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Calcaterra V, Zanelli S, Foppiani A, Verduci E, Benatti B, Bollina R, Bombaci F, Brucato A, Cammarata S, Calabrò E, Cirnigliaro G, Della Torre S, Dell’osso B, Moltrasio C, Marzano AV, Nostro C, Romagnuolo M, Trotta L, Savasi V, Smiroldo V, Zuccotti G. Long COVID in Children, Adults, and Vulnerable Populations: A Comprehensive Overview for an Integrated Approach. Diseases 2024; 12:95. [PMID: 38785750 PMCID: PMC11120262 DOI: 10.3390/diseases12050095] [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: 04/02/2024] [Revised: 04/27/2024] [Accepted: 05/03/2024] [Indexed: 05/25/2024] Open
Abstract
Long COVID affects both children and adults, including subjects who experienced severe, mild, or even asymptomatic SARS-CoV-2 infection. We have provided a comprehensive overview of the incidence, clinical characteristics, risk factors, and outcomes of persistent COVID-19 symptoms in both children and adults, encompassing vulnerable populations, such as pregnant women and oncological patients. Our objective is to emphasize the critical significance of adopting an integrated approach for the early detection and appropriate management of long COVID. The incidence and severity of long COVID symptoms can have a significant impact on the quality of life of patients and the course of disease in the case of pre-existing pathologies. Particularly, in fragile and vulnerable patients, the presence of PASC is related to significantly worse survival, independent from pre-existing vulnerabilities and treatment. It is important try to achieve an early recognition and management. Various mechanisms are implicated, resulting in a wide range of clinical presentations. Understanding the specific mechanisms and risk factors involved in long COVID is crucial for tailoring effective interventions and support strategies. Management approaches involve comprehensive biopsychosocial assessments and treatment of symptoms and comorbidities, such as autonomic dysfunction, as well as multidisciplinary rehabilitation. The overall course of long COVID is one of gradual improvement, with recovery observed in the majority, though not all, of patients. As the research on long-COVID continues to evolve, ongoing studies are likely to shed more light on the intricate relationship between chronic diseases, such as oncological status, cardiovascular diseases, psychiatric disorders, and the persistent effects of SARS-CoV-2 infection. This information could guide healthcare providers, researchers, and policymakers in developing targeted interventions.
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Affiliation(s)
- Valeria Calcaterra
- Department of Internal Medicine and Therapeutics, Università degli Sudi di Pavia, 27100 Pavia, Italy;
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milano, Italy; (S.Z.); (E.V.)
| | - Sara Zanelli
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milano, Italy; (S.Z.); (E.V.)
| | - Andrea Foppiani
- International Center for the Assessment of Nutritional Status and the Development of Dietary Intervention Strategies (ICANS-DIS), Department of Food, Environmental and Nutritional Sciences (DeFENS), Università degli Studi di Milano, 20157 Milano, Italy;
- IRCCS Istituto Auxologico Italiano, Department of Endocrine and Metabolic Medicine, Clinical Nutrition Unit, 20145 Milano, Italy
| | - Elvira Verduci
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milano, Italy; (S.Z.); (E.V.)
- Department of Health Sciences, Università degli Studi di Milano, 20157 Milano, Italy
| | - Beatrice Benatti
- “Aldo Ravelli” Center for Nanotechnology and Neurostimulation, Università degli Studi di Milano, 20157 Milano, Italy; (B.B.); (B.D.)
- Department of Psychiatry, ASST Fatebenefratelli-Sacco, University of Milano, 20154 Milano, Italy; (G.C.); (C.N.)
| | - Roberto Bollina
- Department of Medical Oncology, ASST Rhodense, 20024 Milano, Italy; (R.B.); (S.D.T.); (V.S.)
| | - Francesco Bombaci
- Department of Radiology, ASST Fatebenefratelli Sacco, 20154 Milano, Italy;
| | - Antonio Brucato
- Department of Internal Medicine, ASST Fatebenefratelli-Sacco, 20154 Milano, Italy; (A.B.); (E.C.); (L.T.)
| | - Selene Cammarata
- Department of Woman, Mother and Neonate, Luigi Sacco Hospital, ASST Fatebenefratelli-Sacco, 20154 Milano, Italy; (S.C.); (V.S.)
| | - Elisa Calabrò
- Department of Internal Medicine, ASST Fatebenefratelli-Sacco, 20154 Milano, Italy; (A.B.); (E.C.); (L.T.)
| | - Giovanna Cirnigliaro
- Department of Psychiatry, ASST Fatebenefratelli-Sacco, University of Milano, 20154 Milano, Italy; (G.C.); (C.N.)
| | - Silvia Della Torre
- Department of Medical Oncology, ASST Rhodense, 20024 Milano, Italy; (R.B.); (S.D.T.); (V.S.)
| | - Bernardo Dell’osso
- “Aldo Ravelli” Center for Nanotechnology and Neurostimulation, Università degli Studi di Milano, 20157 Milano, Italy; (B.B.); (B.D.)
- Department of Psychiatry, ASST Fatebenefratelli-Sacco, University of Milano, 20154 Milano, Italy; (G.C.); (C.N.)
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305, USA
- Centro per lo Studio dei Meccanismi Molecolari alla Base delle Patologie Neuro-Psico-Geriatriche, Università degli Studi di Milano, 20157 Milano, Italy
| | - Chiara Moltrasio
- Dermatology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy; (C.M.); (A.V.M.); (M.R.)
| | - Angelo Valerio Marzano
- Dermatology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy; (C.M.); (A.V.M.); (M.R.)
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, 20122 Milano, Italy
| | - Chiara Nostro
- Department of Psychiatry, ASST Fatebenefratelli-Sacco, University of Milano, 20154 Milano, Italy; (G.C.); (C.N.)
| | - Maurizio Romagnuolo
- Dermatology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy; (C.M.); (A.V.M.); (M.R.)
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, 20122 Milano, Italy
| | - Lucia Trotta
- Department of Internal Medicine, ASST Fatebenefratelli-Sacco, 20154 Milano, Italy; (A.B.); (E.C.); (L.T.)
| | - Valeria Savasi
- Department of Woman, Mother and Neonate, Luigi Sacco Hospital, ASST Fatebenefratelli-Sacco, 20154 Milano, Italy; (S.C.); (V.S.)
- Department of Biomedical and Clinical Science, Università degli Studi di Milano, 20157 Milano, Italy
| | - Valeria Smiroldo
- Department of Medical Oncology, ASST Rhodense, 20024 Milano, Italy; (R.B.); (S.D.T.); (V.S.)
| | - Gianvincenzo Zuccotti
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milano, Italy; (S.Z.); (E.V.)
