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Hollister J, Caban-Martinez AJ, Ellingson KD, Beitel S, Fowlkes AL, Lutrick K, Tyner HL, Naleway AL, Yoon SK, Gaglani M, Hunt D, Meece J, Mayo Lamberte J, Schaefer Solle N, Rose S, Dunnigan K, Khan SM, Kuntz JL, Fisher JM, Coleman A, Britton A, Thiese MS, Hegmann KT, Pavuk M, Ramadan FA, Fuller S, Nematollahi A, Sprissler R, Burgess JL. Serum per- and polyfluoroalkyl substance concentrations and longitudinal change in post-infection and post-vaccination SARS-CoV-2 antibodies. Environ Res 2023; 239:117297. [PMID: 37816422 PMCID: PMC10842580 DOI: 10.1016/j.envres.2023.117297] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 09/17/2023] [Accepted: 10/02/2023] [Indexed: 10/12/2023]
Abstract
Per- and polyfluoroalkyl substances (PFAS) are ubiquitous throughout the United States. Previous studies have shown PFAS exposure to be associated with a reduced immune response. However, the relationship between serum PFAS and antibody levels following SARS-CoV-2 infection or COVID-19 vaccination has not been examined. We examined differences in peak immune response and the longitudinal decline of antibodies following SARS-CoV-2 infection and COVID-19 vaccination by serum PFAS levels in a cohort of essential workers in the United States. We measured serum antibodies using an in-house semi-quantitative enzyme-linked immunosorbent assay (ELISA). Two cohorts contributed blood samples following SARS-CoV-2 infection or COVID-19 vaccination. We used linear mixed regression models, adjusting for age, race/ethnicity, gender, presence of chronic conditions, location, and occupation, to estimate differences in immune response with respect to serum PFAS levels. Our study populations included 153 unvaccinated participants that contributed 316 blood draws over a 14-month period following infection, and 860 participants and 2451 blood draws over a 12-month period following vaccination. Higher perfluorooctane sulfonic acid (PFOS), perfluorohexane sulfonic acid (PFHxS), and perfluorononanoic acid (PFNA) concentrations were associated with a lower peak antibody response after infection (p = 0.009, 0.031, 0.015). Higher PFOS, perfluorooctanoic acid (PFOA), PFHxS, and PFNA concentrations were associated with slower declines in antibodies over time after infection (p = 0.003, 0.014, 0.026, 0.025). PFOA, PFOS, PFHxS, and PFNA serum concentrations prior to vaccination were not associated with differences in peak antibody response after vaccination or with differences in decline of antibodies over time after vaccination. These results suggest that elevated PFAS may impede potential immune response to SARS-CoV-2 infection by blunting peak antibody levels following infection; the same finding was not observed for immune response to vaccination.
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Affiliation(s)
- James Hollister
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA.
| | - Alberto J Caban-Martinez
- Department of Public Health Sciences and Physical Medicine and Rehabilitation, University of Miami, Miller School of Medicine, USA
| | - Katherine D Ellingson
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Shawn Beitel
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | | | - Karen Lutrick
- College of Medicine - Tucson, University of Arizona, Tucson, AZ, USA
| | | | - Allison L Naleway
- Kaiser Permanente Northwest Center for Health Research, Portland, OR, USA
| | - Sarang K Yoon
- University of Utah Health, Rocky Mountain Center for Occupational and Environmental Health, USA
| | - Manjusha Gaglani
- Baylor Scott and White Health, Temple, TX, USA; Texas A&M University College of Medicine, Temple, TX, USA
| | | | | | | | - Natasha Schaefer Solle
- Department of Public Health Sciences and Physical Medicine and Rehabilitation, University of Miami, Miller School of Medicine, USA
| | | | | | - Sana M Khan
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Jennifer L Kuntz
- Kaiser Permanente Northwest Center for Health Research, Portland, OR, USA
| | | | - Alissa Coleman
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | | | - Matthew S Thiese
- Rocky Mountain Center for Occupational and Environmental Health, University of Utah, Salt Lake City, UT, USA
| | - Kurt T Hegmann
- Rocky Mountain Center for Occupational and Environmental Health, University of Utah, Salt Lake City, UT, USA
| | - Marian Pavuk
- Agency for Toxic Substances and Disease Registry, CDC, Atlanta, GA, USA
| | - Ferris A Ramadan
- Department of Epidemiology and Biostatistics, University of Arizona, Tucson, AZ, USA
| | | | - Amy Nematollahi
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Ryan Sprissler
- University of Arizona Genetics Core, Office for Research, Innovation and Impact, University of Arizona, Tucson, AZ, USA
| | - Jefferey L Burgess
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
