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Bishop K, Meiring S, Tempia S, von Gottberg A, Wolter N, Kleynhans J, Moosa F, du Plessis M, Moyes J, Makhasi M, Chuene B, Samuels A, Dawood H, Reubenson G, Zar H, Quan V, Cohen C, Walaza S. Risk Factors for Severe COVID-19 Among Children and Adolescents Enrolled in Acute Respiratory Infection Sentinel Surveillance in South Africa, 2020-2022. Influenza Other Respir Viruses 2024; 18:e13300. [PMID: 38666359 PMCID: PMC11046310 DOI: 10.1111/irv.13300] [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: 11/03/2023] [Revised: 04/05/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Identifying children at risk for severe COVID-19 disease from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may guide future mitigation interventions. Using sentinel surveillance data, we aimed to identify risk factors for SARS-CoV-2-associated hospitalisation among patients aged ≤ 18 years with respiratory illness. METHODS From April 2020 to March 2022, patients meeting study case definitions were enrolled at four outpatient influenza-like illness (ILI) and five inpatient severe respiratory infection (SRI) surveillance sites and tested for SARS-CoV-2 infection using polymerase chain reaction (PCR). Each ILI clinic shared a catchment area with its corresponding SRI hospital. Potential risk factors for SARS-CoV-2-associated hospitalisation were analysed using multivariable logistic regression by comparing inpatient versus outpatient SARS-CoV-2 cases. RESULTS Of 4688 participants aged ≤ 18 years, 4556 (97%) with complete PCR and HIV data were included in the analysis. Among patients with ILI and SRI, 92/1145 (8%) and 154/3411 (5%) tested SARS-CoV-2 positive, respectively. Compared to outpatients, hospitalised SARS-CoV-2 cases were associated with age < 6 months ([adjusted odds ratio (aOR) 8.0, 95% confidence interval (CI) 2.7-24.0] versus 1-4 years); underlying medical condition other than HIV [aOR 5.8, 95% CI 2.3-14.6]; laboratory-confirmed Omicron BA.1/BA.2 or Delta variant ([aOR 4.9, 95% CI 1.7-14.2] or [aOR 2.8, 95% CI 1.1-7.3] compared to ancestral SARS-CoV-2); and respiratory syncytial virus coinfection [aOR 6.2, 95% CI 1.0-38.5]. CONCLUSION Aligning with previous research, we identified age < 6 months or having an underlying condition as risk factors for SARS-CoV-2-associated SRI hospitalisation and demonstrated the potential of sentinel surveillance to monitor COVID-19 in children.
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Affiliation(s)
- Kate Bishop
- Division of Public Health Surveillance and ResponseNational Institute for Communicable Diseases (NICD), a division of the National Health Laboratory Service (NHLS)JohannesburgSouth Africa
| | - Susan Meiring
- Division of Public Health Surveillance and ResponseNational Institute for Communicable Diseases (NICD), a division of the National Health Laboratory Service (NHLS)JohannesburgSouth Africa
| | - Stefano Tempia
- Centre for Respiratory Diseases and MeningitisNational Institute for Communicable Diseases (NICD), a division of the National Health Laboratory Service (NHLS)JohannesburgSouth Africa
- School of Public Health, Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
- MassGenicsDuluthGeorgiaUSA
- Influenza ProgramCenters for Disease Control and PreventionPretoriaSouth Africa
| | - Anne von Gottberg
- Centre for Respiratory Diseases and MeningitisNational Institute for Communicable Diseases (NICD), a division of the National Health Laboratory Service (NHLS)JohannesburgSouth Africa
- School of Pathology, Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Nicole Wolter
- Centre for Respiratory Diseases and MeningitisNational Institute for Communicable Diseases (NICD), a division of the National Health Laboratory Service (NHLS)JohannesburgSouth Africa
- School of Pathology, Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Jackie Kleynhans
- Centre for Respiratory Diseases and MeningitisNational Institute for Communicable Diseases (NICD), a division of the National Health Laboratory Service (NHLS)JohannesburgSouth Africa
- School of Public Health, Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Fahima Moosa
- Centre for Respiratory Diseases and MeningitisNational Institute for Communicable Diseases (NICD), a division of the National Health Laboratory Service (NHLS)JohannesburgSouth Africa
| | - Mignon du Plessis
- Centre for Respiratory Diseases and MeningitisNational Institute for Communicable Diseases (NICD), a division of the National Health Laboratory Service (NHLS)JohannesburgSouth Africa
| | - Jocelyn Moyes
- Centre for Respiratory Diseases and MeningitisNational Institute for Communicable Diseases (NICD), a division of the National Health Laboratory Service (NHLS)JohannesburgSouth Africa
| | - Mvuyo Makhasi
- Centre for Respiratory Diseases and MeningitisNational Institute for Communicable Diseases (NICD), a division of the National Health Laboratory Service (NHLS)JohannesburgSouth Africa
| | - Boitumelo Chuene
- Centre for Respiratory Diseases and MeningitisNational Institute for Communicable Diseases (NICD), a division of the National Health Laboratory Service (NHLS)JohannesburgSouth Africa
| | - Aaron M. Samuels
- Influenza ProgramCenters for Disease Control and PreventionPretoriaSouth Africa
- Influenza DivisionNational Center for Immunization and Respiratory Diseases, Centers for Disease Control and PreventionAtlantaGeorgiaUSA
| | - Halima Dawood
- Infectious Diseases Unit, Department of MedicineGreys HospitalPietermaritzburgKwaZulu‐NatalSouth Africa
| | - Gary Reubenson
- Department of Paediatrics and Child Health, Rahima Moosa Mother and Child Hospital, Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Heather J. Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, and SA‐MRC Unit on Child and Adolescent HealthUniversity of Cape TownCape TownSouth Africa
| | - Vanessa Quan
- Division of Public Health Surveillance and ResponseNational Institute for Communicable Diseases (NICD), a division of the National Health Laboratory Service (NHLS)JohannesburgSouth Africa
| | - Cheryl Cohen
- Centre for Respiratory Diseases and MeningitisNational Institute for Communicable Diseases (NICD), a division of the National Health Laboratory Service (NHLS)JohannesburgSouth Africa
- School of Public Health, Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Sibongile Walaza
- Centre for Respiratory Diseases and MeningitisNational Institute for Communicable Diseases (NICD), a division of the National Health Laboratory Service (NHLS)JohannesburgSouth Africa
- DST/NRF Vaccine Preventable DiseasesRespiratory and Meningeal Pathogens Research Unit (RMPRU)JohannesburgSouth Africa
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Kulkarni D, Ismail NF, Zhu F, Wang X, del Carmen Morales G, Srivastava A, Allen KE, Spinardi J, Rahman AE, Kyaw MH, Nair H. Epidemiology and clinical features of SARS-CoV-2 infection in children and adolescents in the pre-Omicron era: A global systematic review and meta-analysis. J Glob Health 2024; 14:05003. [PMID: 38419461 PMCID: PMC10902805 DOI: 10.7189/jogh.14.05003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024] Open
Abstract
Methods We searched MEDLINE, Embase, Global Health, CINAHL, China National Knowledge Infrastructure, Wanfang, CQvip, and the World Health Organization (WHO) COVID-19 global literature databases for primary studies recruiting children aged ≤18 years with a diagnosis of SARS-CoV-2 infection confirmed either by molecular or antigen tests. We used the Joanna Briggs Institute critical appraisal tools to appraise the study quality and conducted meta-analyses using the random effects model for all outcomes except for race/ethnicity as risk factors of SARS-CoV-2 infection. Results We included 237 studies, each reporting at least one of the study outcomes. Based on data from 117 studies, the pooled SARS-CoV-2 positivity rate was 9.30% (95% confidence interval (CI) = 7.15-11.73). Having a comorbidity was identified as a risk factor for SARS-CoV-2 infection (risk ratio (RR) = 1.33; 95% CI = 1.04-1.71) based on data from 49 studies. Most cases in this review presented with mild disease (n = 50; 52.47% (95% CI = 44.03-60.84)). However, 20.70% of paediatric SARS-CoV-2 infections were hospitalised (67 studies), 7.19% required oxygen support (57 studies), 4.26% required intensive care (93 studies), and 2.92% required assisted ventilation (63 studies). The case fatality ratio (n = 119) was 0.87% (95% CI = 0.54-1.28), which included in-hospital and out-of-hospital deaths. Conclusions Our data showed that children were at risk for SARS-CoV-2 infections and severe outcomes in the pre-Omicron era. These findings underscore the need for effective vaccination strategies for the paediatric population to protect against the acute and long-term sequelae of COVID-19. Registration PROSPERO: CRD42022327680.
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Affiliation(s)
- Durga Kulkarni
- Centre for Global Health, University of Edinburgh, Edinburgh, United Kingdom
| | - Nabihah Farhana Ismail
- Centre for Global Health, University of Edinburgh, Edinburgh, United Kingdom
- Communicable Disease Control Unit, Public Health Department, Johor State, Malaysia
| | - Fuyu Zhu
- Schol of Public Health, Nanjing Medical University, China
| | - Xin Wang
- Schol of Public Health, Nanjing Medical University, China
| | | | | | | | | | - Ahmed Ehsanur Rahman
- Centre for Global Health, University of Edinburgh, Edinburgh, United Kingdom
- International Centre for Diarrhoeal Diseases Research, Bangladesh
| | | | - Harish Nair
- Centre for Global Health, University of Edinburgh, Edinburgh, United Kingdom
- Schol of Public Health, Nanjing Medical University, China
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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3
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Hashmi SK, Bodea J, Patni T, Angel S, Bhakta NH, Jeha S, Karol SE, Ribeiro RC, Rubnitz JE, Wolf J, Li Y, Pui CH, Hijano DR, Inaba H. COVID-19 in Pediatric Patients With Acute Lymphoblastic Leukemia or Lymphoma. JAMA Netw Open 2024; 7:e2355727. [PMID: 38363571 PMCID: PMC10873761 DOI: 10.1001/jamanetworkopen.2023.55727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/18/2023] [Indexed: 02/17/2024] Open
Abstract
Importance COVID-19 in pediatric patients with acute lymphoblastic leukemia or lymphoma (ALL/LLy) has not been described in detail and may affect chemotherapy administration and long-term outcomes. Objective To describe the clinical presentation of COVID-19 and chemotherapy modifications in pediatric patients with ALL/LLy. Design, Setting, and Participants This is a retrospective case series of patients at St Jude Children's Research Hospital and its affiliate sites with newly diagnosed ALL/LLy who were treated on the Total XVII protocol (NCT03117751) between March 30, 2020, and June 20, 2022. Participants included patients aged 1 to 18 years who were receiving protocol chemotherapy. Acute symptoms and chemotherapy modifications were evaluated for 60 days after the COVID-19 diagnosis, and viral clearance, adverse events, and second SARS-CoV-2 infections were followed up during the 27-month study period. Exposures SARS-CoV-2; all patients were screened at least weekly and at symptom onset and/or after known exposure to SARS-CoV-2. Main Outcomes and Measures Description of the spectrum of COVID-19 illness and chemotherapy modifications. Results Of 308 pediatric patients, 110 (36%) developed COVID-19 at a median age of 8.2 (IQR, 5.3-14.5) years. Sixty-eight patients (62%) were male. Most patients were in the continuation/maintenance phase of chemotherapy (101 [92%]). Severe disease was rare (7 [6%]) but was associated with older age, higher white blood cell counts at ALL/LLy diagnosis, lower absolute lymphocyte counts at COVID-19 diagnosis, abnormal chest imaging findings, and SARS-CoV-2 reinfection. Rare but serious thrombotic events included pulmonary embolism and cerebral venous sinus thrombosis (n = 1 for each). No multisystem inflammatory syndrome in children or death was seen. SARS-CoV-2 reinfection occurred in 11 patients (10%) and was associated with older age and with receiving standard or high-risk vs low-risk ALL/LLy therapy. Chemotherapy interruptions occurred in 96 patients (87%) and were longer for patients with severe disease, SARS-CoV-2 reinfection, and/or a COVID-19 diagnosis during the pre-Omicron variant period vs the post-Omicron period (after December 27, 2021). Conclusions and Relevance In this case series of COVID-19 in pediatric patients with ALL/LLy, severe COVID-19 was rare, but chemotherapy administration was affected in most patients. Long-term studies are needed to establish the outcomes of COVID-19 in this population.
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Affiliation(s)
- Saman K. Hashmi
- Department of Oncology, St Jude Children’s Research Hospital, Memphis, Tennessee
- Department of Global Pediatric Medicine, St Jude Children’s Research Hospital, Memphis, Tennessee
| | - Jessica Bodea
- Department of Oncology, St Jude Children’s Research Hospital, Memphis, Tennessee
| | - Tushar Patni
- Department of Biostatistics, St Jude Children’s Research Hospital, Memphis, Tennessee
| | - Savannah Angel
- Department of Oncology, St Jude Children’s Research Hospital, Memphis, Tennessee
| | - Nickhill H. Bhakta
- Department of Oncology, St Jude Children’s Research Hospital, Memphis, Tennessee
- Department of Global Pediatric Medicine, St Jude Children’s Research Hospital, Memphis, Tennessee
| | - Sima Jeha
- Department of Oncology, St Jude Children’s Research Hospital, Memphis, Tennessee
- Department of Global Pediatric Medicine, St Jude Children’s Research Hospital, Memphis, Tennessee
| | - Seth E. Karol
- Department of Oncology, St Jude Children’s Research Hospital, Memphis, Tennessee
| | - Raul C. Ribeiro
- Department of Oncology, St Jude Children’s Research Hospital, Memphis, Tennessee
| | - Jeffrey E. Rubnitz
- Department of Oncology, St Jude Children’s Research Hospital, Memphis, Tennessee
| | - Joshua Wolf
- Department of Infectious Diseases, St Jude Children’s Research Hospital, Memphis, Tennessee
| | - Yimei Li
- Department of Biostatistics, St Jude Children’s Research Hospital, Memphis, Tennessee
| | - Ching-Hon Pui
- Department of Oncology, St Jude Children’s Research Hospital, Memphis, Tennessee
- Department of Global Pediatric Medicine, St Jude Children’s Research Hospital, Memphis, Tennessee
| | - Diego R. Hijano
- Department of Infectious Diseases, St Jude Children’s Research Hospital, Memphis, Tennessee
| | - Hiroto Inaba
- Department of Oncology, St Jude Children’s Research Hospital, Memphis, Tennessee
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4
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Tabatabaei SR, Babaie D, Hoseini-Alfatemi SM, Shamshiri A, Karimi A. Determining the coverage and efficacy of the COVID-19 vaccination program at the community level in children aged 12 to 17 in Tehran. GMS HYGIENE AND INFECTION CONTROL 2024; 19:Doc04. [PMID: 38404412 PMCID: PMC10884833 DOI: 10.3205/dgkh000459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
Background The vaccination is one of the acceptable and recomended solution to prevent and control of COVID-19. The aim of this study was to determine the efficacy of sinopharm vaccination in children aged 12-17 in Tehran. Methods The case population study was performed from October 2021 to March 2022 among 1,500 children with positive PCR test reffered in Mofid Children's Hospital in Tehran. 64 children aged 12-17 years were included. The data were collected by the hospital information system (HIS), vaccination information registration systems and questionnaire with their families. The coverage and efficacy of vaccination determined with equels commented by WHO. Results Out of 64 children, 52 children were 12 to 15 years old (13.35±1.08), 12 children were 16 to 17 years old (16.55±0.52). 48.4% had received two doses of vaccine. The highest rate of positive PCR was observed in February 2022. Sinopharm vaccine coverage in this age group was 93.6% for the first dose and 81.1% for the second dose. Based on this information, 48.4% children in this study have received two complete doses of the COVID-19 vaccine. The efficacy of the vaccine was estimated as 94.4% (95% CI 90.2 to 97.7). Conclusion It seems the coverage of Sinopharm vaccination in the age group of 12-17 years in Tehran is favorable and has high efficacy in this age group. In order to obtain more accurate and comprehensive estimation, it is recommended to take a sample on a wider level of the community.
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Affiliation(s)
- Sedigheh Rafiei Tabatabaei
- Pediatric Infections Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Delara Babaie
- Department of Allergy and Clinical Immunology, Mofid Children’s Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyedeh Mahsan Hoseini-Alfatemi
- Pediatric Infections Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ahmadreza Shamshiri
- Research Center for Caries Prevention, Dentistry Research Institute, Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Abdollah Karimi
- Pediatric Infections Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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5
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Aparicio C, Willis ZI, Nakamura MM, Wolf J, Little C, Maron GM, Sue PK, Anosike BI, Miller C, Bio LL, Singh P, James SH, Oliveira CR. Risk Factors for Pediatric Critical COVID-19: A Systematic Review and Meta-Analysis. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.01.17.24301452. [PMID: 38293040 PMCID: PMC10827273 DOI: 10.1101/2024.01.17.24301452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
Background Risk stratification is a cornerstone of the Pediatric Infectious Diseases Society COVID-19 treatment guidance. This systematic review and meta-analysis aimed to define the clinical characteristics and comorbidities associated with critical COVID-19 in children and adolescents. Methods Two independent reviewers screened the literature (Medline and EMBASE) for studies published through August 2023 that reported outcome data on patients aged ≤21 years with COVID-19. Critical disease was defined as an invasive mechanical ventilation requirement, intensive care unit admission, or death. Random effects models were used to estimate pooled odds ratios (OR) with 95% confidence intervals (CI), and heterogeneity was explored through subgroup analyses. Results Among 10,178 articles, 136 studies met the inclusion criteria for review. Data from 70 studies, which collectively examined 172,165 children and adolescents with COVID-19, were pooled for meta-analysis. In previously healthy children, the absolute risk of critical disease from COVID-19 was 4% (95% CI, 1%-10%). Compared with no comorbidities, the pooled OR for critical disease was 3.95 (95% CI, 2.78-5.63) for presence of one comorbidity and 9.51 (95% CI, 5.62-16.06) for ≥2 comorbidities. Key risk factors included cardiovascular and neurological disorders, chronic pulmonary conditions (excluding asthma), diabetes, obesity, and immunocompromise, all with statistically significant ORs >2.00. Conclusions While the absolute risk for critical COVID-19 in children and adolescents without underlying health conditions is relatively low, the presence of one or more comorbidities was associated with markedly increased risk. These findings support the importance of risk stratification in tailoring pediatric COVID-19 management.
