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Pisolkar V, Dena I, Green KL, Palmer-Clarke Y, Hinz T, Muhajarine N. See us, hear us! children, adolescents and families in Saskatchewan coping with mental health during the COVID-19 pandemic. Int J Qual Stud Health Well-being 2024; 19:2361494. [PMID: 38824661 PMCID: PMC11146264 DOI: 10.1080/17482631.2024.2361494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 05/24/2024] [Indexed: 06/04/2024] Open
Abstract
PURPOSE To examine the lived experiences of children and adolescents coping with mental health issues and seeking mental health services in Saskatchewan during the COVID-19 pandemic. METHODS In our descriptive phenomenological qualitative study, we interviewed forty-six individuals, including children aged 8-15 and their parents. Thematic analysis was applied to interpret the interview data. RESULTS Our analysis identified three key themes: pyscho-behavioural impact, academic impact, and social impact. The pandemic adversely affected children due to factors like changes in behaviours such as increased screen time and decreased physical activity, limited access to mental health services, and disruptions to schooling and social interactions. Coping mechanisms varied, ranging from the utilization of available mental health supports and services to individual and family-based strategies. Disparities in timely access to mental health services were evident, with financially stable families accessing private services, while others struggled, particularly in rural areas. Families demonstrated resilience through parental efforts to seek balance and prioritize safety amidst COVID-19 challenges. CONCLUSIONS Social connectedness served as a crucial buffer against pandemic-induced stress. Children faced difficulty in accessing timely mental health services and supports. Echoing participant experiences, our findings emphasize the urgency of targeted interventions and policy adjustments to address existing gaps in mental health service accessibility and availability.
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Affiliation(s)
- Vaidehi Pisolkar
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Isabelle Dena
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Kathryn L. Green
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Yolanda Palmer-Clarke
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
- Saskatchewan Population Health and Evaluation Research Unit (SPHERU), Saskatoon, SK, Canada
| | - Tamara Hinz
- Department of Psychiatry, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Nazeem Muhajarine
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
- Saskatchewan Population Health and Evaluation Research Unit (SPHERU), Saskatoon, SK, Canada
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2
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Korchinski I, Marquez C, McClymont E, Av-Gay G, Andrade J, Elwood C, Jassem A, Krajden M, Morshed M, Sadarangani M, Tanunliong G, Sekirov I, Money D. Maternal-infant transfer of SARS-CoV-2 antibodies following vaccination in pregnancy: A prospective cohort study. Vaccine 2024; 42:126123. [PMID: 38981741 DOI: 10.1016/j.vaccine.2024.07.024] [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: 12/22/2023] [Revised: 04/29/2024] [Accepted: 07/05/2024] [Indexed: 07/11/2024]
Abstract
OBJECTIVES To measure and evaluate the impact of receiving severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines in pregnancy on immunoglobulin G (IgG) and immunoglobulin A (IgA) titres in maternal and infant samples. DESIGN Prospective cohort study. SETTING Tertiary obstetric centre. POPULATION OR SAMPLE 52 pregnant women who received one or more SARS-CoV-2 vaccine doses during pregnancy and their neonates. METHODS IgG and IgA concentrations against SARS-CoV-2 antigens were measured from samples collected at delivery and 4-6 weeks postpartum and compared using Spearman correlations. MAIN OUTCOME MEASURES Maternal and infant IgG and IgA titres in response to vaccination and infection in pregnancy. RESULTS In maternal serum collected at delivery, participants without evidence of prior infection who received 3 + doses of a SARS-CoV-2 vaccine had higher Anti-Spike (S) IgG geometric mean concentrations (log10 AU/mL)(GMC) than those who received 2 doses (3 + Doses = 5.00, 2 Doses = 4.60, p = 0.08). The differences in IgG Anti-S GMC were statistically significant in cord serum, and in postpartum samples of maternal serum, infant serum and breast milk (Cord GMCs: 3 + Doses = 5.32, 2 Doses = 4.98, p < 0.05; Postpartum maternal serum GMCs: 3 + Doses = 5.25, 2 Doses = 4.57, p < 0.001; Postpartum infant serum GMCs: 3 + Doses = 5.10, 2 Doses = 4.72, p = 0.03; Postpartum breast milk GMCs: 3 + Doses = 2.61, 2 Doses = 1.94, p < 0.0001). Among participants with 3 + Doses, those with evidence of SARS-CoV-2 infection had statistically significant higher anti-S IgG GMCs than those without prior infection (Maternal serum at delivery: SARS-CoV-2+=5.65, SARS-CoV-2-=5.00, p = 0.004; Cord: SARS-CoV-2+=5.68, SARS-CoV-2-=5.32, p = 0.02; Postpartum maternal serum: SARS-CoV-2+=5.66, SARS-CoV-2-=5.25, p < 0.001; postpartum infant serum: SARS-CoV-2+=5.50, SARS-CoV-2-=5.10, p = 0.003; Postpartum breast milk: SARS-COV-2+=3.25, SARS-COV-2-=2.61, p = 0.009). Significant positive correlations were found for anti-S IgG titres between paired maternal and infant samples at delivery and postpartum (Delivery: R = 0.91, p < 0.001; postpartum: R = 0.86, p < 0.001). CONCLUSIONS Receipt of a SARS-CoV-2 vaccine and SARS-CoV-2 infection elicit strong IgG and IgA antibody responses in pregnant women with evidence of transplacental transfer to the fetus.
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Affiliation(s)
- I Korchinski
- Women's Health Research Institute, Vancouver, Canada
| | - C Marquez
- British Columbia Center for Disease Control Public Health Laboratory, Vancouver, Canada
| | - E McClymont
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, Canada; Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - G Av-Gay
- Women's Health Research Institute, Vancouver, Canada; Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, Canada
| | - J Andrade
- Women's Health Research Institute, Vancouver, Canada
| | - C Elwood
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, Canada
| | - A Jassem
- British Columbia Center for Disease Control Public Health Laboratory, Vancouver, Canada; Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - M Krajden
- British Columbia Center for Disease Control Public Health Laboratory, Vancouver, Canada; Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - M Morshed
- British Columbia Center for Disease Control Public Health Laboratory, Vancouver, Canada; Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - M Sadarangani
- Department of Pediatrics, University of British Columbia, Vancouver, Canada; Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, Canada
| | - G Tanunliong
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - I Sekirov
- British Columbia Center for Disease Control Public Health Laboratory, Vancouver, Canada; Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - D Money
- Women's Health Research Institute, Vancouver, Canada; Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, Canada.
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3
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Cetinkaya PG, Abras IF, Evcili I, Yildirim T, Ceylan Y, Kara Eroglu F, Kayaoglu B, İpekoglu EM, Akarsu A, Yıldırım M, Kahraman T, Cengiz AB, Sahiner UM, Sekerel BE, Ozsurekci Y, Soyer O, Gursel I. Plasma Extracellular Vesicles Derived from Pediatric COVID-19 Patients Modulate Monocyte and T Cell Immune Responses Based on Disease Severity. Immunol Invest 2024; 53:1141-1175. [PMID: 39115924 DOI: 10.1080/08820139.2024.2385992] [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: 10/02/2024]
Abstract
BACKGROUND The COVID-19 pandemic has caused significant morbidity and mortality globally. The role of plasma-derived extracellular vesicles (EVs) in pediatric COVID-19 patients remains unclear. METHODS We isolated EVs from healthy controls (n = 13) and pediatric COVID-19 patients (n = 104) with varying severity during acute and convalescent phases using serial ultracentrifugation. EV effects on healthy PBMCs, naïve CD4+ T cells, and monocytes were assessed through in vitro assays, flow cytometry, and ELISA. RESULTS Our findings indicate that COVID-19 severity correlates with diverse immune responses. Severe acute cases exhibited increased cytokine levels, decreased IFNγ levels, and lower CD4+ T cell and monocyte counts, suggesting immunosuppression. EVs from severe acute patients stimulated healthy cells to express higher PDL1, increased Th2 and Treg cells, reduced IFNγ secretion, and altered Th1/Th17 ratios. Patient-derived EVs significantly reduced proinflammatory cytokine production by monocytes (p < .001 for mild, p = .0025 for severe cases) and decreased CD4+ T cell (p = .043) and monocyte (p = .033) populations in stimulated healthy PBMCs. CONCLUSION This study reveals the complex relationship between immunological responses and EV-mediated effects, emphasizing the impact of COVID-19 severity. We highlight the potential role of plasma-derived EVs in early-stage immunosuppression in severe COVID-19 patients.
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Affiliation(s)
- Pınar Gur Cetinkaya
- Department of Molecular Biology and Genetics, Bilkent University, Ankara, Turkey
| | - Irem Fatma Abras
- Department of Molecular Biology and Genetics, Bilkent University, Ankara, Turkey
| | - Irem Evcili
- Department of Molecular Biology and Genetics, Bilkent University, Ankara, Turkey
| | - Tugçe Yildirim
- Department of Molecular Biology and Genetics, Bilkent University, Ankara, Turkey
- Basic and Translational Research Program, Izmir Biomedicine and Genome Center, Izmir, Turkey
| | - Yasemin Ceylan
- Department of Molecular Biology and Genetics, Bilkent University, Ankara, Turkey
| | - Fehime Kara Eroglu
- Department of Molecular Biology and Genetics, Bilkent University, Ankara, Turkey
| | - Başak Kayaoglu
- Department of Biological Sciences, Middle East Technical University, Ankara, Turkey
| | - Emre Mert İpekoglu
- Department of Biological Sciences, Middle East Technical University, Ankara, Turkey
| | - Aysegul Akarsu
- Division of Pediatric Allergy and Asthma Unit, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Muzaffer Yıldırım
- Department of Molecular Biology and Genetics, Bilkent University, Ankara, Turkey
- Basic and Translational Research Program, Izmir Biomedicine and Genome Center, Izmir, Turkey
| | - Tamer Kahraman
- Department of Molecular Biology and Genetics, Bilkent University, Ankara, Turkey
| | - Ali Bülent Cengiz
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Umit Murat Sahiner
- Division of Pediatric Allergy and Asthma, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Bulent Enis Sekerel
- Division of Pediatric Allergy and Asthma, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Yasemin Ozsurekci
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Ozge Soyer
- Division of Pediatric Allergy and Asthma, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Ihsan Gursel
- Department of Molecular Biology and Genetics, Bilkent University, Ankara, Turkey
- Basic and Translational Research Program, Izmir Biomedicine and Genome Center, Izmir, Turkey
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Xia S, Bei F, Cai C, Xu L, Gong X, Wang J, Zhang Y, Huang H, Xia H. Clinical characteristics and outcomes of neonatal SARS-CoV-2 infection after the release of the epidemic situation of COVID-19. BMC Pediatr 2024; 24:616. [PMID: 39342170 PMCID: PMC11437735 DOI: 10.1186/s12887-024-05096-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 09/20/2024] [Indexed: 10/01/2024] Open
Abstract
BACKGROUND With the release of the coronavirus disease 2019 (COVID-19) pandemic in late 2022 in China, the number of people infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) roared, including neonatal cases. However, there were few studies on neonatal COVID-19, especially multi-center case reports. This study aimed to explore clinical characteristics and short-term outcomes of neonatal COVID-19 in China. METHODS We reviewed 187 cases of neonatal COVID-19 between December 11, 2022, and January 12, 2023. The diagnosis was assessed by symptoms, laboratory tests, X-ray manifestations, and diagnosis code. Clinical characteristics and outcomes were evaluated. RESULTS In 187 neonatal cases with COVID-19, 84 (44.9%) had severe SARS-CoV-2 infection. Most patients had confirmed exposure to SARS-CoV-2. Fever and respiratory symptoms were common (75.4% and 71.7%, respectively). Severe patients were more likely to have high alanine transaminase (ALT) (> 40U/L) (11.9% vs. 3.9%) and high N-terminal pro-brain natriuretic peptide (NT-proBNP) (> 2000pg/mL) (38.0% vs. 19.6%), compared with nonsevere ones (P < 0.05). None of the patients received COVID-19-specific medical interventions. A few severe patients received corticosteroids (1.1%), and immunoglobulin (0.5%), respectively. All patients were discharged home after the medical care with a median length of stay (LOS) of four days and none of them met the criteria of multisystem inflammatory syndrome in neonates (MIS-N). CONCLUSIONS After the release of the epidemic situation of COVID-19 in late 2022 in China, more neonatal cases with severe COVID-19 had high ALT and NT-proBNP level. Few specific medical interventions were given, and the outcome was satisfying.
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Affiliation(s)
- Siyi Xia
- Department of Neonatology, Xinhua Hospital Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fei Bei
- Department of Neonatology, Shanghai Children's Medical Center Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Cheng Cai
- Department of Neonatology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Liqing Xu
- Department of Neonatology, Shanghai Children's Medical Center Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaohui Gong
- Department of Neonatology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jingjing Wang
- Department of Neonatology, Jiaxing Maternity and Child Health Care Hospital, Shanghai, China
| | - Yongjun Zhang
- Department of Neonatology, Xinhua Hospital Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huafei Huang
- Department of Neonatology, Jiaxing Maternity and Child Health Care Hospital, Shanghai, China.
| | - Hongping Xia
- Department of Neonatology, Xinhua Hospital Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Figueroa AL, Torres D, Reyes-Acuna C, Matherne P, Yeakey A, Deng W, Xu W, Sigal Y, Chambers G, Olsen M, Girard B, Miller JM, Das R, Priddy F. Safety and immunogenicity of a single-dose omicron-containing COVID-19 vaccination in adolescents: an open-label, single-arm, phase 2/3 trial. THE LANCET. INFECTIOUS DISEASES 2024:S1473-3099(24)00501-2. [PMID: 39332418 DOI: 10.1016/s1473-3099(24)00501-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 07/12/2024] [Accepted: 07/26/2024] [Indexed: 09/29/2024]
Abstract
BACKGROUND Most individuals show immunity to SARS-CoV-2 from vaccination or infection, or both. We aimed to determine the safety and immunogenicity of an omicron-containing COVID-19 vaccine (mRNA-1273.222) in vaccine-naive adolescents who were SARS-CoV-2 positive. METHODS Part 3 of the phase 2/3 TeenCOVE trial was a phase 3, open-label, single-arm part done in the USA and the Dominican Republic that enrolled healthy, vaccine-naive adolescents (aged 12-17 years) to receive two 50 μg doses of mRNA-1273.222 (ancestral strain Wuhan-Hu-1 and omicron subvariants BA.4 and BA.5), 6 months apart. Primary reactogenicity and safety outcomes included assessment of solicited local or systemic adverse reactions 7 days after vaccination, and unsolicited and prespecified adverse events throughout study participation. Inferred effectiveness (primary immunogenicity outcome) was established by comparing neutralising antibody responses 28 days after dose 1 of mRNA-1273.222 in SARS-CoV-2-positive adolescents with responses 28 days after dose 2 of mRNA-1273 100 μg primary series in SARS-CoV-2-negative young adults (aged 18-25 years) from the COVE trial. This study is registered with ClinicalTrials.gov (NCT04649151). FINDINGS Between Dec 21, 2022, and June 5, 2023, 379 adolescents (378 of whom were SARS-CoV-2 positive) received at least one mRNA-1273.222 dose and were included in the safety analysis set. The reactogenicity profile was favourable compared with the mRNA-1273 primary series, with no new safety concerns identified. Unsolicited adverse events were reported in 49 (13%) of 379 participants; no deaths or adverse events leading to study discontinuation were reported. The immunogenicity set included 245 adolescents from the per-protocol immunogenicity subset who were SARS-CoV-2 positive at baseline and 296 young adults who were SARS-CoV-2 negative. Compared with the mRNA-1273 primary series in SARS-CoV-2-negative young adults, a single dose of mRNA-1273.222 induced superior (geometric mean ratio [GMR] 95% CI lower bound >1) neutralising antibody responses against omicron BA.4 and BA.5 (GMR 48·95 [95% CI 44·21-54·21]) and non-inferior (GMR 95% CI lower bound >0·667) neutralising antibody responses against ancestral SARS-CoV-2 (GMR 4·25 [95% CI 3·69-4·88]) in SARS-CoV-2-positive adolescents. INTERPRETATION In vaccine-naive, SARS-CoV-2-positive adolescents, single-dose mRNA-1273.222 was effective against COVID-19 based on successful immunobridging to the two-dose mRNA-1273 primary series in young adults. The findings support a simplified single-dose vaccination schedule with variant-containing mRNA vaccines, regardless of previous vaccination status. FUNDING Moderna.
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Affiliation(s)
| | - Dania Torres
- Hospital General Regional Dr Marcelino Velez Santana, Santo Domingo, Dominican Republic
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Manfroi B, Cuc BT, Sokal A, Vandenberghe A, Temmam S, Attia M, El Behi M, Camaglia F, Nguyen NT, Pohar J, Salem-Wehbe L, Pottez-Jouatte V, Borzakian S, Elenga N, Galeotti C, Morelle G, de Truchis de Lays C, Semeraro M, Romain AS, Aubart M, Ouldali N, Mahuteau-Betzer F, Beauvineau C, Amouyal E, Berthaud R, Crétolle C, Arnould MD, Faye A, Lorrot M, Benoist G, Briand N, Courbebaisse M, Martin R, Van Endert P, Hulot JS, Blanchard A, Tartour E, Leite-de-Moraes M, Lezmi G, Ménager M, Luka M, Reynaud CA, Weill JC, Languille L, Michel M, Chappert P, Mora T, Walczak AM, Eloit M, Bacher P, Scheffold A, Mahévas M, Sermet-Gaudelus I, Fillatreau S. Preschool-age children maintain a distinct memory CD4 + T cell and memory B cell response after SARS-CoV-2 infection. Sci Transl Med 2024; 16:eadl1997. [PMID: 39292802 DOI: 10.1126/scitranslmed.adl1997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 07/19/2024] [Indexed: 09/20/2024]
Abstract
The development of the human immune system lasts for several years after birth. The impact of this maturation phase on the quality of adaptive immunity and the acquisition of immunological memory after infection at a young age remains incompletely defined. Here, using an antigen-reactive T cell (ARTE) assay and multidimensional flow cytometry, we profiled circulating severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-reactive CD3+CD4+CD154+ T cells in children and adults before infection, during infection, and 11 months after infection, stratifying children into separate age groups and adults according to disease severity. During SARS-CoV-2 infection, children younger than 5 years old displayed a lower antiviral CD4+ T cell response, whereas children older than 5 years and adults with mild disease had, quantitatively and phenotypically, comparable virus-reactive CD4+ T cell responses. Adults with severe disease mounted a response characterized by higher frequencies of virus-reactive proinflammatory and cytotoxic T cells. After SARS-CoV-2 infection, preschool-age children not only maintained neutralizing SARS-CoV-2-reactive antibodies postinfection comparable to adults but also had phenotypically distinct memory T cells displaying high inflammatory features and properties associated with migration toward inflamed sites. Moreover, preschool-age children had markedly fewer circulating virus-reactive memory B cells compared with the other cohorts. Collectively, our results reveal unique facets of antiviral immunity in humans at a young age and indicate that the maturation of adaptive responses against SARS-CoV-2 toward an adult-like profile occurs in a progressive manner.
