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Mohamed AA, Alanazi AT, Ahmed HH, Elfiky S, Abdel Ghafar MT, Maher I, Taha SA, AbuRahma MZA, Elagawy W, Mohareb DA, Rawy AM, Abostate HM, Youssef AA, Elsayed DS, Abdel-Hamid RM. FokI polymorphism of the vitamin D receptor gene: Linking COVID-19 risk to genetic susceptibility in children. Cytokine 2025; 191:156958. [PMID: 40367829 DOI: 10.1016/j.cyto.2025.156958] [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: 01/13/2025] [Revised: 04/24/2025] [Accepted: 05/05/2025] [Indexed: 05/16/2025]
Abstract
BACKGROUND Vitamin D receptor (VDR), influenced by gene polymorphisms like FokI, may affect susceptibility to infections, including coronavirus disease 2019 (COVID-19). Since studies in children are limited, we aimed to analyze the correlation between the VDR FokI variant and both the incidence and severity of COVID-19 in Egyptian children. METHODS Seventy-seven COVID-19-positive and 107 COVID-19-negative pediatric patients were included. Participants' serum 25(OH)D levels, inflammatory biomarkers, and demographics were evaluated. Real-time polymerase chain reaction (PCR) was used for genotyping the VDR FokI (rs2228570) polymorphism. RESULTS Absolute lymphocyte count (ALC) was significantly lower in COVID-19 patients than in controls, while interleukin-6 (IL-6), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), procalcitonin, and D-dimer were significantly higher (all p < 0.001). Vitamin D insufficiency was significantly more common in COVID-19 cases (18.2 % versus 3.7 %, p = 0.002). Male sex, increased tumor necrosis factor-alpha (TNF-α), and CRP were significantly associated with severe COVID-19 (p = 0.032, 0.029, < 0.001, respectively). The FokI TT genotype in codominant and recessive models and the T allele in the multiplicative model were significantly correlated with 2.4, 3.0, and 1.8 folds increased COVID-19 risk (p = 0.043, < 0.001, and 0.004, respectively). However, VDR FokI variants did not significantly associate with severe COVID-19. CONCLUSION The T allele and TT genotype of the FokI variant in the VDR gene increase susceptibility to COVID-19 but not its severity in Egyptian children. Additional research is required to validate the potential role of vitamin D and its receptor polymorphism in COVID-19.
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Affiliation(s)
- Amal Ahmed Mohamed
- Biochemistry Department, National Hepatology and Tropical Medicine Research Institute, GOTHI, Cairo 11511, Egypt,.
| | - Abdullah Taher Alanazi
- Immunology Laboratory, College of Medical Sciences, MOH-Eradah and Mental Health Complex, Madinah 42311, Saudi Arabia,.
| | - Hoda H Ahmed
- Pediatric Department, Medical Research and Clinical Studies Institute, National Research Centre, Cairo 11511, Egypt.
| | - Samar Elfiky
- Pediatric and Neonatology Department, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt.
| | | | - Ingy Maher
- Biotechnology Department, Modern Sciences and Arts University, Giza 12451, Egypt.
| | - Sherin A Taha
- Pediatric Department, Faculty of Medicine, Suez University, Suez, 43221, Egypt.
| | | | - Waleed Elagawy
- Department of Tropical Medicine, Faculty of Medicine, Port Said University, Port Fouad, 42526, Egypt.
| | - Dina A Mohareb
- Clinical Pathology Department, Faculty of Medicine, Assiut University, Assiut 71515, Egypt.
| | - Abeer M Rawy
- Chest Diseases Department, Faculty of Medicine, Benha University, Benha 13511, Egypt.
| | - Heba M Abostate
- Microbiology and Immunology Department, Faculty of Pharmacy, Egyptian Russian University, Cairo 11511, Egypt.
| | - Amira AlSayed Youssef
- Microbiology Lab Department, Egyptian (CDC) Center of Disease Control at the National Institute of Liver, Digestive and Infectious Diseases, Giza, 12311, Egypt.
| | | | - Rasha M Abdel-Hamid
- Clinical Pathology Department, National Cancer Institute, Cairo University, Cairo, 11562, Egypt.
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Bain V, Correa-Silva S, Matsuo OM, Silva-Avelar I, Zheng Y, Rangel-Santos A, Souza Gonçalves G, de Toledo Fink T, Suguita P, Caires O A Ferreira J, Fernandes Ferreira AE, Litvinov N, Andrade Macaferri da Fonseca F, Astley C, Martins F, Carneiro Sampaio M, de Sousa Marques HH, da Silva CAA, Palmeira P, Bádue Pereira MF. Comprehensive Characterization of Innate and Adaptive Immune Profiles in the Pediatric COVID-19 Convalescent Phase. Pediatr Infect Dis J 2025; 44:557-563. [PMID: 40067781 DOI: 10.1097/inf.0000000000004713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/20/2025]
Abstract
BACKGROUND Knowledge of the effect of SARS-CoV-2 on the innate and adaptive immune responses of children is currently lacking. We investigated the immune profile of recovered pediatric patients 3 to 11 weeks after acute COVID-19. METHODS Children who were previously healthy or had a preexisting chronic disease and had a positive reverse transcription polymerase chain reaction/serology were enrolled (n=23). The control group was composed of 25 patients without COVID-19 paired by age, sex and baseline chronic conditions. We performed immunophenotyping, hematologic and inflammatory markers analysis, cytokines and T-cell receptor excision circle (TREC) quantifications. RESULTS Most COVID-19 convalescent pediatric patients (COVID-19 CPP) had chronic conditions (73.9%), as well as 80% of the controls. Five children developed multisystem inflammatory syndrome in children. COVID-19 CPP had higher lymphocyte numbers than controls due to an increase in CD4+ T cells. Naive, effector memory (EM) reexpressing CD45RA T cells and follicular CD4+ T cells, as well as TRECs and HLA-DR+ and CD38+CD4+ activated T lymphocytes, were increased in those patients. EM2 and EM3 CD4+ T cells, EM2 CD8+ T cells and memory B cells were elevated in the COVID-19 CPP group. Numbers of neutrophils, monocytes and natural killer cells were equivalent but with increased activation in the recovered patients. CONCLUSIONS In the short-term following infection, COVID-19-recovered patients show persistent activation profiles in phagocytes, T-cell subtypes and natural killer cells. Meanwhile, increased production of lymphocytes, TRECs and naive T cells suggests immune response recovery, even in immunosuppressed patients and children with comorbidities. The clinical implications of these findings should be further studied.
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Affiliation(s)
- Vera Bain
- From the Departamento de Pediatria, Faculdade de Medicina FMUSP
| | | | - Olivia M Matsuo
- From the Departamento de Pediatria, Faculdade de Medicina FMUSP
| | | | - Yingying Zheng
- From the Departamento de Pediatria, Faculdade de Medicina FMUSP
| | - Andreia Rangel-Santos
- Laboratorio de Pediatria Clinica (LIM-36), Departamento de Pediatria, Hospital das Clinicas HCFMUSP
| | | | | | | | | | | | | | | | - Camilla Astley
- Applied Physiology and Nutrition Research Group-Center of Lifestyle Medicine, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, Brazil
| | | | | | | | | | - Patricia Palmeira
- Laboratorio de Pediatria Clinica (LIM-36), Departamento de Pediatria, Hospital das Clinicas HCFMUSP
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Pavia AT. Clinical Manifestations and Outcomes of SARS-CoV-2 Infection in Children and Adolescents. Infect Dis Clin North Am 2025; 39:293-308. [PMID: 40187944 DOI: 10.1016/j.idc.2025.02.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2025]
Abstract
Compared to adults, children are more likely to experience asymptomatic infections or mild-to-moderate symptoms of SARS-CoV-2 infection that resemble other viral infections. However, a substantial proportion of children experience severe disease; more than 2000 US children have died of COVID-19, significantly exceeding the death toll from influenza. Risk factors for severe disease include age less than 6 months and 12 to 17 years, as well as the presence of underlying conditions, especially 2 or more conditions. Multisystem inflammatory syndrome in children is a life-threatening post-infectious complication seen in children. Children experience post-acute sequelae of SARS-CoV-2 but at lower rates than adults.
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Affiliation(s)
- Andrew T Pavia
- Division of Pediatric Infectious Diseases, Departments of Pediatrics and Internal Medicine, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT 84112, USA.
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Ohnishi T, Kinoshita M, Narumi S. Impact of COVID-19 on paediatric care in Japan: Analysis of national health insurance claims data. Acta Paediatr 2025; 114:1135-1142. [PMID: 39632550 PMCID: PMC12066892 DOI: 10.1111/apa.17533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2024] [Revised: 11/16/2024] [Accepted: 11/26/2024] [Indexed: 12/07/2024]
Abstract
AIM To quantify the impact of the COVID-19 pandemic on paediatric care use compared to adult care and identify affected subdomains. METHODS Data from the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB) for six fiscal years (FY2016-2021) were analysed. Pre-pandemic (FY2016-FY2019) and pandemic years (FY2020, FY2021) were compared to delineate changes in medical services for paediatric and adult patients. Virtually all individuals who received medical care in Japan during this period were included. RESULTS In FY2019, healthcare utilisation by the paediatric population (under 15 years) accounted for 24% of 245 million first outpatient visits, 7% of 1.2 billion follow-up visits, and 2.6% of 297 million patient-days hospitalisations. In FY2020, outpatient visits of those aged 0-4 years decreased by 44% (first visit) and 24% (follow-up visit) compared to FY2019, and hospitalisations decreased by 47%, with the largest declines observed in community medical institutions across all age groups. CONCLUSION The COVID-19 pandemic led to a substantial reduction in paediatric healthcare utilisation in Japan, varying by age and type of care. These findings may inform the rational allocation of healthcare resources during public health emergencies.
