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Chen C, Zhang H, Feng X, Wang H. Factors Influencing the Use and Demand of New Coronavirus Therapy Drugs Among the Adults During COVID-19 in China. Risk Manag Healthc Policy 2024; 17:1937-1945. [PMID: 39135613 PMCID: PMC11318593 DOI: 10.2147/rmhp.s468700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2024] [Accepted: 08/03/2024] [Indexed: 08/15/2024] Open
Abstract
Background This alteration in the policy of COVID-19 resulted in widespread infections throughout China. Most people only need some antiviral drugs such as lopinavir/ritonavir or Chinese herbal preparations for treatment. In this context, the lack of drug knowledge and inadequate drug availability are evident. This study aims to explore the factors influencing drug use and demand during the COVID-19 epidemic. Methods This study used quota sampling based on gender, age, and place of residence to perform a cross-sectional survey on a sample of 771 adults. The researchers used chi-square tests to understand differences in drug use and demand across characteristics, and binary logistic regression to analyse the influencing factors. Results The study revealed that 85.9% of the participants used drugs following the COVID-19 infection. Participants with college and above, (OR=2.49, 95% CI=1.27-4.88) annual personal income between 30,000 and 80,000CNY (OR=2.19, 95% CI=1.35-3.55) and over 80,000CNY (OR=1.96, 95% CI=1.05-3.66) were more knowledgeable about using drugs. Gender, (OR=0.69, 95% CI=0.50-0.95) age, (OR=2.11, 95% CI=1.15-3.88) residence, (OR=1.58, 95% CI=1.06-2.37) chronic disease conditions (OR=0.46, 95% CI=0.27-0.78) and infection symptoms (OR=0.60, 95% CI=0.38-0.93) as factors influencing the need for drug delivery services. (P<0.05). Conclusion Research has revealed that a significant proportion of infected people in China chose drug treatment during COVID-19. Individuals with severe symptoms use more medication and require more drug delivery and storage. Low-education and low-income populations are lacking in drug knowledge, and older adults with underlying medical conditions are more likely to need drug delivery services. Therefore, governments should prioritize vulnerable groups when formulating drug policies and target drug literacy and guidance. In addition, it is recommended that a drug distribution system be set up within the community so that those in need can have quick and easy access to drugs.
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Affiliation(s)
- Cunchuan Chen
- Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, People’s Republic of China
- NHC Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, 250012, People’s Republic of China
| | - Huifang Zhang
- Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, People’s Republic of China
- NHC Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, 250012, People’s Republic of China
| | - Xia Feng
- Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, People’s Republic of China
- NHC Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, 250012, People’s Republic of China
| | - Haipeng Wang
- Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, People’s Republic of China
- NHC Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, 250012, People’s Republic of China
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Yin Y, Yang G, Wang N, Zeng M, Jiang H, Yuan S, Wu J, Zhang J, Cui J, Zhou G, Yang X, Zhang Y, Sun Z, Yuan J, Lin J, Chen J, Tang M, Chen J. Exploring the prevalence and chest CT predictors of Long COVID in children: a comprehensive study from Shanghai and Linyi. Front Pediatr 2024; 12:1420196. [PMID: 39170602 PMCID: PMC11335557 DOI: 10.3389/fped.2024.1420196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Accepted: 07/23/2024] [Indexed: 08/23/2024] Open
Abstract
Introduction COVID-19 constitutes a pandemic of significant detriment to human health. This study aimed to investigate the prevalence of Long COVID following SARS-CoV-2 infection, analyze the potential predictors of chest CT for the development of Long COVID in children. Methods A cohort of children who visited the respiratory outpatient clinics at Shanghai Children's Medical Center or Linyi Maternal and Child Health Care Hospital from December 2022 to February 2023 and underwent chest CT scans within 1 week was followed up. Data on clinical characteristics, Long COVID symptoms, and chest CT manifestations were collected and analyzed. Multivariate logistic regression models and decision tree models were employed to identify factors associated with Long COVID. Results A total of 416 children were included in the study. Among 277 children who completed the follow-up, the prevalence of Long COVID was 23.1%. Chronic cough, fatigue, brain fog, and post-exertional malaise were the most commonly reported symptoms. In the decision tree model for Long COVID, the presence of increased vascular markings, the absence of normal CT findings, and younger age were identified as predictors associated with a higher likelihood of developing Long COVID in children. However, no significant correlation was found between chest CT abnormality and the occurrence of Long COVID. Discussion Long COVID in children presents a complex challenge with a significant prevalence rate of 23.1%. Chest CT scans of children post-SARS-CoV-2 infection, identified as abnormal with increased vascular markings, indicate a higher risk of developing Long COVID.
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Affiliation(s)
- Yong Yin
- Department of Respiratory Medicine, Linyi Maternal and Child Health Care Hospital, Linyi Branch of Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Linyi, Shandong, China
- Department of Respiratory Medicine, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Children’s Medical Center Pediatric Medical Complex (Pudong), Shanghai, China
- Pediatric AI Clinical Application and Research Center, Shanghai Children’s Medical Center, Shanghai, China
- Shanghai Engineering Research Center of Intelligence Pediatrics (SERCIP), Shanghai, China
- Child Health Advocacy Institute, China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Guijun Yang
- Department of Respiratory Medicine, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Na Wang
- Department of Respiratory Medicine, Linyi Maternal and Child Health Care Hospital, Linyi Branch of Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Linyi, Shandong, China
| | - Mei Zeng
- Department of Respiratory Medicine, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hejun Jiang
- Department of Respiratory Medicine, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shuhua Yuan
- Department of Respiratory Medicine, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jinhong Wu
- Department of Respiratory Medicine, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jing Zhang
- Department of Respiratory Medicine, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Juan Cui
- Department of Respiratory Medicine, Linyi Maternal and Child Health Care Hospital, Linyi Branch of Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Linyi, Shandong, China
| | - Guifang Zhou
- Department of Respiratory Medicine, Linyi Maternal and Child Health Care Hospital, Linyi Branch of Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Linyi, Shandong, China
| | - Xin Yang
- Department of Respiratory Medicine, Linyi Maternal and Child Health Care Hospital, Linyi Branch of Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Linyi, Shandong, China
| | - Yunqin Zhang
- Department of Respiratory Medicine, Linyi Maternal and Child Health Care Hospital, Linyi Branch of Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Linyi, Shandong, China
| | - Zhichao Sun
- Department of Respiratory Medicine, Linyi Maternal and Child Health Care Hospital, Linyi Branch of Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Linyi, Shandong, China
| | - Jiajun Yuan
- Pediatric AI Clinical Application and Research Center, Shanghai Children’s Medical Center, Shanghai, China
- Shanghai Engineering Research Center of Intelligence Pediatrics (SERCIP), Shanghai, China
- Medical Department of Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jilei Lin
- Department of Respiratory Medicine, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Pediatric AI Clinical Application and Research Center, Shanghai Children’s Medical Center, Shanghai, China
- Shanghai Engineering Research Center of Intelligence Pediatrics (SERCIP), Shanghai, China
- Child Health Advocacy Institute, China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Jiande Chen
- Department of Respiratory Medicine, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Mingyu Tang
- Department of Respiratory Medicine, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jing Chen
- Department of Respiratory Medicine, Linyi Maternal and Child Health Care Hospital, Linyi Branch of Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Linyi, Shandong, China
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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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Sharma N, Chahal A, Sharma A. Chest Physiotherapy Interventions for Children During SARS-COV-2 Pandemic. Clin Pediatr (Phila) 2024; 63:96-107. [PMID: 37098728 PMCID: PMC10133862 DOI: 10.1177/00099228231169892] [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: 04/27/2023]
Abstract
Since the first case of Severe Acute Respiratory Syndrome Coronavirus-2/Coronavirus Disease 2019 (SARS-COV-2/COVID-19) was discovered in Wuhan, China, it spread to vast limits globally and became a public health disaster, affecting nearly all countries around the globe. Along with mainstream medical treatment, alternative medicine desperately was the need of the hour for youngsters to manage their symptoms while being self-quarantined and ultimately to improve their chances of survival and recovery from COVID-19. Since the beginning of SARS-COV-2, few studies address the clinical-functional presentation of viral infection and management with physiotherapy for children. Major online electronic databases PubMed, PEDro, and Google Scholar were researched to identify, organize and commission the current review. To create a search strategy, Medical Subject Headings and Descriptors of Science and Health were utilized. The authors looked for other studies by screening the references list of the potentially pertinent papers. These computerized searches turned up studies and those studies' bibliographies with pertinent citations were examined. Personal protective equipment was a crucial component for protection and contact precaution. Following hypoxia, effective oxygen therapy is administered right away. When necessary, under the right circumstances, nasal high-flow oxygen therapy, non-invasive ventilation, lung-protective breathing methods, and prone positioning can be used. Children with SARS-CoV-2/COVID-19 may benefit from physiotherapy interventions with a focus on ventilatory management, airway clearance procedures, early activities, and mobilization.