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Affiliation(s)
- Camila Aparicio
- Department of Pediatrics, Yale University School of Medicine, New Haven, CT
| | - Zachary I. Willis
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC
| | - Mari M. Nakamura
- Antimicrobial Stewardship Program and Division of Infectious Diseases, Boston Children’s Hospital, Boston, MA
| | - Joshua Wolf
- Department of Infectious Diseases, St. Jude Children’s Research Hospital and Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN
| | - Cordell Little
- Department of Pediatrics, Yale University School of Medicine, New Haven, CT
| | - Gabriela M. Maron
- Department of Infectious Diseases, St. Jude Children’s Research Hospital and Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN
| | - Paul K. Sue
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY
| | - Brenda I. Anosike
- Department of Pediatrics, The Children’s Hospital at Montefiore and Albert Einstein College of Medicine, Bronx, NY
| | - Christine Miller
- Department of Pediatrics, Yale University School of Medicine, New Haven, CT
| | - Laura L. Bio
- Department of Pharmacy, Lucile Packard Children’s Hospital, Stanford, CA
| | - Prachi Singh
- Department of Pediatrics, University of California San Francisco, San Francisco, CA
| | - Scott H. James
- Department of Pediatrics, Division of Pediatric Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL
| | - Carlos R. Oliveira
- Department of Pediatrics, Yale University School of Medicine, New Haven, CT
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Johnson JN, Pouraliakbar H, Mahdavi M, Ranjbar A, Pfirman K, Mehra V, Ahmed S, Ba-Atiyah W, Galal MO, Zahr RA, Hussain N, Tadikamalla RR, Farah V, Dzelebdzic S, Muniz JC, Lee M, Williams J, Lee S, Aggarwal SK, Clark DE, Hughes SG, Ganigara M, Nagiub M, Hussain T, Kwok C, Lim HS, Nolan M, Kikuchi DS, Goulbourne CA, Sahu A, Sievers B, Sievers B, Sievers B, Garg R, Armas CR, Paleru V, Agarwal R, Rajagopal R, Bhagirath P, Kozor R, Aneja A, Tunks R, Chen SSM. Society for Cardiovascular Magnetic Resonance 2022 Cases of SCMR case series. J Cardiovasc Magn Reson 2023; 26:100007. [PMID: 38211509 DOI: 10.1016/j.jocmr.2023.100007] [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: 11/27/2023] [Accepted: 12/10/2023] [Indexed: 01/13/2024] Open
Abstract
"Cases of SCMR" is a case series on the SCMR website (https://www.scmr.org) for the purpose of education. The cases reflect the clinical presentation, and the use of cardiovascular magnetic resonance (CMR) in the diagnosis and management of cardiovascular disease. The 2022 digital collection of cases are presented in this manuscript.
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Affiliation(s)
- Jason N Johnson
- Division of Pediatric Cardiology and Pediatric Radiology, The University of Tennessee Health Science Center, Memphis, TN, USA
| | - Hamidreza Pouraliakbar
- Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Mahdavi
- Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Abdolmohammad Ranjbar
- Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran; Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Kristopher Pfirman
- Department of Cardiovascular Medicine, Geisinger Medical Center, Danville, PA, USA
| | - Vishal Mehra
- Department of Cardiovascular Medicine, Geisinger Medical Center, Danville, PA, USA
| | - Shahzad Ahmed
- Department of Cardiovascular Medicine, Geisinger Medical Center, Danville, PA, USA
| | - Wejdan Ba-Atiyah
- Pediatric Cardiology Section, Department of Pediatrics, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Mohammed Omar Galal
- Pediatric Cardiology Section, Department of Pediatrics, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Riad Abou Zahr
- Pediatric Cardiology Section, Department of Pediatrics, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Nasir Hussain
- Department of Advanced Cardiac Imaging, Allegheny General Hospital, Pittsburgh, PA, USA
| | | | - Victor Farah
- Department of Advanced Cardiac Imaging, Allegheny General Hospital, Pittsburgh, PA, USA
| | | | | | - Marc Lee
- Division of Pediatric Cardiology, Nationwide Children's Hospital, Columbus, OH, USA
| | - Jason Williams
- Division of Pediatric Cardiology, Nationwide Children's Hospital, Columbus, OH, USA
| | - Simon Lee
- Division of Pediatric Cardiology, Nationwide Children's Hospital, Columbus, OH, USA
| | | | - Daniel E Clark
- Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Sean G Hughes
- Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Madhusudan Ganigara
- Division of Pediatric Cardiology, The University of Chicago & Biological Sciences, Chicago, IL, USA
| | - Mohamed Nagiub
- Division of Pediatric Cardiology, Virginia Tech Carilion School of Medicine, Roanoke, VA, USA
| | - Tarique Hussain
- Division of Pediatric Cardiology, Children's Medical Center Dallas, Dallas, TX, USA
| | - Cecilia Kwok
- Cardiology Department, Western Health, St Albans, Victoria, Australia
| | - Han S Lim
- Cardiology Department, Austin and Northern Health, University of Melbourne, Victoria, Australia
| | - Mark Nolan
- Cardiology Department, Western Health, St Albans, Victoria, Australia; Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Daniel S Kikuchi
- Osler Medical Residency, The Johns Hopkins Hospital, Baltimore, MD, USA
| | - Clive A Goulbourne
- Division of Cardiology, Department of Medicine, Emory University, Atlanta, GA, USA
| | - Anurag Sahu
- Division of Cardiology, Department of Medicine, Emory University, Atlanta, GA, USA
| | - Berge Sievers
- International School Düsseldorf, Düsseldorf, Germany
| | - Berk Sievers
- International School Düsseldorf, Düsseldorf, Germany
| | - Burkhard Sievers
- Department of Internal Medicine, Divisions of Cardiology, Pulmonology, Vascular Medicine, Nephrology and Intensive Care Medicine, Sana Klinikum Remscheid, Germany
| | - Rimmy Garg
- University of Illinois College of Medicine Peoria, OSF St. Francis Medical Center, Peoria, IL, USA
| | - Carlos Requena Armas
- University of Illinois College of Medicine Peoria, OSF St. Francis Medical Center, Peoria, IL, USA
| | - Vijayasree Paleru
- University of Illinois College of Medicine Peoria, OSF St. Francis Medical Center, Peoria, IL, USA
| | - Ritu Agarwal
- Department of Radiology, Eternal Hospital, Jaipur, India
| | - Rengarajan Rajagopal
- Department of Radiology, All India Institute of Medical Sciences, Jodhpur, India
| | - Pranav Bhagirath
- Department of Cardiology, St. Thomas Hospital, London, England, UK
| | - Rebecca Kozor
- Department of Cardiology, Royal North Shore Hospital, The University of Sydney, St Leonards, Australia
| | - Ashish Aneja
- Department of Cardiology, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Robert Tunks
- Division of Pediatric Cardiology, Penn State Health, Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Sylvia S M Chen
- Adult Congenital Heart Disease, The Prince Charles Hospital, Australia.
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7
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Rothoeft T, Brinkmann F, Maier C, Selzer D, Dings C, Kuehn A, Möhler E, Grote H, Nonnenmacher A, Wenning M, Zemlin M, Richter U, Lehr T, Lücke T. Motivations for Adolescent COVID-19 Vaccination: A Comparative Study of Adolescent and Caregiver Perspectives in Germany. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1890. [PMID: 38136092 PMCID: PMC10742286 DOI: 10.3390/children10121890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 11/28/2023] [Accepted: 12/04/2023] [Indexed: 12/24/2023]
Abstract
Given the crucial role of vaccination in halting the COVID-19 pandemic, it is imperative to understand the factors that motivate adolescents to get vaccinated. We surveyed adolescents and their accompanying guardians scheduled to receive a COVID-19 vaccination (Comirnaty) in an urban region in Germany in mid-2021 regarding their motivation for getting vaccinated and collected data on their sociodemographic characteristics, medical history, vaccination status, and any history of COVID-19 infection in the family. We also queried information strategies related to the SARS-CoV-2 pandemic. Motivations for getting vaccinated were similar among adolescents and their parents. The primary reasons for vaccination were protection against SARS-CoV-2-related illness and gaining access to leisure facilities. This was not influenced by gender, health status, migration background, or the presence of chronic or acute diseases. The percentage of parents who had received SARS-CoV-2 immunization and the proportion of parents with a high level of education were higher among study participants than in the general population. Adolescents were especially willing to be vaccinated if they came from a better educational environment and had a high vaccination rate in the family. Emphasizing the importance of vaccination among all segments of the population and removing barriers to vaccines may lead to an ameliorated acceptance of COVID-19 vaccines.
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Affiliation(s)
- Tobias Rothoeft
- University Hospital of Pediatrics and Adolescent Medicine, St. Josef-Hospital, Ruhr-University Bochum, 44791 Bochum, Germany; (F.B.); (C.M.); (H.G.); (T.L.)
| | - Folke Brinkmann
- University Hospital of Pediatrics and Adolescent Medicine, St. Josef-Hospital, Ruhr-University Bochum, 44791 Bochum, Germany; (F.B.); (C.M.); (H.G.); (T.L.)
- University Children’s Hospital, 23562 Lübeck, Germany
- Airway Research Center North (ARCN), German Center for Lung Research (DZL), 22927 Großhansdorf, Germany
| | - Christoph Maier
- University Hospital of Pediatrics and Adolescent Medicine, St. Josef-Hospital, Ruhr-University Bochum, 44791 Bochum, Germany; (F.B.); (C.M.); (H.G.); (T.L.)
| | - Dominik Selzer
- Department of Clinical Pharmacy, Saarland University, 66123 Saarbrücken, Germany; (D.S.); (C.D.); (A.K.); (T.L.)
| | - Christiane Dings
- Department of Clinical Pharmacy, Saarland University, 66123 Saarbrücken, Germany; (D.S.); (C.D.); (A.K.); (T.L.)
| | - Anna Kuehn
- Department of Clinical Pharmacy, Saarland University, 66123 Saarbrücken, Germany; (D.S.); (C.D.); (A.K.); (T.L.)
| | - Eva Möhler
- Department of Child and Adolescent Psychiatry, Saarland University Hospital, 66421 Homburg, Germany;
| | - Hanna Grote
- University Hospital of Pediatrics and Adolescent Medicine, St. Josef-Hospital, Ruhr-University Bochum, 44791 Bochum, Germany; (F.B.); (C.M.); (H.G.); (T.L.)
| | - Alexandra Nonnenmacher
- School of Education and Psychology, Siegen University, 57076 Siegen, Germany; (A.N.); (U.R.)
| | - Markus Wenning
- Medical Association, Westfalen-Lippe, 48151 Münster, Germany;
| | - Michael Zemlin
- Department of General Pediatrics and Neonatology, Saarland University Hospital, 66421 Homburg, Germany;
| | - Ulf Richter
- School of Education and Psychology, Siegen University, 57076 Siegen, Germany; (A.N.); (U.R.)
| | - Thorsten Lehr
- Department of Clinical Pharmacy, Saarland University, 66123 Saarbrücken, Germany; (D.S.); (C.D.); (A.K.); (T.L.)
| | - Thomas Lücke
- University Hospital of Pediatrics and Adolescent Medicine, St. Josef-Hospital, Ruhr-University Bochum, 44791 Bochum, Germany; (F.B.); (C.M.); (H.G.); (T.L.)
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8
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White BM, Walsh E, Willgerodt M. The Resilience of Pediatric Nurses in Context: A Mixed Methods Study. West J Nurs Res 2023; 45:1085-1093. [PMID: 37882413 DOI: 10.1177/01939459231204693] [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] [Indexed: 10/27/2023]
Abstract
BACKGROUND Resilience, an individual's ability to cope with and recover from stressors, is supported by contextually specific factors. Factors in the work environment may support or hinder nurses' resilience to the specific stressors present in pediatric nursing, an understudied population. OBJECTIVE We aimed to explore the contextual factors in the work environment of pediatric nurses with varying levels of resilience, including social support, the work environment, and opportunities for coping from an individual approach. METHODS This study is a secondary mixed-methods analysis using ordinal logistic regression and a meta-matrix of survey responses and semi-structured interview transcripts from 30 pediatric nurses. RESULTS 5 themes, 3 supporting and 2 hindering resilience, emerged from the interviews. Nurses described their resilience as supported by sharing the burden, support from administration, and taking a break. Participants described resilience as hindered when they found it challenging to provide quality nursing care and when they felt unappreciated or undervalued. No theme significantly changed the odds of having higher resilience. CONCLUSIONS Our findings suggest that nurses recognize resources and conditions within their work environment as influencing their resilience. However, workplace resources and conditions are only one contributor to pediatric nurse resilience. Encouraging breaks and informal opportunities for nurses to support each other may support resilience in pediatric nurses. In addition, nursing leaders can support pediatric nurse resilience by regularly spending time connecting with nurses. Finally, health care organizations should consider how changes in the work environment may hinder nurse resilience by adding stress or changing access to supportive factors.
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Ungar SP, Solomon S, Stachel A, Shust GF, Clouser KN, Bhavsar SM, Lighter J. Hospital and ICU Admission Risk Associated With Comorbidities Among Children With COVID-19 Ancestral Strains. Clin Pediatr (Phila) 2023; 62:1048-1058. [PMID: 36661087 PMCID: PMC9895283 DOI: 10.1177/00099228221150605] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
A large proportion of children have been affected by COVID-19; we evaluated the association between comorbidities and hospitalization/ICU (intensive care unit) admission among 4097 children under age 21 years with symptomatic COVID-19 (not just polymerase chain reaction [PCR]-positive or multisystem inflammatory syndrome in children associated with COVID-19 [MIS-C]) from 2 large health systems from March 2020 to September 2021. Significant comorbidities and demographic factors identified by univariable analysis were included in a multivariable logistic regression compared with children ages 6 to 11 without comorbidities. In all, 475 children (11.6%) were hospitalized, of whom 25.5% required ICU admission. Children under 1 year had high hospitalization risk, but low risk of ICU admission. Presence of at least 1 comorbidity was associated with hospitalization and ICU admission (odds ratio [OR] > 4). Asthma, obesity, chronic kidney disease, sickle cell disease, bone marrow transplantation, and neurologic disorders were associated with hospitalization (adjusted odds ratio [AOR] > 2). Malignancy, intellectual disability, and prematurity were associated with ICU admission (AOR > 4). Comorbidities are significantly associated with hospitalization/ICU admission among children with COVID-19.
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Affiliation(s)
- Stephanie P. Ungar
- Division of Pediatric Infectious
Diseases, Department of Pediatrics, New York University Grossman School of Medicine,
New York, NY, USA
| | - Sadie Solomon
- Department of Infection Prevention and
Control, New York University Langone Health, New York, NY, USA
| | - Anna Stachel
- Department of Infection Prevention and
Control, New York University Langone Health, New York, NY, USA
| | - Gail F. Shust
- Division of Pediatric Infectious
Diseases, Department of Pediatrics, New York University Grossman School of Medicine,
New York, NY, USA
| | - Katharine N. Clouser
- Department of Pediatrics, Hackensack
University Medical Center, Hackensack Meridian School of Medicine, Hackensack, NJ,
USA
| | - Sejal M. Bhavsar
- Department of Pediatrics, Hackensack
University Medical Center, Hackensack Meridian School of Medicine, Hackensack, NJ,
USA
| | - Jennifer Lighter
- Division of Pediatric Infectious
Diseases, Department of Pediatrics, New York University Grossman School of Medicine,
New York, NY, USA
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Schott W, Tao S, Shea L. Prevalence of high-risk conditions for severe COVID-19 among Medicaid-enrolled children with autism and mental health diagnoses in the United States. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:2145-2157. [PMID: 36799305 PMCID: PMC9941459 DOI: 10.1177/13623613231155265] [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] [Indexed: 02/18/2023]
Abstract
LAY ABSTRACT Children are at risk of varying severity of illness and even death from COVID-19. We aim to determine whether autistic children or children with mental health conditions have more underlying health conditions that put people at risk of severe illness from COVID-19. We use data from a national sample of Medicaid-enrolled children for the years 2008-2016. These data include children across the 50 states and the District of Columbia. We compare the prevalence of underlying conditions among autistic children and children with mental health condition to that of other children in Medicaid. This study included 888,487 autistic children, 423,397 with any mental health condition (but not autism), and 932,625 children without any of these diagnoses. We found 29.5% of autistic children and 25.2% of children with mental health conditions had an underlying condition with high risk for severe illness from COVID, compared to 14.1% of children without these diagnoses. Autistic children had over twice the odds of having any underlying conditions, when accounting for age, race, sex, and other characteristics. Children with mental health conditions had 70% higher odds of having these underlying conditions. Mitigation measures in schools and other areas could minimize risk of short- and long-term impacts from COVID for autistic and all children.
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Hurst JH, Mohan AA, Dalapati T, George IA, Aquino JN, Lugo DJ, Pfeiffer TS, Rodriguez J, Rotta AT, Turner NA, Burke TW, McClain MT, Henao R, DeMarco CT, Louzao R, Denny TN, Walsh KM, Xu Z, Mejias A, Ramilo O, Woods CW, Kelly MS. Differential host responses within the upper respiratory tract and peripheral blood of children and adults with SARS-CoV-2 infection. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.07.31.23293337. [PMID: 37577568 PMCID: PMC10418569 DOI: 10.1101/2023.07.31.23293337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
Age is among the strongest risk factors for severe outcomes from SARS-CoV-2 infection. We sought to evaluate associations between age and both mucosal and systemic host responses to SARS-CoV-2 infection. We profiled the upper respiratory tract (URT) and peripheral blood transcriptomes of 201 participants (age range of 1 week to 83 years), including 137 non-hospitalized individuals with mild SARS-CoV-2 infection and 64 uninfected individuals. Among uninfected children and adolescents, young age was associated with upregulation of innate and adaptive immune pathways within the URT, suggesting that young children are primed to mount robust mucosal immune responses to exogeneous respiratory pathogens. SARS-CoV-2 infection was associated with broad induction of innate and adaptive immune responses within the URT of children and adolescents. Peripheral blood responses among SARS-CoV-2-infected children and adolescents were dominated by interferon pathways, while upregulation of myeloid activation, inflammatory, and coagulation pathways was observed only in adults. Systemic symptoms among SARS-CoV-2-infected subjects were associated with blunted innate and adaptive immune responses in the URT and upregulation of many of these same pathways within peripheral blood. Finally, within individuals, robust URT immune responses were correlated with decreased peripheral immune activation, suggesting that effective immune responses in the URT may promote local viral control and limit systemic immune activation and symptoms. These findings demonstrate that there are differences in immune responses to SARS-CoV-2 across the lifespan, including between young children and adolescents, and suggest that these varied host responses contribute to observed differences in the clinical presentation of SARS-CoV-2 infection by age. One Sentence Summary Age is associated with distinct upper respiratory and peripheral blood transcriptional responses among children and adults with SARS-CoV-2 infection.