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Affiliation(s)
- Takuma Ohnishi
- Department of PediatricsKeio University School of MedicineTokyoJapan
- Department of PediatricsNational Hospital Organization Saitama HospitalWakoJapan
| | - Mari Kinoshita
- Department of PediatricsKeio University School of MedicineTokyoJapan
- Health CenterKeio UniversityKanagawaJapan
| | - Satoshi Narumi
- Department of PediatricsKeio University School of MedicineTokyoJapan
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Li W, Zhu W, Tang X, Peng Z, Ye J, Nie S. Similarity of immune-associated markers in COVID-19 and Kawasaki disease: analyses from bioinformatics and machine learning. BMC Pediatr 2025; 25:400. [PMID: 40383755 PMCID: PMC12087065 DOI: 10.1186/s12887-025-05752-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 05/08/2025] [Indexed: 05/20/2025] Open
Abstract
BACKGROUND Infection by the SARS-CoV-2 virus can cause coronavirus disease 2019 (COVID-19) and can also exacerbate the symptoms of Kawasaki disease (KD), an acute vasculitis that mostly affects children. This study used bioinformatics and machine learning to examine similarities in the molecular pathogenesis of COVID-19 and KD. METHODS We first identified disease-associated modules in KD using weighted gene co-expression network analysis. Then, we determined shared differentially expressed genes (DEGs) in training datasets for KD (GSE100154) and COVID-19 (GSE225220), performed functional annotation of these shared DEGs, and used Cytoscape plug-ins (MCODE and Cytohubba) to characterize the protein-protein interaction (PPI) network and identify the hub genes. We performed Least Absolute Shrinkage and Selection Operator(LASSO) regression and receiver operating characteristic (ROC) curve analysis to identify the most robust markers, validated these results by analysis of two other datasets (GSE73461 and GSE18606), and then calculated the correlations of these key genes with immune cells. RESULTS This analysis identified 26 shared DEGs in COVID-19 and KD. The results from functional annotation showed that the shared DEGs primarily functioned in immune responses, the formation of neutrophil extracellular traps, and NOD-like receptor signaling pathways. There were three key genes (PGLYRP1, DEFA4, RETN), and they had positive correlations with monocytes, M0 macrophages, and dendritic cells, which function as immune infiltrating cells in KD. CONCLUSION The potential immune-associated biomarkers (PGLYRP1, DEFA4, RETN) along with their shared pathways, hold promise for advancing investigations into the underlying pathogenesis of KD and COVID-19.
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Affiliation(s)
- Wang Li
- Department of Clinical laboratory, The Eighth Affiliated Hospital, Sun Yat-sen University, 3025 Shennan Middle Road, Shenzhen, Guangdong, 518000, China
| | - Wenjie Zhu
- Department of Clinical laboratory, The Eighth Affiliated Hospital, Sun Yat-sen University, 3025 Shennan Middle Road, Shenzhen, Guangdong, 518000, China
| | - Xiangting Tang
- Department of Clinical laboratory, The Eighth Affiliated Hospital, Sun Yat-sen University, 3025 Shennan Middle Road, Shenzhen, Guangdong, 518000, China
| | - Zhiting Peng
- Department of Clinical laboratory, The Eighth Affiliated Hospital, Sun Yat-sen University, 3025 Shennan Middle Road, Shenzhen, Guangdong, 518000, China
| | - Jiaqi Ye
- Department of Clinical laboratory, The Eighth Affiliated Hospital, Sun Yat-sen University, 3025 Shennan Middle Road, Shenzhen, Guangdong, 518000, China
| | - Shuping Nie
- Department of Clinical laboratory, The Eighth Affiliated Hospital, Sun Yat-sen University, 3025 Shennan Middle Road, Shenzhen, Guangdong, 518000, China.
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Petrea (Cliveți) CL, Ciortea DA, Gurău G, Matei NM, Dinu CA, Bergheș (Oprea) SE, Verga (Răuță) GI, Berbece SI. Vitamin D Imbalance and Hydro-Electrolyte Disturbances in Hospitalized Children: A Comparation Between Post-COVID-19 Status and SARS-CoV-2/EBV Coinfection. Biomedicines 2025; 13:1233. [PMID: 40427060 PMCID: PMC12109002 DOI: 10.3390/biomedicines13051233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2025] [Revised: 05/14/2025] [Accepted: 05/16/2025] [Indexed: 05/29/2025] Open
Abstract
Background/Objectives: SARS-CoV-2 infection has the potential to cause multi-organ involvement and, when associated with Epstein-Barr virus (EBV) coinfection, may worsen the course of disease in pediatric patients by influencing the immune response. Methods: Our retrospective-observational study included 406 hospitalized children with post-COVID-19 status or SARS-CoV-2/EBV coinfection. Results: Hypovitaminosis D was more common in the coinfected sublot (59.18%) than in the COVID-19 one (50.74%), with a higher frequency of severe vitamin D deficiency (16.33% vs. 7.35%). Hypovitaminosis D was significantly associated with female sex (p = 0.033) only in the COVID-19 subgroup. Hypervitaminosis D, although rare, was only associated with severe forms of the disease (7.69%). Between clinical severity and vitamin D level, a statistically significant association of moderate intensity was identified only in the COVID-19 subgroup (χ2 = 11.708, φ = 0.293, p = 0.020). In the same subgroup, a significant correlation was found between vitamin D levels and serum potassium values (χ2 = 10.527, p = 0.032). Moreover, in the COVID-19 subgroup, an association between abnormal sodium levels and increased D-dimer levels was found (χ2 = 7.074, p = 0.029). Conclusions: These results underline the importance of monitoring immunologic, vitamin, and electrolyte imbalance in the management of these cases and highlight the need for personalized therapeutic strategies to prevent long-term complications.
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Affiliation(s)
- Carmen Loredana Petrea (Cliveți)
- Faculty of Medicine and Pharmacy, University “Dunarea de Jos” of Galati, 800008 Galati, Romania; (C.L.P.); (N.M.M.); (C.A.D.); (S.-E.B.); (G.I.V.); (S.I.B.)
- Emergency Clinical Hospital for Children “Sf. Ioan”, 800487 Galati, Romania
| | - Diana-Andreea Ciortea
- Faculty of Medicine and Pharmacy, University “Dunarea de Jos” of Galati, 800008 Galati, Romania; (C.L.P.); (N.M.M.); (C.A.D.); (S.-E.B.); (G.I.V.); (S.I.B.)
- Emergency Clinical Hospital for Children “Maria Sklodowska Curie”, 041451 Bucharest, Romania
| | - Gabriela Gurău
- Faculty of Medicine and Pharmacy, University “Dunarea de Jos” of Galati, 800008 Galati, Romania; (C.L.P.); (N.M.M.); (C.A.D.); (S.-E.B.); (G.I.V.); (S.I.B.)
- Emergency Clinical Hospital for Children “Sf. Ioan”, 800487 Galati, Romania
| | - Nicoleta Mădălina Matei
- Faculty of Medicine and Pharmacy, University “Dunarea de Jos” of Galati, 800008 Galati, Romania; (C.L.P.); (N.M.M.); (C.A.D.); (S.-E.B.); (G.I.V.); (S.I.B.)
- Emergency Clinical Hospital for Children “Sf. Ioan”, 800487 Galati, Romania
| | - Ciprian Adrian Dinu
- Faculty of Medicine and Pharmacy, University “Dunarea de Jos” of Galati, 800008 Galati, Romania; (C.L.P.); (N.M.M.); (C.A.D.); (S.-E.B.); (G.I.V.); (S.I.B.)
| | - Simona-Elena Bergheș (Oprea)
- Faculty of Medicine and Pharmacy, University “Dunarea de Jos” of Galati, 800008 Galati, Romania; (C.L.P.); (N.M.M.); (C.A.D.); (S.-E.B.); (G.I.V.); (S.I.B.)
- Emergency Clinical Hospital for Children “Sf. Ioan”, 800487 Galati, Romania
| | - Gabriela Isabela Verga (Răuță)
- Faculty of Medicine and Pharmacy, University “Dunarea de Jos” of Galati, 800008 Galati, Romania; (C.L.P.); (N.M.M.); (C.A.D.); (S.-E.B.); (G.I.V.); (S.I.B.)
- Emergency Clinical Hospital for Children “Sf. Ioan”, 800487 Galati, Romania
| | - Sorin Ion Berbece
- Faculty of Medicine and Pharmacy, University “Dunarea de Jos” of Galati, 800008 Galati, Romania; (C.L.P.); (N.M.M.); (C.A.D.); (S.-E.B.); (G.I.V.); (S.I.B.)
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Han JS, Chung YN, Kim JK. Retrospective Single-Center Study on the Epidemiological Characteristics of Influenza B Infections in Korea (2007-2024): Analysis of Sex, Age, and Seasonal Patterns. Microorganisms 2025; 13:1141. [PMID: 40431313 PMCID: PMC12113934 DOI: 10.3390/microorganisms13051141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2025] [Revised: 05/13/2025] [Accepted: 05/14/2025] [Indexed: 05/29/2025] Open
Abstract
Influenza B, a globally prevalent respiratory virus, particularly affects children, the elderly, and individuals with chronic diseases. This retrospective single-center study analyzed long-term epidemiological trends using 23,284 PCR test results from Dankook University Hospital, Cheonan-si, Republic of Korea, from 2007 to 2024. The data included inpatients and outpatients who presented with respiratory symptoms and underwent multiplex PCR testing. Unlike previous studies focusing on short-term outbreaks, this study examines extended trends and emerging seasonal patterns. Positivity rates were statistically analyzed by year, season, sex, age group, and the impact of COVID-19 (2020-2022). Significant annual differences (p < 0.001) occurred, with peaks in 2012 and 2018 and a sharp decline during 2020-2022. Children exhibited the highest positivity rate (2.40%), significantly higher than that of adults (2.24%) and the elderly (1.79%) (p < 0.05). Infections peaked in the winter (2.98%) and spring (3.95%), contrary to the belief that Influenza B peaks in winter only. Females had a higher positivity rate (2.13%) than males (1.70%) (p = 0.017). These findings provide novel insights into Influenza B epidemiology, emphasizing the need for prevention strategies beyond winter. The secondary spring peak suggests extending vaccination to early spring may improve influenza control, particularly among high-risk groups.
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Affiliation(s)
- Jeong Su Han
- Department of Biomedical Laboratory Science, College of Health Sciences, Dankook University, Cheonan-si 31116, Republic of Korea;
| | - Yoo Na Chung
- Department of Medicine, College of Medicine, Dankook University, Cheonan-si 31116, Republic of Korea;
| | - Jae Kyung Kim
- Department of Biomedical Laboratory Science, College of Health Sciences, Dankook University, Cheonan-si 31116, Republic of Korea;
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Arango-Lasprilla SC, Albaladejo-Blázquez N, Watson JD, Moreno O, Perrin PB, Ferrer-Cascales R, Arango-Lasprilla JC. Parents' Reports of Colombian Children's Neurobehavioral Symptoms Before, During, and After COVID-19 Infection. NeuroRehabilitation 2025; 56:315-324. [PMID: 40318667 DOI: 10.1177/10538135241312599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2025]
Abstract
BackgroundCOVID-19 disproportionately affected individuals from marginalized and underserved communities, and little research has investigated how COVID-19 might have impacted neurobehavioral symptoms in children from Latin America. What little research suggests that COVID-19 had a negative effect on neurobehavioral symptoms and that this effect was worse for individuals who were younger, had lower education, or other chronic conditions.ObjectiveThe purpose of the current study was to examine the change (before, during, and after) in neurobehavioral symptoms for a sample of Colombian children who tested positive for COVID-19 and to identify key predictors of post-COVID neurobehavioral impairments.MethodsThe Neurobehavioral Symptom Inventory was administered to caregivers (92.90% female) of 85 children (51.80% female) by researchers in Colombia. Data was collected after the child had recovered from COVID-19 with retrospective questions about the child's function before and during COVID-19, as well as at the time of data collection.ResultsAt the domain level, caregivers reported large increases in children's somatic symptoms, a medium increase in affective symptoms, and a small increase in cognitive symptoms before vs. during COVID-19. Caregivers also noted a large increase in children's somatic symptoms, a medium increase in affective symptoms, and a small increase in cognitive symptoms before vs after COVID-19. The somatic symptom domain was the only category to see an improvement following infection (during vs after). Three separate linear regressions indicated that greater COVID-19 severity during the infection significantly predicted greater current (after COVID-19) somatic symptom severity, and the presence of a pre-existing respiratory disease significantly predicted greater current cognitive and affective symptom severity.ConclusionThis study highlights the importance of evaluating and treating neurobehavioral symptoms post-COVID-19 among children in Colombia and identifies this need in an underserved and under-researched population. Future research may examine whether early intervention and rehabilitation strategies help improve post-COVID-19 neurobehavioral symptoms for this group.