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Affiliation(s)
- Nidhi Sharma
- Department of Neurological Physiotherapy, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana, India
| | - Aksh Chahal
- Department of Physiotherapy, School of Medical and Allied Health Sciences, Galgotias University, Greater Noida 20320, Uttar Pradesh, India
| | - Abhishek Sharma
- Department of Paediatric and Neonatal Physiotherapy, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana 133207, India
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Harashchenko T, Umanets T, Podolskiy V, Kaminska T, Marushko Y, Podolskiy V, Lapshyn V, Antypkin Y. Epidemiological, Clinical, and Laboratory Features of Children with SARS-CoV-2 in Ukraine. JOURNAL OF MOTHER AND CHILD 2023; 27:33-41. [PMID: 37545134 PMCID: PMC10405021 DOI: 10.34763/jmotherandchild.20232701.d-23-00012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 02/09/2023] [Indexed: 08/08/2023]
Abstract
INTRODUCTION In December 2019, the Chinese city of Wuhan reported the first cases of pneumonia from a new type of beta coronavirus named SARS-CoV-2. In the early days of the COVID-19 outbreak, paediatric patients were thought to be immune to the new virus; however, further studies have shown people of all ages to be susceptible to the virus. OBJECTIVE Identify and describe the clinical and epidemiological features of COVID-19 among hospitalized children in Ukraine. MATERIALS AND METHODS Retrospective study of 171 children aged 2 months to 18 years who were hospitalized with laboratory-confirmed SARS-CoV-2. RESULTS Most patients in the study had a moderate progression of the disease (77.78%, or n=133), whereas a severe course was noted in 22.22% (n=38). Across age groups, children aged 6-12 was the predominant age group affected (35.67%, or n=61). The most common symptoms were fever in 88.2% of patients, sore throat in 69.2% and cough in 60.9%. Symptoms associated with dyspnoea and cyanosis were significantly more common in children with the severe course (p<0.05). Almost half of children had at least one comorbidity, the most prevalent being chronic tonsillitis (11.8% of patients) and anemia (6.5% of patients). A positive correlation (r=0.7 p<0.05) was found between CRP levels and COVID-19 severity. X-ray changes in the lungs were present in 76.61% of examined children and ground-glass opacity symptom was registered in 50.88%. CONCLUSIONS COVID-19 among hospitalized children in Ukraine usually has a moderate course of illness and a good prognosis.
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Affiliation(s)
- Tetiana Harashchenko
- Department of Respiratory Diseases and Allergy in Children, SI “Institute of Pediatrics, Obstetrics and Gynecology named after Academician O.M. Lukyanova, National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine
| | - Tetiana Umanets
- Department of Respiratory Diseases and Allergy in Children, SI “Institute of Pediatrics, Obstetrics and Gynecology named after Academician O.M. Lukyanova, National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine
| | - Volodymyr Podolskiy
- Department of Respiratory Diseases and Allergy in Children, SI “Institute of Pediatrics, Obstetrics and Gynecology named after Academician O.M. Lukyanova, National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine
| | - Tetiana Kaminska
- Department of Pediatrics, CNE “Kyiv City Children's Clinical Infectious Disease Hospital”, Kyiv, Ukraine
| | - Yuriy Marushko
- Department of Pediatrics, National Medical University named after O.O. Bogomolets, Kyiv, Ukraine
| | - Vasily Podolskiy
- Department of Respiratory Diseases and Allergy in Children, SI “Institute of Pediatrics, Obstetrics and Gynecology named after Academician O.M. Lukyanova, National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine
| | - Volodymyr Lapshyn
- Department of Respiratory Diseases and Allergy in Children, SI “Institute of Pediatrics, Obstetrics and Gynecology named after Academician O.M. Lukyanova, National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine
| | - Yurii Antypkin
- Department of Respiratory Diseases and Allergy in Children, SI “Institute of Pediatrics, Obstetrics and Gynecology named after Academician O.M. Lukyanova, National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine
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Lopez Marin MA, Zdenkova K, Bartackova J, Cermakova E, Dostalkova A, Demnerova K, Vavruskova L, Novakova Z, Sykora P, Rumlova M, Bartacek J. Monitoring COVID-19 spread in selected Prague's schools based on the presence of SARS-CoV-2 RNA in wastewater. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 871:161935. [PMID: 36731569 PMCID: PMC9886433 DOI: 10.1016/j.scitotenv.2023.161935] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 01/13/2023] [Accepted: 01/27/2023] [Indexed: 06/18/2023]
Abstract
The COVID-19 pandemic has demanded a broad range of techniques to better monitor its extent. Owing to its consistency, non-invasiveness, and cost effectiveness, wastewater-based epidemiology has emerged as a relevant approach to monitor the pandemic's course. In this work, we analyzed the extent of the COVID-19 pandemic in five primary schools in Prague, the Czech Republic, and how different preventive measures impact the presence of SARS-CoV-2 RNA copy numbers in wastewaters. Copy numbers were measured by reverse transcription-multiplex quantitative real-time PCR. These copy numbers were compared to the number of infected individuals in each school identified through regular clinical tests. Each school had a different monitoring regime and subsequent application of preventive measures to thwart the spread of COVID-19. The schools that constantly identified and swiftly quarantined infected individuals exhibited persistently low amounts of SARS-CoV-2 RNA copies in their wastewaters. In one school, a consistent monitoring of infected individuals, coupled with a delayed action to quarantine, allowed for the estimation of a linear model to predict the number of infected individuals based on the presence of SARS-CoV-2 RNA in the wastewater. The results show the importance of case detection and quarantining to stop the spread of the pandemic and its impact on the presence of SARS-CoV-2 RNA in wastewaters. This work also shows that wastewater-based epidemiological models can be reliably used even in small water catchments, but difficulties arise to fit models due to the nonconstant input of viral particles into the wastewater systems.
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Affiliation(s)
- Marco A Lopez Marin
- Department of Water Technology and Environmental Engineering, University of Chemistry and Technology Prague, Czechia
| | - K Zdenkova
- Department of Biochemistry and Microbiology, University of Chemistry and Technology Prague, Czechia.
| | - J Bartackova
- Department of Water Technology and Environmental Engineering, University of Chemistry and Technology Prague, Czechia
| | - E Cermakova
- Department of Biochemistry and Microbiology, University of Chemistry and Technology Prague, Czechia
| | - A Dostalkova
- Department of Biotechnology, University of Chemistry and Technology Prague, Czechia
| | - K Demnerova
- Department of Biochemistry and Microbiology, University of Chemistry and Technology Prague, Czechia
| | | | - Z Novakova
- Prazske vodovody a kanalizace, a.s., Czechia
| | - P Sykora
- Prazske vodovody a kanalizace, a.s., Czechia
| | - M Rumlova
- Department of Biotechnology, University of Chemistry and Technology Prague, Czechia
| | - J Bartacek
- Department of Water Technology and Environmental Engineering, University of Chemistry and Technology Prague, Czechia
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Sulaimanov SA. Allergic diseases in children in the age of the COVID-19 pandemic. ROSSIYSKIY VESTNIK PERINATOLOGII I PEDIATRII (RUSSIAN BULLETIN OF PERINATOLOGY AND PEDIATRICS) 2023. [DOI: 10.21508/1027-4065-2022-67-6-25-32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
COVID-19 coronavirus infection caused by the SARS-CoV-2 virus has become a real disaster for all of humanity. Today, issues related to diagnostics, clinical presentations, treatment of the complications, preventive measures, including vaccination for a new coronavirus infection, are relevant. It is also important to identify risk factors for a severe course of the disease, features of the development of infection against the background of comorbid conditions and different immunological reactivity of the human body. The comorbidity of allergic and infectious diseases is based on the common humoral and cellular mechanisms of the immune response. The trigger for the development of allergic diseases is often the viruses of measles and chickenpox, influenza, parainfluenza, rhinoviruses, enteroviruses, respiratory syncytial viruses, coronaviruses, and others. Most allergic patients are predisposed to acute respiratory viral infections. COVID-19 occurs in 0.39–12.3% of children. Children tend to have milder disease than adults and have low mortality rates. At the same time, one should not forget about the adequate support for patients with chronic diseases, especially children with allergic diseases. Viruses and preventive hygiene measures associated with a pandemic are triggers of an exacerbation of bronchial asthma and atopic dermatitis. Early diagnosis, adequate treatment of allergic diseases in children, and provision of doctors with information are also problematic. It is important to understand which patients with bronchial asthma are at particular risk and how inhaled glucocorticosteroids may influence the course and outcome of COVID-19. International associations and societies have developed guidelines for the management of children with allergies during the COVID-19 pandemic. Inhaled glucocorticosteroids for bronchial asthma reduce the expression of genes of the main target receptors for the SARS-CoV-2 virus. Anti-inflammatory therapy for asthma, primarily inhaled glucocorticosteroids, should be continued until asthma control is achieved, which will help reduce the risk of an unfavorable course of COVID-19.
