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van de Berg S, Coyer L, von Both U, Scheuerer T, Kolberg L, Hoch M, Böhmer MM. Coverage and determinants of COVID-19 child vaccination in Munich, Germany in October 2022-January 2023: Results of the COVIP-Virenwächter study. Eur J Pediatr 2024:10.1007/s00431-024-05617-0. [PMID: 38850330 DOI: 10.1007/s00431-024-05617-0] [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: 02/09/2024] [Revised: 05/13/2024] [Accepted: 05/16/2024] [Indexed: 06/10/2024]
Abstract
COVID-19 vaccination reduces the risk of severe disease, in children as well as adults. We studied COVID-19 vaccination coverage among children, parental COVID-19 vaccination intent for their children and determinants of vaccination among children to inform communication strategies. We invited parents of children aged 6 months-11 years in Munich, Germany, to an anonymous online survey between 13.10.2022 and 15.01.2023. Parents reported COVID-19 vaccination status and, for unvaccinated children, vaccination intent per child. We determined vaccination coverage (≥ 1 dose) and parental intent, and subsequently used logistic regression to identify determinants of vaccination, including the 5C psychological antecedents of vaccination (confidence, complacency, constraints, calculation, collective responsibility). In total, 339 parents reported on 591 children. Vaccination coverage was 7% (6/86) amongst 6-months-4-year-olds and 59% (295/498) amongst 5-11-year-olds. For unvaccinated 6-months-4-year-olds, 31% of parents reported high, 13% medium, 56% low vaccination intent; for 5-11-year-olds 8% reported high, 20% medium, 71% low intent. Positive determinants of vaccination were older child age, child belonging to a clinically vulnerable group, as well as parental COVID-19 vaccination, higher education level, country of birth Germany, and high level of trust in official guidelines; a negative determinant was previous vaccination refusal. For 5-11-year-olds, additional positive determinants were higher confidence and lower complacency. Conclusion: While a substantial proportion of 5-11-year-olds were vaccinated against COVID-19, coverage was low among 6-months-4-year-olds. Parental vaccination intent for unvaccinated children was low. Vaccination communication should take into account parental socio-demographic characteristics and specifically address individual risks and benefits of child vaccination. What is Known: • COVID-19 vaccination lowers severe disease risk in all ages. • Germany recommends vaccination for 5-11-years-olds since December 2021 and for 6 months-4 year-olds since November 2022. What is New: • In Munich, vaccine uptake was high in 5-11-year-olds but parental intent for not yet vaccinated children was low; the opposite was the case for 6-months-4-year-olds; vaccination determinants were eligibility, parental education, birth country and general vaccination hesitancy; psychological antecedents were confidence and complacency. • Tailored interventions should address guidelines, health literacy, cultural sensitivity, and boost confidence in vaccines and institutions while raising awareness of COVID-19 risks for children.
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Affiliation(s)
- Sarah van de Berg
- State Institute for Health II, Task Force for Infectious Diseases (GI), Bavarian Health and Food Safety Authority (LGL), Lazarettstrasse 67, 80636, Munich, Germany.
- Postgraduate Training for Applied Epidemiology, Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany.
- ECDC Fellowship Programme, Field Epidemiology path (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.
| | - Liza Coyer
- State Institute for Health II, Task Force for Infectious Diseases (GI), Bavarian Health and Food Safety Authority (LGL), Lazarettstrasse 67, 80636, Munich, Germany
- ECDC Fellowship Programme, Field Epidemiology path (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Ulrich von Both
- Division of Paediatric Infectious Diseases, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, Munich, Germany
| | - Theresa Scheuerer
- State Institute for Health II, Task Force for Infectious Diseases (GI), Bavarian Health and Food Safety Authority (LGL), Lazarettstrasse 67, 80636, Munich, Germany
| | - Laura Kolberg
- Division of Paediatric Infectious Diseases, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, Munich, Germany
| | - Martin Hoch
- State Institute for Health II, Task Force for Infectious Diseases (GI), Bavarian Health and Food Safety Authority (LGL), Lazarettstrasse 67, 80636, Munich, Germany
| | - Merle M Böhmer
- State Institute for Health II, Task Force for Infectious Diseases (GI), Bavarian Health and Food Safety Authority (LGL), Lazarettstrasse 67, 80636, Munich, Germany
- Institute of Social Medicine and Health Systems Research, Otto-von-Guericke-University, Magdeburg, Germany
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Lee NW, Kim YM, Kim YH, Kang SJ, Jang KM, Kim HS, Moon JE, Kim JK. Clinical characteristics and outcomes of COVID-19 in children and adolescents with diabetes in Daegu, South Korea. Ann Pediatr Endocrinol Metab 2024; 29:167-173. [PMID: 38956753 DOI: 10.6065/apem.2346124.062] [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: 05/29/2023] [Accepted: 11/14/2023] [Indexed: 07/04/2024] Open
Abstract
PURPOSE Children with comorbidities have a higher risk of severe, coronavirus disease 2019 (COVID-19). This study investigated the clinical features and outcomes of COVID-19 in children and adolescents with diabetes between January and March 2022. METHODS We retrospectively reviewed the medical records of 123 children and adolescents (73 with type 1 diabetes and 50 with type 2 diabetes, 59 males and 64 females) aged <18 years who had been diagnosed with diabetes. Data were collected from 7 academic medical centers in Daegu, South Korea. RESULTS Thirty-five children with diabetes were diagnosed with COVID-19 (18 with type 1 and 17 with type 2 diabetes). Eighteen of the 35 children with diabetes and COVID-19 and 50 of the 88 children with diabetes alone received a COVID-19 vaccination. No significant differences were observed between patients with diabetes and COVID-19 and patients with diabetes alone in the type of diabetes diagnosed, sex, age, body mass index, hemoglobin A1c, or vaccination status. All children with diabetes and COVID-19 had mild clinical features and were safely managed in their homes. Fourteen children had a fever of 38℃ or higher that lasted for more than 2 days, 11 of whom were not vaccinated (p=0.004). None experienced post-COVID-19 conditions. CONCLUSION All children and adolescents with pre-existing diabetes had mild symptoms of COVID-19 due to low disease severity, high vaccination rates, uninterrupted access to medical care, and continuous glucose monitoring. Unvaccinated children with diabetes who experienced COVID-19 presented with higher and more frequent fevers compared to vaccinated children.
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Affiliation(s)
- Na-Won Lee
- Department of Pediatrics, Daegu Catholic University Hospital, Daegu Catholic University School of Medicine, Daegu, Korea
| | - You-Min Kim
- Department of Pediatrics, Daegu Catholic University Hospital, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Young-Hwan Kim
- Department of Pediatrics, Daegu Catholic University Hospital, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Seok-Jin Kang
- Department of Pediatrics, Keimyung University Hospital, Keimyung University School of Medicine, Daegu, Korea
| | - Kyung-Mi Jang
- Department of Pediatrics, Yeungnam University Hospital, Yeungnam University School of Medicine, Daegu, Korea
| | - Hae-Sook Kim
- Department of Pediatrics, Daegu Fatima Hospital, Daegu, Korea
| | - Jung-Eun Moon
- Department of Pediatrics, Kyungpook University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jin-Kyung Kim
- Department of Pediatrics, Daegu Catholic University Hospital, Daegu Catholic University School of Medicine, Daegu, Korea
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Reyes-Pagcatipunan MG, Isada PMD, Delos Reyes CA. Clinical and Laboratory Profile, Management and Outcome of Pediatric SARS-CoV-2 Infection Admitted at the Philippine General Hospital. ACTA MEDICA PHILIPPINA 2024; 58:14-26. [PMID: 38882922 PMCID: PMC11168954 DOI: 10.47895/amp.v58i7.7717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/18/2024]
Abstract
Background The Philippines has recorded over 470,000 COVID-19 cases in children, with over 1,500 deaths during the same period. Although a Philippine online pediatric COVID-19 registry exists, this only relies on passive surveillance. Objectives This study determined the clinical and laboratory profile, risk factors for severe COVID-19, and mortality, management, and outcome of pediatric SARS-CoV-2 patients admitted at the Philippine General Hospital (PGH) from April 2020 to June 2022 to fill in knowledge gaps on the epidemiology of COVID-19 infection in children. Methods This was a retrospective cohort study of pediatric COVID-19 cases admitted at the PGH, a designated COVID referral center during the study period. Demographic and clinical profile, risk factors, comorbidities, laboratory and radiologic findings, management, and outcomes across different disease severity states were gathered by chart review and the data were analyzed using STATA 17. Results There were 448 pediatric patients admitted and diagnosed with COVID-19 during the study period. Most patients belonged to the 1-5-year age group (25.9%), had no known exposure to a COVID-19 case (65.4%), were mild cases (37.3%%), and did not receive any dose of the COVID-19 vaccine (96.7%). The most common presenting symptoms across all disease categories were fever (44.4%), cough (28.6%), and shortness of breath (26.6%). Multisystem inflammatory syndrome in children (MIS-C) presented with fever (100%) and rash (53.9%). The risk factors for severe disease were the presence of a congenital anomaly lung disease, and elevated procalcitonin. Most patients with MIS-C were previously well with no comorbidities. Laboratory findings which were markedly elevated among severe and critical cases were ESR, CRP, D-dimer, LDH, and IL-6. Ferritin, procalcitonin (PCT) and IL-6 were elevated only in severe to critical COVID-19 cases and remained within normal for the other disease categories. As to treatment, asymptomatic, mild, and moderate cases were given supportive medications (zinc, vitamin D, and vitamin C), while investigational drugs particularly corticosteroids, IVIG, and remdesivir, were used in severe cases.Antibiotics were given to 71.7% of patients at the outset. As to the outcomes, 89% recovered, while 8.9% died. The case fatality rate from COVID-19 infection was at 2.2%. Conclusion Admitted pediatric COVID-19 cases are generally mild but admission is due to underlying illness or comorbidities. Those with severe to critical cases have underlying comorbidities and had either progression or complications due to COVID disease. D-dimer, LDH, IL-6, ferritin and procalcitonin were elevated among severe and critical cases which can be utilized as inflammatory markers.
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Affiliation(s)
- Marimel G Reyes-Pagcatipunan
- Department of Pediatrics, College of Medicine and Philippine General Hospital, University of the Philippines Manila
- National Clinical Trials and Translation Center, University of the Philippines Manila
| | | | - Carmina A Delos Reyes
- Department of Pediatrics, College of Medicine and Philippine General Hospital, University of the Philippines Manila
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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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Mercolini F, Abram N, Cesaro S. Managing acute COVID-19 in immunocompromised pediatric patients. Expert Rev Clin Immunol 2024; 20:349-357. [PMID: 38099388 DOI: 10.1080/1744666x.2023.2295982] [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: 05/14/2023] [Accepted: 12/13/2023] [Indexed: 03/16/2024]
Abstract
INTRODUCTION SARS-CoV-2 infection is a potentially life-threatening infection in immunocompromised pediatric patients, and its management has rapidly evolved during the pandemic. To control SARS-CoV-2 infection over time, the scenario changed for the better with the introduction of specific treatments such as antiviral drugs, vaccines, and monoclonal antibodies, together with drugs blocking the inflammatory cytokine cascade and improvements in supportive care. AREAS COVERED This paper discusses the therapeutic strategies to apply for patients affected by COVID-19 in the pediatric population, with a focus on the immunocompromised patients. EXPERT OPINION Treatment in pediatric patients retraces the therapies investigated and approved in adults and must be calibrated on the basis of the severity of the infection (anti-spike monoclonal antibody, antivirals, anti-inflammatory drugs, and immunomodulators). Transmission prevention policies and vaccination reduce the risk of infection, while early intervention in the immunocompromised patients at high-risk of progression to severe-critical COVID-19 may reduce the period of viral shedding and the need for hospitalization, intensive care admission, and death. In hemato-oncological patients, the delayed treatment of SARS-CoV-2 infection or COVID-19 disease represents a frequent complication and its impact on the patient outcome remains a matter of research for the next few years.
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Affiliation(s)
- Federico Mercolini
- Pediatric Oncology and Hematology "Lalla Seràgnoli", IRCCS, Azienda Ospedaliero-Universitaria di Bologna institution, Bologna, Italy
| | - Nicoletta Abram
- Pediatric Oncology and Hematology "Lalla Seràgnoli", IRCCS, Azienda Ospedaliero-Universitaria di Bologna institution, Bologna, Italy
| | - Simone Cesaro
- Pediatric Hematology Oncology, Department of Mother and Child, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
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Alvarado J, Yerigeri K, Boakye A, Randolph C, Roy A, Onimoe G. Impact of SARS-CoV-2 infection on pain crisis and acute chest syndrome in patients with sickle cell anemia: A retrospective multi-cohort study based on US national data from 2020 to 2022. EJHAEM 2024; 5:299-307. [PMID: 38633124 PMCID: PMC11020112 DOI: 10.1002/jha2.840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 11/28/2023] [Accepted: 12/04/2023] [Indexed: 04/19/2024]
Abstract
COVID-19 infection has been a significant contributor to global morbidity and mortality, especially among those patients with chronic diseases. The Centers for Disease Control and Prevention have classified sickle cell disease (SCD) as a condition that increases the risk of severe illness from COVID-19 infection. A retrospective study was conducted using the TRiNetX health research network database to identify SCA patients ( HbSS, Sbeta-thalassemia zero) who had SARS-CoV-2 infection over 2 years; these were compared with similar patients who did not have the infection in terms of demographics, pain control, and laboratory parameters COVID-19 illness impacts [ain crises and ACS, and prior vaccination against influenza and COVID-19 may represent a protective factor for developing pain crises.
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Affiliation(s)
- Juan Alvarado
- MetroHealth Medical SystemClevelandOhioUSA
- Case Western UniversityClevelandOhioUSA
| | - Keval Yerigeri
- MetroHealth Medical SystemClevelandOhioUSA
- Case Western UniversityClevelandOhioUSA
| | - Anita Boakye
- MetroHealth Medical SystemClevelandOhioUSA
- Case Western UniversityClevelandOhioUSA
| | - Christina Randolph
- MetroHealth Medical SystemClevelandOhioUSA
- Case Western UniversityClevelandOhioUSA
| | - Aparna Roy
- MetroHealth Medical SystemClevelandOhioUSA
- Case Western UniversityClevelandOhioUSA
| | - Grace Onimoe
- MetroHealth Medical SystemClevelandOhioUSA
- Case Western UniversityClevelandOhioUSA
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Shi J, Zhao F, Yang W, Zhu Y, Wang M, Yi B. The Status and Influencing Factors of COVID-19 Vaccination for 3-7-Year-Old Children Born Prematurely. Patient Prefer Adherence 2024; 18:787-796. [PMID: 38572223 PMCID: PMC10987788 DOI: 10.2147/ppa.s451654] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 03/14/2024] [Indexed: 04/05/2024] Open
Abstract
Objective To explore the status and influencing factors of COVID-19 vaccination for 3-7-year-old children born prematurely. Methods A questionnaire was administered to parents of preterm infants born between 1 January 2016 and 31 December 2019 in Gansu Maternal and Child Health Hospital using convenience sampling. Results It was found that 96.81% of 282 parents had known about COVID-19 vaccines and acquired COVID-19- and vaccine-related knowledge primarily through WeChat (104/282, 36.88%) and TikTok (91/282, 32.27%). Most parents of the group whose children were vaccinated with a COVID-19 vaccine believed that this approach was effective in preventing COVID-19 (49.75%), whereas most parents of the group whose children were not vaccinated were worried about the adverse reaction and safety of the vaccine (45.88%). According to the regression analysis, the risk factors of children born prematurely receiving a COVID-19 vaccine were no vaccination against COVID-19 in the mothers (odds ratio [OR]=48.489, 95% CI: 6.524-360.406) and in younger children (OR=12.157, 95% CI: 6.388-23.139). Previous history of referral (OR=0.229, 95% CI: 0.057-0.920), history of diseases (OR=0.130, 95% CI: 0.034-0.503) and high educational level of guardians (OR=0.142, 95% CI: 0.112-0.557) were protective factors for children born prematurely to receive COVID-19 vaccination. Conclusion There is a relatively high proportion of children born prematurely receiving COVID-19 vaccination, but some people still have concerns. Publicity in the later stage can be conducted through WeChat, TikTok and other social media platforms, with special attention paid to the populations with lower education levels.
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Affiliation(s)
- Jingyun Shi
- Department of NICU, Gansu Provincial Maternal and Child Care Hospital (Gansu Provincial Central Hospital), Lanzhou City, Gansu, 730050, People’s Republic of China
| | - Fangping Zhao
- Department of NICU, Gansu Provincial Maternal and Child Care Hospital (Gansu Provincial Central Hospital), Lanzhou City, Gansu, 730050, People’s Republic of China
| | - Wanyin Yang
- Department of NICU, Gansu University of Chinese Medicine, Lanzhou City, Gansu, 730050, People’s Republic of China
| | - Yuru Zhu
- Department of NICU, Gansu Provincial Maternal and Child Care Hospital (Gansu Provincial Central Hospital), Lanzhou City, Gansu, 730050, People’s Republic of China
| | - Min Wang
- Department of NICU, Gansu Provincial Maternal and Child Care Hospital (Gansu Provincial Central Hospital), Lanzhou City, Gansu, 730050, People’s Republic of China
| | - Bin Yi
- Department of NICU, Gansu Provincial Maternal and Child Care Hospital (Gansu Provincial Central Hospital), Lanzhou City, Gansu, 730050, People’s Republic of China
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Üstündağ G, Karadag-Oncel E, Kara-Ulu N, Polat M, Salı E, Çakır D, Şahin A, Akaslan-Kara A, Kaçar P, Işık AD, Erdemli PC, Durmuş SY, Özdemir A, Çelik B, Sütçü M, Kara M, Kandemir-Gülmez T, Çelikyurt A, Ümit Z, Aktürk H, Arıkan K, Kaba Ö, Caymaz C, Bayhan C, Aygün D, Penezoğlu DN, Alataş ŞÖ, Özdemir H, Türel Ö, Akça M, Çelebi-Çongur E, Kepenekli E, Çelik Ü, Ecevit İZ, Belet N, Dalgıç N, Yılmaz N, Yılmaz D, Kuyucu N, Çiftçi E. COVID-19 in hospitalized infants aged under 3 months: multi-center experiences across Turkey. Eur J Pediatr 2024; 183:1153-1162. [PMID: 37971516 DOI: 10.1007/s00431-023-05329-x] [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: 08/23/2023] [Revised: 11/02/2023] [Accepted: 11/03/2023] [Indexed: 11/19/2023]
Abstract
To investigate coronavirus disease 2019 (COVID-19) in infants aged 0 to 3 months because there is currently a significant gap in the literature on the subject. A cross-sectional study was conducted with the involvement of 19 medical centers across Turkey and 570 infants. The majority of the patients were male (58.2%), and the three most common symptoms were fever (78.2%), cough (44.6%), and feeding intolerance (39.9%). The results showed that a small percentage of infants had positive blood (0.9%) or urine cultures (10.2%). Most infants presented with fever (78.2%). Children without underlying conditions (UCs) had mostly a complicated respiratory course and a normal chest radiography. Significant more positive urine culture rates were observed in infants with fever. A higher incidence of respiratory support requirements and abnormal chest findings were seen in infants with chronic conditions. These infants also had a longer hospital stay than those without chronic conditions. Conclusions: Our study discloses the clinical observations and accompanying bacterial infections found in infants aged under 3 months with COVID-19. These findings can shed light on COVID-19 in infancy for physicians because there is limited clinical evidence available. What is Known: • COVID-19 in infants and older children has been seen more mildly than in adults. • The most common symptoms of COVID-19 in infants are fever and cough, as in older children and adults. COVID-19 should be one of the differential diagnoses in infants with fever. What is New: • Although most infants under three months had fever, the clinical course was uneventful and respiratory complications were rarely observed in healthy children. • Infants with underlying conditions had more frequent respiratory support and abnormal chest radiography and stayed longer in the hospital.