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Affiliation(s)
| | | | - Jack D Watson
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Oswaldo Moreno
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Paul B Perrin
- School of Data Science and Department of Psychology, University of Virginia, Charlottesville, VA, USA
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Zhao Q, Wallace B, Ronis T, Jung L. Risk factors of COVID-19 related hospitalization of paediatric patients with rheumatic diseases: a systematic review and meta-analysis. Rheumatology (Oxford) 2025; 64:2369-2376. [PMID: 39657248 DOI: 10.1093/rheumatology/keae664] [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: 07/16/2024] [Revised: 11/03/2024] [Accepted: 11/27/2024] [Indexed: 12/17/2024] Open
Abstract
OBJECTIVE Among adults who develop coronavirus disease 2019 (COVID-19), those with rheumatic diseases (RDs) have similar hospitalization rates compared with those without RDs. Similar comparisons are lacking in children, due to the overall rarity of COVID-19-related hospitalization in this population. We aimed to examine the risk factors for COVID-19-related hospitalization in paediatric patients with RDs. METHODS We conducted a systemic literature search in MEDLINE, EMBASE, Web of Science and China National Knowledge Infrastructure from 1 December 2019, through 22 January 2024. We included observational studies based on inclusion and exclusion criteria. Odds ratios (ORs) with 95% CI were calculated. RESULTS Eight cohort studies capturing 1501 paediatric RD patients with SARS-CoV-2 and 118 COVID-19-related hospitalization were included. Odds of hospitalization was increased in children with RDs compared with healthy children. While the diagnosis of juvenile idiopathic arthritis (JIA) was associated with reduced odds of hospitalization overall (OR 0.43 [95% CI: 0.27, 0.68]), systemic JIA was associated with increased odds of hospitalization (OR 2.54 [95% CI: 1.01, 6.40]). The use of glucocorticoids (OR 5.36 [95% CI: 2.21, 13.04]), rituximab (OR 4.62 [95% CI: 1.87, 11.40]), mycophenolate mofetil (OR 4.17 [95% CI: 1.08, 16.16]), hydroxychloroquine (OR 2.97 [95% CI: 1.42, 6.21]), and IL-1 inhibitors (OR 2.28 [95% CI: 1.09, 4.78]) was associated with increased odds of hospitalization, while the use of TNFα inhibitors was associated with reduced odds (OR 0.35 [95% CI: 0.20, 0.66]). CONCLUSION Children with RDs are at risk of severe COVID-19 outcomes, while children with JIA taking TNFα inhibitors might be at a lower risk.
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Affiliation(s)
- Qianzi Zhao
- Internal Medicine, Trinity Health Ann Arbor, Ann Arbor, MI, USA
| | - Beth Wallace
- Division of Rheumatology, Michigan Medicine, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
| | - Tova Ronis
- Division of Rheumatology, Children's National Hospital, Washington, DC, USA
| | - Lawrence Jung
- Department of Pediatrics, School of Medicine, George Washington University, Washington, DC, USA
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Shang Z, Huang L, Qin S. The underlying mechanism behind the different outcomes of COVID-19 in children and adults. Front Immunol 2025; 16:1440169. [PMID: 40370452 PMCID: PMC12075420 DOI: 10.3389/fimmu.2025.1440169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Accepted: 04/10/2025] [Indexed: 05/16/2025] Open
Abstract
Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, has affected hundreds of millions of people globally, resulting in millions of deaths. During this pandemic, children have demonstrated greater resistance than adults, exhibiting lower infection rates, reduced mortality, and milder symptoms. Summarizing the differences in resistance between children and adults during COVID-19 can provide insights into protective mechanisms and potential implications for future treatments. In this review, we focused on summarizing and discussing the mechanisms for better protection of children in COVID-19. These protective mechanisms encompass several factors: the baseline expression of cell surface receptor ACE2 and hydrolase TMPRSS2, the impact of complications on COVID-19, and age-related cytokine profiles. Additionally, differences in local and systemic immune responses between children and adults also contribute significantly, particularly interferon responses, heterologous protection from non-COVID-19 vaccinations, and immune status variations influenced by micronutrient levels. The advantageous protection mechanisms of these children may provide insights into the prevention and treatment of COVID-19. Importantly, while age-related metabolic profiles and differential COVID-19 vaccine responses may contribute to protection in children, current comparative research remains limited and requires further investigation.
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Affiliation(s)
- Zifang Shang
- Research Experiment Center, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, Guangdong, China
- Guangdong Engineering Technological Research Center of Clinical Molecular Diagnosis and Antibody Drugs, Meizhou People's Hospital, Meizhou, Guangdong, China
| | - Ling Huang
- Department of Critical Medicine, Shenzhen Clinical Research Centre for Geriatrics, Shenzhen People’s Hospital, The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Shijie Qin
- Innovative Vaccine and Immunotherapy Research Center, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China
- Paediatric Research Institute, Shenzhen Children’s Hospital, Shenzhen, China
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Aghabeygiha M, Fahimzad SA, Behzad S, Zadeh RH, Sheikhzadeh F, Tamaddon Y, Hajipour M, Zadeh RH, Neyriz A, Pak N, Shirvani A, Hosseini A, Khalili M. Radiologic analysis of CT imaging patterns and clinical correlations in hospitalized pediatric COVID-19 patients. FRONTIERS IN RADIOLOGY 2025; 5:1571672. [PMID: 40343012 PMCID: PMC12058800 DOI: 10.3389/fradi.2025.1571672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/05/2025] [Accepted: 03/24/2025] [Indexed: 05/11/2025]
Abstract
Background and objective COVID-19 has emerged as a global pandemic affecting individuals of all ages. The disease can lead to severe complications and even death, particularly due to pulmonary involvement. Contrary to popular belief, children can also experience significant complications from COVID-19. To date, there have been limited studies focusing on pulmonary manifestations in pediatric patients with COVID-19. This study aims to investigate the imaging patterns (CT scans) in children diagnosed with COVID-19 in Iran. Materials and methods This retrospective study analyzed data from hospitalized children with COVID-19 in Tehran from March 2020 to September 2020. Information collected included demographic details (sex and age), previous medical history, clinical manifestations, vital signs at admission, laboratory findings, and imaging results, including CT scan and chest x-ray. Results 252 patients were included, with a mean age of 71.2 ± 59.42 months; 58.3% were male. Fever was the most prevalent symptom, occurring in 67.4% of cases. The most common underlying condition was oncological disorders, present in 85% of patients. Notably, 52% required admission to the ICU, and 1.8% needed intubation. CT scans revealed that the most frequent lung involvement patterns were mixed patterns and consolidation, with bilateral involvement being the most common. The mean CT score was calculated at 3 ± 4. Abnormal CT findings were associated with a poorer prognosis, and correlations were observed between specific CT findings and clinical manifestations. Conclusion Chest CT manifestations offer valuable insights for assessing pediatric patients with COVID-19, especially in severe cases and those with pre-existing health conditions. Integrating clinical evaluations with radiological scoring systems facilitates early identification of disease severity.
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Affiliation(s)
| | | | - Shima Behzad
- School of Medicine, Islamic Azad University of Medical Sciences, Tehran, Iran
| | | | | | - Yasaman Tamaddon
- Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Mahmoud Hajipour
- Pediatric Gastroenterology, Hepatology and Nutrition Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Hossein Zadeh
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Neyriz
- Radiology Department, Faculty of Medicine, University of Medical Sciences, Qazvin, Iran
| | - Neda Pak
- Associate Professor of Radiology, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Armin Shirvani
- Pediatric Gastroenterology, Hepatology and Nutrition Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amirhossein Hosseini
- Pediatric Gastroenterology, Hepatology and Nutrition Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mitra Khalili
- Radiology Department, Mofid Children’s Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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12
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Velasco Puyo P, Christou S, Campisi S, Rodríguez-Sánchez MA, Reidel S, Perez-Hoyo S, Mota M, Savvidou I, Rekleiti A, Salvo A, Voi V, Ferrero GB, Mandrile G, Gaglioti CM, Cela E, Ponce-Salas B, Bardón-Cancho EJ, Flevari P, Voskaridou-Dimoula E, Nur E, Biemond BJ, Delaporta P, Beneitez-Pastor D, Collado Gimbert A, Spasiano A, Besse-Hammer T, Lafiatis IG, Dedeken L, Raso S, Ruiz-Llobet A, Bagnato S, Labarque V, Glenthøj A, Ruffo GB, Guerzoni ME, Hafraoui K, Pistoia L, Rosso R, Tagliaferri L, Gonzalez-Urdiales P, Benghiat FS, de Montalembert M, Teles MJ, Vanderfaeillie A, Bertoni E, Cuzzubbo D, Ferreira T, Saunders CJ, Stiakaki E, Van de Velde AL, Diamantidis MD, Kerkhoffs JLH, Oliveira MI, Quota A, Russo R, Van Damme A, Argüello Marina M, Lorite Reggiori M, Rijneveld AW, Rodríguez Gallego A, Colombatti R, Iolascon A, Taher A, Gulbis B, Roy NBA, Mañú-Pereira MDM. COVID- 19 in patients affected by red blood cell disorders, results from the European registry ERN-EuroBloodNet. Orphanet J Rare Dis 2025; 20:183. [PMID: 40241127 PMCID: PMC12001635 DOI: 10.1186/s13023-025-03683-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2025] [Accepted: 03/19/2025] [Indexed: 04/18/2025] Open
Abstract
BACKGROUND Despite several publications covering patients from multiple centers, no international registry covered all patients with red blood cell diseases (RBCD) affected by COVID- 19. The ERN-EuroBloodNet's registry provided real-time registration of SARS-CoV- 2 patients with RBCD, promoting timely disease-specific knowledge sharing during the pandemic's early stages. PROCEDURES The study evaluated patient distribution, the infection across different RBCDs, and severity risk factors across similar healthcare systems, using data collected from the ERN-EuroBloodNet's REDCap platform. RESULTS From April 2020 to April 2023, 681 infections were recorded among 663 patients, of which 373 had transfusion-dependent thalassemia or non-transfusion-dependent thalassemia (TDT/NTDT), and 269 had sickle cell disease (SCD). SCD patients had a higher incidence of COVID- 19 than those with TDT/NTDT (10.5 vs. 4.8 COVID/100 patients). Notably, 92% of the cases were mild, with neither age nor the specific RBCD affecting severity. The number of comorbidities, notably obesity and hypertension, that patients had prior to infection was associated with more severe COVID- 19. During the infection, the presence of vaso-occlusive crises, acute chest syndrome, kidney failure, and ground-glass opacities on chest tomography scans were associated with a more severe clinical picture. The vaccination rate (32%) mirrored that of the general population and showed a protective effect against severe COVID- 19. The observed mortality rate was 0.7%, aligning with Europe's general population. CONCLUSION SARS-CoV- 2 infection in SCD and TDT/NTDT patients is mild and without higher mortality than the general population. The ERN-Eurobloodnet's registry collaborative structure exemplifies the power of international cooperation in tackling rare diseases, especially during health emergencies.
