1
|
Mertz C, Glowinski R, Cohen SH, Mertz S, Ye F, Hall MW, Peeples ME, King T, Wang H, Leber AL, Sanchez PJ, Ramilo O, Mejias A. SARS-CoV-2 RNAemia and clinical outcomes in children with COVID-19. J Infect Dis 2021; 225:208-213. [PMID: 34618885 DOI: 10.1093/infdis/jiab491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 09/23/2021] [Indexed: 01/08/2023] Open
Abstract
The burden of COVID-19 in children represents a fraction of cases worldwide, yet a subset of those infected are at risk for severe disease. We measured plasma SARS-CoV-2 RNA in a cohort of 103 children hospitalized with COVID-19 with diverse clinical manifestations. SARS-CoV-2 RNAemia was detected in 27 (26%) of these children, lasted for a median of 6 [2-9] days, and it was associated with higher rates of oxygen administration, admission to the intensive care unit, and longer hospitalization.
Collapse
Affiliation(s)
- C Mertz
- Center for Vaccines and Immunity, The Abigail Wexner Research Institute at Nationwide Children's Hospital, and The Ohio State University College of Medicine, Columbus, OH, USA
| | - R Glowinski
- Center for Vaccines and Immunity, The Abigail Wexner Research Institute at Nationwide Children's Hospital, and The Ohio State University College of Medicine, Columbus, OH, USA
| | - S H Cohen
- Center for Vaccines and Immunity, The Abigail Wexner Research Institute at Nationwide Children's Hospital, and The Ohio State University College of Medicine, Columbus, OH, USA
| | - S Mertz
- Center for Vaccines and Immunity, The Abigail Wexner Research Institute at Nationwide Children's Hospital, and The Ohio State University College of Medicine, Columbus, OH, USA
| | - F Ye
- Center for Vaccines and Immunity, The Abigail Wexner Research Institute at Nationwide Children's Hospital, and The Ohio State University College of Medicine, Columbus, OH, USA
| | - M W Hall
- Department of Pediatrics, Division of Critical Care Medicine, Nationwide Children's Hospital, and The Ohio State University College of Medicine, Columbus, OH, USA
| | - M E Peeples
- Center for Vaccines and Immunity, The Abigail Wexner Research Institute at Nationwide Children's Hospital, and The Ohio State University College of Medicine, Columbus, OH, USA
| | - T King
- Center for Vaccines and Immunity, The Abigail Wexner Research Institute at Nationwide Children's Hospital, and The Ohio State University College of Medicine, Columbus, OH, USA
| | - H Wang
- Department of Laboratory Medicine, Nationwide Children's Hospital, Columbus, OH, USA
| | - A L Leber
- Department of Laboratory Medicine, Nationwide Children's Hospital, Columbus, OH, USA
| | - P J Sanchez
- Center for Perinatal Research, The Abigail Wexner Research Institute at Nationwide Children's Hospital , and The Ohio State University College of Medicine, Columbus, OH, USA.,Department of Pediatrics, Division of Neonatology, Columbus, OH, USA.,Division of Infectious Diseases, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, OH, USA
| | - O Ramilo
- Center for Vaccines and Immunity, The Abigail Wexner Research Institute at Nationwide Children's Hospital, and The Ohio State University College of Medicine, Columbus, OH, USA.,Division of Infectious Diseases, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, OH, USA
| | - A Mejias
- Center for Vaccines and Immunity, The Abigail Wexner Research Institute at Nationwide Children's Hospital, and The Ohio State University College of Medicine, Columbus, OH, USA.,Division of Infectious Diseases, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, OH, USA
| |
Collapse
|
2
|
Moffet JR, Mahadeo KM, McArthur J, Hsing DD, Gertz SJ, Smith LS, Loomis A, Fitzgerald JC, Nitu ME, Duncan CN, Hall MW, Pinos EL, Tamburro RF, Simmons RA, Troy J, Cheifetz IM, Rowan CM. Correction to: Acute respiratory failure and the kinetics of neutrophil recovery in pediatric hematopoietic cell transplantation: a multicenter study. Bone Marrow Transplant 2019; 55:476. [PMID: 31822810 PMCID: PMC7608367 DOI: 10.1038/s41409-019-0767-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
An amendment to this paper has been published and can be accessed via a link at the top of the paper.