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Hijano DR, Ferrolino JA, Swift EG, Michaels CA, Max A, Hayden RT, Wolf J, Dallas RH, Greene WL, Richardson JL, Hakim H, Morton TH, Cross SJ. SARS-CoV-2 infection in high-risk children following tixagevimab-cilgavimab (Evusheld) pre-exposure prophylaxis: a single-center observational study. Front Oncol 2023; 13:1229655. [PMID: 37601666 PMCID: PMC10436088 DOI: 10.3389/fonc.2023.1229655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 07/10/2023] [Indexed: 08/22/2023] Open
Abstract
From 8 December 2021 to 26 January 2023, tixagevimab-cilgavimab (T-C) was authorized for pre-exposure prophylaxis of COVID-19. During this period, we used a multidisciplinary team to communicate, screen, approach, and administer T-C to eligible patients. Twenty-seven patients were eligible. Of these, 24 (88.9%) received at least one dose of T-C and three patients received two doses. Majority of patients were White, non-Hispanic, and women. Only two patients had COVID-19 prior to receiving T-C. Seventeen (70.8%) had received two or more doses of SARS-CoV-2 vaccine. No serious adverse events were noted. Seven patients developed SARS-CoV-2 infection within 180 days of receiving T-C (median 102 days; range 28-135), and only one patient developed severe COVID-19 requiring intensive mechanical ventilation in the intensive care unit.
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Affiliation(s)
- Diego R. Hijano
- Department of Infectious Diseases, St. Jude Children Research Hospital, Memphis, TN, United States
| | - Jose A. Ferrolino
- Department of Infectious Diseases, St. Jude Children Research Hospital, Memphis, TN, United States
| | - Elizabeth G. Swift
- Center for Advanced Practice Providers, St. Jude Children Research Hospital, Memphis, TN, United States
| | - Carolyn A. Michaels
- Center for Advanced Practice Providers, St. Jude Children Research Hospital, Memphis, TN, United States
| | - Anita Max
- Center for Advanced Practice Providers, St. Jude Children Research Hospital, Memphis, TN, United States
| | - Randall T. Hayden
- Department of Pathology, St. Jude Children Research Hospital, Memphis, TN, United States
| | - Joshua Wolf
- Department of Infectious Diseases, St. Jude Children Research Hospital, Memphis, TN, United States
- Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Ronald H. Dallas
- Department of Infectious Diseases, St. Jude Children Research Hospital, Memphis, TN, United States
| | - William L. Greene
- Center for Advanced Practice Providers, St. Jude Children Research Hospital, Memphis, TN, United States
| | - Julie L. Richardson
- Department of Pharmacy and Pharmaceutical Sciences, St. Jude Children Research Hospital, Memphis, TN, United States
| | - Hana Hakim
- Department of Infectious Diseases, St. Jude Children Research Hospital, Memphis, TN, United States
| | - Ted H. Morton
- Department of Infectious Diseases, St. Jude Children Research Hospital, Memphis, TN, United States
- Department of Pharmacy and Pharmaceutical Sciences, St. Jude Children Research Hospital, Memphis, TN, United States
| | - Shane J. Cross
- Department of Pharmacy and Pharmaceutical Sciences, St. Jude Children Research Hospital, Memphis, TN, United States
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Damps M, Byrska-Maciejasz E, Kowalska M, Rosada-Kurasińska J, Rybojad B, Sordyl J, Zielińska M, Bartkowska-Śniatkowska A. COVID-19 in Pediatric Intensive Care Units in Poland, PAPITCO-19 Study (Polish Analysis of PICU Trends during COVID-19). J Clin Med 2023; 12:3983. [PMID: 37373677 DOI: 10.3390/jcm12123983] [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: 04/26/2023] [Revised: 06/05/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Children suffering from COVID-19 constitute about 10% of the entire population infected with the virus. In most of them, we observe asymptomatic or mild courses; however, about 1% of affected children require a stay in a paediatric intensive care unit (PICU) due to the course of the disease becoming severely life-threatening. The risk of respiratory failure, as with adults, is associated with the coexistence of concomitant diseases. The aim of our study was to analyse patients admitted to PICUs due to the severe course of their SARS-CoV-2 infection. We studied epidemiological and laboratory parameters, as well as the endpoint (survival or death). METHODS A retrospective multi-centre study, the analysis covered all children with a confirmed diagnosis of SARS-CoV-2 virus infection who were admitted to PICUs in the period from November 2020 to August 2021. We studied epidemiological and laboratory parameters, as well as the endpoint (survival or death). RESULTS The study analysed 45 patients (0.075% of all children hospitalised in Poland due to COVID-19 at that time). Mortality calculated in the entire study group was 40% (n = 18). Statistically significant differences between the compared groups (survived and died) concerned the parameters of the respiratory system. Lung Injury Score and the Paediatric Sequential Organ Failure Assessment were used. A significant correlation between disease severity and the patient's prognosis was shown by the liver function parameter AST (p = 0.028). During the analysis of patients requiring mechanical ventilation and assuming survival as the primary outcome, a significantly higher oxygen index on the first day of hospitalisation, lower pSOFA scores and lower AST levels (p: 0.007; 0.043; 0.020; 0.005; 0.039, respectively) were found. CONCLUSIONS As with adults, children with comorbidities are most frequently at risk of severe SARS-CoV-2 infection. Increasing symptoms of respiratory failure, the need for mechanical ventilation and persistently high values of aspartate aminotransferase are indicators of poor prognosis.
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Affiliation(s)
- Maria Damps
- Department of Anaesthesiology and Intensive Care, Upper Silesian Child Health Centre, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland
| | - Elżbieta Byrska-Maciejasz
- Department of Anaesthesiology and Intensive Therapy, University Children's Hospital of Krakow, 30-663 Krakow, Poland
| | - Małgorzata Kowalska
- Department of Epidemiology, School of Medicine in Katowice, Medical University of Silesia, 40-514 Katowice, Poland
| | - Jowita Rosada-Kurasińska
- Department of Paediatric Anaesthesiology and Intensive Care, Poznań University of Medical Sciences, 60-806 Poznan, Poland
| | - Beata Rybojad
- Department of Anaesthesiology and Intensive Therapy, Faculty of Medicine, Medical University of Lublin; 20-035 Lublin, Poland
| | - Joanna Sordyl
- Department of Oncology, Hematology, and Chemotherapy, Upper Silesian Child Health Centre, 40-752 Katowice, Poland
| | - Marzena Zielińska
- Department of Anesthesiology and Intensive Care, Wrocław Medical University, 50-556 Wrocław, Poland
- Department of Paediatric Anesthesiology and Intensive Care, University Clinical Hospital in Wrocław, 50-556 Wrocław, Poland
| | - Alicja Bartkowska-Śniatkowska
- Department of Paediatric Anaesthesiology and Intensive Care, Poznań University of Medical Sciences, 60-806 Poznan, Poland
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Ng DCE, Liew CH, Tan KK, Chin L, Ting GSS, Fadzilah NF, Lim HY, Zailanalhuddin NE, Tan SF, Affan MA, Nasir FFWA, Subramaniam T, Ali MM, Rashid MFA, Ong SQ, Ch'ng CC. Risk factors for disease severity among children with Covid-19: a clinical prediction model. BMC Infect Dis 2023; 23:398. [PMID: 37308825 DOI: 10.1186/s12879-023-08357-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 05/30/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND Children account for a significant proportion of COVID-19 hospitalizations, but data on the predictors of disease severity in children are limited. We aimed to identify risk factors associated with moderate/severe COVID-19 and develop a nomogram for predicting children with moderate/severe COVID-19. METHODS We identified children ≤ 12 years old hospitalized for COVID-19 across five hospitals in Negeri Sembilan, Malaysia, from 1 January 2021 to 31 December 2021 from the state's pediatric COVID-19 case registration system. The primary outcome was the development of moderate/severe COVID-19 during hospitalization. Multivariate logistic regression was performed to identify independent risk factors for moderate/severe COVID-19. A nomogram was constructed to predict moderate/severe disease. The model performance was evaluated using the area under the curve (AUC), sensitivity, specificity, and accuracy. RESULTS A total of 1,717 patients were included. After excluding the asymptomatic cases, 1,234 patients (1,023 mild cases and 211 moderate/severe cases) were used to develop the prediction model. Nine independent risk factors were identified, including the presence of at least one comorbidity, shortness of breath, vomiting, diarrhea, rash, seizures, temperature on arrival, chest recessions, and abnormal breath sounds. The nomogram's sensitivity, specificity, accuracy, and AUC for predicting moderate/severe COVID-19 were 58·1%, 80·5%, 76·8%, and 0·86 (95% CI, 0·79 - 0·92) respectively. CONCLUSION Our nomogram, which incorporated readily available clinical parameters, would be useful to facilitate individualized clinical decisions.
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Affiliation(s)
- David Chun-Ern Ng
- Hospital Tuanku Ja'afar, Negeri Sembilan, Ministry of Health, Jalan Rasah, 70300, Seremban, Malaysia.
| | - Chuin-Hen Liew
- Hospital Tuanku Ampuan Najihah, Negeri Sembilan, Ministry of Health, Jalan Melang, 72000, Kuala Pilah, Malaysia
| | - Kah Kee Tan
- Perdana University Seremban Clinical Academic Center, Negeri Sembilan, Jalan Rasah, 70300, Seremban, Malaysia
| | - Ling Chin
- Hospital Tuanku Ja'afar, Negeri Sembilan, Ministry of Health, Jalan Rasah, 70300, Seremban, Malaysia
| | - Grace Sieng Sing Ting
- Hospital Tuanku Ja'afar, Negeri Sembilan, Ministry of Health, Jalan Rasah, 70300, Seremban, Malaysia
| | - Nur Fadzreena Fadzilah
- Hospital Tuanku Ja'afar, Negeri Sembilan, Ministry of Health, Jalan Rasah, 70300, Seremban, Malaysia
| | - Hui Yi Lim
- Hospital Tuanku Ja'afar, Negeri Sembilan, Ministry of Health, Jalan Rasah, 70300, Seremban, Malaysia
| | - Nur Emylia Zailanalhuddin
- Hospital Tuanku Ja'afar, Negeri Sembilan, Ministry of Health, Jalan Rasah, 70300, Seremban, Malaysia
| | - Shir Fong Tan
- Hospital Tuanku Ja'afar, Negeri Sembilan, Ministry of Health, Jalan Rasah, 70300, Seremban, Malaysia
| | - Muhamad Akmal Affan
- Hospital Tuanku Ja'afar, Negeri Sembilan, Ministry of Health, Jalan Rasah, 70300, Seremban, Malaysia
| | | | - Thayasheri Subramaniam
- Hospital Tuanku Ja'afar, Negeri Sembilan, Ministry of Health, Jalan Rasah, 70300, Seremban, Malaysia
| | - Marlindawati Mohd Ali
- Hospital Tuanku Ja'afar, Negeri Sembilan, Ministry of Health, Jalan Rasah, 70300, Seremban, Malaysia
| | - Mohammad Faid Abd Rashid
- Negeri Sembilan State Health Department, Negeri Sembilan, Ministry of Health, Jalan Rasah, 70300, Seremban, Malaysia
| | - Song-Quan Ong
- Institute for Tropical Biology and Conservation, University Malaysia Sabah, Jalan UMS, 88400, Kota Kinabalu, Sabah, Malaysia
| | - Chin Chin Ch'ng
- Clinical Research Centre Hospital Pulau Pinang, Ministry of Health, Jalan Residensi, 10450, Pulau Pinang, Malaysia
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Chaiyakulsil C, Sritipsukho P, Satdhabudha A, Bunjoungmanee P, Tangsathapornpong A, Sinlapamongkolkul P, Sritipsukho N. Prevalence, risk factors, and vaccine effectiveness of COVID-19 infection in thai children, adolescents, and young adults in the omicron era. Front Pediatr 2023; 11:1173162. [PMID: 37234858 PMCID: PMC10206128 DOI: 10.3389/fped.2023.1173162] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 04/26/2023] [Indexed: 05/28/2023] Open
Abstract
Background and objectives The study of prevalence, risk factors, and vaccine effectiveness (VE) in children, adolescents, and young adults during the Omicron era has been limited, making this the objectives of the study. Methods A prospective, test-negative case-control study was conducted on patients aged 0-24 years old classified as patients under investigation (PUI) from January to May 2022. PUI with positive RT-PCR within 14 days were classified as cases, whilst PUI with negative RT-PCR in 14 days were controls. Univariate and multivariate analyses determined risk factors; VE was calculated using [1-adjusted odds ratio (OR)] × 100. Results The final analyses included 3,490 patients with a PUI infection rate of 45.6%. Heterologous vaccination regimens, including inactivated vaccines, viral vectors, and mRNA were utilized during the study period. A total of 2,563 patients (73.5%) had received at least 2 vaccine doses, regardless of regimen. Male gender and household infections were independent risk factors for the development of infection, with an adjusted OR of 1.55 and 1.45, respectively. Underlying comorbidities and obesity were not significantly associated with the development of infection. Patients with underlying comorbidities were more likely to have at least moderate severity of infection with the adjusted OR of 3.07. Age older than 11 years was associated with lower infection risk and development of at least moderate infection with adjusted OR of 0.4 and 0.34, respectively. Vaccinated participants also had a lower risk of developing at least moderate infection: adjusted OR of 0.40. The adjusted VE of any vaccination regimen for infection prevention for one, two, three, or more than four doses was 21.8%, 30.6%, 53.5%, and 81.2%, respectively. The adjusted VE of any vaccination regimen for prevention of at least moderate severity of the disease for one, two, three, or more than four doses was 5.7%, 24.3% 62.9%, and 90.6%, respectively. Conclusion Disease prevalence among PUI was substantially high during the Omicron wave. A two-dose vaccination regimen does not appear sufficient to ensure protection against infection.
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Affiliation(s)
- Chanapai Chaiyakulsil
- Division of Pediatric Critical Care, Department of Pediatrics, Faculty of Medicine, Thammasat University Hospital, Thammasat University, Pathumthani, Thailand
| | - Paskorn Sritipsukho
- Division of Pediatric Allergy and Immunology, Department of Pediatrics, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
- Center of Excellence in Applied Epidemiology, Thammasat University, Pathumthani, Thailand
| | - Araya Satdhabudha
- Division of Pediatric Pulmonology, Department of Pediatrics, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
| | - Pornumpa Bunjoungmanee
- Division of Pediatric Infectious Disease, Department of Pediatrics, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
| | - Auchara Tangsathapornpong
- Division of Pediatric Infectious Disease, Department of Pediatrics, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
| | - Phakatip Sinlapamongkolkul
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
| | - Naiyana Sritipsukho
- Thammasat Postdoctoral Fellowship, Thammasat University, Pathumthani, Thailand
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16
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Chau SW, Hussain S, Chan SS, Wong OW, Zhang J, Feng H, Lai KY, Ling S, So SH, Tsoi KK, Wing YK, Hung SF, Leung PW. A comparison of sleep-wake patterns among school-age children and adolescents in Hong Kong before and during the COVID-19 pandemic. J Clin Sleep Med 2023; 19:749-757. [PMID: 36692167 PMCID: PMC10071375 DOI: 10.5664/jcsm.10422] [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: 09/14/2022] [Revised: 11/22/2022] [Accepted: 11/22/2022] [Indexed: 01/25/2023]
Abstract
STUDY OBJECTIVES The lifestyles change of children and adolescents during the COVID-19 pandemic due to antipandemic measures can affect their sleep health. Existing studies have used convenient samples and focused on the initial months of the pandemic, leaving a knowledge gap on changes in young people's sleep patterns under the "new normal" under COVID-19. METHODS As part of a territory-wide epidemiological study in Hong Kong, this cross-sectional study recruited primary and secondary school students by stratified random sampling. Sleep parameters were collected using the structured diagnostic interview for sleep patterns and disorders. We investigated the pandemic's effects on sleep parameters by comparing data of participants recruited pre-COVID and those recruited during COVID using multivariate regression, adjusting for age, sex, household income, seasonality, and presence of mental disorders, and the moderators and mediators of the effects. RESULTS Between September 1, 2019 and June 2, 2021, 791 primary and 442 secondary school students were recruited and analyzed. Primary school and secondary school participants assessed before COVID had a longer sleep latency on school days (95% confidence interval [CI] = 1.0-5.2 minutes, adjusted P-value = .010; and 95% CI= 3.9-13.0 minutes, adjusted P-value = .004, respectively) and nonschool days (95% CI = 1.7-7.2 minutes, adjusted P-value = .005; 95% CI = 3.4-13.7 minutes, adjusted P-value = .014, respectively). Low household income was a moderator for later bedtime (adjusted P-value = .032) and later sleep onset (adjusted P-value = .043) during nonschool days among secondary school students. CONCLUSIONS Changes associated with COVID have a widespread and enduring effect on the sleep health of school-aged students in Hong Kong. Household income plays a role in adolescent sleep health resilience, and the impact of antiepidemic measures on the health gaps of the youth should be considered. CITATION Chau SWH, Hussain S, Chan SSM, et al. A comparison of sleep-wake patterns among school-age children and adolescents in Hong Kong before and during the COVID-19 pandemic. J Clin Sleep Med. 2023;19(4):749-757.
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Affiliation(s)
- Steven W.H. Chau
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR
| | - Samara Hussain
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR
| | - Sandra S.M. Chan
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR
| | - Oscar W.H. Wong
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR
| | - Jihui Zhang
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR
| | - Hongliang Feng
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR
| | - Kelly Y.C. Lai
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR
| | - Suk Ling
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR
| | - Suzanne H.W. So
- Department of Psychology, Faculty of Social Science, The Chinese University of Hong Kong, Hong Kong SAR
| | - Kelvin K.F. Tsoi
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR
| | - Yun Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR
| | - Se Fong Hung
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR
| | - Patrick W.L. Leung
- Department of Psychology, Faculty of Social Science, The Chinese University of Hong Kong, Hong Kong SAR
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17
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Beltran DM, Villamil Osorio M, Fonseca SLG, Restrepo-Gualteros SM, Garcia MJR, Rodriguez-Martinez CE. Predictors of severity in severe respiratory infection in children with COVID-19 respiratory infection in a developing country. J Med Virol 2023; 95:e28453. [PMID: 36594415 DOI: 10.1002/jmv.28453] [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: 07/21/2022] [Revised: 12/13/2022] [Accepted: 12/29/2022] [Indexed: 01/04/2023]
Abstract
On March 11, 2020, the WHO declared the COVID-19 pandemic. This name was given to the disease caused by the SARS-CoV 2 virus at its outbreak in December 2019 in Wuhan, Hubei, China. In Colombia, a significant number of cases have been confirmed. The aim of this study was to evaluate children with respiratory symptoms caused by SARS-CoV2 infection, identifying independent predictors of risk of having a severe illness, thus leading to an early approach and intervention in our patients, especially in children with comorbidities. An analytical cross-sectional study was conducted between April 1, 2020 and March 31, 2021 at a fourth-level referral institution in Bogotá on patients under 18 years of age with respiratory symptoms and a COVID-19 diagnosis confirmed in the laboratory. An explanatory binary logistic regression model was performed with an outcome variable of admission to the intensive care unit. A total of 385 children were included in the study, with ages between 9 months and 17 years of age; 50.1% were male, and the ICR was 9.75 years. 41.6% had some comorbidity, 13.5% were admitted to the pediatric ICU, and 3.6% of the total number of patients died. The predictor variables were: use of antibiotics in the first 24 h, neurological comorbidity, and consolidation shown in the chest X-ray. This explains 38.7% of the variability of the variable. In this cohort of patients with COVID-19-associated respiratory symptoms, we identified predictors of severity, so we consider that these patients require a risk approach that allows timely and adequate care.