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Affiliation(s)
- Pablo Velasco Puyo
- Pediatric Oncology and Hematology, Vall d'Hebron Barcelona Hospital, Passeig Vall Hebron 129, 08035, Barcelona, Spain.
| | - Soteroula Christou
- Thalassaemia Clinic, Archbishop Makarios III Hospital (NAMIII), Nicosia, Cyprus
| | - Saveria Campisi
- Medical Area Department, ASP 8 - P.O. Umberto I, Siracusa, Italy
| | - Maria A Rodríguez-Sánchez
- Rare Anemia Disorders Research Laboratory, Cancer and Blood Disorders in Children, Vall d'Hebron Research Institute, Barcelona, Spain
| | - Sara Reidel
- Rare Anemia Disorders Research Laboratory, Cancer and Blood Disorders in Children, Vall d'Hebron Research Institute, Barcelona, Spain
| | - Santiago Perez-Hoyo
- Biostatistics and Bioinformatics Unit, Vall d'Hebron Research Unit (VHIR), Barcelona, Spain
| | - Miriam Mota
- Biostatistics and Bioinformatics Unit, Vall d'Hebron Research Unit (VHIR), Barcelona, Spain
| | - Irene Savvidou
- Thalassaemia Clinic, Archbishop Makarios III Hospital (NAMIII), Nicosia, Cyprus
| | - Anna Rekleiti
- Thalassaemia Clinic, Archbishop Makarios III Hospital (NAMIII), Nicosia, Cyprus
| | - Alessandra Salvo
- Medical Area Department, ASP 8 - P.O. Umberto I, Siracusa, Italy
| | - Vincenzo Voi
- Department of Clinical and Biological Science, AOU San Luigi Gonzaga, University of Turin, Turin, Italy
| | - Giovanni Battista Ferrero
- Department of Clinical and Biological Science, AOU San Luigi Gonzaga, University of Turin, Turin, Italy
| | - Giorgia Mandrile
- Department of Clinical and Biological Science, AOU San Luigi Gonzaga, University of Turin, Turin, Italy
| | - Carmen Maria Gaglioti
- Department of Clinical and Biological Science, AOU San Luigi Gonzaga, University of Turin, Turin, Italy
| | - Elena Cela
- Pediatric Hematology and Oncology Unit, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Spain
| | - Beatriz Ponce-Salas
- Pediatric Hematology and Oncology Unit, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Spain
| | - Eduardo J Bardón-Cancho
- Pediatric Hematology and Oncology Unit, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Spain
| | - Pagona Flevari
- Centre of Excellence in Rare Hematological Diseases-Hemoglobinopathies, "Laiko" General Hospital of Athens, Athens, Greece
| | - Ersi Voskaridou-Dimoula
- Centre of Excellence in Rare Hematological Diseases-Hemoglobinopathies, "Laiko" General Hospital of Athens, Athens, Greece
| | - Erfan Nur
- Clinical Hematology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Bart J Biemond
- Clinical Hematology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Polynexi Delaporta
- First Department of Pediatrics, Thalassemia Unit, National and Kapodistrian University of Athens, Athens, Greece
- Aghia Sophia" Children's Hospital, ERN-EuroBloodNet Center, Athens, Greece
| | | | - Anna Collado Gimbert
- Pediatric Oncology and Hematology, Vall d'Hebron Barcelona Hospital, Passeig Vall Hebron 129, 08035, Barcelona, Spain
| | - Anna Spasiano
- Malalttie Rare del Globulo Rosso, AORN A. Cardarelli, Naples, Italy
| | | | - Ioannis G Lafiatis
- Thalassemia and Sickle Cell Disease Unit, "Vostanio" General Hospital of Mytilene, Mytilene, Greece
| | - Laurence Dedeken
- Pediatric Hemato-Oncology, Hôpital Universitaire Des Enfants Reine Fabiola, H.U.B., Brussels, Belgium
| | - Simona Raso
- Department of Hematology and Rare Diseases, V Cervello Hospital, Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy
| | - Anna Ruiz-Llobet
- Service of Pediatric Hematology, Hospital Sant Joan de Déu, Universitat de Barcelona, Institut de Recerca Hospital Sant Joan de Déu, ERN-EuroBloodNet Member, Barcelona, Spain
| | | | - Veerle Labarque
- Department of Pediatric Hemato-Oncology, University Hospitals Leuven, Louvain, Belgium
- Department of Cardiovascular Sciences, Centre for Molecular and Vascular Biology, KU Leuven, Louvain, Belgium
| | - Andreas Glenthøj
- Department of Hematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Giovan Battista Ruffo
- U.O. Ematologia Con Talassemia, ARNAS Civico di Cristina Benfratelli, Palermo, Italy
| | - Maria Elena Guerzoni
- Pediatrics Unit, Department of Medical and Surgical Sciences for Mother Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Laura Pistoia
- Department of Radiology, Fondazione G. Monasterio CNR - Regione Toscana, Pisa, Italy
| | - Rosamaria Rosso
- UOSD Talassemia, AOU Policlinico "G. Rodolico - San Marco", Catania, Italy
| | - Laura Tagliaferri
- Department of Pediatric Oncology, Hematology and Immunology, Hopp-Children's Cancer Center (KiTZ) Heidelberg, University of Heidelberg, Heidelberg, Germany
| | - Paula Gonzalez-Urdiales
- Pediatric Oncology and Hematology Department, Hospital Universitario Cruces, Barakaldo, Spain
| | | | - Mariane de Montalembert
- Reference Centre for Sickle Cell Disease, Department of General Pediatrics and Pediatric Infectious Diseases, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris Cité, Paris, France
| | - Maria Jose Teles
- Laboratory Hematology, Centro Hospitalar Universitario de Santo Antonio, Porto, Portugal
| | | | - Elisa Bertoni
- Pediatric Onco-Hematology and Bone Marrow Transplant Unit, Children's Hospital, ASST Spedali Civili, Brescia, Italy
| | - Daniela Cuzzubbo
- HSCT and Cellular Therapy Unit, Department of Paediatric Haematology-Oncology, "Anna Meyer" Children's Hospital, Florence, Italy
| | - Teresa Ferreira
- Pediatric Department, Hospital Fernando Fonseca, Amadora, Portugal
| | - Christopher J Saunders
- Haematology Department, Hospital Santo António Dos Capuchos - Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal
| | - Eftichia Stiakaki
- Department of Pediatric Hematology-Oncology and Autologous Hematopoietic Stem Cell Transplantation Unit, University Hospital of Heraklion, University of Crete, Heraklion, Greece
| | - Ann L Van de Velde
- HematologyAntwerp University Hospital, University of Antwerp, Edegem, Belgium
| | - Michael D Diamantidis
- Department of Haematology, Thalassemia and Sickle Cell Disease Unit, General Hospital of Larissa, Larissa, Greece
| | | | - Marisa I Oliveira
- Pediatric Hematology Unit, Hospital D. Estefânia, ULS S. José, Lisbon, Portugal
| | - Alessandra Quota
- Medicine Department, UOSD Talasemia Vittorio Emanuele Hospital, Gela, Italy
| | - Roberta Russo
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples, Italy
- CEINGE - Biotecnologie Avanzate Franco Salvatore, Naples, Italy
| | - An Van Damme
- Department of Pediatric Hematology and Oncology, Saint Luc University Hospital, Brussels, Belgium
| | | | | | | | - Alexis Rodríguez Gallego
- Ethics Committees Support Unit, Vall d'Hebron Research Institute, Barcelona, Spain
- Clinical Pharmacology Service, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Raffaella Colombatti
- Department of Women's and Children's Health, Azienda Ospedale-Università di Padova, Padua, Italy
| | - Achille Iolascon
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples, Italy
- CEINGE - Biotecnologie Avanzate Franco Salvatore, Naples, Italy
| | - Ali Taher
- Division of Hematology and Oncology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Béatrice Gulbis
- Hôpital Universitaire de Bruxelles, Université Libre de Bruxelles, LHUB-ULB, Brussels, Belgium
| | - Noémi B A Roy
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- University of Oxford, Oxford, UK
| | - María Del Mar Mañú-Pereira
- Pediatric Oncology and Hematology, Vall d'Hebron Barcelona Hospital, Passeig Vall Hebron 129, 08035, Barcelona, Spain
- Rare Anemia Disorders Research Laboratory, Cancer and Blood Disorders in Children, Vall d'Hebron Research Institute, Barcelona, Spain
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13
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Esposito S, Puntoni M, Deolmi M, Ramundo G, Maglietta G, Poeta M, Zampogna S, Colomba C, Suppiej A, Cardinale F, Bosis S, Castagnola E, Midulla F, Giaquinto C, Giordano P, Biasucci G, Fainardi V, Nunziata F, Grandinetti R, Condemi A, Raiola G, Guarino A, Caminiti C, Long-Covid-Ped Italian Study Group. Long COVID in pediatric age: an observational, prospective, longitudinal, multicenter study in Italy. Front Immunol 2025; 16:1466201. [PMID: 40270969 PMCID: PMC12015939 DOI: 10.3389/fimmu.2025.1466201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2024] [Accepted: 03/03/2025] [Indexed: 04/25/2025] Open
Abstract
Introduction This observational prospective longitudinal multicenter study examines the occurrence and characteristics of long COVID (LC) in the Italian pediatric population. Methods Conducted across 12 Pediatric Units in Italy from January to March 2022, the study involved 1129 children diagnosed with SARS-CoV-2 infection. Data were collected via self-administered questionnaires at 1-3 months, 3-6 months, and 6-12 months post-infection, with LC defined as symptoms persisting for at least 2 months and occurring 3 months post-diagnosis. Results Results revealed that 68.6% of children reported at least one post-COVID symptom, with 16.2% experiencing LC. The most frequent symptoms included respiratory issues (43.4%), neurological and cognitive dysfunction (27.7%), gastrointestinal symptoms (22.1%), fatigue (21.6%), and sleep disturbances (18.8%). Age and gender differences were significant, with older children and females more prone to cardiovascular and neurological & cognitive dysfunction. Discussion The study highlights that LC in children presents similarly to adults, though less frequently. The occurrence of LC was lower compared to adult populations, likely due to the generally milder course of COVID-19 in children. The findings underscore the need for targeted follow-up and support for affected children, especially considering the long-term persistence of symptoms. Further research is necessary to explore the impact of COVID-19 vaccines on pediatric LC and the effects of different SARS-CoV-2 variants. These insights are crucial for developing strategies to manage and mitigate long-term impacts in children recovering from COVID-19.
