo
- Paediatrics and Neonatology Division, Women's and Children's Health Department, Versilia Hospital, Via Aurelia n. 335, Lido Di Camaioree, Italy, 55049
| | - Diego Peroni
- Allergology Section, Paediatrics Unit, Pisa University Hospital, Via Roma n. 67, 56126, Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma n. 55, 56126, Pisa, Italy
| | - Ahmad Kantar
- Paediatric Asthma and Cough Centre, Istituti Ospedalieri Bergamaschi - Gruppo Ospedaliero San Donato, via Forlanini n. 15, 24036, Ponte S. Pietro - Bergamo, Italy
- Vita-Salute San Raffaele University, Via Olgettina n. 58, 20132, Milan, Italy
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Meyyazhagan A, Pushparaj K, Balasubramanian B, Kuchi Bhotla H, Pappusamy M, Arumugam VA, Easwaran M, Pottail L, Mani P, Tsibizova V, Di Renzo GC. COVID-19 in pregnant women and children: Insights on clinical manifestations, complexities, and pathogenesis. Int J Gynaecol Obstet 2021; 156:216-224. [PMID: 34735717 PMCID: PMC9087615 DOI: 10.1002/ijgo.14007] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 10/27/2021] [Accepted: 11/02/2021] [Indexed: 12/16/2022]
Abstract
Pregnancy changes the body's immune system to counteract the spectrum of infections, including COVID-19, which can pose complications. Pregnant women are less likely to contract COVID-19 infections than the general public. However, pregnant women are at slightly increased risk of becoming severely unwell if they do catch COVID-19, and congenital conditions in pregnant women may worsen the state of infection and lead to critical stages and even mortality. The possibility of vertical transmission has been reported in only a few cases of COVID-19; however, it was not noted in cases of SARS and MERS. Vaccination coverage in pregnant women remains a challenge. Children are the next suspected and vulnerable population to acquire infection after the first and second waves. Children are disproportionately infected compared with older populations, but the severity of infection is less compared to adults. This review highlights the complexities of COVID-19 in pregnant women and the underlying reasons why children tend to be comparatively less severely affected. Ethnicity, nutrition, lifestyle, and therapeutics influence the severity of infection in children. Low expression of angiotensin-converting enzyme 2 receptors, indigenous virus competence, and maternal immunity is the first-line defense for children against COVID-19. Habituating herbal medicines from childhood may help support a robust and defensive immune system to counteract novel antigens and encourage healthy generations.
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Affiliation(s)
- Arun Meyyazhagan
- Department of Obstetrics and Gynecology and Centre for Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy.,Department of Life Sciences, CHRIST (Deemed to be University), Bengaluru, Karnataka, India
| | - Karthika Pushparaj
- Department of Zoology, Avinashilingam Institute for Home Science and Higher Education for Women, Coimbatore, Tamil Nadu, India
| | | | - Haripriya Kuchi Bhotla
- Department of Life Sciences, CHRIST (Deemed to be University), Bengaluru, Karnataka, India
| | - Manikantan Pappusamy
- Department of Life Sciences, CHRIST (Deemed to be University), Bengaluru, Karnataka, India
| | - Vijaya Anand Arumugam
- Medical Genetics and Epigenetics Laboratory, Department of Human Genetics and Molecular Biology, Bharathiar University, Coimbatore, Tamil Nadu, India
| | - Murugesh Easwaran
- Nutritional Improvement of Crops, International Centre for Genetic Engineering and Biotechnology, New Delhi, India
| | - Lalitha Pottail
- Department of Chemistry, School of Physical and Computational Sciences, Avinashilingam Institute for Home Science and Higher Education for Women, Coimbatore, Tamil Nadu, India
| | - Poonkothai Mani
- Department of Zoology, Avinashilingam Institute for Home Science and Higher Education for Women, Coimbatore, Tamil Nadu, India
| | - Valentina Tsibizova
- Institute of Perinatology and Pediatrics, Almazov National Medical Research Centre, Saint Petersburg, Russian Federation
| | - Gian Carlo Di Renzo
- Department of Obstetrics and Gynecology and Centre for Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy
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Petrara MR, Bonfante F, Costenaro P, Cantarutti A, Carmona F, Ruffoni E, Di Chiara C, Zanchetta M, Barzon L, Donà D, Da Dalt L, Bortolami A, Pagliari M, Plebani M, Rossi P, Cotugno N, Palma P, Giaquinto C, De Rossi A. Asymptomatic and Mild SARS-CoV-2 Infections Elicit Lower Immune Activation and Higher Specific Neutralizing Antibodies in Children Than in Adults. Front Immunol 2021; 12:741796. [PMID: 34659235 PMCID: PMC8515185 DOI: 10.3389/fimmu.2021.741796] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 09/10/2021] [Indexed: 12/24/2022] Open
Abstract
Background The immune response plays a pivotal role in dictating the clinical outcome in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected adults, but it is still poorly investigated in the pediatric population. Methods Of 209 enrolled subjects, 155 patients were confirmed by PCR and/or serology as having coronavirus disease 2019 (COVID-19). Blood samples were obtained at a median of 2.8 (interquartile, 2.1–3.7) and 6.1 (5.3–7.2) months after baseline (symptom onset and/or first positive virus detection). The immune profiles of activation, senescence, exhaustion, and regulatory cells were analyzed by flow cytometry. Neutralizing antibodies (nAbs) were detected by a plaque reduction neutralization test. In available nasopharyngeal swabs at baseline, SARS-CoV-2 levels were quantified by digital droplet PCR (ddPCR). Results Overall, COVID-19 patients had higher levels of immune activation, exhaustion, and regulatory cells compared to non-COVID-19 subjects. Within the COVID-19 group, activated and senescent cells were higher in adults than in children and inversely correlated with the nAbs levels. Conversely, Tregs and Bregs regulatory cells were higher in COVID-19 children compared to adults and positively correlated with nAbs. Higher immune activation still persisted in adults after 6 months of infection, while children maintained higher levels of regulatory cells. SARS-CoV-2 levels did not differ among age classes. Conclusions Adults displayed higher immune activation and lower production of anti-SARS-CoV-2 nAbs than children. The different immune response was not related to different viral load. The higher expression of regulatory cells in children may contribute to reduce the immune activation, thus leading to a greater specific response against the virus.