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Affiliation(s)
| | | | | | | | | | - Carlos E Rodriguez-Martinez
- Department of Pediatrics, School of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia.,Department of Pediatric Pulmonology, School of Medicine, Universidad El Bosque, Bogotá, Colombia
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Casassola GM, Schmidt CJ, Affeldt GH, Morais DS, Alvarenga LKB, Miller C, Ziegler B. Functional status of hospitalized pediatric patients with COVID-19 in southern Brazil: a prospective cohort study. J Bras Pneumol 2023; 48:e20220153. [PMID: 36651435 PMCID: PMC9747171 DOI: 10.36416/1806-3756/e20220153] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 09/27/2022] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE The present study aimed to assess the functional status of children diagnosed with COVID-19 at the time of hospitalization and the associations with clinical features. METHODS This prospective cohort study was carried out with children diagnosed with COVID-19 admitted to a tertiary hospital. The patients' functioning was assessed using the pediatric Functional Status Scale (FSS). RESULTS A total of 62 children with a median age of 3 years old were included in the study, and 70% had some comorbidity prior to the diagnosis of COVID-19. The median length of stay was nine days, during which period five patients died. The FSS assessment of the sample showed that approximately 55% had some functional alteration. The group of patients with the highest FSS scores presented a lengthier hospital stay (p = 0.016), required more oxygen therapy (p < 0.001), mechanical ventilation (p = 0.001), and intensive care unit admissions (p = 0.019), and had more cardiac (p = 0.007), neurological (p = 0.003), and respiratory (p = 0.013) comorbidities. In the multivariate analysis, there was an association between the dependent variable length of stay and the total FSS score (b = 0.349, p = 0.004) and the presence of comorbidities (b = 0.357, p = 0.004). CONCLUSIONS We observed that more than half of the children hospitalized due to COVID-19 had some level of functional change. Greater alterations in functional status were associated with the presence of previous comorbidities, a greater need for ventilatory support, and longer hospital stays.
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Affiliation(s)
| | | | - Guilherme Hoff Affeldt
- . Programa de Pós-Graduação em Pneumologia, Universidade Federal do Rio Grande do Sul, Porto Alegre (RS), Brasil
| | | | | | - Cristina Miller
- . Hospital de Clínicas de Porto Alegre, Porto Alegre (RS), Brasil
| | - Bruna Ziegler
- . Hospital de Clínicas de Porto Alegre, Porto Alegre (RS), Brasil
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ICU Admission, Invasive Mechanical Ventilation, and Mortality among Children and Adolescents Hospitalized for COVID-19 in a Private Healthcare System. Int J Pediatr 2023; 2023:1698407. [PMID: 36873820 PMCID: PMC9981283 DOI: 10.1155/2023/1698407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 01/12/2023] [Accepted: 01/27/2023] [Indexed: 02/25/2023] Open
Abstract
Aim The COVID-19 pandemic devastated healthcare around the world. Data about the COVID-19 outcomes among young people are still scarce. We aim to identify factors associated with the composite outcome among children and adolescents hospitalized due to COVID-19. Methods We performed a search in the database of a large Brazilian private healthcare system. Insured people aged 21 years or younger who were hospitalized due to COVID-19 from Feb/28th/2020 to Nov/1st/2021 were included. The primary endpoint was the composite outcome consisting of ICU admission, need for invasive mechanical ventilation, or death. Results We evaluated 199 patients who had an index hospitalization due to COVID-19. The median monthly rate of index hospitalization was 2.7 (interquartile range [IQR], 1.6-3.9) per 100,000 clients aged 21 years or less. The median age of the patients was 4.5 years (IQR, 1.4-14.1). At the index hospitalization, the composite outcome rate was 26.6%. The composite outcome was associated with all the previous coexisting morbidities evaluated. The median follow-up was 249.0 days (IQR, 152.0-438.5). There were 27 readmissions (16 patients) within 30 days after the discharge. Conclusions In conclusion, hospitalized children and adolescents had a composite outcome rate of 26.6% at the index hospitalization. Having previous chronic morbidity was associated with the composite.
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Muacevic A, Adler JR, Şen V. Evaluation of Clinical, Biochemical, and Demographic Characteristics of Paediatric COVID-19 Patients Admitted to Dicle University Hospital. Cureus 2023; 15:e34171. [PMID: 36843786 PMCID: PMC9950032 DOI: 10.7759/cureus.34171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2023] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION AND AIM In this study, we aim to determine how laboratory parameters were related to the clinical courses of patients admitted to the Dicle University Faculty of Medicine Department of Paediatrics and Paediatric Intensive Care Unit with COVID-19 diagnoses from March 2020 to November 2021. MATERIALS AND METHOD Clinical, biochemical and demographic characteristics of 220 patients between 0 and 16 years old with COVID-19 diagnoses at admission were analysed retrospectively. RESULTS We found that 57.3% of patients were male and 42.7% female, with a mean age of 107.8 ± 65.5 (range 1-192) months. Of the cases, 48.6% (n = 107) were asymptomatic, 35.5% (n = 78) were mild, 11.8% (n = 26) were moderately severe and 3.6% (n = 8) were severe. The patients' site of admission, mortality rates, C reactive protein (CRP), lactate dehydrogenase (LDH), ferritin, and fibrinogen levels differed significantly (p < 0.001). CONCLUSION It is important to learn about the clinical course of the disease by accurately interpreting the results of blood parameters and appropriate imaging studies.
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21
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Ortiz-Prado E, Izquierdo-Condoy JS, Fernandez-Naranjo R, Vasconez J, Dávila Rosero MG, Revelo-Bastidas D, Herrería-Quiñonez D, Rubio-Neira M. The deadly impact of COVID-19 among children from Latin America: The case of Ecuador. Front Pediatr 2023; 11:1060311. [PMID: 37152328 PMCID: PMC10160383 DOI: 10.3389/fped.2023.1060311] [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: 10/03/2022] [Accepted: 03/17/2023] [Indexed: 05/09/2023] Open
Abstract
Background The SARS-CoV-2 pandemic remains a critical global health concern, with older adults being the most vulnerable group. Nonetheless, it is crucial to recognize that COVID-19 has caused numerous deaths in children worldwide. Emerging evidence indicates that infants and breastfeeding children, particularly those aged below one year, face a greater risk of hospitalization and mortality than older children with COVID-19. Objective This study aimed to describe the epidemiology of COVID-19 among children during the early phase of the pandemic in Ecuador. Methods We conducted a country-wide population-based analysis of the epidemiology of COVID-19, using incidence and mortality data reported from Ecuador between February 15, 2020 and May 14 2021. Measurements of frequency, central tendency, dispersion, and absolute differences were calculated for all categorical and continuous variables. Results At least 34,001 cases (23,587 confirmed cases, 5,315 probable and 5,099 suspected) and 258 COVID-19 related deaths have been reported among children in Ecuador during the first 16 months of the pandemic. The overall incidence rate was 612 cases per 100,000 children, the mortality rate was 3 per 100,000, while the case fatality rate was 0.76%. The highest risk group for infection was children and adolescents between 15 and 19 years of age; however, the highest mortality rate occurred in children under one year of age. The largest provinces, such as Pichincha, Guavas and Manabí, were the ones that reported the highest number of cases, 27%, 12.1% and 10.8%, respectively. Conclusions This study is the first to report on COVID-19 epidemics among children in Ecuador. Our findings reveal that younger children have a lower risk of SARS-CoV-2 infection, but a higher risk of mortality compared to older children and adolescents. Additionally, we observed significant disparities in infection rates and outcomes among children living in rural areas, those with comorbidities, and those from indigenous ethnic groups.
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Affiliation(s)
- Esteban Ortiz-Prado
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, Calle de los Colimes y Avenida De los Granados, Quito, Ecuador
- Facultad de Ciencias de la Salud, Universidad Latina de Costa Rica,San José, Costa Rica
- Correspondence: Esteban Ortiz-Prado
| | - Juan S. Izquierdo-Condoy
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, Calle de los Colimes y Avenida De los Granados, Quito, Ecuador
| | - Raul Fernandez-Naranjo
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, Calle de los Colimes y Avenida De los Granados, Quito, Ecuador
| | - Jorge Vasconez
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, Calle de los Colimes y Avenida De los Granados, Quito, Ecuador
| | - María Gabriela Dávila Rosero
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, Calle de los Colimes y Avenida De los Granados, Quito, Ecuador
| | - Doménica Revelo-Bastidas
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, Calle de los Colimes y Avenida De los Granados, Quito, Ecuador
| | - Diva Herrería-Quiñonez
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, Calle de los Colimes y Avenida De los Granados, Quito, Ecuador
| | - Mario Rubio-Neira
- Department of Cardiology, Baca Ortiz Pediatric Hospital, Quito, Ecuador
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22
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Non-comorbid Respiratory Factor and Work of Breathing in Pediatric COVID-19 Patient: How is Their Synergistic Correlation with the Level of Care? NURSE MEDIA JOURNAL OF NURSING 2022. [DOI: 10.14710/nmjn.v12i3.45340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Background: Work of breathing (WOB) and non-comorbidities factors in the respiratory system are the two probable findings in pediatric COVID-19 patients. However, the association of those factors with level of care was not well reported.Purpose: This study aimed to identify the relation between potential predictors including comorbidity, low nutritional fulfillment, infectious disease, shock, cough, O2 saturation reduction, abnormal blood gas analysis and sore throat with the level of care among pediatric COVID-19 patients. We also analyzed the synergistic correlation of non-comorbidities factors in the respiratory system and work of breathing to predict level of care in pediatric COVID-19 patients.Methods: A cross-sectional study was conducted in the six referral hospitals from July to September 2020 in four provinces in Indonesia. An observation checklist was used to collect data from the medical records of pediatric patients with COVID-19, including medical diagnosis, demographic, and clinical manifestation. This study included 423 participants aged from 0 to 18. The multivariate logistic regression was performed to test the adjusted odds ratios (AORs) with the 95% confidence intervals (CIs) of the association between WOB, non-comorbid respiratory, and level of care. Moreover, dummy variables (2x2) were made to analyze synergistic correlation of non-comorbid respiratory disease and WOB. The AOR with the 95% CIs was applied in the association between the complication of non-comorbid respiratory diseases and high work of breathing with level of care among pediatric patients with COVID-19.Results: Results showed that age, presence of comorbidity, nutritional fulfillment, infectious disease, shock, work of breathing, O2 saturation reduction, abnormal blood gas analysis, sore throat, and convulsive meningeal consciousness were significantly associated with the level of care (p<0.05). Pediatric patients with non-comorbid respiratory and increased work of breathing had a 15.59 times higher risk of requiring PICU care level (p<0.01). Meanwhile, pediatric patients who experienced both non-comorbid respiratory and increased work of breathing had a 5.76 times risk of requiring an intermediate level of care (p<0.05), and 9.32 times higher risk of requiring a PICU level of care (p<.05).Conclusion: It was found that both non-comorbid respiratory and increased WOB had a significant relationship with the level of care for pediatric patients with COVID-19. Nurse should take into account those clinical findings to increase the awareness in monitoring clinical deterioration in pediatric COVID-19 patients.
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Abstract
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection is common in children, and clinical manifestations can vary depending on age, underlying disease, and vaccination status. Most children will have asymptomatic or mild infection, but certain baseline characteristics can increase the risk of moderate to severe disease. The following article will provide an overview of the clinical manifestations of coronavirus disease 2019 in children, including the post-infectious phenomenon called multisystem inflammatory syndrome in children. Currently available treatment and prophylaxis strategies will be outlined, with the caveat that new therapeutics and clinical efficacy data are constantly on the horizon.
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24
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Joseph G, Klein E, Lustig Y, Weiss-Ottolenghi Y, Asraf K, Indenbaum V, Amit S, Kriger O, Gilboa M, Levy Y, Pessach IM, Kreiss Y, Regev-Yochay G, Stein M. Real-World Immunogenicity and Reactogenicity of Two Doses of Pfizer-BioNTech COVID-19 Vaccination in Children Aged 5-11 Years. Vaccines (Basel) 2022; 10:1954. [PMID: 36423049 PMCID: PMC9693260 DOI: 10.3390/vaccines10111954] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/13/2022] [Accepted: 11/15/2022] [Indexed: 07/30/2023] Open
Abstract
There are limited data concerning the immunogenicity and reactogenicity of COVID-19 vaccines in children. A total of 110 children, 5-11 years old were vaccinated with two doses (with a 3-week interval between doses) of the Pfizer-BioNTech COVID-19 vaccine and were followed for 21, 90, and 180 days after vaccination for immunogenicity, adverse events, and breakthrough infections. Ninety days after the first vaccine dose, the GeoMean (CI 95%) of IgG ascended to 1291.0 BAU (929.6-1790.2) for uninfected children and 1670.0 BAU (1131.0-2466.0) for Infected children. One hundred and eighty days after receiving the first dose of the vaccine, the titers decreased to 535.5 BAU (288.4-993.6) for the uninfected children, while only a small decline was detected among infected children-1479.0 (878.2-2490.0). The neutralizing antibodies titer almost did not change over time in the uninfected children, and even elevated for the infected children. Of the 110 vaccinated children, 75.5% were infected, with only mild COVID-19 infection symptoms. Child vaccination was found to be safe, with mild, mostly local, and of short duration, reported AEs. No serious adverse events (SAEs) were reported after vaccination. The durability of two doses of vaccine in children is longer, thus a booster may not be needed as early as in adults.
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Affiliation(s)
- Gili Joseph
- The Sheba Pandemic Preparedness Research Institute (SPRI), and Infection Prevention & Control Unit, Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel
| | - Elisheva Klein
- The Sheba Pandemic Preparedness Research Institute (SPRI), and Infection Prevention & Control Unit, Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel
| | - Yaniv Lustig
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv 69978, Israel
- Central Virology Laboratory, Public Health Services, Ministry of Health, Tel-Hashomer, Ramat Gan 52621, Israel
| | - Yael Weiss-Ottolenghi
- The Sheba Pandemic Preparedness Research Institute (SPRI), and Infection Prevention & Control Unit, Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel
| | - Keren Asraf
- The Dworman Automated-Mega Laboratory, Sheba Medical Center, Tel-Hashomer, Ramat Gan 52621, Israel
| | - Victoria Indenbaum
- Central Virology Laboratory, Public Health Services, Ministry of Health, Tel-Hashomer, Ramat Gan 52621, Israel
| | - Sharon Amit
- Clinical Microbiology, Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel
| | - Or Kriger
- Clinical Microbiology, Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel
| | - Mayan Gilboa
- The Sheba Pandemic Preparedness Research Institute (SPRI), and Infection Prevention & Control Unit, Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv 69978, Israel
| | - Yuval Levy
- General Management, Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel
| | - Itai M. Pessach
- Pediatric Infectious Diseases Unit, Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel
| | - Yitshak Kreiss
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv 69978, Israel
- General Management, Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel
| | - Gili Regev-Yochay
- The Sheba Pandemic Preparedness Research Institute (SPRI), and Infection Prevention & Control Unit, Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv 69978, Israel
| | - Michal Stein
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv 69978, Israel
- Pediatric Infectious Diseases Unit, Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel
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25
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Kolla E, Weill A, Desplas D, Semenzato L, Zureik M, Grimaldi L. Does Measles, Mumps, and Rubella (MMR) Vaccination Protect against COVID-19 Outcomes: A Nationwide Cohort Study. Vaccines (Basel) 2022; 10:1938. [PMID: 36423033 PMCID: PMC9694832 DOI: 10.3390/vaccines10111938] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/10/2022] [Accepted: 11/14/2022] [Indexed: 10/10/2023] Open
Abstract
Cross-protection from previous live attenuated vaccines is proposed to explain the low impact of COVID-19 on children. This study aimed to evaluate the effect of live attenuated MMR vaccines on the risk of being hospitalized for COVID-19 in children. An exposed (MMR vaccine)-non-exposed cohort study was conducted using the nationwide French National Health Data System (SNDS). We included children born between 1 January 2009 and 31 December 2019. Exposure was defined as a claim of at least one dose of MMR vaccine since birth. Hospitalization for COVID-19 was defined using main diagnostic ICD10 codes. Non-conditional logistic regression was used to calculate the adjusted odds ratios (aORs) of the association between MMR exposure and hospitalization for COVID-19, controlling for socio-demographic and socio-economic factors, co-morbidities, and general health. In total, 6,800,542 (median age 6 IQR [3-8] years) children exposed to a MMR vaccine and 384,162 (6 [3-9] years) not exposed were followed up with for 18 months. Among them, 873 exposed to the MMR vaccine and 38 who were not exposed were hospitalized for COVID-19. In a multi-variate analysis, the exposure of children to MMR vaccination was not associated with a decreased risk of COVID-19 hospitalization versus non-exposure (aOR (95%CI) = 1.09 [0.81-1.48]). A stratified analysis by age showed an aOR = 1.03 [0.64-1.66] for children aged 1-4, an aOR = 1.38 [0.82-2.31] for those aged 5-9, and an aOR = 1.11 [0.54-2.29] for those aged 10-12. Our study suggests that the live attenuated MMR vaccine does not protect children against COVID-19 hospitalization.