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Affiliation(s)
- Susanna Esposito
- Pediatric Clinic, University Hospital, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Matteo Puntoni
- Clinical and Epidemiological Research Unit, University Hospital of Parma, Parma, Italy
| | - Michela Deolmi
- Pediatric Clinic, University Hospital, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Greta Ramundo
- Pediatric Clinic, University Hospital, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Giuseppe Maglietta
- Clinical and Epidemiological Research Unit, University Hospital of Parma, Parma, Italy
| | - Marco Poeta
- Pediatric Infectious Disease Unit, Department of Maternal and Childealth, University Hospital "Federico II", Naples, Italy
| | | | - Claudia Colomba
- Division of Pediatric Infectious Diseases, "G. Di Cristina" Hospital, ARNAS Civico Di Cristina Benfratelli, University of Palermo, Palermo, Italy
| | | | - Fabio Cardinale
- Complex Operating Unit Paediatrics, Giovanni XXIII Paediatric Hospital, University of Bari, Bari, Italy
| | - Samantha Bosis
- S.C. Pediatria-Pneumoinfettivologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Elio Castagnola
- Pediatric Infectious Diseases Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Fabio Midulla
- Department of Maternal, Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Carlo Giaquinto
- Division of Pediatric Infectious Diseases, Department of Women's and Children's Health, University of Padua, Padua, Italy
| | - Paola Giordano
- Department of Interdisciplinary Medicine, Pediatric Section, "Aldo Moro" University of Bari, Bari, Italy
| | - Giacomo Biasucci
- Pediatrics and Neonatology Unit, Department of Medicine and Surgery, University of Parma, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Valentina Fainardi
- Pediatric Clinic, University Hospital, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Francesco Nunziata
- Pediatric Infectious Disease Unit, Department of Maternal and Childealth, University Hospital "Federico II", Naples, Italy
| | - Roberto Grandinetti
- Pediatric Clinic, University Hospital, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Anna Condemi
- Division of Pediatric Infectious Diseases, "G. Di Cristina" Hospital, ARNAS Civico Di Cristina Benfratelli, University of Palermo, Palermo, Italy
| | - Giuseppe Raiola
- Department of Pediatrics, "Pugliese-Ciaccio" Hospital, Catanzaro, Italy
| | - Alfredo Guarino
- Pediatric Infectious Disease Unit, Department of Maternal and Childealth, University Hospital "Federico II", Naples, Italy
| | - Caterina Caminiti
- Clinical and Epidemiological Research Unit, University Hospital of Parma, Parma, Italy
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14
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Al-Iede M, Dannoun M, Al-Ammouri I, Al-Zayadneh E, Daher A, Albaramki J, Alsmady D, Husain O, Abusabra B, Sinan RA, Sarhan L. COVID-19 Infection in Pediatric Patients Presenting to a Tertiary Center in Jordan: Clinical Characteristics and Age-Related Patterns. J Clin Med 2025; 14:2577. [PMID: 40283407 PMCID: PMC12028193 DOI: 10.3390/jcm14082577] [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: 02/14/2025] [Revised: 04/04/2025] [Accepted: 04/08/2025] [Indexed: 04/29/2025] Open
Abstract
Objectives: This study assessed the clinical characteristics of pediatric COVID-19 patients across different age groups during the first and second pandemic waves in Jordan. Methods: A retrospective analysis was conducted at Jordan University Hospital, involving 485 patients aged 1 month to 18 years from September 2020 to July 2021. Patients were categorized into preschool (≤5 years), school-aged (6-10 years), and teenagers (>10 years). Patients' clinical characteristics were analyzed using R (version 2.3.3). Results: The mean age for participants was 10.7 ± 5.7 years. Shortness of breath, abdominal pain, and headaches were significantly more likely among older participants (all p < 0.01). Conversely, younger patients were more likely to experience nasal congestion, decreased activity, and reduced feeding (all p < 0.05). The majority of patients had mild symptom severity. Analysis of physiologic and laboratory parameters demonstrated significant differences among age groups in terms of heart rate, respiratory rate, hemoglobin, neutrophils, lymphocytes, platelets, CRP, and creatinine (all p < 0.05). Respiratory support was mainly observed among younger patients. Antibiotics was the most commonly received medication. In terms of outcomes, two patients had complications during their stay, both of which belonged to the <5 years age group. We observed significant differences in incidence of symptoms and laboratory markers among different pediatric age groups. While younger patients experienced severe complications, their older counterparts exhibited more alarming symptoms and worse counts of immune cells. Conclusions: These findings highlight the importance of age-specific management strategies for COVID-19, emphasizing the need for tailored approaches in both treatment and prevention.
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Affiliation(s)
- Montaha Al-Iede
- Division of Pediatric Pulmonology and Sleep Medicine, Department of Pediatrics, Jordan University Hospital, Amman 11942, Jordan; (M.D.); (E.A.-Z.); (D.A.); (O.H.); (B.A.); (R.A.S.); (L.S.)
- The School of Medicine, The University of Jordan, Amman 11942, Jordan; (A.D.); (J.A.)
| | - Marah Dannoun
- Division of Pediatric Pulmonology and Sleep Medicine, Department of Pediatrics, Jordan University Hospital, Amman 11942, Jordan; (M.D.); (E.A.-Z.); (D.A.); (O.H.); (B.A.); (R.A.S.); (L.S.)
- The School of Medicine, The University of Jordan, Amman 11942, Jordan; (A.D.); (J.A.)
| | - Iyad Al-Ammouri
- Division of Cardiology, Department of Pediatrics, Jordan University Hospital, Amman 11942, Jordan;
- Division of Pediatric Intensive Care, Department of Pediatrics, Jordan University Hospital, Amman 11942, Jordan
| | - Enas Al-Zayadneh
- Division of Pediatric Pulmonology and Sleep Medicine, Department of Pediatrics, Jordan University Hospital, Amman 11942, Jordan; (M.D.); (E.A.-Z.); (D.A.); (O.H.); (B.A.); (R.A.S.); (L.S.)
- The School of Medicine, The University of Jordan, Amman 11942, Jordan; (A.D.); (J.A.)
| | - Amirah Daher
- The School of Medicine, The University of Jordan, Amman 11942, Jordan; (A.D.); (J.A.)
- Division of Pediatric Intensive Care, Department of Pediatrics, Jordan University Hospital, Amman 11942, Jordan
| | - Jumana Albaramki
- The School of Medicine, The University of Jordan, Amman 11942, Jordan; (A.D.); (J.A.)
- Division of Pediatric Nephrology, Department of Pediatrics, Jordan University Hospital, Amman 11942, Jordan
| | - Danah Alsmady
- Division of Pediatric Pulmonology and Sleep Medicine, Department of Pediatrics, Jordan University Hospital, Amman 11942, Jordan; (M.D.); (E.A.-Z.); (D.A.); (O.H.); (B.A.); (R.A.S.); (L.S.)
- The School of Medicine, The University of Jordan, Amman 11942, Jordan; (A.D.); (J.A.)
| | - Omar Husain
- Division of Pediatric Pulmonology and Sleep Medicine, Department of Pediatrics, Jordan University Hospital, Amman 11942, Jordan; (M.D.); (E.A.-Z.); (D.A.); (O.H.); (B.A.); (R.A.S.); (L.S.)
- The School of Medicine, The University of Jordan, Amman 11942, Jordan; (A.D.); (J.A.)
| | - Batool Abusabra
- Division of Pediatric Pulmonology and Sleep Medicine, Department of Pediatrics, Jordan University Hospital, Amman 11942, Jordan; (M.D.); (E.A.-Z.); (D.A.); (O.H.); (B.A.); (R.A.S.); (L.S.)
- The School of Medicine, The University of Jordan, Amman 11942, Jordan; (A.D.); (J.A.)
| | - Rima A. Sinan
- Division of Pediatric Pulmonology and Sleep Medicine, Department of Pediatrics, Jordan University Hospital, Amman 11942, Jordan; (M.D.); (E.A.-Z.); (D.A.); (O.H.); (B.A.); (R.A.S.); (L.S.)
- The School of Medicine, The University of Jordan, Amman 11942, Jordan; (A.D.); (J.A.)
| | - Lena Sarhan
- Division of Pediatric Pulmonology and Sleep Medicine, Department of Pediatrics, Jordan University Hospital, Amman 11942, Jordan; (M.D.); (E.A.-Z.); (D.A.); (O.H.); (B.A.); (R.A.S.); (L.S.)
- The School of Medicine, The University of Jordan, Amman 11942, Jordan; (A.D.); (J.A.)
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15
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Lægsgaard E, Thim SB, Holm M, Rubak S. COVID-19 in Children With Severe Lung Disease-A Tertiary Center Cohort Study in Denmark. Pediatr Pulmonol 2025; 60:e71094. [PMID: 40243356 PMCID: PMC12005064 DOI: 10.1002/ppul.71094] [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: 09/03/2024] [Revised: 02/26/2025] [Accepted: 04/06/2025] [Indexed: 04/18/2025]
Abstract
BACKGROUND Severe lung disease such as chronic pulmonary disease (CPD), severe asthma and cystic fibrosis (CF) in children is associated with increased risk of severe COVID-19. Information regarding SARS-CoV-2 infection, disease severity and outcome of COVID-19 is limited in this pediatric population. OBJECTIVES We captured the number of SARS-CoV-2 infected children and evaluated COVID-19 disease severity in non-immunized children with CPD, asthma, and CF in a cohort at a Danish tertiary center. METHODS The number of children with PCR-verified SARS-CoV-2 infection in the cohort and in the age-related background population was identified through the Danish Microbiology Database. Clinical data were retrieved from the electronic medical health records and from the Danish Health Authority. RESULTS In a cohort of 664 children with severe lung disease 594 were either PCR-tested or had an antibody test for SARS-CoV-2 infection due to symptoms or exposure and 18 (3%) had verified SARS-CoV-2 infection. The total number of verified SARS-CoV-2 infection was at that time 34.575(4.342%) thus, not significantly different from the reference population (p = 0.152). The symptoms ranged from asymptomatic to mild symptoms, and none of the children with severe lung disease required hospitalization due to COVID-19. None of the children were treated with antiviral treatment during the acute infection. CONCLUSION Of the 664 children in the Danish cohort with severe lung disease, none were hospitalized with COVID-19. Our findings imply that this particular group of patients do not experience increased risk of severe COVID-19.