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Affiliation(s)
- Maria Raffaella Petrara
- Oncology and Immunology Section, Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
| | - Francesco Bonfante
- Department of Comparative Biomedical Sciences, Istituto Zooprofilattico Sperimentale delle Venezie (IZSVe), Virology Laboratory, Legnaro, Italy
| | - Paola Costenaro
- Division of Pediatric Infectious Diseases, Department for Women's and Children's Health, University of Padova, Padova, Italy
| | - Anna Cantarutti
- Laboratory of Healthcare Research and Pharmacoepidemiology, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milano, Italy
| | - Francesco Carmona
- Immunology and Diagnostic Molecular Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - Elena Ruffoni
- Immunology and Diagnostic Molecular Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - Costanza Di Chiara
- Division of Pediatric Infectious Diseases, Department for Women's and Children's Health, University of Padova, Padova, Italy
| | - Marisa Zanchetta
- Immunology and Diagnostic Molecular Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - Luisa Barzon
- Department of Molecular Medicine, University of Padova, Padova, Italy
| | - Daniele Donà
- Division of Pediatric Infectious Diseases, Department for Women's and Children's Health, University of Padova, Padova, Italy
| | - Liviana Da Dalt
- Division of Pediatric Infectious Diseases, Department for Women's and Children's Health, University of Padova, Padova, Italy
| | - Alessio Bortolami
- Department of Comparative Biomedical Sciences, Istituto Zooprofilattico Sperimentale delle Venezie (IZSVe), Virology Laboratory, Legnaro, Italy
| | - Matteo Pagliari
- Department of Comparative Biomedical Sciences, Istituto Zooprofilattico Sperimentale delle Venezie (IZSVe), Virology Laboratory, Legnaro, Italy
| | - Mario Plebani
- Department of Laboratory Medicine, University-Hospital of Padova, Padova, Italy.,Department of Medicine-DIMED, University of Padova, Padova, Italy
| | - Paolo Rossi
- Clinical and Research Unit of Clinical Immunology and Vaccinology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.,Chair of Pediatrics, Department of Systems Medicine, University of Rome "Tor Vergata", Roma, Italy
| | - Nicola Cotugno
- Clinical and Research Unit of Clinical Immunology and Vaccinology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.,Chair of Pediatrics, Department of Systems Medicine, University of Rome "Tor Vergata", Roma, Italy
| | - Paolo Palma
- Clinical and Research Unit of Clinical Immunology and Vaccinology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.,Chair of Pediatrics, Department of Systems Medicine, University of Rome "Tor Vergata", Roma, Italy
| | - Carlo Giaquinto
- Division of Pediatric Infectious Diseases, Department for Women's and Children's Health, University of Padova, Padova, Italy
| | - Anita De Rossi
- Oncology and Immunology Section, Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy.,Immunology and Diagnostic Molecular Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
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Naranjo Arango YA, Farfán Cortés AYAA, García Henao JP, Arango Slingsby C, Saldarriaga Rivera LM. Síndrome inflamatorio multisistémico en niños con COVID-19: una visión desde la reumatología. REVISTA COLOMBIANA DE REUMATOLOGÍA 2021. [PMCID: PMC7568207 DOI: 10.1016/j.rcreu.2020.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
La enfermedad por coronavirus 2019 (COVID-19), producida por el SARS-CoV-2, ha tomado una gran importancia en los últimos meses y se encuentra bajo constante investigación por distintas áreas de la medicina, incluida la reumatología, en la búsqueda de la mejor evidencia científica. En el caso de la población pediátrica cobra especial importancia puesto que en un principio se pensaba que el impacto de la pandemia en esta población sería menor, debido a la baja presencia de casos severos, pero la evidencia actual reporta la existencia de cuadros clínicos en niños con diagnóstico de COVID-19 que se caracterizan por un estado inflamatorio alterado consistente en una tormenta de citocinas proinflamatorias que produce manifestaciones similares a las presentadas en enfermedades autoinmunes como la enfermedad de Kawasaki. Se le ha denominado síndrome inflamatorio multisistémico en niños asociado temporalmente con SARS-CoV-2, el cual en muchos casos precisa internación en unidades de cuidados intensivos pediátricos y el manejo multidisciplinario por diversas especialidades.
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Navarro-Olivos E, Padilla-Raygoza N, Flores-Vargas G, Gallardo-Luna MDJ, León-Verdín MG, Lara-Lona E, Magos-Vázquez FJ, Díaz-Martínez DA. COVID-19-Associated Case Fatality Rate in Subjects Under 18 Years Old in Mexico, up to December 31, 2020. Front Pediatr 2021; 9:696425. [PMID: 34660475 PMCID: PMC8517252 DOI: 10.3389/fped.2021.696425] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 08/31/2021] [Indexed: 12/24/2022] Open
Abstract
Background: The emergence of the SARS-CoV-2 and the COVID-19 have become a global health crisis. The infection has been present in all the social sectors. Subjects under 18 years are one of them. The objective was to analyze the case fatality ratio of COVID-19 cases in the Mexican population under 18 years of age registered in the National Epidemiological Surveillance System from March 2020 to December 31, 2020. Material and Methods: The design is cross-sectional, quantitative, and analytical. All the suspected cases of respiratory viral disease, with a real-time polymerase chain reaction (RT-PCR) test result, aged from 0 to 17 years, were included. Descriptive statistics are presented for all the variables. Epidemiological curves were designed. The chi-squared test and its P-values were obtained to show the relationship between comorbidities and death. The case fatality ratio was computed for each comorbidity, sex, and age group. Multivariable logistic regression models were fitted to study the effect between comorbidities with the fatality of cases, adjusting for sex and age group as potential confounders. The alpha value was fixed to 0.05 to assess significance. Results: The number of records for this study was 167,856. Among them, 48,505 were from SARS-CoV-2-positive patients (28.90%), and 119,351 (71.10%) were negative. Of those who died, males (55.29%) (P < 0.05) and those under 2 years of age (50.35%) (P < 0.05) predominated. Unlike in older populations, from the comorbidities considered risk factors for death by COVID-19, only immunosuppression showed a statistically significant effect on the fatality of cases after adjustment by the other related variables. Sex and age group were not confounders for the models in those under 18 years old. Pneumonia, being younger than 5 years, and immunosuppression are related to death. Conclusion: The case fatality ratio in those under 18 years old is low. Special attention must be paid to those children under 5 years. The development of pneumonia is a warning indicator while treating them. On the other hand, having an open database of cases allows the researchers to analyze the impact of COVID-19 in different population sectors, which has clear benefits for public health.