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Affiliation(s)
- Gülnihan Üstündağ
- Izmir Tepecik Training and Research Hospital, Clinic of Pediatric Infectious Diseases, Health Sciences University, Izmir, Turkey
| | - Eda Karadag-Oncel
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey.
| | - Nursel Kara-Ulu
- Faculty of Medicine, Department of Pediatric Infectious Diseases, Gazi University, Ankara, Turkey
| | - Meltem Polat
- Faculty of Medicine, Department of Pediatric Infectious Diseases, Gazi University, Ankara, Turkey
| | - Enes Salı
- Ümraniye Training and Research Hospital, Clinic of Pediatric Infectious Diseases, Health Sciences University, Istanbul, Turkey
| | - Deniz Çakır
- Ümraniye Training and Research Hospital, Clinic of Pediatric Infectious Diseases, Health Sciences University, Istanbul, Turkey
| | - Aslıhan Şahin
- Izmir Tepecik Training and Research Hospital, Clinic of Pediatric Infectious Diseases, Health Sciences University, Izmir, Turkey
| | - Aybüke Akaslan-Kara
- Izmir Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital, Clinic of Pediatric Infectious Diseases, Health Sciences University, Izmir, Turkey
| | - Pelin Kaçar
- Izmir Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital, Clinic of Pediatric Infectious Diseases, Health Sciences University, Izmir, Turkey
| | - Aylin Dizi Işık
- Faculty of Medicine, Department of Pediatric Infectious Diseases, Marmara University, Istanbul, Turkey
| | - Pınar Canizci Erdemli
- Faculty of Medicine, Department of Pediatric Infectious Diseases, Marmara University, Istanbul, Turkey
| | - Sevgi Yaşar Durmuş
- Clinic of Pediatric Infectious Disease, Kayseri City Hospital, Kayseri, Turkey
| | - Ahmet Özdemir
- Clinic of Neonatal Intensive Care Unit, Kayseri City Hospital, Kayseri, Turkey
| | - Binnaz Çelik
- Clinic of Pediatrics, Kayseri City Hospital, Kayseri, Turkey
| | - Murat Sütçü
- Faculty of Medicine, Department of Pediatric Infectious Diseases, Istinye University, Istanbul, Turkey
| | - Manolya Kara
- Faculty of Medicine, Department of Pediatric Infectious Diseases, Istinye University, Istanbul, Turkey
- Faculty of Medicine, Department of Pediatric Infectious Diseases, Yeditepe University, Istanbul, Turkey
| | | | - Aydın Çelikyurt
- Faculty of Medicine, Department of Pediatrics, Koç University, Istanbul, Turkey
| | - Zühal Ümit
- Clinic of Pediatric Infectious Diseases, Manisa City Hospital, Manisa, Turkey
| | - Hacer Aktürk
- Faculty of Medicine, Department of Pediatric Infectious Diseases, Koç University, Istanbul, Turkey
| | - Kamile Arıkan
- Clinic of Pediatric Infectious Diseases, Buca Seyfi Demirsoy Training and Research Hospital, Izmir, Turkey
| | - Özge Kaba
- Clinic of Pediatric Infectious Disease, Başakşehir Çam Ve Sakura City Hospital, Istanbul, Turkey
| | - Canan Caymaz
- Clinic of Pediatric Infectious Disease, Başakşehir Çam Ve Sakura City Hospital, Istanbul, Turkey
| | - Cihangül Bayhan
- Gülhane Training and Research Hospital, Clinic of Pediatric Infectious Diseases, Health Sciences University, Ankara, Turkey
| | - Deniz Aygün
- Faculty of Medicine, Department of Pediatric Infectious Diseases, Cerrahpaşa University Istanbul, Istanbul, Turkey
| | - Döndü Nilay Penezoğlu
- Faculty of Medicine, Department of Pediatric Infectious Diseases, Ankara University, Ankara, Turkey
| | - Şilem Özdem Alataş
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Halil Özdemir
- Faculty of Medicine, Department of Pediatric Infectious Diseases, Ankara University, Ankara, Turkey
| | - Özden Türel
- Faculty of Medicine, Department of Pediatric Infectious Diseases, Bezmialem Foundation University, Istanbul, Turkey
| | - Mehtap Akça
- Faculty of Medicine, Department of Pediatric Infectious Diseases, Mersin University, Mersin, Turkey
| | - Emel Çelebi-Çongur
- Şişli Hamidiye Etfal Training and Research Hospital, Clinic of Pediatric Infectious Diseases, Health Sciences University, Istanbul, Turkey
| | - Eda Kepenekli
- Faculty of Medicine, Department of Pediatric Infectious Diseases, Marmara University, Istanbul, Turkey
| | - Ümit Çelik
- Clinic of Pediatric Infectious Diseases, Adana City Hospital, Adana, Turkey
| | - İsmail Zafer Ecevit
- Gülhane Training and Research Hospital, Clinic of Pediatric Infectious Diseases, Health Sciences University, Ankara, Turkey
| | - Nurşen Belet
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Nazan Dalgıç
- Şişli Hamidiye Etfal Training and Research Hospital, Clinic of Pediatric Infectious Diseases, Health Sciences University, Istanbul, Turkey
| | - Nisel Yılmaz
- Department of Medical Microbiology, Izmir Tepecik Training and Research Hospital, Health Sciences University, Izmir, Turkey
| | - Dilek Yılmaz
- Izmir Tepecik Training and Research Hospital, Clinic of Pediatric Infectious Diseases, Health Sciences University, Izmir, Turkey
- Faculty of Medicine, Department of Pediatric Infectious Diseases, Izmir Katip Çelebi University, Izmir, Turkey
| | - Necdet Kuyucu
- Faculty of Medicine, Department of Pediatric Infectious Diseases, Mersin University, Mersin, Turkey
| | - Ergin Çiftçi
- Faculty of Medicine, Department of Pediatric Infectious Diseases, Ankara University, Ankara, Turkey
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9
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Khojasteh-Kaffash S, Parhizkar Roudsari P, Ghaffari Jolfayi A, Samieefar N, Rezaei N. Pediatric asthma exacerbation and COVID-19 pandemic: Impacts, challenges, and future considerations. J Asthma 2024; 61:81-91. [PMID: 37610180 DOI: 10.1080/02770903.2023.2251062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 08/11/2023] [Accepted: 08/19/2023] [Indexed: 08/24/2023]
Abstract
OBJECTIVE Asthma, a common disease among children and adolescents, poses a great health risk when ignored; therefore, a thorough follow-up to prevent exacerbations is emphasized. The aim of the present study is to investigate asthma exacerbation in children during the Coronavirus disease 2019 (COVID-19) era. DATA SOURCES This narrative review has been done by searching the PubMed and Embase databases using Asthma, COVID-19, Pandemic, and Symptom flare up as keywords. STUDY SELECTIONS Studies related to asthma exacerbation in COVID-19 pandemic were included. RESULTS Based on studies, controlled or mild to moderate asthma has not been considered a risk factor for COVID-19 severity and has not affected hospitalization, intensive care unit (ICU) admission, and mortality. Surprisingly, emergent and non-emergent visits and asthmatic attacks decreased during the pandemic. The three main reasons for decreased incidence and exacerbation of asthma episodes in the COVID-19 era included reduced exposure to environmental allergens, increasing the acceptance of treatment by pediatrics and caregivers, and decreased risk of other respiratory viral infections. Based on the available studies, COVID-19 vaccination had no serious side effects, except in cases of uncontrolled severe asthma, and can be injected in these children. Also, there was no conclusive evidence of asthma exacerbation after the injection of COVID-19 vaccines. CONCLUSION Further studies are recommended to follow the pattern of asthma in the post-pandemic situation and to become prepared for similar future conditions.
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Affiliation(s)
- Soroush Khojasteh-Kaffash
- Student Research Committee, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran
- Network of Interdisciplinarity in Neonates and Infants (NINI), Universal Scientific Education and Research Network (USERN), Tehran, Iran
- USERN Office, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Peyvand Parhizkar Roudsari
- Network of Interdisciplinarity in Neonates and Infants (NINI), Universal Scientific Education and Research Network (USERN), Tehran, Iran
- Metabolomics and Genomics Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Ghaffari Jolfayi
- Network of Interdisciplinarity in Neonates and Infants (NINI), Universal Scientific Education and Research Network (USERN), Tehran, Iran
- Cardiovascular Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Noosha Samieefar
- Network of Interdisciplinarity in Neonates and Infants (NINI), Universal Scientific Education and Research Network (USERN), Tehran, Iran
- USERN Office, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nima Rezaei
- Network of Interdisciplinarity in Neonates and Infants (NINI), Universal Scientific Education and Research Network (USERN), Tehran, Iran
- Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Department of Immunology, School of Medicine, Tehran University of Medical Science, Tehran, Iran
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10
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Rayner DG, Wang E, Su C, Patel OD, Aleluya S, Giglia A, Zhu E, Siddique M. Risk factors for long COVID in children and adolescents: a systematic review and meta-analysis. World J Pediatr 2024; 20:133-142. [PMID: 38055113 DOI: 10.1007/s12519-023-00765-z] [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: 06/21/2023] [Accepted: 09/26/2023] [Indexed: 12/07/2023]
Abstract
BACKGROUND The long-term sequelae of COVID-19 in children and adolescents remain poorly understood and characterized. This systematic review and meta-analysis sought to summarize the risk factors for long COVID in the pediatric population. METHODS We searched six databases from January 2020 to May 2023 for observational studies reporting on risk factors for long COVID or persistent symptoms those were present 12 or more weeks post-infection using multivariable regression analyses. Trial registries, reference lists of included studies, and preprint servers were hand-searched for relevant studies. Random-effects meta-analyses were conducted to pool odds ratios for each risk factor. Individual study risk of bias was rated using QUIPS, and the GRADE framework was used to assess the certainty of evidence for each unique factor. RESULTS Sixteen observational studies (N = 46,262) were included, and 19 risk factors were amenable to meta-analysis. With moderate certainty in the evidence, age (per 2-year increase), allergic rhinitis, obesity, previous respiratory diseases, hospitalization, severe acute COVID-19, and symptomatic acute COVID-19 are probably associated with an increased risk of long COVID. Female sex, asthma, comorbidity, and heart diseases may be associated with an increased risk of long COVID, and Asian and Black races may be associated with a decreased risk of long COVID. We did not observe any credible subgroup effects for any risk factor. CONCLUSIONS The current body of literature presents several compelling risk factors for the development of long COVID in the pediatric population. Further research is necessary to elucidate the pathophysiology of long COVID.
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Affiliation(s)
- Daniel G Rayner
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4K1, Canada.
| | - Elaine Wang
- Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4K1, Canada
| | - Cloris Su
- Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4K1, Canada
| | - Om D Patel
- Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4K1, Canada
| | - Stephanie Aleluya
- Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4K1, Canada
| | - Alessandra Giglia
- Faculty of Science, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4K1, Canada
| | - Evelyn Zhu
- Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4K1, Canada
| | - Maha Siddique
- Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4K1, Canada
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11
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Yun KW. Community-acquired pneumonia in children: updated perspectives on its etiology, diagnosis, and treatment. Clin Exp Pediatr 2024; 67:80-89. [PMID: 37321577 PMCID: PMC10839192 DOI: 10.3345/cep.2022.01452] [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: 12/17/2022] [Revised: 01/19/2023] [Accepted: 02/08/2023] [Indexed: 06/17/2023] Open
Abstract
Pneumonia is a common pediatric infectious disease that is familiar to pediatricians and a major cause of hospitalization worldwide. Recent well-designed epidemiologic studies in developed countries indicated that respiratory viruses are detected in 30%-70%, atypical bacteria in 7%-17%, and pyogenic bacteria in 2%-8% of children hospitalized with community-acquired pneumonia (CAP). The etiological distribution of CAP varies widely by child age and the epidemiological season of the respiratory pathogen. Moreover, diagnostic tests, particularly for the detection of Streptococcus pneumoniae and Mycoplasma pneumoniae, the 2 major bacterial pathogens involved in pediatric CAP, have several limitations. Therefore, management and empirical antimicrobial therapy for children with CAP should be applied in a stepwise manner based on recent epidemiological, etiological, and microbiological evidence.
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Affiliation(s)
- Ki Wook Yun
- Department of Pediatrics, Seoul National University Children’s Hospital, Seoul National University College of Medicine, Seoul, Korea
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12
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Indolfi C, Klain A, Dinardo G, D’Addio E, Ferrara S, Decimo F, Ciprandi G, Tosca MA, Miraglia del Giudice M. COVID-19 Pediatric Follow-Up: Respiratory Long COVID-Associated Comorbidities and Lung Ultrasound Alterations in a Cohort of Italian Children. CHILDREN (BASEL, SWITZERLAND) 2024; 11:166. [PMID: 38397278 PMCID: PMC10887372 DOI: 10.3390/children11020166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 01/21/2024] [Accepted: 01/25/2024] [Indexed: 02/25/2024]
Abstract
In children, the factors that influence COVID-19 disease and its medium- and long-term effects are little known. Our investigation sought to evaluate the presence of comorbidity factors associated with respiratory long COVID manifestations in children and to study ultrasound abnormalities following SARS-CoV-2 infection. Children, who arrived at the 'Respiratory Diseases of Pediatric Interest Unit' at the Department of Woman, Child, and General and Specialized Surgery of the University of Campania 'Luigi Vanvitelli', were selected during the timeframe from September 2021 to October 2022. The children were diagnosed with a SARS-CoV-2 infection that occurred at least one month before the visit. All patients followed a COVID-19 follow-up protocol, developed by the Italian Society of Pediatric Respiratory Diseases (SIMRI), which included: collection of data regarding SARS-CoV-2 illness and history of known respiratory and allergic diseases; physical examination; BMI assessment; baseline spirometry and after bronchodilation test; six-minute walking test; and lung ultrasound (LUS). In a cohort of 104 participants with respiratory long COVID symptoms (64.7% male, average age 8.92 years), 46.1% had fever with other symptoms, and 1% required hospitalization. BMI analysis showed 58.4% of the cohort was overweight. The LUS was positive in 27.0% of cases. A significant BMI association was observed with COVID-19 symptoms and LUS score (p-value < 0.05). No associations were found with asthma or atopy.
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Affiliation(s)
- Cristiana Indolfi
- Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, 80138 Naples, Italy; (C.I.); (G.D.); (E.D.); (S.F.); (F.D.); (M.M.d.G.)
| | - Angela Klain
- Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, 80138 Naples, Italy; (C.I.); (G.D.); (E.D.); (S.F.); (F.D.); (M.M.d.G.)
| | - Giulio Dinardo
- Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, 80138 Naples, Italy; (C.I.); (G.D.); (E.D.); (S.F.); (F.D.); (M.M.d.G.)
| | - Elisabetta D’Addio
- Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, 80138 Naples, Italy; (C.I.); (G.D.); (E.D.); (S.F.); (F.D.); (M.M.d.G.)
| | - Serena Ferrara
- Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, 80138 Naples, Italy; (C.I.); (G.D.); (E.D.); (S.F.); (F.D.); (M.M.d.G.)
| | - Fabio Decimo
- Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, 80138 Naples, Italy; (C.I.); (G.D.); (E.D.); (S.F.); (F.D.); (M.M.d.G.)
| | - Giorgio Ciprandi
- Department of Medicine, Allergy Clinic, Casa di Cura Villa Montallegro, 16145 Genoa, Italy;
| | - Maria Angela Tosca
- Pediatric Allergy Center, Istituto Giannina Gaslini, 16147 Genoa, Italy;
| | - Michele Miraglia del Giudice
- Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, 80138 Naples, Italy; (C.I.); (G.D.); (E.D.); (S.F.); (F.D.); (M.M.d.G.)
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13
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Bardosh K, Krug A, Jamrozik E, Lemmens T, Keshavjee S, Prasad V, Makary MA, Baral S, Høeg TB. COVID-19 vaccine boosters for young adults: a risk benefit assessment and ethical analysis of mandate policies at universities. JOURNAL OF MEDICAL ETHICS 2024; 50:126-138. [PMID: 36600579 PMCID: PMC10850707 DOI: 10.1136/jme-2022-108449] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 09/23/2022] [Indexed: 06/17/2023]
Abstract
In 2022, students at North American universities with third-dose COVID-19 vaccine mandates risk disenrolment if unvaccinated. To assess the appropriateness of booster mandates in this age group, we combine empirical risk-benefit assessment and ethical analysis. To prevent one COVID-19 hospitalisation over a 6-month period, we estimate that 31 207-42 836 young adults aged 18-29 years must receive a third mRNA vaccine. Booster mandates in young adults are expected to cause a net harm: per COVID-19 hospitalisation prevented, we anticipate at least 18.5 serious adverse events from mRNA vaccines, including 1.5-4.6 booster-associated myopericarditis cases in males (typically requiring hospitalisation). We also anticipate 1430-4626 cases of grade ≥3 reactogenicity interfering with daily activities (although typically not requiring hospitalisation). University booster mandates are unethical because they: (1) are not based on an updated (Omicron era) stratified risk-benefit assessment for this age group; (2) may result in a net harm to healthy young adults; (3) are not proportionate: expected harms are not outweighed by public health benefits given modest and transient effectiveness of vaccines against transmission; (4) violate the reciprocity principle because serious vaccine-related harms are not reliably compensated due to gaps in vaccine injury schemes; and (5) may result in wider social harms. We consider counterarguments including efforts to increase safety on campus but find these are fraught with limitations and little scientific support. Finally, we discuss the policy relevance of our analysis for primary series COVID-19 vaccine mandates.