- Department of Biomedical and Clinical Science, Università degli Studi di Milano, 20157 Milano, Italy
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Senter JP, Aisenberg LK, Dudley JW, Luan X, Huang J, Kenyon CC, Hill DA. COVID-19 and Asthma Onset in Children. Pediatrics 2024; 153:e2023064615. [PMID: 38606487 PMCID: PMC11035159 DOI: 10.1542/peds.2023-064615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/31/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Respiratory viral infections increase risk of asthma in infants and children. Infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus can cause severe lung inflammation and prolonged respiratory symptoms. We sought to determine whether SARS-CoV-2 infection modified pediatric incident asthma risk. METHODS This retrospective cohort study examined children ages 1 to 16 within the Children's Hospital of Philadelphia Care Network who received polymerase chain reaction (PCR) testing for SARS-CoV-2 between March 1, 2020 and February 28, 2021. Multivariable Cox regression models assessed the hazard ratio of new asthma diagnosis between SARS-CoV-2 PCR positive and SARS-CoV-2 PCR negative groups within an 18-month observation window. Models were adjusted for demographic characteristics, socioeconomic variables, and atopic comorbidities. RESULTS There were 27 423 subjects included in the study. In adjusted analyses, SARS-CoV-2 PCR positivity had no significant effect on the hazard of new asthma diagnosis (hazard ratio [HR]: 0.96; P = .79). Black race (HR: 1.49; P = .004), food allergies (HR: 1.26; P = .025), and allergic rhinitis (HR: 2.30; P < .001) significantly increased the hazard of new asthma diagnosis. Preterm birth (HR: 1.48; P = .005) and BMI (HR: 1.13; P < .001) significantly increased the hazard of new asthma diagnosis for children <5 years old. CONCLUSIONS SARS-CoV-2 PCR positivity was not associated with new asthma diagnosis in children within the observation period, although known risk factors for pediatric asthma were confirmed. This study informs the prognosis and care of children with a history of SARS-CoV-2 infection.
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Affiliation(s)
| | | | | | - Xianqun Luan
- PolicyLab, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Jing Huang
- PolicyLab, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- Departments of Biostatistics, Epidemiology and Informatics
| | - Chén C. Kenyon
- Departments of Pediatrics
- Clinical Futures
- PolicyLab, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - David A. Hill
- Division of Allergy and Immunology
- Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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3
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Liu L, Zhang L, Zhou P, Zhou W, Li L, Zeng L, Li N, Zhao R, Han T. Cough symptoms in children following COVID-19: a single-center retrospective study. Front Pediatr 2024; 12:1301571. [PMID: 38646512 PMCID: PMC11026548 DOI: 10.3389/fped.2024.1301571] [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: 09/25/2023] [Accepted: 03/25/2024] [Indexed: 04/23/2024] Open
Abstract
Background Cough is the most common respiratory symptom in children with mild coronavirus disease 2019 (COVID-19); however, evidence regarding the duration and severity of COVID-19-related cough is sparse. Herein, we investigated the correlation between cough severity/duration and disease duration in children with allergic diseases following COVID-19. Methods This single-center, retrospective case-control study was conducted at the Department of Pediatrics, Peking University Third Hospital, from February 6-13, 2023. Children aged 0-16 completed a questionnaire survey collecting basic information and weekly cough scores for 8 consecutive weeks after COVID-19 in December 2022. The Kaplan-Meier method was used to draw event curves, and the log-rank method was used to compare inter-group differences. Stepwise regression was applied for multivariate analysis of correlations between age, sex, allergic diseases, and the degree and duration of cough following COVID-19. Results Overall, 686 children were included, of whom 183 (26.7%) had allergic diseases and 503 (73.3%) did not. Kaplan-Meier analysis identified significant differences between patients with and without allergic disease (log-rank test, P = 0.002) and between patients with no allergic disease and those with one and more than one allergic disease (log-rank test, P = 0.003). Multivariate regression identified a link between the presence of more than one allergic disease and coughing for >4 weeks after infection (P < 0.001). Allergic disease was the primary factor linked to cough symptoms lasting 8 weeks and cough severity (P < 0.001). Conclusions Allergic disease contributes to the prolonged duration and severity of coughing in children with mild COVID-19.
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Affiliation(s)
- Ling Liu
- Department of Pediatrics, Peking University Third Hospital, Beijing, China
| | - Lu Zhang
- Department of Pediatrics, Peking University Third Hospital, Beijing, China
| | - Pengxiang Zhou
- Department of Pharmacy, Peking University Third Hospital, Beijing, China
- Institute for Drug Evaluation, Peking University Health Science Center, Beijing, China
| | - Wei Zhou
- Department of Pediatrics, Peking University Third Hospital, Beijing, China
| | - Linghui Li
- Department of Pediatrics, Peking University Third Hospital, Beijing, China
| | - Lin Zeng
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
| | - Nan Li
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
| | - Rongsheng Zhao
- Department of Pharmacy, Peking University Third Hospital, Beijing, China
- Institute for Drug Evaluation, Peking University Health Science Center, Beijing, China
| | - Tongyan Han
- Department of Pediatrics, Peking University Third Hospital, Beijing, China
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Oh J, Lee M, Kim M, Kim HJ, Lee SW, Rhee SY, Koyanagi A, Smith L, Kim MS, Lee H, Lee J, Yon DK. Incident allergic diseases in post-COVID-19 condition: multinational cohort studies from South Korea, Japan and the UK. Nat Commun 2024; 15:2830. [PMID: 38565542 PMCID: PMC10987608 DOI: 10.1038/s41467-024-47176-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 03/20/2024] [Indexed: 04/04/2024] Open
Abstract
As mounting evidence suggests a higher incidence of adverse consequences, such as disruption of the immune system, among patients with a history of COVID-19, we aimed to investigate post-COVID-19 conditions on a comprehensive set of allergic diseases including asthma, allergic rhinitis, atopic dermatitis, and food allergy. We used nationwide claims-based cohorts in South Korea (K-CoV-N; n = 836,164; main cohort) and Japan (JMDC; n = 2,541,021; replication cohort A) and the UK Biobank cohort (UKB; n = 325,843; replication cohort B) after 1:5 propensity score matching. Among the 836,164 individuals in the main cohort (mean age, 50.25 years [SD, 13.86]; 372,914 [44.6%] women), 147,824 were infected with SARS-CoV-2 during the follow-up period (2020-2021). The risk of developing allergic diseases, beyond the first 30 days of diagnosis of COVID-19, significantly increased (HR, 1.20; 95% CI, 1.13-1.27), notably in asthma (HR, 2.25; 95% CI, 1.80-2.83) and allergic rhinitis (HR, 1.23; 95% CI, 1.15-1.32). This risk gradually decreased over time, but it persisted throughout the follow-up period (≥6 months). In addition, the risk increased with increasing severity of COVID-19. Notably, COVID-19 vaccination of at least two doses had a protective effect against subsequent allergic diseases (HR, 0.81; 95% CI, 0.68-0.96). Similar findings were reported in the replication cohorts A and B. Although the potential for misclassification of pre-existing allergic conditions as incident diseases remains a limitation, ethnic diversity for evidence of incident allergic diseases in post-COVID-19 condition has been validated by utilizing multinational and independent population-based cohorts.
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Affiliation(s)
- Jiyeon Oh
- Department of Medicine, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Myeongcheol Lee
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea
- Department of Regulatory Science, Kyung Hee University, Seoul, South Korea
| | - Minji Kim
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea
- Department of Regulatory Science, Kyung Hee University, Seoul, South Korea
| | - Hyeon Jin Kim
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea
- Department of Regulatory Science, Kyung Hee University, Seoul, South Korea
| | - Seung Won Lee
- Department of Precision Medicine, Sungkyunkwan University School of Medicine, Suwon, South Korea
| | - Sang Youl Rhee
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea
- Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, South Korea
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Deu, Barcelona, Spain
| | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Min Seo Kim
- Medical and Population Genetics and Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Hayeon Lee
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea.