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Affiliation(s)
- Efraín Navarro-Olivos
- Directorate of Teaching and Research, Institute of Public Health From Guanajuato State, Guanajuato, Mexico
| | - Nicolás Padilla-Raygoza
- Department of Research and Technological Development, Directorate of Teaching and Research, Institute of Public Health From Guanajuato State, Guanajuato, Mexico
| | - Gilberto Flores-Vargas
- Department of Research and Technological Development, Directorate of Teaching and Research, Institute of Public Health From Guanajuato State, Guanajuato, Mexico
| | - María de Jesús Gallardo-Luna
- Department of Research and Technological Development, Directorate of Teaching and Research, Institute of Public Health From Guanajuato State, Guanajuato, Mexico
| | - Ma Guadalupe León-Verdín
- Department of Research and Technological Development, Directorate of Teaching and Research, Institute of Public Health From Guanajuato State, Guanajuato, Mexico
| | - Elia Lara-Lona
- Department of Medicine and Nutrition, Division of Health Sciences, Universidad de Guanajuato, León, Mexico
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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: 3.0] [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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Totan M, Gligor FG, Duică L, Grigore N, Silișteanu S, Maniu I, Antonescu E. A Single-Center (Sibiu, Romania), Retrospective Study (March-November 2020) of COVID-19 Clinical and Epidemiological Features in Children. J Clin Med 2021; 10:jcm10163517. [PMID: 34441813 PMCID: PMC8396872 DOI: 10.3390/jcm10163517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/06/2021] [Accepted: 08/06/2021] [Indexed: 12/17/2022] Open
Abstract
The aim of this study was to describe and analyze epidemiological and clinical features of children screened for COVID-19 at Sibiu Pediatric Clinical Hospital during the first 9 months (March–November) of coronavirus disease pandemic in Romania. A total of 203 pediatric patients with a confirmed diagnosis of COVID-19 were included in the study. The median age of the patients was 121 (IQR 18–181) months and 52.22% had mild clinical type with pneumonia, 35.47% were moderate cases, 3.94% severe cases, 0.99% critically ill cases and 7.39% were asymptomatic. The most common symptoms were fever (n = 130, 64.03%), nasal congestion (n = 138, 67.98%), cough (n = 128, 63.05%) followed by sore throat (n = 64, 31.52%), rhinorrhea (n = 63, 31.03%), fatigue (n = 57, 28.07%), headache (n = 47, 23.15%), diarrhea (n = 39, 19.21%), vomiting (n = 32, 15.76%), myalgia (n = 24, 11.82%), abdominal pain (n = 22, 10.83%). A higher proportion of infants with severe or critical disease was encountered with lymphopenia (n = 9, 90%), neutrophilia (n = 5, 50%), leukocytosis (n = 5, 50%) compared with asymptomatic infants (n = 10, 66.67%, n = 1, 6.67%, n = 3, 20%) or mild (n = 53, 50%, n = 19, 17.92%, n = 15, 14.15%) and moderate (n = 37, 51.39%, n = 9, 12.50%, n = 6, 8.33%) cases (p = 0.095, p = 0.042, p = 0.034). Pediatric patients generally had mild or moderate type of COVID-19, and the critically ill cases were rare. In our study, frequent symptoms were observed in both the systemic and respiratory systems, ear, nose and throat system, and less from gastrointestinal system, central nervous system or ocular system. Additionally, there is an increase in liver and myocardial enzyme levels with an increase in disease severity. Understanding the clinical and laboratory characteristics of pediatric patients is important for diagnosis, management and effective control of the disease.
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Affiliation(s)
- Maria Totan
- Faculty of Medicine, Lucian Blaga University of Sibiu, 2A Lucian Blaga Str., 550169 Sibiu, Romania; (F.G.G.); (L.D.); (N.G.); (E.A.)
- Clinical Laboratory, Clinical Pediatric Hospital, 2-4 Pompeiu Onofreiu Str., 550166 Sibiu, Romania
- Correspondence: (M.T.); (I.M.)
| | - Felicia Gabriela Gligor
- Faculty of Medicine, Lucian Blaga University of Sibiu, 2A Lucian Blaga Str., 550169 Sibiu, Romania; (F.G.G.); (L.D.); (N.G.); (E.A.)
| | - Lavinia Duică
- Faculty of Medicine, Lucian Blaga University of Sibiu, 2A Lucian Blaga Str., 550169 Sibiu, Romania; (F.G.G.); (L.D.); (N.G.); (E.A.)
| | - Nicolae Grigore
- Faculty of Medicine, Lucian Blaga University of Sibiu, 2A Lucian Blaga Str., 550169 Sibiu, Romania; (F.G.G.); (L.D.); (N.G.); (E.A.)
- County Clinical Emergency Hospital, 2-4 Corneliu Coposu Str., 550245 Sibiu, Romania
| | - Sinziana Silișteanu
- Department of Health and Human Development, Stefan cel Mare University of Suceava, 13 University Str., 720229 Suceava, Romania;
| | - Ionela Maniu
- Research Team, Pediatric Clinical Hospital Sibiu, 550166 Sibiu, Romania
- Research Center in Informatics and Information Technology, Mathematics and Informatics Department, Faculty of Sciences, “Lucian Blaga” University of Sibiu, 550025 Sibiu, Romania
- Correspondence: (M.T.); (I.M.)
| | - Elisabeta Antonescu
- Faculty of Medicine, Lucian Blaga University of Sibiu, 2A Lucian Blaga Str., 550169 Sibiu, Romania; (F.G.G.); (L.D.); (N.G.); (E.A.)
- County Clinical Emergency Hospital, 2-4 Corneliu Coposu Str., 550245 Sibiu, Romania
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Hashemi SMA, Thijssen M, Hosseini SY, Tabarraei A, Pourkarim MR, Sarvari J. Human gene polymorphisms and their possible impact on the clinical outcome of SARS-CoV-2 infection. Arch Virol 2021; 166:2089-2108. [PMID: 33934196 PMCID: PMC8088757 DOI: 10.1007/s00705-021-05070-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 02/23/2021] [Indexed: 12/13/2022]
Abstract
The SARS-CoV-2 pandemic has become one of the most serious health concerns globally. Although multiple vaccines have recently been approved for the prevention of coronavirus disease 2019 (COVID-19), an effective treatment is still lacking. Our knowledge of the pathogenicity of this virus is still incomplete. Studies have revealed that viral factors such as the viral load, duration of exposure to the virus, and viral mutations are important variables in COVID-19 outcome. Furthermore, host factors, including age, health condition, co-morbidities, and genetic background, might also be involved in clinical manifestations and infection outcome. This review focuses on the importance of variations in the host genetic background and pathogenesis of SARS-CoV-2. We will discuss the significance of polymorphisms in the ACE-2, TMPRSS2, vitamin D receptor, vitamin D binding protein, CD147, glucose-regulated protein 78 kDa, dipeptidyl peptidase-4 (DPP4), neuropilin-1, heme oxygenase, apolipoprotein L1, vitamin K epoxide reductase complex 1 (VKORC1), and immune system genes for the clinical outcome of COVID-19.
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Affiliation(s)
- Seyed Mohammad Ali Hashemi
- Department of Bacteriology and Virology, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Microbiology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Marijn Thijssen
- Laboratory for Clinical and Epidemiological Virology, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, 3000 Leuven, Belgium
| | - Seyed Younes Hosseini
- Department of Bacteriology and Virology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alijan Tabarraei
- Infectious Diseases Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Mahmoud Reza Pourkarim
- Laboratory for Clinical and Epidemiological Virology, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, 3000 Leuven, Belgium
- Health Policy Research Centre, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Jamal Sarvari
- Department of Bacteriology and Virology, Shiraz University of Medical Sciences, Shiraz, Iran
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Falsaperla R, Giacchi V, Lombardo G, Mauceri L, Lena G, Saporito MAN, Vitaliti G, Palumbo MA, Ruggieri M. Neonates Born to COVID-19 Mother and Risk in Management within 4 Weeks of Life: A Single-Center Experience, Systematic Review, and Meta-Analysis. Am J Perinatol 2021; 38:1010-1022. [PMID: 34082444 DOI: 10.1055/s-0041-1729557] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE The new coronavirus infection from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been recognized as a global public health emergency, and neonates may be more vulnerable due to their immature immune system. The first aim of this study was to report our experience on the management of neonates from mothers with SARS-CoV-2 infection focusing on a 28-day follow-up since birth. The second aim is to assess how many data on neonatal outcomes of the first month of life are reported in literature, performing a systematic review and meta-analysis. STUDY DESIGN We report our experience based on routine management of neonates born to mothers with SARS-CoV-2 infection and follow-up until 28 days of life. RESULTS In our experience at discharge, 1/48 (2.08%) of entrusted (mother refusing personal protective equipment) and none of separated presented positive nasopharyngeal swab (p = NS). All babies show good outcome at 28 days of life. The literature data show that the percentage of positive separated infants is significantly higher than the percentage of infants entrusted to positive mothers with appropriate control measures (13.63 vs. 2.4%; p = 0.0017). Meta-analysis of studies focused on follow-up showed a 2.94% higher risk of incidence of SARS-CoV-2 infection in entrusted newborns than in separated newborns (95% confidence interval: 0.39-22.25), but this was not significant (p = 0.30). CONCLUSION A vertical transmission in utero cannot be totally excluded. Since in newborns, the disease is often ambiguous with mild or absent symptoms, it is important to define the most efficient joint management for infants born to COVID-19 positive mothers, being aware that the risk of horizontal transmission from a positive mother, when protective measures are applied, does not seem to increase the risk of infection or to affect the development of newborns from birth to first four weeks of life, and encourages the benefits of breastfeeding and skin-to-skin practice. KEY POINTS · Entrusting the newborn to the positive mother does not increase the risk of infection.. · Our follow-up shows that newborns have good growth and outcome at one month of life.. · Applying protective measures we suggest breastfeeding and skin-to-skin practice..