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Affiliation(s)
- Kevin Bardosh
- School of Public Health, University of Washington, Seattle, Washington, USA
- Edinburgh Medical School, University of Edinburgh, Edinburgh, UK
| | - Allison Krug
- Epidemiology, Artemis Biomedical Communications, Virginia Beach, Virginia, USA
| | - Euzebiusz Jamrozik
- University of Oxford Wellcome Centre for Ethics and Humanities, Oxford, UK
| | - Trudo Lemmens
- Faculty of Law and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Salmaan Keshavjee
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Vinay Prasad
- Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
| | - Marty A Makary
- Department of Surgery, Johns Hopkins University, Baltimore, Maryland, USA
| | - Stefan Baral
- Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Tracy Beth Høeg
- Clinical Research, Acumen, LLC, Burlingame, California, USA
- Sierra Nevada Memorial Hospital, Grass Valley, California, USA
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14
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Anastasopoulou S, Svensson E, Wickström R, Hertting O, Rinder MR, Bennet R, Eriksson M. Seizures in hospitalised paediatric patients with SARS-CoV-2 and comparison of severity with seizures in hospitalised paediatric patients with other respiratory viruses during the COVID-19 pandemic: a population-based cohort study. Arch Dis Child 2024; 109:152-157. [PMID: 37798081 PMCID: PMC10850622 DOI: 10.1136/archdischild-2023-325974] [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: 06/16/2023] [Accepted: 09/20/2023] [Indexed: 10/07/2023]
Abstract
OBJECTIVE To study seizures in patients hospitalised due to SARS-CoV-2 infection, and compare their severity with seizures in patients hospitalised due to other viral respiratory tract infections (RTIs). DESIGN Observational population-based cohort study. SETTING Northern Stockholm. PATIENTS Patients aged 1 month-18 years hospitalised due to SARS-CoV-2 with and without seizures, and patients of the same age hospitalised due to other viral RTIs with seizures, between 1 March 2020 and 30 June 2022. MAIN OUTCOME MEASURES The prevalence of seizures in hospitalised patients due to SARS-CoV-2, the evaluation of assumed predictors of seizures and the comparison of severity markers in patients with SARS-CoV-2 versus other RTIs. RESULTS 32 of 239 included patients (13.4%) admitted due to SARS-CoV-2 infection had seizures. Central nervous system (CNS) disease and the omicron period had significantly increased OR for seizures (OR: 5.12; CI: 2.06 to 12.72 and OR: 3.01; CI: 1.15 to 7.88, respectively). Seizures in patients with SARS-CoV-2 were more common in children older than 5 years (p=0.001), even in the absence of fever (p=0.007), as compared with other viral RTIs. The duration of hospitalisation was longer in patients with seizures due to other viral RTIs (p=0.023). There was no significant difference regarding severity markers of seizures between the two groups. CONCLUSIONS CNS disease and the omicron period were risk factors for seizures in patients with SARS-CoV-2, who were older than patients with other RTIs. The severity of seizures was comparable between the two groups; hospitalisation was however longer in patients with other RTIs.
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Affiliation(s)
- Stavroula Anastasopoulou
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Pediatric Neurology Department, Karolinska University Hospital, Stockholm, Sweden
| | - Eva Svensson
- Pediatric Neurology Department, Karolinska University Hospital, Stockholm, Sweden
| | - Ronny Wickström
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Pediatric Neurology Department, Karolinska University Hospital, Stockholm, Sweden
- Paediatric Neurology, Karolinska Institute, Stockholm, Sweden
| | - Olof Hertting
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Pediatric Emergencies and Infections Department, Karolinska University Hospital, Stockholm, Sweden
| | - Malin Ryd Rinder
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Pediatric Emergencies and Infections Department, Karolinska University Hospital, Stockholm, Sweden
| | - Rutger Bennet
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Pediatric Emergencies and Infections Department, Karolinska University Hospital, Stockholm, Sweden
| | - Margareta Eriksson
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Pediatric Emergencies and Infections Department, Karolinska University Hospital, Stockholm, Sweden
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15
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Aparicio C, Willis ZI, Nakamura MM, Wolf J, Little C, Maron GM, Sue PK, Anosike BI, Miller C, Bio LL, Singh P, James SH, Oliveira CR. Risk Factors for Pediatric Critical COVID-19: A Systematic Review and Meta-Analysis. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.01.17.24301452. [PMID: 38293040 PMCID: PMC10827273 DOI: 10.1101/2024.01.17.24301452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
Background Risk stratification is a cornerstone of the Pediatric Infectious Diseases Society COVID-19 treatment guidance. This systematic review and meta-analysis aimed to define the clinical characteristics and comorbidities associated with critical COVID-19 in children and adolescents. Methods Two independent reviewers screened the literature (Medline and EMBASE) for studies published through August 2023 that reported outcome data on patients aged ≤21 years with COVID-19. Critical disease was defined as an invasive mechanical ventilation requirement, intensive care unit admission, or death. Random effects models were used to estimate pooled odds ratios (OR) with 95% confidence intervals (CI), and heterogeneity was explored through subgroup analyses. Results Among 10,178 articles, 136 studies met the inclusion criteria for review. Data from 70 studies, which collectively examined 172,165 children and adolescents with COVID-19, were pooled for meta-analysis. In previously healthy children, the absolute risk of critical disease from COVID-19 was 4% (95% CI, 1%-10%). Compared with no comorbidities, the pooled OR for critical disease was 3.95 (95% CI, 2.78-5.63) for presence of one comorbidity and 9.51 (95% CI, 5.62-16.06) for ≥2 comorbidities. Key risk factors included cardiovascular and neurological disorders, chronic pulmonary conditions (excluding asthma), diabetes, obesity, and immunocompromise, all with statistically significant ORs >2.00. Conclusions While the absolute risk for critical COVID-19 in children and adolescents without underlying health conditions is relatively low, the presence of one or more comorbidities was associated with markedly increased risk. These findings support the importance of risk stratification in tailoring pediatric COVID-19 management.
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Affiliation(s)
- Camila Aparicio
- Department of Pediatrics, Yale University School of Medicine, New Haven, CT
| | - Zachary I. Willis
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC
| | - Mari M. Nakamura
- Antimicrobial Stewardship Program and Division of Infectious Diseases, Boston Children’s Hospital, Boston, MA
| | - Joshua Wolf
- Department of Infectious Diseases, St. Jude Children’s Research Hospital and Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN
| | - Cordell Little
- Department of Pediatrics, Yale University School of Medicine, New Haven, CT
| | - Gabriela M. Maron
- Department of Infectious Diseases, St. Jude Children’s Research Hospital and Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN
| | - Paul K. Sue
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY
| | - Brenda I. Anosike
- Department of Pediatrics, The Children’s Hospital at Montefiore and Albert Einstein College of Medicine, Bronx, NY
| | - Christine Miller
- Department of Pediatrics, Yale University School of Medicine, New Haven, CT
| | - Laura L. Bio
- Department of Pharmacy, Lucile Packard Children’s Hospital, Stanford, CA
| | - Prachi Singh
- Department of Pediatrics, University of California San Francisco, San Francisco, CA
| | - Scott H. James
- Department of Pediatrics, Division of Pediatric Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL
| | - Carlos R. Oliveira
- Department of Pediatrics, Yale University School of Medicine, New Haven, CT
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16
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Korematsu S, Fujisawa T, Saito N, Tezuka J, Miura K, Kobayashi I, Miyata I, Kosugi Y, Gohda Y, Koike Y, Suda A, Matsuo A, Sasaki M, Handa Y, Fujiwara M, Ono A, Koizumi S, Oishi T, Tanaka T, Ando Y, Taba N, Tsurinaga Y, Sato T, Kanai R, Yashiro M, Takagi T, Hida S, Harazaki M, Hoshina T, Okada S, Yasutomi M, Nakata S, Muto A, Tanabe S, Ueda Y, Hasegawa S, Kameda M, Tanaka‐Taya K, Fujimoto T, Okada K. Suppressed pediatric asthma hospitalizations during the COVID-19 pandemic in Japan, from a national survey. Clin Transl Allergy 2024; 14:e12330. [PMID: 38282201 PMCID: PMC10795717 DOI: 10.1002/clt2.12330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 12/06/2023] [Accepted: 12/28/2023] [Indexed: 01/30/2024] Open
Abstract
BACKGROUND Acute asthma exacerbation in children is often caused by respiratory infections. In this study, a coordinated national surveillance system for acute asthma hospitalizations and causative respiratory infections was established. We herein report recent trends in pediatric acute asthma hospitalizations since the COVID-19 pandemic in Japan. METHODS Thirty-three sentinel hospitals in Japan registered all of their hospitalized pediatric asthma patients and their causal pathogens. The changes in acute asthma hospitalization in children before and after the onset of the COVID-19 pandemic and whether or not COVID-19 caused acute asthma exacerbation were investigated. RESULTS From fiscal years 2010-2019, the median number of acute asthma hospitalizations per year was 3524 (2462-4570), but in fiscal years 2020, 2021, and 2022, the numbers were 820, 1,001, and 1,026, respectively (the fiscal year in Japan is April to March). This decrease was observed in all age groups with the exception of the 3- to 6-year group. SARS-CoV-2 was evaluated in 2094 patients from fiscal years 2020-2022, but the first positive case was not detected until February 2022. Since then, only 36 of them have been identified with SARS-CoV-2, none of which required mechanical ventilation. Influenza, RS virus, and human metapneumovirus infections also decreased in FY 2020. In contrast, 24% of patients had not been receiving long-term control medications before admission despite the severity of bronchial asthma. CONCLUSION SARS-CoV-2 was hardly detected in children with acute asthma hospitalization during the COVID-19 pandemic. This result indicated that SARS-CoV-2 did not induce acute asthma exacerbation in children. Rather, infection control measures implemented against the pandemic may have consequently reduced other respiratory virus infections and thus acute asthma hospitalizations during this period. However, the fact that many hospitalized patients have not been receiving appropriate long-term control medications is a major problem that should be addressed.
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17
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Korzeniewska-Eksterowicz A, Brzezinska O, Dryja U, Matczak D, Sopilnyak A, Szuszkiewicz E, Przysło Ł, Szmyd K, Jabłońska K, Krych P, Wojtków-Zielińska A, Wąsińska E, Niedźwiecki M. COVID-19 in pediatric palliative care patients: Multicenter, retrospective cohort study. Palliat Med 2024; 38:150-155. [PMID: 37937380 DOI: 10.1177/02692163231206928] [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] [Indexed: 11/09/2023]
Abstract
BACKGROUND Studies have shown the risk factors for COVID-19 severity in children, including comorbidities, but information on the infection course in children with life-limiting conditions is sparse. AIM To describe the effect of COVID-19 on pediatric patients receiving palliative care due to life-limiting conditions. DESIGN We conducted retrospective cohort study. The WHO Clinical Progression Scale was used to measure COVID-19 severity. SETTING/PARTICIPANTS Seven of the 24 invited pediatric palliative care centers participated in this study. We analyzed the medical records of children under palliative care with confirmed COVID-19 (January 2020-April 2022). RESULTS Records of 60 patients with COVID-19 aged 0.24 to 21.6 years (mean (SD); 9.8 (6.6)) were collected. The largest group of patients with COVID-19 was children with congenital malformations and chromosomal abnormalities (42%); the most common manifestation was fever (85%). Bacterial coinfection was confirmed in 17 (28%) children. Fifteen (25%) children required hospitalization, including four admitted to the Intensive Care Unit. Mild COVID-19 was identified in 44 (73%) children, moderate in 11 (18%), severe in 3 (5%), and death in 2 (3%). Six of the 20 eligible children were vaccinated against SARS-CoV-2, followed by 16 mothers and fathers. CONCLUSION In the study population initial presentation of COVID-19 was predominantly a mild; however, the small sample size precluded definitive conclusions. For children under palliative care, we should identify if they have an advance care plan for COVID-19, such as desires for intensive care support. Further studies are needed to define the short and long-term effects of COVID-19 in children with life-limiting conditions.
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Affiliation(s)
- Aleksandra Korzeniewska-Eksterowicz
- Pediatric Palliative Care Unit, Department of Pediatrics, Oncology and Hematology, Medical University of Lodz, Lodz, Poland
- Gajusz Foundation-Pediatric Palliative Care Center, Lodz, Poland
| | - Olga Brzezinska
- Department of Rheumatology With Subdepartment of Internal Medicine, Medical University of Lodz, Lodz, Poland
| | - Urszula Dryja
- Gajusz Foundation-Pediatric Palliative Care Center, Lodz, Poland
| | - Dominka Matczak
- Gajusz Foundation-Pediatric Palliative Care Center, Lodz, Poland
| | - Andriy Sopilnyak
- Pediatric Palliative Care Unit, Department of Pediatrics, Oncology and Hematology, Medical University of Lodz, Lodz, Poland
- Gajusz Foundation-Pediatric Palliative Care Center, Lodz, Poland
| | | | - Łukasz Przysło
- Department of Developmental Neurology and Epileptology, Research Institute of Polish Mother's Memorial Hospital, Lodz, Poland
| | - Krzystof Szmyd
- Hospice for Children of Lower Silesia "Formula Dobra," Wrocław, Poland
| | | | - Piotr Krych
- Home Children's Hospice Promyczek, Otwock, Poland
| | | | | | - Maciej Niedźwiecki
- Department of Pediatrics, Hematology and Oncology, Medical University of Gdansk, Gdansk, Poland
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18
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Liu LT, Tsai JJ. Unveiling COVID-19 treatment strategies for immunocompromised individuals: Therapeutic innovations and latest findings. Int J Rheum Dis 2024; 27:e14900. [PMID: 38287550 DOI: 10.1111/1756-185x.14900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/17/2023] [Accepted: 08/22/2023] [Indexed: 01/31/2024]
Affiliation(s)
- Li-Teh Liu
- Department of Medical Laboratory Science and Biotechnology, College of Medical Technology, Chung-Hwa University of Medical Technology, Tainan City, Taiwan
| | - Jih-Jin Tsai
- Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan
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19
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Edwards KM. The Therapy of SARS-CoV-2 Infection in Children. J Clin Med 2023; 13:120. [PMID: 38202127 PMCID: PMC10779459 DOI: 10.3390/jcm13010120] [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: 11/23/2023] [Revised: 12/11/2023] [Accepted: 12/20/2023] [Indexed: 01/12/2024] Open
Abstract
The impact of SARS-CoV-2 infections in children has fortunately been lower than what has been seen in adults. However, even previously healthy children have developed severe disease, sometimes with subsequent mortality, and those who are infants or adolescents, are from racial and ethnic minority groups, or have certain chronic conditions are at higher risk of these outcomes. During the pandemic, extensive studies of therapeutic agents, including antivirals and immunomodulators, were conducted in adults. Few trials included children, and most were in older children and adolescents. Thus, the potential benefits of therapies in children must be extrapolated from adult evidence. Despite these limitations, advisory committees of the National Institute of Health (NIH), the Infectious Disease Society of America (IDSA), and the Pediatric Infectious Diseases Society (PIDS) were constituted, and expert consensus guidelines were developed. This review provides a synthesis of those comprehensive recommendations for therapy in children. These address treatment during the early infectious period with antiviral agents, including remdesivir and nirmatrelvir/ritonavir, as well as treatment in the later period of immune dysregulation with corticosteroids and immunomodulators. In addition, the therapeutic approach for multisystem inflammatory syndrome in children (MIS-C), also referred to as Pediatric Inflammatory Multisystem Syndrome temporally associated with SARS-CoV-2 (PIMS-TS), is also provided.
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Affiliation(s)
- Kathryn M Edwards
- Division of Infectious Diseases, Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
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20
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Staines-Boone AT, Vignesh P, Tsumura M, de la Garza Fernández G, Tyagi R, Rawat A, Das J, Tomomasa D, Asano T, Hijikata A, Salazar-Gálvez Y, Kanegane H, Okada S, Reyes SOL. Fatal COVID-19 Infection in Two Children with STAT1 Gain-of-Function. J Clin Immunol 2023; 44:20. [PMID: 38129739 DOI: 10.1007/s10875-023-01634-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 11/28/2023] [Indexed: 12/23/2023]
Abstract
While SARS-CoV-2 infection causes a mild disease in most children, SARS-CoV-2 infection may be lethal in a few of them. In the defense against SARS-CoV-2, type I interferons are key players, and several studies have identified a defective or neutralized interferon response as the cause of overwhelming viral infection. However, inappropriate, untimely, or excessive interferon production may also be detrimental to the host. Here, we describe two patients with STAT1 gain-of-function (GOF), a known type I interferonopathy, who died of COVID-19. Whole-exome sequencing and interferon-gamma-activated sequence (GAS) and interferon-sensitive responsive element (ISRE) reporter assay were performed to identify and characterize STAT1 variants. Patient 1 developed hemophagocytic lymphohistiocytosis (HLH) in the context of COVID-19 infection and died in less than a week at the age of 4 years. Patient 2 developed a high fever, cough, and hypoxemia and succumbed to COVID-19 pneumonia at the age of 5 years. Two heterozygous missense variants, p.E563Q and p.K344E, in STAT1 were identified. Functional validation by reporter assay and immunoblot confirmed that both variants are gain-of-function (GOF). GOF variants transiently expressing cells exhibited enhanced upregulation of downstream genes, including ISG15, MX1, and OAS1, in response to IFN-α stimulation. A catastrophic course with HLH or acute respiratory failure is thought to be associated with inappropriate immunoregulatory mechanisms to handle SARS-CoV-2 in STAT1 GOF. While most patients with inborn errors of immunity who developed COVID-19 seem to handle it well, these cases suggest that patients with STAT1-GOF might be at risk of developing fatal complications due to SARS-CoV-2.
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Affiliation(s)
- Aidé Tamara Staines-Boone
- Immunology Service at Hospital de Especialidades UMAE 25 Mexican Social Security, Institute (IMSS), Monterrey, Mexico
| | - Pandiarajan Vignesh
- Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
| | - Miyuki Tsumura
- Department of Pediatrics, Hiroshima University Graduate School of Biomedical and Health Science, Hiroshima, Japan
| | - Germán de la Garza Fernández
- Immune Deficiencies Laboratory at the National Institute of Pediatrics, Health Secretariat, Av Iman 1, Piso 9 Torre de Investigación, Col. Insurgentes Cuicuilco, Coyoacán, 04530, Mexico City, CDMX, Mexico
| | - Reva Tyagi
- Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Amit Rawat
- Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Jhumki Das
- Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Dan Tomomasa
- Department of Pediatrics and Developmental Biology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Takaki Asano
- Department of Pediatrics, Hiroshima University Graduate School of Biomedical and Health Science, Hiroshima, Japan
| | - Atsushi Hijikata
- School of Life Sciences, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | - Yuridia Salazar-Gálvez
- Immunology Service at Hospital de Especialidades UMAE 25 Mexican Social Security, Institute (IMSS), Monterrey, Mexico
| | - Hirokazu Kanegane
- Department of Child Health and Development, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Satoshi Okada
- Department of Pediatrics, Hiroshima University Graduate School of Biomedical and Health Science, Hiroshima, Japan.
| | - Saul O Lugo Reyes
- Immune Deficiencies Laboratory at the National Institute of Pediatrics, Health Secretariat, Av Iman 1, Piso 9 Torre de Investigación, Col. Insurgentes Cuicuilco, Coyoacán, 04530, Mexico City, CDMX, Mexico.