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Affiliation(s)
- Esben Lægsgaard
- Department of Child and Adolescent HealthCenter of Pediatric Pulmonology and Allergology, Aarhus University HospitalAarhusDenmark
| | - Signe Bødker Thim
- Department of Child and Adolescent HealthCenter of Pediatric Pulmonology and Allergology, Aarhus University HospitalAarhusDenmark
| | - Mette Holm
- Department of Child and Adolescent HealthAarhus University HospitalAarhusDenmark
| | - Sune Rubak
- Department of Child and Adolescent HealthCenter of Pediatric Pulmonology and Allergology, Aarhus University HospitalAarhusDenmark
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Vieira APR, Carvalho PRA, Machado SH, da Rocha TS. Clinical and laboratory markers defining MIS-C and hyperinflammation in COVID-19: a cross-sectional study in a tertiary hospital. Adv Rheumatol 2025; 65:16. [PMID: 40097994 DOI: 10.1186/s42358-025-00447-6] [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: 10/01/2024] [Accepted: 03/10/2025] [Indexed: 03/19/2025] Open
Abstract
BACKGROUND Numerous inflammatory complications related to COVID are described, including the Multisystem inflammatory Syndrome in Children (MIS-C) and Hyperinflammation. There is a scarcity of studies comparing these two groups. METHODS Retrospective longitudinal outcome-conditioned study. Demographic, clinical, and laboratory variables are analyzed. Patients with history of COVID contact or infection with at least 24 h of fever, two or more systems involved and up to 21 years were included. Patients with no laboratory signal of inflammation or with other diagnoses for the condition were excluded. Demographic and laboratory data are presented as medians with interquartile ranges. Dichotomous variables and prevalences are reported as percentages. A ROC curve analysis was conducted to assess the discriminatory ability of these tests in relation to the MIS-C and hyperinflammation groups. RESULTS We present fifty-four patients, thirty-one with MIS-C and twenty-three with hyperinflammation. The most frequent symptom in the MIS-C group was altered mental status in 61% vs. 46% (p = 0.014) and conjunctival hyperemia in 29% vs. 4% (p = 0.032). The most frequent laboratory findings were hypoalbuminemia in 68% vs. 26% (p = 0.002), increased serum troponin in 42% vs. 26% (p = 0.034), increased d-dimers in 94% vs. 76% (p = 0.015), as well as increased BNP in 55% vs. 17% (p = 0.02). On the other hand, the hyperinflammation group more frequently presented respiratory dysfunction in 57% vs. 13% (p = < 0.001) and serum ferritin equal or greater than 500 ng/mL in 94% vs. 77% (p = 0.046). CONCLUSIONS This is an original study comparing clinical and laboratory findings between MIS-C and hyperinflammation due to COVID. Altered mental status is more frequently associated with MIS-C while respiratory symptoms are associated with hyperinflammation. In addition, regarding laboratory tests, there is hypoalbuminemia, increase in serum troponin, BNP, and D-dimers specially in the MIS-C group and hyperferritinemia in the hyperinflammation group. Further studies are needed to assess the cutoff point of biological markers such as BNP, troponin, and d-dimers for diagnosis and/or prognosis in the pediatric population with MIS-C.
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Affiliation(s)
- Ana Paula Radünz Vieira
- Pediatric Rheumatology Division, Federal University of Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos Street, 2350 - Santa Cecília, Porto Alegre City, Rio Grande do Sul, 90035-903, Brazil.
| | - Paulo Roberto Antonaccio Carvalho
- Pediatric Intensive Care Division, Federal University of Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos Street, 2350 - Santa Cecília, Porto Alegre City, Rio Grande do Sul, 90035-903, Brazil
| | - Sandra Helena Machado
- Pediatric Rheumatology Division, Federal University of Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos Street, 2350 - Santa Cecília, Porto Alegre City, Rio Grande do Sul, 90035-903, Brazil
| | - Taís Sica da Rocha
- Pediatric Intensive Care Division, Federal University of Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos Street, 2350 - Santa Cecília, Porto Alegre City, Rio Grande do Sul, 90035-903, Brazil
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Tariverdi M, Rahmati M, Mohammadian M, Rajaei S, Kargarfard Jahromy M, Rahimi N, Hosseini Teshnizi S, Tamaddondar M, Badri S, Abdollahi H. Cardiac complications associated with COVID-19: a single-center study from Southern Iran. Front Pediatr 2025; 13:1452353. [PMID: 40161501 PMCID: PMC11949905 DOI: 10.3389/fped.2025.1452353] [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: 06/20/2024] [Accepted: 02/25/2025] [Indexed: 04/02/2025] Open
Abstract
Background Children account for a small percentage of COVID-19 cases and tend to exhibit milder symptoms compared to adults. Cardiovascular involvement has been observed in pediatric COVID-19 cases. This study aimed to determine the frequency of cardiac disorders in children hospitalized with COVID-19. Methods This cross-sectional study was conducted on pediatric patients admitted to Bandar Abbas Children Hospital, Iran, from March to September 2020. Patients with negative RT-PCR results for SARS-CoV-2, non-COVID-19 pulmonary involvement or pre-existing cardiovascular conditions were excluded. COVID-19 diagnostic subgroups were determined based on national guidelines. Clinical evaluations included chest CT scans to assess pulmonary involvement and cardiac assessments such as clinical symptoms, electrocardiography and echocardiography. Cardiac abnormalities were defined as clinical heart failure, dysrhythmias or abnormal echocardiography. Multivariable logistic regression was applied to analyze the associations between cardiac abnormalities, age and lung involvement, with statistical significance set at P < 0.05. Results This cross-sectional study was conducted in 2020 on 475 children aged 1 month to 14 years. Among the participants, 48.4% had suspected, 30.5% had probable, and 21.1% had confirmed COVID-19. Cardiac abnormalities were identified in 35.2% of patients, including dysrhythmia (20.2%), heart failure (7.6%), and abnormal echocardiography findings (13.1%). The odds of cardiac abnormalities were 3.3 times higher in children with unilateral lung involvement and 5.9 times higher in those with bilateral lung involvement compared to those without lung involvement. Additionally, older age was associated with a 5.7% reduction in the odds of cardiac abnormalities. Conclusions Cardiac abnormalities in pediatric COVID-19 patients show a significant correlation with pulmonary involvement, highlighting their link to disease severity. Routine cardiac assessments may help identify complications and guide management, especially during sporadic cases and seasonal outbreaks.
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Affiliation(s)
- Marjan Tariverdi
- Department of Pediatrics, Clinical Research Development Center of Children’s Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Mohammadbagher Rahmati
- Department of Pediatrics, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Maryam Mohammadian
- Department of Pediatrics, Clinical Research Development Center of Children’s Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Shahrokh Rajaei
- Department of Pediatric Cardiology, Clinical Research Development Center of Children’s Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Mohammadreza Kargarfard Jahromy
- Department of Pediatric Cardiology, Clinical Research Development Center of Children’s Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Niloufar Rahimi
- Student Research Committee, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Saeed Hosseini Teshnizi
- Department of Biostatistics, Faculty of Nursing and Midwifery, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Mohammad Tamaddondar
- Department of Nephrology and Internal Medicine, Shahid Mohammadi Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Shiva Badri
- Community Health Nursing, Clinical Research Development Center of Children’s Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Hossein Abdollahi
- Student Research Committee, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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Jayaratne K, Illangasinghe P, Wanniarachchi S, Hettiarachchi D, de Silva C, Liyanage G. Epidemic profile of COVID-19 child deaths in Sri Lanka: a retrospective nationwide analysis. BMC Pediatr 2025; 25:174. [PMID: 40055621 PMCID: PMC11887372 DOI: 10.1186/s12887-025-05507-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2024] [Accepted: 02/11/2025] [Indexed: 05/13/2025] Open
Abstract
INTRODUCTION Understanding the impact of the COVID-19 pandemic on child survival is crucial. Analysing COVID-19-related child deaths, even years after the pandemic, is critical for informing future pandemic preparedness and response efforts. METHODS We conducted an analysis of all "SARS-CoV-2/COVID-19 positive deaths" among children and adolescents (aged < 18 years) recorded through a purposefully designed Child Death Surveillance and Response System (CDSRS) from October 2020 to September 2022. It included all deaths with a positive SARS-CoV-2. The analysis involved a thorough review of documents (bedhead tickets, field/institutional investigation and postmortem examination reports, and compiled case scenarios). Multivariable backward logistic regression was conducted to identify risk factors associated with deaths attributed to COVID-19 infection. Additionally, a comparison of socio-demographic characteristics was conducted between deaths due to all causes and those attributed to COVID-19 infection. RESULTS A total of 111 deaths with a positive SARS-CoV-2 test were analyzed. Among these, 81 deaths (73%) were categorized as directly attributed to COVID-19 infection. Fourteen children (17.2%) had Multisystem Inflammatory Syndrome. Cardiovascular disease was the most common comorbidity (28.4%). The odds of deaths attributed to COVID-19 infection were eleven times higher with chronic diseases compared to incidental SARS-CoV-2 positive test (OR:11.22, 95% CI:1.735, 72.496). Tamil ethnicity appeared to be protective when compared to the Sinhalese (OR:0.07, 95% CI: 0.008, 0.598). The model explained 44.8% of the variance. When compared to national all-cause mortality data, females (p = 0.03), post-neonatal infants (p < 0.001), and > 5-18 years (p = 0.005) were identified as being at higher risk of death due to COVID-19 infection. CONCLUSION The proportion of COVID-19-positive deaths during the study period was higher than that reported in high-income countries, with most deaths directly attributed to SARS-CoV-2. Higher mortality rates were observed among post-neonatal infants, children over five years, females, those with Sinhalese ethnicity, and pre-existing chronic medical conditions, particularly cardiovascular disease.