Collapse
Affiliation(s)
- J R Moffet
- Department of Pediatrics, Division of Blood and Marrow Transplant, Duke Children's Hospital, Duke University, Durham, NC, USA.
| | - K M Mahadeo
- Department of Pediatrics, Stem Cell Transplantation and Cellular Therapy, University of Texas at MD Anderson Cancer Center, Houston, TX, USA
| | - J McArthur
- Department of Pediatrics, Division of Critical Care, St. Jude's Children's Research Hospital, Memphis, TN, USA
| | - D D Hsing
- Department of Pediatrics, Division of Critical Care, Weil Cornell Medical College, New York Presbyterian Hospital, New York City, NY, USA
| | - S J Gertz
- Department of Pediatrics, St. Barnabas Medical Center, Livingston, NJ, USA
| | - L S Smith
- Department of Pediatrics, Division of Pediatric Critical Care Medicine, Seattle Children's Hospital, University of Washington, Seattle, WA, USA
| | - A Loomis
- Department of Pediatrics, Division of Critical Care, Masonic Children's Hospital, University of Minnesota, Minneapolis, MN, USA
| | - J C Fitzgerald
- Department of Anesthesiology and Critical Care, Division of Critical Care, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - M E Nitu
- Department of Pediatrics, Division of Critical Care, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN, USA
| | - C N Duncan
- Department of Pediatrics, Pediatric Oncology, Dana-Farber Cancer Institute Harvard University, Boston, MA, USA
| | - M W Hall
- Department of Pediatrics, Division of Critical Care, Nationwide Children's Hospital, The Ohio State University, Columbus, OH, USA
| | - E L Pinos
- Department of Pediatrics, Division of Critical Care, Penn State Hershey Children's Hospital, Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - R F Tamburro
- Department of Pediatrics, Division of Critical Care, Penn State Hershey Children's Hospital, Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - R A Simmons
- Duke CTSI Biostatistics, Epidemiology and Research Design (BERD) Methods Core, Department of Biostatistics & Bioinformatics, Duke University, Durham, NC, USA
| | - J Troy
- Department of Pediatrics, Division of Blood and Marrow Transplant, Duke Children's Hospital, Duke University, Durham, NC, USA
| | - I M Cheifetz
- Department of Pediatrics, Division of Critical Care, Duke Children's Hospital, Duke University, Durham, NC, USA
| | - C M Rowan
- Department of Pediatrics, Division of Critical Care, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN, USA
| | | |
Collapse
|
3
|
Moffet JR, Mahadeo KM, McArthur J, Hsing DD, Gertz SJ, Smith LS, Loomis A, Fitzgerald JC, Nitu ME, Duncan CN, Hall MW, Pinos EL, Tamburro RF, Simmons RA, Troy J, Cheifetz IM, Rowan CM. Acute respiratory failure and the kinetics of neutrophil recovery in pediatric hematopoietic cell transplantation: a multicenter study. Bone Marrow Transplant 2019; 55:341-348. [PMID: 31527817 PMCID: PMC7091821 DOI: 10.1038/s41409-019-0649-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Revised: 07/09/2019] [Accepted: 08/10/2019] [Indexed: 11/23/2022]
Abstract
In this multicenter study, we investigated the kinetics of neutrophil recovery in relation to acuity and survival among 125 children undergoing allogeneic hematopoietic cell transplantation (allo-HCT) who required invasive mechanical ventilation (IMV). Recovery of neutrophils, whether prior to or after initiation of IMV, was associated with a significantly decreased risk of death relative to never achieving neutrophil recovery. A transient increase in acuity (by oxygenation index and vasopressor requirements) occurred among a subset of the patients who achieved neutrophil recovery after initiation of IMV; 61.5% of these patients survived to discharge from the intensive care unit (ICU). Improved survival among patients who subsequently achieved neutrophil recovery on IMV was not limited to those with peri-engraftment respiratory distress syndrome. The presence of a respiratory pathogen did not affect the risk of death while on IMV but was associated with an increased length of IMV (p < 0.01). Among patients undergoing HCT who develop respiratory failure and require advanced therapeutic support, neutrophil recovery at time of IMV and/or presence of a respiratory pathogen should not be used as determining factors when counseling families about survival.