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8
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Airth A, Whittle JR, Dimou J. How has the COVID-19 pandemic impacted clinical care and research in Neuro-Oncology? J Clin Neurosci 2022; 105:91-102. [PMID: 36122487 PMCID: PMC9452416 DOI: 10.1016/j.jocn.2022.09.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 08/08/2022] [Accepted: 09/03/2022] [Indexed: 12/18/2022]
Abstract
The COVID-19 pandemic has challenged the continued delivery of healthcare globally. Due to disease risk, clinicians were forced to re-evaluate the safety and priorities of pre-pandemic care. Neuro-oncology presents unique challenges, as patients can deteriorate rapidly without intervention. These challenges were also observed in countries with reduced COVID-19 burden with centres required to rapidly develop strategies to maintain efficient and equitable care. This review aims to summarise the impact of the pandemic on clinical care and research within the practice of Neuro-oncology. A narrative review of the literature was performed using MEDLINE and EMBASS and results screened using PRISMA guidelines with relevant inclusion and exclusion criteria. Search strategies included variations of ‘Neuro-oncology’ combined with COVID-19 and other clinical-related terms. Most adult and paediatric neurosurgical centres experienced reductions in new referrals and operations for brain malignancies, and those who did present for treatment frequently had operations cancelled or delayed. Many radiation therapy and medical oncology centres altered treatment plans to mitigate COVID-19 risk for patients and staff. New protocols were developed that aimed to reduce in-person visits and reduce the risk of developing severe complications from COVID-19. The COVID-19 pandemic has presented many challenges to the provision of safe and accessible healthcare. Despite these challenges, some benefits to healthcare provision such as the use of telemedicine are likely to remain in future practice. Neuro-oncology staff must remain vigilant to ensure patient and staff safety.
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Affiliation(s)
- Angus Airth
- Melbourne Medical School, The University of Melbourne, Parkville, Victoria, Australia
| | - James R Whittle
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Personalised Oncology Division, Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia; Department of Medical Biology, University of Melbourne, Parkville, Victoria, Australia
| | - James Dimou
- Department of Neurosurgery, Royal Melbourne Hospital, Parkville, Victoria, Australia.
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9
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Alassaf A, Ellithy K, Mehta T, Aljbawi W, Ali H, Soliman A, Al Amri M, Nashwan AJ. Severe pulmonary hemorrhage in a 3-week-old neonate with COVID-19 infection: A case report. Clin Case Rep 2022; 10:e6189. [PMID: 35957799 PMCID: PMC9360337 DOI: 10.1002/ccr3.6189] [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: 05/22/2022] [Revised: 07/18/2022] [Accepted: 07/21/2022] [Indexed: 11/12/2022] Open
Abstract
Our patient is a 3-week-old female neonate, presented with complaints of low-grade fever and a congested nose for one day. Eventually, she developed progressive desaturation, hypotension, and poor perfusion due to severe pulmonary hemorrhage. Then, she developed cardiac arrest and was declared dead.
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Affiliation(s)
- Anood Alassaf
- Pediatrics DepartmentSidra MedicineDohaQatar
- Pediatrics DepartmentHamad Medical CorporationDohaQatar
| | - Khaled Ellithy
- Pediatric Intensive Care UnitHamad Medical CorporationDohaQatar
| | - Tejas Mehta
- Pediatric Intensive Care UnitHamad Medical CorporationDohaQatar
| | - Walid Aljbawi
- Pediatric Intensive Care UnitHamad Medical CorporationDohaQatar
| | | | - Ashraf Soliman
- Pediatric Endocrinology DepartmentHamad Medical CorporationDohaQatar
| | - Mohammed Al Amri
- Pediatric Emergency DepartmentHamad Medical CorporationDohaQatar
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10
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Cloete J, Kruger A, Masha M, du Plessis NM, Mawela D, Tshukudu M, Manyane T, Komane L, Venter M, Jassat W, Goga A, Feucht U. Paediatric hospitalisations due to COVID-19 during the first SARS-CoV-2 omicron (B.1.1.529) variant wave in South Africa: a multicentre observational study. THE LANCET. CHILD & ADOLESCENT HEALTH 2022; 6:294-302. [PMID: 35189083 PMCID: PMC8856663 DOI: 10.1016/s2352-4642(22)00027-x] [Citation(s) in RCA: 118] [Impact Index Per Article: 59.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/17/2022] [Accepted: 01/19/2022] [Indexed: 12/13/2022]
Abstract
Background South Africa reported a notable increase in COVID-19 cases from mid-November, 2021, onwards, starting in Tshwane District, which coincided with the rapid community spread of the SARS-CoV-2 omicron (B.1.1.529) variant. This increased infection rate coincided with a rapid increase in paediatric COVID-19-associated admissions to hospital (hereafter referred to as hospitalisations). Methods The Tshwane Maternal-Child COVID-19 study is a multicentre observational study in which we investigated the clinical manifestations and outcomes of paediatric patients (aged ≤19 years) who had tested positive for SARS-CoV-2 and were admitted to hospital for any reason in Tshwane District during a 6-week period at the beginning of the fourth wave of the COVID-19 epidemic in South Africa. We used five data sources, which were: (1) COVID-19 line lists; (2) collated SARS-CoV-2 testing data; (3) SARS-CoV-2 genomic sequencing data; (4) COVID-19 hospitalisation surveillance; and (5) clinical data of public sector COVID-19-associated hospitalisations among children aged 13 years and younger. Findings Between Oct 31 and Dec 11, 2021, 6287 children and adolescents in Tshwane District were recorded as having COVID-19. During this period, 2550 people with COVID-19 were hospitalised, of whom 462 (18%) were aged 19 years or younger. The number of paediatric cases was higher than in the three previous SARS-CoV-2 waves, uncharacteristically increasing ahead of adult hospitalisations. 75 viral samples from adults and children in the district were sequenced, of which 74 (99%) were of the omicron variant. Detailed clinical notes were available for 138 (75%) of 183 children aged ≤13 years with COVID-19 who were hospitalised. 87 (63%) of 138 children were aged 0–4 years. In 61 (44%) of 138 cases COVID-19 was the primary diagnosis, among whom symptoms included fever (37 [61%] of 61), cough (35 [57%]), shortness of breath (19 [31%]), seizures (19 [31%]), vomiting (16 [26%]), and diarrhoea (15 [25%]). Median length of hospital stay was 2 days [IQR 1–3]). 122 (88%) of 138 children with available data needed standard ward care and 27 (20%) needed oxygen therapy. Seven (5%) of 138 children were ventilated and four (3%) died during the study period, all related to complex underlying copathologies. All children and 77 (92%) of 84 parents or guardians with available data were unvaccinated to COVID-19. Interpretation Rapid increases in paediatric COVID-19 cases and hospitalisations mirror high community transmission of the SARS-CoV-2 omicron variant in Tshwane District, South Africa. Continued monitoring is needed to understand the long-term effect of the omicron variant on children and adolescents. Funding South African Medical Research Council, South African Department of Science & Innovation, G7 Global Health Fund.
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Affiliation(s)
- Jeané Cloete
- Department of Paediatrics and Child Health, University of Pretoria, Pretoria, South Africa; Centre for Maternal, Fetal, Newborn and Child Health Care Strategies, University of Pretoria, Pretoria, South Africa; Maternal and Infant Health Care Strategies Research Unit, South African Medical Research Council, Pretoria, South Africa.