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Affiliation(s)
- Benoît Manfroi
- Université Paris Cité, INSERM U1151, CNRS UMR8253, Institut Necker Enfants Malades-INEM, F-75015 Paris, France
| | - Bui Thi Cuc
- Université Paris Cité, INSERM U1151, CNRS UMR8253, Institut Necker Enfants Malades-INEM, F-75015 Paris, France
| | - Aurélien Sokal
- Université Paris Cité, INSERM U1151, CNRS UMR8253, Institut Necker Enfants Malades-INEM, F-75015 Paris, France
- Action thématique incitative sur programme-Avenir Team, Auto-Immune and Immune B cells, F-75015 Paris, France
- Service de Médecine interne, Hôpital Beaujon, Assistance Publique-Hôpitaux de Paris (AP-HP), 92110 Clichy, France
- Service de Médecine Interne, Centre Hospitalier Universitaire Henri-Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil (UPEC), 94000 Créteil, France
| | - Alexis Vandenberghe
- Université Paris Cité, INSERM U1151, CNRS UMR8253, Institut Necker Enfants Malades-INEM, F-75015 Paris, France
- Action thématique incitative sur programme-Avenir Team, Auto-Immune and Immune B cells, F-75015 Paris, France
- Service de Médecine Interne, Centre Hospitalier Universitaire Henri-Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil (UPEC), 94000 Créteil, France
- INSERM U955, équipe 2. Institut Mondor de Recherche Biomédicale (IMRB), Université Paris-Est Créteil (UPEC), 94000 Créteil, France
| | - Sarah Temmam
- Pathogen Discovery Laboratory, Institut Pasteur, Université Paris Cité, and Institut Pasteur, the WOAH Collaborating Center for the Detection and Identification in Humans of Emerging Animal Pathogens, Université Paris Cité, 75015 Paris, France
| | - Mikaël Attia
- Molecular Genetics of RNA Viruses, Department of Virology, Institut Pasteur, Université Paris-Cité, CNRS UMR 3569, 75015 Paris, France
| | - Mohamed El Behi
- Université Paris Cité, INSERM U1151, CNRS UMR8253, Institut Necker Enfants Malades-INEM, F-75015 Paris, France
| | - Francesco Camaglia
- Laboratoire de physique de l'École normale supérieure, CNRS, Paris Sciences et Lettres (PSL) University, Sorbonne Université, and Université de Paris, 75005 Paris, France
| | - Ngan Thu Nguyen
- Université Paris Cité, INSERM U1151, CNRS UMR8253, Institut Necker Enfants Malades-INEM, F-75015 Paris, France
| | - Jelka Pohar
- Université Paris Cité, INSERM U1151, CNRS UMR8253, Institut Necker Enfants Malades-INEM, F-75015 Paris, France
- Immunology and Cellular Immunotherapy (ICI) Group, Department of Genetic Toxicology and Cancer Biology, National Institute of Biology, 1000 Ljubljana, Slovenia
| | - Layale Salem-Wehbe
- Université Paris Cité, INSERM U1151, CNRS UMR8253, Institut Necker Enfants Malades-INEM, F-75015 Paris, France
| | - Valentine Pottez-Jouatte
- Université Paris Cité, INSERM U1151, CNRS UMR8253, Institut Necker Enfants Malades-INEM, F-75015 Paris, France
| | - Sibyline Borzakian
- Université Paris Cité, INSERM U1151, CNRS UMR8253, Institut Necker Enfants Malades-INEM, F-75015 Paris, France
- CNRS UMR 9187, INSERM U1196, Chemistry and Modeling for the Biological of Cancer, Institut Curie, PSL Research University, 91405 Orsay, France
- Université Paris-Saclay, 91405 Orsay, France
| | - Narcisse Elenga
- Service de Pédiatrie, Centre Hospitalier de Cayenne, 97300 French Guiana
| | - Caroline Galeotti
- Department of Pediatric Rheumatology, Bicêtre Hospital, AP-HP, Paris-Saclay University, 94275 Le Kremlin-Bicêtre, France
| | - Guillaume Morelle
- Department of General Paediatrics, Hôpital Bicêtre, AP-HP, University of Paris Saclay, 94275 Le Kremlin-Bicêtre, France
| | - Camille de Truchis de Lays
- Service de Pédiatrie. Hôpital Jean-Verdier, AP-HP, Hôpitaux Universitaires Paris Seine-Saint-Denis, 93140 Bondy, France
| | - Michaela Semeraro
- University of Paris Cité, and Clinical Investigation Center, Clinical Research Unit, Necker-Children's Hospital, Assistance Publique-Hôpitaux de Paris, 75015 Paris, France
| | - Anne-Sophie Romain
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Trousseau Hospital, General Paediatrics Department, 75012 Paris, France
| | - Mélodie Aubart
- INSERM U1163, Genetic Predisposition to Infectious Diseases, Imagine Institute, Université Paris Cité, Paris F-75015, France
- Pediatric Neurology Department, Necker-Enfants Malades Universitary Hospital, AP-HP, Paris-Cité University, 75015 Paris, France
| | - Naim Ouldali
- Department of General Pediatrics, Pediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, 75019 Paris, France
- Paris Cité University, INSERM UMR 1137, Infection, Antimicrobials, Modelling, Evolution (IAME), 75018 Paris, France
| | - Florence Mahuteau-Betzer
- CNRS UMR 9187, INSERM U1196, Chemistry and Modeling for the Biological of Cancer, Institut Curie, PSL Research University, 91405 Orsay, France
- Université Paris-Saclay, 91405 Orsay, France
| | - Claire Beauvineau
- CNRS UMR 9187, INSERM U1196, Chemistry and Modeling for the Biological of Cancer, Institut Curie, PSL Research University, 91405 Orsay, France
- Université Paris-Saclay, 91405 Orsay, France
| | - Elsa Amouyal
- SIREDO Pediatric Oncology Center, Institut Curie, Paris-Science Lettres University, 75005 Paris, France
| | - Romain Berthaud
- Pediatric Nephrology, Maladies Rénales Héréditaires de l'Enfant et de l'Adulte (MARHEA) Reference Center, Necker-Children's Hospital, Assistance Publique-Hôpitaux de Paris, 75015 Paris, France
- Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), 75015 Paris, France
| | - Célia Crétolle
- Département de Pédiatrie, Service de Chirurgie viscérale pédiatrique, Hôpital Universitaire Necker-Enfants Malades, GH Paris Centre, 75015 Paris, France
| | - Marc Duval Arnould
- Department of General Paediatrics, Hôpital Bicêtre, AP-HP, University of Paris Saclay, 94275 Le Kremlin-Bicêtre, France
| | - Albert Faye
- Pediatric Neurology Department, Necker-Enfants Malades Universitary Hospital, AP-HP, Paris-Cité University, 75015 Paris, France
| | - Mathie Lorrot
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Trousseau Hospital, General Paediatrics Department, 75012 Paris, France
| | - Grégoire Benoist
- Service de pédiatrie générale et hôpital de jour allergologie, CHU Ambroise-Paré, AP-HP, 92100 Boulogne-Billancourt, France
| | - Nelly Briand
- University of Paris Cité, and Clinical Investigation Center, Clinical Research Unit, Necker-Children's Hospital, Assistance Publique-Hôpitaux de Paris, 75015 Paris, France
| | - Marie Courbebaisse
- Faculté de Médecine, Université Paris Cité, 75015 Paris, France
- Explorations fonctionnelles rénales, Physiologie, Hôpital européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris, 75908 Paris Cedex 15, France
| | - Roland Martin
- Institute of Experimental Immunology, University of Zurich, Winterthurerstrasse 190, 8057 Zurich, Switzerland
- Therapeutic Immune Design, Center for Molecular Medicine, Department of Clinical Neuroscience, Karolinska Institute, 171 76 Stockholm, Sweden
| | - Peter Van Endert
- Université Paris Cité, INSERM U1151, CNRS UMR8253, Institut Necker Enfants Malades-INEM, F-75015 Paris, France
- Service Immunologie Biologique, AP-HP, Hôpital Universitaire Necker-Enfants Malades, F-75015 Paris, France
| | - Jean-Sébastien Hulot
- PARCC, INSERM, Université Paris Cité, 75015 Paris, France
- Centre d'Investigation Clinique, AP-HP, INSERM CIC-1418, Européen Georges Pompidou Hospital, 75015 Paris, France
| | - Anne Blanchard
- Centre d'Investigation Clinique, AP-HP, INSERM CIC-1418, Européen Georges Pompidou Hospital, 75015 Paris, France
- Sorbonne Paris Cité, Paris Descartes University, 75015 Paris, France
| | - Eric Tartour
- Pediatric Nephrology, Maladies Rénales Héréditaires de l'Enfant et de l'Adulte (MARHEA) Reference Center, Necker-Children's Hospital, Assistance Publique-Hôpitaux de Paris, 75015 Paris, France
- PARCC, INSERM, Université Paris Cité, 75015 Paris, France
- Department of Immunology, Hôpital Européen Georges-Pompidou, AP-HP, CEDEX 15, 75908 Paris, France
| | - Maria Leite-de-Moraes
- Université Paris Cité, INSERM U1151, CNRS UMR8253, Institut Necker Enfants Malades-INEM, F-75015 Paris, France
| | - Guillaume Lezmi
- Université Paris Cité, INSERM U1151, CNRS UMR8253, Institut Necker Enfants Malades-INEM, F-75015 Paris, France
- AP-HP, Hôpital Necker-Enfants Malades, Service de Pneumologie et Allergologie Pédiatriques, 75015 Paris, France
| | - Mickael Ménager
- Laboratory of Inflammatory Responses and Transcriptomic Networks in Diseases, Atip-Avenir Team, Université Paris Cité, Imagine Institute, 75015 Paris, France
- Labtech Single-Cell@Imagine, Imagine Institute, 75015 Paris, France
| | - Marine Luka
- Laboratory of Inflammatory Responses and Transcriptomic Networks in Diseases, Atip-Avenir Team, Université Paris Cité, Imagine Institute, 75015 Paris, France
- Labtech Single-Cell@Imagine, Imagine Institute, 75015 Paris, France
| | - Claude-Agnès Reynaud
- Université Paris Cité, INSERM U1151, CNRS UMR8253, Institut Necker Enfants Malades-INEM, F-75015 Paris, France
- Action thématique incitative sur programme-Avenir Team, Auto-Immune and Immune B cells, F-75015 Paris, France
| | - Jean-Claude Weill
- Université Paris Cité, INSERM U1151, CNRS UMR8253, Institut Necker Enfants Malades-INEM, F-75015 Paris, France
- Action thématique incitative sur programme-Avenir Team, Auto-Immune and Immune B cells, F-75015 Paris, France
| | - Laetitia Languille
- Service de Médecine Interne, Centre Hospitalier Universitaire Henri-Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil (UPEC), 94000 Créteil, France
| | - Marc Michel
- Service de Médecine Interne, Centre Hospitalier Universitaire Henri-Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil (UPEC), 94000 Créteil, France
| | - Pascal Chappert
- Université Paris Cité, INSERM U1151, CNRS UMR8253, Institut Necker Enfants Malades-INEM, F-75015 Paris, France
- Action thématique incitative sur programme-Avenir Team, Auto-Immune and Immune B cells, F-75015 Paris, France
- INSERM U955, équipe 2. Institut Mondor de Recherche Biomédicale (IMRB), Université Paris-Est Créteil (UPEC), 94000 Créteil, France
| | - Thierry Mora
- Laboratoire de physique de l'École normale supérieure, CNRS, Paris Sciences et Lettres (PSL) University, Sorbonne Université, and Université de Paris, 75005 Paris, France
| | - Aleksandra M Walczak
- Laboratoire de physique de l'École normale supérieure, CNRS, Paris Sciences et Lettres (PSL) University, Sorbonne Université, and Université de Paris, 75005 Paris, France
| | - Marc Eloit
- Pathogen Discovery Laboratory, Institut Pasteur, Université Paris Cité, and Institut Pasteur, the WOAH Collaborating Center for the Detection and Identification in Humans of Emerging Animal Pathogens, Université Paris Cité, 75015 Paris, France
- Ecole Nationale Vétérinaire d'Alfort, University of Paris-Est, 94700 Maisons-Alfort, France
| | - Petra Bacher
- Institute of Immunology, Christian-Albrecht Universität zu Kiel and UKSH Schleswig-Holstein, 24105 Kiel, Germany
- Institute of Clinical Molecular Biology, Christian-Albrecht University of Kiel and UKSH Schleswig-Holstein, 24105 Kiel, Germany
| | - Alexander Scheffold
- Institute of Immunology, Christian-Albrecht Universität zu Kiel and UKSH Schleswig-Holstein, 24105 Kiel, Germany
| | - Matthieu Mahévas
- Université Paris Cité, INSERM U1151, CNRS UMR8253, Institut Necker Enfants Malades-INEM, F-75015 Paris, France
- Action thématique incitative sur programme-Avenir Team, Auto-Immune and Immune B cells, F-75015 Paris, France
- Service de Médecine Interne, Centre Hospitalier Universitaire Henri-Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil (UPEC), 94000 Créteil, France
- INSERM U955, équipe 2. Institut Mondor de Recherche Biomédicale (IMRB), Université Paris-Est Créteil (UPEC), 94000 Créteil, France
| | - Isabelle Sermet-Gaudelus
- Université Paris Cité, INSERM U1151, CNRS UMR8253, Institut Necker Enfants Malades-INEM, F-75015 Paris, France
- Reference Center for Rare Diseases: Cystic Fibrosis and Other Epithelial Respiratory Protein Misfolding Diseases, Hôpital Necker-Enfants Malades, AP-HP Centre Université Paris Cité, 75015 Paris, France
| | - Simon Fillatreau
- Université Paris Cité, INSERM U1151, CNRS UMR8253, Institut Necker Enfants Malades-INEM, F-75015 Paris, France
- Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), 75015 Paris, France
- Faculté de Médecine, Université Paris Cité, 75015 Paris, France
- Service Immunologie Biologique, AP-HP, Hôpital Universitaire Necker-Enfants Malades, F-75015 Paris, France
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Kıvrak U, Köle MT, Akçay G, Yükselmiş U, Genç FA, Karaaslan A, Çetin C, Arsan AK, Akın Y, Şimşek Ş. Evaluation of Long-term Posterior Segment Parameters in Children Who Had Recovered From Multisystem Inflammatory Syndrome. Ophthalmic Surg Lasers Imaging Retina 2024; 55:518-526. [PMID: 38917398 DOI: 10.3928/23258160-20240415-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
BACKGROUND AND OBJECTIVE To evaluate long-term posterior segment findings in children recovering from multisystemic inflammatory syndrome (MIS-C) associated with severe acute respiratory syndrome coronavirus 2. PATIENTS AND METHODS Our study included 22 patients who were admitted to an intensive care unit with a diagnosis of MIS-C between November 2021 and March 2022, and 25 healthy controls. The study included pediatric patients who had an eye examination an average of 12.35 ± 2.18 months after recovery from MIS-C. Detailed eye examinations and measurements of all participants were obtained retrospectively from patient files. Posterior segment parameters were measured using swept-source optical coherence tomography (OCT) and OCT-angiography (OCT-A); these parameters included peripapillary retinal nerve fiber layer (pRNFL) thickness, central macular thickness (CMT), subfoveal choroidal thickness (SCT), macular vascular densities (VD), and foveal avascular zone (FAZ) area. RESULTS Mean age was 9.7 ± 3.6 years in the MIS-C group and 10.6 ± 2.8 years in the healthy control group (P = 0.316). There were no statistically significant differences between the MIS-C group and the healthy control group in terms of pRNFL thickness, CMT, and SCT. However, in the MIS-C group, the macular superficial vascular plexus and deep vascular plexus showed significantly lower VD in the superior, inferior, nasal, and temporal quadrants compared to the healthy controls (P < 0.05 for all). A comparison of the superficial and deep FAZ area parameters of both groups showed no statistically significant difference (P > 0.05). CONCLUSIONS We showed that patients who had recovered from MIS-C had retinal vascular damage at the long-term follow-up. Following up with these patients after recovery with OCT and OCT-A, which are noninvasive methods commonly used in the detailed evaluation of the posterior segment of the eye, could be beneficial for understanding the long-term effects of MIS-C on retinal microvasculature. [Ophthalmic Surg Lasers Imaging Retina 2024;55:518-526.].
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8
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Capraz M, Tekcan A, Cihangiroglu M, Nursal AF, Capraz A, Menekse E, Dortok Demir H, Kuruca N, Yigit S. The effect of the MBL2 gene rs1800450 variant on COVID-19 development in Turkish patients. NUCLEOSIDES, NUCLEOTIDES & NUCLEIC ACIDS 2024:1-11. [PMID: 39210720 DOI: 10.1080/15257770.2024.2395872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 08/12/2024] [Accepted: 08/19/2024] [Indexed: 09/04/2024]
Abstract
The coronavirus disease 2019 (COVID-19) is a recent pandemic occurring worldwide due to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, spreading mainly through large respiratory droplets or maybe through other transmission routes. The human genome has the most varied immune response genes correlated with infectious diseases. Genetic variants of mannose-binding lectin 2 (MBL2), an immunomodulatory gene, were associated with the risk, severity, and frequency of viral infections. In the present study, we hypothesized that the MBL2 gene rs1800450 variant could be associated with the development of COVID-19 disease in a Turkish population. Ninety-eight COVID-19 patients and 98 healthy, ethnically matched controls were studied. We isolated genomic DNA from whole blood and analyzed the MBL2 rs1800450 using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Associations were analyzed with the SPSS 20 statistical software. We found that MBL2 rs1800450 genotype distribution was significantly different between patients and controls. The patients had a higher MBL2 rs1800450 AA genotype than the controls had (4.94% in patients vs. 3.12% in controls, p = 0.006). The subjects carrying AA genotype had a 10.83-fold increased risk for COVID-19 disease (OR = 10.83, %95 CI = 1.359-86.349). We could not detect any significant difference between the COVID-19 patients and healthy controls in allele frequencies. Our findings demonstrated that the MBL2 rs1800450 BB genotype might increase the susceptibility to COVID-19 disease in the Turkish population. We suggest further studies with a larger sample size and other ethnic populations.
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Affiliation(s)
- Mustafa Capraz
- Department of Internal Medicine, Faculty of Medicine, Amasya University, Amasya, Turkey
| | - Akin Tekcan
- Department of Medical Biology, Faculty of Medicine, Amasya University, Amasya, Turkey
| | - Mustafa Cihangiroglu
- Department of Infectious Diseases, Faculty of Medicine, Amasya University, Amasya, Turkey
| | - Ayse Feyda Nursal
- Department of Medical Genetics, Faculty of Medicine, Hitit University, Corum, Turkey
| | - Aylin Capraz
- Department of Chest Diseases, Faculty of Medicine, Amasya University, Amasya, Turkey
| | - Elif Menekse
- Laboratory of Medical Biochemistry, Amasya University Sabuncuoglu Serefeddin Education and Research Hospital, Amasya, Turkey
| | - Hatice Dortok Demir
- Department of Medical Biochemistry, Faculty of Medicine, Amasya University, Amasya, Turkey
| | - Nilufer Kuruca
- Department of Pathology, Faculty of Veterinary Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Serbulent Yigit
- Department of Genetics, Faculty of Veterinary Medicine, Ondokuz Mayıs University, Samsun, Turkey
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9
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Goussard P, Van Wyk L, Venkatakrishna S, Rabie H, Schubert P, Frigati L, Walzl G, Burger C, Doruyter A, Andronikou S, Gie AG, Rhode D, Jacobs C, Van der Zalm M. SARS-CoV-2 coinfection in children with severe airway obstruction due to pulmonary tuberculosis. Pediatr Pulmonol 2024. [PMID: 39185631 DOI: 10.1002/ppul.27232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Revised: 08/06/2024] [Accepted: 08/17/2024] [Indexed: 08/27/2024]
Abstract
INTRODUCTION The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic had a significant impact on tuberculosis (TB) control globally, with the number of new TB diagnoses decreasing. Coinfection with some viruses, especially measles, could aggravate TB in children. This is presumably a result of depressed cellular immunity. Reports on children with TB and SARS-CoV-2 coinfection are limited. METHODS A retrospective analysis of children up to 13 years old admitted to Tygerberg Hospital, Cape Town, South Africa, from March 2020 to December 2022 with suspected TB-induced airway compression requiring bronchoscopy. Children were included if they presented with severe intrathoracic airway obstruction and/or radiographic evidence of complicated TB. The patients were divided into two groups based on SARS-CoV-2 respiratory polymerase chain reaction results. Demographics, TB exposure, microbiology, SARS-CoV-2 laboratory data, imaging, inflammatory cytokine levels, and bronchoscopy data were collected. Statistical analyses compared SARS-CoV-2 positive and negative groups. RESULTS Of the 50 children undergoing bronchoscopy for TB airway obstruction, 7 (14%) were SARS-CoV-2 positive. Cough was more prevalent in the SARS-CoV-2 positive group (p = 0.04). There was no difference in TB culture yield between groups. However, SARS-CoV-2 positive children showed slower radiological improvement at 1 month (p = 0.01), pleural effusions (p < 0.001), and a higher need for endoscopic enucleation (p < 0.001). FDG PET/CT scans indicated an ongoing inflammation in the SARS-CoV-2 positive group. CONCLUSIONS Coinfection with SARS-CoV-2 in children with TB airway obstruction appears to complicate the disease course, necessitating more medical interventions and demonstrating a longer duration of the TB inflammatory process. Further research is needed to understand the impact of viral infections on TB progression and outcomes in pediatric patients.
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Affiliation(s)
- P Goussard
- Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Tygerberg Hospital, Stellenbosch University, Cape Town, South Africa
| | - L Van Wyk
- Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Tygerberg Hospital, Stellenbosch University, Cape Town, South Africa
| | - S Venkatakrishna
- Department of Pediatric Radiology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - H Rabie
- Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Tygerberg Hospital, Stellenbosch University, Cape Town, South Africa
| | - P Schubert
- National Health Laboratory Service, Department of Pathology, Division of Anatomical Pathology, Tygerberg Hospital, Faculty of Medicine and Health Science, Stellenbosch University, Cape Town, South Africa
| | - L Frigati
- Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Tygerberg Hospital, Stellenbosch University, Cape Town, South Africa
| | - G Walzl
- DSI-NRF Centre of Excellence for Biomedical Tuberculosis Research and South African Medical Research Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - C Burger
- Division of Nuclear Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa
| | - A Doruyter
- Division of Nuclear Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa
- NuMeRI Node for Infection Imaging, Central Analytical Facilities, Stellenbosch University, Cape Town, South Africa
| | - S Andronikou
- Department of Pediatric Radiology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - A G Gie
- Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Tygerberg Hospital, Stellenbosch University, Cape Town, South Africa
| | - D Rhode
- Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Tygerberg Hospital, Stellenbosch University, Cape Town, South Africa
| | - C Jacobs
- Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Tygerberg Hospital, Stellenbosch University, Cape Town, South Africa
| | - M Van der Zalm
- Department of Paediatrics and Child Health, Desmond Tutu TB Centre, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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10
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de Miguel Lavisier B, Molina Gutiérrez MÁ, Púa Torrejón RC, García Herrero MÁ, Rodríguez Mesa MD, Furones García M, López López R, Bueno Barriocanal M, García Sánchez P, Ruíz Domínguez JA, de Ceano-Vivas Lacalle M. Seizures in Children With Severe Acute Respiratory Syndrome Coronavirus 2 Infection. Pediatr Neurol 2024; 157:151-156. [PMID: 38924826 DOI: 10.1016/j.pediatrneurol.2024.05.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 04/25/2024] [Accepted: 05/29/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Although respiratory symptoms are the most prominent manifestations of coronavirus disease 2019 (COVID-19), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and especially the omicron variant, may cause neurological manifestations such as seizures. It remains unclear if specific variants of the virus increase the risk of seizures more than others. MATERIAL AND METHODS This was a retrospective multicenter study of pediatric (zero to 16 years) patients with COVID-19 who attended five pediatric emergency departments in Madrid, Spain, between March 2020 and July 2022. An analysis of demographics, medical history, and seizure characteristics was conducted. The data obtained were correlated with the incidence of the different strains of SARS-CoV-2 in the Community of Madrid. RESULTS A total of 2411 seizures (infectious and noninfectious) were recorded, and 35 of them (1.4%) were positive for SARS-CoV-2. Of those 35 patients, 18 (51.4%) reported a history of previous seizures. The highest percentage of cases occurred when the omicron variant was the most prevalent (28 [80%] vs 7 [20%] before omicron variant). Typical febrile seizures accounted for 52.9% of the cases. No treatment was required in more than half (57.1%) of the cases. CONCLUSION during the emergence of the omicron variant, there has been an increase in the number of COVID-19-associated seizures. These findings highlight the need for SARS-CoV-2 screening in patients with febrile and afebrile seizures, in addition to other microbiological, biochemical, or neuroimaging tests, depending on the patient's age and clinical presentation.
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11
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Zhao XJ, Liu XL, Gu HJ, Liu T, Li DY, Zhang S, Wu J, Du KG, Tian S, Chen JJ, Xu Q, Lv CL, Jiang BG, Wang H, Kou ZQ, Wang GL, Fang LQ. SARS-CoV-2 reinfection broadens the antibody responses and promotes the phenotypic differentiation of virus-specific memory T cells in adolescents. J Med Virol 2024; 96:e29873. [PMID: 39165041 DOI: 10.1002/jmv.29873] [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: 02/19/2024] [Revised: 07/10/2024] [Accepted: 08/10/2024] [Indexed: 08/22/2024]
Abstract
The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron subvariants raises concerns regarding the effectiveness of immunity acquired from previous Omicron subvariants breakthrough infections (BTIs) or reinfections (RIs) against the current circulating Omicron subvariants. In this study, we prospectively investigate the dynamic changes of virus-specific antibody and T cell responses among 77 adolescents following Omicron BA.2.3 BTI with or without subsequent Omicron BA.5 RI. Notably, the neutralizing antibodies (NAbs) titers against various detected SARS-CoV-2 variants, especially the emerging Omicron CH.1.1, XBB.1.5, XBB.1.16, EG.5.1, and JN.1 subvariants, exhibited a significant decrease along the time. A lower level of IgG and NAbs titers post-BTI was found to be closely associated with subsequent RI. Elevated NAbs levels and shortened antigenic distances were observed following Omicron BA.5 RI. Robust T cell responses against both Omicron BA.2- and CH.1.1-spike peptides were observed at each point visited. The exposure to Omicron BA.5 promoted phenotypic differentiation of virus-specific memory T cells, even among the non-seroconversion adolescents. Therefore, updated vaccines are needed to provide effective protection against newly emerging SARS-CoV-2 variants among adolescents.