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21
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Huang PC, Lin TY, Chen CC, Wang SW, Tsai BY, Tsai PJ, Tu YF, Ko WC, Cheng CM, Shieh CC, Liu CC, Shen CF. Age and prior vaccination determine the antibody level in children with primary SARS-CoV-2 Omicron infection. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2023; 56:1187-1197. [PMID: 37739902 DOI: 10.1016/j.jmii.2023.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 08/09/2023] [Accepted: 08/27/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND Protection against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reinfection relies on immunity generated after primary infection. However, humoral immunity following primary infection with the Omicron variant is not well understood. METHODS We prospectively recruited children <19 years with virologically-confirmed SARS-CoV-2 infection at National Cheng Kung University Hospital from February 2022 to September 2022 during the first wave of Omicron BA.2 outbreak in Taiwan. Serum samples were collected one month after acute infection to measure anti-spike protein receptor binding domain antibody levels and surrogate virus neutralizing antibody (NAb) levels against wild type disease and variants. RESULTS Of the 164 patients enrolled, most were under 5 years (65.2%) with a diagnosis of upper respiratory tract infection. Children under 6 months with maternal coronavirus disease 2019 (COVID-19) vaccination had higher levels of both anti-SARS-CoV-2 spike antibody (119.0 vs 27.4 U/ml, p < 0.05) and anti-wild type NAb (56.9% vs 27.6% inhibition, p = 0.001) than those without. Children aged 5-12 years with prior vaccination had higher anti-spike antibody, anti-wild type, and anti-Omicron BA.2 NAb levels than those without (all p < 0.05). In previously naïve children without maternal or self-vaccination, those 6 months to 2 years had the highest antibody levels. Multivariable linear regression analysis showed age was the only independent factor associated with antibody level. CONCLUSIONS In our study, children aged 6 months to 2 years have the highest antibody responses to SARS-CoV-2 Omicron variant infection. Age and prior vaccination are the main factors influencing the immunogenicity of SARS-CoV-2 infection.
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Affiliation(s)
- Pin-Chen Huang
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan, ROC
| | - Ting-Yu Lin
- Department of Pediatrics, Kuo General Hospital, Tainan, Taiwan
| | - Chih-Chia Chen
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan, ROC; Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan, ROC
| | - Shih-Wei Wang
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan, ROC
| | - Bo-Yang Tsai
- Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan, ROC
| | - Pei-Jane Tsai
- Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan, ROC; Center of Infectious Disease and Signaling Research, National Cheng Kung University, Tainan, 70101, Taiwan, ROC; Department of Medical Laboratory Science and Biotechnology, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan, ROC
| | - Yi-Fang Tu
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan, ROC
| | - Wen-Chien Ko
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan, ROC
| | - Chao-Min Cheng
- Institute of Biomedical Engineering, National Tsing Hua University, Hsinchu 30013, Taiwan, ROC
| | - Chi-Chang Shieh
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan, ROC; Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan, ROC
| | - Ching-Chuan Liu
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan, ROC; Center of Infectious Disease and Signaling Research, National Cheng Kung University, Tainan, 70101, Taiwan, ROC
| | - Ching-Fen Shen
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan, ROC; Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan, ROC.
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22
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Park H, Kim KR, Huh HJ, Yoon Y, Park E, Cho J, Lee J, Lee J, Kim JH, Kim YJ. Complications of the Central Nervous System in Pediatric Patients With Common Cold Coronavirus Infection During 2014-2019. J Korean Med Sci 2023; 38:e358. [PMID: 38013644 PMCID: PMC10681840 DOI: 10.3346/jkms.2023.38.e358] [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: 05/02/2023] [Accepted: 08/31/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND In pediatric patients, the common cold coronavirus (ccCoV) usually causes mild respiratory illness. There are reports of coronavirus causing central nervous system (CNS) infection in experimental animal models. Some immunocompromised patients have also been reported to have fatal CNS infections with ccCoV. The aim of this study was to investigate the clinical characteristics of CNS complications related to ccCoV infection. METHODS From January 2014 to December 2019, a retrospective analysis was performed of medical records from hospitalized patients under 19 years of age whose ccCoV was detected through polymerase chain reaction in respiratory specimens. The CNS complications were defined as clinically diagnosed seizure, meningitis, encephalopathy, and encephalitis. RESULTS A total of 436 samples from 420 patients were detected as ccCoV. Among the 420 patients, 269 patients were immunocompetent and 151 patients were immunocompromised. The most common type of ccCoV was OC43 (52% in immunocompetent, 37% in immunocompromised). CNS complications were observed in 9.4% (41/436). The most common type of CNS complication was the fever-provoked seizure under pre-existing neurologic disease (42% in immunocompetent and 60% in immunocompromised patients). Among patients with CNS complications, two immunocompetent patients required intensive care unit admission due to encephalitis. Three patients without underlying neurological disease started anti-seizure medications for the first time at this admission. There was no death related to ccCoV infection. CONCLUSION ccCoV infection may cause severe clinical manifestations such as CNS complications or neurologic sequelae, even in previously healthy children.
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Affiliation(s)
- Hwanhee Park
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyung-Ran Kim
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hee Jae Huh
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yoonsun Yoon
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Esther Park
- Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Joongbum Cho
- Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jiwon Lee
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jeehun Lee
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji Hye Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yae-Jean Kim
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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23
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Wu J, Qiu L, Xiong W, Shen Y, Li J, Wu J, Zhou Q. COVID-19 anxiety and related factors amid adjusted epidemic prevention policies: a cross-sectional study on patients with late-life depression in China. BMJ Open 2023; 13:e072725. [PMID: 38000824 PMCID: PMC10680000 DOI: 10.1136/bmjopen-2023-072725] [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: 02/18/2023] [Accepted: 11/08/2023] [Indexed: 11/26/2023] Open
Abstract
OBJECTIVES To explore the prevalence and associated factors of COVID-19 anxiety in patients with late-life depression (LLD) during the adjustment of epidemic prevention policies in China. DESIGN Cross-sectional study. SETTING The data analysed in this study were collected from seven regions in China between November 2022 and January 2023. PARTICIPANTS A total of 1205 patients with LLD (aged 60-78 years) participated in the survey. They completed a social demographic assessment and the Chinese version of the five-point Coronavirus Anxiety Scale (CAS). PRIMARY OUTCOME MEASURES The primary outcome was the anxiety level of the participants. Patients were categorised into two groups based on their anxiety levels, one with anxiety and one without, according to CAS scores. RESULTS The prevalence of COVID-19 anxiety in depressed older adults was 47.3%. Regression analysis revealed that the average COVID-19 anxiety score was significantly higher among females (AOR: 2.177, 95% CI 1.201 to 3.947), widowed individuals (AOR: 3.015, 95% CI 1.379 to 6.591), patients residing at a distance from healthcare facilities (AOR: 3.765, 95% CI 1.906 to 7.438), and those who frequently experienced worry (AOR: 1.984, 95% CI 1.111 to 3.543). Conversely, the anxiety score was significantly lower among divorced individuals (AOR: 0.491, 95% CI 0.245 to 0.988), those aged 70 years and above (AOR: 0.117, 95% CI 0.064 to 0.213), patients without difficulty obtaining medication (AOR: 0.027, 95% CI 0.007 to 0.097), those living with family members (AOR: 0.080, 95% CI 0.022 to 0.282) or in nursing homes compared with those living alone (AOR: 0.019, 95% CI 0.004 to 0.087). CONCLUSION Women with LLD who are widowed, live far from healthcare facilities, and are prone to excessive worry are more likely to experience anxiety. It is advisable to implement appropriate preventive measures and provide psychosocial support programmes for this vulnerable group during the COVID-19 pandemic.
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Affiliation(s)
- Jianhong Wu
- Department of Pharmacy, The Affiliated Mental Health Center of Jiangnan University, Wuxi, Jiangsu, China
| | - Linghe Qiu
- Department of General Psychiatry, The Affiliated Mental Health Center of Jiangnan University, Wuxi, Jiangsu, China
| | - Wendian Xiong
- School of Life Sciences and Health Engineering, Jiangnan University, Wuxi, Jiangsu, China
| | - Yuan Shen
- Department of Pharmacy, The Affiliated Mental Health Center of Jiangnan University, Wuxi, Jiangsu, China
| | - Jun Li
- Department of Pharmacy, Nanjing First Hospital, Nangjing, Jiangsu, China
| | - Ju Wu
- Department of Pharmacy, Jiangsu Provincial Rongjun Hospital, Wuxi, Jiangsu, China
| | - Qin Zhou
- Department of Pharmacy, The Affiliated Mental Health Center of Jiangnan University, Wuxi, Jiangsu, China
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24
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Gaietto K, Bergum N, Rosser F, Snyder O, Acevedo-Torres N, DiCicco LA, Butler G, Rauenswinter S, Iagnemma J, Wolfson D, Han YY, Kazmerski TM, Forno E. Odds of COVID-19-associated asthma exacerbations in children higher during Omicron wave. Pediatr Pulmonol 2023; 58:3179-3187. [PMID: 37594160 PMCID: PMC10592137 DOI: 10.1002/ppul.26642] [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: 06/01/2023] [Revised: 08/07/2023] [Accepted: 08/10/2023] [Indexed: 08/19/2023]
Abstract
BACKGROUND We aimed to determine the association of COVID-19 variant wave with asthma exacerbations in children with asthma. METHODS We conducted a retrospective cross-sectional study of children in the Western Pennsylvania COVID-19 Registry (WPACR). We extracted data for all children in the WPACR with asthma and compared their acute clinical presentation and outcomes during the Pre-Delta (7/1/20-6/30/21), Delta (8/1/21-12/14/21), and Omicron (12/15/21-8/30/22) waves. We conducted multivariable logistic regression analyses of SARS-CoV-2-associated asthma exacerbations, adjusting for characteristics that have been associated with COVID-19 outcomes in prior studies. RESULTS Among 573 children with asthma in the WPACR during the study period, the proportion of children with COVID-19 who had an asthma exacerbation was higher during the Omicron wave than during the prior two variant waves (40.2% vs. 22.6% vs. 26.2%, p = 0.002; unadjusted OR = 2.12 [95% confidence interval (CI) = 1.39-3.22], p < 0.001). In our multivariable regression models, the odds of an asthma exacerbation were 2.8 times higher during the Omicron wave than during prior waves (adjusted OR = 2.80 [95% CI = 1.70-4.61]). Results were similar after additionally adjusting for asthma severity but were no longer significant after additionally adjusting for poor asthma control. CONCLUSION The proportion of children with asthma experiencing an asthma exacerbation during SARS-CoV-2 infection was higher during Omicron than prior variant waves, adding to the body of evidence that COVID-19-associated respiratory symptoms vary by variant. These findings provide additional support for vaccination and prevention.
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Affiliation(s)
- Kristina Gaietto
- Division of Pulmonary Medicine, Department of Pediatrics, UPMC Children’s Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA, USA
| | - Nicholas Bergum
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Franziska Rosser
- Division of Pulmonary Medicine, Department of Pediatrics, UPMC Children’s Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA, USA
| | - Oliver Snyder
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | | - Leigh Anne DiCicco
- Division of Hospital Medicine, Department of Pediatrics, UPMC Children’s Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA, USA
| | - Gabriella Butler
- UPMC Children’s Hospital of Pittsburgh Clinical Analytics, Pittsburgh, PA, USA
| | | | | | - David Wolfson
- UPMC Children’s Community Pediatrics, Pittsburgh, PA, USA
| | - Yueh-Ying Han
- Division of Pulmonary Medicine, Department of Pediatrics, UPMC Children’s Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA, USA
| | - Traci M Kazmerski
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, UPMC Children’s Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA, USA
| | - Erick Forno
- Division of Pulmonary Medicine, Department of Pediatrics, UPMC Children’s Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA, USA
- Now at the Division of Pulmonary, Allergy, and Sleep Medicine, Riley Children’s Hospital, Department of Pediatrics, Indiana University, Indianapolis, IN
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25
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Gaietto K, Bergum N, Acevedo-Torres N, Snyder O, DiCicco LA, Butler G, Rauenswinter S, Iagnemma J, Wolfson D, Kazmerski TM, Forno E. The Impact of SARS-CoV-2 Infection on Symptom Control and Lung Function in Children with Asthma. Ann Am Thorac Soc 2023; 20:1605-1613. [PMID: 37495209 PMCID: PMC10632927 DOI: 10.1513/annalsats.202302-117oc] [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: 02/08/2023] [Accepted: 07/26/2023] [Indexed: 07/28/2023] Open
Abstract
Rationale: Little is known about the long-term impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on children with asthma. Objectives: To determine whether SARS-CoV-2 infection affects symptom control and lung function in children with asthma. Methods: Using data from clinical registries and the electronic health record, we conducted a prospective case-control study of children with asthma aged 6-21 years who had (cases) or did not have (control subjects) SARS-CoV-2 infection, comparing baseline and follow-up asthma symptom control and spirometry within an ∼18-month time frame and, for cases, within 18 months of acute coronavirus disease (COVID-19). Results: A total of 171 cases had baseline and follow-up asthma symptom data, and 114 cases had baseline and follow-up spirometry measurements. There were no significant differences in asthma symptom control (P = 0.50), forced expiratory volume in 1 second (P = 0.47), forced vital capacity (P = 0.43), forced expiratory volume in 1 second/forced vital capacity (P = 0.43), or forced expiratory flow, midexpiratory phase (P = 0.62), after SARS-CoV-2 infection. Compared with control subjects (113 with symptom data and 237 with spirometry data), there were no significant differences in follow-up asthma symptom control or lung function. A similar proportion of cases and control subjects had poorer asthma symptom control (17.5% vs. 9.7%; P = 0.07) or worse lung function (29.0% vs. 32.5%; P = 0.50) at follow-up. Patients whose asthma control worsened after COVID-19 had a shorter time to follow-up (3.5 [1.5-7.5] vs. 6.1 [3.1-9.8] mo; P = 0.007) and were more likely to have presented with an asthma exacerbation during COVID-19 (46% vs. 26%; P = 0.04) than those without worse control. Conclusions: We found no significant differences in asthma symptom control or lung function in youth with asthma up to 18 months after acute COVID-19, suggesting that COVID-19 does not affect long-term asthma severity or control in the pediatric population.
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Affiliation(s)
- Kristina Gaietto
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Division of Pulmonary Medicine
| | - Nicholas Bergum
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Division of Pulmonary Medicine
| | | | | | - Leigh Anne DiCicco
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Division of Hospital Medicine
| | | | - Sherry Rauenswinter
- University of Pittsburgh Medical Center Children’s Community Pediatrics, Pittsburgh, Pennsylvania
| | - Jennifer Iagnemma
- University of Pittsburgh Medical Center Children’s Community Pediatrics, Pittsburgh, Pennsylvania
| | - David Wolfson
- University of Pittsburgh Medical Center Children’s Community Pediatrics, Pittsburgh, Pennsylvania
| | - Traci M. Kazmerski
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Division of Adolescent and Young Adult Medicine, University of Pittsburgh Medical Center Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania; and
| | - Erick Forno
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Division of Pulmonary Medicine
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26
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Constantin T, Pék T, Horváth Z, Garan D, Szabó AJ. Multisystem inflammatory syndrome in children (MIS-C): Implications for long COVID. Inflammopharmacology 2023; 31:2221-2236. [PMID: 37460909 PMCID: PMC10518292 DOI: 10.1007/s10787-023-01272-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 06/12/2023] [Indexed: 09/26/2023]
Abstract
The COVID-19 pandemic caused by the coronavirus 2 of the severe acute respiratory syndrome (SARS-CoV-2) has significantly affected people around the world, leading to substantial morbidity and mortality. Although the pandemic has affected people of all ages, there is increasing evidence that children are less susceptible to SARS-CoV-2 infection and are more likely to experience milder symptoms than adults. However, children with COVID-19 can still develop serious complications, such as multisystem inflammatory syndrome in children (MIS-C). This narrative review of the literature provides an overview of the epidemiology and immune pathology of SARS-CoV-2 infection and MIS-C in children. The review also examines the genetics of COVID-19 and MIS-C in children, including the genetic factors that can influence the susceptibility and severity of the diseases and their implications for personalized medicine and vaccination strategies. By examining current evidence and insights from the literature, this review aims to contribute to the development of effective prevention and treatment strategies for COVID-19, MIS-C, and long COVID syndromes in children.
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Affiliation(s)
- Tamás Constantin
- Department of Pediatrics, Semmelweis University, Tűzoltó u. 7-9., Budapest, 1094, Hungary.
| | - Tamás Pék
- Department of Pediatrics, Semmelweis University, Tűzoltó u. 7-9., Budapest, 1094, Hungary
| | - Zsuzsanna Horváth
- Department of Pediatrics, Semmelweis University, Tűzoltó u. 7-9., Budapest, 1094, Hungary
| | - Diána Garan
- Department of Pediatrics, Semmelweis University, Tűzoltó u. 7-9., Budapest, 1094, Hungary
| | - Attila J Szabó
- Department of Pediatrics, Semmelweis University, Tűzoltó u. 7-9., Budapest, 1094, Hungary
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27
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Huang SM, Wu CH, Yen TY, Wu ET, Wang CC, Lu FL, Lu CY, Chen JM, Lee PI, Lee WT, Chang LY, Huang LM. Clinical characteristics and factors associated with severe COVID-19 in hospitalized children during the SARS-CoV-2 Omicron pandemic in Taiwan. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2023; 56:961-969. [PMID: 37385831 PMCID: PMC10273769 DOI: 10.1016/j.jmii.2023.06.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 05/02/2023] [Accepted: 06/10/2023] [Indexed: 07/01/2023]
Abstract
BACKGROUND Since April 2022, a notable increase in COVID-19 cases with the rapid spread of the SARS-CoV-2 Omicron variant has been reported in Taiwan. In the epidemic, children were one of the most vulnerable groups, so we analyzed their clinical presentations and factors associated with severe complications of COVID-19 in children. METHODS We included hospitalized patients under 18 years old with lab-confirmed SARS-CoV-2 infection from March 1, 2022, to July 31, 2022. We collected the demographic and clinical characteristics of the patients. Patients requiring intensive care were defined as severe cases. RESULTS Among the 339 enrolled patients, the median age was 31 months (interquartile range (IQR), 8-79.0 months); and 96 patients (28.3%) had underlying diseases. Fever was noted in 319 patients (94.1%) with a median duration of two days (IQR 2-3 days). Twenty-two patients (6.5%) were severe cases, including 10 patients (2.9%) with encephalopathy with abnormal neuroimaging and ten patients (2.9%) with shock. Two patients (0.6%) died. Patients with congenital cardiovascular disease (aOR: 21.689), duration of fever up to four days or more (aOR: 6.466), desaturation (aOR: 16.081), seizure (aOR: 20.92), and procalcitonin >0.5 ng/mL (aOR: 7.886) had a higher risk of severe COVID-19. CONCLUSIONS Vital signs need close monitoring, early management and/or intensive care may be applied in COVID-19 patients with congenital cardiovascular diseases, fever lasting ≥4 days, seizures, desaturation and/or elevated procalcition since they are at higher risks of severe diseases.