Collapse
Affiliation(s)
- J R Moffet
- Department of Pediatrics, Division of Blood and Marrow Transplant, Duke Children's Hospital, Duke University, Durham, NC, USA.
| | - K M Mahadeo
- Department of Pediatrics, Stem Cell Transplantation and Cellular Therapy, University of Texas at MD Anderson Cancer Center, Houston, TX, USA
| | - J McArthur
- Department of Pediatrics, Division of Critical Care, St. Jude's Children's Research Hospital, Memphis, TN, USA
| | - D D Hsing
- Department of Pediatrics, Division of Critical Care, Weil Cornell Medical College, New York Presbyterian Hospital, New York City, NY, USA
| | - S J Gertz
- Department of Pediatrics, St. Barnabas Medical Center, Livingston, NJ, USA
| | - L S Smith
- Department of Pediatrics, Division of Pediatric Critical Care Medicine, Seattle Children's Hospital, University of Washington, Seattle, WA, USA
| | - A Loomis
- Department of Pediatrics, Division of Critical Care, Masonic Children's Hospital, University of Minnesota, Minneapolis, MN, USA
| | - J C Fitzgerald
- Department of Anesthesiology and Critical Care, Division of Critical Care, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - M E Nitu
- Department of Pediatrics, Division of Critical Care, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN, USA
| | - C N Duncan
- Department of Pediatrics, Pediatric Oncology, Dana-Farber Cancer Institute Harvard University, Boston, MA, USA
| | - M W Hall
- Department of Pediatrics, Division of Critical Care, Nationwide Children's Hospital, The Ohio State University, Columbus, OH, USA
| | - E L Pinos
- Department of Pediatrics, Division of Critical Care, Penn State Hershey Children's Hospital, Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - R F Tamburro
- Department of Pediatrics, Division of Critical Care, Penn State Hershey Children's Hospital, Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - R A Simmons
- Duke CTSI Biostatistics, Epidemiology and Research Design (BERD) Methods Core, Department of Biostatistics & Bioinformatics, Duke University, Durham, NC, USA
| | - J Troy
- Department of Pediatrics, Division of Blood and Marrow Transplant, Duke Children's Hospital, Duke University, Durham, NC, USA
| | - I M Cheifetz
- Department of Pediatrics, Division of Critical Care, Duke Children's Hospital, Duke University, Durham, NC, USA
| | - C M Rowan
- Department of Pediatrics, Division of Critical Care, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN, USA
| | | |
Collapse
|
4
|
|
5
|
|
6
|
|
7
|
|
8
|
Abstract
Minute concentrations of ADP are released when platelets are exposed to shear stress during extracorporeal flow. However, based on current methods, these low concentrations have not been shown to have a significant impact on platelet function. We report here the formation of rigid microaggregates (MA) in response to low concentrations of ADP. A newly developed light scattering whole blood aggregometer (LSWBA) was used to detect an aggregation dose response to ADP (0-2 microM) in heparinized (1.5 U/ml) human blood. Although the LSWBA showed that ADP induced MA were reversible, evidence provided by constant pressure filtration (50 mm Hg) suggested that aggregates existed as rigid particles in the blood for up to 6 minutes. The possible implications of these findings to extracorporeal circulation are discussed.