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Affiliation(s)
- Xin-Jing Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
- State Key Laboratory of Pathogen and Biosecurity, Academy of Military Medical Science, Beijing, China
| | - Xiao-Lin Liu
- Institute of Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, China
| | - Hong-Jing Gu
- State Key Laboratory of Pathogen and Biosecurity, Academy of Military Medical Science, Beijing, China
| | - Ti Liu
- Institute of Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, China
| | - De-Yu Li
- State Key Laboratory of Pathogen and Biosecurity, Academy of Military Medical Science, Beijing, China
| | - Sheng Zhang
- State Key Laboratory of Pathogen and Biosecurity, Academy of Military Medical Science, Beijing, China
| | - Jie Wu
- Department of Infectious Disease Control and Prevention, Binzhou Center for Disease Control and Prevention, Jinan, China
| | - Kai-Ge Du
- Institute of Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, China
| | - Shen Tian
- State Key Laboratory of Pathogen and Biosecurity, Academy of Military Medical Science, Beijing, China
| | - Jin-Jin Chen
- State Key Laboratory of Pathogen and Biosecurity, Academy of Military Medical Science, Beijing, China
| | - Qiang Xu
- State Key Laboratory of Pathogen and Biosecurity, Academy of Military Medical Science, Beijing, China
| | - Chen-Long Lv
- State Key Laboratory of Pathogen and Biosecurity, Academy of Military Medical Science, Beijing, China
| | - Bao-Gui Jiang
- State Key Laboratory of Pathogen and Biosecurity, Academy of Military Medical Science, Beijing, China
| | - Hui Wang
- State Key Laboratory of Pathogen and Biosecurity, Academy of Military Medical Science, Beijing, China
| | - Zeng-Qiang Kou
- Institute of Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, China
| | - Guo-Lin Wang
- State Key Laboratory of Pathogen and Biosecurity, Academy of Military Medical Science, Beijing, China
| | - Li-Qun Fang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
- State Key Laboratory of Pathogen and Biosecurity, Academy of Military Medical Science, Beijing, China
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12
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Surendran VA, Ibrahim JM, Thodi RC, Nair AS, Sukumaran ST. Diterpenoid and C20 diterpenoid alkaloid as a potent inhibitor of SARS-CoV-2 main protease (M pro): from Piper barberi Gamble, an endemic and endangered species of Southern Western Ghats. J Biomol Struct Dyn 2024; 42:6997-7013. [PMID: 37482792 DOI: 10.1080/07391102.2023.2238075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 07/12/2023] [Indexed: 07/25/2023]
Abstract
The present study investigated the phytochemicals and in silico anti-nCoV properties of Piper barberi, an endangered and endemic species of Southern Western Ghats. Using conventional soxhlet extraction method, the leaf and stem were extracted separately with methanol (PBLM and PBSM). The bioactive compounds from the extracts were identified using HR-LCMS/MS-qTOF analysis. These compounds were subjected to various in silico analyses to identify potential drug candidates against nCoV. The HR LCMS/MS analysis of PBLM and PBSM revealed the presence of phenols, flavonoids, alkaloids, and terpenoids in it and this is the first report of the phytoconstituents present in the species P. barberi. All the identified bioactive compounds were subjected to predict ADMET. Out of 49 identified compounds, only 31 passed drug-likeness properties and toxicity tests. Molecular interaction studies were conducted using the AutoDockTools 4.2.6., which showed that only 13 compounds exhibited acceptable binding affinity with the nCoV target Mpro. Structural stability and binding free energy analyses of the five compounds with the higher binding affinity indicated that the bioactive compounds Hetisine and Ajaconine are stable with both hydrogen bonds and hydrophobic interactions. Hetisine shows stable binding among these two compounds with two hydrogen bond interactions with the crucial catalytic dyad residue (His41). Thus, this study concludes that these compounds might potentially be used as an alternative drug candidate for managing nCoV. However, further experimental validation, including in vitro and in vivo assays, is required to substantiate the results.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
| | - Junaida M Ibrahim
- Department of Computational Biology & Bioinformatics, University of Kerala, Thiruvananthapuram, India
| | | | - Achuthsankar S Nair
- Department of Computational Biology & Bioinformatics, University of Kerala, Thiruvananthapuram, India
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13
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Kozawa K, Higashimoto Y, Kawamura Y, Miura H, Hattori F, Mihara Y, Nakai H, Nishimura N, Ozaki T, Ihira M, Yoshikawa T. Temporal patterns of asymptomatic SARS-CoV-2 infection among pediatric population in Japan: A 3-year analysis. J Med Virol 2024; 96:e29847. [PMID: 39105394 DOI: 10.1002/jmv.29847] [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: 04/02/2024] [Revised: 07/02/2024] [Accepted: 07/27/2024] [Indexed: 08/07/2024]
Abstract
To elucidate the seroprevalence and rate of asymptomatic infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Japanese children, serological analysis was performed using serum samples collected from March 2020 to February 2023. A total of 1493 serum samples were collected during the first study period (March 2020 to February 2021). None of the serum samples was positive for SARS-CoV-2 antibody. In the second period (March 2021 to February 2022), seven of the 1055 patients (0.7%) experienced SARS-CoV-2 infection. The third period (March 2022 to February 2023) was divided into three terms: from March to June 30, 2022; from July to October 2022; and from November 2022 to February 2023. The seroprevalence gradually increased throughout this period, with rates of 6.0%, 18.6%, and 30.4% in the three terms, respectively. Pediatric cases of asymptomatic SARS-CoV-2 infection occurred after the surge of Omicron variants. Since none of the SARS-CoV-2 antibody-positive patients had a previous history of coronavirus disease 2019, the seroprevalence rate in this study may represent the rate of asymptomatic infection.
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Affiliation(s)
- Kei Kozawa
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Yuki Higashimoto
- Department of Clinical Microbiology, Fujita Health University School of Medical Sciences, Toyoake, Aichi, Japan
| | - Yoshiki Kawamura
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Hiroki Miura
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Fumihiko Hattori
- Department of Pediatrics, Toyokawa City Hospital, Toyokawa, Aichi, Japan
| | - Yuka Mihara
- Department of Pediatrics, Kariya Toyota General Hospital, Kariya, Aichi, Japan
| | - Hidetaka Nakai
- Department of Pediatrics, Toyokawa City Hospital, Toyokawa, Aichi, Japan
| | - Naoko Nishimura
- Department of Pediatrics, Konan Kosei Hospital, Konan, Aichi, Japan
| | - Takao Ozaki
- Department of Pediatrics, Konan Kosei Hospital, Konan, Aichi, Japan
| | - Masaru Ihira
- Department of Clinical Science for Biological Monitoring, Fujita Health University School of Medical Sciences, Toyoake, Aichi, Japan
| | - Tetsushi Yoshikawa
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
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Alcantara DMC, Dos Santos CM, Torres JM, Stutz C, Vieira CA, Moreira RMDS, Rodrigues R, Marcon GEB, Ferreira EDC, Mendes FML, Sarti ECFB, de Oliveira TF, Lemos EF, Andrade UV, Lichs GGDC, Demarchi LHF, Zardin MCSU, Gonçalves CCM, Guilhermino JDF, Fernandez ZDC. Long-term surveillance of SARS-CoV-2 in the school community from Campo Grande, Brazil. BMC Public Health 2024; 24:2057. [PMID: 39085807 PMCID: PMC11290088 DOI: 10.1186/s12889-024-19555-x] [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: 02/27/2024] [Accepted: 07/22/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has significantly impacted education systems worldwide, with Brazil being one of the countries with the longest school closures. Over a million children and teenagers have been affected, leading to increased hunger and nutritional deficiencies. This study aimed to implement long-term surveillance of SARS-CoV-2 infections in public and private schools in Campo Grande, Brazil, after returning to in-person classes. METHODS The study involved testing and genomic surveillance at 23 public and private schools in Campo Grande, Mato Grosso do Sul, Brazil, from October 18, 2021 to November 21, 2022. The participants eligible for enrollment were students aged 6-17 years and staff members from school institutions. At the time of collection, participants were asked if they had symptoms in the last two weeks. Whole-genome sequencing of SARS-CoV-2 was conducted to identify circulating variants and to compare them with those detected in the municipality. The demographic data and clinical history of the participants were described, and a logistic regression model was used to understand how the RT-qPCR results could be related to different characteristics. RESULTS The study included 999 participants, most of whom were women. A total of 85 tests were positive, with an overall positivity rate of 3.2%. The dynamics of case frequency were consistent with those observed in the municipality during the study period. The most common symptoms reported were cough, rhinorrhea, headache, and sore throat. Symptoms were significantly associated with SARS-CoV-2 infection. Eleven lineages were identified in school community samples, with a frequency of occurrence per period similar to that found in the sequences available for the municipality. The most prevalent lineages within the sampling period were BA.2 (59.3%) and BA.5 (29.6%). CONCLUSIONS Our findings demonstrate that schools can play a crucial role in epidemiological surveillance, helping trigger rapid responses to pathogens such as SARS-CoV-2. Long-term surveillance can be used to track outbreaks and assess the role of children and adults in transmission. It can also contribute to pandemic preparedness, enabling a rapid response to emergencies, such as COVID-19.
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Affiliation(s)
| | - Camila Maria Dos Santos
- FIOCRUZ Mato Grosso do Sul, Fundação Oswaldo Cruz (FIOCRUZ), Campo Grande, Mato Grosso do Sul, Brazil
| | - Jaire Marinho Torres
- FIOCRUZ Mato Grosso do Sul, Fundação Oswaldo Cruz (FIOCRUZ), Campo Grande, Mato Grosso do Sul, Brazil
| | - Claudia Stutz
- FIOCRUZ Mato Grosso do Sul, Fundação Oswaldo Cruz (FIOCRUZ), Campo Grande, Mato Grosso do Sul, Brazil
- Programa de Pós-Graduação em Ciências Farmacêuticas, Faculdade de Ciências Farmacêuticas, Alimentos e Nutrição (FACFAN), Fundação Universidade Federal de Mato Grosso do Sul (UFMS), Campo Grande, Mato Grosso do Sul, Brazil
| | - Camila Aoyama Vieira
- FIOCRUZ Mato Grosso do Sul, Fundação Oswaldo Cruz (FIOCRUZ), Campo Grande, Mato Grosso do Sul, Brazil
| | - Raissa Mariele Dos Santos Moreira
- Instituto Integrado de Saúde (INISA), Fundação Universidade Federal de Mato Grosso do Sul (UFMS), Campo Grande, Mato Grosso do Sul, Brazil
| | - Rudielle Rodrigues
- FIOCRUZ Mato Grosso do Sul, Fundação Oswaldo Cruz (FIOCRUZ), Campo Grande, Mato Grosso do Sul, Brazil
| | | | - Eduardo de Castro Ferreira
- FIOCRUZ Mato Grosso do Sul, Fundação Oswaldo Cruz (FIOCRUZ), Campo Grande, Mato Grosso do Sul, Brazil
- Programa de Pós-graduação em Doenças Infecciosas e Parasitárias, Faculdade de Medicina (FAMED), Fundação Universidade Federal de Mato Grosso do Sul (UFMS), Campo Grande, Mato Grosso do Sul, Brazil
| | - Flavia Maria Lins Mendes
- FIOCRUZ Mato Grosso do Sul, Fundação Oswaldo Cruz (FIOCRUZ), Campo Grande, Mato Grosso do Sul, Brazil
| | | | | | - Everton Ferreira Lemos
- Universidade Estadual de Mato Grosso do Sul (UEMS), Campo Grande, Mato Grosso do Sul, Brazil
| | | | - Gislene Garcia de Castro Lichs
- Laboratório Central de Saúde Pública do Estado de Mato Grosso do Sul (LACEN/MS), Campo Grande, Mato Grosso do Sul, Brazil
| | - Luiz Henrique Ferraz Demarchi
- Programa de Pós-graduação em Doenças Infecciosas e Parasitárias, Faculdade de Medicina (FAMED), Fundação Universidade Federal de Mato Grosso do Sul (UFMS), Campo Grande, Mato Grosso do Sul, Brazil
- Laboratório Central de Saúde Pública do Estado de Mato Grosso do Sul (LACEN/MS), Campo Grande, Mato Grosso do Sul, Brazil
| | | | - Crhistinne Cavalheiro Maymone Gonçalves
- Programa de Pós-graduação em Doenças Infecciosas e Parasitárias, Faculdade de Medicina (FAMED), Fundação Universidade Federal de Mato Grosso do Sul (UFMS), Campo Grande, Mato Grosso do Sul, Brazil
- Secretaria de Estado de Saúde de Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
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15
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Altamirano J, Govindarajan P, Blomkalns AL, Leary S, Robinson I, Chun LX, Shaikh NJ, Robinson ML, Lopez M, Tam GKY, Carrington YJ, De Araujo MB, Walter KS, Andrews JR, Burns J, Hogan C, Pinsky BA, Maldonado Y. Natural history of shedding and household transmission of severe acute respiratory syndrome coronavirus 2 using intensive high-resolution sampling. PLoS One 2024; 19:e0305300. [PMID: 39052659 PMCID: PMC11271927 DOI: 10.1371/journal.pone.0305300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 05/27/2024] [Indexed: 07/27/2024] Open
Abstract
IMPORTANCE The COVID-19 pandemic has led to 775 million documented cases and over 7 million deaths worldwide as of March 2024 and is an ongoing health crisis. To limit viral spread within households and in the community, public health officials have recommended self-isolation, self-quarantine of exposed household contacts, and mask use. Yet, risk of household transmission (HHT) may be underestimated due to low frequency of sampling, and risk factors for HHT are not well understood. OBJECTIVES To estimate the secondary attack rate of SARS-CoV-2 within households and to define the risk factors for new infections in household members who are in close contact with the index case. DESIGN, SETTING, AND PARTICIPANTS In this prospective cohort study, from March 2020-December 2021 we enrolled 60 households with index cases who tested positive for SARS-CoV-2. All household contacts and index cases were tested daily for SARS-CoV-2 via reverse transcription polymerase chain reaction (RT-PCR) using self-collected anterior nares specimens. Households were followed until all study participants in the household tested negative for SARS-CoV-2 for seven consecutive days. We collected sex, age, race/ethnicity, comorbidities, and relationship to index case for secondary contacts, household level characteristics including primary income, household density, and square feet per person on property. We compared the sociodemographic variables between COVID-19 positive and negative household members and between households where secondary transmission did and did not occur. MAIN OUTCOMES AND MEASURES Daily anterior nares swabs were tested for SARS-CoV-2 using RT-PCR, in order to assess duration of nasal shedding of SARS-CoV-2, as well as risk of transmission to secondary household contacts. RESULTS Of the 163 participants in this study, 84 (51.5%) were women; median age (IQR) was 36.0 (17.0-54.0) years of age; 78 (47.8%) were white and 48 (29.5%) were Hispanic/LatinX. Of the fifty households with household contacts, at least one secondary case occurred in twenty-six households (52.0%) and forty-five household contacts (43.7%) were infected. Secondary attack rate was lowest among children of index cases (6/23, 26.1%). Modified Poisson regression identified that the risk of transmission to household contacts increases significantly with age (Risk ratio for each increase in years of age = 1.01, 95% CI = 1.00-1.02). Mixed effects regression models identified that participants with chronic diseases, such as asthma, diabetes, cancer, or cardiac disease, had higher Cts at baseline when compared to participants without chronic diseases (6.62, 95% CI: 1.46-11.77, p = 0.02) and show a slower rate of increase in Ct over time (-0.43, 95% CI: -0.77 to -0.09, p = 0.02). CONCLUSIONS AND RELEVANCE This study suggests that HHT represents a key source of community-based infection of SARS-CoV-2. Allocation of resources for contact investigations and prevention interventions should focus on the individuals at highest risk of infection in households, especially those with higher density homes.
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Affiliation(s)
- Jonathan Altamirano
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California, United States of America
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California, United States of America
| | - Prasanthi Govindarajan
- Department of Emergency Medicine, Stanford University School of Medicine, Stanford, California, United States of America
| | - Andra L. Blomkalns
- Department of Emergency Medicine, Stanford University School of Medicine, Stanford, California, United States of America
| | - Sean Leary
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California, United States of America
| | - India Robinson
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California, United States of America
| | - Leanne X. Chun
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California, United States of America
| | - Nuzhat J. Shaikh
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California, United States of America
| | - Makeda L. Robinson
- Department of Medicine-Division of Infectious Diseases, Stanford University School of Medicine, Stanford, California, United States of America
| | - Marcela Lopez
- Department of Epidemiology and Biostatistics, University of California, Irvine, California, United States of America
| | - Grace K-Y Tam
- Department of Emergency Medicine, Stanford University School of Medicine, Stanford, California, United States of America
| | - Yuan J. Carrington
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California, United States of America
| | - Monique B. De Araujo
- Department of Emergency Medicine, Stanford University School of Medicine, Stanford, California, United States of America
| | - Katharine S. Walter
- Department of Medicine-Division of Infectious Diseases, Stanford University School of Medicine, Stanford, California, United States of America
| | - Jason R. Andrews
- Department of Medicine-Division of Infectious Diseases, Stanford University School of Medicine, Stanford, California, United States of America
| | - Julianne Burns
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California, United States of America
| | - Catherine Hogan
- Department of Pathology, Stanford University School of Medicine, Stanford, California, United States of America
| | - Benjamin A. Pinsky
- Department of Pathology, Stanford University School of Medicine, Stanford, California, United States of America
| | - Yvonne Maldonado
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California, United States of America
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16
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Dulkadir R, Oztelcan Gunduz B. Differentiating COVID-19 and influenza in children: hemogram parameters as diagnostic tools. Front Public Health 2024; 12:1377785. [PMID: 39056079 PMCID: PMC11269124 DOI: 10.3389/fpubh.2024.1377785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 06/27/2024] [Indexed: 07/28/2024] Open
Abstract
Introduction It is not always possible to differentiate between influenza and COVID-19 based on symptoms alone. This is a topic of significant importance as it aims to determine whether there are specific hematological parameters that can be used to distinguish between influenza and COVID-19 in children. Methodology Two hundred thirty-one children between the ages of 1 month and 18 years who presented to the children's outpatient clinic between June 2021 and June 2022 with similar symptoms and were tested with an influenza test and a COVID-19 PCR test were included in the study. Of the patients included in the study, 130 tested positive for COVID-19 and 101 positive for influenza. The patients were evaluated for hematological parameters. Results Age, eosinophils and monocyte factors were shown to be statistically significantly effective in COVID-19. The risk of COVID-19 increased 1,484-fold with age, 10,708-fold with increasing eosinophil count, and 1,591-fold with increasing monocyte count. The performance of the monocyte count and eosinophil count was assessed by receiver operating characteristic curve (ROC) analysis. According to the performed ROC analysis, the area under the curve (AUC) value was observed to be 0.990 for monocytes. According to the cutoff point >1.50, the sensitivity value was determined as 98.4% and the specificity value as 97.0%. AUC significance for eosinophils was found to be 0.989. According to the cutoff point >0.02, the sensitivity value was determined as 99.2% and the specificity value as 93.1%. Conclusion In the diagnosis of COVID-19, the eosinophil count and monocyte count are easily accessible, inexpensive, and important parameters in terms of differential diagnosis and can help in the differentiation of COVID-19 from influenza during seasonal outbreaks of the latter. Developing parameters for clinicians to use in diagnosing COVID-19 and influenza can facilitate their work in practice.
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17
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Caorsi R, Consolaro A, Speziani C, Sozeri B, Ulu K, Faugier-Fuentes E, Menchaca-Aguayo H, Ozen S, Sener S, Akhter Rahman S, Imnul Islam M, Haerynck F, Simonini G, Mastri MV, Avcin T, Sršen S, de Albuquerque Pedrosa Fernandes T, Stanevicha V, Vojinovic J, Sobh A, Fingerhutova S, Minxova L, Gagro A, Rodrigues Fonseca A, Pandya D, Varbanova B, Sánchez-Manubens J, Ganeva M, Montin D, Boyarchuk O, Minghini A, Bracaglia C, Brogan P, Candotti F, Cattalini M, Meyts I, Minoia F, Taddio A, Wouters C, De Benedetti F, Bovis F, Ravelli A, Ruperto N, Gattorno M, Bilginer Y, Laila K, Islam MM, Meertens B, Hoste L, Dehoorne J, Schelstraete P, Vandekerckhove K, Willems J, Matthijs I, Filocamo E Gisella Beatrice Beretta G, Magalhaes CS, Chubata O, Ricci F, Vukovic A, Temelkova K, Avramovic MZ, Emersic N, Bizjak M, Vesel T, Rodrigues MF, Gasparello de Almeida R, Lukjanovica K, Elnagdy MH, Soliman A, Terifajova E, Brejchova I, Magner M, Myrup C, Vougiouka O, Jelusic M, La Torre F, Rigante D, Maggio MC, Verdoni L, Rubio-Perez N, Cornejo GV, Villarreal Trevino AV, Brito I, Oliveira-Ramos F, Alexeeva E, Chasnyk V, Arkachaisri T, Boyko Y, Vyzhga Y, Samsonenko S. The HyperPed-COVID international registry: Impact of age of onset, disease presentation and geographical distribution on the final outcome of MIS-C. J Autoimmun 2024; 147:103265. [PMID: 38838452 DOI: 10.1016/j.jaut.2024.103265] [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: 02/14/2024] [Revised: 05/09/2024] [Accepted: 05/21/2024] [Indexed: 06/07/2024]
Abstract
OBJECTIVES The aim of the study was to establish an international multicenter registry to collect data on patients with Multisystem Inflammatory Syndrome in Children (MIS-C), in order to highlight a relationship between clinical presentation, age of onset and geographical distribution on the clinical outcome. STUDY DESIGN Multicenter retrospective study involving different international societies for rare immunological disorders.1009 patients diagnosed with MIS-C between March and September 2022, from 48 centers and 22 countries were collected. Five age groups (<1, 1-4, 5-11, 12-16, >16 years) and four geographic macro-areas, Western Europe, Central-Eastern Europe, Latin America, Asian-African resource-limited countries (LRC), were identified. RESULTS Time to referral was significantly higher in LRC. Intensive anti-inflammatory treatment, including biologics, respiratory support and mechanic ventilation were more frequently used in older children and in European countries. The mortality rate was higher in very young children (<1 year), in older patients (>16 years of age) and in LRC. Multivariate analysis identified the residence in LRC, presence of severe cardiac involvement, renal hypertension, lymphopenia and non-use of heparin prophylaxis, as the factors most strongly associated with unfavorable outcomes. CONCLUSIONS The stratification of patients by age and geographic macro-area provided insights into the clinical presentation, treatment and outcome of MIS-C. The mortality and sequelae rates exhibited a correlation with the age and geographical areas. Patients admitted and treated in LRC displayed more severe outcomes, possibly due to delays in hospital admission and limited access to biologic drugs and to intensive care facilities.