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Affiliation(s)
- Epiphane Kolla
- EPI-PHARE (Scientific Interest Group in Epidemiology of Health Products), French National Agency for the Safety of Medicines and Health Products, French National Health Insurance, CEDEX, 93285 Saint-Denis, France
- INSERM (National Institute of Health and Medical Research), University of Paris-Saclay, University Versailles Saint Quentin, Anti-Infective Evasion and Pharmacoepidemiology Team, 78180 Montigny-Le-Bretonneux, France
| | - Alain Weill
- EPI-PHARE (Scientific Interest Group in Epidemiology of Health Products), French National Agency for the Safety of Medicines and Health Products, French National Health Insurance, CEDEX, 93285 Saint-Denis, France
| | - David Desplas
- EPI-PHARE (Scientific Interest Group in Epidemiology of Health Products), French National Agency for the Safety of Medicines and Health Products, French National Health Insurance, CEDEX, 93285 Saint-Denis, France
| | - Laura Semenzato
- EPI-PHARE (Scientific Interest Group in Epidemiology of Health Products), French National Agency for the Safety of Medicines and Health Products, French National Health Insurance, CEDEX, 93285 Saint-Denis, France
| | - Mahmoud Zureik
- EPI-PHARE (Scientific Interest Group in Epidemiology of Health Products), French National Agency for the Safety of Medicines and Health Products, French National Health Insurance, CEDEX, 93285 Saint-Denis, France
- INSERM (National Institute of Health and Medical Research), University of Paris-Saclay, University Versailles Saint Quentin, Anti-Infective Evasion and Pharmacoepidemiology Team, 78180 Montigny-Le-Bretonneux, France
| | - Lamiae Grimaldi
- Clinical Research Unit AP-HP, Paris-Saclay, Hôpital Raymond Poincare, School of Medicine Simone Veil, University Versailles Saint Quentin—University Paris Saclay, INSERM (National Institute of Health and Medical Research), CESP, Anti-Infective Evasion and Pharmacoepidemiology Team, 78180 Montigny-Le-Bretonneux, France
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26
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Fattahi P, Abdi S, Saeedi E, Sirous S, Firuzian F, Mohammadi M, Taheri N, Khaki M, Qandian A, Lotfi F, Iranmehr A, Nemati S, Rajabpour MV. In-hospital mortality of COVID-19 in Iranian children and youth: A multi-centre retrospective cohort study. J Glob Health 2022; 12:05048. [PMID: 36370421 PMCID: PMC9653210 DOI: 10.7189/jogh.12.05048] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background COVID-19 presents as a mild and less severe respiratory disease among children. However, it is still lethal and could lead to death in paediatric cases. The current study aimed to investigate the clinical characteristics of children and young people hospitalized due to COVID-19 in Qazvin-Iran. We also investigated the risk factors of death due to COVID-19 in paediatric cases. Methods We performed a retrospective cohort study on 645 children and young people (ages 0-17) hospitalized since the beginning of the COVID-19 pandemic. The cases were confirmed with positive results of reverse transcription-polymerase chain reaction (RT-PCR). The data were retrieved from an electronic database of demographic, epidemiological, and clinical characteristics. Results The median age of the admitted patients was 4.0 years, 33.6% were under 12 months old, and 53.0% were female. Fever, cough, nausea/vomiting, dyspnoea, and myalgia were the most common symptoms presented by 50.5%, 47.6%, 24.2%, and 23.0% of the patients, respectively. Overall, we observed 16 cases of death and the in-hospital fatality rate was 2.5%. We also found comorbidity as an independent risk factor of death (odds ratio (OR) = 3.8, 95% confidence interval (CI) = 1.2-12.1, P-value = 0.022). Finally, we observed an increased risk of death in patients with dyspnoea (OR = 11.0, 95% CI = 2.8-43.7). Conclusion In-hospital mortality was relatively high in paediatric patients who were hospitalized due to COVID-19 in Iran. The risk of hospitalization, ICU admission, and death was higher among children with younger ages, underlying causes, and dyspnoea.
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Affiliation(s)
- Pedram Fattahi
- Student Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
- Cancer Research Center, Cancer Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sepideh Abdi
- Cancer Research Center, Cancer Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Elnaz Saeedi
- Student Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Samin Sirous
- Cancer Research Center, Cancer Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farnaz Firuzian
- School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mehdi Mohammadi
- Emergency Medicine Management Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Negar Taheri
- Cancer Research Center, Cancer Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mina Khaki
- Cancer Research Center, Cancer Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Qandian
- Communicable disease office, Deputy of Health, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Fereshte Lotfi
- Cancer Research Center, Cancer Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Arad Iranmehr
- Neurological Surgery Department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeed Nemati
- Cancer Research Center, Cancer Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mojtaba Vand Rajabpour
- Cancer Research Center, Cancer Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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27
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Qatawneh MA, Altarawneh M, Alhazaimeh R, Jazazi M, Jarrah O, Shorman A, Alsadah L, Mustafa M. Manifestations of COVID-19 infection in children with malignancy: A single-center experience in Jordan. World J Virol 2022; 11:321-330. [PMID: 36188736 PMCID: PMC9523322 DOI: 10.5501/wjv.v11.i5.321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 06/28/2022] [Accepted: 09/02/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) has been the cause of a global health crisis since the end of 2019. All countries are following the guidelines and re-commendations released by the World Health Organization to decrease the spread of the disease. Children account for only 3%-5% of COVID-19 cases. Few data are available regarding the clinical course, disease severity, and mode of treatment in children with malignancy and COVID-19.
AIM To evaluate the treatment plan and outcome of children with malignancy who contracted COVID-19.
METHODS A retrospective study of the medical files of patients with malignancy who contracted COVID-19 between July 2020 and June 2021 was performed. The following data were reviewed for all patients: primary disease, laboratory data, admission ward, clinical status upon admission, disease course, treatment plan, and outcome. Eligible patients were those with malignancy who tested positive for COVID-19 by reverse transcription polymerase chain reaction.
RESULTS A total of 40 patients who had malignancy contracted COVID-19 from July 1, 2020 to June 1, 2021. Their primary diseases were as follows: 34 patients (85%) had hematological malignancies (30 had acute lymphoblastic leukemia, 2 had acute myeloblastic leukemia, and 2 had Hodgkin lymphoma), whereas 6 patients (15%) had solid tumors (2 had neuroblastoma, 2 had rhabdomyosarcoma, and 2 had central nervous system tumors). Twelve patients (30%) did not need hospitalization and underwent home isolation only, whereas twenty-eight patients (70%) required hospitalization (26 patients were admitted in the COVID-19 ward and 2 were admitted in the pediatric intensive care unit).
CONCLUSION COVID-19 with malignancy in the pediatric age group has a benign course and does not increase the risk of having severe infection compared to other children.
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Affiliation(s)
- Mousa Ahmad Qatawneh
- Department of Hematology and Medical Oncology and Stem Cell Transplantation Unit, Queen Rania Children’s Hospital, Royal Medical Services, Amman 11183, Jordan
| | - Moath Altarawneh
- Department of Hematology and Medical Oncology and Stem Cell Transplantation Unit, Queen Rania Children’s Hospital, Royal Medical Services, Amman 11183, Jordan
| | - Ruba Alhazaimeh
- Department of Hematology and Medical Oncology and Stem Cell Transplantation Unit, Queen Rania Children’s Hospital, Royal Medical Services, Amman 11183, Jordan
| | - Mais Jazazi
- Department of Hematology and Medical Oncology and Stem Cell Transplantation Unit, Queen Rania Children’s Hospital, Royal Medical Services, Amman 11183, Jordan
| | - Omaiema Jarrah
- Department of Hematology and Medical Oncology and Stem Cell Transplantation Unit, Queen Rania Children’s Hospital, Royal Medical Services, Amman 11183, Jordan
| | - Alaa Shorman
- Department of Neonatology, Queen Rania Children’s Hospital, Royal Medical Services, Amman 11183, Jordan
| | - Laila Alsadah
- Department of General Pediatrics, Queen Rania Children’s Hospital, Royal Medical Services, Amman 11183, Jordan
| | - Maher Mustafa
- Department of Hematology and Medical Oncology and Stem Cell Transplantation Unit, Queen Rania Children’s Hospital, Royal Medical Services, Amman 11183, Jordan
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Ferraro VA, Zanconato S, Carraro S. Impact of COVID-19 in Children with Chronic Lung Diseases. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11483. [PMID: 36141755 PMCID: PMC9517525 DOI: 10.3390/ijerph191811483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 09/08/2022] [Accepted: 09/10/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND since December 2019, the world has become victim of the coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The aim of our narrative review is to analyze the impact of COVID-19 in children suffering from chronic lung disease (CLD). METHODS we searched the MEDLINE/Pubmed database using the terms "SARS-CoV-2" or "COVID-19" or "Coronavirus Diseases 2019"; AND "chronic lung diseases" or "chronic respiratory diseases" or "asthma" or "cystic fibrosis" or "primary ciliary dyskinesia" or "bronchopulmonary dysplasia"; and limiting the search to the age range 0-18 years. RESULTS AND CONCLUSIONS although COVID-19 rarely presents with a severe course in children, CLD may represent a risk factor; especially when already severe or poorly controlled before SARS-CoV-2 infection. On the other hand, typical features of children with CLD (e.g., the accurate adoption of prevention measures, and, in asthmatic patients, the regular use of inhaled corticosteroids and T2 inflammation) might have a role in preventing SARS-CoV-2 infection. Moreover, from a psychological standpoint, the restrictions associated with the pandemic had a profound impact on children and adolescents with CLD.
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Bozzola E, Caffarelli C, Santamaria F, Corsello G. The year 2021 in COVID-19 pandemic in children. Ital J Pediatr 2022; 48:161. [PMID: 36064605 PMCID: PMC9444079 DOI: 10.1186/s13052-022-01360-0] [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: 06/21/2022] [Accepted: 08/30/2022] [Indexed: 01/08/2023] Open
Abstract
In this article, the developments in the field of COVID-19 pandemic published in the Italian Journal of Pediatrics in 2021 are reflected. We describe progresses in SARS-CoV-2 transmission route, clinical presentation, diagnosis, treatment, and access to health care facilities in children. They led to substantial changes in the clinical approach.
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Affiliation(s)
- Elena Bozzola
- Department of Pediatric, IRCCS Bambino Gesù Children's Hospital, Pediatric Diseases Unit, Rome, Italy.
| | - Carlo Caffarelli
- Department of Medicine and Surgery, Clinica Pediatrica, Azienda Ospedaliera-Universitaria, University of Parma, Parma, Italy
| | - Francesca Santamaria
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Giovanni Corsello
- Department of Sciences for Health Promotion and Mother and Child Care "G. D'Alessandro", University of Palermo, Palermo, Italy
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D’Ascenzi F, Castelletti S, Adami PE, Cavarretta E, Sanz-de la Garza M, Maestrini V, Biffi A, Kantor P, Pieles G, Verhagen E, Tiberi M, Hanssen H, Papadakis M, Niebauer J, Halle M. Cardiac screening prior to return to play after SARS-CoV-2 infection: focus on the child and adolescent athlete: A Clinical Consensus Statement of the Task Force for Childhood Health of the European Association of Preventive Cardiology. Eur J Prev Cardiol 2022; 29:2120-2124. [PMID: 36059208 PMCID: PMC9494331 DOI: 10.1093/eurjpc/zwac180] [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: 04/06/2022] [Revised: 08/10/2022] [Accepted: 08/16/2022] [Indexed: 01/11/2023]
Abstract
Cardiac sequelae after COVID-19 have been described in athletes, prompting the need to establish a return-to-play (RTP) protocol to guarantee a safe return to sports practice. Sports participation is strongly associated with multiple short- and long-term health benefits in children and adolescents and plays a crucial role in counteracting the psychological and physical effects of the current pandemic. Therefore, RTP protocols should be balanced to promote safe sports practice, particularly after an asymptomatic SARS-CoV-2 infection that represents the common manifestation in children. The present consensus document aims to summarize the current evidence on the cardiac sequelae of COVID-19 in children and young athletes, providing key messages for conducting the RTP protocol in paediatric athletes to promote a safe sports practice during the COVID-19 era.
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Affiliation(s)
| | - Silvia Castelletti
- IRCCS Istituto Auxologico Italiano, Cardiomyopathy Unit and Department of Cardiovascular, Neural and Metabolic Sciences, Milan, Italy
| | - Paolo Emilio Adami
- Health and Science Department, World Athletics, Monaco, Principality of Monaco
| | - Elena Cavarretta
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy,Mediterranea Cardiocentro, Naples, Italy
| | - María Sanz-de la Garza
- Cardiovascular Institute, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Viviana Maestrini
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Alessandro Biffi
- Med-Ex, Medicine and Exercise srl, Medical Partner Scuderia Ferrari, Rome, Italy
| | - Paul Kantor
- Division of Cardiology, Department of Pediatrics, Children’s Hospital of Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Guido Pieles
- Sports Medicine Department, Aspetar, Orthopaedic and Sports Medicine Hospital, Doh, Qatar,Institute of Sport Exercise and Health (ISEH), University College London, London, UK
| | - Evert Verhagen
- Amsterdam Collaboration on Health & Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, University Medical Centers - Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Monica Tiberi
- Sport Medicine, Department of Prevention, ASUR Marche Area Vasta 1, Pesaro, Italy
| | - Henner Hanssen
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
| | - Michael Papadakis
- Cardiovascular Clinical Academic Group, St George’s, University of London, London, UK
| | - Josef Niebauer
- University Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University of Salzburg, Salzburg, Austria
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Sarfraz M, Sarfraz A, Sarfraz Z, Nadeem Z, Khalid J, Butt SZ, Thevuthasan S, Felix M, Cherrez-Ojeda I. Contributing factors to pediatric COVID-19 and MIS-C during the initial waves: A systematic review of 92 case reports. Ann Med Surg (Lond) 2022; 81:104227. [PMID: 35937636 PMCID: PMC9339082 DOI: 10.1016/j.amsu.2022.104227] [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: 05/13/2022] [Revised: 07/19/2022] [Accepted: 07/20/2022] [Indexed: 11/25/2022] Open
Abstract
Background As the coronavirus disease 2019 (COVID-19) pandemic continues to sweep the world with unprecedented speed and devastation, data has shown that cases in the pediatric population have been significantly lower than in the adult population. We conducted a systematic review of case reports to identify the contributing factors of confirmed pediatric COVID-19 patients. Methods Using the PubMed platform, and Cochrane Central, we searched for primary studies alone. All database searches were performed between December 2019 and December 2020. We incorporated keywords including “pediatrics,” “Case reports,” “Cases,” “Covid-19″ into all searches. Results A total of 92 records were included in this novel review. Of all patients, 58% were male and the mean age of the patients was 6.2 years (SD: 5.9). Contributing factors to MIS-C infections were G6PD deficiency (17.6%), Group A streptococcus co-infection (17.6%), infancy (11.8%), whereas those in COVID-19 pediatric patients included congenital (18.5%), and genetic defects (13.8%), in addition to vertical transmission or during infancy (16.9%). Data of baseline demographic characteristics and clinical sequelae of included COVID-19 pediatric and MIS-C patients is presented. Conclusion With schools reopening and closing, the pediatric age group is susceptible to high rates of COVID-19 community transmission. We provide insights into potential contributing factors to pediatric COVID-19 and MIS-C patients. These insights are critical to guide future guidelines on the management and potential vaccination efforts. COVID-19 continues to devastate communities worldwide. The pediatric population has faced the ups and downs of the many variants of disease. This systematic review includes a total of 92 studies and identifies key contributing factors from developmental, maternal and pediatric. We provide insights into potential contributing factors to pediatric COVID-19 and MIS-C patients. These insights are critical to guide future guidelines on the management and potential vaccination efforts.
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32
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Satdhabudha A, Chaiyakulsil C, Uppala R, Niyomkarn W, Tovichien P, Norasettekul V, Ruangnapa K, Smathakanee C, Choursamran B, Kulbun A, Jaroenying R, Kamalaporn H, Sriboonyong T, Roekworachai K, Sunkonkit K, Tangsathapornpong A, Bunjoungmanee P, Pao-in W, Thaweekul P, Tantiyavarong P, Ratanavongkosol T, Thongnual C, Sritipsukho P, Deerojanawong J. Development and validation of the predictive score for pediatric COVID-19 pneumonia: A nationwide, multicenter study. PLoS One 2022; 17:e0273842. [PMID: 36037228 PMCID: PMC9423652 DOI: 10.1371/journal.pone.0273842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 08/16/2022] [Indexed: 12/03/2022] Open
Abstract
Background Due to the possibility of asymptomatic pneumonia in children with COVID-19 leading to overexposure to radiation and problems in limited-resource settings, we conducted a nationwide, multi-center study to determine the risk factors of pneumonia in children with COVID-19 in order to create a pediatric pneumonia predictive score, with score validation. Methods This was a retrospective cohort study done by chart review of all children aged 0–15 years admitted to 13 medical centers across Thailand during the study period. Univariate and multivariate analyses as well as backward and forward stepwise logistic regression were used to generate a final prediction model of the pneumonia score. Data during the pre-Delta era was used to create a prediction model whilst data from the Delta one was used as a validation cohort. Results The score development cohort consisted of 1,076 patients in the pre-Delta era, and the validation cohort included 2,856 patients in the Delta one. Four predictors remained after backward and forward stepwise logistic regression: age < 5 years, number of comorbidities, fever, and dyspnea symptoms. The predictive ability of the novel pneumonia score was acceptable with the area under the receiver operating characteristics curve of 0.677 and a well-calibrated goodness-of-fit test (p = 0.098). The positive likelihood ratio for pneumonia was 0.544 (95% confidence interval (CI): 0.491–0.602) in the low-risk category, 1.563 (95% CI: 1.454–1.679) in the moderate, and 4.339 (95% CI: 2.527–7.449) in the high-risk. Conclusion This study created an acceptable clinical prediction model which can aid clinicians in performing an appropriate triage for children with COVID-19.
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Affiliation(s)
- Araya Satdhabudha
- Department of Pediatrics, Faculty of Medicine, Thammasat University Hospital, Thammasat University, Pathumthani, Thailand
| | - Chanapai Chaiyakulsil
- Department of Pediatrics, Faculty of Medicine, Thammasat University Hospital, Thammasat University, Pathumthani, Thailand
- * E-mail:
| | - Rattapon Uppala
- Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Watit Niyomkarn
- Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Prakarn Tovichien
- Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | | | - Kanokpan Ruangnapa
- Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | | | | | - Aunya Kulbun
- Department of Pediatrics, Her Royal Highness Maha Chakri Sirindhorn Medical Center, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok, Thailand
| | - Rasintra Jaroenying
- Department of Pediatrics, Faculty of Medicine, Phramongkutklao Hospital, Bangkok, Thailand
- Phramongkutklao Hospital Sleep Disorder Center, Faculty of Medicine, Phramongkutklao Hospital, Bangkok, Thailand
| | - Harutai Kamalaporn
- Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Tidarat Sriboonyong
- Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | | | - Kanokkarn Sunkonkit
- Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Auchara Tangsathapornpong
- Department of Pediatrics, Faculty of Medicine, Thammasat University Hospital, Thammasat University, Pathumthani, Thailand
| | - Pornumpa Bunjoungmanee
- Department of Pediatrics, Faculty of Medicine, Thammasat University Hospital, Thammasat University, Pathumthani, Thailand
| | - Wanida Pao-in
- Department of Pediatrics, Faculty of Medicine, Thammasat University Hospital, Thammasat University, Pathumthani, Thailand
| | - Patcharapa Thaweekul
- Department of Pediatrics, Faculty of Medicine, Thammasat University Hospital, Thammasat University, Pathumthani, Thailand
| | - Pichaya Tantiyavarong
- Department of Clinical Epidemiology, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
| | | | | | - Paskorn Sritipsukho
- Department of Pediatrics, Faculty of Medicine, Thammasat University Hospital, Thammasat University, Pathumthani, Thailand
- Center of Excellence in Applied Epidemiology, Thammasat University, Pathumthani, Thailand
| | - Jitladda Deerojanawong
- Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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de Faria RM, Jantsch LB, Neves ET, Hausen CF, de Barros APZ, Sehnem GD, de Miranda MJ. Social and territorial inequalities in the mortality of children and adolescents due to COVID-19 in Brazil. Rev Bras Enferm 2022; 75:e20210482. [PMID: 35946619 PMCID: PMC9728821 DOI: 10.1590/0034-7167-2021-0482] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 03/31/2022] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To analyze the mortality rate of COVID-19 among children and adolescents aged 0 to 14 years. METHODS Ecological and exploratory study of children's mortality rate by COVID-19 in Brazil, from February to October 2020. The study used the Severe Acute Respiratory Syndrome database to collect the data and made the analysis using descriptive spatial statistics by age and race/color classification. RESULT The mortality rate due to COVID-19 represented 1.34 deaths per one hundred thousand in the total group evaluated. The age group with the highest frequency and mortality rate was 1 to 4 years of age. There is a higher frequency of deaths in the brown and Indigenous population. CONCLUSION The distribution of deaths due to COVID-19 is unequal in the national territory, and there is a wide variation in the mortality rate by age and race/color groups.