Collapse
Affiliation(s)
- M W Hall
- Department of Chemical Engineering, Brigham Young University, Provo, Utah 84602, USA
| | | | | | | |
Collapse
|
9
|
Abstract
Biomateria related thromboembolism is a complex phenomenon, affected by such variables as biomaterial surface chemistry, hemodynamics, and individual donor variations. Thus, isolation of the individual variables would greatly facilitate the understanding and inhibition of this phenomenon. A low volume in vitro model with this potential has been developed, with the initial focus on studying the influence of hemodynamics on thromboembolism (TE) in human blood. Patterned after a larger in vitro model for bovine blood used successfully in our laboratory, the smaller model directed fresh human blood in a single pass through 1/32 inch ID PVC tubing and a flow cell at 3 ml/min. The flow cell consisted of alternating abrupt expansions and contractions of cylindrical tubing that could be modified to study the effects of hemodynamic parameters on TE. Thrombus growth in the flow cell was monitored visually by transillumination microscopy. Emboli from the flow cell were detected continuously by a light-scattering microemboli detector (LSMD), and their strength was assessed by using the constant-pressure filtration (CPF) method. Preliminary studies confirmed the potential of this model. Thrombi were observed visually in the flow cell at sites of high vorticity and at flow separation and reattachment points and were also observed to embolize. Emboli were detected by the LSMD downstream of the flow cell in significantly greater numbers than upstream and were coincident with the embolization of thrombi observed visually. Emboli collected downstream of the flow cell occluded the CPF filters at 50 mm Hg, suggesting that they possessed sufficient strength to occlude microvessels. This model may be used to aid in developing a computer model of thromboembolism, which could subsequently be refined with clinical data.
Collapse
Affiliation(s)
- P D Goodman
- Department of Chemical Engineering, Brigham Young University, Provo, Utah 84602, USA
| | | | | | | |
Collapse
|
10
|
|
11
|
Peevy KJ, Hall MW. Transcutaneous oxygen monitoring: economic impact on neonatal care. Pediatrics 1985; 75:1065-7. [PMID: 4000781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Five years (1978 to 1982) of respiratory care data were reviewed to determine the changes in patient charges, hospital costs, and frequency of neonatal blood gas analysis created by the introduction of transcutaneous oxygen monitoring. During the 4 years of transcutaneous oxygen monitoring (1979 to 1982), an estimated $196,000 reduction in patient charges was accomplished. When reduced patient charges were balanced with the increased cost to the hospital for equipment, supplies, and personnel time, a net reduction of more than $100,000 for health care delivery was achieved. Transcutaneous oxygen monitoring is an example of technologic achievement in which society receives both economic and medical benefits.
Collapse
|
12
|
Hall MW, Thomas EE. Effect of selected dietary buffers upon utilization of concentrate- or roughage-based cattle diets: laboratory studies. J Anim Sci 1984; 59:227-36. [PMID: 6086563 DOI: 10.2527/jas1984.591227x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Four chemical buffers were evaluated with in vitro rumen fermentation studies using both an 80% concentrate and a 50% roughage diet. Treatments included a positive control (PC), negative control (NC) and four buffered diets in which 500 mg of either CaHPO4, CaCO3, NaHCO3 or Na4P2O7 were added. The PC consisted of unbuffered diet with one part rumen fluid and four parts McDougall's artificial saliva. In the unbuffered NC and buffered treatments, three-fourths of the artificial saliva was replaced by iso-osmotic saline. In the concentrate-based diet, NaHCO3 and Na4P2O7 elevated (P less than .05) pH above the NC. Starch digestion and total VFA were increased (P less than .05) by NaHCO3 compared with the NC while the molar proportion of individual VFA was not altered. Tetrasodium pyrophosphate had no effect on starch digestion or total VFA, but did increase (P less than .05) the molar proportion of acetic acid. Regarding the 50% roughage diet, both NaHCO3 and Na4P2O7 elevated (P less than .05) starch and cellulose digestion and total VFA compared with the NC. Both NaHCO3 and Na4P2O7 increased (P less than .05) the molar proportion of acetate to equal that of the PC. Tetrasodium pyrophosphate decreased (P less than .05) apparent starch digestion compared with the NC, but increased (P less than .05) the molar proportion of acetate. Compared with the NC, CaHPO4 and Na4P2O7 increased the quantity of microbial alpha-amino N in both diets. Soluble P was highly correlated with microbial protein synthesis in both the concentrate- and roughage-based diets (.92 and .90, respectively).