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Affiliation(s)
- Song-Ming Huang
- Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Pediatrics, Fu Jen Catholic University Hospital, New Taipei City, Taiwan
| | - Chi-Hsien Wu
- Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Ting-Yu Yen
- Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
| | - En-Ting Wu
- Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Ching-Chia Wang
- Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Frank Leigh Lu
- Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chun-Yi Lu
- Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Jong-Min Chen
- Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Ping-Ing Lee
- Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Wang-Tso Lee
- Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Luan-Yin Chang
- Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
| | - Li-Min Huang
- Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
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Sarri G, Liu W, Zabotka L, Freitag A, Claire R, Wangge G, Elvidge J, Dawoud D, Bennett D, Wen X, Li X, Rentsch CT, Uddin MJ, Ali MS, Gokhale M, Déruaz-Luyet A, Moga DC, Guo JJ, Zullo AR, Patorno E, Lin KJ. Prognostic Factors of COVID-19: An Umbrella Review Endorsed by the International Society for Pharmacoepidemiology. Clin Pharmacol Ther 2023; 114:604-613. [PMID: 37342987 DOI: 10.1002/cpt.2977] [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: 03/14/2023] [Accepted: 06/12/2023] [Indexed: 06/23/2023]
Abstract
During the coronavirus disease 2019 (COVID-19) pandemic, the urgency for updated evidence to inform public health and clinical care placed systematic literature reviews (SLRs) at the cornerstone of research. We aimed to summarize evidence on prognostic factors for COVID-19 outcomes through published SLRs and to critically assess quality elements in the findings' interpretation. An umbrella review was conducted via electronic databases from January 2020 to April 2022. All SLRs (and meta-analyses) in English were considered. Data screening and extraction were conducted by two independent reviewers. AMSTAR 2 tool was used to assess SLR quality. The study was registered with PROSPERO (CRD4202232576). Out of 4,564 publications, 171 SLRs were included of which 3 were umbrella reviews. Our primary analysis included 35 SLRs published in 2022, which incorporated studies since the beginning of the pandemic. Consistent findings showed that, for adults, older age, obesity, heart disease, diabetes, and cancer were more strongly predictive of risk of hospitalization, intensive care unit admission, and mortality due to COVID-19. Male sex was associated with higher risk of short-term adverse outcomes, but female sex was associated with higher risk of long COVID. For children, socioeconomic determinants that may unravel COVID-19 disparities were rarely reported. This review highlights key prognostic factors of COVID-19, which can help clinicians and health officers identify high-risk groups for optimal care. Findings can also help optimize confounding adjustment and patient phenotyping in comparative effectiveness research. A living SLR approach may facilitate dissemination of new findings. This paper is endorsed by the International Society for Pharmacoepidemiology.
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Affiliation(s)
| | - Wei Liu
- Office of Surveillance and Epidemiology, CDER, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Luke Zabotka
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | | | - Ravinder Claire
- National Institute for Health and Care Excellence, London, UK
| | | | - Jamie Elvidge
- National Institute for Health and Care Excellence, London, UK
| | - Dalia Dawoud
- National Institute for Health and Care Excellence, London, UK
- Cairo University, Cairo, Egypt
| | - Dimitri Bennett
- Takeda Development Center Americas, Inc., Cambridge, Massachusetts, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Xuerong Wen
- College of Pharmacy, University of Rhode Island, Kingston, Rhode Island, USA
| | - Xiaojuan Li
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
| | - Christopher T Rentsch
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Md Jamal Uddin
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet, Bangladesh
- Department of General Educational Development (GED), Daffodil International University, Dhaka, Bangladesh
| | - M Sanni Ali
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
- Liverpool School of Tropical Medicine, Liverpool, UK
| | | | | | - Daniela C Moga
- Department of Pharmacy Practice and Science, College of Pharmacy, University of Kentucky, Lexington, Kentucky, USA
| | - Jeff Jianfei Guo
- Division of Pharmacy Practice & Administrative Sciences, College of Pharmacy, University of Cincinnati, Cincinnati, Ohio, USA
| | - Andrew R Zullo
- Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island, USA
| | - Elisabetta Patorno
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Kueiyu Joshua Lin
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Ahmed IS, Tapponi SL, Widatallah ME, Alakkad YM, Haider M. Unmasking the enigma: An in-depth analysis of COVID-19 impact on the pediatric population. J Infect Public Health 2023; 16:1346-1360. [PMID: 37433256 PMCID: PMC10299956 DOI: 10.1016/j.jiph.2023.06.017] [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: 05/26/2023] [Revised: 06/18/2023] [Accepted: 06/21/2023] [Indexed: 07/13/2023] Open
Abstract
OBJECTIVES COVID-19, caused by the novel coronavirus, has had a profound and wide-reaching impact on individuals of all age groups across the globe, including children. This review article aims to provide a comprehensive analysis of COVID-19 in children, covering essential topics such as epidemiology, transmission, pathogenesis, clinical features, risk factors, diagnosis, treatment, vaccination, and others. By delving into the current understanding of the disease and addressing the challenges that lie ahead, this article seeks to shed light on the unique considerations surrounding COVID-19 in children and contribute to a deeper comprehension of this global health crisis affecting our youngest population. METHODS A comprehensive literature search was conducted to gather the most recent and relevant information regarding COVID-19 in children. Multiple renowned databases, including MEDLINE, PubMed, Scopus, as well as authoritative sources such as the World Health Organization (WHO), the U.S. Food and Drug Administration (FDA), the European Medicines Agency (EMA), and the National Institutes of Health (NIH) websites and others were thoroughly searched. The search included articles, guidelines, reports, clinical trials results and expert opinions published within the past three years, ensuring the inclusion of the latest research findings on COVID-19 in children. Several relevant keywords, including "COVID-19," "SARS-CoV-2," "children," "pediatrics," and related terms were used to maximize the scope of the search and retrieve a comprehensive set of articles. RESULTS AND CONCLUSION Three years since the onset of the COVID-19 pandemic, our understanding of its impact on children has evolved, but many questions remain unanswered. While SAR-CoV-2 generally leads to mild illness in children, the occurrence of severe cases and the potential for long-term effects cannot be overlooked. Efforts to comprehensively study COVID-19 in children must continue to improve preventive strategies, identify high-risk populations, and ensure optimal management. By unraveling the enigma surrounding COVID-19 in children, we can strive towards safeguarding their health and well-being in the face of future global health challenges.
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Affiliation(s)
- Iman Saad Ahmed
- Department of Pharmaceutics & Pharmaceutical Technology, College of Pharmacy, University of Sharjah, Sharjah 27272, United Arab Emirates; Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates.
| | - Sara Luay Tapponi
- Department of Pharmaceutics & Pharmaceutical Technology, College of Pharmacy, University of Sharjah, Sharjah 27272, United Arab Emirates
| | - Marwa Eltahir Widatallah
- Department of Pharmaceutics & Pharmaceutical Technology, College of Pharmacy, University of Sharjah, Sharjah 27272, United Arab Emirates
| | - Yumna Mohamed Alakkad
- Department of Pharmaceutics & Pharmaceutical Technology, College of Pharmacy, University of Sharjah, Sharjah 27272, United Arab Emirates
| | - Mohamed Haider
- Department of Pharmaceutics & Pharmaceutical Technology, College of Pharmacy, University of Sharjah, Sharjah 27272, United Arab Emirates; Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates
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Greenan-Barrett J, Aston S, Deakin CT, Ciurtin C. The impact of immunocompromise on outcomes of COVID-19 in children and young people-a systematic review and meta-analysis. Front Immunol 2023; 14:1159269. [PMID: 37691952 PMCID: PMC10485615 DOI: 10.3389/fimmu.2023.1159269] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 08/04/2023] [Indexed: 09/12/2023] Open
Abstract
Background Despite children and young people (CYP) having a low risk for severe coronavirus disease 2019 (COVID-19) outcomes, there is still a degree of uncertainty related to their risk in the context of immunodeficiency or immunosuppression, primarily due to significant reporting bias in most studies, as CYP characteristically experience milder or asymptomatic COVID-19 infection and the severe outcomes tend to be overestimated. Methods A comprehensive systematic review to identify globally relevant studies in immunosuppressed CYP and CYP in general population (defined as younger than 25 years of age) up to 31 October 2021 (to exclude vaccinated populations) was performed. Studies were included if they reported the two primary outcomes of our study, admission to intensive therapy unit (ITU) and mortality, while data on other outcomes, such as hospitalization and need for mechanical ventilation were also collected. A meta-analysis estimated the pooled proportion for each severe COVID-19 outcome, using the inverse variance method. Random effects models were used to account for interstudy heterogeneity. Findings The systematic review identified 30 eligible studies for each of the two populations investigated: immunosuppressed CYP (n = 793) and CYP in general population (n = 102,022). Our meta-analysis found higher estimated prevalence for hospitalization (46% vs. 16%), ITU admission (12% vs. 2%), mechanical ventilation (8% vs. 1%), and increased mortality due to severe COVID-19 infection (6.5% vs. 0.2%) in immunocompromised CYP compared with CYP in general population. This shows an overall trend for more severe outcomes of COVID-19 infection in immunocompromised CYP, similar to adult studies. Interpretation This is the only up-to-date meta-analysis in immunocompromised CYP with high global relevance, which excluded reports from hospitalized cohorts alone and included 35% studies from low- and middle-income countries. Future research is required to characterize individual subgroups of immunocompromised patients, as well as impact of vaccination on severe COVID-19 outcomes. Systematic Review Registration PROSPERO identifier, CRD42021278598.
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Affiliation(s)
- James Greenan-Barrett
- Department of Adolescent Rheumatology, University College London Hospital (UCLH), London, United Kingdom
| | - Samuel Aston
- Medical School, University College London (UCL), London, United Kingdom
| | - Claire T Deakin
- Centre for Adolescent Rheumatology Versus Arthritis at UCL, UCLH and Great Ormond Street (GOS) Hospital (GOSH), London, United Kingdom
- UCL GOS Institute of Child Health, UCL, London, United Kingdom
- Department of Paediatric Rheumatology GOSH, London, United Kingdom
| | - Coziana Ciurtin
- Centre for Adolescent Rheumatology Versus Arthritis at UCL, UCLH and Great Ormond Street (GOS) Hospital (GOSH), London, United Kingdom
- National Institute of Health Research - Biomedical Research Centre, UCLH, London, United Kingdom
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31
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Hijano DR, Ferrolino JA, Swift EG, Michaels CA, Max A, Hayden RT, Wolf J, Dallas RH, Greene WL, Richardson JL, Hakim H, Morton TH, Cross SJ. SARS-CoV-2 infection in high-risk children following tixagevimab-cilgavimab (Evusheld) pre-exposure prophylaxis: a single-center observational study. Front Oncol 2023; 13:1229655. [PMID: 37601666 PMCID: PMC10436088 DOI: 10.3389/fonc.2023.1229655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 07/10/2023] [Indexed: 08/22/2023] Open
Abstract
From 8 December 2021 to 26 January 2023, tixagevimab-cilgavimab (T-C) was authorized for pre-exposure prophylaxis of COVID-19. During this period, we used a multidisciplinary team to communicate, screen, approach, and administer T-C to eligible patients. Twenty-seven patients were eligible. Of these, 24 (88.9%) received at least one dose of T-C and three patients received two doses. Majority of patients were White, non-Hispanic, and women. Only two patients had COVID-19 prior to receiving T-C. Seventeen (70.8%) had received two or more doses of SARS-CoV-2 vaccine. No serious adverse events were noted. Seven patients developed SARS-CoV-2 infection within 180 days of receiving T-C (median 102 days; range 28-135), and only one patient developed severe COVID-19 requiring intensive mechanical ventilation in the intensive care unit.
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Affiliation(s)
- Diego R. Hijano
- Department of Infectious Diseases, St. Jude Children Research Hospital, Memphis, TN, United States
| | - Jose A. Ferrolino
- Department of Infectious Diseases, St. Jude Children Research Hospital, Memphis, TN, United States
| | - Elizabeth G. Swift
- Center for Advanced Practice Providers, St. Jude Children Research Hospital, Memphis, TN, United States
| | - Carolyn A. Michaels
- Center for Advanced Practice Providers, St. Jude Children Research Hospital, Memphis, TN, United States
| | - Anita Max
- Center for Advanced Practice Providers, St. Jude Children Research Hospital, Memphis, TN, United States
| | - Randall T. Hayden
- Department of Pathology, St. Jude Children Research Hospital, Memphis, TN, United States
| | - Joshua Wolf
- Department of Infectious Diseases, St. Jude Children Research Hospital, Memphis, TN, United States
- Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Ronald H. Dallas
- Department of Infectious Diseases, St. Jude Children Research Hospital, Memphis, TN, United States
| | - William L. Greene
- Center for Advanced Practice Providers, St. Jude Children Research Hospital, Memphis, TN, United States
| | - Julie L. Richardson
- Department of Pharmacy and Pharmaceutical Sciences, St. Jude Children Research Hospital, Memphis, TN, United States
| | - Hana Hakim
- Department of Infectious Diseases, St. Jude Children Research Hospital, Memphis, TN, United States
| | - Ted H. Morton
- Department of Infectious Diseases, St. Jude Children Research Hospital, Memphis, TN, United States
- Department of Pharmacy and Pharmaceutical Sciences, St. Jude Children Research Hospital, Memphis, TN, United States
| | - Shane J. Cross
- Department of Pharmacy and Pharmaceutical Sciences, St. Jude Children Research Hospital, Memphis, TN, United States
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Ketkar A, Willey V, Pollack M, Glasser L, Dobie C, Wenziger C, Teng CC, Dube C, Cunningham D, Verduzco-Gutierrez M. Assessing the risk and costs of COVID-19 in immunocompromised populations in a large United States commercial insurance health plan: the EPOCH-US Study. Curr Med Res Opin 2023; 39:1103-1118. [PMID: 37431293 DOI: 10.1080/03007995.2023.2233819] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 06/30/2023] [Accepted: 07/04/2023] [Indexed: 07/12/2023]
Abstract
OBJECTIVE To estimate the prevalence of patients with an immunocompromising condition at risk for COVID-19, estimate COVID-19 prevalence rate (PR) and incidence rate (IR) by immunocompromising condition, and describe COVID-19-related healthcare resource utilization (HCRU) and costs. METHODS Using the Healthcare Integrated Research Database (HIRD), patients with ≥1 claim for an immunocompromising condition of interest or ≥2 claims for an immunosuppressive (IS) treatment and COVID-19 diagnosis during the infection period (1 April 2020-31 March 2022) and had ≥12 months baseline data were included. Cohorts (other than the composite cohort) were not mutually exclusive and were defined by each immunocompromising condition. Analyses were descriptive in nature. RESULTS Of the 16,873,161 patients in the source population, 2.7% (n = 458,049) were immunocompromised (IC). The COVID-19 IR for the composite IC cohort during the study period was 101.3 per 1000 person-years and the PR was 13.5%. The highest IR (195.0 per 1000 person-years) and PR (20.1%) were seen in the end-stage renal disease (ESRD) cohort; the lowest IR (68.3 per 1000 person-years) and PR (9.4%) were seen in the hematologic or solid tumor malignancy cohort. Mean costs for hospitalizations associated with the first COVID-19 diagnosis were estimated at nearly $1 billion (2021 United States dollars [USD]) for 14,516 IC patients, with a mean cost of $64,029 per patient. CONCLUSIONS Immunocompromised populations appear to be at substantial risk of severe COVID-19 outcomes, leading to increased costs and HCRU. Effective prophylactic options are still needed for these high-risk populations as the COVID-19 landscape evolves.
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Affiliation(s)
| | | | | | - Lisa Glasser
- AstraZeneca Biopharmaceuticals Medical, Wilmington, DE, USA
| | | | | | - Chia-Chen Teng
- AstraZeneca Biopharmaceuticals Medical, Wilmington, DE, USA
| | - Christine Dube
- AstraZeneca Biopharmaceuticals Medical, Wilmington, DE, USA
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Tandon M, DiGiacomo DV, Zhou B, Hesterberg P, Rosenberg CE, Barmettler S, Farmer JR. Response to SARS-CoV-2 initial series and additional dose vaccine in pediatric patients with predominantly antibody deficiency. Front Immunol 2023; 14:1217718. [PMID: 37575247 PMCID: PMC10413262 DOI: 10.3389/fimmu.2023.1217718] [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: 05/05/2023] [Accepted: 07/10/2023] [Indexed: 08/15/2023] Open
Abstract
Data regarding response to SARS-CoV-2 immunization in pediatric patients with predominantly antibody deficiency (PAD) is limited. We evaluated SARS-CoV-2 immunization response by anti-SARS-CoV-2-spike antibody level in 15 pediatric PAD patients. These data were compared to a published cohort of adult PAD patients (n=62) previously analyzed following SARS-CoV-2 immunization at our single center institution. We evaluated demographics, clinical characteristics, immunophenotype, infection history, and past medication use by chart review. Following a two-dose monovalent initial series SARS-CoV-2 immunization, mean anti-SARS-CoV-2-spike antibody levels were significantly higher in pediatric PAD patients compared to adult PAD patients (2,890.7 vs. 140.1 U/mL; p<0.0001). Pediatric PAD patients with low class-switched memory B-cells, defined as <2% of total CD19+ B-cells, had significantly lower mean anti-SARS-CoV-2-spike antibody levels than those without (p=0.02). Following a third-dose monovalent SARS-CoV-2 immunization, the mean anti-SARS-CoV-2-spike antibody levels in pediatric PAD patients significantly increased (2,890.7 to 18,267.2 U/mL; p<0.0001). These data support Centers for Disease Control guidelines regarding three-part SARS-CoV-2 vaccine series, including in the pediatric PAD patient demographic.