| | - Annelet Kruger
- Centre for Maternal, Fetal, Newborn and Child Health Care Strategies, University of Pretoria, Pretoria, South Africa; Department of Family Medicine, University of Pretoria, Pretoria, South Africa; Maternal and Infant Health Care Strategies Research Unit, South African Medical Research Council, Pretoria, South Africa; Tshwane District Health Services, Gauteng Department of Health, Pretoria, South Africa
| | - Maureen Masha
- National Institute of Communicable Diseases, Johannesburg, South Africa; Right to Care, Johannesburg, South Africa
| | - Nicolette M du Plessis
- Department of Paediatrics and Child Health, University of Pretoria, Pretoria, South Africa; Centre for Maternal, Fetal, Newborn and Child Health Care Strategies, University of Pretoria, Pretoria, South Africa; Maternal and Infant Health Care Strategies Research Unit, South African Medical Research Council, Pretoria, South Africa
| | - Dini Mawela
- Department of Paediatrics, Sefako Makgatho Health Sciences University, Dr George Mukhari Academic Hospital, Pretoria, South Africa
| | - Mphailele Tshukudu
- Tshwane District Health Services, Gauteng Department of Health, Pretoria, South Africa
| | - Tabea Manyane
- Tshwane District Health Services, Gauteng Department of Health, Pretoria, South Africa
| | - Lekwetji Komane
- Tshwane District Health Services, Gauteng Department of Health, Pretoria, South Africa
| | - Marietjie Venter
- Department of Medical Virology, University of Pretoria, Pretoria, South Africa
| | - Waasila Jassat
- National Institute of Communicable Diseases, Johannesburg, South Africa
| | - Ameena Goga
- Department of Paediatrics and Child Health, University of Pretoria, Pretoria, South Africa; HIV Prevention Research Unit, South African Medical Research Council, Pretoria, South Africa
| | - Ute Feucht
- Department of Paediatrics and Child Health, University of Pretoria, Pretoria, South Africa; Centre for Maternal, Fetal, Newborn and Child Health Care Strategies, University of Pretoria, Pretoria, South Africa; Maternal and Infant Health Care Strategies Research Unit, South African Medical Research Council, Pretoria, South Africa; Tshwane District Health Services, Gauteng Department of Health, Pretoria, South Africa
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Castellar-López J, Villamizar-Villamizar W, Amaranto-Pallares A, Rosales-Rada W, De Los Angeles Vélez Verbel M, Chang A, Jiménez FT, Mendoza-Torres E. Recent Insights into COVID-19 in Children and Clinical Recommendations. Curr Pediatr Rev 2022; 18:121-137. [PMID: 34872479 DOI: 10.2174/1573396317666211206124347] [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: 04/02/2021] [Revised: 06/30/2021] [Accepted: 09/01/2021] [Indexed: 01/08/2023]
Abstract
Pediatric coronavirus disease 2019 (COVID-19) and multisystem inflammatory syndrome in children (MIS-C) have been recognized in multiple countries globally. In this review, we provide recent insights into SARS-CoV-2 infection in children from epidemiological, clinical, and laboratory perspectives, including reports on the disease course and therapy. We highlight key features of SARS-CoV-2 infection in children, the relationship between MIS-C and Kawasaki disease, and summarize treatment guidelines for COVID-19 in children from institutional protocols from Colombia, case reports, recommendations based on expert consensus, and official statements from organizations such as the World Health Organization (WHO), United States Center for Disease Control (CDC), Colombian Association of Infectious Diseases, and the Colombian Society of Pediatrics. Finally, we discuss gaps in research with suggestions for future research on the pathogenesis underlying pediatric COVID-19.
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Affiliation(s)
- Jairo Castellar-López
- Faculty of Exact and Natural Sciences, Grupo de Investigación Avanzada en Biomedicina, Universidad Libre Barranquilla, Barranquilla, Colombia
| | | | - Aldo Amaranto-Pallares
- Faculty of Health Sciences, Universidad Libre Seccional Barranquilla, Barranquilla, Colombia
| | - Wendy Rosales-Rada
- Faculty of Exact and Natural Sciences, Grupo de Investigación Avanzada en Biomedicina, Universidad Libre Barranquilla, Barranquilla, Colombia.,Department of Medicine, Grupo de Investigación en Biotecnología. Division of Health Sciences. Universidad del Norte, Colombia
| | | | - Aileen Chang
- Department of Medicine, George Washington University, Washington D.C., USA
| | - Franklin Torres Jiménez
- Faculty of Health Sciences, Universidad Libre Seccional Barranquilla, Barranquilla, Colombia
| | - Evelyn Mendoza-Torres
- Faculty of Health Sciences, Universidad Libre Seccional Barranquilla, Barranquilla, Colombia
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12
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Shah K, Upadhyaya M, Kandre Y, Pandya A, Saraf V, Saxena D, Mavalankar D. Epidemiological, clinical and biomarker profile of pediatric patients infected with COVID-19. QJM 2021; 114:476-495. [PMID: 34293142 PMCID: PMC8420635 DOI: 10.1093/qjmed/hcab206] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/25/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Given the limited and diverse nature of published literature related to COVID-19 in pediatrics, it is imperative to provide evidence-based summary of disease characteristics for guiding policy decisions. We aim to provide comprehensive overview of epidemiological, clinical and biomarker profile of COVID-19 infection in pediatric population. METHODS For this umbrella review, published systematic reviews from PubMed and pre-print databases were screened. Literature search was conducted from December 2019 to April 2021. Details of clinical, radiological and laboratory features were collected from each review. Qualitative observations were synthesized and pooled prevalence of mortality and asymptomatic cases were assessed using meta-analysis. RESULTS Evidence synthesis of 38 systematic reviews included total 1145 studies and 334 398 children and adolescents. Review revealed that COVID-19 is relatively milder with better prognosis in pediatrics. However, patients with comorbidity are at higher risk. Meta-analysis of reviews showed that 21.17% (95% CI: 17.818-24.729) of the patients were asymptomatic and mortality rate was 0.12% (95% CI: 0.0356-0.246). Though there was no publication bias, significant heterogeneity was observed. Fever (48-64%) and cough (35-55.9%) were common symptoms, affecting almost every alternate patient. Ground-glass opacities (prevalence range: 27.4-61.5%) was most frequent radiographic observation. Rise in C-reactive protein, lactate dehydrogenase and D-dimer ranged from 14% to 54%, 12.2-50% and 0.3-67%, respectively. Some of the included reviews (44.7%-AMSTAR; 13.2%-GRADE) were of lower quality. CONCLUSION Current umbrella review provides most updated information regarding characteristics of COVID-19 infection in pediatrics and can be used to guide policy decision regarding vaccination prioritization, early screening and identification of at-risk population.
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Affiliation(s)
- Komal Shah
- Assistant Professor, Indian Institute of Public Health Gandhinagar - 382042, Gujarat, India
- Dr. Komal Shah (*Corresponding Author) Assistant Professor, Indian Institute of Public Health – Gandhinagar, Opp. Air Force Head Quarters, Nr. Lekawada Bus Stop, Gandhinagar-Chiloda Road, Gandhinagar – 382042, Mob: 9924264500,
| | - Mudita Upadhyaya
- Independent Researcher, 9138 Harbor Hills Drive, Houston Texas, 77054, USA
| | - Yogini Kandre
- Programe Associate, Indian Institute of Public Health Gandhinagar - 382042, Gujarat, India
| | - Apurvakumar Pandya
- Economic Evaluation Specialist, Indian Institute of Public Health Gandhinagar-382042, Gujarat, India
| | - Vishakh Saraf
- MPH Student, Indian Institute of Public Health Gandhinagar-382042, Gujarat, India
| | - Deepak Saxena
- Professor, Indian Institute of Public Health Gandhinagar-382042, Gujarat, India
| | - Dileep Mavalankar
- Director, Indian Institute of Public Health Gandhinagar - 382042, Gujarat, India
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13
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Pinilla YT, Friessinger E, Griesbaum JM, Berner L, Heinzel C, Elsner K, Fendel R, Held J, Kreidenweiss A. Prevalence of SARS-CoV-2 Infection in Children by Antibody Detection in Saliva: Protocol for a Prospective Longitudinal Study (Coro-Buddy). JMIR Res Protoc 2021; 10:e27739. [PMID: 34533472 PMCID: PMC8510152 DOI: 10.2196/27739] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 07/22/2021] [Accepted: 08/10/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The world has been confronted with the COVID-19 pandemic for more than one year. Severe disease is more often found among elderly people, whereas most young children and adolescents show mild symptoms or even remain asymptomatic, so that infection might be undiagnosed. Therefore, only limited epidemiological data on SARS-CoV-2 infection in children and young adults are available. OBJECTIVE This study aims to determine the prevalence of SARS-CoV-2 antibodies in children from the city of Tübingen, Germany, and to measure the incidence of new cases over 12 months. METHODS SARS-CoV-2 antibodies will be measured in saliva as a surrogate for a previous SARS-CoV-2 infection. Children will be sampled at their preschools, primary schools, and secondary schools at three time points: July 2020, October to December 2020, and April to July 2021. An adult cohort will be sampled at the same time points (ie, adult comparator group). The saliva-based SARS-CoV-2-antibody enzyme-linked immunosorbent assay will be validated using blood and saliva samples from adults with confirmed previous SARS-CoV-2 infections (ie, adult validation group). RESULTS The first study participant was enrolled in July 2020, and recruitment and enrollment continued until July 2021. We have recruited and enrolled 1850 children, 560 adults for the comparator group, and 83 adults for the validation group. We have collected samples from the children and the adults for the comparator group at the three time points. We followed up with participants in the adult validation group every 2 months and, as of the writing of this paper, we were at time point 7. We will conduct data analysis after the data collection period. CONCLUSIONS Infection rates in children are commonly underreported due to a lack of polymerase chain reaction testing. This study will report on the prevalence of SARS-CoV-2 infections in infants, school children, and adolescents as well as the incidence change over 12 months in the city of Tübingen, Germany. The saliva sampling approach for SARS-CoV-2-antibody measurement allows for a unique, representative, population-based sample collection process. TRIAL REGISTRATION ClinicalTrials.gov NCT04581889; https://clinicaltrials.gov/ct2/show/NCT04581889. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/27739.