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Affiliation(s)
- Roberta Caorsi
- IRCCS Istituto Giannina Gaslini, UOC Reumatologia e Malattie Autoinfiammatorie, Genoa, Italy
| | - Alessandro Consolaro
- IRCCS Istituto Giannina Gaslini, UOC Reumatologia e Malattie Autoinfiammatorie, Genoa, Italy; Università Degli Studi di Genova, Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Genoa, Italy
| | - Camilla Speziani
- IRCCS Istituto Giannina Gaslini, UOC Reumatologia e Malattie Autoinfiammatorie, Genoa, Italy
| | - Betul Sozeri
- Health Sciences University, Umraniye Training and Research Hospital, Department of Pediatric Rheumatology, Istanbul, Turkey
| | - Kadir Ulu
- Health Sciences University, Umraniye Training and Research Hospital, Department of Pediatric Rheumatology, Istanbul, Turkey
| | - Enrique Faugier-Fuentes
- Hospital Infantil de México Federico Gómez, Medicina Interna y Reumatologia, Mexico City, Mexico
| | - Hector Menchaca-Aguayo
- Hospital Infantil de México Federico Gómez, Medicina Interna y Reumatologia, Mexico City, Mexico
| | - Seza Ozen
- Hacettepe University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Rheumatology, Ankara, Turkey
| | - Seher Sener
- Hacettepe University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Rheumatology, Ankara, Turkey
| | | | - Mohammad Imnul Islam
- Bangabandhu Sheikh Mujib Medical University (BSMMU), Paediatrics, Dhaka, Bangladesh
| | | | - Gabriele Simonini
- IRCCS Meyer Children's Hospital, Rheumatology Unit, ERN-ReCONNECT Center, Florence, Italy
| | - Mariel Viviana Mastri
- Hospital Interzonal de Agudos Especializado en Pediatría, Sor María Ludovica. Sala de Reumatologia La Plata, Argentina
| | - Tadej Avcin
- University Children's Hospital, University Medical Center Ljubljana, Department of Allergology, Rheumatology and Clinical Immunology, Ljubljana, Slovenia
| | - Saša Sršen
- University Hospital Centre Split, Department of Pediatrics, Split, Croatia
| | | | - Valda Stanevicha
- Riga Stradins University, Children University Hospital, Riga, Latvia
| | - Jelena Vojinovic
- University of Nis, Faculty of Medicine, University Clinical Center Nis, Clinic of Pediatrics, Department of Pediatric Rheumatology, Nis, Serbia
| | - Ali Sobh
- Mansoura University Children's Hospital, Faculty of Medicine Mansoura University, Mansura, Egypt
| | - Sarka Fingerhutova
- General University Hospital and 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Lenka Minxova
- University Hospital Hradec Kralove, Department of Pediatrics, Hradec Kralove, Czech Republic
| | - Alenka Gagro
- Children's Hospital Zagreb, Department of Pulmonology, Allergology, Clinical Immunology and Rheumatology, The University of Zagreb School of Medicine, Zagreb, Croatia
| | - Adriana Rodrigues Fonseca
- Universidade Federal Do Rio de Janeiro, Instituto de Puericultura e Pediatria Martagao Gesteira (IPPMG), Rio de Janeiro, Brazil
| | | | - Boriana Varbanova
- Varna Medical University, Department of Pediatrics First Pediatric Clinic, Varna, Bulgaria
| | - Judith Sánchez-Manubens
- Hospital Parc Taulí de Sabadell, Reumatologia Pediàtrica - Servei de Medicina Pediàtrica, Barcelona, Spain
| | - Margarita Ganeva
- University Children Hospital, Department of Paediatric Rheumatology, Sofia, Bulgaria
| | - Davide Montin
- Regina Margherita Children Hospital, Immunology and Rheumatology Unit, Turin, Italy
| | - Oksana Boyarchuk
- I.Horbachevsky Ternopil National Medical University, Department of Children's Diseases and Pediatric Surgery, Ternopil, Ukraine
| | - Andrea Minghini
- IRCCS Istituto Giannina Gaslini, UOC Reumatologia e Malattie Autoinfiammatorie, Genoa, Italy
| | - Claudia Bracaglia
- IRCCS Ospedale Pediatrico Bambino Gesù, Division of Rheumatology, Rome, Italy
| | - Paul Brogan
- UCL GOS Institute of Child Health, London, UK
| | - Fabio Candotti
- Division of Immunology and Allergy, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Marco Cattalini
- Pediatrics Clinic, University of Brescia and ASST Spedali Civili di Brescia, Brescia, Italy
| | | | - Francesca Minoia
- Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Pediatria e Immunoreumatologia2 Milan, Italy
| | - Andrea Taddio
- Institute of Child and Maternal Health - IRCCS "Burlo Garofolo" and University of Trieste, Trieste, Italy
| | - Carine Wouters
- UZ Leuven - Universitair Ziekenhuis, Leuven, Belgium; KU Leuven - University of Leuven, Department of Microbiology and Immunology, Laboratory Immunobiology, Leuven, Belgium
| | | | - Francesca Bovis
- University of Genoa, Department of Health Sciences (DISSAL), Genoa, Italy
| | - Angelo Ravelli
- IRCCS Istituto Giannina Gaslini, Direzione Scientifica, Genoa, Italy
| | - Nicolino Ruperto
- IRCCS Istituto Giannina Gaslini, UOC Servizio di Sperimentazioni Cliniche Pediatriche, PRINTO, Genoa, Italy
| | - Marco Gattorno
- IRCCS Istituto Giannina Gaslini, UOC Reumatologia e Malattie Autoinfiammatorie, Genoa, Italy.
| | - Yelda Bilginer
- Hacettepe University Children's Hospital, Ankara, Turkey
| | - Kamrul Laila
- Bangabandhu Sheikh Mujib Medical Universit, Dhaka, Bangladesh
| | | | | | | | | | | | | | | | | | | | | | - Oksana Chubata
- Ternopil Regional Children's Hospital, Ternopil, Ukraine
| | - Francesca Ricci
- Clinica Pediatrica Dell'Università di Brescia, Spedali Civili, Brescia, Italy
| | | | | | - Mojca Zajc Avramovic
- Tajnsek University Children's Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Nina Emersic
- Tajnsek University Children's Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Masa Bizjak
- Tajnsek University Children's Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Tina Vesel
- Tajnsek University Children's Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | | | | | | | | | | | - Eva Terifajova
- University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | | | - Martin Magner
- Thomayer University Hospital, Prague, Czech Republic
| | | | | | - Marija Jelusic
- University Hospital Centre Zagreb, University School of Medicine, Zagreb, Croatia
| | - Francesco La Torre
- Ospedale Pediatrico Giovanni XXIII - Azienda Ospedaliero-Universitaria Consorziale-Policlinico, Bari, Italy
| | | | | | | | - Nadina Rubio-Perez
- Hospital Universitario Dr. J. E. Gonzalez, Universidad, Autónoma de Nuevo León, Monterrey, NL, Mexico
| | | | | | | | | | - Ekaterina Alexeeva
- State Institution Scientific Center of Children Health of Rams Moscow, Moscow, Russian Federation
| | - Vyacheslav Chasnyk
- Saint-Petersburg State Pediatric Medical Academy, Saint-Petersburg, Russian Federation
| | | | - Yaryna Boyko
- Western Ukrainian Specialized Children's Medical Centre, Lviv, Ukraine
| | - Yulia Vyzhga
- National Pirogov Memorial Medical University, Vinnytsia, Ukraine
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Köstekci YE, Aydın A, Arga G, Ramoğlu MG, Okulu E, Özdemir H, Uçar T, Karahan ZC, Erdeve Ö, Atasay B, Arsan S. Diagnostic challenge in a preterm infant with multiorgan failure: SARS-CoV-2 infection or neonatal multisystem inflammatory syndrome? Pediatr Neonatol 2024; 65:404-405. [PMID: 38418330 DOI: 10.1016/j.pedneo.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 12/28/2023] [Accepted: 01/09/2024] [Indexed: 03/01/2024] Open
Affiliation(s)
- Yasemin Ezgi Köstekci
- Ankara University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Turkey.
| | - Alperen Aydın
- Ankara University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Cardiology, Turkey
| | - Gül Arga
- Ankara University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Infectious Disease, Turkey
| | - Mehmet Gökhan Ramoğlu
- Ankara University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Cardiology, Turkey
| | - Emel Okulu
- Ankara University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Turkey
| | - Halil Özdemir
- Ankara University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Infectious Disease, Turkey
| | - Tayfun Uçar
- Ankara University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Cardiology, Turkey
| | | | - Ömer Erdeve
- Ankara University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Turkey
| | - Begüm Atasay
- Ankara University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Turkey
| | - Saadet Arsan
- Ankara University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Turkey
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Nauriyal D, Dubey R, Agrawal P, Kumar D, Punj A, Nasser K. A cross-sectional study on clinical characteristics and severity of children with COVID-19 admitted to a teaching institute in North India. J Family Med Prim Care 2024; 13:2653-2662. [PMID: 39071009 PMCID: PMC11272026 DOI: 10.4103/jfmpc.jfmpc_1734_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 01/08/2024] [Accepted: 01/17/2024] [Indexed: 07/30/2024] Open
Abstract
Background SARS-CoV-2 infection presentation in children is usually milder than in adults but can be severe and fatal as well. Data on the pediatric population regarding severity and clinical presentation are still limited, and there is a need to have a better understanding of clinical features, severity, and laboratory parameters. Aims and Objective To document clinical and laboratory characteristics and outcomes of children with SARS-CoV-2 in a low-middle-income country and to evaluate clinicodemographic factors and biochemical markers associated with severity and mortality. Materials and Methods A hospital-based cross-sectional study was conducted among 112 COVID-19-positive children at a designated Level-3 center in North India. Clinical characteristics, laboratory parameters, and severity of COVID-19 cases as well as factors associated with the severity of the disease, were analyzed by descriptive statistics and a Chi-square test. Results The adolescent age group (age 12-18 years) was affected most (64.3%). Male patients accounted for 56.3% of total cases. Fever was the most common symptom (41.1%) followed by cough. Presenting complaints were highest from the respiratory system (32.1%) followed by the gastrointestinal (8.9%) and the neurological system (7.1%). Majority of patients had mild disease (87%) while 13% had the moderate-severe disease. Spo2 < 95% (P = 0.00001), neutrophilia (P < 0.000001), lymphopenia (P < 0.000001), elevated values of C-reactive protein (P < 0.00001), Interleukin-6 (P = 0.002), D- dimer (P = 0.00014) and respiratory symptoms as presenting complaints (P < 0.000001) were found to be significantly associated with severity of disease. Conclusion The male and adolescent age group was affected most. Presenting complaints were highest from the respiratory system. Unusual presentation may have gastrointestinal or neurological presentation. Most children with COVID-19 had mild disease. Moderate to severe disease was not uncommon. Factors including neutrophilia, lymphopenia, elevated lab values of C-reactive protein, D-dimer, and interleukin-6 had a significant association with the severity of the disease. These biomarkers can help predict the severity of the disease.
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Affiliation(s)
- Deepty Nauriyal
- Department of Pediatrics, Subharti Medical, College, Meerut, Uttar Pradesh, India
| | - Rishabh Dubey
- Department of Pediatrics, Subharti Medical, College, Meerut, Uttar Pradesh, India
| | - Pulak Agrawal
- Department of Pediatrics, Subharti Medical, College, Meerut, Uttar Pradesh, India
| | - Deepak Kumar
- Department of Community Medicine, Maharishi Markandeshwar University and Hospital, Solan, Himachal Pradesh, India
| | - Ajay Punj
- Department of Pediatrics, Subharti Medical, College, Meerut, Uttar Pradesh, India
| | - Kaynat Nasser
- Department of Community Medicine, Subharti Medical College, Meerut, Uttar Pradesh, India
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20
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Quadros DRS, Shah J, Migowa A, Samia P, Macharia W. Clinical and epidemiological profiles of pediatric COVID-19 in two private Kenyan hospitals. Pan Afr Med J 2024; 48:48. [PMID: 39280814 PMCID: PMC11399460 DOI: 10.11604/pamj.2024.48.48.39305] [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: 02/14/2023] [Accepted: 03/05/2024] [Indexed: 09/18/2024] Open
Abstract
Introduction COVID-19 infection has attracted global attention with limited published data on the burden in African children. Methods hospital-based longitudinal survey in children with COVID-19 infection, aged 0-18 years admitted between August 2020 and December 2021. The main objective of the study was to describe socio-demographic, clinical and diagnostic manifestations of COVID-19 infection in children. Results the study enrolled 85 children. Median age was 5•1 years (IQR = 1•3 - 12•4) with equal gender distribution. Under five years were 52•9%. Average length of hospital stay among non-severe cases was three days (IQR=2•0-5•0). No deaths were reported. Fifteen patients (18•7%) were asymptomatic. The most common presenting symptoms were fever (51•8%), vomiting (36•5%), cough (27•1%), diarrhea (20•0%), nasal congestion (14•1%) and fast breathing (12•9%). Two patients presented in shock and features consistent with Multisystemic Inflammatory Syndrome in Childhood (MIS-C). Procalcitonin and C-reactive proteins were elevated in 76•9% and 45•8% respectively. Majority (n=80) had white cell counts within normal range and none had bacterial pathogens isolated from blood (n=63). Liver and Renal function tests were within the normal range in the majority of those tested (n=24 and n=64 respectively). Three of the five patients with elevated platelet count (>500 x109/L) had clinical diagnosis of MIS-C. Eight of 20 patients subjected to imaging had radiological features of bilateral ground glass opacifications while six of nine patients who presented with cardiovascular compromise had mild to moderate ventricular dysfunction on echocardiography. Conclusion our study suggests that children in the African setting manifest a mild form of the COVID-19 infection with low mortality.
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Affiliation(s)
- Del-rossi Sean Quadros
- Department of Pediatrics and Child Health, Aga Khan University Hospital, Nairobi (AKUHN), Nairobi, Kenya
| | - Jasmit Shah
- Department of Internal Medicine, Aga Khan University Hospital, Nairobi (AKUHN), Nairobi, Kenya
| | - Angela Migowa
- Department of Pediatrics and Child Health, Aga Khan University Hospital, Nairobi (AKUHN), Nairobi, Kenya
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Pauline Samia
- Department of Pediatrics and Child Health, Aga Khan University Hospital, Nairobi (AKUHN), Nairobi, Kenya
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - William Macharia
- Department of Pediatrics and Child Health, Aga Khan University Hospital, Nairobi (AKUHN), Nairobi, Kenya
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21
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Yuan L, Sun C, Zeng Z, Wang H. Children aged 0-14 years had a far lower mortality risk during the entire COVID-19 pandemic in four major industrial countries: an observational study. Eur J Pediatr 2024; 183:2645-2653. [PMID: 38502322 DOI: 10.1007/s00431-024-05522-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 02/29/2024] [Accepted: 03/11/2024] [Indexed: 03/21/2024]
Abstract
The purpose of this study is to describe the morbidity and mortality of children during the entire COVID-19 pandemic. Age-disaggregated data of 108,003,741 cases and 560,426 deaths were collected from Canada, France, Germany, and Italy. The number of cases and deaths per million people per week, as well as case fatality rates (CFRs), were calculated for patients aged 0-14 and ≥ 15 years. During the first pandemic period in the four countries, starting from weeks 4 to 11 (in 2020) and ending at week 22 (in 2021), the number of deaths per million people per week and the CFRs in the ≥ 15 years age group were 500 to 2513 and 442 to 1662 times greater, respectively, than those in the 0-14 years age group. The number of deaths per million people per week was significantly lower in the first pandemic period than in the second pandemic period, which started at week 23 (2021) and ended from week 22 to week 25 (2023). During the second pandemic period in the four countries, the disparities between the ≥ 15 years and 0-14 years age groups decreased, and the number of deaths per million people per week in the ≥ 15 years age group was 76 to 180 times greater than it in the 0-14 years age group. CONCLUSION Children aged 0-14 years had a far lower mortality risk during the entire COVID-19 pandemic, and the impact of viral variants and/or vaccination on the mortality rate is difficult to distinguish. WHAT IS KNOWN • Although extensive studies have focused on COVID-19-induced mortality, most of them are provisional reports performed during the unfolding of the pandemic and provide imprecise conclusion. WHAT IS NEW • We described the morbidity and mortality for children aged 0-14 years using complete survey data recorded during the entire COVID-19 pandemic. • The number of deaths per million people per week was far lower in children aged 0-14 years, while the number of deaths per million people per week in children aged 0-14 years was significantly higher in the second period which starting from week 23 (2021) and ending at week 22 to 25 (2023) than in the first period which starting from week 1 to 11 (2020) and ending at week 22 (2021).
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Affiliation(s)
- Lang Yuan
- Department of Pulmonology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200062, People's Republic of China
| | - Chao Sun
- Department of Pulmonology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200062, People's Republic of China.
| | - Zeyu Zeng
- Department of Pulmonology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200062, People's Republic of China
| | - Haojie Wang
- Department of Pulmonology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200062, People's Republic of China
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22
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Pradhan DD, Jena P, Misra S, Meher BK, Das L. Impact of Covid-19 on Psychosocial Well-Being of School-Going Children: A Cross-Sectional Study. Cureus 2024; 16:e62561. [PMID: 39027783 PMCID: PMC11254846 DOI: 10.7759/cureus.62561] [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: 06/17/2024] [Indexed: 07/20/2024] Open
Abstract
INTRODUCTION The mandated closure of schools due to Covid-19 is likely to have a negative impact on school-going children. This study aimed to assess the psychosocial well-being of school children during the pandemic in eastern India. METHODS This cross-sectional study was conducted in the outpatient pediatric department of tertiary care teaching hospitals. Children between the ages of 4 and 14 were enrolled. The main outcome measures included the Emotional Symptoms Scale, Conduct Problem Scale, Hyperactivity Scale, Peer Problem Scale, and Prosocial Scale from the Strength and Difficulties Questionnaire (SDQ), as well as the Children's Hope Scale. RESULTS Out of 169 children aged 4-14, 104 (61.5%) were male, 140 (82.8%) were from urban areas, 66 (39.1%) had a family member who was a healthcare worker or frontline worker, and 12 (7.1%) had experienced the death of a family member due to Covid-19. Anxiety-related and depressive symptoms were observed in 81 (47.9%) and 70 (41.4%) children, respectively. Psychosocial difficulties with a 'clinically significant problem likely' were observed in 26 (15.4%) children, more common in males (16.35%, P=0.035) and older children (12-14 years). Children from families with healthcare/frontline workers, Covid-affected families, loss of job in the earning member, and uninvolved parenting style were associated with more psychosocial difficulties. The mean (SD) hope score was 22.46 ± 6.42 in children above eight years. CONCLUSION The psychosocial well-being of school-going children is adversely affected during Covid-19, particularly in families with frontline workers, loss of job, and death of family members due to Covid-19. The poor hope score in children aged 8 years and above indicates an adverse impact on their ability to achieve future goals.
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Affiliation(s)
| | - Pravati Jena
- Pediatrics, Kalinga Institute of Medical Sciences, KIIT University, Bhubaneswar, IND
| | - Sreesom Misra
- Pediatrics, Sriram Chandra Bhanja Medical College and Hospital, Cuttack, IND
| | - Bijay Kumar Meher
- Pediatrics, Sriram Chandra Bhanja Medical College and Hospital, Cuttack, IND
| | - Leena Das
- Pediatrics, Post Graduate Institute of Medical Education and Research and Capital Hospital, Bhubaneswar, IND
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23
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Doucette EJ, Ricketson L, Tarannum T, Alatorre I, Gray J, Constantinescu C, Kuhn S, Dunn JKE, Kellner JD. COVID-19 vaccine confidence, concerns, and uptake in children aged 5 and older in Calgary, Alberta: a longitudinal cohort study. Paediatr Child Health 2024; 29:150-157. [PMID: 38827369 PMCID: PMC11141603 DOI: 10.1093/pch/pxad062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 08/16/2023] [Indexed: 06/04/2024] Open
Abstract
Objectives Beginning early in the pandemic, there was a worldwide effort to develop effective vaccines against the SARS-CoV-2 virus. Before and after the approval and implementation of vaccines, there were concerns about their need as well as their safety and rapid development. We explored child demographic characteristics and parental concerns to identify factors associated with the decision to vaccinate. Methods A cohort of 1035 children from Calgary was assembled in 2020 to participate in 5 visits every 6 months for survey completion and blood sampling for SARS-CoV-2 antibodies. Visits 1 to 2 occurred before approval of vaccines for children; Visits 3 to 5 occurred after vaccine approval for different age groups. We described vaccine concerns and utilized logistic regression to examine factors associated with the decision to vaccinate in children ≥5 years of age. Results Children ≥12 years of age, of non-white or non-black ethnicity, and who had received previous influenza vaccines had higher odds of being vaccinated against SARS-CoV-2. Children with previous SARS-CoV-2 infection had lower odds of being vaccinated. The most common concerns in early 2021 were about vaccine safety. By summer 2022, the most common concern was a belief that vaccines were not necessary. Through the study 88% of children were vaccinated. Conclusions Age, ethnicity, previous infections, and vaccine attitudes were associated with parental decision to vaccinate against SARS-CoV-2. For children who remained unvaccinated, parents continued to have safety concerns and questioned the necessity of the vaccine. Complacency about the need for vaccination may be more challenging to address and overcome than concerns about safety alone.
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Affiliation(s)
- Emily J Doucette
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Leah Ricketson
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Tarannum Tarannum
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Isabella Alatorre
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Joslyn Gray
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Cora Constantinescu
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Susan Kuhn
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Jessica K E Dunn
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - James D Kellner
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
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24
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Grimes LP, Gerber JS. Neonatal and infant infection with SARS-CoV-2. Semin Perinatol 2024; 48:151922. [PMID: 38897825 DOI: 10.1016/j.semperi.2024.151922] [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] [Indexed: 06/21/2024]
Abstract
Despite the substantial body of investigative work describing the Coronavirus Disease 2019 (COVID-19) pandemic, its impact on neonates and infants remains less well characterized. Here, we review the data on epidemiology of COVID-19 in this population. Widespread use of universal testing for SARS-CoV-2 among pregnant persons presenting for delivery complicates interpretation of the risks of perinatal exposure. While many neonates and infants with COVID-19 are well-appearing or have only mild signs of illness, factors such as preterm birth, low birth weight, and medical comorbidities increase the risk of severe infection. We highlight potential protective maternal factors, summarize treatment options and discuss vaccine development. Higher quality data are needed to better inform our understanding of COVID-19 in neonates and infants.