- Department of Biomedical Engineering, Kyung Hee University, Yongin, South Korea.
| | - Jinseok Lee
- Department of Biomedical Engineering, Kyung Hee University, Yongin, South Korea.
- Department of Electronics and Information Convergence Engineering, Kyung Hee University, Yongin, South Korea.
| | - Dong Keon Yon
- Department of Medicine, Kyung Hee University College of Medicine, Seoul, South Korea.
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea.
- Department of Regulatory Science, Kyung Hee University, Seoul, South Korea.
- Department of Pediatrics, Kyung Hee University College of Medicine, Seoul, South Korea.
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Khojasteh-Kaffash S, Parhizkar Roudsari P, Ghaffari Jolfayi A, Samieefar N, Rezaei N. Pediatric asthma exacerbation and COVID-19 pandemic: Impacts, challenges, and future considerations. J Asthma 2024; 61:81-91. [PMID: 37610180 DOI: 10.1080/02770903.2023.2251062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 08/11/2023] [Accepted: 08/19/2023] [Indexed: 08/24/2023]
Abstract
OBJECTIVE Asthma, a common disease among children and adolescents, poses a great health risk when ignored; therefore, a thorough follow-up to prevent exacerbations is emphasized. The aim of the present study is to investigate asthma exacerbation in children during the Coronavirus disease 2019 (COVID-19) era. DATA SOURCES This narrative review has been done by searching the PubMed and Embase databases using Asthma, COVID-19, Pandemic, and Symptom flare up as keywords. STUDY SELECTIONS Studies related to asthma exacerbation in COVID-19 pandemic were included. RESULTS Based on studies, controlled or mild to moderate asthma has not been considered a risk factor for COVID-19 severity and has not affected hospitalization, intensive care unit (ICU) admission, and mortality. Surprisingly, emergent and non-emergent visits and asthmatic attacks decreased during the pandemic. The three main reasons for decreased incidence and exacerbation of asthma episodes in the COVID-19 era included reduced exposure to environmental allergens, increasing the acceptance of treatment by pediatrics and caregivers, and decreased risk of other respiratory viral infections. Based on the available studies, COVID-19 vaccination had no serious side effects, except in cases of uncontrolled severe asthma, and can be injected in these children. Also, there was no conclusive evidence of asthma exacerbation after the injection of COVID-19 vaccines. CONCLUSION Further studies are recommended to follow the pattern of asthma in the post-pandemic situation and to become prepared for similar future conditions.
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Affiliation(s)
- Soroush Khojasteh-Kaffash
- Student Research Committee, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran
- Network of Interdisciplinarity in Neonates and Infants (NINI), Universal Scientific Education and Research Network (USERN), Tehran, Iran
- USERN Office, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Peyvand Parhizkar Roudsari
- Network of Interdisciplinarity in Neonates and Infants (NINI), Universal Scientific Education and Research Network (USERN), Tehran, Iran
- Metabolomics and Genomics Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Ghaffari Jolfayi
- Network of Interdisciplinarity in Neonates and Infants (NINI), Universal Scientific Education and Research Network (USERN), Tehran, Iran
- Cardiovascular Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Noosha Samieefar
- Network of Interdisciplinarity in Neonates and Infants (NINI), Universal Scientific Education and Research Network (USERN), Tehran, Iran
- USERN Office, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nima Rezaei
- Network of Interdisciplinarity in Neonates and Infants (NINI), Universal Scientific Education and Research Network (USERN), Tehran, Iran
- Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Department of Immunology, School of Medicine, Tehran University of Medical Science, Tehran, Iran
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Kim BG, Lee H, Yeom SW, Jeong CY, Park DW, Park TS, Moon JY, Kim TH, Sohn JW, Yoon HJ, Kim JS, Kim SH. Increased Risk of New-Onset Asthma After COVID-19: A Nationwide Population-Based Cohort Study. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024; 12:120-132.e5. [PMID: 37774780 DOI: 10.1016/j.jaip.2023.09.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 09/01/2023] [Accepted: 09/05/2023] [Indexed: 10/01/2023]
Abstract
BACKGROUND Previous studies have suggested that respiratory virus infections may be associated with new-onset asthma. However, whether coronavirus disease 2019 (COVID-19) is associated with an increased risk of new-onset asthma remains unclear. OBJECTIVE We aimed to evaluate whether recent COVID-19 increases the risk of new-onset asthma and whether COVID-19 vaccination could mitigate this risk. METHODS We constructed 3 different study designs using the Korean National Health Insurance claim-based database: study 1: COVID-19-diagnosed subjects (COVID-19 cohort) and their matched controls; study 2: COVID-19-vaccinated subjects (vaccination cohort) and their matched controls; and study 3: vaccination cohort and their matched controls, excluding subjects diagnosed with COVID-19. RESULTS In study 1, 1.6% of the COVID-19 cohort and 0.7% of the matched cohort developed new-onset asthma, with incidences of 31.28 and 14.55 per 1,000 person-years, respectively (P < .001). The COVID-19 cohort had a higher risk of new-onset asthma (adjusted hazard ratio [aHR] 2.14; 95% CI 1.88-2.45) than matched controls. In study 2, the vaccination cohort had a lower risk of new-onset asthma than the matched controls (aHR 0.82; 95% CI 0.76-0.89). However, among subjects without a COVID-19 diagnosis, COVID-19 vaccination was not associated with a reduced risk of new-onset asthma in study 3 (aHR 0.95; 95% CI 0.87-1.04). In subgroup analysis, the risk of new-onset asthma was significantly lower in fully vaccinated subjects and higher in older subjects and in those with diabetes mellitus than in their counterparts. CONCLUSIONS The COVID-19 was associated with a higher incidence of new-onset asthma, which might be preventable by COVID-19 vaccination.
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Affiliation(s)
- Bo-Guen Kim
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Hyun Lee
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Sang Woo Yeom
- Department of Medical Informatics, Jeonbuk National University Medical School, Jeonju, Korea
| | - Cho Yun Jeong
- Department of Medical Informatics, Jeonbuk National University Medical School, Jeonju, Korea
| | - Dong Won Park
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Tai Sun Park
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Ji-Yong Moon
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Tae-Hyung Kim
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Jang Won Sohn
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Ho Joo Yoon
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Jong Seung Kim
- Department of Medical Informatics, Jeonbuk National University Medical School, Jeonju, Korea; Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea; Department of Otorhinolaryngology-Head and Neck Surgery, Jeonbuk National University Medical School, Jeonju, Korea.