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Affiliation(s)
- Yudi T Pinilla
- Institut für Tropenmedizin, Universitätsklinikum Tübingen, Tübingen, Germany
| | - Evelyn Friessinger
- Institut für Tropenmedizin, Universitätsklinikum Tübingen, Tübingen, Germany
| | | | - Lilith Berner
- Institut für Tropenmedizin, Universitätsklinikum Tübingen, Tübingen, Germany
| | - Constanze Heinzel
- Institut für Tropenmedizin, Universitätsklinikum Tübingen, Tübingen, Germany
| | - Käthe Elsner
- Institut für Tropenmedizin, Universitätsklinikum Tübingen, Tübingen, Germany
| | - Rolf Fendel
- Institut für Tropenmedizin, Universitätsklinikum Tübingen, Tübingen, Germany
| | - Jana Held
- Institut für Tropenmedizin, Universitätsklinikum Tübingen, Tübingen, Germany
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- German Center for Infection Research, partner site Tübingen, Tübingen, Germany
| | - Andrea Kreidenweiss
- Institut für Tropenmedizin, Universitätsklinikum Tübingen, Tübingen, Germany
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- German Center for Infection Research, partner site Tübingen, Tübingen, Germany
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Severe Acute Respiratory Syndrome Coronavirus 2 Vaccination for Paediatric Patients With Inflammatory Bowel Diseases. J Pediatr Gastroenterol Nutr 2021; 73:433-436. [PMID: 34347673 DOI: 10.1097/mpg.0000000000003260] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
In this communication, the members of the Porto group (the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN], inflammatory bowel diseases [IBD] working group) provide the current available evidence regarding vaccination of children and young adolescents with IBD against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Our intent is to help provide meaningful answers to the concerns that parents and adolescents may have.
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McDonald L, Wise H, Muecksch F, Poston D, Mavin S, Templeton K, Furrie E, Richardson C, McGuire J, Jarvis L, Malloy K, McAuley A, Palmateer N, Dickson E, Hatziioannou T, Bieniasz P, Jenks S. Comparison of SARS-CoV-2 serological assays for use in epidemiological surveillance in Scotland. JOURNAL OF CLINICAL VIROLOGY PLUS 2021; 1:100028. [PMID: 35262014 PMCID: PMC8200328 DOI: 10.1016/j.jcvp.2021.100028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 06/11/2021] [Accepted: 06/12/2021] [Indexed: 11/18/2022] Open
Abstract
Background Sero-surveillance of SARS-CoV-2 is crucial to monitoring levels of population exposure and informing public health responses, but may be influenced by variability in performance between available assays. Methods Five commercial immunoassays and a neutralising activity assay were used to detect antibodies to SARS-CoV-2 in routine primary care and paediatric samples collected during the first wave of the pandemic in NHS Lothian, Scotland as part of ongoing surveillance efforts. For each assay, sensitivity and specificity was calculated relative to consensus results (majority of immunoassays positive = overall positive) and neutralising activity. Quantitative correlation was performed between serological and neutralising titres. Results Seroprevalence ranged from 3.4-7.3 % in primary care patients and 3-5.9 % in paediatric patients according to different immunoassays. Neutralising activity was detectable in 2.8 % and 1.3 % respectively. Relative assay performance changed depending on comparison to immunoassay consensus versus neutralising activity and qualititative versus quantitative agreement. Cross-reactivity with endemic seasonal coronaviruses was confirmed by neutralising assay in false positives for one immunoassay. Presence of false positives for another assay was found specifically in paediatric but not adult samples. Conclusions Five serological assays show variable accuracy when applied to the general population, impacting seroprevalence estimates. Assay performance may also vary in detection of protective neutralising antibody levels. These aspects should be considered in assay selection and interpretation in epidemiological studies.
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Affiliation(s)
| | - Helen Wise
- Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, Scotland
| | - Frauke Muecksch
- Laboratory of Retrovirology, The Rockefeller University, New York, New York, USA
| | - Daniel Poston
- Laboratory of Retrovirology, The Rockefeller University, New York, New York, USA
| | - Sally Mavin
- Scottish Microbiology Reference Laboratory, NHS Highland, Inverness, Scotland
| | - Kate Templeton
- Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, Scotland
| | - Elizabeth Furrie
- Ninewells Hospital and Medical School, NHS Tayside, Dundee, Scotland
| | | | | | - Lisa Jarvis
- Scottish National Blood Transfusion Service, The Jack Copland Centre, Edinburgh, Scotland
| | - Kristen Malloy
- Scottish National Blood Transfusion Service, The Jack Copland Centre, Edinburgh, Scotland
| | - Andrew McAuley
- Public Health Scotland, Glasgow, Scotland
- School of Health & Life Sciences, Glasgow Caledonian University, Glasgow, Scotland
| | - Norah Palmateer
- Public Health Scotland, Glasgow, Scotland
- School of Health & Life Sciences, Glasgow Caledonian University, Glasgow, Scotland
| | | | | | - Paul Bieniasz
- Laboratory of Retrovirology, The Rockefeller University, New York, New York, USA
- Howard Hughes Medical Institute, The Rockefeller University, New York, New York, USA
| | - Sara Jenks
- Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, Scotland
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16
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COVID-19: potential therapeutics for pediatric patients. Pharmacol Rep 2021; 73:1520-1538. [PMID: 34458951 PMCID: PMC8403523 DOI: 10.1007/s43440-021-00316-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 07/06/2021] [Accepted: 07/26/2021] [Indexed: 02/06/2023]
Abstract
The global spread of COVID-19 has imparted significant economic, medical, and social burdens. Like adults, children are affected by this pandemic. However, milder clinical symptoms are often experienced by them. Only a minimal proportion of the affected patients may develop severe and complicated COVID-19. Supportive treatment is recommended in all patients. Antiviral and immunomodulatory medications are spared for hospitalized children with respiratory distress or severe to critical disease. Up till now, remdesivir is the only USFDA-approved anti-COVID-19 medication indicated in the majority of symptomatic patients with moderate to severe disease. Dexamethasone is solely recommended in patients with respiratory distress maintained on oxygen or ventilatory support. The use of these medications in pediatric patients is founded on evidence deriving from adult studies. No randomized controlled trials (RCTs) involving pediatric COVID-19 patients have assessed these medications' efficacy and safety, among others. Similarly, three novel monoclonal anti-SARS-CoV-2 spike protein antibodies, bamlanivimab, casirivimab and imdevimab, have been recently authorized by the USFDA. Nonetheless, their efficacy has not been demonstrated by multiple RCTs. In this review, we aim to dissect the various potential therapeutics used in children with COVID-19. We aspire to provide a comprehensive review of the available evidence and display the mechanisms of action and the pharmacokinetic properties of the studied therapeutics. Our review offers an efficient and practical guide for treating children with COVID-19.
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Shahid S, Raza M, Junejo S, Maqsood S. Clinical features and outcome of COVID-19 positive children from a tertiary healthcare hospital in Karachi. J Med Virol 2021; 93:5988-5997. [PMID: 34228363 PMCID: PMC8427002 DOI: 10.1002/jmv.27178] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 06/22/2021] [Accepted: 07/01/2021] [Indexed: 12/28/2022]
Abstract
As the coronavirus disease 2019 (COVID‐19) pandemic continues to evolve, differences in epidemiological and clinical features among pediatrics have been noticed across different countries. We describe the spectrum of COVID‐19 in pediatric patients treated in tertiary health care. We conducted a retrospective chart review of pediatric patients admitted to Indus Hospital & Health care network, Korangi campus, Karachi; from April 1st, 2020 to July 31st, 2020. A total of 141 COVID‐19 cases were reported, males were 81 (57%) and the median age was 8 (0.3–17) years. Moderate and severe infections were noted in 36(26%), and 17(12%) children respectively. Fever (50%) was the most common clinical feature. The SF ratio less than 264 was significantly associated with severe disease (p < .05). Lab investigations that differed significantly across disease severity groups included IL‐6 levels (p < .01) and Prothrombin time (p < .05). Majority of children were advised home isolation 89 (63%), 29 (20.5%) were admitted while mortality was observed in 10 (7%) children. No significant difference was observed between children with and without malignancy. Pre‐existing comorbidities are significantly associated with COVID‐19 infections among children. Reduced SF ratio, elevated Prothrombin time, and interleukin‐6 levels are associated with greater disease severity.