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Affiliation(s)
- Logan P Grimes
- Division of Infectious Diseases, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Jeffrey S Gerber
- Division of Infectious Diseases, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
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25
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Herbert C, Wang B, Lin H, Yan Y, Hafer N, Pretz C, Stamegna P, Wright C, Suvarna T, Harman E, Schrader S, Nowak C, Kheterpal V, Orvek E, Wong S, Zai A, Barton B, Gerber BS, Lemon SC, Filippaios A, Gibson L, Greene S, Colubri A, Achenbach C, Murphy R, Heetderks W, Manabe YC, O’Connor L, Fahey N, Luzuriaga K, Broach J, Roth K, McManus DD, Soni A. Performance of and Severe Acute Respiratory Syndrome Coronavirus 2 Diagnostics Based on Symptom Onset and Close Contact Exposure: An Analysis From the Test Us at Home Prospective Cohort Study. Open Forum Infect Dis 2024; 11:ofae304. [PMID: 38911947 PMCID: PMC11191649 DOI: 10.1093/ofid/ofae304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 05/29/2024] [Indexed: 06/25/2024] Open
Abstract
Background Understanding changes in diagnostic performance after symptom onset and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exposure within different populations is crucial to guide the use of diagnostics for SARS-CoV-2. Methods The Test Us at Home study was a longitudinal cohort study that enrolled individuals across the United States between October 2021 and February 2022. Participants performed paired antigen-detection rapid diagnostic tests (Ag-RDTs) and reverse-transcriptase polymerase chain reaction (RT-PCR) tests at home every 48 hours for 15 days and self-reported symptoms and known coronavirus disease 2019 exposures immediately before testing. The percent positivity for Ag-RDTs and RT-PCR tests was calculated each day after symptom onset and exposure and stratified by vaccination status, variant, age category, and sex. Results The highest percent positivity occurred 2 days after symptom onset (RT-PCR, 91.2%; Ag-RDT, 71.1%) and 6 days after exposure (RT-PCR, 91.8%; Ag-RDT, 86.2%). RT-PCR and Ag-RDT performance did not differ by vaccination status, variant, age category, or sex. The percent positivity for Ag-RDTs was lower among exposed, asymptomatic than among symptomatic individuals (37.5% (95% confidence interval [CI], 13.7%-69.4%) vs 90.3% (75.1%-96.7%). Cumulatively, Ag-RDTs detected 84.9% (95% CI, 78.2%-89.8%) of infections within 4 days of symptom onset. For exposed participants, Ag-RDTs detected 94.0% (95% CI, 86.7%-97.4%) of RT-PCR-confirmed infections within 6 days of exposure. Conclusions The percent positivity for Ag-RDTs and RT-PCR tests was highest 2 days after symptom onset and 6 days after exposure, and performance increased with serial testing. The percent positivity of Ag-RDTs was lowest among asymptomatic individuals but did not differ by sex, variant, vaccination status, or age category.
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Affiliation(s)
- Carly Herbert
- Program in Digital Medicine, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
- University of Massachusetts Center for Clinical and Translational Science, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Biqi Wang
- Program in Digital Medicine, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
- Division of Health System Science, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Honghuang Lin
- Program in Digital Medicine, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
- Division of Health System Science, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Yi Yan
- Division of Microbiology, OHT7 Office of Product Evaluation and Quality, Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Nathaniel Hafer
- University of Massachusetts Center for Clinical and Translational Science, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
- Program in Molecular Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Caitlin Pretz
- Program in Digital Medicine, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Pamela Stamegna
- Program in Digital Medicine, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Colton Wright
- Program in Digital Medicine, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | | | | | | | | | | | - Elizabeth Orvek
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Steven Wong
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Adrian Zai
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Bruce Barton
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Ben S Gerber
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Stephenie C Lemon
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Andreas Filippaios
- Program in Digital Medicine, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Laura Gibson
- Division of Infectious Disease, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Sharone Greene
- Division of Infectious Disease, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Andres Colubri
- Department of Microbiology and Physiological Systems, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Chad Achenbach
- Division of Infectious Disease, Department of Medicine, Havey Institute for Global Health, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Robert Murphy
- Division of Infectious Disease, Department of Medicine, Havey Institute for Global Health, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - William Heetderks
- National Institute of Biomedical Imaging and Bioengineering, NIH, via contract with Kelly Services, Bethesda, Maryland, USA
| | - Yukari C Manabe
- Division of Infectious Disease, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Laurel O’Connor
- Department of Emergency Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Nisha Fahey
- Program in Digital Medicine, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
- Department of Pediatrics, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Katherine Luzuriaga
- University of Massachusetts Center for Clinical and Translational Science, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
- Program in Molecular Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - John Broach
- University of Massachusetts Center for Clinical and Translational Science, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
- Department of Emergency Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Kristian Roth
- Division of Microbiology, OHT7 Office of Product Evaluation and Quality, Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - David D McManus
- Program in Digital Medicine, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
- Division of Health System Science, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
- Division of Cardiology, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Apurv Soni
- Program in Digital Medicine, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
- Division of Health System Science, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
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26
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Baltu D, Kurt-Sukur ED, Tastemel Ozturk T, Gulhan B, Ozaltin F, Duzova A, Topaloglu R. COVID-19 vaccination among adolescents and young adults with chronic kidney conditions: a single-center experience. KLINISCHE PADIATRIE 2024. [PMID: 38821068 DOI: 10.1055/a-2319-2648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2024]
Abstract
BACKGROUND Following the pandemic of COVID-19, the main focus has been on COVID-19 vaccines and herd immunity. Although the safety of the COVID-19 vaccines has been shown in clinical trials, children with chronic diseases were not included. We investigated the side effect profile and safety of the COVID-19 vaccines in adolescents with kidney disease. METHODS A questionnaire including demographic information, history of COVID-19, vaccination status, and vaccine-related side effects was administered to the patients with chronic kidney disease (CKD) stage 2-5, glomerular disease treated with immunosuppression, and kidney transplant recipients. RESULTS Ninety-eight patients were vaccinated with CoronaVac-inactivated SARS-CoV-2 (n=16) or BNT162b2 messenger RNA (mRNA) COVİD-19 (n=82) vaccine. The mean age was 16.90±2.36 years. The most common side effects were local pain, fatigue, and fever. No serious side effects or renal disease flare were observed. There was no significant difference in the side effects reported after the BNT162b2 mRNA-RNA as compared to the Corona Vac-inactivated SARS-CoV-2 vaccine. No significant relationship was found between the frequency of side effects according to age, glomerular filtration rate, immunosuppressive treatments, CKD stage, and the underlying disease. CONCLUSION Although the reported data are subjective because they were obtained through a questionnaire and studies with long-term follow-up are needed, our early experience suggests that the vaccine is safe and adolescents and young adults should be encouraged to be vaccinated.
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Affiliation(s)
| | - Eda Didem Kurt-Sukur
- Department of Pediatric Nephrology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Tugba Tastemel Ozturk
- Department of Pediatric Nephrology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Bora Gulhan
- Department of Pediatric Nephrology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Fatih Ozaltin
- Department of Pediatric Nephrology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ali Duzova
- Department of Pediatric Nephrology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Rezan Topaloglu
- Department of Pediatric Nephrology, Hacettepe University Faculty of Medicine, Ankara, Turkey
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27
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Mentor G, Farrar DS, Di Chiara C, Dufour MSK, Valois S, Taillefer S, Drouin O, Renaud C, Kakkar F. The Effect of Age and Comorbidities: Children vs. Adults in Their Response to SARS-CoV-2 Infection. Viruses 2024; 16:801. [PMID: 38793682 PMCID: PMC11126068 DOI: 10.3390/v16050801] [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: 04/04/2024] [Revised: 05/09/2024] [Accepted: 05/14/2024] [Indexed: 05/26/2024] Open
Abstract
While children have experienced less severe coronavirus disease (COVID-19) after SARS-CoV-2 infection than adults, the cause of this remains unclear. The objective of this study was to describe the humoral immune response to COVID-19 in child vs. adult household contacts, and to identify predictors of the response over time. In this prospective cohort study, children with a positive SARS-CoV-2 polymerase chain reaction (PCR) test (index case) were recruited along with their adult household contacts. Serum IgG antibodies against SARS-CoV-2 S1/S2 spike proteins were compared between children and adults at 6 and 12 months after infection. A total of 91 participants (37 adults and 54 children) from 36 families were enrolled. Overall, 78 (85.7%) participants were seropositive for anti-S1/S2 IgG antibody at 6 months following infection; this was higher in children than in adults (92.6% vs. 75.7%) (p = 0.05). Significant predictors of a lack of SARS-CoV-2 seropositivity were age ≥ 25 vs. < 12 years (odds ratio [OR] = 0.23, p = 0.04), presence of comorbidities (vs. none, adjusted OR = 0.23, p = 0.03), and immunosuppression (vs. immunocompetent, adjusted OR = 0.17, p = 0.02).
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Affiliation(s)
- Girlande Mentor
- CHU Sainte-Justine, Département de Pédiatrie, Faculté de Médecine, Université de Montréal, Montreal, QC H3T 1C5, Canada; (G.M.); (O.D.)
| | - Daniel S. Farrar
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, ON M5G 1E8, Canada (C.D.C.)
| | - Costanza Di Chiara
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, ON M5G 1E8, Canada (C.D.C.)
- Division of Infectious Diseases, The Hospital for Sick Children, Toronto, ON M5G 1E8, Canada
| | - Mi-Suk Kang Dufour
- Unité de Recherche Clinique Appliqué, Centre de Recherche du CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada;
| | - Silvie Valois
- Centre D’infectiologie Mère-Enfant, Centre de Recherche du CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada; (S.V.)
| | - Suzanne Taillefer
- Centre D’infectiologie Mère-Enfant, Centre de Recherche du CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada; (S.V.)
| | - Olivier Drouin
- CHU Sainte-Justine, Département de Pédiatrie, Faculté de Médecine, Université de Montréal, Montreal, QC H3T 1C5, Canada; (G.M.); (O.D.)
| | - Christian Renaud
- Département de Microbiologie et Immunologie, Faculté de Médecine, Université de Montréal, Montreal, QC H3T 1C5, Canada;
| | - Fatima Kakkar
- CHU Sainte-Justine, Département de Pédiatrie, Faculté de Médecine, Université de Montréal, Montreal, QC H3T 1C5, Canada; (G.M.); (O.D.)
- Centre D’infectiologie Mère-Enfant, Centre de Recherche du CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada; (S.V.)
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Chen L, Wang L, Xing Y, Xie J, Su B, Geng M, Ren X, Zhang Y, Liu J, Ma T, Chen M, Miller JE, Dong Y, Song Y, Ma J, Sawyer S. Persistence and Variation of the Indirect Effects of COVID-19 Restrictions on the Spectrum of Notifiable Infectious Diseases in China: Analysis of National Surveillance Among Children and Adolescents From 2018 to 2021. JMIR Public Health Surveill 2024; 10:e47626. [PMID: 38748469 PMCID: PMC11137434 DOI: 10.2196/47626] [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: 03/27/2023] [Revised: 02/21/2024] [Accepted: 02/25/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND Beyond the direct effect of COVID-19 infection on young people, the wider impact of the pandemic on other infectious diseases remains unknown. OBJECTIVE This study aims to assess changes in the incidence and mortality of 42 notifiable infectious diseases during the pandemic among children and adolescents in China, compared with prepandemic levels. METHODS The Notifiable Infectious Disease Surveillance System of China was used to detect new cases and fatalities among individuals aged 5-22 years across 42 notifiable infectious diseases spanning from 2018 to 2021. These infectious diseases were categorized into 5 groups: respiratory, gastrointestinal and enterovirus, sexually transmitted and blood-borne, zoonotic, and vector-borne diseases. Each year (2018-2021) was segmented into 4 phases: phase 1 (January 1-22), phase 2 (January 23-April 7), phase 3 (April 8-August 31), and phase 4 (September 1-December 31) according to the varying intensities of pandemic restrictive measures in 2020. Generalized linear models were applied to assess the change in the incidence and mortality within each disease category, using 2018 and 2019 as the reference. RESULTS A total of 4,898,260 incident cases and 3701 deaths were included. The overall incidence of notifiable infectious diseases decreased sharply during the first year of the COVID-19 pandemic (2020) compared with prepandemic levels (2018 and 2019), and then rebounded in 2021, particularly in South China. Across the past 4 years, the number of deaths steadily decreased. The incidence of diseases rebounded differentially by the pandemic phase. For instance, although seasonal influenza dominated respiratory diseases in 2019, it showed a substantial decline during the pandemic (percent change in phase 2 2020: 0.21, 95% CI 0.09-0.50), which persisted until 2021 (percent change in phase 4 2021: 1.02, 95% CI 0.74-1.41). The incidence of gastrointestinal and enterovirus diseases decreased by 33.6% during 2020 but rebounded by 56.9% in 2021, mainly driven by hand, foot, and mouth disease (percent change in phase 3 2021: 1.28, 95% CI 1.17-1.41) and infectious diarrhea (percent change in phase 3 2020: 1.22, 95% CI 1.17-1.28). Sexually transmitted and blood-borne diseases were restrained during the first year of 2021 but rebounded quickly in 2021, mainly driven by syphilis (percent change in phase 3 2020: 1.31, 95% CI 1.23-1.40) and gonorrhea (percent change in phase 3 2020: 1.10, 95% CI 1.05-1.16). Zoonotic diseases were not dampened by the pandemic but continued to increase across the study period, mainly due to brucellosis (percent change in phase 2 2020: 0.94, 95% CI 0.75-1.16). Vector-borne diseases showed a continuous decline during 2020, dominated by hemorrhagic fever (percent change in phase 2 2020: 0.68, 95% CI 0.53-0.87), but rebounded in 2021. CONCLUSIONS The COVID-19 pandemic was associated with a marked decline in notifiable infectious diseases in Chinese children and adolescents. These effects were not sustained, with evidence of a rebound to prepandemic levels by late 2021. To effectively address the postpandemic resurgence of infectious diseases in children and adolescents, it will be essential to maintain disease surveillance and strengthen the implementation of various initiatives. These include extending immunization programs, prioritizing the management of sexually transmitted infections, continuing feasible nonpharmaceutical intervention projects, and effectively managing imported infections.
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Affiliation(s)
- Li Chen
- Institute of Child and Adolescent Health, School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Liping Wang
- Division of Infectious Disease Control and Prevention, Key Laboratory of Surveillance and Early Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yi Xing
- Institute of Child and Adolescent Health, School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Junqing Xie
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
| | - Binbin Su
- Institute of Population Research, Peking University Asia-Pacific Economic Cooperation Health Sciences Academy, Beijing, China
| | - Mengjie Geng
- Division of Infectious Disease Control and Prevention, Key Laboratory of Surveillance and Early Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiang Ren
- Division of Infectious Disease Control and Prevention, Key Laboratory of Surveillance and Early Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yi Zhang
- Institute of Child and Adolescent Health, School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Jieyu Liu
- Institute of Child and Adolescent Health, School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Tao Ma
- Institute of Child and Adolescent Health, School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Manman Chen
- Institute of Child and Adolescent Health, School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Jessica E Miller
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Yanhui Dong
- Institute of Child and Adolescent Health, School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Yi Song
- Institute of Child and Adolescent Health, School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Jun Ma
- Institute of Child and Adolescent Health, School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Susan Sawyer
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
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Nagasawa M, Shimoyama T, Hashimoto S, Nakagawa R, Yokoyama H, Okada M, Udagawa T, Oshiba A. Impact of the Omicron Strain on Febrile Convulsions Requiring Hospitalization in Children: A Single-Center Observational Study. Pediatr Rep 2024; 16:399-409. [PMID: 38804377 PMCID: PMC11130907 DOI: 10.3390/pediatric16020034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 05/07/2024] [Accepted: 05/09/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND The emergence of the Omicron strain of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at the end of December 2021 has drastically increased the number of infected children in Japan, along with the number of children with febrile convulsions, but its clinical impact is unclear. MATERIALS AND METHODS We compared the frequency of SARS-CoV-2 infection in children hospitalized with febrile convulsions with the frequency of SARS-CoV-2 infection in children with fever and respiratory symptoms without convulsions. RESULTS In 2021 and 2022, 49 and 58 children required emergency hospitalization for febrile convulsions (FC group) with status epilepticus or cluster spasms, in which 24 and 38 children underwent a Filmarray® respiratory panel test (FA test), respectively, and others received a quantitative antigen test for SARS-CoV-2. In 2022, only six patients tested positive for SARS-CoV-2 (10.3%, 6/58). As a reference group, 655 children aged <10 years who underwent the FA test for fever and respiratory symptoms during the same period were investigated, and 4 (1.8%, 4/223) and 42 (9.7%, 42/432) tested positive for SARS-CoV-2 in 2021 and 2022, respectively. Rhinovirus/enterovirus (RV/EV) was the most frequently detected virus (40.3%, 264/655), followed by respiratory syncytial virus (RSV) (18.9%, 124/655) and parainfluenza virus 3 (PIV3) (7.8%, 51/655). There was no significant difference in the trend of detected viruses between the two groups. CONCLUSIONS The frequency and severity of febrile convulsions requiring hospitalization associated with SARS-CoV-2 infection of the Omicron strain may be similar to that of other respiratory viruses in children.
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Affiliation(s)
- Masayuki Nagasawa
- Department of Pediatrics, Musashino Red Cross Hospital, 1-26-1, Kyonan-cho, Musashino 180-8610, Tokyo, Japan; (T.S.); (S.H.); (T.U.); (A.O.)
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Borgi A, Meftah K, Trabelsi I, Kyaw MH, Zaghden H, Bouafsoun A, Mezghani F, Missaoui N, Abdel Ali A, Essaddam L, Khemiri H, Haddad-Boubaker S, Boussetta K, Khemiri M, Ben Becher S, Boukthir S, Triki H, Menif K, Smaoui H. Retrospective Analysis of Clinical Characteristics and Disease Outcomes in Children and Adolescents Hospitalized Due to COVID-19 Infection in Tunisia. Viruses 2024; 16:779. [PMID: 38793660 PMCID: PMC11125722 DOI: 10.3390/v16050779] [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: 03/18/2024] [Revised: 05/03/2024] [Accepted: 05/07/2024] [Indexed: 05/26/2024] Open
Abstract
Due to low susceptibility of coronavirus disease of 2019 (COVID-19) in children, limited studies are available regarding COVID-19 in the pediatric population in Tunisia. The current study evaluated the incidence, clinical characteristics, and outcomes of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infection among children hospitalized at Béchir Hamza Children's Hospital. A retrospective cohort analysis was conducted using the hospital database between March 2020 and February 2022 with children aged ≤15 years with SARS-CoV-2 infection (confirmed by RT-PCR). A total of 327 COVID-19 hospitalized patients with a mean age of 3.3 years were included; the majority were male. Neurological disease (20%) was the most common comorbidity, while fever (95.3%) followed by cough (43.7%) and dyspnea (39.6%) were the most frequent symptoms reported. Severe disease with oxygen requirement occurred in 30% of the patients; 13% were admitted in the Intensive Care Unit. The overall incidence rate of COVID-19 hospitalization (in Tunis governorates) was 77.02 per 100,000 while the inpatient case fatality rate was 5% in the study population. The most prevalent circulating variant during our study period was Delta (48.8%), followed by Omicron (26%). More than 45% of the study population were <6 months and one-fourth (n = 25, 26.5%) had at least one comorbidity. Thus, the study findings highlight the high disease burden of COVID-19 in infants.
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Affiliation(s)
- Aida Borgi
- Pediatric Intensive Care Unit, Children’s Hospital of Tunis, Tunis 1007, Tunisia; (A.B.); (K.M.)
| | - Khaoula Meftah
- Laboratory of Microbiology, Children’s Hospital of Tunis, Tunis 1007, Tunisia; (K.M.)
| | - Ines Trabelsi
- Pediatric Department B, Children’s Hospital of Tunis, Tunis 1007, Tunisia; (I.T.)
| | | | | | - Aida Bouafsoun
- Laboratory of Microbiology, Children’s Hospital of Tunis, Tunis 1007, Tunisia; (K.M.)
| | - Fatma Mezghani
- Pediatric Department A, Children’s Hospital of Tunis, Tunis 1007, Tunisia
| | - Nada Missaoui
- Pediatric Department C, Children’s Hospital of Tunis, Tunis 1007, Tunisia
| | - Alya Abdel Ali
- Department of Pediatrics and Emergency, Children’s Hospital of Tunis, Tunis 1007, Tunisia
| | - Leila Essaddam
- Department of Pediatrics and Emergency, Children’s Hospital of Tunis, Tunis 1007, Tunisia
| | - Haifa Khemiri
- Laboratory of Clinical Virology, WHO Regional Reference Laboratory for Poliomyelitis and Measles for the EMR, Institute Pasteur of Tunis, Tunis 1002, Tunisia
| | - Sondes Haddad-Boubaker
- Laboratory of Clinical Virology, WHO Regional Reference Laboratory for Poliomyelitis and Measles for the EMR, Institute Pasteur of Tunis, Tunis 1002, Tunisia
| | - Khedija Boussetta
- Pediatric Department B, Children’s Hospital of Tunis, Tunis 1007, Tunisia; (I.T.)
| | - Monia Khemiri
- Pediatric Department A, Children’s Hospital of Tunis, Tunis 1007, Tunisia
| | - Saida Ben Becher
- Department of Pediatrics and Emergency, Children’s Hospital of Tunis, Tunis 1007, Tunisia
| | - Samir Boukthir
- Pediatric Department C, Children’s Hospital of Tunis, Tunis 1007, Tunisia
| | - Henda Triki
- Laboratory of Clinical Virology, WHO Regional Reference Laboratory for Poliomyelitis and Measles for the EMR, Institute Pasteur of Tunis, Tunis 1002, Tunisia
| | - Khaled Menif
- Pediatric Intensive Care Unit, Children’s Hospital of Tunis, Tunis 1007, Tunisia; (A.B.); (K.M.)
| | - Hanen Smaoui
- Laboratory of Microbiology, Children’s Hospital of Tunis, Tunis 1007, Tunisia; (K.M.)