| | - Sang-Heon Kim
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
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Özata MC, Dikici Ü, Özdemir Ö. COVID-19 frequency and clinical course in children with asthma. World J Virol 2023; 12:272-285. [PMID: 38187499 PMCID: PMC10768388 DOI: 10.5501/wjv.v12.i5.272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 09/13/2023] [Accepted: 11/30/2023] [Indexed: 12/25/2023] Open
Abstract
BACKGROUND The epidemic of severe acute respiratory syndrome coronavirus 2 infection, known as the coronavirus disease 2019 (COVID-19), has caused a global health concern. Since its emergence, numerous studies have focused on various clinical manifestations and outcomes in different populations. However, studies are ongoing as the consequences and impact of COVID-19 in children with chronic diseases such as asthma are controversial. AIM To fill this research gap by retrospectively evaluating the course, laboratory, and clinical findings of COVID-19 among 414 asthmatic children followed up from the pediatric allergy outpatient clinic and known to have had COVID-19. METHODS The data of 5510 patients over the age of 5 diagnosed with asthma in our hospital's data were retrospectively scanned with specific parameters using protocol numbers from the hospital filing system. The data included retrospective evaluation of pulmonary function test results before and after COVID-19, routine hematological and biochemical parameters, sensitization states (total IgE, specific IgE, and skin prick test results), and radiological (computed tomography) findings. To inquire about the course and symptoms of COVID-19, asthma patients or their parents were then called and evaluated with a questionnaire. RESULTS As a result of retrospectively scanning the data of 5510 asthma patients over the age of 5, it was determined that 414 (7.5%) patients had COVID-19. The mean age of 414 patients was 17.18 ± 4.08 (min: 6; max: 28) years. Two hundred and three of our 414 patients are male, and 211 are female. When their vaccination status was questioned, 21.5% were vaccinated. When the symptoms of our 290 patients were questioned, it was stated that 59.0% had fever symptoms. The rate of using regular prophylactic asthma medications was 19%. The rate of using salbutamol in asthma was found to be 22%. The rate of patients using methylprednisolone was 1%. Emergency service admission was 17.2%, and hospitalization was found to be 4.8%. Leukopenia (< 4000) was found in 14.1% of patients, and 8.08% of our patients had neutropenia (< 1500). Lymphopenia (< 1500) was detected in 44.4% of patients, and lymphocytosis (> 4000) was found in 5.05% of patients. In 65% of our patients, the C-reactive protein value was elevated. A high aspartate aminotransferase and alanine aminotransferase value was detected in 3.2% and 5.4% of patients were found, respectively. 31% of patients had an elevated lactate dehydrogenase value. Typical radiological findings for COVID-19 were detected in 3/309 of patients. CONCLUSION According to our study, there is a correlation between the severity of COVID-19 and asthma symptoms and the course of the disease. However, it is worth noting that the retrospective nature of the study and the differences in sample size, age, and demographic characteristics between the two groups do not allow for an optimal comparison. Therefore, further investigation is needed to explore the relationship between COVID-19 and asthma, and it can be suggested that COVID-19 may trigger asthma attacks and asthma may impact the course of COVID-19.
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Affiliation(s)
| | - Ümmügülsüm Dikici
- Department of Pediatric Allergy and Immunology, Sakarya University, Adapazarı 54100, Sakarya, Türkiye
| | - Öner Özdemir
- Department of Pediatric Allergy and Immunology, Sakarya University, Adapazarı 54100, Sakarya, Türkiye
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Zhang H, Lin J, Wu J, Zhang J, Zhang L, Yuan S, Chen J, Tang Q, Zhang A, Cui Y, Xu X, Dai H, Shi H, Hu X, Xie D, Chen J, He F, Yin Y. Allergic diseases aggravate the symptoms of SARS-CoV-2 infection in China. Front Immunol 2023; 14:1284047. [PMID: 38204754 PMCID: PMC10777727 DOI: 10.3389/fimmu.2023.1284047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 12/08/2023] [Indexed: 01/12/2024] Open
Abstract
Background The relationship between allergic diseases and the adverse outcomes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been a subject of controversy. This study aimed to investigate the association between allergic diseases and the incidence and severity of symptoms in SARS-CoV-2 infection. Methods Clinical data of individuals, including children and their parents, infected with SARS-CoV-2 from December 2022 to January 2023 in China were retrospectively analyzed. The data were collected through questionnaires. Statistical analysis, including chi-squared tests, nonparametric analysis, one-way ANOVA, and logistic regression analysis, was used to examine the relationship between allergic diseases, prior medication, and the symptoms of SARS-CoV-2 infection. Results There were 3,517 adults and 3,372 children with SARS-CoV-2 infection included in the study. Fever was found to occur at similar rates in children (86.5%) and adults (86.8%). However, other symptoms related to respiratory issues (such as cough and sore throat), neurological symptoms (headache, loss of smell, and loss of taste), and systemic symptoms (muscle soreness and weakness) were observed more frequently in adults (P < 0.001). Additionally, adults exhibited higher overall symptom scores, indicating greater severity. Allergic diseases were found to be associated with the incidence of certain SARS-CoV-2 infection symptoms in both children and adults. Specifically, children with allergic rhinitis (AR) were observed to be more susceptible to upper respiratory symptoms (OR: 1.320, 95% CI: 1.081-1.611, P = 0.006), while asthma patients were found to be more susceptible to severe respiratory symptoms (OR: 1.736, 95% CI: 1.250-2.411, P = 0.001). Similar patterns were identified in adults. Furthermore, AR was also suggested to be a risk factor for symptom severity in both children (OR: 1.704, 95% CI: 1.314-2.209, P < 0.001) and adults (OR: 1.736, 95% CI: 1.250-2.411, P = 0.001). However, prior medication for allergic diseases did not exhibit a preventive effect on SARS-CoV-2 infection symptoms. Conclusions Both children and adults with allergic diseases were found to be more prone to experiencing symptoms of SARS-CoV-2 infection, and these symptoms tended to be more severe.