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Affiliation(s)
- Megha Tandon
- Division of Rheumatology, Allergy and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, MA, United States
| | - Daniel V. DiGiacomo
- Division of Rheumatology, Allergy and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | - Baijun Zhou
- Division of Rheumatology, Allergy and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, MA, United States
| | - Paul Hesterberg
- Division of Rheumatology, Allergy and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | - Chen E. Rosenberg
- Division of Rheumatology, Allergy and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | - Sara Barmettler
- Division of Rheumatology, Allergy and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | - Jocelyn R. Farmer
- Harvard Medical School, Boston, MA, United States
- Division of Allergy and Inflammation, Beth Israel Lahey Health, Boston, Massachusetts, United States
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Soriano-Arandes A, Brett A, Buonsenso D, Emilsson L, de la Fuente Garcia I, Gkentzi D, Helve O, Kepp KP, Mossberg M, Muka T, Munro A, Papan C, Perramon-Malavez A, Schaltz-Buchholzer F, Smeesters PR, Zimmermann P. Policies on children and schools during the SARS-CoV-2 pandemic in Western Europe. Front Public Health 2023; 11:1175444. [PMID: 37564427 PMCID: PMC10411527 DOI: 10.3389/fpubh.2023.1175444] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 06/26/2023] [Indexed: 08/12/2023] Open
Abstract
During the pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), mitigation policies for children have been a topic of considerable uncertainty and debate. Although some children have co-morbidities which increase their risk for severe coronavirus disease (COVID-19), and complications such as multisystem inflammatory syndrome and long COVID, most children only get mild COVID-19. On the other hand, consistent evidence shows that mass mitigation measures had enormous adverse impacts on children. A central question can thus be posed: What amount of mitigation should children bear, in response to a disease that is disproportionally affecting older people? In this review, we analyze the distinct child versus adult epidemiology, policies, mitigation trade-offs and outcomes in children in Western Europe. The highly heterogenous European policies applied to children compared to adults did not lead to significant measurable differences in outcomes. Remarkably, the relative epidemiological importance of transmission from school-age children to other age groups remains uncertain, with current evidence suggesting that schools often follow, rather than lead, community transmission. Important learning points for future pandemics are summarized.
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Affiliation(s)
- Antoni Soriano-Arandes
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Ana Brett
- Infectious Diseases Unit and Emergency Service, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Milan, Italy
| | - Louise Emilsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Solna, Sweden
- Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Isabel de la Fuente Garcia
- Pediatric Infectious Diseases, National Pediatric Center, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
| | - Despoina Gkentzi
- Department of Paediatrics, Patras Medical School, Patras, Greece
| | - Otto Helve
- Department of Health Security, Institute for Health and Welfare, Helsinki, Finland
- Pediatric Research Center, Children's Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Kasper P. Kepp
- Section of Biophysical and Biomedicinal Chemistry, DTU Chemistry, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Maria Mossberg
- Department of Pediatrics, Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Taulant Muka
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Epistudia, Bern, Switzerland
| | - Alasdair Munro
- NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
- Faculty of Medicine, Institute of Life Sciences, University of Southampton, Southampton, United Kingdom
| | - Cihan Papan
- Institute for Hygiene and Public Health, University Hospital Bonn, Bonn, Germany
| | - Aida Perramon-Malavez
- Computational Biology and Complex Systems (BIOCOM-SC) Group, Department of Physics, Universitat Politècnica de Catalunya (UPC·BarcelonaTech), Barcelona, Spain
| | | | - Pierre R. Smeesters
- Department of Pediatrics, University Hospital Brussels, Academic Children’s Hospital Queen Fabiola, Université Libre de Bruxelles, Brussels, Belgium
- Molecular Bacteriology Laboratory, Université Libre de Bruxelles, Brussels, Belgium
| | - Petra Zimmermann
- Department of Community Health, Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
- Department of Paediatrics, Fribourg Hospital, Fribourg, Switzerland
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35
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Wang D, Li L, Ma X, Lin Y, Chen L, Arigonggaowa, Peng X, Shi J, Yang J, Ju R, Li Z, Cao J, Liu C, Feng Z, Li Q. Receipt of COVID-19 vaccine in preterm-born children aged 3-7 in China. Front Public Health 2023; 11:1191941. [PMID: 37546314 PMCID: PMC10400273 DOI: 10.3389/fpubh.2023.1191941] [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] [Received: 03/23/2023] [Accepted: 06/20/2023] [Indexed: 08/08/2023] Open
Abstract
Objectives To determine the COVID-19 vaccination rate in preterm-born children aged 3-7 in China and influential factors, identify vaccination-related adverse reactions, and clarify reasons behind parental refusal of vaccination to their children. Methods This cross-sectional study was conducted in parents of preterm-born children aged 3-7 in different regions of China through WeChat. Results Of 1,924 Chinese preterm-born children aged 3-7 included in this study, 1,552 (80.7%) had been vaccinated against COVID-19, with a higher vaccination rate in eastern China. Children older than 4 years, kids in kindergartens and primary schools, children living in eastern or western China, and children whose fathers had received at least one dose of a COVID-19 vaccine tended to be vaccinated against COVID-19 after adjusting for other covariates. Conversely, children living in urban areas, children whose annual family income was < 50,000 CNY or more than 300,000 CNY, premature children who underwent hospital transfers, and children with underlying diseases were less likely to get vaccinated. Adverse reactions occurred in 59/1,552 (3.8%) vaccinated children. Parents of 118/372 (31.7%) children expressed their concerns over adverse reactions to COVID-19 vaccination. Other reasons like the absence of information about the place where they could get vaccination were mentioned as well. Conclusions COVID-19 vaccination-related adverse reactions rarely occurred and most of them were mild among preterm-born children aged 3-7. Higher vaccination coverage can be achieved as parents are provided with more scientific data about benefits of vaccination, vaccination contraindications and precautions, and more information about vaccination sites.
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Affiliation(s)
- Dan Wang
- Newborn Intensive Care Unit, Faculty of Pediatrics, The Seventh Medical Center of Chinese People's Liberation Army (CPLA) General Hospital, Beijing, China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Li Li
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
| | - Xiaofeng Ma
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
| | - Yunfeng Lin
- Department of Neonatology, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
- Department of Neonatology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
- Fujian Key Laboratory of Women and Children's Critical Diseases Research (Fujian Maternity and Child Health Hospital), Fuzhou, China
| | - Liping Chen
- Newborn Intensive Care Unit, Jiangxi Provincial Children's Hospital, Nanchang, China
| | - Arigonggaowa
- Department of Neonatology, Inner Mongolia Maternal and Child Health Hospital, Hohhot, China
| | - Xianglian Peng
- Department of Neonatology, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, China
| | - Jingyun Shi
- Department of Neonatology, Gansu Provincial Maternal and Child Hospital, Lanzhou, China
| | - Jie Yang
- Department of Neonatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Rong Ju
- Department of Neonatology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Zhankui Li
- Department of Neonatology, Northwest Women's and Children's Hospital (Maternal and Child Health Care Hospital of Shaanxi Province), Xi'an, China
| | - Jingke Cao
- Newborn Intensive Care Unit, Faculty of Pediatrics, The Seventh Medical Center of Chinese People's Liberation Army (CPLA) General Hospital, Beijing, China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Changgen Liu
- Newborn Intensive Care Unit, Faculty of Pediatrics, The Seventh Medical Center of Chinese People's Liberation Army (CPLA) General Hospital, Beijing, China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Zhichun Feng
- Newborn Intensive Care Unit, Faculty of Pediatrics, The Seventh Medical Center of Chinese People's Liberation Army (CPLA) General Hospital, Beijing, China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Qiuping Li
- Newborn Intensive Care Unit, Faculty of Pediatrics, The Seventh Medical Center of Chinese People's Liberation Army (CPLA) General Hospital, Beijing, China
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Ramírez-Cázares AC, Hernández-Ruíz YG, Martínez-Longoria CA, Tamez-Gómez CE, Medina-Macías O, Treviño-Montalvo RG. Clinical characteristics of pediatric patients with confirmed SARS-CoV-2 infection who followed rigorous measures during two years of the COVID-19 pandemic in a hospital in Mexico. Front Pediatr 2023; 11:1150738. [PMID: 37441570 PMCID: PMC10333513 DOI: 10.3389/fped.2023.1150738] [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: 01/24/2023] [Accepted: 06/09/2023] [Indexed: 07/15/2023] Open
Abstract
Background COVID-19 infections have been described as asymptomatic or mild, with a low incidence of severe cases in children and adolescents who followed the basic hygiene measures. The objective of this study was to describe the clinical and epidemiological characteristics of our pediatric population during four waves of the COVID-19 pandemic from a private hospital. Methods A retrospective observational study in patients under 15 years old with confirmed SARS-CoV-2 infection by real-time reverse transcription-polymerase chain reaction (RT-PCR) test from April 1, 2020 to April 30, 2022. Demographic, clinical, and therapy variables were examined, and the Chi-square test was used for comparisons. Results From 5,870 RT-PCR taken through the first two years of the pandemic, 1,371 tested positive, obtaining a positivity rate of 23.37%. Patients' median (IQR) age was 9.0 (7.0) years, and most were male (n = 705, 51.4%). The primary comorbidities were rhinitis (n = 239, 17.4%) and asthma (n = 172, 12.5%). Most cases were scholars (n = 568, 41.4%) during the fourth COVID-19 wave (n = 831, 60.6%). Almost all cases (88.2%) reported prior exposure to SARS-CoV-2-infected households. Six percent (n = 82) of the patients reported being vaccinated against SARS-CoV-2. Most participants (89.3%) received outpatient care, and 0.6% required hospitalization. Nine (0.6%) patients were diagnosed with Multisystemic Inflammatory Syndrome in Children (MIS-C). The second COVID-19 wave reported a higher frequency of anosmia and dysgeusia; the third wave reported fever and malaise, and the fourth wave reported cough, odynophagia, and vomiting (p < 0.05). The second wave reported no treatment (n = 23, 15.3%), while the third and fourth waves reported outpatient care and hospitalization (n = 367, 95.1%; and n = 4, 1.0%, respectively) (p = <0.001). Reinfection cases were frequent during the second wave (n = 8, 5.3%) (p=<0.001). Rhinorrhea, vomiting, and diarrhea were reported mainly by infants; fever by preschoolers; abdominal pain by scholars; and headache, odynophagia, anosmia, dysgeusia, myalgia, arthralgia, and malaise by adolescents (p < 0.05). Neither treatment nor reinfection showed age-related differences (p = 0.496 and p = 0.224, respectively). Conclusion The study demonstrated a lower positive rate for SARS-CoV-2 in our hospital'The majority of cases in our study were outpatients who reported a mild infection with a favorable evolution based on symptomatic treatment.
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Affiliation(s)
- Ana Carolina Ramírez-Cázares
- Vicerrectoría de Ciencias de la Salud, Escuela de Medicina, Universidad de Monterrey, San Pedro Garza García, Mexico
- Pediatric Department, Hospital Clínica Nova, San Nicolas de los Garza, Mexico
| | - Yodira Guadalupe Hernández-Ruíz
- Vicerrectoría de Ciencias de la Salud, Escuela de Medicina, Universidad de Monterrey, San Pedro Garza García, Mexico
- Research Department, Hospital Clínica Nova, San Nicolas de los Garza, Mexico
| | | | | | - Obed Medina-Macías
- Vicerrectoría de Ciencias de la Salud, Escuela de Medicina, Universidad de Monterrey, San Pedro Garza García, Mexico
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Emeksiz HC, Hepokur MN, Şahin SE, Şirvan BN, Çiçek B, Önder A, Yıldız M, Aksakal DK, Bideci A, Ovalı HF, İşman F. Immunogenicity, safety and clinical outcomes of the SARS-CoV-2 BNT162b2 vaccine in adolescents with type 1 diabetes. Front Pediatr 2023; 11:1191706. [PMID: 37435175 PMCID: PMC10331611 DOI: 10.3389/fped.2023.1191706] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 06/12/2023] [Indexed: 07/13/2023] Open
Abstract
Introduction The mRNA-based BNT162b2 (Pfizer-BioNTech) vaccine has been shown to elicit robust systemic immune response and confer substantial protection against the severe coronavirus disease (COVID-19), with a favorable safety profile in adolescents. However, no data exist regarding immunogenicity, reactogenicity and clinical outcomes of COVID-19 vaccines in adolescents with type 1 diabetes (T1D). In this prospective observational cohort study, we examined the humoral immune responses and side effects induced by the BNT162b2 vaccine, as well as, the rate and symptomatology of laboratory-confirmed COVID-19 vaccine breakthrough infections after completion of dual-dose BNT162b2 vaccination in adolescents with T1D and compared their data with those of healthy control adolescents. The new data obtained after the vaccination of adolescents with T1D could guide their further COVID-19 vaccination schedule. Methods A total of 132 adolescents with T1D and 71 controls were enrolled in the study, of whom 81 COVID-19 infection-naive adolescents with T1D (patient group) and 40 COVID-19 infection-naive controls (control group) were eligible for the final analysis. The response of participants to the BNT162b2 vaccine was assessed by measuring their serum IgG antibodies to the spike protein of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), 4-6 weeks after the receipt of first and second vaccine doses. Data about the adverse events of the vaccine was collected after the receipt of each vaccine dose. The rate of COVID-19 vaccine breakthrough infections was evaluated in the 6-month period following second vaccination. Results After vaccinations, adolescents with T1D and controls exhibited similar, highly robust increments in anti-SARS-CoV-2 IgG titers. All the participants in the patient and control groups developed anti-SARS-CoV-2 IgG titers over 1,050 AU/ml after the second vaccine dose which is associated with a neutralizing effect. None of the participants experienced severe adverse events. The rate of breakthrough infections in the patient group was similar to that in the control group. Clinical symptomatology was mild in all cases. Conclusion Our findings suggest that two-dose BNT162b2 vaccine administered to adolescents with T1D elicits robust humoral immune response, with a favorable safety profile and can provide protection against severe SARS-CoV-2 infection similar to that in healthy adolescents.
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Affiliation(s)
- Hamdi Cihan Emeksiz
- Department of Pediatric Endocrinology, Professor Doctor Süleyman Yalçın City Hospital, Istanbul Medeniyet University, Istanbul, Türkiye
| | - Merve Nur Hepokur
- Department of Pediatric Endocrinology, Professor Doctor Süleyman Yalçın City Hospital, Istanbul Medeniyet University, Istanbul, Türkiye
| | - Sibel Ergin Şahin
- Department of Pediatric Endocrinology, Professor Doctor Süleyman Yalçın City Hospital, Istanbul Medeniyet University, Istanbul, Türkiye
| | - Banu Nursoy Şirvan
- Department of Pediatric Endocrinology, Professor Doctor Süleyman Yalçın City Hospital, Istanbul Medeniyet University, Istanbul, Türkiye
| | - Burçin Çiçek
- Department of Pediatric Endocrinology, Professor Doctor Süleyman Yalçın City Hospital, Istanbul Medeniyet University, Istanbul, Türkiye
| | - Aşan Önder
- Department of Pediatric Endocrinology, Professor Doctor Süleyman Yalçın City Hospital, Istanbul Medeniyet University, Istanbul, Türkiye
| | - Metin Yıldız
- Department of Pediatric Endocrinology, Professor Doctor Süleyman Yalçın City Hospital, Istanbul Medeniyet University, Istanbul, Türkiye
| | - Derya Karaman Aksakal
- Department of Pediatric Endocrinology, Professor Doctor Süleyman Yalçın City Hospital, Istanbul Medeniyet University, Istanbul, Türkiye
| | - Aysun Bideci
- Department of Pediatric Endocrinology, Gazi University Hospital, Ankara, Türkiye
| | - Hüsnü Fahri Ovalı
- Department of Pediatrics, Professor Doctor Süleyman Yalçın City Hospital, Istanbul Medeniyet University, Istanbul, Türkiye
| | - Ferruh İşman
- Department of Biochemistry, Professor Doctor Süleyman Yalçın City Hospital, Istanbul Medeniyet University, Istanbul, Türkiye
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Damps M, Byrska-Maciejasz E, Kowalska M, Rosada-Kurasińska J, Rybojad B, Sordyl J, Zielińska M, Bartkowska-Śniatkowska A. COVID-19 in Pediatric Intensive Care Units in Poland, PAPITCO-19 Study (Polish Analysis of PICU Trends during COVID-19). J Clin Med 2023; 12:3983. [PMID: 37373677 DOI: 10.3390/jcm12123983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 06/05/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Children suffering from COVID-19 constitute about 10% of the entire population infected with the virus. In most of them, we observe asymptomatic or mild courses; however, about 1% of affected children require a stay in a paediatric intensive care unit (PICU) due to the course of the disease becoming severely life-threatening. The risk of respiratory failure, as with adults, is associated with the coexistence of concomitant diseases. The aim of our study was to analyse patients admitted to PICUs due to the severe course of their SARS-CoV-2 infection. We studied epidemiological and laboratory parameters, as well as the endpoint (survival or death). METHODS A retrospective multi-centre study, the analysis covered all children with a confirmed diagnosis of SARS-CoV-2 virus infection who were admitted to PICUs in the period from November 2020 to August 2021. We studied epidemiological and laboratory parameters, as well as the endpoint (survival or death). RESULTS The study analysed 45 patients (0.075% of all children hospitalised in Poland due to COVID-19 at that time). Mortality calculated in the entire study group was 40% (n = 18). Statistically significant differences between the compared groups (survived and died) concerned the parameters of the respiratory system. Lung Injury Score and the Paediatric Sequential Organ Failure Assessment were used. A significant correlation between disease severity and the patient's prognosis was shown by the liver function parameter AST (p = 0.028). During the analysis of patients requiring mechanical ventilation and assuming survival as the primary outcome, a significantly higher oxygen index on the first day of hospitalisation, lower pSOFA scores and lower AST levels (p: 0.007; 0.043; 0.020; 0.005; 0.039, respectively) were found. CONCLUSIONS As with adults, children with comorbidities are most frequently at risk of severe SARS-CoV-2 infection. Increasing symptoms of respiratory failure, the need for mechanical ventilation and persistently high values of aspartate aminotransferase are indicators of poor prognosis.