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Sacco C, Del Manso M, Mateo-Urdiales A, Rota MC, Petrone D, Riccardo F, Bella A, Siddu A, Battilomo S, Proietti V, Popoli P, Menniti Ippolito F, Palamara AT, Brusaferro S, Rezza G, Pezzotti P, Fabiani M. Effectiveness of BNT162b2 vaccine against SARS-CoV-2 infection and severe COVID-19 in children aged 5-11 years in Italy: a retrospective analysis of January-April, 2022. Lancet 2022; 400:97-103. [PMID: 35780801 PMCID: PMC9246475 DOI: 10.1016/s0140-6736(22)01185-0] [Citation(s) in RCA: 66] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 05/28/2022] [Accepted: 06/09/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND By April 13, 2022, more than 4 months after the approval of BNT162b2 (Pfizer-BioNTech) for children, less than 40% of 5-11-year-olds in Italy had been vaccinated against COVID-19. Estimating how effective vaccination is in 5-11-year-olds in the current epidemiological context dominated by the omicron variant (B.1.1.529) is important to inform public health bodies in defining vaccination policies and strategies. METHODS In this retrospective population analysis, we assessed vaccine effectiveness against SARS-CoV-2 infection and severe COVID-19, defined as an infection leading to hospitalisation or death, by linking the national COVID-19 surveillance system and the national vaccination registry. All Italian children aged 5-11 years without a previous diagnosis of infection were eligible for inclusion and were followed up from Jan 17 to April 13, 2022. All children with inconsistent vaccination data, diagnosed with SARS-CoV-2 infection before the start date of the study or without information on the municipality of residence were excluded from the analysis. With unvaccinated children as the reference group, we estimated vaccine effectiveness in those who were partly vaccinated (one dose) and those who were fully vaccinated (two doses). FINDINGS By April 13, 2022, 1 063 035 (35·8%) of the 2 965 918 children aged 5-11 years included in the study had received two doses of the vaccine, 134 386 (4·5%) children had received one dose only, and 1 768 497 (59·6%) were unvaccinated. During the study period, 766 756 cases of SARS-CoV-2 infection and 644 cases of severe COVID-19 (627 hospitalisations, 15 admissions to intensive care units, and two deaths) were notified. Overall, vaccine effectiveness in the fully vaccinated group was 29·4% (95% CI 28·5-30·2) against SARS-CoV-2 infection and 41·1% (22·2-55·4) against severe COVID-19, whereas vaccine effectiveness in the partly vaccinated group was 27·4% (26·4-28·4) against SARS-CoV-2 infection and 38·1% (20·9-51·5) against severe COVID-19. Vaccine effectiveness against infection peaked at 38·7% (37·7-39·7) at 0-14 days after full vaccination and decreased to 21·2% (19·7-22·7) at 43-84 days after full vaccination. INTERPRETATION Vaccination against COVID-19 in children aged 5-11 years in Italy showed a lower effectiveness in preventing SARS-CoV-2 infection and severe COVID-19 than in individuals aged 12 years and older. Effectiveness against infection appears to decrease after completion of the current primary vaccination cycle. FUNDING None. TRANSLATION For the Italian translation of the summary see Supplementary Materials section.
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Affiliation(s)
- Chiara Sacco
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy.
| | - Martina Del Manso
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | | | - Maria Cristina Rota
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Daniele Petrone
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Flavia Riccardo
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Antonino Bella
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Andrea Siddu
- General Directorate of Prevention, Ministero della Salute, Rome, Italy
| | - Serena Battilomo
- General Directorate of Health Information System and Statistics, Ministero della Salute, Rome, Italy
| | - Valeria Proietti
- General Directorate of Health Information System and Statistics, Ministero della Salute, Rome, Italy
| | - Patrizia Popoli
- National Centre for Drug Research and Evaluation, Istituto Superiore di Sanità, Rome, Italy
| | | | | | | | - Giovanni Rezza
- General Directorate of Prevention, Ministero della Salute, Rome, Italy
| | - Patrizio Pezzotti
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Massimo Fabiani
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
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Bhatt NS, Sharma A, St. Martin A, Abid MB, Brown VI, Diaz Perez MA, Frangoul H, Gadalla SM, Herr MM, Krem MM, Lazarus HM, Martens MJ, Mehta PA, Nishihori T, Prestidge T, Pulsipher MA, Rangarajan HG, Williams KM, Winestone LE, Yin DE, Riches ML, Dandoy CE, Auletta JJ. Clinical Characteristics and Outcomes of COVID-19 in Pediatric and Early Adolescent and Young Adult Hematopoietic Stem Cell Transplant Recipients: A Cohort Study. Transplant Cell Ther 2022; 28:696.e1-696.e7. [PMID: 35798233 PMCID: PMC9251957 DOI: 10.1016/j.jtct.2022.06.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 05/23/2022] [Accepted: 06/27/2022] [Indexed: 11/18/2022]
Abstract
Adult hematopoietic stem cell transplantation (HSCT) recipients are at a high risk of adverse outcomes after COVID-19. Although children have had better outcomes after COVID-19 compared to adults, data on risk factors and outcomes of COVID-19 among pediatric HSCT recipients are lacking. We describe outcomes of HSCT recipients who were ≤21 years of age at COVID-19 diagnosis and were reported to the Center for International Blood and Marrow Transplant Research between March 27, 2020, and May 7, 2021. The primary outcome was overall survival after COVID-19 diagnosis. We determined risk factors of COVID-19 as a secondary outcome in a subset of allogeneic HSCT recipients. A total of 167 pediatric HSCT recipients (135 allogeneic; 32 autologous HSCT recipients) were included. Median time from HSCT to COVID-19 was 15 months (interquartile range [IQR] 7-45) for allogeneic HSCT recipients and 16 months (IQR 6-59) for autologous HSCT recipients. Median follow-up from COVID-19 diagnosis was 53 days (range 1-270) and 37 days (1-179) for allogeneic and autologous HSCT recipients, respectively. Although COVID-19 was mild in 87% (n = 146/167), 10% (n = 16/167) of patients required supplemental oxygen or mechanical ventilation. The 45-day overall survival was 95% (95% confidence interval [CI], 90-99) and 90% (74-99) for allogeneic and autologous HSCT recipients, respectively. Cox regression analysis showed that patients with a hematopoietic cell transplant comorbidity index (HCT-CI) score of 1-2 were more likely to be diagnosed with COVID-19 (hazard ratio 1.95; 95% CI, 1.03-3.69, P = .042) compared to those with an HCT-CI of 0. Pediatric and early adolescent and young adult HSCT recipients with pre-HSCT comorbidities were more likely to be diagnosed with COVID-19. Overall mortality, albeit higher than the reported general population estimates, was lower when compared with previously published data focusing on adult HSCT recipients.
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Nguyen-The PN, Thanh TT, Thanh NH, Quoc LT, Ngoc-Quang NM, Quoc DD, Minh TN, Bich-Y NL, Minh TT, Hoang-Lam NG, Thi-Minh VT. Risk factors for disease severity and mortality of children with Covid-19: A study at a Vietnamese Children's hospital. J Infect Chemother 2022; 28:1380-1386. [PMID: 35738340 PMCID: PMC9212605 DOI: 10.1016/j.jiac.2022.06.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/13/2022] [Accepted: 06/15/2022] [Indexed: 10/25/2022]
Abstract
INTRODUCTION To find out risk factors for disease severity and mortality of pediatric COVID-19 in the fourth wave of COVID-19 in Vietnam. METHODS This retrospective cohort study was performed at Children's Hospital 1 from July to December 2021. All children with COVID-19 confirmed by a positive Realtime RT-PCR SARS-CoV-2 result and treated at COVID-19 department for at least 72 h were included. RESULTS Of the 850 cases admitting to COVID-19 department, 555 children with COVID-19 confirmed by positive RT-PCR and treated at our center for more than 72 h. Median age of confirmed cases was 22.3 (IQR: 3.2-88.6) months, 55.1% were male, and 84.5% had a history of close contact with confirmed COVID-19 patients. The rate of mild, moderate and severe/critical cases was 73,7%, 9.0% and 17.3%, respectively. One hundred ninety-two children (34.6%) had underlying diseases, in which, neurologic disease was the most common underlying disease (7.9%). Underlying disease, dyspnea, elevated CRP >20 mg/L and elevated ferritin were independent factors related to severe illness. Twenty-point two percent of patients in our study needed respiratory support, including 22 invasive mechanical ventilation cases. Eighteen cases (3.2%) died because of severe comorbidities, poor response to treatment. CONCLUSIONS In our study, the severe/critical and mortality rates in pediatric COVID-19 cases were relatively high. All fatal cases had severe comorbidities. Underlying disease, dyspnea, and elevated inflammatory markers were independent factors related to severity in pediatric COVID-19 cases.
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Affiliation(s)
- Phung Nguyen Nguyen-The
- University of Medicine and Pharmacy at Ho Chi Minh City, Viet Nam; Children's Hospital 1, Ho Chi Minh City, Viet Nam.
| | - Tran Thuc Thanh
- University of Medicine and Pharmacy at Ho Chi Minh City, Viet Nam; Children's Hospital 1, Ho Chi Minh City, Viet Nam
| | | | | | | | | | - Tran Nhut Minh
- University of Medicine and Pharmacy at Ho Chi Minh City, Viet Nam
| | | | - Tran Tuan Minh
- University of Medicine and Pharmacy at Ho Chi Minh City, Viet Nam
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Loss of Continuity of Care in Pediatric Neurology Services during COVID-19 Lockdown: An Additional Stressor for Parents. CHILDREN 2022; 9:children9060867. [PMID: 35740804 PMCID: PMC9222060 DOI: 10.3390/children9060867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 06/06/2022] [Accepted: 06/09/2022] [Indexed: 11/17/2022]
Abstract
Background. This study aimed to investigate the consequence of the COVID 19-related lockdown on the well-being of children with neurological and neurodevelopmental disorders and the repercussion on parental stress during the period 9 March 2020–3 May 2020. Methods. A web-based survey was shared via mail with the parents of children affected by chronic neurologic disorders and neurodevelopmental disorders in the continuity of care in two Italian tertiary centers, independently by the severity of the diseases and the required frequency of controls. For each patient, they were asked to identify a single main caregiver, among the two parents, to fill in the questionnaire. Parental stress was measured via the Perceived Stress Scale (PSS). Statistical analysis was performed with IBM SPSS Statistics version 25. The differences between the clinical groups were performed with one way ANOVA. The dimensional effect of the clinical variables on outcome was evaluated by multiple linear regression analysis. Results. The survey was completed by 250 parents (response rate = 48.9 %). Sars-Cov2 infection was reported in two patients only. A total of 44.2% of the patients had completely interrupted school activities while 70% of parents underwent changes in their job modalities. Health care services were disrupted in 77% of patients. Higher PSS scores were detected in the parents of children with neurodevelopmental disorders (p = 0.035). Conclusions. The loss of continuity of care during the lockdown must be considered as a risk factor for parents caring for children with chronic neurologic diseases and neurodevelopmental disorders in further phases of the current pandemic.
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Abstract
Coronavirus disease 2019 (COVID-19) is an ongoing pandemic caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) virus. More than 5 million children have been infected in the United States. Risk factors for more severe disease progression include obesity, pulmonary disease, gastrointestinal disorders, and neurologic comorbidities. Children with COVID-19 are admitted to the pediatric intensive care unit because of severe acute COVID-19 illness or COVID-19-associated multisystem inflammatory syndrome in children. The delta surge of 2021 was responsible for an increased disease burden in children and points to the key role of vaccinating children against this sometimes-deadly disease.
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Affiliation(s)
- Meena Kalyanaraman
- Pediatric Critical Care Medicine, Children's Hospital of New Jersey at Newark Beth Israel Medical Center, C-5, 201 Lyons Avenue, Newark, NJ 07112, USA.
| | - Michael R. Anderson
- Children’s National Hospital, George Washington University School of Medicine and Health Sciences
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Moreno CAM, Camelo CG, Sampaio PHMDA, Fonseca ATQSM, Estephan EDP, Silva AMS, Pirola RN, Silva LHL, Lima KDF, Albuquerque MAVD, Camelo Filho AE, Marques MVO, Yanagiura MT, Cavalcante WCP, Matsui Junior C, Isihi LMDA, Mendonça RH, Pouza AFP, Carvalho MSD, Reed UC, Zanoteli E. Effect of the COVID-19 pandemic on patients with inherited neuromuscular disorders. ARQUIVOS DE NEURO-PSIQUIATRIA 2022; 80:563-569. [PMID: 35946707 PMCID: PMC9387196 DOI: 10.1590/0004-282x-anp-2021-0166] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 08/06/2021] [Accepted: 08/31/2021] [Indexed: 06/15/2023]
Abstract
BACKGROUND The COVID-19 pandemic has brought substantial challenges for current practices in treating hereditary neuromuscular disorders (hNMDs). However, this infection has not been the only concern for these patients. Social distancing has compromised multidisciplinary assistance and physical activity, and has brought about several mental health issues. We presented a follow-up on 363 patients with hNMDs at a Brazilian tertiary center during the peak of the COVID-19 pandemic. OBJECTIVE We aimed to show the frequency and severity of SARS-CoV-2 infection among hNMD patients and to demonstrate the effects of the pandemic on life habits, disease progression and multidisciplinary supportive care status. METHODS Three hundred and sixty-three patients (58% male and 42% female) were followed for three months through three teleconsultations during the peak of the COVID-19 pandemic in Brazil. RESULTS There were decreases in the numbers of patients who underwent physical, respiratory and speech therapies. For several patients, their appetite (33%) and sleep habits (25%) changed. Physical exercises and therapies were interrupted for most of the patients. They reported new onset/worsening of fatigue (17%), pain (17%), contractions (14%) and scoliosis (7%). Irritability and sleep, weight and appetite changes, and especially diminished appetite and weight loss, were more frequent in the group that reported disease worsening. There was a low COVID-19 contamination rate (0.8%), and all infected patients had a mild presentation. CONCLUSION The isolation by itself was protective from a COVID-19 infection perspective. However, this isolation might also trigger a complex scenario with life habit changes that are associated with an unfavorable course for the NMD.
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Affiliation(s)
| | - Clara Gontijo Camelo
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, São Paulo SP, Brazil
| | | | | | | | | | - Renann Nunes Pirola
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, São Paulo SP, Brazil
| | | | | | | | | | | | - Mario Teruo Yanagiura
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, São Paulo SP, Brazil
| | | | - Ciro Matsui Junior
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, São Paulo SP, Brazil
| | | | - Rodrigo Holanda Mendonça
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, São Paulo SP, Brazil
| | | | - Mary Souza de Carvalho
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, São Paulo SP, Brazil
| | - Umbertina Conti Reed
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, São Paulo SP, Brazil
| | - Edmar Zanoteli
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, São Paulo SP, Brazil
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Campbell JI, Dubois MM, Savage TJ, Hood-Pishchany MI, Sharma TS, Petty CR, Lamb GS, Nakamura MM. Comorbidities Associated with Hospitalization and Progression Among Adolescents with Symptomatic Coronavirus Disease 2019. J Pediatr 2022; 245:102-110.e2. [PMID: 35240138 PMCID: PMC8883759 DOI: 10.1016/j.jpeds.2022.02.048] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 02/16/2022] [Accepted: 02/23/2022] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To identify subgroups likely to benefit from monoclonal antibody and antiviral therapy by evaluating the relationship between comorbidities and hospitalization among US adolescents with symptomatic coronavirus disease 2019 (COVID-19). STUDY DESIGN We analyzed the relationship between presence of comorbidities and need for hospitalization within 28 days of COVID-19 diagnosis for adolescents aged 12-17 years listed in the Pediatric COVID-19 US registry, a multicenter retrospective cohort of US pediatric patients with COVID-19. Comorbidities assessed included obesity, chronic kidney disease (CKD), diabetes, immunosuppressive disease or treatment, sickle cell disease (SCD), heart disease, neurologic disease/neurodevelopmental disorders, and pulmonary disease (excluding patients with mild asthma). We used multivariable logistic regression to determine race/ethnicity-adjusted associations between comorbidities and hospitalization. RESULTS A total of 1877 patients met our inclusion criteria, of whom 284 (15%) were hospitalized within 28 days of their COVID-19 diagnosis. In a race/ethnicity-adjusted model, the following comorbidities were independently associated with increased odds of hospitalization: SCD (aOR, 6.9; 95% CI, 3.0-15.9), immunocompromising condition (aOR, 6.4; 95% CI, 3.8-10.8), obesity (aOR, 3.2; 95% CI, 2.1-4.9), diabetes (aOR, 3.0; 95% CI, 1.4-6.2), neurologic disease (aOR, 2.8; 95% CI, 1.8-4.3), and pulmonary disease (excluding mild asthma) (aOR, 1.9; 95% CI, 1.2-3.1). Heart disease and CKD were not independently associated with hospitalization. CONCLUSIONS SCD, immunocompromising conditions, obesity, diabetes, neurologic disease, and pulmonary disease (excluding mild asthma) were associated with hospitalization for symptomatic COVID-19. Adolescents with acute COVID-19 and these comorbidities should be prioritized for consideration of therapy to avert hospitalization.
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Affiliation(s)
- Jeffrey I. Campbell
- Division of Infectious Diseases, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA
| | - Melanie M. Dubois
- Division of Infectious Diseases, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA
| | - Timothy J. Savage
- Division of Infectious Diseases, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA,Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Boston, MA
| | - M. Indriati Hood-Pishchany
- Division of Infectious Diseases, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA
| | - Tanvi S. Sharma
- Division of Infectious Diseases, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA
| | - Carter R. Petty
- Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, Boston, MA; and
| | - Gabriella S. Lamb
- Division of Infectious Diseases, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA
| | - Mari M. Nakamura
- Division of Infectious Diseases, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA,Antimicrobial Stewardship Program, Boston Children's Hospital, Boston, MA,Reprint requests: Mari M. Nakamura, MD, MPH, Antimicrobial Stewardship Program, Boston Children's Hospital, 300 Longwood Ave, Mailstop BCH 3052, Boston, MA 02115
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Pediatric patients with COVID-19 admitted to a PICU in Southern Brazil, excluding MIS-C. ACTA COLOMBIANA DE CUIDADO INTENSIVO 2022. [PMCID: PMC8692061 DOI: 10.1016/j.acci.2021.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Objective To describe pediatric patients admitted to a PICU with a diagnosis of COVID-19 and to compare some variables in relation to severely ill patients and critically ill children, excluding patients with MIS-C. Method Retrospective case series of patients aged 24 days to 15 years with a diagnosis of COVID-19 admitted to a PICU from April 1, 2020, to April 1, 2021. We describe data regarding epidemiological characteristics, clinical manifestations, laboratory, and imaging tests, treatment, and outcome. We also divided the patients into two groups: severely ill patients and critically ill patients (those who required invasive mechanical ventilation (IMV), non-invasive ventilation or shock), and we compared some variables to determine possible predictors of greater severity. Results 32 children were admitted with severe COVID-19; 20 of them were considered critical. The median age was 2 years. Of the patients, 50% were male and 81% had comorbidities, and 44% had 3 or more comorbidities. Respiratory failure was the main cause of hospitalization. Fifty-six percent required IMV, and 37% used vasoactive drugs. Bacterial or viral co-infection occurred in 41%. A total of 81% of our patients received antimicrobials, 53% patients received low-dose corticoids, and 25% received enoxaparin. Patients with 3 or more comorbidities were significantly more frequent in the critically ill group. Conclusion Most of the children admitted to PICU had comorbidities, and children under 1 year of age made up almost half of the sample. In our study, the presence of three or more comorbidities was more frequent in pediatric patients with critical COVID-19.