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Affiliation(s)
- Raffaele Falsaperla
- Neonatal Intensive Care, San Marco Hospital, AUO Policlinico "G. Rodolico - San Marco", University of Catania, Catania, Italy.,Unit of Paediatrics and Pediatric Emergency, San Marco Hospital, AUO Policlinico "G. Rodolico - San Marco", Catania, Italy
| | - Valentina Giacchi
- Neonatal Intensive Care, San Marco Hospital, AUO Policlinico "G. Rodolico - San Marco", University of Catania, Catania, Italy
| | - Giulia Lombardo
- Department of Clinical and Experimental Medicine, Post Graduate Programme in Paediatrics, University of Catania, Catania, Italy
| | - Laura Mauceri
- Neonatal Intensive Care, San Marco Hospital, AUO Policlinico "G. Rodolico - San Marco", University of Catania, Catania, Italy
| | - Germana Lena
- Department of Clinical and Experimental Medicine, Post Graduate Programme in Paediatrics, University of Catania, Catania, Italy
| | - Marco Andrea Nicola Saporito
- Neonatal Intensive Care, San Marco Hospital, AUO Policlinico "G. Rodolico - San Marco", University of Catania, Catania, Italy
| | - Giovanna Vitaliti
- Unit of Paediatrics and Pediatric Emergency, San Marco Hospital, AUO Policlinico "G. Rodolico - San Marco", Catania, Italy
| | - Marco Antonio Palumbo
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - Martino Ruggieri
- Department of Clinical and Experimental Medicine Section of Paediatrics and Child Neuropsychiatry, AUO Policlinico "G. Rodolico - San Marco", University of Catania, Italy
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Böncüoğlu E, Coşkun M, Kıymet E, Öztürk Atasoy T, Şahinkaya Ş, Cem E, Düzgöl M, Yılmaz Çelebi M, Akaslan Kara A, Arıkan KÖ, Bayram N, Devrim İ. Can laboratory findings predict pulmonary involvement in children with COVID-19 infection? Pediatr Pulmonol 2021; 56:2489-2494. [PMID: 33983678 PMCID: PMC8242787 DOI: 10.1002/ppul.25452] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 04/05/2021] [Accepted: 04/30/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Studies investigating clinical and imaging findings of coronavirus disease 2019 (COVID-19) pneumonia and predictors for lung injury mostly focus on adults. In this study, we aimed to evaluate the role of laboratory findings in predicting lung involvement in children with COVID-19. METHODS Children with COVID-19 confirmed by reverse-transcription polymerase chain reaction or COVID-19 IgM and who underwent chest computed tomography (CT) scans were reviewed retrospectively. Admission absolute neutrophil count (ANC), absolute lymphocyte count (ALC), ANC/ALC ratio, platelet count, D-dimer, fibrinogen, ferritin, procalcitonin, C-reactive protein (CRP), and lactate dehydrogenase levels were compared in patients with normal and abnormal CT scans. RESULTS A total of 101 children were included. Among the patients, 68 (67.3%) had normal CT scans, and 33 (32.7%) had pulmonary involvement. The median CRP, ferritin, and fibrinogen levels were significantly higher in children with abnormal CT findings. The model of binary logistic regression based on the presence of cough, shortness of breath, fibrinogen, ferritin, and CRP levels showed that the possibility of having abnormal CT was 1.021 times more likely for every one unit increase in fibrinogen levels. CONCLUSION Fibrinogen might be useful to predict pulmonary involvement of COVID-19 in children. Restricting radiological imaging to patients with significant symptoms and high fibrinogen levels might be helpful in children with COVID-19 infections.
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Affiliation(s)
- Elif Böncüoğlu
- Department of Pediatric Infectious Diseases, University of Health Sciences Dr. Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital, İzmir, Turkey
| | - Mehmet Coşkun
- Department of Radiology, University of Health Sciences Dr. Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital, İzmir, Turkey
| | - Elif Kıymet
- Department of Pediatric Infectious Diseases, University of Health Sciences Dr. Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital, İzmir, Turkey
| | - Tülay Öztürk Atasoy
- Department of Radiology, University of Health Sciences Dr. Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital, İzmir, Turkey
| | - Şahika Şahinkaya
- Department of Pediatric Infectious Diseases, University of Health Sciences Dr. Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital, İzmir, Turkey
| | - Ela Cem
- Department of Pediatric Infectious Diseases, University of Health Sciences Dr. Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital, İzmir, Turkey
| | - Mine Düzgöl
- Department of Pediatric Infectious Diseases, University of Health Sciences Dr. Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital, İzmir, Turkey
| | - Miray Yılmaz Çelebi
- Department of Pediatric Infectious Diseases, University of Health Sciences Dr. Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital, İzmir, Turkey
| | - Aybüke Akaslan Kara
- Department of Pediatric Infectious Diseases, University of Health Sciences Dr. Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital, İzmir, Turkey
| | - Kamile Ö Arıkan
- Department of Pediatric Infectious Diseases, University of Health Sciences Dr. Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital, İzmir, Turkey
| | - Nuri Bayram
- Department of Pediatric Infectious Diseases, University of Health Sciences Dr. Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital, İzmir, Turkey
| | - İlker Devrim
- Department of Pediatric Infectious Diseases, University of Health Sciences Dr. Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital, İzmir, Turkey
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Monzani A, Tagliaferri F, Bellone S, Genoni G, Rabbone I. A Global Overview of COVID-19 Research in the Pediatric Field: Bibliometric Review. JMIR Pediatr Parent 2021; 4:e24791. [PMID: 34081597 PMCID: PMC8315163 DOI: 10.2196/24791] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 04/20/2021] [Accepted: 05/11/2021] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Since the beginning of the COVID-19 pandemic, a great number of papers have been published in the pediatric field. OBJECTIVE We aimed to assess research around the globe on COVID-19 in the pediatric field by bibliometric analysis, identifying publication trends and topic dissemination and showing the relevance of publishing authors, institutions, and countries. METHODS The Scopus database was comprehensively searched for all indexed documents published between January 1, 2020, and June 11, 2020, dealing with COVID-19 in the pediatric population (0-18 years). A machine learning bibliometric methodology was applied to evaluate the total number of papers and citations, journal and publication types, the top productive institutions and countries and their scientific collaboration, and core keywords. RESULTS A total of 2301 papers were retrieved, with an average of 4.8 citations per article. Of this, 1078 (46.9%) were research articles, 436 (18.9%) were reviews, 363 (15.8%) were letters, 186 (8.1%) were editorials, 7 (0.3%) were conference papers, and 231 (10%) were categorized as others. The studies were published in 969 different journals, headed by The Lancet. The retrieved papers were published by a total of 12,657 authors from 114 countries. The most productive countries were the United States, China, and Italy. The four main clusters of keywords were pathogenesis and clinical characteristics (keyword occurrences: n=2240), public health issues (n=352), mental health (n=82), and therapeutic aspects (n=70). CONCLUSIONS In the pediatric field, a large number of articles were published within a limited period on COVID-19, testifying to the rush to spread new findings on the topic in a timely manner. The leading authors, countries, and institutions evidently belonged to the most impacted geographical areas. A focus on the pediatric population was often included in general articles, and pediatric research about COVID-19 mainly focused on the clinical features, public health issues, and psychological impact of the disease.