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Affiliation(s)
- Saba Shahid
- Department of Pediatrics, The Indus Hospital & Health network, Karachi, Pakistan
| | - Mohammad Raza
- Department of Pediatrics, The Indus Hospital & Health network, Karachi, Pakistan
| | - Samina Junejo
- Department of Pediatrics, The Indus Hospital & Health network, Karachi, Pakistan
| | - Sidra Maqsood
- Indus hospital Research Centre, Indus Hospital and Health network, Karachi, Pakistan
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Venugopal A, Kumar S, Sinha S. Evaluation of knowledge, attitude and practice of guidelines towards the novel covid 19 among eye care professionals of a government medical college in north India. INDIAN JOURNAL OF CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY 2021; 7:314-320. [DOI: 10.18231/j.ijceo.2021.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/21/2024]
Abstract
The novel COVID-19 pandemic, caused by the SARS CoV- 2 virus, has led to widespread public health concerns across the globe. Ophthalmology professionals may be susceptible to infection due to close patient proximity during slit lamp examination and the potential contamination of instruments. The knowledge, attitude, practice (KAP)study can provide an insight of ECPs’(eye care practitioners) knowledge, methods of practice and attitude during this pandemic. This helps to reduce their risk, and that of their family, of contracting the virus, reduce morbidity and mortality associated with being infected.Data and results obtained from this study can also be used to make emergency policies and implement them to stop the spread and impact of a similar outbreak in future.A cross-sectional study was conducted to evaluate the knowledge, attitude and practice of guidelines amongst the Eye care professionals towards the novel Covid-19. The demographic characteristics and infection rate of Covid-19 among the professionals during practice was also recorded and analyzed.In this hospital based cross-sectional study, total 67 eye care professionals including nurses, optometrist participated in the study with their due consent. Among total 67 participants, 60 (89.5%) were doctors, 4 (5.97%) were nurses and 3 (4.477) were optometrists All the participants including doctors, nurses and optometrists achieved a mean of 97.8% in the knowledge section of questionnaire.100% of the participants wear mask and maintain social distancing while all of them have received training regarding practice and management of patients during Covid19 and all the participants have a positive attitude towards the measure taken to combat Covid-19 pandemic.The eye care professionals participated in this study shows a good knowledge, positive attitude and practice of guidelines by the government of India are followed for the pandemic of Covid-19.
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Farooq A, Alam F, Saeed A, Butt F, Khaliq MA, Malik A, Chaudhry M, Abdullah M. Multisystem Inflammatory Syndrome in Children and Adolescents (MIS-C) under the Setting of COVID-19: A Review of Clinical Presentation, Workup and Management. Infect Dis (Lond) 2021; 14:11786337211026642. [PMID: 34220204 PMCID: PMC8221672 DOI: 10.1177/11786337211026642] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 05/30/2021] [Indexed: 12/29/2022] Open
Abstract
Earlier in its course, SARS-CoV-2 was primarily identified to cause an acute respiratory illness in adults, the elderly and immunocompromised, while children were known to be afflicted with milder symptoms. However, since mid-April of 2020, latent effects of the virus have begun emerging in children and adolescents, which is characterised by a multisystem hyperinflammatory state; thus, the term Multisystem Inflammatory Syndrome in Children (MIS-C) was introduced by the WHO and CDC. The syndrome manifests itself approximately 4 weeks after COVID-19 infection, with symptoms mimicking Kawasaki Disease and Kawasaki Disease Shock Syndrome. Demographically, MIS-C peaks in children aged 5 to 14 years, with clusters in Europe, North and Latin America seen, later followed by Asia. Although the exact pathophysiology behind the syndrome is unknown, recent studies have proposed a post-infectious immune aetiology, which explains the increased levels of immunoglobulins seen in affected patients. Patient presentation includes, but is not limited to, persistent fever, rash, gastrointestinal symptoms and cardiac complications including myocarditis. These patients also have raised inflammatory markers including C reactive protein, ferritin and interleukin-6. In poorly controlled patients, the syndrome can lead to multiorgan failure and death. The mainstay of treatment includes the use of intravenous immunoglobulins, steroids, immune modulators and aspirin. Adjunct therapy includes the use of low molecular weight heparin or warfarin for long term anticoagulation. Currently very little is known about the syndrome, highlighting the need for awareness amongst healthcare workers and parents. Moreover, with increased cases of COVID-19 as a result of the second wave, it is essential to keep MIS-C in mind when attending patients with a past history of COVID-19 exposure or infection. Additionally, once these patients have been identified and treated, strict follow-up must be done in order carry out long term studies, and to identify possible sequelae and complications.
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Affiliation(s)
- Ayesha Farooq
- CMH Lahore Medical College and Institute of Dentistry, Lahore, PK-PB, Punjab, Pakistan
| | - Fatima Alam
- CMH Lahore Medical College and Institute of Dentistry, Lahore, PK-PB, Punjab, Pakistan
| | - Asma Saeed
- CMH Lahore Medical College and Institute of Dentistry, Lahore, PK-PB, Punjab, Pakistan
| | - Farooq Butt
- Sialkot Medical College Pvt Ltd, Sialkot, PK-PB Punjab, Pakistan
| | - Muhammad Azeem Khaliq
- CMH Lahore Medical College and Institute of Dentistry, Lahore, PK-PB, Punjab, Pakistan
| | - Ayesha Malik
- Hameed Latif Hospital, Lahore, Lahore, PK-PB Punjab, Pakistan
| | | | - Mohammad Abdullah
- CMH Lahore Medical College and Institute of Dentistry, Lahore, PK-PB, Punjab, Pakistan
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Immune Response to SARS-CoV-2 in an Asymptomatic Pediatric Allergic Cohort. Antibodies (Basel) 2021; 10:antib10020022. [PMID: 34199430 PMCID: PMC8293035 DOI: 10.3390/antib10020022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 04/29/2021] [Accepted: 05/29/2021] [Indexed: 11/17/2022] Open
Abstract
Disease-specific COVID-19 pediatric comorbidity has not been studied effectively to date. Atopy and food anaphylaxis disease states require improved characterization of SARS-CoV-2 infection risk. To provide the first such characterization, we assessed serum samples of a highly atopic, food anaphylactic, asymptomatic pediatric cohort from across the US during the height of the pandemic. From our biobank, 172 pediatric patient serum samples were characterized specific to atopic, food anaphylactic, and immunologic markers in the US at the beginning of the pandemic, from 1 February to 20 April 2020. Clinical and demographic data were further analyzed in addition to sample analysis for SARS-CoV-2 IgM and IgG ELISA. SARS-CoV-2 antibody results were positive in six patients (4%). Nearly half of the pediatric patients had a history of asthma (49%). Total IgE, total IgG, and IgG1-3 were similar in those positive and negative to SARS-CoV-2. Median total IgG4 in the SARS-CoV-2 positive group was nearly three times (p-value = 0.02) that of the negative group. Atopy controller medications did not confer additional benefit. Our data suggest that food anaphylaxis and highly atopic children are not at increased risk for SARS-CoV-2 seropositivity. This specific population appears either at equal or potentially less risk than the general population. Total and specific IgG4 may be a novel predictor of SARS-CoV-2 infection risk specific to the allergic pediatric population.
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Clinical characteristics and evolution of pediatric patients with acute leukemia and SARS-COV2 virus infection in a third level hospital in Mexico. PEDIATRIC HEMATOLOGY ONCOLOGY JOURNAL 2021. [PMCID: PMC7686788 DOI: 10.1016/j.phoj.2020.11.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Introduction Reports have revealed that people susceptible to severe forms of COVID-19 are older adults with comorbidities; However, the pediatric population has also been affected, considering children with underlying conditions such as onco-hematological conditions to be high risk. We present a cases series in a third level hospital. Material and methods We conducted a retrospective study in children under the age of 16 years with a diagnosis of acute leukemia and infection with the SARS-CoV2 virus. Descriptive statistics with means and percentages were used. To show differences between the groups, Chi-square test, Student t test and Mann-Whitney U test were used depending on the type of variable and its distribution. Results SARS-CoV2 virus infection was confirmed in 15 children diagnosed with acute leukemia, at different stages of treatment. The mean age was 7.5 years, 8 male and 7 female, 11 of them diagnosed with acute B-cell lymphoblastic leukemia, one with acute T-cell lymphoblastic leukemia and 3 with acute myeloid leukemia. The mean days of hospital stay at the diagnosis of COVID-19 was 22. Thirteen of the children had fever and neutropenia. 7 patients died. There was a statistically significant correlation with the outcome in patients who presented a prolongation of aPTT, an increase in D-dimer, an increase in liver enzymes and severe respiratory distress with the need for mechanical ventilation. Conclusion The risk of death in children with leukemia and COVID-19 was associated with prolonged aPTT, increased D-dimer, increased liver enzymes, respiratory distress, and the need for mechanical ventilation.