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Abda A, del Giorgio F, Gauvin L, Autmizguine J, Kakkar F, Drouin O. Association between area-level material deprivation and incidence of hospitalization among children with SARS-CoV-2 in Montreal. Paediatr Child Health 2022; 27:S27-S32. [PMID: 35620560 PMCID: PMC9126283 DOI: 10.1093/pch/pxab106] [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: 07/30/2021] [Accepted: 11/25/2022] [Indexed: 11/14/2022] Open
Abstract
Background Although sociodemographic factors have been linked with SARS-CoV-2 infection and hospitalizations in adults, there are little data on the association between sociodemographic characteristics and SARS-CoV-2-related hospitalization in children. The objective of this study was to determine the association between area-level material deprivation and incidence of hospitalization with SARS-CoV-2 among children. Methods We conducted a retrospective cohort study of all children (0 to 17 years of age) with a PCR-confirmed SARS-CoV-2 infection March 1, 2020 through May 31, 2021 at a tertiary-care paediatric hospital, in Montreal, Canada. Data were collected through chart review and included age, sex, and postal code, allowing linkage to dissemination area-level material deprivation, measured with the Pampalon Material Deprivation Index (PMDI) quintiles. We examined the association between PMDI quintiles and hospitalization using Poisson regression. Results During the study period, 964 children had a positive PCR-confirmed SARS-CoV-2 test and 124 were hospitalized. Children living in the most deprived quintile of PMDI represented 40.7% of hospitalizations. Incidence rate ratio of hospitalization for this group compared to the most privileged quintile was 2.42 (95%CI: 1.33; 4.41). Conclusion Children living in the most materially deprived areas had more than twice the rate of hospitalizations for COVID-19 than children living in most privileged areas. Special efforts should be deployed to protect children who live in disadvantaged areas, especially pending vaccination of younger children.
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Affiliation(s)
- Assil Abda
- Department of Pediatrics, Université de Montréal, Montréal, Québec, Canada
| | - Francesca del Giorgio
- Faculty of Medicine, McGill University, Montréal, Québec, Canada
- CHU Sainte-Justine Research Centre, Montréal, Québec, Canada
| | - Lise Gauvin
- Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, Montréal, Québec, Canada
- Centre de recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montréal, Québec, Canada
| | - Julie Autmizguine
- Department of Pediatrics, Université de Montréal, Montréal, Québec, Canada
- CHU Sainte-Justine Research Centre, Montréal, Québec, Canada
- Department of Pharmacology and Physiology, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Fatima Kakkar
- Department of Pediatrics, Université de Montréal, Montréal, Québec, Canada
- CHU Sainte-Justine Research Centre, Montréal, Québec, Canada
- Division of Infectious Diseases, Department of Pediatrics, CHU Sainte-Justine, Montréal, Québec, Canada
| | - Olivier Drouin
- Department of Pediatrics, Université de Montréal, Montréal, Québec, Canada
- CHU Sainte-Justine Research Centre, Montréal, Québec, Canada
- Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, Montréal, Québec, Canada
- Division of General Pediatrics, Department of Pediatrics, CHU Sainte-Justine, Montréal, Québec, Canada
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Duman M, Şık N, Tekşam Ö, Akça H, Kurt F, Çağlar AA, Yıldız LA, Taşar MA, Fidancı İ, Yayla BCC, Yılmaz D, Güngör E, Demir Ş, Çokuğraş H, Cebeci SO, Önal P, Saz EU, Yurtseven A, Uysalol M, Yıldız R, Gümüş S, Bal A, Bayturan SŞ, Zengin N, Atik S, Çiftdoğan DY, Berksoy E, Çiçek A, Şahin S, Kızıl MC, Kara Y, Apa H, Ulusoy E, Kara AA, Yesil E, Erdem M, Turan C, Arslanoglu S, Duyu M, Besli GE, Arslan G, Oflu AT, Çeleğen M, Buldu E, Pişkin İE, Kardeş H, Yılmaz HL, Yıldızdaş D, Gökulu G, Çay P, Özer U, Güleryüz OD, Çolak Ö, Güneysu ST. COVID-19 disease in children presenting to the pediatric emergency department: A multicenter study with 8886 cases from Turkey. Am J Emerg Med 2022; 59:133-140. [PMID: 35849960 PMCID: PMC9181308 DOI: 10.1016/j.ajem.2022.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/03/2022] [Accepted: 06/04/2022] [Indexed: 11/16/2022] Open
Abstract
Background The aim was to evaluate the epidemiological, clinical, laboratory, and radiologic data of children with SARS-CoV-2 positivity by polymerase chain reaction (PCR) together with treatment strategies and clinical outcomes and to evaluate cases of multisystem inflammatory syndrome in children (MIS-C) in this population. Methods This was a multicenter retrospective observational cohort study performed in the pediatric emergency departments of 19 tertiary hospitals. From March 11, 2020, to May 31, 2021, children who were diagnosed with confirmed nasopharyngeal/tracheal specimen SARS-CoV-2 PCR positivity or positivity for serum-specific antibodies against SARS-CoV-2 were included. Demographics, presence of chronic illness, symptoms, history of contact with SARS-CoV-2 PCR-positive individuals, laboratory and radiologic investigations, clinical severity, hospital admissions, and prognosis were recorded. Results A total of 8886 cases were included. While 8799 (99.0%) cases resulted in a diagnosis of SARS-CoV-2 with PCR positivity, 87 (1.0%) patients were diagnosed with MIS-C. Among SARS-CoV-2 PCR-positive patients, 51.0% were male and 8.5% had chronic illnesses. The median age was 11.6 years (IQR: 5.0–15.4) and 737 (8.4%) patients were aged <1 year. Of the patients, 15.5% were asymptomatic. The most common symptoms were fever (48.5%) and cough (30.7%) for all age groups. There was a decrease in the rate of fever as age increased (p < 0.001); the most common age group for this symptom was <1 year with the rate of 69.6%. There was known contact with a SARS-CoV-2 PCR-positive individual in 67.3% of the cases, with household contacts in 71.3% of those cases. In terms of clinical severity, 83 (0.9%) patients were in the severe-critical group. There was hospital admission in 1269 (14.4%) cases, with 106 (1.2%) of those patients being admitted to the pediatric intensive care unit (PICU). Among patients with MIS-C, 60.9% were male and the median age was 6.4 years (IQR: 3.9–10.4). Twelve (13.7%) patients presented with shock. There was hospital admission in 89.7% of these cases, with 29.9% of the patients with MIS-C being admitted to the PICU. Conclusion Most SARS-CoV-2 PCR-positive patients presented with a mild clinical course. Although rare, MIS-C emerges as a serious consequence with frequent PICU admission. Further understanding of the characteristics of COVID-19 disease could provide insights and guide the development of therapeutic strategies for target groups.
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Affiliation(s)
- Murat Duman
- Division of Pediatric Emergency Care, Department of Pediatrics, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey.
| | - Nihan Şık
- Division of Pediatric Emergency Care, Department of Pediatrics, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Özlem Tekşam
- Hacettepe University Ihsan Dogramaci Children's Hospital, Ankara, Turkey
| | - Halise Akça
- Ankara City Hospital, Department of Pediatric Emergency Medicine, Ankara, Turkey
| | - Funda Kurt
- Ankara City Hospital, Department of Pediatric Emergency Medicine, Ankara, Turkey
| | - Ayla Akca Çağlar
- Ankara City Hospital, Department of Pediatric Emergency Medicine, Ankara, Turkey
| | - Leman Akcan Yıldız
- Ankara City Hospital, Department of Pediatric Emergency Medicine, Ankara, Turkey
| | - Medine Ayşin Taşar
- University of Health Sciences, Ankara Training and Research Hospital, Pediatric Emergency Department, Ankara, Turkey
| | - İlknur Fidancı
- University of Health Sciences, Ankara Training and Research Hospital, Pediatric Emergency Department, Ankara, Turkey
| | - Burcu Ceylan Cura Yayla
- University of Health Sciences, Ankara Training and Research Hospital, Pediatric Emergency Department, Ankara, Turkey
| | - Durgül Yılmaz
- Division of Pediatric Emergency Care, Department of Pediatrics, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Emre Güngör
- Hacettepe University Ihsan Dogramaci Children's Hospital, Ankara, Turkey
| | - Şule Demir
- Aydın Gynecology and Childhood Hospital, Pediatric Emergency Department, Aydın, Turkey
| | - Haluk Çokuğraş
- Cerrahpasa Faculty of Medicine, İstanbul University-Cerrahpasa, Istanbul, Turkey
| | - Sinem Oral Cebeci
- Cerrahpasa Faculty of Medicine, İstanbul University-Cerrahpasa, Istanbul, Turkey
| | - Pınar Önal
- Cerrahpasa Faculty of Medicine, İstanbul University-Cerrahpasa, Istanbul, Turkey
| | | | | | - Metin Uysalol
- Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Division of Pediatric Emergency, Istanbul, Turkey
| | - Raif Yıldız
- Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Division of Pediatric Emergency, Istanbul, Turkey
| | - Süheyla Gümüş
- Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Division of Pediatric Emergency, Istanbul, Turkey
| | - Alkan Bal
- Manisa Celal Bayar University Faculty of Medicine, Hafsa Sultan Hospital, Manisa, Turkey
| | - Semra Şen Bayturan
- Manisa Celal Bayar University Faculty of Medicine, Hafsa Sultan Hospital, Manisa, Turkey
| | - Neslihan Zengin
- Manisa Celal Bayar University Faculty of Medicine, Hafsa Sultan Hospital, Manisa, Turkey
| | - Sinem Atik
- Manisa Celal Bayar University Faculty of Medicine, Hafsa Sultan Hospital, Manisa, Turkey
| | - Dilek Yılmaz Çiftdoğan
- Pediatric Emergency Medicine Clinic, University of Health Sciences, Tepecik Education and Research Hospital, Izmir, Turkey
| | - Emel Berksoy
- Pediatric Emergency Medicine Clinic, University of Health Sciences, Tepecik Education and Research Hospital, Izmir, Turkey
| | - Alper Çiçek
- Pediatric Emergency Medicine Clinic, University of Health Sciences, Tepecik Education and Research Hospital, Izmir, Turkey
| | - Sabiha Şahin
- Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey
| | - Mahmut Can Kızıl
- Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey
| | - Yalçın Kara
- Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey
| | - Hurşit Apa
- Dr. Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital, Izmir, Turkey
| | - Emel Ulusoy
- Dr. Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital, Izmir, Turkey
| | - Aybüke Akaslan Kara
- Dr. Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital, Izmir, Turkey
| | - Edanur Yesil
- Mersin City Training and Research Hospital, Mersin, Turkey
| | - Meltem Erdem
- Mersin City Training and Research Hospital, Mersin, Turkey
| | - Caner Turan
- Mersin City Training and Research Hospital, Mersin, Turkey
| | - Sertac Arslanoglu
- Istanbul Medeniyet University Faculty of Medicine, Goztepe Prof Dr Suleyman Yalcin City Hospital, Istanbul, Turkey
| | - Muhterem Duyu
- Istanbul Medeniyet University Faculty of Medicine, Goztepe Prof Dr Suleyman Yalcin City Hospital, Istanbul, Turkey
| | - Gulser Esen Besli
- Istanbul Medeniyet University Faculty of Medicine, Goztepe Prof Dr Suleyman Yalcin City Hospital, Istanbul, Turkey
| | - Gazi Arslan
- Derince Training and Research Hospital, Kocaeli, Turkey
| | - Ayşe Tolunay Oflu
- Afyonkarahisar Health Sciences University Faculty of Medicine, Department of Pediatrics, Afyon, Turkey
| | - Mehmet Çeleğen
- Afyonkarahisar Health Sciences University Faculty of Medicine, Department of Pediatrics, Afyon, Turkey
| | - Ebru Buldu
- Afyonkarahisar Health Sciences University Faculty of Medicine, Department of Pediatrics, Afyon, Turkey
| | - İbrahim Etem Pişkin
- Zonguldak Bulent Ecevit University Faculty of Medicine, Department of Pediatrics, Zonguldak, Turkey
| | - Hakan Kardeş
- Zonguldak Bulent Ecevit University Faculty of Medicine, Department of Pediatrics, Zonguldak, Turkey
| | | | | | - Gamze Gökulu
- Cukurova University, Faculty of Medicine, Adana, Turkey
| | - Pınar Çay
- Cukurova University, Faculty of Medicine, Adana, Turkey
| | - Utku Özer
- Cukurova University, Faculty of Medicine, Adana, Turkey
| | | | - Özlem Çolak
- Gazi University, Faculty of Medicine, Department of Pediatric Emergency, Ankara, Turkey
| | - Songül Tomar Güneysu
- Gazi University, Faculty of Medicine, Department of Pediatric Emergency, Ankara, Turkey
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Abda A, del Giorgio F, Gauvin L, Autmizguine J, Kakkar F, Drouin O. L’association entre la défavorisation matérielle par quartier et l’incidence d’hospitalisation chez les enfants infectés par le SRAS-CoV-2 à Montréal. Paediatr Child Health 2022; 27:S108-S114. [PMID: 36092292 PMCID: PMC9384184 DOI: 10.1093/pch/pxac015] [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: 07/30/2021] [Accepted: 11/25/2021] [Indexed: 11/15/2022] Open
Abstract
Historique Même si les facteurs sociodémographiques sont liés à l’infection par le SRAS-CoV-2 et aux hospitalisations chez les adultes, peu de données portent sur l’association entre ces caractéristiques et les hospitalisations attribuables au SRAS-CoV-2 chez les enfants. La présente étude visait à déterminer l’association entre la défavorisation matérielle par quartier et l’incidence d’hospitalisations à cause du SRAS-CoV-2 chez les enfants. Méthodologie Les chercheurs ont réalisé une étude de cohorte rétrospective de tous les enfants (de 0 à 17 ans) atteints d’une infection par le SRAS-CoV-2 confirmée par un test d’amplification en chaîne par polymérase après transcription inverse (PCR) entre le 1er mars et le 31 mai 2021 dans un hôpital pédiatrique de soins tertiaires de Montréal, au Canada. Ils ont colligé les données par examen des dossiers et ont inclus l’âge, le sexe et les codes postaux, afin de pouvoir lier la défavorisation matérielle à l’échelle de l’aire de diffusion, mesurée au moyen des quintiles de l’indice de défavorisation matérielle de Pampalon. Ils ont examiné l’association entre les quintiles de cet indice et les hospitalisations à l’aide de la régression de Poisson. Résultats Pendant la période de l’étude, 964 enfants ont reçu un résultat positif au SRAS-CoV-2 confirmé par un test PCR, et 124 d’entre eux ont été hospitalisés. Au total, 40,7 % des enfants hospitalisés habitaient dans le quintile le plus défavorisé d’après l’indice de défavorisation matérielle de Pampalon. Le rapport du taux d’incidence des hospitalisations dans ce groupe était de 2,42 (intervalle de confiance à 95 % : 1,33; 4,41) par rapport au quintile le plus privilégié. Conclusion Plus du double des enfants qui habitaient dans les quartiers les plus défavorisés sur le plan matériel étaient hospitalisés à cause de la COVID-19 par rapport à ceux qui habitaient dans les quartiers les plus privilégiés. Il faudrait déployer des efforts particuliers pour protéger les enfants qui habitent dans des quartiers défavorisés, particulièrement dans l’attente de la vaccination des plus jeunes.
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Affiliation(s)
- Assil Abda
- Département de pédiatrie, Université de Montréal , Montréal (Québec) Canada
| | - Francesca del Giorgio
- Faculté de médecine, Université McGill , Montréal (Québec) Canada
- Centre de recherche du Centre hospitalier universitaire Sainte-Justine , Montréal (Québec) Canada
| | - Lise Gauvin
- Département de médecine sociale et préventive, École de santé publique, Université de Montréal , Montréal (Québec) Canada
- Centre de recherche du Centre hospitalier de l’Université de Montréal , Montréal (Québec) Canada
| | - Julie Autmizguine
- Département de pédiatrie, Université de Montréal , Montréal (Québec) Canada
- Centre de recherche du Centre hospitalier universitaire Sainte-Justine , Montréal (Québec) Canada
- Département de pharmacologie et de physiologie, faculté de médecine, Université de Montréal , Montréal (Québec) Canada
| | - Fatima Kakkar
- Département de pédiatrie, Université de Montréal , Montréal (Québec) Canada
- Centre de recherche du Centre hospitalier universitaire Sainte-Justine , Montréal (Québec) Canada
- Service d’infectiologie, département de pédiatrie, Centre hospitalier universitaire Sainte-Justine , Montréal (Québec) Canada
| | - Olivier Drouin
- Département de pédiatrie, Université de Montréal , Montréal (Québec) Canada
- Centre de recherche du Centre hospitalier universitaire Sainte-Justine , Montréal (Québec) Canada
- Département de médecine sociale et préventive, École de santé publique, Université de Montréal , Montréal (Québec) Canada
- Service de pédiatrie générale, département de pédiatrie, Centre hospitalier universitaire Sainte-Justine , Montréal (Québec) Canada
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Chaiyakulsil C, Sritipsukho P, Satdhabudha A, Bunjoungmanee P, Tangsathapornpong A, Sinlapamongkolkul P, Sritipsukho N. An epidemiological study of pediatric COVID-19 in the era of the variant of concern. PLoS One 2022; 17:e0267035. [PMID: 35427379 PMCID: PMC9012366 DOI: 10.1371/journal.pone.0267035] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 03/31/2022] [Indexed: 12/24/2022] Open
Abstract
Background There were limited epidemiological data of pediatric COVID-19 in Asia outside China, especially during the era of the variants of concern such as the Delta and Alpha variants. The objective was to describe the clinical epidemiology of pediatric COVID-19 in a tertiary care center in Thailand from April to August 2021. The identification of risk factors for the development of pneumonia in these children was also performed. Methods This retrospective cohort study was conducted by retrospective chart review of all children aged 0–15 years admitted to Thammasat University Hospital care system during the study period. The risk factors for the development of pneumonia were analyzed using logistic regression. Results A total of 698 children were included for analysis, of which 52% were male. The mean age of the cohort was 7.2 + 4.5 years old. Radiographic pneumonia was identified in 100 children (14.3%) and a total of 16 children (2.3%) were diagnosed with severe and critical diseases. The mortality rate was 0.1%. Children younger than 1 year and children with comorbidity were at higher risk of developing pneumonia (Adjusted odds ratios 2.99 (95% confidence interval (CI): 1.56–5.74) and 2.32 (95% CI: 1.15–4.67), respectively). Conclusion In the era of the variants of concern, the proportion of children with severe and critical diseases remained low. However, prudence must be taken in caring for younger children and children with comorbidity.