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Affiliation(s)
- Huishan Zhang
- Department of Respiratory Medicine, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jilei Lin
- Department of Respiratory Medicine, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jinhong Wu
- Department of Respiratory Medicine, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jing Zhang
- Department of Respiratory Medicine, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Lei Zhang
- Department of Respiratory Medicine, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Shuhua Yuan
- Department of Respiratory Medicine, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jiande Chen
- Department of Respiratory Medicine, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Qiuyu Tang
- Department of Respiratory Medicine, Shanghai Children’s Medical Centre Affiliated to Shanghai Jiaotong University School of Medicine, Fujian Children’s Hospital, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology And Pediatrics, Fujian Medical University, Fuzhou, Fujian, China
| | - Ailian Zhang
- Department of Respiratory Medicine, The Second Hospital of Jiaxing, Jiaxing, Zhejiang, China
| | - Yuxia Cui
- Department of Respiratory Medicine, Guizhou Provincial People’s Hospital, Shanghai Children’s Medical Center, Shanghai JiaoTong University School of Medicine, Guiyang, Guizhou, China
| | - Xiaojuan Xu
- Department of Respiratory Medicine, Shaoxing Central Hospital, Shaoxing, Zhejiang, China
| | - Hongxie Dai
- Department of Respiratory Medicine, Zhoupu Hospital Affiliated to Shanghai University of Medicine & Health Sciences, Shanghai, China
| | - Hongbo Shi
- Department of Respiratory Medicine, Ningbo Medical Center Lihuili Hospital, Ningbo, Zhejiang, China
| | - Xiaowei Hu
- Department of Respiratory Medicine, Shanghai Children’s Medical Centre Affiliated to Shanghai Jiaotong University School of Medicine, Fujian Children’s Hospital, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology And Pediatrics, Fujian Medical University, Fuzhou, Fujian, China
| | - Dan Xie
- Department of Respiratory Medicine, Sanya Women and Children’s Hospital Affiliated to Hainan Medical College, Shanghai Children’s Medical Center, Sanya, Hainan, China
| | - Jing Chen
- Department of Respiratory Medicine, Linyi Maternal and Child Healthcare Hospital, Linyi, Shandong, China
| | - Fengquan He
- HongHe MCH (HongHe Hani and Yi Autonomous Prefecture Maternal and Child Health Hospital), Honghe, Yunnan, China
| | - Yong Yin
- Department of Respiratory Medicine, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Department of Respiratory Medicine, Sanya Women and Children’s Hospital Affiliated to Hainan Medical College, Shanghai Children’s Medical Center, Sanya, Hainan, China
- Department of Respiratory Medicine, Linyi Maternal and Child Healthcare Hospital, Linyi, Shandong, China
- Department of Respiratory Medicine, Shanghai Children’s Medical Center Pediatric Medical Complex (Pudong), Shanghai, China
- Pediatric Artificial Intelligence Clinical Application and Research Center, Shanghai Children’s Medical Center, Shanghai, China
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9
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Fireman Klein E, Yaacoby-Bianu K, Orlin I, Zetser A, Purits N, Livnat G. Exhaled Breath Condensate and Respiratory Sequelae in Children Post-COVID-19. Respiration 2023; 102:479-486. [PMID: 37393889 DOI: 10.1159/000530971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 05/02/2023] [Indexed: 07/04/2023] Open
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes an acute respiratory illness. A substantial proportion of adults experience persistent symptoms. There is a paucity of data on respiratory sequelae in children. Exhaled breath condensate (EBC) is a non-invasive tool used to assess airway inflammation. OBJECTIVES This study aimed to evaluate EBC parameters, respiratory, mental and physical ability among children post COVID-19 infection. METHODS Observational study of confirmed SARS-CoV-2 infection cases among children, aged 5-18 years, evaluated once, 1-6 months post positive SARS-CoV-2 PCR testing. All subjects performed spirometry, 6-min walk test (6MWT), EBC (pH, interleukin-6), and completed medical history questionnaires, Depression, Anxiety, and Stress Scale (DASS-21), and physical activity scores. Severity of COVID-19 disease was classified according to WHO criteria. RESULTS Fifty-eight children were included and classified asymptomatic (n = 14), mild (n = 37), and moderate (n = 7) disease. The asymptomatic group included younger patients compared to the mild and moderate groups (8.9 ± 2.5y vs. 12.3 ± 3.6y and 14.6 ± 2.5y, respectively, p = 0.001), as well as lower DASS-21 total scores (3.4 ± 4 vs. 8.7 ± 9.4 and 8.7 ± 0.6 respectively, p = 0.056), with higher scores in proximity to positive PCR (p = 0.011). No differences were found between the 3 groups regarding EBC, 6MWT, spirometry, body mass index percentile, and activity scores. CONCLUSIONS COVID-19 is an asymptomatic-mild disease in most young healthy children, with gradually diminishing emotional symptoms. Children without prolonged respiratory symptoms revealed no significant pulmonary sequelae as evaluated by EBC markers, spirometry, 6MWT, and activity scores. Larger studies are required to assess long-term pediatric consequences of post SARS-CoV-2 infection, to assess the need for pulmonology surveillance.
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Affiliation(s)
- Einat Fireman Klein
- Pulmonology division, Carmel Medical Center, Haifa, Israel
- Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Karin Yaacoby-Bianu
- Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
- Pediatric Pulmonology unit, Carmel Medical Center, Haifa, Israel
| | - Ido Orlin
- Department of Pediatrics, Carmel Medical Center, Haifa, Israel
| | - Anna Zetser
- Chemistry Laboratory, Carmel Medical Center, Haifa, Israel
| | - Nona Purits
- Pediatric Pulmonology unit, Carmel Medical Center, Haifa, Israel
| | - Galit Livnat
- Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
- Pediatric Pulmonology unit, Carmel Medical Center, Haifa, Israel
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10
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Al-Shamrani A, Al-Shamrani K, Al-Otaibi M, Alenazi A, Aldosaimani H, Aldhalaan Z, Alalkami H, Yousef AA, Kobeisy S, Alharbi S. Residual Cough and Asthma-like Symptoms Post-COVID-19 in Children. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1031. [PMID: 37371263 DOI: 10.3390/children10061031] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 05/29/2023] [Accepted: 06/05/2023] [Indexed: 06/29/2023]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) has rapidly spread worldwide and is characterized by different presentations ranging from asymptomatic to severe pneumonia. COVID-19 affects all age groups, including pediatric patients. We observed numerous children complaining of a cough post-COVID-19, even if it was trivial. The most reported persistent symptoms after recovery from COVID-19 were insomnia, coughing, fatigue, dyspnea, loss of taste and/or smell, and headache. To date, residual cough post-COVID-19 has been reported in pediatrics and adolescents. METHOD we conducted a retrospective study, with a self-administered questionnaire by the patient or caregiver, 12 months post-COVID-19-infection. RESULT A total of 94.8% of patients were Saudi citizens and were mainly from the southern region of Saudi Arabia (50.0%). Mothers (64.4%) submitted most of the results. The ages were as follows: 6-14 years (51.0%), 3-5 years (32.3%), and younger than 2 years of age (only 16.7%). Females accounted for 41.7% of those studied. Nearly half of the patients (48.5%) had had a previous COVID-19 infection in 2022, with only 2.1% infected in 2019. Only 27/194 (13.9%) patients required hospital admission, and 7 of them (4.2%) required intensive care treatment. A total of 179 (92.2%) patients still reported persistent symptoms 4 weeks post-COVID-19-infection. A cough was reported in 69.8% of patients, followed by cough and wheezing in 12.3%. The cough was described as dry in 78.0% and nocturnal in 54.1%, while 42.5% did not notice any diurnal variation. For those reporting residual cough, 39.3% found that it affected school attendance and daily activities, 31.1% reported associated chest pain, 51.9% associated it with wheezing, and 27.1% associated it with shortness of breath. For 54.4%, the residual cough lasted less than one month, while 31.4% reported a 1-2 month duration. Only 1.0% had a duration of cough of more than 3 months. For cough relief, 28.2% used bronchodilators, 19.9% used cough syrup, 16.6% used a combination of bronchodilators and steroid inhalers, and 1.7% used antibiotics. Surprisingly, 33% attempted herbal remedies for cough relief. Sesame oil was used the most (40.0%), followed by a mixture of olive oil and sesame oil (25.0%), and 21.7% used male frankincense. The majority (78.4%) sought medical advice for their post-infection cough, either from general pediatricians (39.5%) or via specialist pediatric pulmonology consultations (30.9%). A total of 11.0% with a residual cough reported having pets at home, while 27.2% reported secondhand smoke exposure in the household. Before infection with COVID-19, only 32.6% were diagnosed with asthma, while 68.2% reported a diagnosis of atopic skin. CONCLUSIONS There was a high prevalence of residual cough post-COVID-19, extended for a minimum of two months, and the characteristics of the cough were very similar to those of asthmatic patients. There was still a high prevalence of using cough syrup and herbal remedies, especially olive oil, sesame oil, and male frankincense. A residual cough adversely affected school attendance in daily activities, and there was a high prevalence of other siblings in the family being affected. The study showed that a minority of patients were seen by the pulmonologist; luckily, long COVID was rare in our study, and so further studies are highly needed to confirm the association with asthma. More educational programs are highly needed regarding herbal remedies and cough syrup.