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Nieves DJ, Tran MT, Singh J, Ashouri N, Morphew T, Lusk JG, Adler-Shohet FC, Marano R, Osborne S, Strickland J, Arrieta AC. Remdesivir Use in Pediatric Patients with Acute SARS-CoV-2 Infection Is Safe and Well Tolerated. CHILDREN (BASEL, SWITZERLAND) 2025; 12:331. [PMID: 40150613 PMCID: PMC11941674 DOI: 10.3390/children12030331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2025] [Revised: 02/26/2025] [Accepted: 03/03/2025] [Indexed: 03/29/2025]
Abstract
Background/Objective: Millions of children were infected with SARS-CoV-2, and a small proportion progressed to severe disease, especially those with underlying risk factors. Adult COVID-19 studies showed mortality benefits with Remdesivir. Data on Remdesivir use in pediatrics are limited. We report on the safety and tolerability of Remdesivir in pediatric patients seen at our institution. Methods: This was a retrospective cohort study of patients <19 years old with acute SARS-CoV-2 infection who received at least one dose of Remdesivir. Patients followed strict institutional guidelines for safety monitoring including standard clinical and laboratory daily observations. Demographics and underlying conditions were reported as averages; for laboratory values, linear regression was applied within a generalized linear mixed-effects model framework to evaluate the significance of changes in average levels over time. Results: We enrolled 318 patients with acute SARS-CoV2 infection from May 2020 to December 2022. In total, 53% were male, and the age range was distributed broadly. In total, 61% were school-aged children (28% 5-11 and 33% 12-18 years of age). In total, 62% of cases were Hispanic. The most common reasons for Remdesivir treatment included respiratory distress (201; 63%) and having high-risk underlying conditions (109; 34%). Therapy was completed as planned in 91% and discontinued early in 9%. Mean baseline, peak, and end of treatment values for AST were 57 (95% CI 53, 61), 79 (95% CI 73, 84) (p < 0.001), and 55 (51, 59) (p = 0.479); for ALT, they were 42 (38, 47), 59 (95% CI 52, 66) (p < 0.001), and 46 (95% CI 41, 52) (p = 0.054); and for bilirubin, they were 0.56 (95% CI 0.50, 0.62), 0.67 (95% CI 0.61, 0.74) (p < 0.001), and 0.44 (95% CI 0.40, 0.48) (p < 0.001), respectively. During Remdesivir treatment, we did not observe marrow suppression or renal toxicity. Conclusions: No clinically significant hematological or renal toxicity was noted. Mean liver enzymes increased modestly and returned to baseline without interrupting treatment. Remdesivir was well tolerated in patients <19 years old.
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Affiliation(s)
- Delma J. Nieves
- Division of Infectious Diseases, Department of Pediatrics, CHOC Children’s Hospital, University of California, Orange, CA 92868, USA; (J.S.); (N.A.); (A.C.A.)
| | - M. Tuan Tran
- Division of Infectious Diseases, Department of Pharmacy, CHOC Children’s Hospital, Orange, CA 92868, USA;
| | - Jasjit Singh
- Division of Infectious Diseases, Department of Pediatrics, CHOC Children’s Hospital, University of California, Orange, CA 92868, USA; (J.S.); (N.A.); (A.C.A.)
| | - Negar Ashouri
- Division of Infectious Diseases, Department of Pediatrics, CHOC Children’s Hospital, University of California, Orange, CA 92868, USA; (J.S.); (N.A.); (A.C.A.)
| | - Tricia Morphew
- CHOC Research Institute, Orange, CA 92868, USA; (T.M.); (S.O.)
| | - Jennifer G. Lusk
- Division of Hospitalist Medicine, Department of Pediatrics, CHOC Children’s Hospital, University of California, Orange, CA 92868, USA;
| | | | - Rachel Marano
- Rady Children’s Hospital, University of California, San Diego, CA 92123, USA;
| | | | - Jennifer Strickland
- Division of Infectious Diseases, CHOC Children’s Hospital, Orange, CA 92868, USA;
| | - Antonio C. Arrieta
- Division of Infectious Diseases, Department of Pediatrics, CHOC Children’s Hospital, University of California, Orange, CA 92868, USA; (J.S.); (N.A.); (A.C.A.)
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20
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Wan L, Liu Y, Tan S, Xiao J, Feng B, Fang J, Xie D. Prevalence and factors of COVID-19 among children in Hunan, China, following the deregulation of epidemic control: an observational study in epidemiology. BMJ Open 2025; 15:e089651. [PMID: 40032399 PMCID: PMC11877153 DOI: 10.1136/bmjopen-2024-089651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Accepted: 12/19/2024] [Indexed: 03/05/2025] Open
Abstract
OBJECTIVES To investigate the prevalence and factors of COVID-19 infection in children aged 0-6 years within Hunan Province following the deregulation of epidemic control. DESIGN This is an observational study in epidemiology, using an on-site questionnaire survey to investigate the current status of COVID-19 infection and its influencing factors in children aged 0-6 years in Hunan Province from 16 February to 24 March 2023. SETTING Multi-stage stratified sampling method was applied in this study. The regions were categorised as developed, medium and underdeveloped. One municipality was selected from each category. In each municipality, one district and one county were chosen for cluster sampling. PARTICIPANTS Children aged 0-6 years in Hunan Province. RESULTS A total of 78 115 children aged 0-6 years were enrolled in this study, of 30 659 (39.2%) had a confirmed positive SARS-CoV-2 test result or related clinical symptoms. The majority of COVID-19 infections in children were of mild type (92.0%), and very few were severe and critical (0.4% and 0.1%). The majority (74.6%-88.7%) of children had minimal lifestyle behavioural changes after infected with COVID-19. Parents of the child working as a staff member (OR=0.654, 95% CI: 0.603, 0.709) and civil servant (OR=0.865, 95% CI: 0.794, 0.941), living in a rural area (OR=0.384, 95% CI: 0.369, 0.400) and no COVID-19 exposure (OR=0.108, 95% CI: 0.104, 0.113) were protective factors for COVID-19 infection in children. CONCLUSION Children experienced a large number of COVID-19 infections following the deregulation, fewer severe cases and fewer changes in lifestyle. Easing epidemic control measures in the later stage of the pandemic did not aggravate the consequences of the epidemic.
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Affiliation(s)
- Lijia Wan
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan, China
| | - Yixu Liu
- Central South University Xiangya School of Public Health, Changsha, Hunan, China
| | - Sanfeng Tan
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan, China
| | - Juan Xiao
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan, China
| | - Binbin Feng
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan, China
| | - Junqun Fang
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan, China
| | - Donghua Xie
- Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan, China
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21
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Astley C, Drezner JA, Sieczkowska SM, Ihara A, Franco T, Gil S, DO Prado DML, Longobardi I, Suguita P, Fink T, Lindoso L, Matsuo O, Martins F, Bain V, Leal GN, Badue MF, Marques HH, Silva CA, Roschel H, Gualano B. Exercise in Pediatric COVID-19: A Randomized Controlled Trial. Med Sci Sports Exerc 2025; 57:514-523. [PMID: 39501479 DOI: 10.1249/mss.0000000000003589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2025]
Abstract
PURPOSE This study assessed the impact of a 12-wk, home-based exercise training (HBET) program on health-related quality of life (HRQOL; primary outcome), and cardiovascular and metabolic parameters in pediatric COVID-19 patients. METHODS This was a single-center, randomized controlled trial conducted in a tertiary hospital in Sao Paulo, from October 2020 to January 2022. Thirty-two patients (mean age, 12 ± 3.3 yr) were randomly assigned to either HBET or standard of care (CONTROL) in a 2:1 ratio 4 months (range: 0.7-6.6 months) after COVID-19 discharge ( n = 25 mild, n = 4 moderate, n = 3 severe illness). The HBET group underwent supervised and unsupervised sessions three times a week for 12 wk emphasizing aerobic and body weight exercises, while the CONTROL group received standard care, which included general advice for a healthy lifestyle with no prescribed exercise intervention. HRQOL (evaluated by the Pediatric Quality of Life Inventory), cardiopulmonary exercise test, brachial endothelial function and echocardiography assessments were conducted in both groups. Statistical analysis was performed using an intention-to-treat approach for the primary analysis and complete case (per-protocol) as sensitivity analysis.The significance was set at P ≤ 0.05 and P ≤ 0.10 was considered as trend. RESULTS There was no difference in HRQOL between groups. Intention-to-treat analysis indicated a trend toward increased oxygen uptake (V̇O 2 ) at anaerobic threshold following the intervention in the HBET group. In addition, a sensitivity analysis showed significant changes in peak heart rate and 1-min recovery, respiratory exchange ratio, and chronotropic response. A trend toward significance was observed in ventilation-to-maximum voluntary ventilation ratio and chronotropic response in the HBET group. No other between-group differences were detected for the cardiopulmonary exercise test, brachial flow-mediated dilation, and echocardiography variables (all P > 0.05). CONCLUSIONS In this randomized controlled trial, a 12-wk HBET intervention did not impact HRQOL in pediatric COVID-19 patients. However, exercise was able to improve the V̇O 2 at the ventilatory anaerobic threshold, heart rate peak and 1-min recovery, ventilation-to-maximum voluntary ventilation ratio, and chronotropic response, with no changes observed in other cardiovascular parameters. Further studies are needed to investigate the long-term effects of exercise interventions on the recovery of pediatric COVID-19 patients with and without preexisting chronic conditions.
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Affiliation(s)
| | - Jonathan A Drezner
- Department of Family Medicine, Center for Sports Cardiology, University of Washington, Seattle, WA
| | | | | | | | | | | | | | - Priscila Suguita
- Chidren and Adolescent Institute, Clinical Hospital, School of Medicine, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Thais Fink
- Chidren and Adolescent Institute, Clinical Hospital, School of Medicine, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Livia Lindoso
- Chidren and Adolescent Institute, Clinical Hospital, School of Medicine, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Olivia Matsuo
- Chidren and Adolescent Institute, Clinical Hospital, School of Medicine, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Fernanda Martins
- Chidren and Adolescent Institute, Clinical Hospital, School of Medicine, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Vera Bain
- Chidren and Adolescent Institute, Clinical Hospital, School of Medicine, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Gabriela Nunes Leal
- Chidren and Adolescent Institute, Clinical Hospital, School of Medicine, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Maria Fernanda Badue
- Chidren and Adolescent Institute, Clinical Hospital, School of Medicine, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Heloisa Helena Marques
- Chidren and Adolescent Institute, Clinical Hospital, School of Medicine, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Clovis Artur Silva
- Chidren and Adolescent Institute, Clinical Hospital, School of Medicine, University of Sao Paulo, Sao Paulo, SP, Brazil
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22
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Ruch K, MacDonald KD, Parkhotyuk K, Schilling D, Olson M, Mehess S, Milner K, McEvoy CT. Neonatal pulmonary function tests in infants born to COVID-19 positive mothers. J Perinatol 2025:10.1038/s41372-025-02237-w. [PMID: 39984719 DOI: 10.1038/s41372-025-02237-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2024] [Revised: 12/26/2024] [Accepted: 02/11/2025] [Indexed: 02/23/2025]
Abstract
OBJECTIVE To compare pulmonary function tests (PFTs), specifically passive respiratory system compliance (Crs), in infants of mothers positive for COVID-19 during pregnancy compared to PFTs from a historical cohort of matched, healthy reference infants. STUDY DESIGN A prospective cohort study of infants born to COVID-19 positive mothers. Crs was measured with the single breath occlusion technique. Historical cohort data was obtained from a pre-COVID-19 data repository. Respiratory questionnaires were done at 1-year postnatal age. RESULTS Twenty-four PFTs in the COVID-19 cohort were compared with PFTs from 24 reference subjects. Infants of the COVID-19 positive mothers had a Crs of 3.57 ml/cmH2O versus 3.76 mL/cmH2O in the reference group (p > 0.05). The remaining PFT outcomes were comparable between groups. The COVID-19 infants reported more allergic symptoms and conditions through 1-year. CONCLUSION We found no difference in Crs in infants of mothers with COVID-19 during pregnancy compared to a historical pre-COVID reference cohort.