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Affiliation(s)
- Chanapai Chaiyakulsil
- Faculty of Medicine, Division of Pediatric Critical Care, Department of Pediatrics, Thammasat University Hospital, Thammasat University, Pathumthani, Thailand
- * E-mail:
| | - Paskorn Sritipsukho
- Faculty of Medicine, Division of Pediatric Allergy and Immunology, Department of Pediatrics, Thammasat University, Pathumthani, Thailand
- Center of Excellence in Applied Epidemiology, Thammasat University, Pathumthani, Thailand
| | - Araya Satdhabudha
- Faculty of Medicine, Division of Pediatric Pulmonology, Department of Pediatrics, Thammasat University, Pathumthani, Thailand
| | - Pornumpa Bunjoungmanee
- Faculty of Medicine, Division of Pediatric Infectious Disease, Department of Pediatrics, Thammasat University, Pathumthani, Thailand
| | - Auchara Tangsathapornpong
- Faculty of Medicine, Division of Pediatric Infectious Disease, Department of Pediatrics, Thammasat University, Pathumthani, Thailand
| | - Phakatip Sinlapamongkolkul
- Faculty of Medicine, Division of Pediatric Hematology and Oncology, Department of Pediatrics, Thammasat University, Pathumthani, Thailand
| | - Naiyana Sritipsukho
- Thammasat Postdoctoral Fellowship, Thammasat University, Pathumthani, Thailand
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Sakurai A, Marshall S, Ogasawara T, Ogasawara T, Aoka Y, Sakura H, Uchigata Y, Ogawa T. REGN-COV2 antibody cocktail in patients with SARS-CoV-2: Observational study from a single institution in Japan. J Infect Chemother 2022; 28:943-947. [PMID: 35414436 PMCID: PMC8986486 DOI: 10.1016/j.jiac.2022.03.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 01/16/2022] [Accepted: 03/30/2022] [Indexed: 12/15/2022]
Abstract
Introduction A new treatment for coronavirus disease (COVID-19), REGN-COV2, a cocktail consisting of two neutralizing antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been approved for patients at a risk of developing more severe disease. Methods We retrospectively reviewed patients recently diagnosed with COVID-19 with risk factors for severe infection, who were treated with the REGN-COV2 antibody cocktail between July and September 2021. The REGN-COV2 antibody cocktail was administered to patients within 7 days of disease onset, with an oxygen saturation of >93%, and with at least one comorbidity. We investigated the percentage of patients with COVID-19-related hospitalization or death, the duration of symptoms after treatment, and the adverse effects of treatment. Results A total of 108 patients were reviewed. Of them, 64% were aged ≥50 years, 31% had obesity, 36% had hypertension, and 18% had diabetes. In addition, 49% had multiple risk factors for severe COVID-19. Overall, 12 patients (11%) needed COVID-19-related hospitalization. No adverse effects of treatment were observed. Conclusions This study shows that treatment with the REGN-COV2 antibody cocktail is safe and beneficial in patients at a risk of developing severe COVID-19.
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Boogaard CO, Graves T, Ricks JR, Badh R, Cronin B, Koay WLA, Hanisch B, Rahn K, Williams AR, Gorman K, Shah RK, Biddle CL. COVID-19 Patient Vaccine Program Design and Implementation: An Academic Children's Hospital's Model, Approach, and Outcomes. J Ambul Care Manage 2022; 45:85-94. [PMID: 35202025 PMCID: PMC8884123 DOI: 10.1097/jac.0000000000000406] [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] [Indexed: 11/25/2022]
Abstract
To slow the spread of the 2019 novel coronavirus disease (COVID-19) and reduce the associated morbidity and mortality, the Children's National Hospital developed a multidisciplinary, collaborative vaccine program aimed at equitably and expeditiously vaccinating the pediatric population of the surrounding community. Interdepartmental collaboration, professional expertise, and community partnerships allowed for a dynamic and successful program design that began as large volume-centralized vaccine clinics and expanded to smaller volume ambulatory clinics. This strategy proved successful at meeting local vaccine demand; however, strategies to improve vaccine uptake in communities with high rates of hesitancy are still needed to maximize vaccine equity.
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Affiliation(s)
- Claire O'Connell Boogaard
- Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia (Drs Boogaard, Hanisch, Shah, and Biddle and Ms Koay); Children's National Hospital, Washington, District of Columbia (Drs Boogaard, Hanisch, Williams, Shah, and Biddle, Mss Graves, Ricks, Cronin, Koay, Rahn, and Gorman, and Mr Badh)
| | - Teresa Graves
- Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia (Drs Boogaard, Hanisch, Shah, and Biddle and Ms Koay); Children's National Hospital, Washington, District of Columbia (Drs Boogaard, Hanisch, Williams, Shah, and Biddle, Mss Graves, Ricks, Cronin, Koay, Rahn, and Gorman, and Mr Badh)
| | - Jeanne R. Ricks
- Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia (Drs Boogaard, Hanisch, Shah, and Biddle and Ms Koay); Children's National Hospital, Washington, District of Columbia (Drs Boogaard, Hanisch, Williams, Shah, and Biddle, Mss Graves, Ricks, Cronin, Koay, Rahn, and Gorman, and Mr Badh)
| | - Ranjodh Badh
- Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia (Drs Boogaard, Hanisch, Shah, and Biddle and Ms Koay); Children's National Hospital, Washington, District of Columbia (Drs Boogaard, Hanisch, Williams, Shah, and Biddle, Mss Graves, Ricks, Cronin, Koay, Rahn, and Gorman, and Mr Badh)
| | - Bridget Cronin
- Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia (Drs Boogaard, Hanisch, Shah, and Biddle and Ms Koay); Children's National Hospital, Washington, District of Columbia (Drs Boogaard, Hanisch, Williams, Shah, and Biddle, Mss Graves, Ricks, Cronin, Koay, Rahn, and Gorman, and Mr Badh)
| | - Wei Li Adeline Koay
- Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia (Drs Boogaard, Hanisch, Shah, and Biddle and Ms Koay); Children's National Hospital, Washington, District of Columbia (Drs Boogaard, Hanisch, Williams, Shah, and Biddle, Mss Graves, Ricks, Cronin, Koay, Rahn, and Gorman, and Mr Badh)
| | - Benjamin Hanisch
- Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia (Drs Boogaard, Hanisch, Shah, and Biddle and Ms Koay); Children's National Hospital, Washington, District of Columbia (Drs Boogaard, Hanisch, Williams, Shah, and Biddle, Mss Graves, Ricks, Cronin, Koay, Rahn, and Gorman, and Mr Badh)
| | - Katie Rahn
- Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia (Drs Boogaard, Hanisch, Shah, and Biddle and Ms Koay); Children's National Hospital, Washington, District of Columbia (Drs Boogaard, Hanisch, Williams, Shah, and Biddle, Mss Graves, Ricks, Cronin, Koay, Rahn, and Gorman, and Mr Badh)
| | - Andrew R. Williams
- Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia (Drs Boogaard, Hanisch, Shah, and Biddle and Ms Koay); Children's National Hospital, Washington, District of Columbia (Drs Boogaard, Hanisch, Williams, Shah, and Biddle, Mss Graves, Ricks, Cronin, Koay, Rahn, and Gorman, and Mr Badh)
| | - Kathleen Gorman
- Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia (Drs Boogaard, Hanisch, Shah, and Biddle and Ms Koay); Children's National Hospital, Washington, District of Columbia (Drs Boogaard, Hanisch, Williams, Shah, and Biddle, Mss Graves, Ricks, Cronin, Koay, Rahn, and Gorman, and Mr Badh)
| | - Rahul K. Shah
- Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia (Drs Boogaard, Hanisch, Shah, and Biddle and Ms Koay); Children's National Hospital, Washington, District of Columbia (Drs Boogaard, Hanisch, Williams, Shah, and Biddle, Mss Graves, Ricks, Cronin, Koay, Rahn, and Gorman, and Mr Badh)
| | - Cara L. Biddle
- Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia (Drs Boogaard, Hanisch, Shah, and Biddle and Ms Koay); Children's National Hospital, Washington, District of Columbia (Drs Boogaard, Hanisch, Williams, Shah, and Biddle, Mss Graves, Ricks, Cronin, Koay, Rahn, and Gorman, and Mr Badh)
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Cinteză E, Voicu C, Filip C, Ioniță M, Popescu M, Bălgrădean M, Nicolescu A, Mahmoud H. Myocardial Infarction in Children after COVID-19 and Risk Factors for Thrombosis. Diagnostics (Basel) 2022; 12:diagnostics12040884. [PMID: 35453932 PMCID: PMC9025069 DOI: 10.3390/diagnostics12040884] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 03/24/2022] [Accepted: 03/29/2022] [Indexed: 12/19/2022] Open
Abstract
Acute myocardial infarction (AMI) in children is rather anecdotic. However, following COVID-19, some conditions may develop which may favor thrombosis, myocardial infarction, and death. Such a condition is Kawasaki-like disease (K-lD). K-lD appears in children as a subgroup of the multisystem inflammatory syndrome (MIS-C). In some cases, K-lD patients may develop giant coronary aneurysms. The evolution and characteristics of coronary aneurysms from K-lD appear to be different from classical Kawasaki disease (KD) aneurysms. Differences include a lower percentage of aneurysm formation than in non-COVID-19 KD, a smaller number of giant forms, a tendency towards aneurysm regression, and fewer thrombotic events associated with AMI. We present here a review of the literature on the thrombotic risks of post-COVID-19 coronary aneurysms, starting from a unique clinical case of a 2-year-old boy who developed multiple coronary aneurysms, followed by AMI. In dehydration conditions, 6 months after COVID-19, the boy developed anterior descending artery occlusion and a slow favorable outcome of the AMI after thrombolysis. This review establishes severity criteria and risk factors that predispose to thrombosis and AMI in post-COVID-19 patients. These may include dehydration, thrombophilia, congenital malformations, chronic inflammatory conditions, chronic kidney impairment, acute cardiac failure, and others. All these possible complications should be monitored during acute illness. Ischemic heart disease prevalence in children may increase in the post-COVID-19 era, due to an association between coronary aneurysm formation, thrombophilia, and other risk factors whose presence will make a difference in long-term prognosis.
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Affiliation(s)
- Eliza Cinteză
- “Carol Davila” Pediatrics Department, University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- “Marie Curie” Emergency Children’s Hospital, 041451 Bucharest, Romania; (C.F.); (M.I.); (M.P.); (A.N.); (H.M.)
- Correspondence: (E.C.); (C.V.)
| | - Cristiana Voicu
- “Marie Curie” Emergency Children’s Hospital, 041451 Bucharest, Romania; (C.F.); (M.I.); (M.P.); (A.N.); (H.M.)
- Correspondence: (E.C.); (C.V.)
| | - Cristina Filip
- “Marie Curie” Emergency Children’s Hospital, 041451 Bucharest, Romania; (C.F.); (M.I.); (M.P.); (A.N.); (H.M.)
| | - Mihnea Ioniță
- “Marie Curie” Emergency Children’s Hospital, 041451 Bucharest, Romania; (C.F.); (M.I.); (M.P.); (A.N.); (H.M.)
| | - Monica Popescu
- “Marie Curie” Emergency Children’s Hospital, 041451 Bucharest, Romania; (C.F.); (M.I.); (M.P.); (A.N.); (H.M.)
| | - Mihaela Bălgrădean
- “Carol Davila” Pediatrics Department, University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- “Marie Curie” Emergency Children’s Hospital, 041451 Bucharest, Romania; (C.F.); (M.I.); (M.P.); (A.N.); (H.M.)
| | - Alin Nicolescu
- “Marie Curie” Emergency Children’s Hospital, 041451 Bucharest, Romania; (C.F.); (M.I.); (M.P.); (A.N.); (H.M.)
| | - Hiyam Mahmoud
- “Marie Curie” Emergency Children’s Hospital, 041451 Bucharest, Romania; (C.F.); (M.I.); (M.P.); (A.N.); (H.M.)
- Royal Brompton Hospital, London SW3 6NP, UK
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Cason C, Zamagni G, Cozzi G, Tonegutto D, Ronfani L, Oretti C, De Manzini A, Barbi E, Comar M, Amaddeo A. Spread of Respiratory Pathogens During the COVID-19 Pandemic Among Children in the Northeast of Italy. Front Microbiol 2022; 13:804700. [PMID: 35401434 PMCID: PMC8988150 DOI: 10.3389/fmicb.2022.804700] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 01/25/2022] [Indexed: 12/20/2022] Open
Abstract
The social distancing measures adopted during the coronavirus disease 2019 (COVID-19) pandemic led to a profound change in the behavioral habits of the population. This study analyzes the impact of restriction measures on the shaping of the epidemiology of common winter respiratory pathogens in the pediatric population of northeast of Italy. From August 2020 to March 2021, a total of 1,227 nasopharyngeal swabs from symptomatic pediatric patients were tested for the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), influenza A and B, adenovirus, other coronaviruses, parainfluenza virus 1–4, enterovirus, bocavirus, metapneumovirus, respiratory syncytial virus, rhinovirus, Bordetella pertussis, Bordetella parapertussis, and Mycoplasma pneumoniae. To relate virus positivity with the clinic characteristics of the subjects enrolled, multinomial logistic models were estimated. SARS-CoV-2 was detected in 5.2% of the children; fever resulted as risk factor for infection [relative risk ratio (RRR) = 2.88, p = 0.034]. Rhinovirus was detected in the 40.7% of the subjects, with cough and rhinitis as risk factors (respectively, RRR = 1.79, p = 0.001 and RRR = 1.53, p = 0.018). Other coronaviruses were found in 10.8% of children and were associated to pharyngodynia (RRR = 4.94, p < 0.001). Adenovirus, observed in 11.6% of subjects, showed to have fever as risk factor (RRR = 6.44, p < 0.001). Bocavirus was detected in 3.2% of children. In conclusion, our results showed that social isolation measures had an impact on the circulation of RSV and influenza, although children under the age of 2 were most affected by the other respiratory infections. Therefore, this study highlights the need for continuing surveillance for a delayed spread of RSV and other respiratory pathogens.
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Affiliation(s)
- Carolina Cason
- Department of Advanced Translational Microbiology, Institute for Maternal and Child Health, IRCCS “Burlo Garofolo,” Trieste, Italy
| | - Giulia Zamagni
- Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health, IRCCS “Burlo Garofolo,” Trieste, Italy
| | - Giorgio Cozzi
- Emergency Department, Institute for Maternal and Child Health, IRCCS “Burlo Garofolo,” Trieste, Italy
| | - Davide Tonegutto
- Emergency Department, Institute for Maternal and Child Health, IRCCS “Burlo Garofolo,” Trieste, Italy
| | - Luca Ronfani
- Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health, IRCCS “Burlo Garofolo,” Trieste, Italy
| | - Chiara Oretti
- Department of Services, Azienda Sanitaria Universitaria Integrata Giuliano Isontina (ASUGI), Trieste, Italy
| | - Andrea De Manzini
- Department of Services, Azienda Sanitaria Universitaria Integrata Giuliano Isontina (ASUGI), Trieste, Italy
| | - Egidio Barbi
- Emergency Department, Institute for Maternal and Child Health, IRCCS “Burlo Garofolo,” Trieste, Italy
- Department of Medical Sciences, University of Trieste, Trieste, Italy
| | - Manola Comar
- Department of Advanced Translational Microbiology, Institute for Maternal and Child Health, IRCCS “Burlo Garofolo,” Trieste, Italy
- Department of Medical Sciences, University of Trieste, Trieste, Italy
- *Correspondence: Manola Comar,
| | - Alessandro Amaddeo
- Emergency Department, Institute for Maternal and Child Health, IRCCS “Burlo Garofolo,” Trieste, Italy
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COVID-19 Mortality in Children: A Referral Center Experience from Iran (Mofid Children’s Hospital, Tehran, Iran). CANADIAN JOURNAL OF INFECTIOUS DISEASES AND MEDICAL MICROBIOLOGY 2022; 2022:2737719. [PMID: 35340920 PMCID: PMC8942697 DOI: 10.1155/2022/2737719] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 01/27/2022] [Accepted: 02/09/2022] [Indexed: 01/08/2023]
Abstract
Background. The novel coronavirus disease 2019 (COVID-19) started in Wuhan, China, in December 2019. It spread widely around the world and was described as a pandemic by the World Health Organization (WHO). The knowledge regarding the mortality rate and risk factors of COVID-19 among the pediatric population is lacking. In this regard, we aimed to report the clinical and laboratory characteristics of deceased pediatric patients with SARS-CoV-2 infection. Method. This cross-sectional study was conducted in Mofid Children’s Hospital, Tehran, Iran, from February 2020 to April 2021. Recorded documents of 59 pediatric patients (under 18 years old) assumed to have COVID-19 who had died in the COVID-19 ward and COVID-19 intensive care unit (ICU) were retrospectively evaluated. All statistical analyses were performed using SPSS software (v. 26.0, Chicago, IL). A
value of less than 0.05 was considered statistically significant. Results. From 711 COVID-19 definite and suspected patients, 59 children died. Of these deceased pediatric patients, 34 were boys (57.62%) and 25 were girls (42.37%), with a total mean age of 5.6 years. The median length of stay in the hospital was 10 days (range 1–215). 91.52% had underlying comorbidities of which neurological diseases accounted for the largest share. 54 patients were admitted to the ICU and 83.05% of them had intubation during their hospitalization. In addition, the most common reasons for death in our study were related to respiratory and multiorgan failure. Conclusion. According to our knowledge, we are the first team to report such a thorough study in the field of COVID-19 pediatric mortality in Iran. Mortality was observed in all age groups of children, especially in those with previous comorbidities, specifically neurological disease. Abnormally elevated tests of ESR, CRP, LDH, AST, and ALT as well as the presence of proteinuria and hematuria were found in more than 50% of patients in our investigations, and ICU admission between both definite and suspected groups had significant differences, so monitoring and considering these factors may help to control and reduce the progression of the disease to death.
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