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Dubowski K, Braganza GT, Bozack A, Colicino E, DeFelice N, McGuinn L, Maru D, Lee AG. COVID-19 subphenotypes at hospital admission are associated with mortality: a cross-sectional study. Ann Med 2023; 55:12-23. [PMID: 36444856 PMCID: PMC10795648 DOI: 10.1080/07853890.2022.2148733] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 11/13/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND We have an incomplete understanding of COVID-19 characteristics at hospital presentation and whether underlying subphenotypes are associated with clinical outcomes and therapeutic responses. METHODS For this cross-sectional study, we extracted electronic health data from adults hospitalized between 1 March and 30 August 2020 with a PCR-confirmed diagnosis of COVID-19 at five New York City Hospitals. We obtained clinical and laboratory data from the first 24 h of the patient's hospitalization. Treatment with tocilizumab and convalescent plasma was assessed over hospitalization. The primary outcome was mortality; secondary outcomes included intubation, intensive care unit (ICU) admission and length of stay (LOS). First, we employed latent class analysis (LCA) to identify COVID-19 subphenotypes on admission without consideration of outcomes and assigned each patient to a subphenotype. We then performed robust Poisson regression to examine associations between COVID-19 subphenotype assignment and outcome. We explored whether the COVID-19 subphenotypes had a differential response to tocilizumab and convalescent plasma therapies. RESULTS A total of 4620 patients were included. LCA identified six subphenotypes, which were distinct by level of inflammation, clinical and laboratory derangements and ranged from a hypoinflammatory subphenotype with the fewest derangements to a hyperinflammatory with multiorgan dysfunction subphenotypes. Multivariable regression analyses found differences in risk for mortality, intubation, ICU admission and LOS, as compared to the hypoinflammatory subphenotype. For example, in multivariable analyses the moderate inflammation with fever subphenotype had 3.29 times the risk of mortality (95% CI 2.05, 5.28), while the hyperinflammatory with multiorgan failure subphenotype had 17.87 times the risk of mortality (95% CI 11.56, 27.63), as compared to the hypoinflammatory subphenotype. Exploratory analyses suggested that subphenotypes may differential respond to convalescent plasma or tocilizumab therapy. CONCLUSION COVID-19 subphenotype at hospital admission may predict risk for mortality, ICU admission and intubation and differential response to treatment.KEY MESSAGEThis cross-sectional study of COVID patients admitted to the Mount Sinai Health System, identified six distinct COVID subphenotypes on admission. Subphenotypes correlated with ICU admission, intubation, mortality and differential response to treatment.
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Affiliation(s)
- Kathryn Dubowski
- Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Giovanna T. Braganza
- School of Public Health, State University of New York, Downstate Health Sciences University, Brooklyn, NY, USA
| | - Anne Bozack
- School of Public Health, Environmental Health Sciences, University of California Berkeley, Berkeley, CA, USA
| | - Elena Colicino
- Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Nicholas DeFelice
- Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Laura McGuinn
- Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Duncan Maru
- Department of Global Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alison G. Lee
- Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Malara A, Noale M, Trevisan C, Abbatecola AM, Borselli G, Cafariello C, Gareri P, Fumagalli S, Mossello E, Volpato S, Monzani F, Coin A, Okoye C, Bellelli G, Del Signore S, Zia G, Antonelli Incalzi R, Palmieri A, Fedele G, Onder G. Efficacy of COVID-19 control measures on post-vaccination outbreak in Italian Long Term Care Facilities: implications for policies. Front Public Health 2023; 11:1091974. [PMID: 37346108 PMCID: PMC10280634 DOI: 10.3389/fpubh.2023.1091974] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 05/16/2023] [Indexed: 06/23/2023] Open
Abstract
Background Numerous individual and organizational factors can influence the spread of SARS-CoV-2 infection in Long Term Care Facilities (LTCFs). A range of outbreak control measures are still implemented in most facilities involving administrations, staff, residents and their families. This study aims to evaluate which measure could influence the transmission of SARS-CoV-2 infection among residents during the period March 2021-June 2022. Methods We enrolled 3,272 residents aged ≥60 years. The outbreak control measures adopted to prevent or manage the infection included entry regulations, contact-regulating procedures, and virological surveillance of residents and staff. The association between LTCFs' and participants' characteristics with new cases of COVID-19 infections was analyzed using multilevel logistic regression models. Results In 33.8% of the facilities 261 cases of SARS-CoV-2 infection were reported. Among participant characteristics, gender and age were not associated with SARS-CoV-2 infection, while having received the vaccine booster dose was protective against infection [Odds Ratio (OR) = 0.34, 95% Confidence Interval (CI) 0.12-0.99, p = 0.048]. In addition, the implementation of protected areas for family visits was associated with a significant reduction of the probability of infections (OR = 0.18, 95% CI 0.03-0.98, p = 0.047). Overall, about 66% of the variability in the probability of SARS-CoV-2 infection during the observational period may be due to facility structure characteristics and 34% to the participant characteristics. Conclusions These data showed that vaccination booster doses and family visit restriction-control are still needed to make the LTCFs safer against SARS-CoV-2 infection.