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Pousa PA, Mendonça TSC, Oliveira EA, Simões-E-Silva AC. Extrapulmonary manifestations of COVID-19 in children: a comprehensive review and pathophysiological considerations. J Pediatr (Rio J) 2021; 97:116-139. [PMID: 32980319 PMCID: PMC7508521 DOI: 10.1016/j.jped.2020.08.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 08/25/2020] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE The aim of this review was to summarize the most common extrapulmonary manifestations in pediatric patients with COVID-19, as well as to discuss clinical, epidemiological, and pathophysiological aspects of these clinical presentations in children. SOURCE OF DATA An extensive search of literature was performed in order to identify pediatric cases with extrapulmonary manifestations between January 1, 2020 and June 21, 2020. Generic keywords, such as "Novel coronavirus" or "Novel coronavirus 2019" or "2019 nCoV" or "COVID-19" or "SARS-CoV-2" were searched on PubMed database, associated either with age filters or generic pediatric terms. SUMMARY OF FINDINGS A total of 28 articles, including 199 patients, were considered suitable to review and data extraction. The main findings were summarized in tables. The main non-pulmonary manifestations in pediatric patients, in decreasing order of frequency, were gastrointestinal, renal, cardiovascular, neurological, hematological and lymphatic, cutaneous, hepatic, ocular, olfactory, and gustatory. Multisystem impairment and Kawasaki-like disease were also described. CONCLUSIONS Differences in immune response of children and variations of tissue expression of angiotensin converting enzyme 2, the virus receptor, are likely to influence clinical, epidemiological, and pathophysiological patterns of the disease.
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Affiliation(s)
- Pedro A Pousa
- Universidade Federal de Minas Gerais (UFMG), Faculdade de Medicina, Laboratório Interdisciplinar de Pesquisa Médica, Belo Horizonte, MG, Brazil
| | - Tamires S C Mendonça
- Universidade Federal de Minas Gerais (UFMG), Faculdade de Medicina, Laboratório Interdisciplinar de Pesquisa Médica, Belo Horizonte, MG, Brazil
| | - Eduardo A Oliveira
- Universidade Federal de Minas Gerais (UFMG), Faculdade de Medicina, Departamento de Pediatria, Unidade de Nefrologia Pediátrica, Belo Horizonte, MG, Brazil
| | - Ana Cristina Simões-E-Silva
- Universidade Federal de Minas Gerais (UFMG), Faculdade de Medicina, Laboratório Interdisciplinar de Pesquisa Médica, Belo Horizonte, MG, Brazil; Universidade Federal de Minas Gerais (UFMG), Faculdade de Medicina, Departamento de Pediatria, Unidade de Nefrologia Pediátrica, Belo Horizonte, MG, Brazil.
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Beytout Q, Pepiot J, Maruani A, Devulder D, Aubert R, Beylot-Barry M, Amici JM, Jullien D, Mahé E. Impact of the COVID-19 pandemic on children with psoriasis. Ann Dermatol Venereol 2021; 148:106-111. [PMID: 33637347 PMCID: PMC7901834 DOI: 10.1016/j.annder.2021.01.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 12/04/2020] [Accepted: 01/18/2021] [Indexed: 12/19/2022]
Abstract
Background Children with psoriasis may have been directly impacted by the COVID-19 pandemic and their illness may also have affected their ability to follow preventive measures. Objective To investigate the impact of the COVID-19 pandemic on children with psoriasis. Methods A survey of children (< 18 years) with psoriasis, conducted from June 10 to June 29, 2020. Results In total, 92 children were included: 71.7% had psoriasis lesions at the time of home lockdown while 45.2% were receiving systemic treatments, and two contracted COVID-19. During lockdown, psoriasis worsened in 47.3% of the children and 18.8% stopped their systemic treatments, mainly for reasons linked to the pandemic. A total of 41.3% had a consultation for psoriasis during lockdown (71.1% by teleconsultation): 39.5% due to worsening of their psoriasis and 21.1% for pandemic-related issues. Among patients not having a consultation during lockdown, 27.5% had a cancellation by the doctor and 9.3% had concerns over going to see the doctor. Finally, 22.8% of patients reported finding it difficult to respect hygiene measures because of their psoriasis, e.g., application of alcohol-based hand sanitizers (47.6%), handwashing routines (42.9%), and wearing a mask (28.6%). Conclusions This study demonstrates the major clinical impact of the COVID-19 pandemic on children with psoriasis. Teleconsultations played a key role in patient management as regards patient monitoring, provision of information, and renewal of treatments. It is vital that we learn from these data to improve and adapt the monitoring of chronic dermatoses in both children and adults in the event of a future health crisis.
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Affiliation(s)
- Q Beytout
- Service de dermatologie, hôpital Victor-Dupouy, 69, rue du Lieutenant Colonel-Prudhon, 95107 Argenteuil cedex, France
| | - J Pepiot
- Association France Psoriasis, 53, rue Compans, 75019 Paris, France
| | - A Maruani
- Inserm 1246-SPHERE, unité de dermatologie pédiatrique, service de dermatologie, CHRU Tours, université de Tours, 2, boulevard Tonnellé, 37000 Tours, France
| | - D Devulder
- Association France Psoriasis, 53, rue Compans, 75019 Paris, France
| | - R Aubert
- Association France Psoriasis, 53, rue Compans, 75019 Paris, France
| | - M Beylot-Barry
- Inserm u 1053. UMR BaRiton, service de dermatologie, hôpital Saint-André, CHU de Bordeaux, université de Bordeaux, 1, rue Jean-Burguet, 33000 Bordeaux, France
| | - J-M Amici
- Dermatologie, Cabinet Libéral, 36, avenue René-Cassagne, 33150 Cenon, France
| | - D Jullien
- Service de dermatologie, hôpital Edouard-Herriot, hôpitaux civils de Lyon, 5, place d'Arsonval, 69003 Lyon, France
| | - E Mahé
- Service de dermatologie, hôpital Victor-Dupouy, 69, rue du Lieutenant Colonel-Prudhon, 95107 Argenteuil cedex, France.
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Managing children with brain tumors during the COVID-19 era: Don't stop the care! Comput Struct Biotechnol J 2021; 19:705-709. [PMID: 33505640 PMCID: PMC7817528 DOI: 10.1016/j.csbj.2021.01.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 01/07/2021] [Accepted: 01/07/2021] [Indexed: 02/08/2023] Open
Abstract
The COVID-19 pandemic has substantially stressed health care systems globally, subsequently reducing cancer care services and delaying treatments. Pediatric populations infected by COVID-19 have shown mild clinical symptoms compared to adults, perhaps due to decreased susceptibility. Several scientific societies and governments have released information on the management of patients with cancer, wherein they warn against exposure to SARS-CoV-2 infection and suggest continuing treatment. To determine the best diagnostic and therapeutic approach, multidisciplinary tumor boards should convene regularly, including through conference calls and telematics platforms. A prompt diagnostic workup may reduce children's suffering and prevent loss of confidence in the health care system among parents. Moreover, ensuring adequate support and information regarding measures for preventing SARS-CoV-2 infection in pediatric patients and their families is essential for avoiding panic and excessive stress, allowing early reporting of any suspected symptoms of cancer and, in turn, facilitating early diagnosis and prompt modulation of treatment.
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Abstract
Background: Due to the increasing prevalence of covid-19, the World Health Organization declared on 30 January 2020, the spread of the new coronavirus as a 6th public health emergency of international concern. Objectives: To assess the extent of the disease in the pediatric population in our region, we conducted a clinical pediatric screening for Covid-19 and evaluated factors that affected its manifestation in children. Methods: In this study, 474761 children under 19 years of age were screened in two phases. In the first phase, 680 cases were considered as suspect and referred to the health centers, where the second phase of screening took place. Finally, 230 probable cases were referred to specialized centers for further investigation. Results: Almost all of the cases had pneumonia and symptoms of shortness of breath, cough, and fever over 38°C (56.7%). Other clinical symptoms included hypotension (17.4%), Hemoptysis (16.1), sore throat (11.6%) and difficult breathing (6.7%). 26% of patients had a history of chronic disease (mainly pulmonary and cardiac). There was a statistically significant relationship between the probable causes and the symptoms of the disease (P < 0.05), between age and probable cases (P < 0.05), and between death and underlying disease (P < 0.05). However, of all the cases, only 15 (6.5%) had a positive PCR test, 39 patients were hospitalized (17%), 173 cases (75%) received outpatient treatment and 18 cases (7.8%) died. Conclusions: Children with shortness of breath, cough, pneumonia, fever over 38 and underlying disease are suspicious for Covid-19 and should be hospitalized to be evaluated with laboratory tests.
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Aleebrahim-Dehkordi E, Soveyzi F, Deravi N, Rabbani Z, Saghazadeh A, Rezaei N. Human Coronaviruses SARS-CoV, MERS-CoV, and SARS-CoV-2 in Children. J Pediatr Nurs 2021; 56:70-79. [PMID: 33186866 PMCID: PMC7580518 DOI: 10.1016/j.pedn.2020.10.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 09/07/2020] [Accepted: 10/19/2020] [Indexed: 12/18/2022]
Abstract
The novel coronavirus, known as 2019-nCoV or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused an epidemic with high mortality and morbidity since December 2019, in Wuhan, China. The infection has now been transmitted to more than 210 countries worldwide and caused more than 200,000 deaths. Similar to other coronaviruses such as Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) and the Middle East Respiratory Syndrome Coronavirus (MERS-CoV), SARS-CoV-2 appears to less commonly affect pediatrics and to cause less severe disease along with fewer symptoms compared to adults. Available data suggest that the pediatric population is just as likely as adults to become infected with SARS-CoV-2. However, they may be asymptotic or have milder symptoms than adults; they can be potential carriers of the disease. This article reviews the present understanding of SARS-CoV-2 infection in the pediatric age group in comparison with MERS-CoV and SARS-CoV.