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Affiliation(s)
- Alice Monzani
- Division of Pediatrics, Department of Health Sciences, Università del Piemonte Orientale, Novara, Italy
| | - Francesco Tagliaferri
- Division of Pediatrics, Department of Health Sciences, Università del Piemonte Orientale, Novara, Italy
| | - Simonetta Bellone
- Division of Pediatrics, Department of Health Sciences, Università del Piemonte Orientale, Novara, Italy
| | - Giulia Genoni
- Pediatric and Neonatal Intensive Care Unit, Maggiore della Carità University Hospital, Novara, Italy
| | - Ivana Rabbone
- Division of Pediatrics, Department of Health Sciences, Università del Piemonte Orientale, Novara, Italy
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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: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 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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42
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Jia Z, Yan X, Gao L, Ding S, Bai Y, Zheng Y, Cui Y, Wang X, Li J, Lu G, Xu Y, Zhang X, Li J, Chen N, Shang Y, Han M, Liu J, Zhou H, Li C, Lu W, Liu J, Wang L, Fan Q, Wu J, Shen H, Jiao R, Chen C, Gao X, Tian M, Lu W, Yang Y, Wong GWK, Wang T, Jin R, Shen A, Xu B, Shen K. Comparison of Clinical Characteristics Among COVID-19 and Non-COVID-19 Pediatric Pneumonias: A Multicenter Cross-Sectional Study. Front Cell Infect Microbiol 2021; 11:663884. [PMID: 34277466 PMCID: PMC8281119 DOI: 10.3389/fcimb.2021.663884] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 05/05/2021] [Indexed: 01/08/2023] Open
Abstract
Background The pandemic of Coronavirus Disease 2019 (COVID-19) brings new challenges for pediatricians, especially in the differentiation with non-COVID-19 pneumonia in the peak season of pneumonia. We aimed to compare the clinical characteristics of pediatric patients with COVID-19 and other respiratory pathogens infected pneumonias. Methods We conducted a multi-center, cross-sectional study of pediatric inpatients in China. Based on pathogenic test results, pediatric patients were divided into three groups, including COVID-19 pneumonia group, Non-COVID-19 viral (NCV) pneumonia group and Non-viral (NV) pneumonia group. Their clinical characteristics were compared by Kruskal-Wallis H test or chi-square test. Results A total of 636 pediatric pneumonia inpatients, among which 87 in COVID-19 group, 194 in NCV group, and 355 in NV group, were included in analysis. Compared with NCV and NV patients, COVID-19 patients were older (median age 6.33, IQR 2.00-12.00 years), and relatively fewer COVID-19 patients presented fever (63.2%), cough (60.9%), shortness of breath (1.1%), and abnormal pulmonary auscultation (18.4%). The results were verified by the comparison of COVID-19, respiratory syncytial virus (RSV) and influenza A (IFA) pneumonia patients. Approximately 42.5%, 44.8%, and 12.6% of the COVID-19 patients presented simply ground-glass opacity (GGO), simply consolidation, and the both changes on computed tomography (CT) scans, respectively; the proportions were similar as those in NCV and NV group (p>0.05). Only 47.1% of COVID-19 patients had both lungs pneumonia, which was significantly lower than that proportion of nearly 80% in the other two groups. COVID-19 patients presented lower proportions of increased white blood cell count (16.5%) and abnormal procalcitonin (PCT) (10.7%), and a higher proportion of decreased lymphocyte count (44.0%) compared with the other two groups. Conclusion Majority clinical characteristics of pediatric COVID-19 pneumonia patients were milder than non-COVID-19 patients. However, lymphocytopenia remained a prominent feature of COVID-19 pediatric pneumonia.
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Affiliation(s)
- Zhongwei Jia
- School of Public Health, Peking University, Beijing, China.,Center for Intelligent Public Health, Institute for Artificial Intelligence, Peking University, Beijing, China.,Center for Drug Abuse Control and Prevention, National Institute of Health Data Science, Peking University, Beijing, China
| | - Xiangyu Yan
- School of Public Health, Peking University, Beijing, China.,Center for Intelligent Public Health, Institute for Artificial Intelligence, Peking University, Beijing, China.,Center for Drug Abuse Control and Prevention, National Institute of Health Data Science, Peking University, Beijing, China
| | - Liwei Gao
- China National Clinical Research Center for Respiratory Diseases, Department of Respiratory Medicine, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, China.,Research Unit of Critical Infection in Children, Chinese Academy of Medical Sciences, Beijing, China
| | - Shenggang Ding
- Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yan Bai
- Pediatric Department, Union Hospital, Tongji Medical College, Huazhong University of Science And Technology, Hubei, China
| | - Yuejie Zheng
- Department of Respiratory Medicine, Shenzhen Children's Hospital, Shenzhen, China
| | - Yuxia Cui
- Department of Pediatrics, Guizhou Provincial People's Hospital, Guizhou, China
| | - Xianfeng Wang
- Department of Pediatrics, Shenzhen Third People's Hospital, Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China
| | - Jingfeng Li
- Department of Pediatrics, Taihe Hospital, Shiyan, China
| | - Gen Lu
- Department of Pediatric, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Yi Xu
- Department of Pediatric, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Xiangyu Zhang
- School of Public Health, Peking University, Beijing, China.,Center for Intelligent Public Health, Institute for Artificial Intelligence, Peking University, Beijing, China.,Center for Drug Abuse Control and Prevention, National Institute of Health Data Science, Peking University, Beijing, China
| | - Junhua Li
- Department of Pediatrics, Xiangyang Central Hospital, Xiangyang, China
| | - Ning Chen
- Department of Pediatric, Shengjing Hospital of China Medical University, Liaoning, China
| | - Yunxiao Shang
- Department of Pediatric, Shengjing Hospital of China Medical University, Liaoning, China
| | - Mingfeng Han
- Department of Respiratory Medicine, The Second People's Hospital of Fuyang, Anhui, China
| | - Jun Liu
- Department of Pediatrics, The People Hospital of Bozhou, Anhui, China
| | - Hourong Zhou
- Department of General Practice, Guizhou Provincial People's Hospital, Guiyang, Guizhou, China.,Office of Academic Research, Jiangjunshan Hospital, Guizhou, China
| | - Cen Li
- Department of Pediatrics, Guizhou Provincial People's Hospital, Guizhou, China
| | - Wanqiu Lu
- Department of Pediatrics, The Affiliated Hospital of Guizhou University, Guizhou, China
| | - Jun Liu
- China National Clinical Research Center for Respiratory Diseases, Department of Respiratory Medicine, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, China.,Research Unit of Critical Infection in Children, Chinese Academy of Medical Sciences, Beijing, China
| | - Lina Wang