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Affiliation(s)
- Alba Malara
- Associazione Nazionale Strutture Territoriali-Humanitas Foundation, Rome, Italy
| | - Marianna Noale
- Neuroscience Institute, National Research Council, Padua, Italy
| | - Caterina Trevisan
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
- Department of Medicine, University of Padua, Padua, Italy
| | | | - Gilda Borselli
- Italian Society of Gerontology and Geriatrics, Florence, Italy
| | | | - Pietro Gareri
- Center for Cognitive Disorders and Dementia (CDCD) Catanzaro Lido – ASP Catanzaro, Catanzaro, Italy
| | - Stefano Fumagalli
- Department of Experimental and Clinical Medicine, University of Florence and Division of Geriatric and Intensive Care Medicine, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Enrico Mossello
- Department of Experimental and Clinical Medicine, University of Florence and Division of Geriatric and Intensive Care Medicine, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Stefano Volpato
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Fabio Monzani
- Geriatrics Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Chukwuma Okoye
- Geriatrics Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giuseppe Bellelli
- School of Medicine and Surgery, University of Milano-Bicocca and Acute Geriatric Unit, San Gerardo Hospital, Monza, Italy
| | | | | | - Raffaele Antonelli Incalzi
- Unit of Geriatrics, Department of Medicine, Campus Bio-Medico University and Teaching Hospital, Rome, Italy
| | - Annapina Palmieri
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanità, Rome, Italy
| | - Giorgio Fedele
- Department of Infectious Disease, Istituto Superiore di Sanità, Rome, Italy
| | - Graziano Onder
- Department of Geriatrics, Universita' Cattolica Sacro Cuore, Rome, Italy
- Fondazione Policlinico Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
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Nongpiur A, Barman B, Syiem K, Mawiong AM, Anand N, Nune A. A cross-sectional study of the mental health burden among COVID-19 survivors. Indian J Psychiatry 2023; 65:661-666. [PMID: 37485412 PMCID: PMC10358821 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_105_23] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 05/02/2023] [Accepted: 05/05/2023] [Indexed: 07/25/2023] Open
Abstract
Introduction Coronavirus disease 2019 (COVID-19) pandemic has had a significant impact on mental health, including stress, anxiety, and depression. This study aimed to assess the incidence and severity of mental health issues among individuals diagnosed with COVID-19 infection. Methods A semi-structured proforma for socio-demographic and clinical parameters was used to collect cross-sectional hospital-based data of subjects who tested positive for COVID-19 infection. The Modified Fatigue Impact Scale (MFIS), Hospital Anxiety and Depression Scale (HADS), and Perceived Stress Scale (PSS) were used to assess the presence of physical, psychological, and cognitive symptoms. The presence of anxiety, depression, and stress was based on the cut-off scores for HADS-A (≥8), HADS-D (≥8), and PSS (≥14), respectively. Results A total of 101 patients comprising 39 (38.6%) males were recruited. Compared to nuclear families, we observed that patients living in joint families had significantly greater severity scores for fatigue [MFIS (p = 0.04)], anxiety [HADS-A (p = 0.004)], depression [HADS-D (p = 0.004)], and stress [PSS (p = 0.02)]. Based on the cut-off scores, we found that 44 (43.6%) patient had anxiety, 41 (40.6%) had depressive, and 72 (71.3%) had moderate to high stress symptoms, respectively. We also observed significantly greater fatigue and anxiety scores, that is, MFIS (p = 0.008) and HADS-A (p = 0.03) in those who received oxygen therapy compared to those who did not. The subjects who received corticosteroids were older (p = 0.01) and had significantly higher stress scores [PSS (p < 0.001)]. The study showed that patients who were assessed more than 3 months post-COVID-19 infection had higher fatigue and depression scores; however, the difference did not reach statistical significance (MFIS P = 0.058; HADS P = 0.059). Conclusion Our study confirms that COVID-19 infection can cause various adverse mental health issues. Mitigating the hazardous effects of COVID-19 pandemic on mental health should be a top priority for public health to prevent long-term complications.