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Vameghi M, Saatchi M, Bahrami G, Soleimani F, Takaffoli M. How did we protect children against COVID-19 in Iran? Prevalence of COVID-19 and vaccination in the socio-economic context of COVID-19 epidemic. PLoS One 2024; 19:e0303043. [PMID: 38722835 PMCID: PMC11081304 DOI: 10.1371/journal.pone.0303043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 04/16/2024] [Indexed: 05/13/2024] Open
Abstract
INTRODUCTION The COVID-19 pandemic posed significant risks to children worldwide. This study aimed to assess the COVID-19 protection status of children and explored the relationship between household socio-economic status and COVID-19 morbidity and preventive measures, including vaccination and mask-wearing, in two cities in Iran. METHOD A population-based cross-sectional study was conducted from July to October 2022 among 7 to 18-year-old children and their families in Tehran and Karaj. A total of 3,022 samples were selected using stratified multistage cluster sampling. Data were collected through interviews with children and adults, using questionnaires and was analyzed with Stata software version 14. RESULTS The analysis focused on 2,878 children with a median age of 12. Over half (54%) reported that the pandemic negatively affected their family's financial status, with 45% describing its impact on children's needs as negative or very negative. Just under 50% of respondents consistently wore masks during the study period, and around 54% had received at least one dose of the COVID-19 vaccine. Reasons for not getting vaccinated included concerns about side effects, ineligibility for the target age group, and overcrowding at vaccination sites. The odds of not getting vaccinated were significantly lower for children aged 15-18, with boys more likely to refuse vaccination than girls. CONCLUSION The financial impact of the pandemic in Iran affected families' ability to meet their children's needs. Moreover, low vaccination acceptance rates increased children's vulnerability to health problems and contributed to COVID-19 infections. Efforts should be made to increase vaccination acceptance, particularly among immigrant populations.
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Affiliation(s)
- Meroe Vameghi
- Social Welfare Management Research Center, Social Health Research Institute, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohammad Saatchi
- Department of Biostatistics and Epidemiology, University of Social Welfare and Rehabilitation Science, Tehran, Iran
- Health in Emergency and Disaster Research Center, Social Health Research Institute, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Giti Bahrami
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Farin Soleimani
- Paediatric Neurorehabilitation Research Centre, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Marzieh Takaffoli
- Social Welfare Management Research Center, Social Health Research Institute, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Rusk SA, DiBari J, Mason DM, Li M, Hong X, Wang G, Pearson C, Mirolli G, Cheng TL, Kogan MD, Zuckerman B, Wang X. The impact of COVID-19 on psychiatric clinical encounters among low-income racially-diverse children. J Child Psychol Psychiatry 2024; 65:631-643. [PMID: 37088737 PMCID: PMC10590822 DOI: 10.1111/jcpp.13809] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/28/2023] [Indexed: 04/25/2023]
Abstract
BACKGROUND There is a lack of longitudinal data to examine the impact of COVID-19 on all types of clinical encounters among United States, underrepresented BIPOC (Black, Indigenous, and people of color), children. This study aims to examine the changes in all the outpatient clinical encounters during the pandemic compared to the baseline, with particular attention to psychiatric encounters and diagnoses. METHOD This study analyzed 3-year (January 2019 to December 2021) longitudinal clinical encounter data from 3,394 children in the Boston Birth Cohort, a US urban, predominantly low-income, Black and Hispanic children. Outcomes of interest were completed outpatient clinical encounters and their modalities (telemedicine vs. in person), including psychiatric care and diagnoses, primary care, emergency department (ED), and developmental and behavioral pediatrics (DBP). RESULTS The study children's mean (SD) age is 13.9 (4.0) years. Compared to 2019, psychiatric encounters increased by 38% in 2020, most notably for diagnoses of adjustment disorders, depression, and post-traumatic stress disorders (PTSD). In contrast, primary care encounters decreased by 33%, ED encounters decreased by 55%, and DBP care decreased by 16% in 2020. Telemedicine was utilized the most for psychiatric and DBP encounters and the least for primary care encounters in 2020. A remarkable change in 2021 was the return of primary care encounters to the 2019 level, but psychiatric encounters fluctuated with spikes in COVID-19 case numbers. CONCLUSIONS Among this sample of US BIPOC children, compared to the 2019 baseline, psychiatric encounters increased by 38% during 2020, most notably for the new diagnoses of adjustment disorder, depression, and PTSD. The 2021 data showed a full recovery of primary care encounters to the baseline level but psychiatric encounters remained sensitive to the pandemic spikes. The long-term impact of the pandemic on children's mental health warrants further investigation.
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Affiliation(s)
- Serena A. Rusk
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health
| | - Jessica DiBari
- Office of Epidemiology and Research, Maternal and Child Health Bureau, Health Resources and Services Administration, U.S. Department of Health and Human Services
| | - Dana M. Mason
- Office of Epidemiology and Research, Maternal and Child Health Bureau, Health Resources and Services Administration, U.S. Department of Health and Human Services
| | - Mengmeng Li
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health
| | - Xiumei Hong
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health
| | - Guoying Wang
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health
| | - Colleen Pearson
- Department of Pediatrics, Boston University Chobanian & Avedisian School of Medicine and Boston Medical Center
| | - Gabrielle Mirolli
- Department of Pediatrics, Boston University Chobanian & Avedisian School of Medicine and Boston Medical Center
| | - Tina L. Cheng
- Department of Pediatrics, Cincinnati Children’s Hospital and University of Cincinnati
| | - Michael D. Kogan
- Office of Epidemiology and Research, Maternal and Child Health Bureau, Health Resources and Services Administration, U.S. Department of Health and Human Services
| | - Barry Zuckerman
- Department of Pediatrics, Boston University Chobanian & Avedisian School of Medicine and Boston Medical Center
| | - Xiaobin Wang
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health
- Department of Pediatrics, Johns Hopkins University School of Medicine
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Hai NTT, Nhung VP, Tam NTT, Ngoc TTB, Thuong MTH, Dai HV, Duong NT, Hai NV, Ton ND, Thach PN, Ha NH. HLA alleles associated with susceptibility and severity of the COVID-19 in Vietnamese. Hum Immunol 2024; 85:110796. [PMID: 38580537 DOI: 10.1016/j.humimm.2024.110796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 03/22/2024] [Accepted: 03/25/2024] [Indexed: 04/07/2024]
Abstract
The diversity of clinical manifestations in COVID-19 has been observed not only among individuals but also among various populations in globally. HLA molecules play a central role in physiology, protective immunity, and deleterious, disease-related autoimmune reactivity or overreaction. This study exploited the association between HLA frequencies and SARS-CoV-2 susceptibility and disease severity among the Vietnamese cohort (159 patients and 52 controls). A significant difference in frequency of both HLA class I and II in mild, moderate, and severe/fatal COVID-19 patients and negative exposure individuals - the controls were observed. Regarding SARS-CoV-2 sensitivity, HLA-A*03:01, 30:01, HLA-DQA1*01:02, DRB1*15:01, and DRB5*02:02 presented higher frequency in the control group compared with infected patients but DRB1 09:01 frequency was higher in infected patients. Regarding COVID-19 severity, HLA-F*01:01, 01:03 and DPA1*01:03 and 02:01, DPB1*04:01, DQA1*01:02, and DQB1*05:02 alleles were detected with higher frequency in severe patients but DOB*01:01, DRB1*05:01 and 09:01 had a significantly higher frequency in the mild group than remaining groups. Surprisingly, HLA-DQA1*01:02 and DRB1*09:01 alleles were identified with both inversely potential roles in protective function and severe risk. The obtained data herein will contribute to explore on the role of host genetic background in the pathology of COVID-19 disease.
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Affiliation(s)
- Nguyen Thi Thanh Hai
- National Hospital for Tropical Diseases, Kim Chung, Dong Anh, Hanoi 10000, Viet Nam; Department of Biochemistry, Hanoi Medical University, 1 Ton That Tung, Dong Da, Hanoi 10000, Viet Nam
| | - Vu Phuong Nhung
- Institute of Genome Research, Vietnam Academy of Science and Technology, 18 Hoang Quoc Viet, Cau Giay, Hanoi 10000, Viet Nam
| | - Nguyen Thi Thanh Tam
- Department of Biochemistry, Hanoi Medical University, 1 Ton That Tung, Dong Da, Hanoi 10000, Viet Nam
| | - Tran Thi Bich Ngoc
- Institute of Genome Research, Vietnam Academy of Science and Technology, 18 Hoang Quoc Viet, Cau Giay, Hanoi 10000, Viet Nam
| | - Ma Thi Huyen Thuong
- Institute of Genome Research, Vietnam Academy of Science and Technology, 18 Hoang Quoc Viet, Cau Giay, Hanoi 10000, Viet Nam
| | - Ha Van Dai
- National Hospital for Tropical Diseases, Kim Chung, Dong Anh, Hanoi 10000, Viet Nam
| | - Nguyen Thuy Duong
- Institute of Genome Research, Vietnam Academy of Science and Technology, 18 Hoang Quoc Viet, Cau Giay, Hanoi 10000, Viet Nam; Graduate University of Science and Technology, Vietnam Academy of Science and Technology, 18 Hoang Quoc Viet, Cau Giay, Hanoi 100000, Viet Nam
| | - Nong Van Hai
- Institute of Genome Research, Vietnam Academy of Science and Technology, 18 Hoang Quoc Viet, Cau Giay, Hanoi 10000, Viet Nam; Graduate University of Science and Technology, Vietnam Academy of Science and Technology, 18 Hoang Quoc Viet, Cau Giay, Hanoi 100000, Viet Nam
| | - Nguyen Dang Ton
- Institute of Genome Research, Vietnam Academy of Science and Technology, 18 Hoang Quoc Viet, Cau Giay, Hanoi 10000, Viet Nam; Graduate University of Science and Technology, Vietnam Academy of Science and Technology, 18 Hoang Quoc Viet, Cau Giay, Hanoi 100000, Viet Nam
| | - Pham Ngoc Thach
- National Hospital for Tropical Diseases, Kim Chung, Dong Anh, Hanoi 10000, Viet Nam
| | - Nguyen Hai Ha
- Institute of Genome Research, Vietnam Academy of Science and Technology, 18 Hoang Quoc Viet, Cau Giay, Hanoi 10000, Viet Nam; Graduate University of Science and Technology, Vietnam Academy of Science and Technology, 18 Hoang Quoc Viet, Cau Giay, Hanoi 100000, Viet Nam.
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Mercan A, Beşe SA, Köksal ZG, Kara SS, Uysal P, Erge D. Impulse oscillometry assessment of respiratory function in pediatric patients with a history of COVID-19. Pediatr Pulmonol 2024; 59:1394-1401. [PMID: 38390766 DOI: 10.1002/ppul.26926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 02/08/2024] [Accepted: 02/12/2024] [Indexed: 02/24/2024]
Abstract
OBJECTIVE While coronavirus disease 2019 (COVID-19) is generally considered to exhibit a less severe clinical course in children than in adults, studies have demonstrated that respiratory symptoms can endure for more than 3 months following infection in at least one-third of pediatric cases. The present study evaluates the respiratory functions of children aged 3-15 years within 3-6 months of their recovery from COVID-19 using impulse oscillometry (IOS) and compares them with the values of healthy children. METHODS Included in this prospective cross-sectional study were 63 patients (patient group) aged 3-15 years who contracted COVID-19 between December 2021 and May 2022, as well as 57 healthy children as a control group, matched for age and sex. The demographic, clinical, and laboratory data of the patients were recorded, and respiratory function was assessed based on airway resistance (zR5, zR20, R5-20) and reactance (zX5, zX20, reactance area [AX], resonant frequency [Fres]) using an IOS device. RESULTS There were no significant differences in the age, weight, height, and body weight z score values of the two groups (p > .05). While the zR5 and R5-20 levels of the patient group were higher (p = .008 and p < .001, respectively) than those of the controls, the zR20, AX, and Fres values did not differ significantly between the groups (p > .05). The parameters indicating the reactance, including zX5 and zX20, were significantly lower in the patient group than in the control group (p = .028 and p < .001, respectively). CONCLUSION Total and peripheral airway resistances were found to be elevated in children who had recovered from COVID-19 in the preceding 3-6 months.
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Affiliation(s)
- Adnan Mercan
- Division of Pediatric Immunology and Allergy, Department of Pediatrics, Aydın Adnan Menderes University Faculty of Medicine, Aydın, Türkiye
| | - Simge Atar Beşe
- Division of Pediatric Immunology and Allergy, Department of Pediatrics, Aydın Adnan Menderes University Faculty of Medicine, Aydın, Türkiye
| | - Zeynep Güleç Köksal
- Division of Pediatric Immunology and Allergy, Department of Pediatrics, Aydın Adnan Menderes University Faculty of Medicine, Aydın, Türkiye
| | - Soner Sertan Kara
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Aydın Adnan Menderes University Faculty of Medicine, Aydın, Türkiye
| | - Pınar Uysal
- Division of Pediatric Immunology and Allergy, Department of Pediatrics, Aydın Adnan Menderes University Faculty of Medicine, Aydın, Türkiye
| | - Duygu Erge
- Division of Pediatric Immunology and Allergy, Department of Pediatrics, Aydın Adnan Menderes University Faculty of Medicine, Aydın, Türkiye
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Schwartz DA, Mohagheghi P, Moshfegh F, Zafaranloo N, Khalili N, Heidarzadeh M, Habibelahi A, Ghafoury R, Afrashteh F. Epidemiology and Clinical Features of COVID-19 among 4,015 Neonates in Iran: Results of the National Study from the Iranian Maternal and Neonatal Network. Am J Perinatol 2024; 41:e1698-e1708. [PMID: 36990455 PMCID: PMC11136567 DOI: 10.1055/a-2065-4714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 03/10/2023] [Indexed: 03/31/2023]
Abstract
OBJECTIVE The coronavirus disease 2019 (COVID-19) pandemic had a significant impact on pregnant women and neonates in Iran. This retrospective study describes the national experience among neonates having suspected and confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection following hospital admission to examine the epidemiology, demographic, and clinical features. STUDY DESIGN All nationwide cases of suspected and confirmed neonatal SARS-CoV-2 infection were drawn from the Iranian Maternal and Neonatal Network (IMaN) between February 2020 and February 2021. IMaN registers demographic, maternal, and neonatal health data throughout Iran. Statistical analysis of demographic, epidemiological, and clinical data were performed. RESULTS There were 4,015 liveborn neonates having suspected or confirmed SARS-CoV-2 infection that fulfilled the study inclusion criteria identified in the IMaN registry from 187 hospitals throughout Iran. There were 1,392 (34.6%) neonates that were preterm, including 304 (7.6%) less than 32 weeks' gestation. Among the 2,567 newborns admitted to the hospital immediately after birth, the most common clinical problems were respiratory distress (1,095 cases; 42.6%), sepsis-like syndrome (355; 13.8%), and cyanosis (300 cases; 11.6%). Of 683 neonates transferred from another hospital, the most frequent problems were respiratory distress (388; 56.8%), sepsis-like syndrome (152; 22.2%), and cyanosis (134; 19.6%). Among 765 neonates discharged home after birth and subsequently admitted to the hospital, sepsis-like syndrome (244 cases; 31.8%), fever (210; 27.4%), and respiratory distress (185; 24.1%) were most frequent. A total of 2,331 (58%) of neonates required respiratory care, with 2,044 surviving and 287 having a neonatal death. Approximately 55% of surviving neonates received respiratory support, compared with 97% of neonates who expired. Laboratory abnormalities included elevations of white blood cell count, creatine phosphokinase, liver enzymes, and C-reactive protein. CONCLUSION This report adds the national experience of Iran to the list of reports from multiple countries describing their experience with COVID-19 in neonates, demonstrating that newborns are not exempt from COVID-19-morbidity and mortality. KEY POINTS · Most common clinical problem was respiratory distress.. · Sepsis-like syndrome was also frequently present.. · A total of 58% of all neonates required respiratory care..
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Affiliation(s)
| | - Parisa Mohagheghi
- Department of Neonatology, Iran University of Medical Sciences, Tehran, Iran
| | - Fereshteh Moshfegh
- Department of Pediatrics, Iran University of Medical Sciences, Tehran, Iran
| | - Nazanin Zafaranloo
- Department of Pediatrics, Omid Hospital, Iran University of Medical and Sciences, Tehran, Iran
| | - Narjes Khalili
- Department of Community and Family Medicine, Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | | | - Abbas Habibelahi
- Department of Neonatology, Neonatal Health Office, Ministry of Health IR, Tehran, Iran
| | - Roya Ghafoury
- Student Research Committee, School of Medicine, Iran University of Medical and Sciences, Tehran, Iran
| | - Fatemeh Afrashteh
- Student Research Committee, School of Medicine, Iran University of Medical and Sciences, Tehran, Iran
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Zhang N, Wang Z, Li H, Chen K, Wang HS, Shao JB, Jiang SY, Zhai XW, Jiang H. Immunophenotype of lymphocytes and real-world outcome of COVID-19 infection in children with hematology and oncology. BMC Cancer 2024; 24:538. [PMID: 38678181 PMCID: PMC11056048 DOI: 10.1186/s12885-024-12262-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 04/15/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Patients with immunocompromise were suspected to encounter a high risk for severe coronavirus disease 2019 (COVID-19) infection on early period; however, data is lacking nowadays and immune response remain unclear. METHODS In this retrospective study, internet questionnaire survey and medical records were acquired in pediatric hematology oncology patients. Clinical severity, immunological characteristics, and outcomes were analyzed from December 1, 2022 to January 31, 2023 at the 3rd year of pandemic in China. RESULTS A total of 306 patients were included, with 21 patients (6.9%) asymptomatic, 262 (85.6%) mild severity, 17 (5.6%) moderate severity, 5 (1.6%) severe severity, and 1 (0.3%) critical severity. Seventy-eight (25.5%) patients were on intensive chemotherapy, and 32.0% children were on maintenance chemotherapy. Delays in cancer therapy occurred in 86.7% patients. Univariable analysis revealed active chemotherapy (P < 0.0001), long duration of symptom (P < 0.0001), low lymphocytes count (P = 0.095), low CD3 + and CD8 + T cell count (P = 0.013, P = 0.022), high percentage of CD4 + TCM (P = 0.016), and low percentage of transitional B cells (P = 0.045) were high risk factors for severe COVID-19 infection. Cox regression model showed that the absolute lymphocytes count (P = 0.027) and long duration of symptom (P = 0.002) were the independent factors for severity. Patients with CD8 + dominant and B cell depletion subtype wasn't related with severity, but had higher percentage of CD8 + effector memory T cells (TEM) and terminally differentiated effector memory T cells (TEMRA) (P < 0.001, P < 0.001), and a longer COVID-19 duration (P = 0.045). CONCLUSION The severity was relatively mild in children with immunodeficiencies in the third year of COVID-19 pandemic. Low lymphocyte count and long duration of symptom were the independent risk factors with COVID-19 severity. Delays in cancer care remain a major concern and the long outcome is pending.
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Affiliation(s)
- Na Zhang
- Department of Hematology and Oncology, Shanghai Children's Hospital, School of medicine, Shanghai Jiao Tong University, 200040, Shanghai, China
| | - Zhen Wang
- Department of Hematology and Oncology, Shanghai Children's Hospital, School of medicine, Shanghai Jiao Tong University, 200040, Shanghai, China
| | - Hong Li
- Department of Hematology and Oncology, Shanghai Children's Hospital, School of medicine, Shanghai Jiao Tong University, 200040, Shanghai, China
| | - Kai Chen
- Department of Hematology and Oncology, Shanghai Children's Hospital, School of medicine, Shanghai Jiao Tong University, 200040, Shanghai, China
| | - Hong-Sheng Wang
- Department of Hematology and Oncology, Children's Hospital of Fudan University, Shanghai, China
| | - Jing-Bo Shao
- Department of Hematology and Oncology, Shanghai Children's Hospital, School of medicine, Shanghai Jiao Tong University, 200040, Shanghai, China
| | - Sha-Yi Jiang
- Department of Hematology and Oncology, Shanghai Children's Hospital, School of medicine, Shanghai Jiao Tong University, 200040, Shanghai, China
| | - Xiao-Wen Zhai
- Department of Hematology and Oncology, Children's Hospital of Fudan University, Shanghai, China
| | - Hui Jiang
- Department of Hematology and Oncology, Shanghai Children's Hospital, School of medicine, Shanghai Jiao Tong University, 200040, Shanghai, China.
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Jiang J, Shen Z, Cao J. Seizures in febrile children with SARS-CoV-2 infection: clinical features, short-term follow-up. BMC Pediatr 2024; 24:257. [PMID: 38627666 PMCID: PMC11022318 DOI: 10.1186/s12887-024-04691-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 03/04/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND As the Omicron variant of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) emerges, the neurological manifestations correlated with this epidemic have garnered increasing attention. This study was primarily intended to compare seizures in febrile children with and without SARS-CoV-2 infection and to conduct short-term follow-up of the SARS-CoV-2-infected patients. METHODS Retrospective analysis of patients admitted to the Children's Hospital of Chongqing Medical University for fever and seizures between October 1 and December 30, 2022. Based on the results of SARS-CoV-2 Reverse Transcription-Polymerase Chain Reaction(RT-PCR) at the time of admission, the patients were divided into a Coronavirus disease 2019(COVID-19) positive group and a COVID-19 negative group. Aside from that, we followed up COVID-19-positive patients for 3 months after their discharge from the hospital. The follow-up included monitoring for post-discharge seizures. RESULTS Compared with the COVID-19-negative group, the COVID-19-positive group had a higher proportion of seizure duration ≥ 15 min(18.7%VS5.1%;P = 0.001), seizure ≥ 2 time(54.4%VS41.0%; P = 0.024), status epilepticus(15.4%VS5.1%; P = 0.005), and Electroencephalogram (EEG) abnormalities(29.4%VS13.6%; P = 0.016). Among the 161 individuals under follow-up, 21 (13.0%)experienced a recurrence of seizures. CONCLUSIONS Although the incidence of seizure duration ≥ 15 min, number of seizures ≥ 2 time, and status epilepticus was higher in the COVID-19-positive group, the majority of patients had a favorable prognosis. Nonetheless, patients with COVID-19 who present with seizures and persistent impaired consciousness need to be alerted to serious neurological disorders such as acute necrotizing encephalopathy. Owing to the consideration that some patients may experience a recurrence of seizures within a short period of time, it is paramount to provide guardians with education about the emergency management of seizures and to follow up with patients over time.
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Affiliation(s)
- Jipeng Jiang
- Department of General Medicine, Nation Clinical Research Center for Child Health and Disorders, Ministry of Education Key Labiratory of Child Development and Disorders, Childrens Hospital of Chongqing Medical University, No.136 Zhongshan 2nd Road, Yuzhong District, Chongqing, China
- China International Science and Technology Cooperation base of Child development and Critical Disorders, No.136 Zhongshan 2nd Road, Yuzhong District, Chongqing, China
- Chongqing Key Laboratory of Pediatrics, No.136 Zhongshan 2nd Road, Yuzhong District, Chongqing, China
| | - Zhengsong Shen
- Department of General Medicine, Nation Clinical Research Center for Child Health and Disorders, Ministry of Education Key Labiratory of Child Development and Disorders, Childrens Hospital of Chongqing Medical University, No.136 Zhongshan 2nd Road, Yuzhong District, Chongqing, China
| | - Jie Cao
- Department of General Medicine, Nation Clinical Research Center for Child Health and Disorders, Ministry of Education Key Labiratory of Child Development and Disorders, Childrens Hospital of Chongqing Medical University, No.136 Zhongshan 2nd Road, Yuzhong District, Chongqing, China.