- China National Clinical Research Center for Respiratory Diseases, Department of Respiratory Medicine, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, China.,Research Unit of Critical Infection in Children, Chinese Academy of Medical Sciences, Beijing, China
| | - Qihong Fan
- Department of Pediatrics, Jingzhou First People's Hospital, Jingzhou, China
| | - Jiang Wu
- Department of Pediatrics, Huangshi Maternity and Child Health Care Hospital, Huangshi, China
| | - Hanling Shen
- Department of Pediatrics, Suizhou Maternity and Child Health Care Hospital, Suizhou, China
| | - Rong Jiao
- Department of Pediatrics, Xiangyang First People's Hospital, Xiangyang, China
| | - Chunxi Chen
- Department of Pediatrics, Xishui People's Hospital, Huanggang, China
| | - Xiaoling Gao
- Department of Pediatrics, People's Hospital of Tuanfeng County, Huanggang, China
| | - Maoqiang Tian
- Department of Pediatrics, Tongren People's Hospital of Guizhou Province, Guizhou, China
| | - Wei Lu
- Department of Pediatrics, Yichang Central People's Hospital, Yichang, China
| | - Yonghong Yang
- Beijing Pediatric Research Institute, Beijing, China.,Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, China
| | - Gary Wing-Kin Wong
- Department of Pediatrics, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Tianyou Wang
- Center of Hematologic Oncology, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, China
| | - Runming Jin
- Pediatric Department, Union Hospital, Tongji Medical College, Huazhong University of Science And Technology, Hubei, China
| | - Adong Shen
- Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, China
| | - Baoping Xu
- China National Clinical Research Center for Respiratory Diseases, Department of Respiratory Medicine, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, China.,Research Unit of Critical Infection in Children, Chinese Academy of Medical Sciences, Beijing, China
| | - Kunling Shen
- China National Clinical Research Center for Respiratory Diseases, Department of Respiratory Medicine, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, China
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43
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La Regina DP, Nenna R, Schramm D, Freitag N, Goussard P, Eber E, Midulla F. The use of pediatric flexible bronchoscopy in the COVID-19 pandemic era. Pediatr Pulmonol 2021; 56:1957-1966. [PMID: 33730395 PMCID: PMC8251429 DOI: 10.1002/ppul.25358] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 02/01/2021] [Accepted: 02/21/2021] [Indexed: 12/11/2022]
Abstract
On March 11, 2020, the World Health Organization (WHO) declared the pandemic because of a novel coronavirus, called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In January 2020, the first transmission to healthcare workers (HCWs) was described. SARS-CoV-2 is transmitted between people because of contact, droplets, and airborne. Airborne transmission is caused by aerosols that remain infectious when suspended in air over long distances and time. In the clinical setting, airborne transmission may occur during aerosol generating procedures like flexible bronchoscopy. To date, although the role of children in the transmission of SARS-CoV-2 is not clear the execution of bronchoscopy is associated with a considerably increased risk of SARS-CoV-2 transmission to HCWs. The aim of this overview is to summarize available recommendations and to apply them to pediatric bronchoscopy. We performed systematic literature searches using the MEDLINE (accessed via PubMed) and Scopus databases. We reviewed major recommendations and position statements published at the moment by the American Association for Bronchology and Interventional Pulmonology, WHO, European Center for Disease Prevention and Control and expert groups on the management of patients with COVID-19 to limit transmission among HCWs. To date there is a lack of recommendations for safe bronchoscopy during the pandemic period. The main indications concern adults and little has been said about children. We have summarized available recommendations and we have applied them to pediatric bronchoscopy.
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Affiliation(s)
- Domenico Paolo La Regina
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Raffaella Nenna
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Dirk Schramm
- Department of General Pediatrics, Neonatology, and Pediatric Cardiology, University Children's Hospital Duesseldorf, Duesseldorf, Germany
| | - Nadine Freitag
- Department of General Pediatrics, Neonatology, and Pediatric Cardiology, University Children's Hospital Duesseldorf, Duesseldorf, Germany
| | - Pierre Goussard
- Department of Pediatrics and Child Health, Faculty of Medicine and Health Sciences, Tygerberg Hospital, Stellenbosch University, Cape Town, South Africa
| | - Ernst Eber
- Division of Pediatric Pulmonology and Allergology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
| | - Fabio Midulla
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
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44
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Massalska MA, Gober HJ. How Children Are Protected From COVID-19? A Historical, Clinical, and Pathophysiological Approach to Address COVID-19 Susceptibility. Front Immunol 2021; 12:646894. [PMID: 34177895 PMCID: PMC8226076 DOI: 10.3389/fimmu.2021.646894] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 05/21/2021] [Indexed: 01/08/2023] Open
Abstract
The origin and the global spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing coronavirus disease 2019 (COVID-19) in early 2020 was accompanied by high rates of mortality in regions belonging to the ancient silk road, such as the south of China, Iran, Turkey and the northern parts of Italy. However, children seem to be spared in the epidemic as very small percentage worldwide being ill. The protection of children and neonates suggests the involvement of a specific component of adaptive immunity present at early development. Native immunoglobulin belonging to the class of IgM is abundantly present in neonates and children and is known for its recognition of self- and altered self-antigens. Native IgM may be able to neutralize virus by the recognition of endogenous "danger signal" encoded in the viral envelope and originally imprinted in the membranes of infected and stressed cells. Noteworthy, thrombosis and vasculitis, two symptoms in severely affected adult and pediatric patients are shared between COVID-19 and patients with Behcet's disease, an autoimmune disorder exhibiting a region-specific prevalence in countries of the former silk road. Molecular mechanisms and clinical indicators suggest reactive oxygen species as trigger factor for severe progression of COVID-19 and establish a link to the innate immune defense against bacteria. The selective pressure exerted by bacterial pathogens may have shaped the genetics of inhabitants at this ancient trade route in favor of bacterial defense, to the detriment of severe COVID-19 progression in the 21th century.