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Affiliation(s)
- Arvind Nongpiur
- Department of Psychiatry, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong, Meghalaya, India
| | - Bhupen Barman
- Department of General Medicine, All India Institute of Medical Sciences (AIIMS) Guwahati, Assam, India
| | - Kimberly Syiem
- Department of Psychiatry, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong, Meghalaya, India
| | - Andreecia Mn Mawiong
- Meghalaya Institute of Mental health and Neurosciences (MIMHANS), Meghalaya, India
| | - Naveen Anand
- Manasa Nursing Home (Neuro and Psychiatric Care Center), Shivamogga, Karnataka, India
| | - Arvind Nune
- Southport and Ormskirk NHS Trust, Southport, UK
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Malarvili MB, Alexie M, Dahari N, Kamarudin A. On Analyzing Capnogram as a Novel Method for Screening COVID-19: A Review on Assessment Methods for COVID-19. Life (Basel) 2021; 11:1101. [PMID: 34685472 PMCID: PMC8538964 DOI: 10.3390/life11101101] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 08/12/2021] [Accepted: 10/12/2021] [Indexed: 12/15/2022] Open
Abstract
In November 2019, the novel coronavirus disease COVID-19 was reported in Wuhan city, China, and was reported in other countries around the globe. COVID-19 is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Strategies such as contact tracing and a vaccination program have been imposed to keep COVID-19 under control. Furthermore, a fast, noninvasive and reliable testing device is needed urgently to detect COVID-19, so that contact can be isolated and ringfenced before the virus spreads. Although the reverse transcription polymerase chain reaction (RT-PCR) test is considered the gold standard method for the diagnosis of SARS-CoV-2 infection, this test presents some limitations which cause delays in detecting the disease. The antigen rapid test (ART) test, on the other hand, is faster and cheaper than PCR, but is less sensitive, and may limit SARS-CoV-2 detection. While other tests are being developed, accurate, noninvasive and easy-to-use testing tools are in high demand for the rapid and extensive diagnosis of the disease. Therefore, this paper reviews current diagnostic methods for COVID-19. Following this, we propose the use of expired carbon dioxide (CO2) as an early screening tool for SARS-CoV-2 infection. This system has already been developed and has been tested on asthmatic patients. It has been proven that expired CO2, also known as capnogram, can help differentiate between respiratory conditions and, therefore, could be used to detect SARS-CoV-2 infection, as it causes respiratory tract-related diseases.
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Affiliation(s)
- M. B. Malarvili
- School of Biomedical and Health Science Engineering, Universiti Teknologi Malaysia, Skudai, Johor Bahru 81310, Malaysia; (M.A.); (N.D.)
| | - Mushikiwabeza Alexie
- School of Biomedical and Health Science Engineering, Universiti Teknologi Malaysia, Skudai, Johor Bahru 81310, Malaysia; (M.A.); (N.D.)
- College of Science and Technology (CST), Center or Excellence in Biomedical Engineering and E-Health (CEBE), University of Rwanda, KN 67 Street Nyarugenge, Kigali 3900, Rwanda
| | - Nadhira Dahari
- School of Biomedical and Health Science Engineering, Universiti Teknologi Malaysia, Skudai, Johor Bahru 81310, Malaysia; (M.A.); (N.D.)