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Affiliation(s)
- Abdullah Al-Shamrani
- Department of Pediatrics, Prince Sultan Military Medical City, Al Faisal University, P.O. Box 7897, Riyadh 11159, Saudi Arabia
| | - Khalid Al-Shamrani
- College of Medicine, Al Marifah University, P.O. Box 92882, Riyadh 11663, Saudi Arabia
| | - Maram Al-Otaibi
- Department of Pediatrics, Prince Sultan Military Medical City, P.O. Box 26523, Riyadh 12841, Saudi Arabia
| | - Ayed Alenazi
- Respiratory Division, Department of Pediatrics, Prince Sultan Military Medical City, P.O. Box 7456, Riyadh 13326, Saudi Arabia
| | - Hareth Aldosaimani
- Department of Emergency, Prince Sultan Military Medical City, P.O. Box 282236, Riyadh 11392, Saudi Arabia
| | - Zeyad Aldhalaan
- Department of Infectious Disease, Prince Sultan Military Medical City, P.O. Box 106383, Riyadh 11666, Saudi Arabia
| | - Haleimah Alalkami
- Department of Pediatrics, Abha Maternity & Children Hospital, P.O. Box 62521, Abha 3613, Saudi Arabia
| | - Abdullah A Yousef
- Department of Pediatrics, King Fahd Hospital of the University, P.O. Box 2208, Al-Khobar 31952, Saudi Arabia
- College of Medicine, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 34212, Saudi Arabia
| | - Sumayyah Kobeisy
- Dr. Soliman Fakeeh Hospital, P.O. Box 2537, Jeddah 21461, Saudi Arabia
| | - Saleh Alharbi
- Dr. Soliman Fakeeh Hospital, P.O. Box 2537, Jeddah 21461, Saudi Arabia
- Department of Pediatrics, Umm Al-Qura University, P.O. Box 715, Mecca 24382, Saudi Arabia
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11
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Sansone F, Pellegrino GM, Caronni A, Bonazza F, Vegni E, Lué A, Bocci T, Pipolo C, Giusti G, Di Filippo P, Di Pillo S, Chiarelli F, Sferrazza Papa GF, Attanasi M. Long COVID in Children: A Multidisciplinary Review. Diagnostics (Basel) 2023; 13:1990. [PMID: 37370884 DOI: 10.3390/diagnostics13121990] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 06/01/2023] [Accepted: 06/01/2023] [Indexed: 06/29/2023] Open
Abstract
Long COVID syndrome has emerged as a long-lasting consequence of acute SARS-CoV-2 infection in adults. In addition, children may be affected by Long COVID, with potential clinical issues in different fields, including problems in school performance and daily activities. Yet, the pathophysiologic bases of Long COVID in children are largely unknown, and it is difficult to predict who will develop the syndrome. In this multidisciplinary clinical review, we summarise the latest scientific data regarding Long COVID and its impact on children. Special attention is given to diagnostic tests, in order to help the physicians to find potential disease markers and quantify impairment. Specifically, we assess the respiratory, upper airways, cardiac, neurologic and motor and psychological aspects. Finally, we also propose a multidisciplinary clinical approach.
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Affiliation(s)
| | | | - Antonio Caronni
- Department of Neurorehabilitation Sciences, IRCCS Istituto Auxologico Italiano, Ospedale San Luca, 20122 Milan, Italy
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, 20133 Milan, Italy
| | - Federica Bonazza
- Department of Health Sciences, Clinical Psychology, University of Milan, Via di Rudinì 8, 20142 Milan, Italy
| | - Elena Vegni
- Department of Health Sciences, Clinical Psychology, University of Milan, Via di Rudinì 8, 20142 Milan, Italy
- Unit of Clinical Psychology, San Paolo Hospital, ASST Santi Paolo e Carlo, Via di Rudinì 8, 20142 Milan, Italy
| | - Alberto Lué
- Service of Digestive Diseases, University Clinic Hospital Lozano Blesa, IIS Aragón, 50009 Zaragoza, Spain
| | - Tommaso Bocci
- Department of Health Sciences, University of Milan, 20146 Milan, Italy
- Clinical Neurology Unit, Department of Health Sciences, "Azienda Socio-Sanitaria Territoriale Santi Paolo e Carlo", University of Milan, 20146 Milan, Italy
| | - Carlotta Pipolo
- Department of Health Sciences, Otorhinolaryngology Department, ASST Santi Paolo e Carlo, University of Milan, 20142 Milan, Italy
| | - Giuliano Giusti
- Paediatric Cardiology Unit, Niguarda Hospital, 20162 Milan, Italy
| | - Paola Di Filippo
- Paediatric Allergy and Pulmonology Unit, Department of Paediatrics, University of Chieti-Pescara, 66100 Chieti, Italy
| | - Sabrina Di Pillo
- Paediatric Allergy and Pulmonology Unit, Department of Paediatrics, University of Chieti-Pescara, 66100 Chieti, Italy
| | - Francesco Chiarelli
- Paediatric Allergy and Pulmonology Unit, Department of Paediatrics, University of Chieti-Pescara, 66100 Chieti, Italy
| | | | - Marina Attanasi
- Paediatric Allergy and Pulmonology Unit, Department of Paediatrics, University of Chieti-Pescara, 66100 Chieti, Italy
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12
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Zheng YB, Zeng N, Yuan K, Tian SS, Yang YB, Gao N, Chen X, Zhang AY, Kondratiuk AL, Shi PP, Zhang F, Sun J, Yue JL, Lin X, Shi L, Lalvani A, Shi J, Bao YP, Lu L. Prevalence and risk factor for long COVID in children and adolescents: A meta-analysis and systematic review. J Infect Public Health 2023; 16:660-672. [PMID: 36931142 PMCID: PMC9990879 DOI: 10.1016/j.jiph.2023.03.005] [Citation(s) in RCA: 38] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 01/09/2023] [Accepted: 03/05/2023] [Indexed: 03/09/2023] Open
Abstract
BACKGROUND Millions of COVID-19 pediatric survivors are facing the risk of long COVID after recovery from acute COVID-19. The primary objective of this study was to systematically review the available literature and determine the pooled prevalence of, and risk factors for long COVID among the pediatric survivors. METHODS Studies that assessed the prevalence of, or risk factors associated with long COVID among pediatric COVID-19 survivors were systematically searched in PubMed, Embase, and Cochrane Library up to December 11th, 2022. Random effects model was performed to estimate the pooled prevalence of long COVID among pediatric COVID-19 patients. Subgroup analyses and meta-regression on the estimated prevalence of long COVID were performed by stratification with follow-up duration, mean age, sex ratio, percentage of multisystem inflammatory syndrome, hospitalization rate at baseline, and percentage of severe illness. RESULTS Based on 40 studies with 12,424 individuals, the pooled prevalence of any long COVID was 23.36 % ([95 % CI 15.27-32.53]). The generalized symptom (19.57 %, [95 % CI 9.85-31.52]) was reported most commonly, followed by respiratory (14.76 %, [95 % CI 7.22-24.27]), neurologic (13.51 %, [95 % CI 6.52-22.40]), and psychiatric (12.30 %, [95% CI 5.38-21.37]). Dyspnea (22.75 %, [95% CI 9.38-39.54]), fatigue (20.22 %, [95% CI 9.19-34.09]), and headache (15.88 %, [95 % CI 6.85-27.57]) were most widely reported specific symptoms. The prevalence of any symptom during 3-6, 6-12, and> 12 months were 26.41 % ([95 % CI 14.33-40.59]), 20.64 % ([95 % CI 17.06-24.46]), and 14.89 % ([95 % CI 6.09-26.51]), respectively. Individuals with aged over ten years, multisystem inflammatory syndrome, or had severe clinical symptoms exhibited higher prevalence of long COVID in multi-systems. Factors such as older age, female, poor physical or mental health, or had severe infection or more symptoms were more likely to have long COVID in pediatric survivors. CONCLUSIONS Nearly one quarter of pediatric survivors suffered multisystem long COVID, even at 1 year after infection. Ongoing monitoring, comprehensive prevention and intervention is warranted for pediatric survivors, especially for individuals with high risk factors.