Collapse
|
13
|
Hall MW, Peevy KJ. Infant ventilator design: performance during expiratory limb occlusion. Crit Care Med 1983; 11:26-9. [PMID: 6571722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
We examined the specifications and design of the inspiratory pressure regulating valve of 8 continuous flow, pressure-limited infant ventilators. Two pressure regulating designs are currently available; one placing the primary pressure regulating valve on the inspiratory limb, the other placing it on the expiratory limb. Seven ventilators incorporate the latter design to limit inspiratory pressure and must have a safety pressure-relief valve located on the inspiratory limb to vent pressure in case of circuit occlusion. These pressure-relief valves are generally set by the manufacturer far in excess of pressures normally used for infant ventilation. Alarm systems are often absent or inadequate to warn of high pressure conditions during circuit obstruction. A case report detailing the fatal complication of prolonged excessive airway pressure during circuit occlusion is presented. Improvements in the pressure-relief valve designs currently available are possible, and may be necessary to provide adequate protection from barotrauma. The majority of infant ventilators currently available expose the patient to unnecessary excessive airway pressures in the case of expiratory limb occlusion, and the lack of alarm systems may leave the operator unaware of malfunction.
Collapse
|
14
|
|
15
|
Woodard FE, Sproul OJ, Hall MW, Ghosh MM. Abatement of pollution from a poultry processing plant. J Water Pollut Control Fed 1972; 44:1909-15. [PMID: 5072435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
|
16
|
Hall MW. Petroleum-processing wastes. J Water Pollut Control Fed 1972; 44:1098-100. [PMID: 4556338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
|
17
|
Hall MW. THE RELATION OF BACTERIUM PNEUMOSINTES TO INFLUENZA: A STUDY WITH A STRAIN OF THE ORGANISM DERIVED FROM THE NASOPHARYNGEAL WASHINGS OF A CASE OF INFLUENZA. J Exp Med 1926; 44:539-51. [PMID: 19869205 PMCID: PMC2131192 DOI: 10.1084/jem.44.4.539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Nasopharyngeal washings from a case of epidemic influenza have proven capable of initiating a pathological change in rabbits and in guinea pigs characterized after an incubation period of 1 or 2 days, by some elevation of temperature, reduction in the number of circulating leucocytes, especially of the mononuclears, and by a pulmonary lesion during the period of reaction, which is distinguishable from those accidentally incurred at the time of death. From one such animal, in the second passage of the virus, an anaerobic coccobacius, corresponding in all respects to Bact. pneumosintes, was isolated by the method employed by Olitsky and Gates. This organism also proved capable of initiating the pathological change in animals found after inoculation with influenzal material. The observation of Olitsky and Gates that the presence of this organism in the lungs of experimental animals predisposes to pulmonary localization of other bacteria with the production of definite pneumonic lesions has been confirmed. Bact. pneumosintes infections may be induced by subcutaneous injection of infected material.
Collapse
Affiliation(s)
- M W Hall
- Laboratories of the U. S. Army Medical School, Washington, D.C
| |
Collapse
|
18
|
Hall MW, Lacy GR. The Mechanism of The Russell Double Sugar Tube. J Infect Dis 1926. [DOI: 10.1093/infdis/38.1.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|