- China International Science and Technology Cooperation base of Child development and Critical Disorders, No.136 Zhongshan 2nd Road, Yuzhong District, Chongqing, China.
- Chongqing Key Laboratory of Pediatrics, No.136 Zhongshan 2nd Road, Yuzhong District, Chongqing, China.
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Schatz C, Knabl L, Lee HK, Seeboeck R, von Laer D, Lafon E, Borena W, Mangge H, Prüller F, Qerimi A, Wilflingseder D, Posch W, Haybaeck J. Machine Learning to Identify Critical Biomarker Profiles in New SARS-CoV-2 Variants. Microorganisms 2024; 12:798. [PMID: 38674742 PMCID: PMC11052335 DOI: 10.3390/microorganisms12040798] [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: 02/02/2024] [Revised: 03/31/2024] [Accepted: 04/03/2024] [Indexed: 04/28/2024] Open
Abstract
The global dissemination of SARS-CoV-2 resulted in the emergence of several variants, including Alpha, Alpha + E484K, Beta, and Omicron. Our research integrated the study of eukaryotic translation factors and fundamental components in general protein synthesis with the analysis of SARS-CoV-2 variants and vaccination status. Utilizing statistical methods, we successfully differentiated between variants in infected individuals and, to a lesser extent, between vaccinated and non-vaccinated infected individuals, relying on the expression profiles of translation factors. Additionally, our investigation identified common causal relationships among the translation factors, shedding light on the interplay between SARS-CoV-2 variants and the host's translation machinery.
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Affiliation(s)
- Christoph Schatz
- Tyrolpath Obrist Brunhuber GmbH, 6311 Zams, Austria (L.K.)
- Institute of Pathology, Neuropathology and Molecular Pathology, Medical University of Innsbruck, Muellerstrasse 44, 6020 Innsbruck, Austria;
| | - Ludwig Knabl
- Tyrolpath Obrist Brunhuber GmbH, 6311 Zams, Austria (L.K.)
| | - Hye Kyung Lee
- Laboratory of Genetics and Physiology, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 20892, USA;
| | - Rita Seeboeck
- Department Life Sciences, IMC University of Applied Sciences Krems, 3500 Krems, Austria;
- Clinical Institute of Pathology, University Hospital St. Poelten, Karl Landsteiner University of Health Science, 3100 St. Poelten, Austria
| | - Dorothee von Laer
- Institute of Virology, Medical University of Innsbruck, Peter-Mayr-Strasse 4b, 6020 Innsbruck, Austria (W.B.)
| | - Eliott Lafon
- Institute of Hygiene and Medical Microbiology, Medical University of Innsbruck, Schöpfstrasse 41, 6020 Innsbruck, Austria (D.W.); (W.P.)
| | - Wegene Borena
- Institute of Virology, Medical University of Innsbruck, Peter-Mayr-Strasse 4b, 6020 Innsbruck, Austria (W.B.)
| | - Harald Mangge
- Clinical Institute for Medical and Chemical Laboratory Diagnosis (CIMCL), Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Florian Prüller
- Clinical Institute for Medical and Chemical Laboratory Diagnosis (CIMCL), Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Adelina Qerimi
- Institute of Pathology, Neuropathology and Molecular Pathology, Medical University of Innsbruck, Muellerstrasse 44, 6020 Innsbruck, Austria;
| | - Doris Wilflingseder
- Institute of Hygiene and Medical Microbiology, Medical University of Innsbruck, Schöpfstrasse 41, 6020 Innsbruck, Austria (D.W.); (W.P.)
- Department of Pathobiology, Infectiology, Veterinary University of Vienna, Veterinärplatz 1, 1210 Vienna, Austria
| | - Wilfried Posch
- Institute of Hygiene and Medical Microbiology, Medical University of Innsbruck, Schöpfstrasse 41, 6020 Innsbruck, Austria (D.W.); (W.P.)
| | - Johannes Haybaeck
- Department of Pathology, Saint Vincent Hospital Zams, 6511 Zams, Austria
- Diagnostic and Research Center for Molecular BioMedicine, Institute of Pathology, Medical University of Graz, 8010 Graz, Austria
- Department of Pathology, Laborteam, 9403 Goldach, Switzerland
- Department of Pathology, University Medical Centre Maribor, 2000 Maribor, Slovenia
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Zama D, Zanaroli A, Corbelli A, Lo Vecchio A, Del Bene M, Colombini A, Compagno F, Barone A, Fontanili I, Rosaria D'Amico M, Papa MR, Petris MG, Calore E, Montalto S, Meneghello L, Brescia L, Mura R, La Spina M, Muggeo P, Rinieri S, Meazza C, Perruccio K, Cellini M, Spadea M, Mercolini F, Petroni V, De Santis R, Soncini E, Provenzi M, Giurici N, Ziino O, Tridello G, Cesaro S. SARS-CoV-2 Infection in the Pediatric Oncology Population: The Definitive Comprehensive Report of the Infectious Diseases Working Group of AIEOP. J Infect Dis 2024; 229:1050-1058. [PMID: 37962869 DOI: 10.1093/infdis/jiad496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 09/20/2023] [Accepted: 11/11/2023] [Indexed: 11/15/2023] Open
Abstract
OBJECTIVE The objective of this study was to assess the clinical impact and outcome of the SARS-CoV-2 infection on children with cancer or those who received a hematopoietic stem cell transplantation. METHODS AIEOP (Italian Association of Pediatric Hematology and Oncology) performed a nationwide multicenter observational cohort study, including consecutive patients between April 2020 and November 2022. RESULTS Twenty-five Italian centers participated and 455 patients were enrolled. We reported a significant increasing trend of symptomatic cases over the years, while the number of nonmild infections remained stable. Early infection after oncologic diagnosis (<60 days) and severe neutropenia were identified as independent risk factors for developing moderate, severe, or critical infections. The percentage of patients who were asymptomatic and mildly symptomatic and who stopped chemotherapy reduced over the years of the pandemic. Nine patients died, but no death was attributed to SARS-CoV-2 infection. CONCLUSIONS SARS-CoV-2 infection presented a self-limiting benign course in the Italian pediatric oncohematology population during the pandemic, and its main consequence has been the discontinuation of cancer-directed therapies. The rate of patients who were asymptomatic and stopped chemotherapy reduced over the years, suggesting that the continuation of chemotherapy is a feasible option.
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Affiliation(s)
- Daniele Zama
- Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna
| | - Andrea Zanaroli
- Pediatric Oncology and Hematology Department, Istituto di Ricovero e Cura a Carattere Scientifico, Azienda Ospedaliero-Universitaria di Bologna
| | - Agnese Corbelli
- Pediatric Hematology and Oncology, Department of Mother and Child, Azienda Ospedaliera Universitaria Integrata, Verona
| | - Andrea Lo Vecchio
- Department of Translational Medical Sciences, Section of Pediatrics, University of Naples Federico II, Naples
| | - Margherita Del Bene
- Department of Translational Medical Sciences, Section of Pediatrics, University of Naples Federico II, Naples
| | - Antonella Colombini
- Antonella Colombini, Fondazione IRCCS, Ospedale San Gerardo dei Tintori, Monza
| | - Francesca Compagno
- Pediatric Hematology/Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia
| | - Angelica Barone
- Pediatric Onco-hematology Unit, Ospedale dei Bambini, Azienda Ospedaliero-Universitaria di Parma
| | - Ilaria Fontanili
- Pediatric Onco-hematology Unit, Ospedale dei Bambini, Azienda Ospedaliero-Universitaria di Parma
| | | | | | - Maria Grazia Petris
- Women's and Children's Health, Clinic of Pediatric Hemato-oncology, University of Padua
| | - Elisabetta Calore
- Pediatric Hematology, Oncology and Stem Cell Transplant Division, Department of Women's and Children's Health
- European Reference Network for Paediatric Transplantation Member for Hematopoietic Stem Cell Transplantation, University Hospital of Padova
| | - Shana Montalto
- Pediatric Infectious Diseases Unit, IRCCS Istituto Giannina Gaslini, Genoa
| | | | | | - Rosamaria Mura
- Pediatric Oncology Unit, Azienda Ospedaliera Brotzu, Cagliari
| | - Milena La Spina
- Pediatric Hematology and Oncology Unit, AOU Policlinico "Rodolico-San Marco," University of Catania
| | - Paola Muggeo
- Pediatric Oncology-Hematology Unit, Department of Pediatrics, Azienda Ospedaliero Universitaria Policlinico, Bari
| | - Simona Rinieri
- Pediatric Unit, Onco-hematology Day Hospital, Sant'Anna Hospital, Ferrara
| | - Cristina Meazza
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano
| | - Katia Perruccio
- Pediatric Oncology-Hematology, Santa Maria della Misericordia Hospital, Perugia
| | - Monica Cellini
- Pediatric Oncology-Hematology Unit, Department of Mother and Child, Azienda Ospedaliero Universitaria Modena
| | - Manuela Spadea
- Department of Public Health and Pediatrics, University of Turin
- Pediatric Onco-hematology, Stem Cell Transplantation and Cellular Therapy Division, Regina Margherita Children's Hospital, Turin
| | - Federico Mercolini
- Pediatric Oncology and Hematology Department, Istituto di Ricovero e Cura a Carattere Scientifico, Azienda Ospedaliero-Universitaria di Bologna
- Pediatric Onco-hematology Unit, Department of Pediatrics, Hospital of Bolzano
| | - Valeria Petroni
- Division of Pediatric Hematology and Oncology, Ospedale G Salesi, Ancona
| | - Raffaella De Santis
- Hemato-oncology Unit, Department of Pediatrics, "Casa Sollievo Della Sofferenza" Hospital, San Giovanni Rotondo
| | - Elena Soncini
- Pediatric Oncohematology and Bone Marrow Transplant Unit, Children's Hospital, Spedali Civili, Brescia
| | | | - Nagua Giurici
- Pediatric Hematology-Oncology, Institute for Maternal and Child Health IRCCS "Burlo Garofolo,"Trieste
| | - Ottavio Ziino
- Department of Pediatric Hemato-oncology, ARNAS Ospedali Civico, G Di Cristina, Palermo, Italy
| | - Gloria Tridello
- Pediatric Hematology and Oncology, Department of Mother and Child, Azienda Ospedaliera Universitaria Integrata, Verona
| | - Simone Cesaro
- Pediatric Hematology and Oncology, Department of Mother and Child, Azienda Ospedaliera Universitaria Integrata, Verona
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Zhang F, Zhang J, Li M, Jin Z, Wen Y. Assessing the impact of different contact patterns on disease transmission: Taking COVID-19 as a case. PLoS One 2024; 19:e0300884. [PMID: 38603698 PMCID: PMC11008907 DOI: 10.1371/journal.pone.0300884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 03/02/2024] [Indexed: 04/13/2024] Open
Abstract
Human-to-human contact plays a leading role in the transmission of infectious diseases, and the contact pattern between individuals has an important influence on the intensity and trend of disease transmission. In this paper, we define regular contacts and random contacts. Then, taking the COVID-19 outbreak in Yangzhou City, China as an example, we consider age heterogeneity, household structure and two contact patterns to establish discrete dynamic models with switching between daytime and nighttime to depict the transmission mechanism of COVID-19 in population. We studied the changes in the reproduction number with different age groups and household sizes at different stages. The effects of the proportion of two contacts patterns on reproduction number were also studied. Furthermore, taking the final size, the peak value of infected individuals in community and the peak value of quarantine infected individuals and nucleic acid test positive individuals as indicators, we evaluate the impact of the number of random contacts, the duration of the free transmission stage and summer vacation on the spread of the disease. The results show that a series of prevention and control measures taken by the Chinese government in response to the epidemic situation are reasonable and effective, and the young and middle-aged adults (aged 18-59) with household size of 6 have the strongest transmission ability. In addition, the results also indicate that increasing the proportion of random contact is beneficial to the control of the infectious disease in the phase with interventions. This work enriches the content of infectious disease modeling and provides theoretical guidance for the prevention and control of follow-up major infectious diseases.
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Affiliation(s)
- Fenfen Zhang
- College of Mathematics and Statistics, Taiyuan Normal University, Jinzhong, Shanxi, China
- Shanxi College of Technology, Shuozhou, Shanxi, China
- Complex Systems Research Center, Shanxi University, Taiyuan, Shanxi, China
- Shanxi Key Laboratory of Mathematical Techniques and Big Data Analysis on Disease Control and Prevention, Shanxi University, Taiyuan, Shanxi, China
- Key Laboratory of Complex Systems and Data Science of Ministry of Education, Shanxi University, Taiyuan, Shanxi, China
| | - Juan Zhang
- Complex Systems Research Center, Shanxi University, Taiyuan, Shanxi, China
- Shanxi Key Laboratory of Mathematical Techniques and Big Data Analysis on Disease Control and Prevention, Shanxi University, Taiyuan, Shanxi, China
- Key Laboratory of Complex Systems and Data Science of Ministry of Education, Shanxi University, Taiyuan, Shanxi, China
| | - Mingtao Li
- School of Mathematics, Taiyuan University of Technology, Taiyuan, Shanxi, China
| | - Zhen Jin
- Complex Systems Research Center, Shanxi University, Taiyuan, Shanxi, China
- Shanxi Key Laboratory of Mathematical Techniques and Big Data Analysis on Disease Control and Prevention, Shanxi University, Taiyuan, Shanxi, China
- Key Laboratory of Complex Systems and Data Science of Ministry of Education, Shanxi University, Taiyuan, Shanxi, China
| | - Yuqi Wen
- School of Materials Science & Engineering, Beijing Institute of Technology, Beijing, China
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Jia H, Chang Y, Chen Y, Chen X, Zhang H, Hua X, Xu M, Sheng Y, Zhang N, Cui H, Han L, Zhang J, Fu X, Song J. A single-cell atlas of lung homeostasis reveals dynamic changes during development and aging. Commun Biol 2024; 7:427. [PMID: 38589700 PMCID: PMC11001898 DOI: 10.1038/s42003-024-06111-x] [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: 08/08/2023] [Accepted: 03/26/2024] [Indexed: 04/10/2024] Open
Abstract
Aging is a global challenge, marked in the lungs by function decline and structural disorders, which affects the health of the elderly population. To explore anti-aging strategies, we develop a dynamic atlas covering 45 cell types in human lungs, spanning from embryonic development to aging. We aim to apply the discoveries of lung's development to address aging-related issues. We observe that both epithelial and immune cells undergo a process of acquisition and loss of essential function as they transition from development to aging. During aging, we identify cellular phenotypic alternations that result in reduced pulmonary compliance and compromised immune homeostasis. Furthermore, we find a distinctive expression pattern of the ferritin light chain (FTL) gene, which increases during development but decreases in various types of lung cells during the aging process.
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Affiliation(s)
- Hao Jia
- Beijing Key Laboratory of Preclinical Research and Evaluation for Cardiovascular Implant Materials, Animal Experimental Centre, National Centre for Cardiovascular Disease, Department of Cardiac Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yuan Chang
- Beijing Key Laboratory of Preclinical Research and Evaluation for Cardiovascular Implant Materials, Animal Experimental Centre, National Centre for Cardiovascular Disease, Department of Cardiac Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yulin Chen
- Beijing Key Laboratory of Preclinical Research and Evaluation for Cardiovascular Implant Materials, Animal Experimental Centre, National Centre for Cardiovascular Disease, Department of Cardiac Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Traditional Chinese and Western Medicine, Gansu University of Chinese Medicine, Lanzhou, China
| | - Xiao Chen
- Beijing Key Laboratory of Preclinical Research and Evaluation for Cardiovascular Implant Materials, Animal Experimental Centre, National Centre for Cardiovascular Disease, Department of Cardiac Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hang Zhang
- Beijing Key Laboratory of Preclinical Research and Evaluation for Cardiovascular Implant Materials, Animal Experimental Centre, National Centre for Cardiovascular Disease, Department of Cardiac Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiumeng Hua
- Beijing Key Laboratory of Preclinical Research and Evaluation for Cardiovascular Implant Materials, Animal Experimental Centre, National Centre for Cardiovascular Disease, Department of Cardiac Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Mengda Xu
- Beijing Key Laboratory of Preclinical Research and Evaluation for Cardiovascular Implant Materials, Animal Experimental Centre, National Centre for Cardiovascular Disease, Department of Cardiac Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yixuan Sheng
- Beijing Key Laboratory of Preclinical Research and Evaluation for Cardiovascular Implant Materials, Animal Experimental Centre, National Centre for Cardiovascular Disease, Department of Cardiac Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ningning Zhang
- Beijing Key Laboratory of Preclinical Research and Evaluation for Cardiovascular Implant Materials, Animal Experimental Centre, National Centre for Cardiovascular Disease, Department of Cardiac Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hao Cui
- Beijing Key Laboratory of Preclinical Research and Evaluation for Cardiovascular Implant Materials, Animal Experimental Centre, National Centre for Cardiovascular Disease, Department of Cardiac Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lei Han
- Beijing Key Laboratory of Preclinical Research and Evaluation for Cardiovascular Implant Materials, Animal Experimental Centre, National Centre for Cardiovascular Disease, Department of Cardiac Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of General Surgery, Yanan Hospital, Kunming Medical University, Kunming, China
| | - Jian Zhang
- Thoracic Surgery Department, the third affiliated hospital of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, China.
| | - Xiaodong Fu
- Department of Cardiology, Guangzhou Institute of Cardiovascular Disease, Guangdong Key Laboratory of Vascular Diseases, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
| | - Jiangping Song
- Beijing Key Laboratory of Preclinical Research and Evaluation for Cardiovascular Implant Materials, Animal Experimental Centre, National Centre for Cardiovascular Disease, Department of Cardiac Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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Nawi MA, Lau SCD, Chin ST, Teh KH, Ho LSB, Alias H. Caring for a child with cancer during COVID-19 pandemic: an assessment of the parents' perception and stress level. Front Public Health 2024; 12:1223362. [PMID: 38655523 PMCID: PMC11036860 DOI: 10.3389/fpubh.2024.1223362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 03/18/2024] [Indexed: 04/26/2024] Open
Abstract
Background The emergence of COVID-19 pandemic has led to heightened fear and uncertainty among parents of children with cancer. This study was conducted to evaluate the parental perceptions toward effects of COVID-19 infection to children with cancer, determine their stress level and factors contributing to high stress level during the pandemic. Methods This cross-sectional study was conducted in three paediatric oncology centres in Malaysia from September 2020 until December 2022. A total of 167 parents were recruited. Parents completed a set of questionnaires to assess their perception on effect of COVID-19 infection to children with cancer and COVID Stress Scale (CSS) to assess the parents' stress level. Results Patients' mean age at study entry was 8.75 years (SD 4.38). Ninety-one (54.5%) patients were still on active treatment. More than 80% of the parents obtained information regarding COVID-19 infection from mass media and social networking. Fear of their children contracting COVID-19 infection was high especially among patients who were still on treatment. Forty-nine (29.3%) parents were significantly affected by the pandemic leading to loss of job or monthly income. Twenty-nine (17.4%) patients required treatment modification during the pandemic. The median total score for CSS was 78.0 (IQR 25th 64.0; 75th 95.0). Ninety-one (54.5%) respondents were very/extremely stressed based on the CSS scores. Components with high scores were xenophobia (median score 18.0; IQR 25th 13.0, 75th 22.0), fear of danger (median score 17.0; IQR 25th 14.0, 75th 20.0) and contamination fears (median score 16.0; IQR 25th 12.0, 75th 19.0). Lower household income was associated with higher stress level (p = 0.006). Conclusion Our study demonstrated high awareness regarding risk of COVID-19 infection among parents of oncology children. Half of the parents had high stress level, with low household income identified as a factor associated with high stress level.
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Affiliation(s)
- Muhamad Aizat Nawi
- Department of Paediatrics, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Sie Chong Doris Lau
- Department of Paediatrics, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Shi Tying Chin
- Department of Paediatrics, Sarawak General Hospital, Kuching, Malaysia
| | - Kok Hoi Teh
- Department of Paediatrics, Hospital Tunku Azizah, Kuala Lumpur, Malaysia
| | - Lee Sue Betty Ho
- Department of Paediatrics, Sarawak General Hospital, Kuching, Malaysia
| | - Hamidah Alias
- Department of Paediatrics, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
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Liu YQ, Yuan WH, Tao Y, Zhao L, Guo WL. Development of a machine learning model and nomogram to predict seizures in children with COVID-19: a two-center study. J Trop Pediatr 2024; 70:fmae011. [PMID: 38670794 DOI: 10.1093/tropej/fmae011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
OBJECTIVE This study aimed to use machine learning to evaluate the risk factors of seizures and develop a model and nomogram to predict seizures in children with coronavirus disease 2019 (COVID-19). MATERIAL AND METHODS A total of 519 children with COVID-19 were assessed to develop predictive models using machine learning algorithms, including extreme gradient boosting (XGBoost), random forest (RF) and logistic regression (LR). The performance of the models was assessed using area under the receiver operating characteristic curve (AUC) values. Importance matrix plot and SHapley Additive exPlanations (SHAP) values were calculated to evaluate feature importance and to show the visualization results. The nomogram and clinical impact curve were used to validate the final model. RESULTS Two hundred and seventeen children with COVID-19 had seizures. According to the AUC, the RF model performed the best. Based on the SHAP values, the top three most important variables in the RF model were neutrophil percentage, cough and fever duration. The nomogram and clinical impact curve also verified that the RF model possessed significant predictive value. CONCLUSIONS Our research indicates that the RF model demonstrates excellent performance in predicting seizures, and our novel nomogram can facilitate clinical decision-making and potentially offer benefit for clinicians to prevent and treat seizures in children with COVID-19.