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Affiliation(s)
- Yong-Bo Zheng
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, China; Peking-Tsinghua Centre for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
| | - Na Zeng
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China; School of Public Health, Peking University, Beijing, China; Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Kai Yuan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, China
| | - Shan-Shan Tian
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, China
| | - Ying-Bo Yang
- The First Affiliated Hospital of Xinxiang Medical University, Henan, China
| | - Nan Gao
- The First Affiliated Hospital of Xinxiang Medical University, Henan, China
| | - Xuan Chen
- The First Affiliated Hospital of Xinxiang Medical University, Henan, China
| | - An-Yi Zhang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, China
| | - Alexandra L Kondratiuk
- NIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College, London W2 1NY, UK
| | - Pei-Pei Shi
- Department of Neurology, Taiyuan Central Hospital of Shanxi Medical University, Taiyuan, China
| | - Fang Zhang
- Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China
| | - Jie Sun
- Pain Medicine Center, Peking University Third Hospital, Beijing, China
| | - Jing-Li Yue
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, China
| | - Xiao Lin
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, China
| | - Le Shi
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, China
| | - Ajit Lalvani
- NIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College, London W2 1NY, UK
| | - Jie Shi
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Yan-Ping Bao
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China; School of Public Health, Peking University, Beijing, China.
| | - Lin Lu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, China; Peking-Tsinghua Centre for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China; National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China.
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13
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Pavliuk O, Kolesnyk H. Machine-learning method for analyzing and predicting the number of hospitalizations of children during the fourth wave of the COVID-19 pandemic in the Lviv region. JOURNAL OF RELIABLE INTELLIGENT ENVIRONMENTS 2023; 9:17-26. [PMID: 36065343 PMCID: PMC9434091 DOI: 10.1007/s40860-022-00188-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 08/04/2022] [Indexed: 11/13/2022]
Abstract
The purpose of this paper is to develop a machine-learning model for analyzing and predicting the number of hospitalizations of children in the Lviv region during the fourth wave of the COVID-19 pandemic. This wave is characterized by dominance of a new strain of the virus-Omicron-that spreads faster than previous ones and often affects children. Their high sociability and a low level of vaccination in Ukraine resulted in a sharp increase in the number of hospitalizations. The complexity of the research is also related to the geolocation of the Lviv region. This article analyzes and predicts the number of hospitalizations of children during the fourth wave of the COVID-19 pandemic for the first time for the Lviv region. Data were obtained from publicly available resources. Public Domain Software-the Python programming language and the Pandas library-was used for software implementation of the machine-learning method: the developed model consists of two components-analysis and prediction. The analysis of the number of hospitalized children was performed using the Pearson correlation coefficient. Short- and medium-term predictions were made with the use of non-iterative SGTM neural-like structures that were taught in supervised mode and tested in online mode. The RMS and maximum ones that were reduced to the range of error values of short-term (up to a week) and medium-term (up to 2 weeks) predictions did not exceed 0.48% and 0.61% and 1.81% and 2.83%, respectively. The developed model can also be used for predicting other COVID-19 parameters.
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Affiliation(s)
- Olena Pavliuk
- grid.10067.300000 0001 1280 1647Department of Automated Control Systems, Lviv Polytechnic National University, Stepan Bandera Str., 12, Lviv, 79013 Ukraine
| | - Halyna Kolesnyk
- grid.10067.300000 0001 1280 1647Foreign Languages Department, Lviv Polytechnic National University, Stepan Bandera Str., 12, Lviv, 79013 Ukraine
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14
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Brindisi G, Spalice A, Anania C, Bonci F, Gori A, Capponi M, Cinicola B, De Castro G, Martinelli I, Pulvirenti F, Matera L, Mancino E, Guido CA, Zicari AM. COVID-19, Anosmia, and Allergies: Is There a Relationship? A Pediatric Perspective. J Clin Med 2022; 11:jcm11175019. [PMID: 36078947 PMCID: PMC9457095 DOI: 10.3390/jcm11175019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/06/2022] [Accepted: 08/25/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Between June and July 2020, we evaluated children and adolescents concerning post-infection surveillance after a COVID-19 positivity during the lockdown. We aimed to assess whether the anamnestic presence of allergies could correlate with the presence of SARS-CoV-2 symptoms, and in particular with anosmia. Material and methods: For each patient, we collected anamnestic data, the presence of allergies documented by performing skin prick tests, and COVID-19 symptoms. Then, if over six years of age, each patient underwent an active anterior rhinomanometry. Results: A total of 296 patients were enrolled, of whom 105 (35.4%) reported allergies. Considering COVID-19 symptoms, 74 subjects (25%) presented an asymptomatic form, 222 (75%) reported symptoms, and anosmia recurred in 60 subjects (27.03%). A statistically significant relationship was found between allergies and symptomatic COVID-19 (p = 0.042), allergies, and anosmia (p = 0.05), and allergies and anosmia in males (p = 0.007). Moreover, anosmic patients presented a higher body mass index, older age, and a longer COVID-19 duration with statistical significance (p = 0.001, 0.001, 0.006, respectively). Conclusions: Allergic subjects seem to develop symptomatic COVID-19 more frequently and allergies appear to be a protective factor from anosmia’s onset in males.