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Affiliation(s)
- Magdalena Anna Massalska
- Department of Pathophysiology and Immunology, National Institute of Geriatrics, Rheumatology, and Rehabilitation, Warsaw, Poland
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45
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Porritt RA, Paschold L, Rivas MN, Cheng MH, Yonker LM, Chandnani H, Lopez M, Simnica D, Schultheiß C, Santiskulvong C, Van Eyk J, McCormick JK, Fasano A, Bahar I, Binder M, Arditi M. HLA class I-associated expansion of TRBV11-2 T cells in multisystem inflammatory syndrome in children. J Clin Invest 2021; 131:146614. [PMID: 33705359 PMCID: PMC8121516 DOI: 10.1172/jci146614] [Citation(s) in RCA: 121] [Impact Index Per Article: 40.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 03/04/2021] [Indexed: 12/12/2022] Open
Abstract
Multisystem inflammatory syndrome in children (MIS-C), a hyperinflammatory syndrome associated with SARS-CoV-2 infection, shares clinical features with toxic shock syndrome, which is triggered by bacterial superantigens. Superantigen specificity for different Vβ chains results in Vβ skewing, whereby T cells with specific Vβ chains and diverse antigen specificity are overrepresented in the T cell receptor (TCR) repertoire. Here, we characterized the TCR repertoire of MIS-C patients and found a profound expansion of TCRβ variable gene 11-2 (TRBV11-2), with up to 24% of clonal T cell space occupied by TRBV11-2 T cells, which correlated with MIS-C severity and serum cytokine levels. Analysis of TRBJ gene usage and complementarity-determining region 3 (CDR3) length distribution of MIS-C expanded TRBV11-2 clones revealed extensive junctional diversity. Patients with TRBV11-2 expansion shared HLA class I alleles A02, B35, and C04, indicating what we believe is a novel mechanism for CDR3-independent T cell expansion. In silico modeling indicated that polyacidic residues in the Vβ chain encoded by TRBV11-2 (Vβ21.3) strongly interact with the superantigen-like motif of SARS-CoV-2 spike glycoprotein, suggesting that unprocessed SARS-CoV-2 spike may directly mediate TRBV11-2 expansion. Overall, our data indicate that a CDR3-independent interaction between SARS-CoV-2 spike and TCR leads to T cell expansion and possibly activation, which may account for the clinical presentation of MIS-C.
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Affiliation(s)
- Rebecca A. Porritt
- Departments of Pediatrics, Division of Infectious Diseases and Immunology, Infectious and Immunologic Diseases Research Center (IIDRC) and Department of Biomedical Sciences and
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Lisa Paschold
- Department of Internal Medicine IV, Oncology/Hematology, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Magali Noval Rivas
- Departments of Pediatrics, Division of Infectious Diseases and Immunology, Infectious and Immunologic Diseases Research Center (IIDRC) and Department of Biomedical Sciences and
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Mary Hongying Cheng
- Department of Computational and Systems Biology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Lael M. Yonker
- Mucosal Immunology and Biology Research Center and Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Harsha Chandnani
- Department of Pediatrics, Loma Linda University Hospital, Loma Linda, California, USA
| | - Merrick Lopez
- Department of Pediatrics, Loma Linda University Hospital, Loma Linda, California, USA
| | - Donjete Simnica
- Department of Internal Medicine IV, Oncology/Hematology, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Christoph Schultheiß
- Department of Internal Medicine IV, Oncology/Hematology, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | | | - Jennifer Van Eyk
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - John K. McCormick
- Department of Microbiology and Immunology, University of Western Ontario, London, Ontario, Canada
| | - Alessio Fasano
- Mucosal Immunology and Biology Research Center and Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Ivet Bahar
- Department of Computational and Systems Biology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Mascha Binder
- Department of Internal Medicine IV, Oncology/Hematology, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Moshe Arditi
- Departments of Pediatrics, Division of Infectious Diseases and Immunology, Infectious and Immunologic Diseases Research Center (IIDRC) and Department of Biomedical Sciences and
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
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46
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Wehbe Z, Hammoud SH, Yassine HM, Fardoun M, El-Yazbi AF, Eid AH. Molecular and Biological Mechanisms Underlying Gender Differences in COVID-19 Severity and Mortality. Front Immunol 2021; 12:659339. [PMID: 34025658 PMCID: PMC8138433 DOI: 10.3389/fimmu.2021.659339] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 04/20/2021] [Indexed: 12/13/2022] Open
Abstract
Globally, over two million people have perished due to the recent pandemic caused by SARS-CoV-2. The available epidemiological global data for SARS-CoV-2 portrays a higher rate of severity and mortality in males. Analyzing gender differences in the host mechanisms involved in SARS-CoV-2 infection and progression may offer insight into the more detrimental disease prognosis and clinical outcome in males. Therefore, we outline sexual dimorphisms which exist in particular host factors and elaborate on how they may contribute to the pronounced severity in male COVID-19 patients. This includes disparities detected in comorbidities, the ACE2 receptor, renin-angiotensin system (RAS), signaling molecules involved in SARS-CoV-2 replication, proteases which prime viral S protein, the immune response, and behavioral considerations. Moreover, we discuss sexual disparities associated with other viruses and a possible gender-dependent response to SARS-CoV-2 vaccines. By specifically highlighting these immune-endocrine processes as well as behavioral factors that differentially exist between the genders, we aim to offer a better understanding in the variations of SARS-CoV-2 pathogenicity.
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Affiliation(s)
- Zena Wehbe
- Department of Biology, American University of Beirut, Beirut, Lebanon
| | - Safaa Hisham Hammoud
- Department of Pharmacology and Therapeutics, Beirut Arab University, Beirut, Lebanon
| | | | - Manal Fardoun
- Department of Biology, American University of Beirut, Beirut, Lebanon
| | - Ahmed F. El-Yazbi
- Department of Pharmacology and Toxicology, American University of Beirut, Beirut, Lebanon
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Alexandria University, Alexandria, Egypt
| | - Ali H. Eid
- Department of Basic Medical Sciences, College of Medicine, Qatar University Health, Qatar University, Doha, Qatar
- Biomedical and Pharmaceutical Research Unit, Qatar University Health, Qatar University, Doha, Qatar
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47
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Tao Y, Yang R, Wen C, Fan J, Ma J, He Q, Zhao Z, Song X, Chen H, Shi G, Yin M, Fang N, Zhang H, Chen H, Mo X. Preliminary analyses of scRNA sequencing and immunohistochemistry of children's lung tissues indicate the expression of SARS-CoV-2 entry-related genes may not be the key reason for the milder syndromes of COVID-19 in children. Clin Transl Med 2021; 11:e300. [PMID: 34047474 PMCID: PMC8140187 DOI: 10.1002/ctm2.300] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 01/11/2021] [Accepted: 01/14/2021] [Indexed: 01/03/2023] Open
Affiliation(s)
- Yue Tao
- The Laboratory of Pediatric Infectious Diseases, Pediatric Translational Medicine InstituteShanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong UniversityShanghaiChina
| | - Ruwen Yang
- The Laboratory of Pediatric Infectious Diseases, Pediatric Translational Medicine InstituteShanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong UniversityShanghaiChina
| | - Chen Wen
- Department of Cardiothoracic SurgeryShanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong UniversityShanghaiChina
| | - Jue Fan
- Singleron BiotechnologiesNanjingChina
| | - Jing Ma
- Department of PathologyShanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong UniversityShanghaiChina
| | - Qiao He
- Department of PathologyShanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong UniversityShanghaiChina
| | - Zhiguang Zhao
- Wenzhou Medical University Second Affiliated HospitalWenzhouChina
| | - Xinyu Song
- Department of Cardiothoracic SurgeryFirst Affiliated Hospital of Soochow UniversitySuzhouChina
| | - Hao Chen
- Department of Cardiothoracic SurgeryShanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong UniversityShanghaiChina
| | - Guocheng Shi
- Department of Cardiothoracic SurgeryShanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong UniversityShanghaiChina
| | - Minzhi Yin
- Department of PathologyShanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong UniversityShanghaiChina
| | - Nan Fang
- Singleron BiotechnologiesNanjingChina
| | - Hao Zhang
- Department of Cardiothoracic SurgeryShanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong UniversityShanghaiChina
| | - Huiwen Chen
- Department of Cardiothoracic SurgeryShanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong UniversityShanghaiChina
| | - Xi Mo
- The Laboratory of Pediatric Infectious Diseases, Pediatric Translational Medicine InstituteShanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong UniversityShanghaiChina
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48
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Tao Y, Yang R, Wen C, Fan J, Ma J, He Q, Zhao Z, Song X, Chen H, Shi G, Yin M, Fang N, Zhang H, Chen H, Mo X. Preliminary analyses of scRNA sequencing and immunohistochemistry of children's lung tissues indicate the expression of SARS-CoV-2 entry-related genes may not be the key reason for the milder syndromes of COVID-19 in children. Clin Transl Med 2021; 11:e300. [PMID: 34047474 DOI: 10.1101/2020.05.25.20110890] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 01/11/2021] [Accepted: 01/14/2021] [Indexed: 05/28/2023] Open
Abstract
SUMMARYTo explore whether the expression levels of viral-entry associated genes might contribute to the milder symptoms in children, we analyzed the expression of these genes in both children and adults’ lung tissues by single cell RNA sequencing (scRNA-seq) and immunohistochemistry (IHC). Both scRNA-seq and IHC analyses showed comparable levels of the key genes for SARS-CoV-2 entry in children and adults, includingACE2, TMPRSS2andFURIN, suggesting that instead of lower virus intrusion rate, other factors are more likely to be the key reasons for the milder symptoms of SARS-CoV-2 infected children.