| | - Anhar Kamarudin
- Faculty of Medicine, University Malaya Medical Centre (UMMC), Kuala Lumpur 59100, Malaysia;
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Haller G, Jacquerioz Bausch F, Gayet-Ageron A. Systematic screening for SARS-CoV-2 in pregnant women admitted for delivery: not as easy as it sounds. J Perinat Med 2021; 49:526-527. [PMID: 33554556 DOI: 10.1515/jpm-2020-0574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 12/07/2020] [Indexed: 11/15/2022]
Affiliation(s)
- Guy Haller
- Department of Acute Care Medicine-Woman's Hospital, Geneva University Hospitals, Geneva, Switzerland.,Department of Epidemiology and Preventive Medicine, Health Services Management and Research Unit, Monash University, Melbourne, Australia
| | - Frédérique Jacquerioz Bausch
- Department of Medical Genetics and Laboratory, Centre for Emerging Viral Diseases, Geneva University Hospitals, Geneva, Switzerland
| | - Angèle Gayet-Ageron
- Department of Health and Community Medicine, Division of Clinical Epidemiology/Infection Control Program, Geneva University Hospitals, Geneva, Switzerland
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Mastrolia MV, Marrani E, Calabri GB, L'Erario M, Maccora I, Favilli S, Duchini PP, Pagnini I, Simonini G. Fast recovery of cardiac function in PIMS-TS patients early using intravenous anti-IL-1 treatment. Crit Care 2021; 25:131. [PMID: 33827651 PMCID: PMC8024939 DOI: 10.1186/s13054-021-03548-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 03/23/2021] [Indexed: 11/15/2022]
Affiliation(s)
- Maria Vincenza Mastrolia
- Rheumatology Unit, Meyer Children's University Hospital, Viale Gaetano Pieraccini, 24, 50139, Firenze, Italy.
| | - Edoardo Marrani
- Rheumatology Unit, Meyer Children's University Hospital, Viale Gaetano Pieraccini, 24, 50139, Firenze, Italy
| | | | - Manuela L'Erario
- Pediatric Intensive Care Unit, Meyer Children's University Hospital, Firenze, Italy
| | - Ilaria Maccora
- Rheumatology Unit, Meyer Children's University Hospital, Viale Gaetano Pieraccini, 24, 50139, Firenze, Italy
| | - Silvia Favilli
- Cardiologic Unit, Meyer Children's University Hospital, Firenze, Italy
| | - Pier Paolo Duchini
- Pediatric Intensive Care Unit, Meyer Children's University Hospital, Firenze, Italy
| | - Ilaria Pagnini
- Rheumatology Unit, Meyer Children's University Hospital, Viale Gaetano Pieraccini, 24, 50139, Firenze, Italy
| | - Gabriele Simonini
- Rheumatology Unit, NEUROFARBA Department, Meyer Children's University Hospital, University of Florence, Firenze, Italy
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Remppis J, Ganzenmueller T, Kohns Vasconcelos M, Heinzel O, Handgretinger R, Renk H. A case series of children and young people admitted to a tertiary care hospital in Germany with COVID-19. BMC Infect Dis 2021; 21:133. [PMID: 33522901 PMCID: PMC7848863 DOI: 10.1186/s12879-021-05791-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 01/11/2021] [Indexed: 12/14/2022] Open
Abstract
Background While our knowledge about COVID-19 in adults has rapidly increased, data on the course of disease and outcome in children with different comorbidities is still limited. Methods Prospective, observational study at a tertiary care children’s hospital in southern Germany. Clinical and virology data from all paediatric patients admitted with SARS-CoV-2 infection at our hospital were prospectively assessed. Results Between March and November 2020, 14 patients were admitted with COVID-19. One patient was admitted a second time with COVID-19 6 months after initial disease. Among seven patients with severe underlying comorbidities, three developed multisystem inflammatory syndrome (MIS-C), two were admitted to the paediatric intensive care unit. One patient needed invasive ventilation. Another patient died shortly after discharge of COVID-19-related complications. Conclusions While COVID-19 generally causes mild disease in children, severe respiratory illness and MIS-C occur, in some cases with fatal outcome. Children with underlying diseases might be at special risk for severe disease.
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Affiliation(s)
- Jonathan Remppis
- Department of Haematology and Oncology, University Children's Hospital Tuebingen, Hoppe-Seyler-Straße 1, 72076, Tuebingen, Germany.
| | - Tina Ganzenmueller
- Institute for Medical Virology, University Hospital Tuebingen, Elfriede-Aulhorn-Str. 6, 72076, Tuebingen, Germany
| | - Malte Kohns Vasconcelos
- Institute for Medical Microbiology and Hospital Hygiene, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Oliver Heinzel
- Department of Haematology and Oncology, University Children's Hospital Tuebingen, Hoppe-Seyler-Straße 1, 72076, Tuebingen, Germany
| | - Rupert Handgretinger
- Department of Haematology and Oncology, University Children's Hospital Tuebingen, Hoppe-Seyler-Straße 1, 72076, Tuebingen, Germany
| | - Hanna Renk
- Department of Haematology and Oncology, University Children's Hospital Tuebingen, Hoppe-Seyler-Straße 1, 72076, Tuebingen, Germany
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