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Affiliation(s)
- Giulia Brindisi
- Department of Mother-Child, Urological Science, Sapienza University of Rome, 00161 Rome, Italy
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy
- Correspondence: ; Tel.: +39-06-49979333
| | - Alberto Spalice
- Department of Mother-Child, Urological Science, Sapienza University of Rome, 00161 Rome, Italy
| | - Caterina Anania
- Department of Mother-Child, Urological Science, Sapienza University of Rome, 00161 Rome, Italy
| | - Flaminia Bonci
- Department of Mother-Child, Urological Science, Sapienza University of Rome, 00161 Rome, Italy
| | - Alessandra Gori
- Department of Mother-Child, Urological Science, Sapienza University of Rome, 00161 Rome, Italy
| | - Martina Capponi
- Department of Mother-Child, Urological Science, Sapienza University of Rome, 00161 Rome, Italy
| | - Bianca Cinicola
- Department of Mother-Child, Urological Science, Sapienza University of Rome, 00161 Rome, Italy
- Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Giovanna De Castro
- Department of Mother-Child, Urological Science, Sapienza University of Rome, 00161 Rome, Italy
| | - Ivana Martinelli
- Department of Mother-Child, Urological Science, Sapienza University of Rome, 00161 Rome, Italy
| | - Federica Pulvirenti
- Primary Immune Deficiencies Unit, Department of Internal Medicine and Infectious Diseases, Azienda Ospedaliera Universitaria Policlinico Umberto I, 00185 Rome, Italy
| | - Luigi Matera
- Department of Mother-Child, Urological Science, Sapienza University of Rome, 00161 Rome, Italy
| | - Enrica Mancino
- Department of Mother-Child, Urological Science, Sapienza University of Rome, 00161 Rome, Italy
| | - Cristiana Alessia Guido
- Department of Mother-Child, Urological Science, Sapienza University of Rome, 00161 Rome, Italy
| | - Anna Maria Zicari
- Department of Mother-Child, Urological Science, Sapienza University of Rome, 00161 Rome, Italy
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15
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Ponce-Campos SD, Díaz JM, Moreno-Agundis D, González-Delgado AL, Andrade-Lozano P, Avelar-González FJ, Hernández-Cuellar E, Torres-Flores F. A Physiotherapy Treatment Plan for Post-COVID-19 Patients That Improves the FEV1, FVC, and 6-Min Walk Values, and Reduces the Sequelae in 12 Sessions. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:907603. [PMID: 36188947 PMCID: PMC9397810 DOI: 10.3389/fresc.2022.907603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 05/10/2022] [Indexed: 11/13/2022]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causal agent of Coronavirus disease 2019 (COVID-19), a pandemic disease declared in 2020. The clinical manifestations of this pathology are heterogeneous including fever, cough, dyspnea, anosmia, headache, fatigue, taste dysfunction, among others. Survivors of COVID-19 have demonstrated several persistent symptoms derived from its multisystemic physiopathology. These symptoms can be fatigue, dyspnea, chest pain, dry and productive cough, respiratory insufficiency, and psychoemotional disturbance. To reduce and recover from the post-COVID-19 sequelae is fundamental an early and multifactorial medical treatment. Integral post-COVID-19 physiotherapy is a tool to reduce dyspnea, improve lung capacity, decrease psychoemotional alterations, as well as increase the muscle strength affected by this disease. Thus, the aim of this study was to establish a novel physiotherapeutic plan for post-COVID-19 patients, evaluating the effect of this treatment in the reduction of the sequelae in terms of lung capacity, cardio-respiratory, and muscular strength improvements. This was a cross-sectional study in which a protocol of 12 sessions in 4 weeks of physiotherapy was implemented in the patients enrolled. We conducted a medical assessment, an interview, a DASS-21 test, a spirometry, a 6-min walk test, and a hand dynamometer test to evaluate the post-COVID condition of patients before and after the sessions. A total of 42 patients participated in the program. Results of this work showed a decrease of around 50% of post-COVID-19 sequelae and an improvement in the psychoemotional status of patients. Also, we observed an increase of 7.16% in the FEV1 value and 7.56% for FVC. In addition, the maximal functional capacity increased by 0.577 METs, the 6-min walk test performance increased by 13%, and the SpO2 improved by 1.40%. Finally, the handgrip strength test showed an improvement in the left hand and right hand of 2.90 and 2.24 Kg, respectively. We developed this study to propose a novel methodology to provide information for a better treatment and management of post-COVID-19 patients.
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Affiliation(s)
- Silvia Denise Ponce-Campos
- Unidad Medico Didáctica, Universidad Autónoma de Aguascalientes, Aguascalientes, Mexico
- Unidad de Medicina Interna, Adscripción al Servicio de Neumología, Hospital General ISSSTE Aguascalientes, Aguascalientes, Mexico
| | - Juan Manuel Díaz
- Unidad Medico Didáctica, Universidad Autónoma de Aguascalientes, Aguascalientes, Mexico
- *Correspondence: Juan Manuel Díaz
| | | | | | - Paulina Andrade-Lozano
- Departamento de Medicina, Universidad Autónoma de Aguascalientes, Aguascalientes, Mexico
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16
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Gutmann D, Donath H, Herrlich L, Lehmkühler T, Landeis A, Ume ER, Hutter M, Goßmann AK, Weis F, Weiß M, Rabenau HF, Zielen S. Exhaled Aerosols in SARS-CoV-2 Polymerase Chain Reaction-Positive Children and Age-Matched-Negative Controls. Front Pediatr 2022; 10:941785. [PMID: 35923787 PMCID: PMC9339682 DOI: 10.3389/fped.2022.941785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 06/14/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Children and adolescents seem to be less affected by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease in terms of severity, especially until the increasing spread of the omicron variant in December 2021. Anatomical structures and lower number of exhaled aerosols may in part explain this phenomenon. In a cohort of healthy and SARS-CoV-2 infected children, we compared exhaled particle counts to gain further insights about the spreading of SARS-CoV-2. MATERIALS AND METHODS In this single-center prospective observational trial, a total of 162 children and adolescents (age 6-17 years), of whom 39 were polymerase chain reaction (PCR)-positive for SARS-CoV-2 and 123 PCR-negative, were included. The 39 PCR-positive children were compared to 39 PCR-negative age-matched controls. The data of all PCR-negative children were analyzed to determine baseline exhaled particle counts in children. In addition, medical and clinical history was obtained and spirometry was measured. RESULTS Baseline exhaled particle counts were low in healthy children. Exhaled particle counts were significantly increased in SARS-CoV-2 PCR-positive children (median 355.0/L; range 81-6955/L), compared to age-matched -negative children (median 157.0/L; range 1-533/L; p < 0.001). CONCLUSION SARS-CoV-2 PCR-positive children exhaled significantly higher levels of aerosols than healthy children. Overall children had low levels of exhaled particle counts, possibly indicating that children are not the major driver of the SARS-CoV-2 pandemic. TRIAL REGISTRATION [ClinicalTrials.gov], Identifier [NCT04739020].
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Affiliation(s)
- Desiree Gutmann
- Division of Allergology, Pulmonology and Cystic Fibrosis, Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Helena Donath
- Division of Allergology, Pulmonology and Cystic Fibrosis, Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Laura Herrlich
- Division of Allergology, Pulmonology and Cystic Fibrosis, Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Timon Lehmkühler
- Division of Allergology, Pulmonology and Cystic Fibrosis, Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Anton Landeis
- Division of Allergology, Pulmonology and Cystic Fibrosis, Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Emily R Ume
- Division of Allergology, Pulmonology and Cystic Fibrosis, Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Martin Hutter
- Division of Allergology, Pulmonology and Cystic Fibrosis, Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | | | - Frederik Weis
- Palas GmbH, Partikel- und Lasermesstechnik, Karlsruhe, Germany
| | - Maximilian Weiß
- Palas GmbH, Partikel- und Lasermesstechnik, Karlsruhe, Germany
| | - Holger F Rabenau
- Institute for Medical Virology, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Stefan Zielen
- Division of Allergology, Pulmonology and Cystic Fibrosis, Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
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