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Affiliation(s)
- Maria Damps
- Department of Anaesthesiology and Intensive Care, Upper Silesian Child Health Centre, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland
| | - Elżbieta Byrska-Maciejasz
- Department of Anaesthesiology and Intensive Therapy, University Children's Hospital of Krakow, 30-663 Krakow, Poland
| | - Małgorzata Kowalska
- Department of Epidemiology, School of Medicine in Katowice, Medical University of Silesia, 40-514 Katowice, Poland
| | - Jowita Rosada-Kurasińska
- Department of Paediatric Anaesthesiology and Intensive Care, Poznań University of Medical Sciences, 60-806 Poznan, Poland
| | - Beata Rybojad
- Department of Anaesthesiology and Intensive Therapy, Faculty of Medicine, Medical University of Lublin; 20-035 Lublin, Poland
| | - Joanna Sordyl
- Department of Oncology, Hematology, and Chemotherapy, Upper Silesian Child Health Centre, 40-752 Katowice, Poland
| | - Marzena Zielińska
- Department of Anesthesiology and Intensive Care, Wrocław Medical University, 50-556 Wrocław, Poland
- Department of Paediatric Anesthesiology and Intensive Care, University Clinical Hospital in Wrocław, 50-556 Wrocław, Poland
| | - Alicja Bartkowska-Śniatkowska
- Department of Paediatric Anaesthesiology and Intensive Care, Poznań University of Medical Sciences, 60-806 Poznan, Poland
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Chanda BM, Chen XQ. Breastfeeding during the COVID-19 pandemic. Front Pediatr 2023; 11:1120763. [PMID: 37342530 PMCID: PMC10277472 DOI: 10.3389/fped.2023.1120763] [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: 12/10/2022] [Accepted: 05/10/2023] [Indexed: 06/23/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused many significant changes to all aspects of day to day life. The disease has spread and reached pandemic proportions. The principle route of transmission is the respiratory route. Infants, pregnant women and breastfeeding mothers have all been affected. Many interventions and guidelines from important societies have been instituted in order to curb the transmission of the disease. These have involved both pharmacological and non-pharmacological methods. COVID-19 vaccines have also emerged as important methods of primary prevention of the disease. But several questions have been raised concerning the safety and efficacy of their use in pregnant and breastfeeding mothers. It has also not been clear if the vaccines are effective in generating a robust immune response in the pregnant women and breastfeeding mothers to confer passive immunity to the fetuses and infants, respectively. And they have not been tested in infants. The aspect of infant feeding has equally been affected. Although breast milk has not been known to serve as the vehicle of transmission of the virus, there is still some lack of uniformity of practice regarding breastfeeding when a mother has SARS-CoV-2 infection. This has led to infant feeding being done by the use of commercial formula feeds, pasteurized human donor breast milk, feeding on the mother's own expressed breast milk by a care giver and directly breastfeeding with skin to skin contact. This is despite breast milk being the most physiologically appropriate type of feed for infants. Therefore the pertinent question remains; should breastfeeding continue during the pandemic continue? This review also seeks to analyse the vast amount of scientific information regarding the subject and to synthesize science-based information.
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Affiliation(s)
- Bwalya Mpelwa Chanda
- Department of Pediatrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xiao-Qing Chen
- Department of Pediatrics, First Affiliation Hospital of Nanjing Medical University, Nanjing, China
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Yilmaz D, Soyoz M, Sahin A, Cerci-Alkac B, Karahan-Coven HI, Ekemen-Keles Y, Ustundag G, Kara-Aksay A, Yilmaz N, Pirim İ. Association between mannose binding lectin gene polymorphisms and clinical severity of COVID-19 in children. Mol Biol Rep 2023:10.1007/s11033-023-08524-z. [PMID: 37231213 DOI: 10.1007/s11033-023-08524-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 05/12/2023] [Indexed: 05/27/2023]
Abstract
BACKGROUND Mannose-binding lectin (MBL) is a member of innate immunity and acts with MASP (MBL-associated serine protease) to activate the lectin pathway of the complement system. MBL gene polymorphisms are associated with susceptibility to infectious diseases. This study investigated whether MBL2 genotype, serum MBL levels, and serum MASP-2 levels affect the course of SARS-CoV-2 infection. METHODS AND RESULTS Pediatric patients diagnosed with COVID-19 by positive real-time polymerase chain reaction (PCR) were included in the study. Single nucleotide polymorphisms in the promoter and exon 1 in the MBL2 gene (rs11003125, rs7096206, rs1800450, rs1800451, rs5030737) were identified by a PCR and restriction fragment length polymorphisms analysis. Serum MBL and MASP-2 levels were measured by ELISA. COVID-19 patients were divided into asymptomatic and symptomatic. Variables were compared between these two groups. A total of 100 children were included in the study. The mean age of the patients was 130 ± 67.2 months. Of the patients, 68 (68%) were symptomatic, and 32 (32%) were asymptomatic. The polymorphisms in the - 221nt and - 550nt promoter regions did not differ between groups (p > 0.05). All codon 52 and codon 57 genotypes were determined as wild-type AA. AB genotypes were found 45.6% in symptomatic patients while 23.5% in asymptomatics. Moreover, BB genotype was detected 9.4% in symptomatic and 6.3% in asymptomatic patients (p < 0.001). B allele was more frequent in symptomatic patients (46.3%) compared to asymptomatic patients (10.9%). (p < 0.001). Serum MBL and MASP-2 levels did not differ statistically between the groups (p = 0.295, p = 0.073). CONCLUSION These findings suggest that codon 54 polymorphism in the MBL2 gene exon-1 region can be associated with the symptomatic course of COVID-19.
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Affiliation(s)
- Dilek Yilmaz
- Department of Pediatric Infectious Diseases, Health Sciences University Tepecik Training and Research Hospital, Izmir, Turkey
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Izmir Katip Çelebi University, Izmir, Turkey
| | - Mustafa Soyoz
- Department of Medical Biology and Genetics, Faculty of Medicine, Izmir Katip Celebi University, Izmir, Turkey
| | - Aslıhan Sahin
- Department of Pediatric Infectious Diseases, Health Sciences University Tepecik Training and Research Hospital, Izmir, Turkey.
| | - Burcu Cerci-Alkac
- Department of Medical Biology and Genetics, Faculty of Medicine, Izmir Katip Celebi University, Izmir, Turkey
| | | | - Yıldız Ekemen-Keles
- Department of Pediatric Infectious Diseases, Health Sciences University Tepecik Training and Research Hospital, Izmir, Turkey
| | - Gulnihan Ustundag
- Department of Pediatric Infectious Diseases, Health Sciences University Tepecik Training and Research Hospital, Izmir, Turkey
| | - Ahu Kara-Aksay
- Department of Pediatric Infectious Diseases, Health Sciences University Tepecik Training and Research Hospital, Izmir, Turkey
| | - Nisel Yilmaz
- Department of Medical Microbiology, Health Sciences University Tepecik Training and Research Hospital, Izmir, Turkey
| | - İbrahim Pirim
- Department of Medical Biology and Genetics, Faculty of Medicine, Izmir Katip Celebi University, Izmir, Turkey
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41
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Yılmaz D, Üstündağ G, Büyükçam A, Salı E, Çelik Ü, Avcu G, Belet N, Çakmak Taşkın E, Öcal Demir S, Birbilen AZ, Kılıç Ö, Metin Akcan Ö, Tekin Yılmaz A, Aldemir Kocabaş B, Hatipoğlu N, Karbuz A, Çakır D, Sütçü M, Aygün FD, Çelik T, Bayturan Şen S, Dalgıç N, Ümit Z, Kara SS, Karadağ Öncel E, Bolat A, Kılıç Çil M, Turan C, Çakıl Güzin A, Topal S, Esen Besli G, Doğan G, Şahin S, Akın F, Bildirici Y, Timurtaş Dayar G, Ergül Sarı E, Kızmaz İşançlı D, Kara M, Önal P, Aylaç H, Lüleci D, Yaşar B, Dede E, Çağlar A, Akova S, Afat Turgut E, Yazıcı Özkaya P, Kandemir Gülmez T, Ulusoy E, Duyu M, Kara Y, Çeliktaş H, Tekeli O, Çağlar F, Gül D, Oral Cebeci S, Battal F, Bal A, Aygün E, Uysalol M, Arslan G, Özkavaklı A, Kızıl MC, Yazar A, Aygün F, Somer A, Kuyucu N, Dinleyici EÇ, Kara A. A snapshot of pediatric inpatients and outpatients with COVID-19: a point prevalence study from Turkey. Eur J Pediatr 2023:10.1007/s00431-023-04982-6. [PMID: 37140703 PMCID: PMC10157577 DOI: 10.1007/s00431-023-04982-6] [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: 12/14/2022] [Revised: 03/31/2023] [Accepted: 04/13/2023] [Indexed: 05/05/2023]
Abstract
This multi-center point prevalence study evaluated children who were diagnosed as having coronavirus disease 2019 (COVID-19). On February 2nd, 2022, inpatients and outpatients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were included in the study from 12 cities and 24 centers in Turkey. Of 8605 patients on February 2nd, 2022, in participating centers, 706 (8.2%) had COVID-19. The median age of the 706 patients was 92.50 months, 53.4% were female, and 76.7% were inpatients. The three most common symptoms of the patients with COVID-19 were fever (56.6%), cough (41.3%), and fatigue (27.5%). The three most common underlying chronic diseases (UCDs) were asthma (3.4%), neurologic disorders (3.3%), and obesity (2.6%). The SARS-CoV-2-related pneumoniae rate was 10.7%. The COVID-19 vaccination rate was 12.5% in all patients. Among patients aged over 12 years with access to the vaccine given by the Republic of Turkey Ministry of Health, the vaccination rate was 38.7%. Patients with UCDs presented with dyspnea and pneumoniae more frequently than those without UCDs (p < 0.001 for both). The rates of fever, diarrhea, and pneumoniae were higher in patients without COVID-19 vaccinations (p = 0.001, p = 0.012, and p = 0.027). Conclusion: To lessen the effects of the disease, all eligible children should receive the COVID-19 vaccine. The illness may specifically endanger children with UCDs. What is Known: • Children with COVID-19 mainly present with fever and cough, as in adults. • COVID-19 may specifically threaten children with underlying chronic diseases. What is New: • Children with obesity have a higher vaccination rate against COVID-19 than children without obesity. • Among unvaccinated children, fever and pneumoniae might be seen at a higher ratio than among vaccinated children.
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Affiliation(s)
- Dilek Yılmaz
- Department of Pediatric Infectious Diseases, İzmir Katip Çelebi University Faculty of Medicine, İzmir, Turkey
| | - Gülnihan Üstündağ
- Pediatric Infectious Disease Clinic, Health Science University İzmir Tepecik Training and Research Hospital, Konak 35020, İzmir, Turkey.
| | - Ayşe Büyükçam
- Pediatric Infectious Disease Clinic, Health Science University Gülhane Training and Research Hospital, Ankara, Turkey
| | - Enes Salı
- Pediatric Infectious Disease Clinic, Health Science University Ümraniye Training and Research Hospital, Istanbul, Turkey
| | - Ümit Çelik
- Pediatric Infectious Disease Clinic, Adana City Hospital, Adana, Turkey
| | - Gülhadiye Avcu
- Department of Pediatric Infectious Diseases, Ege University Faculty of Medicine, İzmir, Turkey
| | - Nurşen Belet
- Department of Pediatric Infectious Diseases, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Esra Çakmak Taşkın
- Pediatric Infectious Disease Clinic, Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Sevliya Öcal Demir
- Pediatric Infectious Disease Clinic, Medeniyet University Göztepe Süleyman Yalçın City Hospital, Istanbul, Turkey
| | - Ahmet Ziya Birbilen
- Gaziantep Cengiz Gökçek Gynecology and Pediatrics Hospital, Pediatric Emergency Clinic, Gaziantep, Turkey
| | - Ömer Kılıç
- Department of Pediatric Infectious Diseases, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey
| | - Özge Metin Akcan
- Department of Pediatric Infectious Diseases, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Ayşe Tekin Yılmaz
- Pediatric Infectious Disease Clinic, Eskişehir City Hospital, Eskişehir, Turkey
| | - Bilge Aldemir Kocabaş
- Pediatric Infectious Disease Clinic, Health Science University Antalya Training and Research Hospital, Antalya, Turkey
| | - Nevin Hatipoğlu
- Pediatric Infectious Disease Clinic, Health Science University İstanbul Bakırköy Doctor Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Adem Karbuz
- Pediatric Infectious Disease Clinic, Cemil Taşçıoğlu City Hospital, İstanbul Prof. Dr, Istanbul, Turkey
| | - Deniz Çakır
- Pediatric Infectious Disease Clinic, Health Science University Ümraniye Training and Research Hospital, Istanbul, Turkey
| | - Murat Sütçü
- Department of Pediatric Infectious Diseases, İstinye University Faculty of Medicine, Istanbul, Turkey
| | - Fatma Deniz Aygün
- Department of Pediatric Infectious Diseases, Cerrahpaşa University Faculty of Medicine, Istanbul, Turkey
| | - Taylan Çelik
- Department of Pediatric Infectious Diseases, Çanakkale 18 Mart University Faculty of Medicine, Çanakkale, Turkey
| | - Semra Bayturan Şen
- Department of Pediatric Infectious Diseases, Celal Bayar University Faculty of Medicine, Manisa, Turkey
| | - Nazan Dalgıç
- Pediatric Infectious Disease Clinic, Health Science University Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Zühal Ümit
- Pediatric Infectious Disease Clinic, Manisa City Hospital, Manisa, Turkey
| | - Soner Sertan Kara
- Department of Pediatric Infectious Diseases, Adnan Menderes University Faculty of Medicine, Aydın, Turkey
| | - Eda Karadağ Öncel
- Pediatric Infectious Disease Clinic, Health Science University İzmir Tepecik Training and Research Hospital, Konak 35020, İzmir, Turkey
| | - Ahmet Bolat
- Pediatrics Clinic, Health Science University Gülhane Training and Research Hospital, Ankara, Turkey
| | - Merve Kılıç Çil
- Pediatric Infectious Disease Clinic, Adana City Hospital, Adana, Turkey
| | - Caner Turan
- Department of Pediatric Emergency Medicine, Ege University Faculty of Medicine, İzmir, Turkey
| | - Ayşe Çakıl Güzin
- Department of Pediatric Infectious Diseases, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Sevgi Topal
- Pediatric Intensive Care Unit, Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Gülser Esen Besli
- Pediatric Emergency Clinic, Medeniyet University Göztepe Süleyman Yalçın City Hospital, Istanbul, Turkey
| | - Gizem Doğan
- Gaziantep Cengiz Gökçek Gynecology and Pediatrics Hospital, Pediatrics Clinic, Gaziantep, Turkey
| | - Sabiha Şahin
- Department of Pediatric Emergency Medicine, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey
| | - Fatih Akın
- Department of Pediatrics, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Yaşar Bildirici
- Pediatrics Clinic, Eskişehir City Hospital, Eskişehir, Turkey
| | - Gülperi Timurtaş Dayar
- Pediatric Infectious Disease Clinic, Health Science University Antalya Training and Research Hospital, Antalya, Turkey
| | - Emine Ergül Sarı
- Pediatrics Clinic, Health Science University İstanbul Bakırköy Doctor Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Didem Kızmaz İşançlı
- Pediatric Infectious Disease Clinic, Cemil Taşçıoğlu City Hospital, İstanbul Prof. Dr, Istanbul, Turkey
| | - Manolya Kara
- Department of Pediatric Infectious Diseases, İstinye University Faculty of Medicine, Istanbul, Turkey
| | - Pınar Önal
- Department of Pediatric Infectious Diseases, Cerrahpaşa University Faculty of Medicine, Istanbul, Turkey
| | - Hakan Aylaç
- Department of Pediatrics, Çanakkale 18 Mart University Faculty of Medicine, Çanakkale, Turkey
| | - Duygu Lüleci
- Department of Pediatrics, Celal Bayar University Faculty of Medicine, Manisa, Turkey
| | - Belma Yaşar
- Pediatric Infectious Disease Clinic, Health Science University Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Elif Dede
- Department of Pediatric Infectious Diseases, İstanbul University Faculty of Medicine, Istanbul, Turkey
| | - Aykut Çağlar
- Department of Pediatric Emergency Medicine , Adnan Menderes University Faculty of Medicine, Aydın, Turkey
| | - Sevgi Akova
- Pediatric Emergency Clinic, Health Science University Ümraniye Training and Research Hospital, Istanbul, Turkey
| | - Elif Afat Turgut
- Pediatric Infectious Disease Clinic, Adana City Hospital, Adana, Turkey
| | - Pınar Yazıcı Özkaya
- Department of Pediatric Intensive Care, Ege University Faculty of Medicine, İzmir, Turkey
| | | | - Emel Ulusoy
- Department of Pediatric Emergency Medicine, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Muhterem Duyu
- Pediatric Intensive Care Unit, Medeniyet University Göztepe Süleyman Yalçın City Hospital, Istanbul, Turkey
| | - Yalçın Kara
- Department of Pediatric Infectious Diseases, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey
| | - Hüseyin Çeliktaş
- Department of Pediatrics, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Onur Tekeli
- Pediatric Infectious Disease Clinic, Health Science University Antalya Training and Research Hospital, Antalya, Turkey
| | - Fatma Çağlar
- Pediatric Emergency Clinic, Health Science University İstanbul Bakırköy Doctor Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Doruk Gül
- Department of Pediatrics, İstinye University Faculty of Medicine, Istanbul, Turkey
| | - Sinem Oral Cebeci
- Department of Pediatric Emergency Medicine, Cerrahpaşa University Faculty of Medicine, Istanbul, Turkey
| | - Fatih Battal
- Department of Pediatrics, Çanakkale 18 Mart University Faculty of Medicine, Çanakkale, Turkey
| | - Alkan Bal
- Department of Pediatric Emergency Medicine, Celal Bayar University Faculty of Medicine, Manisa, Turkey
| | - Emre Aygün
- Pediatrics Clinic, Health Science University Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Metin Uysalol
- Department of Pediatric Emergency Medicine, İstanbul University Faculty of Medicine, Istanbul, Turkey
| | - Gazi Arslan
- Department of Pediatric Intensive Care, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Ayberk Özkavaklı
- Pediatrics Clinic, Medeniyet University Göztepe Süleyman Yalçın City Hospital, Istanbul, Turkey
| | - Mahmut Can Kızıl
- Department of Pediatric Infectious Diseases, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey
| | - Abdullah Yazar
- Department of Pediatrics, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Fatih Aygün
- Department of Pediatric Intensive Care, Cerrahpaşa University Faculty of Medicine, Istanbul, Turkey
| | - Ayper Somer
- Department of Pediatric Infectious Diseases, İstanbul University Faculty of Medicine, Istanbul, Turkey
| | - Necdet Kuyucu
- Department of Pediatric Infectious Diseases, Mersin University Faculty of Medicine, Mersin, Turkey
| | - Ener Çağrı Dinleyici
- Department of Pediatric Intensive Care, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey
| | - Ateş Kara
- Department of Pediatric Infectious Diseases, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Iovine E, Di Mattia G, Nenna R, La Regina DP, Mancino E, Petrarca L, Conti MG, Matera L, Virgili F, Midulla F. Lung function after SARS-CoV-2 infection: A prospective cohort study in children. Pediatr Pulmonol 2023. [PMID: 37083203 DOI: 10.1002/ppul.26425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 03/29/2023] [Accepted: 04/03/2023] [Indexed: 04/22/2023]
Abstract
INTRODUCTION Although impaired lung function after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been described in adults, it is unclear whether lung function might be altered in children, especially among asymptomatic or mildly symptomatic patients. In this study, we report the results of lung function testing performed after SARS-CoV-2 infection in a large pediatric population. METHODS The study included 589 patients with previous confirmed SARS-CoV-2 infection aged 0-18 years. Both symptomatic and asymptomatic patients during acute infection were enrolled in the study. A spirometry was performed in all cooperating patients. RESULTS The mean age of enrolled patients was 9.6 years and the mean time from infection to enrollment was 171 days. Spirometry was performed and deemed evaluable in 433 patients. No patient had reduced forced vital capacity (FVC) and only 14 patients (3.2%) had a forced expiratory volume in the First second (FEV1) < 80%. The mean spirometry values recorded were in the normal range. There were no statistically significant differences in spirometry values between patients with respiratory symptoms during infection and those without. Similarly, there were no differences in spirometry parameters according to the time elapsed between infection and enrollment. CONCLUSION Lung function, according to spirometry values, does not appear to be impaired long after infection in the pediatric population. The presence of respiratory symptoms during SARS-CoV-2 infection would not represent a risk factor for impaired lung function in this cohort of patients.