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Affiliation(s)
- Yu-Qi Liu
- Department of Radiology, Children's Hospital of Soochow University, Suzhou 215025, China
| | - Wei-Hua Yuan
- Department of Radiology, Changzhou Children's Hospital of Nantong University, Changzhou 213003, China
| | - Yue Tao
- Department of Radiology, Children's Hospital of Soochow University, Suzhou 215025, China
| | - Lian Zhao
- Department of Radiology, Children's Hospital of Soochow University, Suzhou 215025, China
| | - Wan-Liang Guo
- Department of Radiology, Children's Hospital of Soochow University, Suzhou 215025, China
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Louie-Poon S, Reid K, Appiah PO, Hartling L, Scott SD. "There is a strangeness in this disease": A qualitative study of parents' experiences caring for a child diagnosed with COVID-19. PLoS One 2024; 19:e0300146. [PMID: 38564592 PMCID: PMC10986929 DOI: 10.1371/journal.pone.0300146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 02/22/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND The beginning of the COVID-19 pandemic marked a period of uncertainty as public health guidelines, diagnostic criteria, and testing protocols or procedures have continuously evolved. Despite the virus being declared a worldwide pandemic, little research has been done to understand how parents manage caring for their child diagnosed with COVID-19. We sought to understand parents' experiences and information need when caring for a child diagnosed with COVID-19. METHODS A qualitative descriptive study with an inductive and exploratory approach was completed. Participants were recruited through social media and local public health clinics. Data collection and analysis were concurrent. Semi-structured virtual interviews were conducted with 27 participants. Thematic analysis was conducted. FINDINGS Four major themes emerged: a) dealing with uncertainty; b) anxiety; c) social stigma and stress; d) a sense of community. CONCLUSION Our study highlights that parent experiences were diverse and multi-faceted, and their experiences evolved and shifted over the course of the pandemic. Parents would benefit from clear and consistent evidence-based online information. Understanding the perspectives of parents caring for a child with COVID-19 is an important step in developing future resources tailored to meet their unique experiences and information needs.
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Affiliation(s)
| | - Kathy Reid
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | | | - Lisa Hartling
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Shannon D. Scott
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
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Wu YX, Wang DD, Zhao RQ, Jin OX, Yang JY, Zhang MX, Wang LZ. Differences in clinical characteristics of early-onset and late-onset severe acute respiratory syndrome coronavirus 2 infections in neonates. Eur J Pediatr 2024; 183:1741-1750. [PMID: 38233605 PMCID: PMC11001696 DOI: 10.1007/s00431-024-05433-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 01/09/2024] [Accepted: 01/11/2024] [Indexed: 01/19/2024]
Abstract
Differences in clinical characteristics of early-onset and late-onset severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in neonates remain unclear. This study aimed to determine whether there are differences in the main clinical, radiological, and laboratory features of early-onset and late-onset SARS-CoV-2 infections in neonates. This single-center, prospective cohort study enrolled neonates with SARS-CoV-2 infection from December 7, 2022, to January 3, 2023, and evaluated their clinical characteristics during hospitalization. All neonates (N = 58) infected with SARS-CoV-2 within 28 days of birth who were admitted to the neonatal intensive care unit of Taizhou Hospital were included. These neonates were classified into the early-onset (diagnosed within 7 days of birth) and late-onset (diagnosed more than 7 days after birth) groups. The symptoms, treatment, and prognosis of SARS-CoV-2 infection were the main study outcomes. The incidence of hospitalization attributable to SARS-CoV-2 infection was 10.6% (58 of 546 neonates) in Linhai. Sixteen (28%) of the 58 SARS-CoV-2 infections were early-onset cases, and 42 (72%) were late-onset cases. The common symptoms among the late-onset group were fever (p < 0.001) and cough (p < 0.001). Neonates with late-onset SARS-CoV-2 infection (p < 0.001) were significantly more likely to develop pneumonia. Conclusion: The clinical symptoms and rates of pneumonia caused by SARS-CoV-2 infection in neonates differed between the early-onset and late-onset groups. Different clinical management is necessary for neonates with early-onset and late-onset SARS-CoV-2 infections. What is Known: • Neonates are susceptible to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). • Differences in clinical characteristics of early-onset and late-onset SARS-CoV-2 infections in neonates remain unclear. What is New: • Fever and cough were the most common symptoms among neonates with late-onset infection. • Neonates with late-onset SARS-CoV-2 infection were more likely to develop pneumonia.
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Affiliation(s)
- Yi-Xin Wu
- Department of Pediatrics, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, 150 Ximen Street, Linhai, 317000, Zhejiang, China
| | - Dan-Dan Wang
- Department of Pediatrics, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, 150 Ximen Street, Linhai, 317000, Zhejiang, China
| | - Ru-Qi Zhao
- Department of Pediatrics, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, 150 Ximen Street, Linhai, 317000, Zhejiang, China
| | - Ou-Xuan Jin
- Department of Pediatrics, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, 150 Ximen Street, Linhai, 317000, Zhejiang, China
| | - Jing-Yun Yang
- Department of Pediatrics, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, 150 Ximen Street, Linhai, 317000, Zhejiang, China
| | - Mei-Xian Zhang
- Department of Pediatrics, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, 150 Ximen Street, Linhai, 317000, Zhejiang, China.
- Evidence-based Medicine Center, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, 150 Ximen Street, Linhai, 317000, Zhejiang Province, China.
| | - Li-Zhen Wang
- Department of Pediatrics, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, 150 Ximen Street, Linhai, 317000, Zhejiang, China.
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Sun YK, Wang C, Lin PQ, Hu L, Ye J, Gao ZG, Lin R, Li HM, Shu Q, Huang LS, Tan LH. Severe pediatric COVID-19: a review from the clinical and immunopathophysiological perspectives. World J Pediatr 2024; 20:307-324. [PMID: 38321331 PMCID: PMC11052880 DOI: 10.1007/s12519-023-00790-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 12/14/2023] [Indexed: 02/08/2024]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) tends to have mild presentations in children. However, severe and critical cases do arise in the pediatric population with debilitating systemic impacts and can be fatal at times, meriting further attention from clinicians. Meanwhile, the intricate interactions between the pathogen virulence factors and host defense mechanisms are believed to play indispensable roles in severe COVID-19 pathophysiology but remain incompletely understood. DATA SOURCES A comprehensive literature review was conducted for pertinent publications by reviewers independently using the PubMed, Embase, and Wanfang databases. Searched keywords included "COVID-19 in children", "severe pediatric COVID-19", and "critical illness in children with COVID-19". RESULTS Risks of developing severe COVID-19 in children escalate with increasing numbers of co-morbidities and an unvaccinated status. Acute respiratory distress stress and necrotizing pneumonia are prominent pulmonary manifestations, while various forms of cardiovascular and neurological involvement may also be seen. Multiple immunological processes are implicated in the host response to COVID-19 including the type I interferon and inflammasome pathways, whose dysregulation in severe and critical diseases translates into adverse clinical manifestations. Multisystem inflammatory syndrome in children (MIS-C), a potentially life-threatening immune-mediated condition chronologically associated with COVID-19 exposure, denotes another scientific and clinical conundrum that exemplifies the complexity of pediatric immunity. Despite the considerable dissimilarities between the pediatric and adult immune systems, clinical trials dedicated to children are lacking and current management recommendations are largely adapted from adult guidelines. CONCLUSIONS Severe pediatric COVID-19 can affect multiple organ systems. The dysregulated immune pathways in severe COVID-19 shape the disease course, epitomize the vast functional diversity of the pediatric immune system and highlight the immunophenotypical differences between children and adults. Consequently, further research may be warranted to adequately address them in pediatric-specific clinical practice guidelines.
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Affiliation(s)
- Yi-Kan Sun
- Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China
- The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310030, China
| | - Can Wang
- Surgical Intensive Care Unit, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China
| | - Pei-Quan Lin
- Surgical Intensive Care Unit, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China
| | - Lei Hu
- Surgical Intensive Care Unit, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China
| | - Jing Ye
- Surgical Intensive Care Unit, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China
| | - Zhi-Gang Gao
- Department of General Surgery, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China
| | - Ru Lin
- Department of Cardiopulmonary and Extracorporeal Life Support, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China
| | - Hao-Min Li
- Clinical Data Center, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China
| | - Qiang Shu
- Department of Cardiac Surgery, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China
- National Clinical Research Center for Child Health, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China
| | - Li-Su Huang
- National Clinical Research Center for Child Health, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China.
- Department of Infectious Diseases, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China.
| | - Lin-Hua Tan
- Surgical Intensive Care Unit, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310052, China.
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Gerber N, Lutrario C, Rosenthal M, Platt S, Holzer R, Flynn P. Coronary artery dilation in non-hospitalised children with asymptomatic or mild COVID-19. Cardiol Young 2024; 34:854-858. [PMID: 37905350 DOI: 10.1017/s1047951123003694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
INTRODUCTION Infection with Sars-CoV-2 is known to cause cardiac injury and coronary artery changes in moderate to severe acute COVID-19 and post-acute multisystem inflammatory syndrome in children (MIS-C). However, little is known about the potential for cardiac involvement, in particular coronary artery dilation, in asymptomatic or mild cases of COVID-19. METHODS A retrospective review of children ≤ 18 years of age with a history of asymptomatic or mild COVID-19 disease who underwent echocardiography after Sars-CoV-2 infection is conducted. Patients were excluded if they had been hospitalised for COVID-19/MIS-C or had a history of cardiac disease that could affect coronary artery dimension. Coronary artery dilation was defined as the Boston Z-score greater than 2.0. RESULTS One hundred and fifty-seven patients met inclusion criteria with a mean age of 9.4 years (+/- 5.4 years). Eighty-four (54%) patients were identified as having COVID-19 through positive antibody testing. All patients underwent electrocardiogram and echocardiogram as part of their cardiology evaluation. One hundred and thirty-five (86%) patients had a normal evaluation or only a minor variant on electrocardiogram, while 22 patients had abnormalities on echocardiogram, 4 of which demonstrated coronary artery dilation based on the Boston Z-score. CONCLUSIONS Much of the literature for post-infectious screening and follow-up focuses on patients with a history of moderate to severe COVID-19 disease, emphasising the need for surveillance for the potential development of myocarditis. In this study, 4 out of 157 (2.5%) children with a history of asymptomatic or mild COVID-19 disease without MIS-C were found to have some degree of coronary artery dilation. The significance of this finding currently remains unknown.
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Affiliation(s)
- Nicole Gerber
- Division of Pediatric Emergency Medicine, Department of Emergency Medicine, New York-Presbyterian Hospital / Weill Cornell Medicine, New York, NY, USA
| | - Christopher Lutrario
- Department of Pediatrics, New York-Presbyterian Hospital / Weill Cornell Medicine, New York, NY, USA
| | - Michelle Rosenthal
- Division of Pediatric Emergency Medicine, Department of Emergency Medicine, New York-Presbyterian Hospital / Weill Cornell Medicine, New York, NY, USA
| | - Shari Platt
- Division of Pediatric Emergency Medicine, Department of Emergency Medicine, New York-Presbyterian Hospital / Weill Cornell Medicine, New York, NY, USA
| | - Ralf Holzer
- Division of Pediatric Cardiology, New York-Presbyterian Hospital / Weill Cornell Medicine, New York, NY, USA
- Department of Pediatrics, New York-Presbyterian Hospital / Weill Cornell Medicine, New York, NY, USA
| | - Patrick Flynn
- Division of Pediatric Cardiology, New York-Presbyterian Hospital / Weill Cornell Medicine, New York, NY, USA
- Department of Pediatrics, New York-Presbyterian Hospital / Weill Cornell Medicine, New York, NY, USA
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Nguyen SN, Vu LT, Nguyen HT, Dao GH, Nguyen ANT. Clinical Epidemiological Characteristics and Risk Factors for Severity of SARS-CoV-2 Pneumonia in Pediatric Patients: A Hospital-Based Study in Vietnam. Cureus 2024; 16:e58371. [PMID: 38756320 PMCID: PMC11097285 DOI: 10.7759/cureus.58371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2024] [Indexed: 05/18/2024] Open
Abstract
Introduction Coronavirus disease (COVID-19) is an infectious disease caused by SARS-CoV-2, which can cause organ failure in several organs, cardiac problems, or acute respiratory distress syndrome (ARDS). Identifying clinical epidemiological characteristics and risk factors for complications of COVID-19 allows clinicians to diagnose and treat promptly. Objectives This study aims to describe the clinical epidemiological characteristics of COVID-19 and assess risk factors for the severity of SARS-CoV-2 pneumonia in children treated at Haiphong Children's Hospital. Methods A descriptive cross-sectional study was conducted in Haiphong Children's Hospital, Haiphong, Vietnam, for one year, from January 1, 2022, to December 31, 2022. Results In our study, 540 children were evaluated; the male-to-female ratio was 1.48/1; the median age was 23 months (IQR=6-74); Children aged under one year accounted for the highest proportion (n=202; 37.4%); 40 (7.4%) children had underlying illnesses. The number of admitted patients diagnosed with COVID-19 peaked in February 2022. Regarding severity, 380 (70.4%) cases were mild, 136 (25.2%) were moderate, only 24 (4.4%) cases were severe, and no children died. Common symptoms were fever in 483 (89.4%), coughing in 399 (73.9%), and tachypnea in 163 (30.2%) children. Laboratory features: white blood cell count, platelet count, serum CRP, and coagulation test showed little change. Around 116 (21.5%) had lymphopenia and 148 (27.4%) had pneumonia. Patients under one year were approximately 1.64 times more likely to experience pneumonia complications from COVID-19 than those without such a history (OR=1.64, 95%CI = 1.12 - 2.41, p=0.0112). Patients with underlying conditions were approximately 2.08 times more likely to experience pneumonia complications from COVID-19 compared to those without such conditions (OR=2.08, 95%CI =1.08 - 4.02, p=0.0289). Conclusion In COVID-19 pediatric patients, the severity of the disease was mild to moderate without any mortality. Children aged under one year accounted for the highest proportion of all COVID-19 patients. This study found that age under one year and underlying illnesses are related to pneumonia in COVID-19 pediatric patients.
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Affiliation(s)
- Sang N Nguyen
- Pediatrics, Haiphong University of Medicine and Pharmacy, Haiphong, VNM
| | - Lam T Vu
- Pediatrics, Haiphong University of Medicine and Pharmacy, Haiphong, VNM
| | - Ha T Nguyen
- Otolaryngology, Hanoi Medical University, Hanoi, VNM
| | - Giang H Dao
- Pediatrics, Haiphong University of Medicine and Pharmacy, Haiphong, VNM
| | - Anh Ngoc T Nguyen
- Pediatrics, Haiphong University of Medicine and Pharmacy, Haiphong, VNM
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Hilberath J, Mast AS, Holweg M, Kränkel L, Remppis J, Renk H, Lang P, Schulte J, Fuchs J, Slavetinsky C. Quality of life and healthcare utilization during the COVID-19 pandemic are more restricted in chronically ill than in healthy children: a tertiary care children's hospital experience. Eur J Pediatr 2024; 183:1801-1810. [PMID: 38253757 PMCID: PMC11001739 DOI: 10.1007/s00431-023-05382-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 12/05/2023] [Accepted: 12/10/2023] [Indexed: 01/24/2024]
Abstract
The global COVID-19 pandemic forced changes in everyday life of children and adolescents due to government containment measures, an altered healthcare accessibility and utilization, and public concern about SARS-CoV-2 transmission. Data on the challenges and impact on children and their families with chronic diseases are limited. The primary objectives of this study were to assess (i) concerns for SARS-CoV-2 infection, (ii) perceived effects on health-related and overall quality of life (HRQoL and QoL), and (iii) accessibility and utilization of healthcare, comparing families with chronically ill children to families with healthy children during the second SARS-CoV-2 infection wave in Germany. A caregiver questionnaire was designed and participation offered in the emergency department and outpatient clinic of a German tertiary care children's hospital. 45.9% of the 205 participants were majorly concerned about their children contracting a SARS-CoV-2 infection. Caregivers of chronically ill children (128/205, 62.4%) stated significantly more often a negative impact on their child's QoL (w = 0.17; p = 0.014), while caregivers of chronically ill adolescents over the age of 13 expressed significantly more frequent a negative impact on their child's HRQoL (w = 0.21; p = 0.016). Outpatient appointments for chronically ill children were significantly more often canceled (w = 0.17; p = 0.025). Caregivers of chronically ill children were significantly more likely to report that they would actively delay hospital visits for emerging health issues due to the pandemic (w = 0.12; p = 0.049). Conclusion: Our findings underscore the importance of identifying families with chronically ill children as a vulnerable patient group with higher burdens during the COVID-19 pandemic and potential future pandemics. Healthcare providers may mitigate such burdens by ensuring reliable appointment allocation, offering contactless healthcare options, and providing tailored advice regarding vulnerabilities and preventive measures specific to their chronically ill children. What is Known: • The SARS-CoV-2 pandemic has led to significant restrictions in everyday life and both accessibility and utilization of healthcare for children and adolescents. • Chronically ill children faced exceptional challenges as they depend on regular and functioning medical care, but data comparing the pandemic's impact between chronically ill and healthy children are lacking. What is New: • The perceived impact of the SARS-CoV-2 pandemic on quality of life is more negative for chronically ill children and their health-related quality of life is more often affected compared to healthy children. • Caregivers of chronically ill children would more often delay a visit to their child's doctor during the SARS-CoV-2 pandemic and their medical appointments are more often postponed which both could increase health burdens for such vulnerable patients.
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Affiliation(s)
- Johannes Hilberath
- Department of Hematology and Oncology, University Children's Hospital Tübingen, Hoppe-Seyler-Straße 1, 72076, Tübingen, Germany
| | - Anna-Sophia Mast
- Department of Hematology and Oncology, University Children's Hospital Tübingen, Hoppe-Seyler-Straße 1, 72076, Tübingen, Germany.
| | - Maximilian Holweg
- Pediatric Surgery and Urology, University Children's Hospital Tübingen, University of Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Germany
| | - Lara Kränkel
- Pediatric Surgery and Urology, University Children's Hospital Tübingen, University of Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Germany
- Institute of Medical Microbiology and Hygiene, University Hospital Tübingen, Tübingen, Germany
| | - Jonathan Remppis
- Department of Hematology and Oncology, University Children's Hospital Tübingen, Hoppe-Seyler-Straße 1, 72076, Tübingen, Germany
| | - Hanna Renk
- University Children's Hospital Tübingen, Hoppe-Seyler-Straße 1, 72076, Tübingen, Germany
| | - Peter Lang
- Department of Hematology and Oncology, University Children's Hospital Tübingen, Hoppe-Seyler-Straße 1, 72076, Tübingen, Germany
| | - Johannes Schulte
- Department of Hematology and Oncology, University Children's Hospital Tübingen, Hoppe-Seyler-Straße 1, 72076, Tübingen, Germany
| | - Jörg Fuchs
- Pediatric Surgery and Urology, University Children's Hospital Tübingen, University of Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Germany
| | - Christoph Slavetinsky
- Pediatric Surgery and Urology, University Children's Hospital Tübingen, University of Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Germany.
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Pace RM, King-Nakaoka EA, Morse AG, Pascoe KJ, Winquist A, Caffé B, Navarrete AD, Lackey KA, Pace CD, Fehrenkamp BD, Smith CB, Martin MA, Barbosa-Leiker C, Ley SH, McGuire MA, Meehan CL, Williams JE, McGuire MK. Prevalence and duration of SARS-CoV-2 fecal shedding in breastfeeding dyads following maternal COVID-19 diagnosis. Front Immunol 2024; 15:1329092. [PMID: 38585272 PMCID: PMC10996396 DOI: 10.3389/fimmu.2024.1329092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 03/08/2024] [Indexed: 04/09/2024] Open
Abstract
Background There is a paucity of data on the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in feces of lactating women with coronavirus disease 2019 (COVID-19) and their breastfed infants as well as associations between fecal shedding and symptomatology. Objective We examined whether and to what extent SARS-CoV-2 is detectable in the feces of lactating women and their breastfed infants following maternal COVID-19 diagnosis. Methods This was a longitudinal study carried out from April 2020 to December 2021 involving 57 breastfeeding maternal-infant dyads: 33 dyads were enrolled within 7 d of maternal COVID-19 diagnosis, and 24 healthy dyads served as controls. Maternal/infant fecal samples were collected by participants, and surveys were administered via telephone over an 8-wk period. Feces were analyzed for SARS-CoV-2 RNA. Results Signs/symptoms related to ears, eyes, nose, and throat (EENT); general fatigue/malaise; and cardiopulmonary signs/symptoms were commonly reported among mothers with COVID-19. In infants of mothers with COVID-19, EENT, immunologic, and cardiopulmonary signs/symptoms were most common, but prevalence did not differ from that of infants of control mothers. SARS-CoV-2 RNA was detected in feces of 7 (25%) women with COVID-19 and 10 (30%) of their infants. Duration of fecal shedding ranged from 1-4 wk for both mothers and infants. SARS-CoV-2 RNA was sparsely detected in feces of healthy dyads, with only one mother's and two infants' fecal samples testing positive. There was no relationship between frequencies of maternal and infant SARS-CoV-2 fecal shedding (P=0.36), although presence of maternal or infant fever was related to increased likelihood (7-9 times greater, P≤0.04) of fecal shedding in infants of mothers with COVID-19.
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Affiliation(s)
- Ryan M. Pace
- Margaret Ritchie School of Family and Consumer Sciences, University of Idaho, Moscow, ID, United States
- College of Nursing, University of South Florida, Tampa, FL, United States
| | - Elana A. King-Nakaoka
- University of Washington School of Medicine, Seattle, WA, United States
- WWAMI Medical Education, University of Idaho, Moscow, ID, United States
| | - Andrew G. Morse
- University of Washington School of Medicine, Seattle, WA, United States
- WWAMI Medical Education, University of Idaho, Moscow, ID, United States
| | - Kelsey J. Pascoe
- College of Nursing, Washington State University, Spokane, WA, United States
| | - Anna Winquist
- College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Beatrice Caffé
- Department of Anthropology, Washington State University, Pullman, WA, United States
| | - Alexandra D. Navarrete
- Department of Medicine, Oregon Health and Sciences University, Portland, OR, United States
| | - Kimberly A. Lackey
- Margaret Ritchie School of Family and Consumer Sciences, University of Idaho, Moscow, ID, United States
| | - Christina D.W. Pace
- Margaret Ritchie School of Family and Consumer Sciences, University of Idaho, Moscow, ID, United States
| | - Bethaney D. Fehrenkamp
- Margaret Ritchie School of Family and Consumer Sciences, University of Idaho, Moscow, ID, United States
- University of Washington School of Medicine, Seattle, WA, United States
- WWAMI Medical Education, University of Idaho, Moscow, ID, United States
| | - Caroline B. Smith
- Department of Anthropology, Washington State University, Pullman, WA, United States
| | - Melanie A. Martin
- Department of Anthropology, University of Washington, Seattle, WA, United States
- Center for Studies in Demography and Ecology, University of Washington, Seattle, WA, United States
| | | | - Sylvia H. Ley
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States
| | - Mark A. McGuire
- Department of Animal, Veterinary and Food Sciences, University of Idaho, Moscow, ID, United States
| | - Courtney L. Meehan
- Department of Anthropology, Washington State University, Pullman, WA, United States
| | - Janet E. Williams
- Department of Animal, Veterinary and Food Sciences, University of Idaho, Moscow, ID, United States
| | - Michelle K. McGuire
- Margaret Ritchie School of Family and Consumer Sciences, University of Idaho, Moscow, ID, United States
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