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Affiliation(s)
- Yue Tao
- The Laboratory of Pediatric Infectious Diseases, Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Ruwen Yang
- The Laboratory of Pediatric Infectious Diseases, Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Chen Wen
- Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jue Fan
- Singleron Biotechnologies, Nanjing, China
| | - Jing Ma
- Department of Pathology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Qiao He
- Department of Pathology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Zhiguang Zhao
- Wenzhou Medical University Second Affiliated Hospital, Wenzhou, China
| | - Xinyu Song
- Department of Cardiothoracic Surgery, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Hao Chen
- Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Guocheng Shi
- Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Minzhi Yin
- Department of Pathology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Nan Fang
- Singleron Biotechnologies, Nanjing, China
| | - Hao Zhang
- Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Huiwen Chen
- Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xi Mo
- The Laboratory of Pediatric Infectious Diseases, Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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49
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Al-Beltagi M, Saeed NK, Bediwy AS, El-Sawaf Y. Paediatric gastrointestinal disorders in SARS-CoV-2 infection: Epidemiological and clinical implications. World J Gastroenterol 2021; 27:1716-1727. [PMID: 33967552 PMCID: PMC8072196 DOI: 10.3748/wjg.v27.i16.1716] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/12/2021] [Accepted: 04/05/2021] [Indexed: 02/06/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic is a threat worldwide for individuals of all ages, including children. Gastrointestinal manifestations could be the initial presenting manifestation in many patients, especially in children. These symptoms are more common in patients with severe disease than in patients with non-severe disease. Approximately 48.1% of patients had a stool sample that was positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral RNA. Children typically form 1%-8% of all laboratory-confirmed cases of SARS-CoV-2. Gastrointestinal manifestations of COVID-19 in children are not rare, with a prevalence between 0 and 88%, and a wide variety of presentations, including diarrhoea, vomiting, and abdominal pain, can develop before, with or after the development of respiratory symptoms. Atypical manifestations such as appendicitis or liver injury could also appear, especially in the presence of multisystem inflammatory disease. In this review, we discussed the epidemiology of COVID-19 gastrointestinal diseases in children as well as their implications on the diagnosis, misdiagnosis, prognosis, and faecal-oral transmission route of COVID-19 and the impact of gastrointestinal diseases on the gut microbiome, child nutrition, and disease management.
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Affiliation(s)
- Mohammed Al-Beltagi
- Department of Pediatric, Faculty of Medicine, Tanta University, Tanta 31527, Algharbia, Egypt
- Department of Pediatrics, University Medical Center, Arabian Gulf University, Manama 26671, Bahrain
| | - Nermin Kamal Saeed
- Microbiology Section, Pathology Department, Salmaniya Medical Complex, Manama 12, Bahrain
- Department of Microbiology, Royal College of Surgeons in Ireland - Bahrain, Bahrain, Busaiteen 15503, Muharraq, Bahrain
| | - Adel Salah Bediwy
- Department of Chest Diseases, Tanta University, Tanta 31527, Algharbia, Egypt
- Department of Pulmonology, University Medical Center, Arabian Gulf University, Manama 26671, Bahrain
| | - Yasser El-Sawaf
- Department of Tropical Medicine, Tanta University, Tanta 31527, Algharbia, Egypt
- Department of Gastroenterology, University Medical Center, Arabian Gulf University, Manama 26671, Bahrain
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Al-Beltagi M, Saeed NK, Bediwy AS, El-Sawaf Y. Paediatric gastrointestinal disorders in SARS-CoV-2 infection: Epidemiological and clinical implications. World J Gastroenterol 2021. [PMID: 33967552 DOI: 10.3748/wjg.v27.i16.1716.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic is a threat worldwide for individuals of all ages, including children. Gastrointestinal manifestations could be the initial presenting manifestation in many patients, especially in children. These symptoms are more common in patients with severe disease than in patients with non-severe disease. Approximately 48.1% of patients had a stool sample that was positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral RNA. Children typically form 1%-8% of all laboratory-confirmed cases of SARS-CoV-2. Gastrointestinal manifestations of COVID-19 in children are not rare, with a prevalence between 0 and 88%, and a wide variety of presentations, including diarrhoea, vomiting, and abdominal pain, can develop before, with or after the development of respiratory symptoms. Atypical manifestations such as appendicitis or liver injury could also appear, especially in the presence of multisystem inflammatory disease. In this review, we discussed the epidemiology of COVID-19 gastrointestinal diseases in children as well as their implications on the diagnosis, misdiagnosis, prognosis, and faecal-oral transmission route of COVID-19 and the impact of gastrointestinal diseases on the gut microbiome, child nutrition, and disease management.
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Affiliation(s)
- Mohammed Al-Beltagi
- Department of Pediatric, Faculty of Medicine, Tanta University, Tanta 31527, Algharbia, Egypt
| | - Nermin Kamal Saeed
- Microbiology Section, Pathology Department, Salmaniya Medical Complex, Manama 12, Bahrain
| | - Adel Salah Bediwy
- Department of Chest Diseases, Tanta University, Tanta 31527, Algharbia, Egypt
| | - Yasser El-Sawaf
- Department of Tropical Medicine, Tanta University, Tanta 31527, Algharbia, Egypt
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