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Affiliation(s)
- Elahe Aleebrahim-Dehkordi
- Systematic Review and Meta-analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Iran; Medical Plants Research Center, Basic Health Sciences Institute, Shahrekord University of Medical Sciences, Iran
| | - Faezeh Soveyzi
- Systematic Review and Meta-analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Iran; School of Medicine, Tehran University of Medical Sciences, Iran
| | - Niloofar Deravi
- Systematic Review and Meta-analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Iran; Student's Research Committee, School of medicine, Shahid Beheshti University of Medical Sciences, Iran
| | - Zahra Rabbani
- Systematic Review and Meta-analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Iran; School of Medicine, Tehran University of Medical Sciences, Iran
| | - Amene Saghazadeh
- Systematic Review and Meta-analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Iran; Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Iran
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Iran; Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Iran; Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Iran.
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27
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Benou S, Ladhani S, Dimitriou G, Gkentzi D. Atypical Manifestations of Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Children: A Systematic Review. Curr Pediatr Rev 2021; 17:162-171. [PMID: 33823780 DOI: 10.2174/1573396317666210406153302] [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: 09/16/2020] [Revised: 01/06/2021] [Accepted: 03/09/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND In December 2019, a local outbreak of pneumonia was presented in Wuhan (China) and quickly identified to be caused by a novel coronavirus, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The disease caused by SARS-CoV-2 was named COVID-19 and was soon declared a pandemic because of the millions of infections and thousands of deaths worldwide. Children infected with SARS-CoV-2 usually develop the asymptomatic or mild type of disease compared to adults. They are also more likely to have atypical and non-specific clinical manifestations than adults. METHODS A literature search was performed through PubMed and Scopus to summarize the extrapulmonary manifestations of SARS-CoV-2 infection in children since the beginning of the pandemic. Peer-reviewed papers in English were retrieved using the following keywords and combinations: 'pediatric,' 'child,' 'infant,' 'neonate,' 'novel coronavirus,' 'SARS-CoV-2,' 'COVID 19' and 'gastrointestinal,' 'renal,' 'cardiac,' 'dermatologic' or 'ophthalmologic'. We included published case series and case reports providing clinical symptoms and signs in SARS-CoV2 pediatric patients. RESULTS Although fever and symptoms of upper respiratory infection are the most frequently presented, a variety of other atypical presentations has also been reported. The clinical spectrum includes dermatological, ophthalmological, neurological, cardiovascular, renal, reproductive, and gastrointestinal presentations. In addition, a rare multi-inflammatory syndrome associated with SARS-- CoV-2 infection has been reported in children, often leading to shock and requiring inotropic support and mechanical ventilation. CONCLUSION Clinicians need to be aware of the wider range of extrapulmonary atypical manifestations of SARS-CoV-2 infection in children, so that appropriate testing, treatment, and public health measures can be implemented rapidly.
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Affiliation(s)
- Sofia Benou
- Department of Paediatrics, Patras Medical School, Rion 26504, Greece
| | - Shamez Ladhani
- Paediatric Infectious Disease Research Group, St. George's University of London, Cranmer Terrace, London SW17 0RE, United Kingdom
| | - Gabriel Dimitriou
- Department of Paediatrics, Patras Medical School, Rion 26504, Greece
| | - Despoina Gkentzi
- Department of Paediatrics, Patras Medical School, Rion 26504, Greece
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Wedel J, Steinmann P, Štrakl M, Hriberšek M, Ravnik J. Can CFD establish a connection to a milder COVID-19 disease in younger people? Aerosol deposition in lungs of different age groups based on Lagrangian particle tracking in turbulent flow. COMPUTATIONAL MECHANICS 2021; 67:1497-1513. [PMID: 33758453 PMCID: PMC7977503 DOI: 10.1007/s00466-021-01988-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 02/06/2021] [Indexed: 05/09/2023]
Abstract
To respond to the ongoing pandemic of SARS-CoV-2, this contribution deals with recently highlighted COVID-19 transmission through respiratory droplets in form of aerosols. Unlike other recent studies that focused on airborne transmission routes, this work addresses aerosol transport and deposition in a human respiratory tract. The contribution therefore conducts a computational study of aerosol deposition in digital replicas of human airways, which include the oral cavity, larynx and tracheobronchial airways down to the 12th generation of branching. Breathing through the oral cavity allows the air with aerosols to directly impact the larynx and tracheobronchial airways and can be viewed as one of the worst cases in terms of inhalation rate and aerosol load. The implemented computational model is based on Lagrangian particle tracking in Reynolds-Averaged Navier-Stokes resolved turbulent flow. Within this framework, the effects of different flow rates, particle diameters and lung sizes are investigated to enable new insights into local particle deposition behavior and therefore virus loads among selected age groups. We identify a signicant increase of aerosol deposition in the upper airways and thus a strong reduction of virus load in the lower airways for younger individuals. Based on our findings, we propose a possible relation between the younger age related fluid mechanical protection of the lower lung regions due to the airway size and a reduced risk of developing a severe respiratory illness originating from COVID-19 airborne transmission.
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Affiliation(s)
- Jana Wedel
- Institute of Applied Mechanics, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Paul Steinmann
- Institute of Applied Mechanics, University of Erlangen-Nuremberg, Erlangen, Germany
- Glasgow Computational Engineering Center, University of Glasgow, Glasgow, Scotland
| | - Mitja Štrakl
- Faculty of Mechanical Engineering, University of Maribor, Maribor, Slovenia
| | - Matjaž Hriberšek
- Faculty of Mechanical Engineering, University of Maribor, Maribor, Slovenia
| | - Jure Ravnik
- Faculty of Mechanical Engineering, University of Maribor, Maribor, Slovenia
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Raine S, Liu A, Mintz J, Wahood W, Huntley K, Haffizulla F. Racial and Ethnic Disparities in COVID-19 Outcomes: Social Determination of Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8115. [PMID: 33153162 PMCID: PMC7663309 DOI: 10.3390/ijerph17218115] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/20/2020] [Accepted: 10/26/2020] [Indexed: 12/18/2022]
Abstract
As of 18 October 2020, over 39.5 million cases of coronavirus disease 2019 (COVID-19) and 1.1 million associated deaths have been reported worldwide. It is crucial to understand the effect of social determination of health on novel COVID-19 outcomes in order to establish health justice. There is an imperative need, for policy makers at all levels, to consider socioeconomic and racial and ethnic disparities in pandemic planning. Cross-sectional analysis from COVID Boston University's Center for Antiracist Research COVID Racial Data Tracker was performed to evaluate the racial and ethnic distribution of COVID-19 outcomes relative to representation in the United States. Representation quotients (RQs) were calculated to assess for disparity using state-level data from the American Community Survey (ACS). We found that on a national level, Hispanic/Latinx, American Indian/Alaskan Native, Native Hawaiian/Pacific Islanders, and Black people had RQs > 1, indicating that these groups are over-represented in COVID-19 incidence. Dramatic racial and ethnic variances in state-level incidence and mortality RQs were also observed. This study investigates pandemic disparities and examines some factors which inform the social determination of health. These findings are key for developing effective public policy and allocating resources to effectively decrease health disparities. Protective standards, stay-at-home orders, and essential worker guidelines must be tailored to address the social determination of health in order to mitigate health injustices, as identified by COVID-19 incidence and mortality RQs.
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Affiliation(s)
- Samuel Raine
- Nova Southeastern University Dr. Kiran C. Patel College of Allopathic Medicine, Davie, FL 33328, USA; (A.L.); (J.M.); (W.W.); (K.H.)
| | - Amy Liu
- Nova Southeastern University Dr. Kiran C. Patel College of Allopathic Medicine, Davie, FL 33328, USA; (A.L.); (J.M.); (W.W.); (K.H.)
| | - Joel Mintz
- Nova Southeastern University Dr. Kiran C. Patel College of Allopathic Medicine, Davie, FL 33328, USA; (A.L.); (J.M.); (W.W.); (K.H.)
| | - Waseem Wahood
- Nova Southeastern University Dr. Kiran C. Patel College of Allopathic Medicine, Davie, FL 33328, USA; (A.L.); (J.M.); (W.W.); (K.H.)
| | - Kyle Huntley
- Nova Southeastern University Dr. Kiran C. Patel College of Allopathic Medicine, Davie, FL 33328, USA; (A.L.); (J.M.); (W.W.); (K.H.)
| | - Farzanna Haffizulla
- Department of Internal Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Davie, FL 33328, USA
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