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Affiliation(s)
- Elio Iovine
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Greta Di Mattia
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Raffaella Nenna
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Domenico Paolo La Regina
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Enrica Mancino
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Laura Petrarca
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Maria Giulia Conti
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Luigi Matera
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Fabrizio Virgili
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Fabio Midulla
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
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Sadeghi P, Pezeshki PS, Rezaei N. Coronavirus disease 2019 (COVID-19) in pediatric patients with autoimmune disorders. Eur J Pediatr 2023:10.1007/s00431-023-04958-6. [PMID: 37074460 PMCID: PMC10113973 DOI: 10.1007/s00431-023-04958-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 03/25/2023] [Accepted: 03/30/2023] [Indexed: 04/20/2023]
Abstract
Coronavirus disease 2019 (COVID-19) infection in pediatric patients with autoimmune disorders is an area of particular concern since autoimmune diseases can increase the risk of complications from the virus. However, as the infection rates were significantly higher in adults compared to children, this at-risk group of children was relatively underrepresented in COVID-19 research. The underlying inflammatory basis of autoimmune diseases and medications that affect the immune system, such as corticosteroids, could increase the risk of severe infection in this group of patients. COVID-19 could reportedly lead to a variety of alterations in the immune system. These alterations are plausibly dependent on the underlying immune-mediated diseases or prior use of immunomodulatory drugs. Patients administrating immunomodulatory agents, especially those with severe immune system dysregulation, can experience severe symptoms of COVID-19. Nonetheless, receiving immunosuppressive medications can benefit patients by preventing cytokine storm syndromes and lung tissue damage, threatening outcomes of COVID-19. CONCLUSION In this review, we sought to evaluate the currently available literature on the impact of autoimmune disease and its related therapeutic approaches on the COVID-19 infection course of disease in children and reflect on the gaps in the evidence and the need for further research in this field. WHAT IS KNOWN • The majority of children infected with COVID-19 demonstrate mild to moderate clinical manifestations compared to adults, whereas those children with pre-existing autoimmune conditions are at a greater risk for severe symptoms. •There is currently limited understanding of the pathophysiology and clinical outcomes of COVID-19 in pediatric patients with autoimmune disorders due to scattered reports and inadequate evidence. WHAT IS NEW • Generally, children with autoimmune disorders have more unfavorable outcomes than healthy children; yet, the severity is not extreme, and is highly dependent on their autoimmune disease type and severity, as well as the medication they are taking.
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Affiliation(s)
- Parniyan Sadeghi
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Parmida Sadat Pezeshki
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Cancer Immunology Project (CIP), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Nima Rezaei
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
- Research Center for Immunodeficiencies, Children's Medical Center Hospital, Tehran University of Medical Sciences, Dr. Qarib St, Keshavarz Blvd, 14194, Tehran, Iran.
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
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McGowan EC, McGrath M, Law A, O’Shea TM, Aschner JL, Blackwell CK, Fry RC, Ganiban JM, Higgins R, Margolis A, Sathyanarayana S, Taylor G, Alshawabkeh AN, Cordero JF, Spillane NT, Hudak ML, Camargo CA, Dabelea D, Dunlop AL, Elliott AJ, Ferrara AM, Talavera-Barber M, Singh AM, Karagas MR, Karr C, O’Connor TG, Paneth N, Wright RJ, Wright RO, Cowell W, Stanford JB, Bendixsen C, Lester BM. Health Care Utilization During the COVID-19 Pandemic Among Individuals Born Preterm. JAMA Netw Open 2023; 6:e2310696. [PMID: 37115545 PMCID: PMC10148204 DOI: 10.1001/jamanetworkopen.2023.10696] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 03/16/2023] [Indexed: 04/29/2023] Open
Abstract
Importance Limited data exist on pediatric health care utilization during the COVID-19 pandemic among children and young adults born preterm. Objective To investigate differences in health care use related to COVID-19 concerns during the pandemic among children and young adults born preterm vs those born at term. Design, Setting, and Participants In this cohort study, questionnaires regarding COVID-19 and health care utilization were completed by 1691 mother-offspring pairs from 42 pediatric cohorts in the National Institutes of Health Environmental Influences on Child Health Outcomes Program. Children and young adults (ages 1-18 years) in these analyses were born between 2003 and 2021. Data were recorded by the August 31, 2021, data-lock date and were analyzed between October 2021 and October 2022. Exposures Premature birth (<37 weeks' gestation). Main Outcomes and Measures The main outcome was health care utilization related to COVID-19 concerns (hospitalization, in-person clinic or emergency department visit, phone or telehealth evaluations). Individuals born preterm vs term (≥37 weeks' gestation) and differences among preterm subgroups of individuals (<28 weeks', 28-36 weeks' vs ≥37 weeks' gestation) were assessed. Generalized estimating equations assessed population odds for health care used and related symptoms, controlling for maternal age, education, and psychiatric disorder; offspring history of bronchopulmonary dysplasia (BPD) or asthma; and timing and age at COVID-19 questionnaire completion. Results Data from 1691 children and young adults were analyzed; among 270 individuals born preterm, the mean (SD) age at survey completion was 8.8 (4.4) years, 151 (55.9%) were male, and 193 (71.5%) had a history of BPD or asthma diagnosis. Among 1421 comparison individuals with term birth, the mean (SD) age at survey completion was 8.4 (2.4) years, 749 (52.7%) were male, and 233 (16.4%) had a history of BPD or asthma. Preterm subgroups included 159 individuals (58.5%) born at less than 28 weeks' gestation. In adjusted analyses, individuals born preterm had a significantly higher odds of health care utilization related to COVID-19 concerns (adjusted odds ratio [aOR], 1.70; 95% CI, 1.21-2.38) compared with term-born individuals; similar differences were also seen for the subgroup of individuals born at less than 28 weeks' gestation (aOR, 2.15; 95% CI, 1.40-3.29). Maternal history of a psychiatric disorder was a significant covariate associated with health care utilization for all individuals (aOR, 1.44; 95% CI, 1.17-1.78). Conclusions and Relevance These findings suggest that during the COVID-19 pandemic, children and young adults born preterm were more likely to have used health care related to COVID-19 concerns compared with their term-born peers, independent of a history of BPD or asthma. Further exploration of factors associated with COVID-19-related health care use may facilitate refinement of care models.
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Affiliation(s)
- Elisabeth C. McGowan
- The Warren Alpert School of Medicine, Brown University, Providence, Rhode Island
| | - Monica McGrath
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Andrew Law
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | - Judy L. Aschner
- Albert Einstein College of Medicine, New York, New York
- Hackensack University Medical Center and Hackensack Meridian School of Medicine, Hackensack, New Jersey
| | | | - Rebecca C. Fry
- The University of North Carolina at Chapel Hill, Chapel Hill
| | - Jody M. Ganiban
- George Washington University, Washington, District of Columbia
| | - Rosemary Higgins
- Department of Global and Community Health, College of Health and Human Sciences, George Mason University, Fort Myers, Florida
- Marieb College of Health and Human Services, Florida Gulf Coast University, Fort Myers
| | - Amy Margolis
- Columbia University Irving Medical Center, New York, New York
| | - Sheela Sathyanarayana
- University of Washington, Seattle
- Seattle Children’s Research Institute, Seattle, Washington
| | | | | | - José F. Cordero
- Department of Epidemiology and Biostatistics, University of Georgia, Athens
| | - Nicole T. Spillane
- Hackensack University Medical Center and Hackensack Meridian School of Medicine, Hackensack, New Jersey
| | - Mark L. Hudak
- Department of Pediatrics, University of Florida College of Medicine, Jacksonville
| | | | - Dana Dabelea
- Lifecourse Epidemiology of Adiposity and Diabetes Center, University of Colorado Anschutz Medical Campus, Aurora
| | | | | | | | - Maria Talavera-Barber
- Avera McKennan Hospital, Sioux Falls, South Dakota
- University Health Center, Avera Research Institute, Sioux Falls, South Dakota
| | - Anne Marie Singh
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison
| | | | - Catherine Karr
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle
| | | | - Nigel Paneth
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing
| | - Rosalind J. Wright
- Institute for Exposomic Research, Icahn School of Medicine Mount Sinai, New York, New York
| | - Robert O. Wright
- Institute for Exposomic Research, Icahn School of Medicine Mount Sinai, New York, New York
| | - Whitney Cowell
- Department of Pediatrics, NYU Grossman School of Medicine, New York, New York
| | | | - Casper Bendixsen
- Marshfield Clinic Research Institute, Marshfield Clinic Health System, Marshfield, Wisconsin
| | - Barry M. Lester
- The Warren Alpert School of Medicine, Brown University, Providence, Rhode Island
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Votto M, Castagnoli R, Marseglia GL, Licari A, Brambilla I. COVID-19 and autoimmune diseases: is there a connection? Curr Opin Allergy Clin Immunol 2023; 23:185-192. [PMID: 36728317 DOI: 10.1097/aci.0000000000000888] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE OF REVIEW This review summarizes current evidence on the potential link between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and autoimmunity. RECENT FINDINGS Several viral infections are potential triggers of reactive and autoimmune diseases by inducing type II and type IV hypersensitivity reactions. Recent evidence demonstrated that SARS-CoV-2 infection is not an exception, triggering the production of tissue-specific autoantibodies during the acute phase of coronavirus disease 2019 (COVID-19) and leading to autoimmune diseases development as long-term complication. The significant immune dysregulation with cytokine storm and organ damage observed in patients with severe to critical COVID-19 is considered the main mechanism explaining the high levels of autoantibodies, which are also implicated in disease severity and the need for an intensive care assessment. Multisystem inflammatory syndrome in children (MIS-C) is an immune-mediated disease where the recent viral infection leads to systemic inflammation, as already observed in other reactive and autoimmune diseases. SUMMARY Autoimmunity may be a complication of SAR-CoV-2 infection. Understanding the pathogenesis of autoimmune manifestations in COVID-19 might help prevent the incidence or exacerbation of autoimmune disorders and design better and more efficient treatment strategies in children and adult populations.
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Affiliation(s)
- Martina Votto
- Pediatric Unit, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia
| | - Riccardo Castagnoli
- Pediatric Unit, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia
- Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Gian Luigi Marseglia
- Pediatric Unit, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia
- Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Amelia Licari
- Pediatric Unit, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia
- Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Ilaria Brambilla
- Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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Sokolovskaya VV, Litvinova AA, Balukhto DA, Kuzmina IN, Krikova AV, Kozlov RS. New coronavirus infection in pediatric practice: clinical and epidemiological features of COVID-19 in the city of Smolensk. CHILDREN INFECTIONS 2023. [DOI: 10.22627/2072-8107-2023-22-1-5-10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
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Kurihara C, Kuniyoshi KM, Rehan VK. Preterm Birth, Developmental Smoke/Nicotine Exposure, and Life-Long Pulmonary Sequelae. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10040608. [PMID: 37189857 DOI: 10.3390/children10040608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/20/2023] [Accepted: 03/21/2023] [Indexed: 05/17/2023]
Abstract
This review delineates the main pulmonary issues related to preterm birth, perinatal tobacco/nicotine exposure, and its effects on offspring, focusing on respiratory health and its possible transmission to subsequent generations. We review the extent of the problem of preterm birth, prematurity-related pulmonary effects, and the associated increased risk of asthma later in life. We then review the impact of developmental tobacco/nicotine exposure on offspring asthma and the significance of transgenerational pulmonary effects following perinatal tobacco/nicotine exposure, possibly via its effects on germline epigenetics.
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Affiliation(s)
- Chie Kurihara
- Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Katherine M Kuniyoshi
- Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Virender K Rehan
- Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA
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Convalescent Plasma Treatment of Patients Previously Treated with B-Cell-Depleting Monoclonal Antibodies Suffering COVID-19 Is Associated with Reduced Re-Admission Rates. Viruses 2023; 15:v15030756. [PMID: 36992465 PMCID: PMC10059055 DOI: 10.3390/v15030756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 03/12/2023] [Accepted: 03/12/2023] [Indexed: 03/17/2023] Open
Abstract
Patients receiving treatment with B-cell-depleting monoclonal antibodies, such as anti-CD20 monoclonal antibodies, such as rituximab and obinutuzumab, either for hematological disease or another diagnosis, such as a rheumatological disease, are at an increased risk for medical complications and mortality from COVID-19. Since inconsistencies persist regarding the use of convalescent plasma (CP), especially in the vulnerable patient population that has received previous treatment with B-cell-depleting monoclonal antibodies, further studies should be performed in thisdirection. The aim of the present study was to describe the characteristics of patients with previous use of B-cell-depleting monoclonal antibodies and describe the potential beneficial effects of CP use in terms of mortality, ICU admission and disease relapse. In this retrospective cohort study, 39 patients with previous use of B-cell-depleting monoclonal antibodies hospitalized in the COVID-19 department of a tertiary hospital in Greece were recorded and evaluated. The mean age was 66.3 years and 51.3% were male. Regarding treatment for COVID-19, remdesivir was used in 89.7%, corticosteroids in 94.9% and CP in 53.8%. In-hospital mortality was 15.4%. Patients who died were more likely to need ICU admission and also had a trend towards a longer hospital stay, even though the last did not reach statistical significance. Patients treated with CP had a lower re-admission rate for COVID-19 after discharge. Further studies should be performed to identify the role of CP in patients with treatment with B-cell-depleting monoclonal antibodies suffering from COVID-19.
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da Fonseca Lima EJ, Leite RD. COVID-19 vaccination in children: a public health priority. J Pediatr (Rio J) 2023; 99 Suppl 1:S28-S36. [PMID: 36564007 PMCID: PMC9767816 DOI: 10.1016/j.jped.2022.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 11/20/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE Covid-19 had a direct impact on children's health. The aim of this review was to analyze epidemiological and clinical data, the consequences of the pandemic, and vaccination aspects in this group. SOURCES OF DATA The searches were carried out from January 2020 to November 2022, in the MEDLINE databases (PubMed) and publications of the Brazilian Ministry of Health and the Brazilian Society of Pediatrics. SUMMARY OF FINDINGS Covid-19 has a mild presentation in most children; however, the infection can progress to the severe form and, in some cases, to MIS-C. The prevalence of the so-called long Covid in children was 25.24%. Moreover, several indirect impacts occurred on the health of children and adolescents. Vaccination played a crucial role in enabling the reduction of severe disease and mortality rates. Children and adolescents, as a special population, were excluded from the initial clinical trials and, therefore, vaccination was introduced later in this group. Despite its importance, there have been difficulties in the efficient implementation of vaccination in the pediatric population. The CoronaVac vaccines are authorized in Brazil for children over three years of age and the pediatric presentations of the Pfizer vaccine have shown significant effectiveness and safety. CONCLUSIONS Covid-19 in the pediatric age group was responsible for the illness and deaths of a significant number of children. For successful immunization, major barriers have to be overcome. Real-world data on the safety and efficacy of several pediatric vaccines is emphasized, and the authors need a uniform message about the importance of immunization for all children.
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Affiliation(s)
- Eduardo Jorge da Fonseca Lima
- Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife, PE, Brazil; Faculdade Pernambucana de Saúde (FPS), Recife, PE, Brazil.
| | - Robério Dias Leite
- Universidade Federal do Ceará, Departamento de Saúde da Mulher, da Criança e do Adolescente, Fortaleza, CE, Brazil; Hospital São José de Doenças Infecciosas da Secretaria de Saúde do Estado do Ceará, Fortaleza, CE, Brazil
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50
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Laorden D, Domínguez-Ortega J, Carpio C, Barranco P, Villamañán E, Romero D, Quirce S, Álvarez-Sala R. Long COVID outcomes in an asthmatic cohort and its implications for asthma control. Respir Med 2023; 207:107092. [PMID: 36535372 PMCID: PMC9755318 DOI: 10.1016/j.rmed.2022.107092] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 12/05/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022]
Affiliation(s)
- Daniel Laorden
- Department of Pneumology, Hospital La Paz, Universidad Autónoma de Madrid, IdiPAZ, and CIBER of Respiratory Diseases, Madrid, Spain.
| | - Javier Domínguez-Ortega
- Department of Allergy, Hospital La Paz, IdiPAZ, and CIBER of Respiratory Diseases, Madrid, Spain
| | - Carlos Carpio
- Department of Pneumology, Hospital La Paz, Universidad Autónoma de Madrid, IdiPAZ, and CIBER of Respiratory Diseases, Madrid, Spain
| | - Pilar Barranco
- Department of Allergy, Hospital La Paz, IdiPAZ, and CIBER of Respiratory Diseases, Madrid, Spain
| | | | - David Romero
- Department of Pneumology, Hospital La Paz, Universidad Autónoma de Madrid, IdiPAZ, and CIBER of Respiratory Diseases, Madrid, Spain
| | - Santiago Quirce
- Department of Allergy, Hospital La Paz, IdiPAZ, and CIBER of Respiratory Diseases, Madrid, Spain
| | - Rodolfo Álvarez-Sala
- Department of Pneumology, Hospital La Paz, Universidad Autónoma de Madrid, IdiPAZ, and CIBER of Respiratory Diseases, Madrid, Spain
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