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Affiliation(s)
- Katy Ruch
- Division of Neonatology, Department of Pediatrics, Oregon Health & Science University, Portland, OR, USA
| | - Kelvin D MacDonald
- Division of Pediatric Pulmonology, Department of Pediatrics, Oregon Health & Science University, Portland, OR, USA
| | - Kseniya Parkhotyuk
- Division of Neonatology, Department of Pediatrics, Oregon Health & Science University, Portland, OR, USA
| | - Diane Schilling
- Division of Neonatology, Department of Pediatrics, Oregon Health & Science University, Portland, OR, USA
| | - Mathew Olson
- Division of Neonatology, Department of Pediatrics, Oregon Health & Science University, Portland, OR, USA
| | - Shawn Mehess
- Department of Psychology, Portland State University, Portland, OR, USA
| | - Kristin Milner
- Division of Neonatology, Department of Pediatrics, Oregon Health & Science University, Portland, OR, USA
| | - Cindy T McEvoy
- Division of Neonatology, Department of Pediatrics, Oregon Health & Science University, Portland, OR, USA.
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23
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Gonçalves BMM, Francisco RPV, Rodrigues ÁS, Junior JCS. Coronavirus disease 2019 infection severity among different variants in children under 2-years old in Brazil. Clinics (Sao Paulo) 2025; 80:100592. [PMID: 39983544 PMCID: PMC11889657 DOI: 10.1016/j.clinsp.2025.100592] [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: 06/24/2024] [Accepted: 01/18/2025] [Indexed: 02/23/2025] Open
Abstract
To analyze whether there is a significant difference in the virulence, symptoms, and outcomes of different Coronavirus Disease 2019 (COVID-19) variants in children under 2-years of age. We collected data from the Sistema de Informação de Vigilância Epidemiológica da Gripe, a nationwide Brazilian database on severe acute respiratory syndrome. The patients were classified according to four variants of concern: wild-type, gamma, delta, and omicron. The wild-type variant was defined as the baseline. A total of 11,153 patients were analyzed. The risk of presenting dyspnea (adjusted Odds Ratio[Aor = 1.20], 95 % Confidence Interval [95 % CI 1.07-1.34]) was higher in patients with gamma infection. Respiratory discomfort was more likely to be present for the omicron (Aor = 1.29, 95 % CI 1.15-1.43) and gamma (aOR = 1.26, 95 % CI 1.13-1.41) infections. Desaturation was more likely to be present for the omicron (aOR = 1.67, 95 % CI 1.50-1.86), gamma (aOR = 1.16, 95 % CI 1.43-1.79), and delta (aOR 1.41, CI 95 % 1.18-1.68) infections. Infection by the omicron variant was a protective factor for intubation (aOR = 0.78, 95 % CI 0.67-0.91) and death (aOR = 0.43, 95 % CI 0.35-0.53). Additionally, delta infection was a protective factor against death (aOR = 0.60, 95 % CI 0.43-0.85). The wild-type variant was responsible for most of the cases that evolved with death. Omicron appears to be responsible for milder symptoms than delta. Children between 1 and 6 months of age account for most cases, which is a concern because there is no vaccination coverage.
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Affiliation(s)
| | - Rossana P V Francisco
- Department of Obstetrics and Gynecology, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Ágatha S Rodrigues
- Department of Obstetrics and Gynecology, Universidade de São Paulo (USP), São Paulo, SP, Brazil; Department of Statistics, Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brazil
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24
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Peng Z, Zhou G. Progress on diagnosis and treatment of multisystem inflammatory syndrome in children. Front Immunol 2025; 16:1551122. [PMID: 40046058 PMCID: PMC11879827 DOI: 10.3389/fimmu.2025.1551122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2024] [Accepted: 01/24/2025] [Indexed: 05/13/2025] Open
Abstract
Since the emergence of COVID-19 in December 2019, the novel SARS-CoV-2 virus has primarily affected adults, with children representing a smaller proportion of cases. However, the escalation of the pandemic has led to a notable increase in pediatric cases of Multisystem Inflammatory Syndrome in Children (MIS-C). The pathogenesis of MIS-C is largely attributed to immune-mediated mechanisms, such as cytokine storms and endothelial damage, following SARS-CoV-2 infection. In this review, we comprehensively describe MIS-C, including its definitions as proposed by the CDC, WHO, and RCPCH, which emphasize persistent fever, excessive inflammatory responses, and multi-organ involvement. Additionally, we summarize current treatment approaches, prioritizing immunotherapy with intravenous immunoglobulin and corticosteroids, along with anticoagulation therapy, and monoclonal antibodies in severe cases.
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Affiliation(s)
| | - Gang Zhou
- Department of Pediatric Respiratory Diseases, Chongqing University Three Gorges Hospital, Chongqing, China
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25
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Mota Amaral GG, Sgorlon G, Batista Ferreira V, Serrano Batista F, da Silva Soares Farias L, Barbagelata LS, dos Santos MC, da Silva Bedran RL, Souza Vieira Dall'Acqua D, Benevides Matos N. SARS-CoV-2 Infection Among Children in Rondônia, Western Brazilian Amazon: SARS-CoV-2 Among Children in Rondônia. Adv Virol 2025; 2025:6655790. [PMID: 39995617 PMCID: PMC11850067 DOI: 10.1155/av/6655790] [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: 02/01/2024] [Revised: 06/28/2024] [Accepted: 12/19/2024] [Indexed: 02/26/2025] Open
Abstract
We analyzed 364 children symptomatic or asymptomatic for respiratory symptoms, aged 0.1 month-17 years, selected from primary healthcare units of different municipalities of Rondônia from June 2021 to September 2022. Data were collected from medical and electronic records for epidemiological characterization. The positive cohort (n = 96) was quantified using a real-time (RT) qPCR and sequenced by next-generation sequencing. Whole-genome sequences were obtained, SARS-CoV-2 strains were classified using the Pango system, and the maximum likelihood method was used for phylogenetic analyses. Among the patients, 59.34% (216/364) were male and 40.66% (148/364) were female. Children aged 10-14 years showed the highest rate of SARS-CoV-2 positivity. At the time of collection, 54.12% (197/364) of the patients were not age-eligible for immunization against COVID-19. The unvaccinated group accounted for 34.07% (124/364), with the highest proportion in the age groups of 5-9 and 10-14 years. Most patients exhibited mild symptoms. Seventy-nine high-quality genomes were obtained: Delta variant of concern (VOC) was the most prevalent (most abundant strain: AY.99.2), Omicron VOC was reported in 26 individuals (most frequent subvariant: BA.1.1), and Gamma VOC with 22 cases (12 cases of P.1 strain). The viral load showed a median of 7.26 log10 copies/mL, with a mean symptom duration of 4 days. Most of the cases were from children who were unvaccinated and age-ineligible for immunization and were associated with Delta and Omicron VOCs with an increase in subvariants during the study period.
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Affiliation(s)
- Gil Guibson Mota Amaral
- Department of Microorganisms Biology, Oswaldo Cruz Foundation, Fiocruz Rondônia, Porto Velho, Rondônia, Brazil
- Department of Postgraduate Program in Experimental Biology, Federal University of Rondônia-UNIR, Porto Velho, Rondônia, Brazil
| | - Gabriella Sgorlon
- Department of Postgraduate Program in Experimental Biology, Federal University of Rondônia-UNIR, Porto Velho, Rondônia, Brazil
- Department of Molecular Virology, Oswaldo Cruz Foundation, Fiocruz Rondônia, Porto Velho, Rondônia, Brazil
| | - Valcimar Batista Ferreira
- Department of Microorganisms Biology, Oswaldo Cruz Foundation, Fiocruz Rondônia, Porto Velho, Rondônia, Brazil
| | - Flávia Serrano Batista
- Department of Health Surveillance Agency-AGEVISA, State Coordination of Covid-19, Porto Velho, Rondônia, Brazil
| | | | | | | | | | - Deusilene Souza Vieira Dall'Acqua
- Department of Postgraduate Program in Experimental Biology, Federal University of Rondônia-UNIR, Porto Velho, Rondônia, Brazil
- Department of Molecular Virology, Oswaldo Cruz Foundation, Fiocruz Rondônia, Porto Velho, Rondônia, Brazil
- Division of Microbiology, Tropical Medicine Research Center-CEPEM, Porto Velho, Rondônia, Brazil
- National Institute of Epidemiology in Western Amazonia-INCT-EPIAMO, Porto Velho, Rondônia, Brazil
| | - Najla Benevides Matos
- Department of Microorganisms Biology, Oswaldo Cruz Foundation, Fiocruz Rondônia, Porto Velho, Rondônia, Brazil
- Department of Postgraduate Program in Experimental Biology, Federal University of Rondônia-UNIR, Porto Velho, Rondônia, Brazil
- Division of Microbiology, Tropical Medicine Research Center-CEPEM, Porto Velho, Rondônia, Brazil
- National Institute of Epidemiology in Western Amazonia-INCT-EPIAMO, Porto Velho, Rondônia, Brazil
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Chen H, Li Y, Yuan L, Liu F, Sun Q, Luo Q, Lei Y, Hou Y, Li J, Cai L, Tang S. Age-related immune response disparities between adults and children with severe COVID-19: a case-control study in China. Front Microbiol 2025; 16:1525051. [PMID: 39967737 PMCID: PMC11832681 DOI: 10.3389/fmicb.2025.1525051] [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: 11/08/2024] [Accepted: 01/13/2025] [Indexed: 02/20/2025] Open
Abstract
Background Elucidation of immune response differences is critical for uncovering underlying mechanisms and developing potential intervention measures among adults and children with COVID-19. Methods In this retrospective study, we analyzed serum biochemical markers and cytokine profiles among adults and children with COVID-19 in the First People's Hospital of Chenzhou in Hunan, China from 1 December 2022 to 13 February 2023. A case-control study was conducted using propensity score matching (PSM) to mitigate possible confounding factors. Results The significant differences observed included lymphocyte exhaustion, an increased neutrophil-to-lymphocyte (NEU/LYM) ratio, high levels of C-reactive protein (CRP), and a cytokine storm, characterized by high levels of Th1 proinflammatory cytokines, including interleukin 1β (IL-1β), IL-6, IL-8, interferon type I (IFN-γ), and tumor necrosis factor (TNF-α) in the lung among severe adult COVID-19 patients. Additionally, systemic immune responses were observed in children with COVID-19. Conclusion Significant differences in immune responses between adults and children with COVID-19 highlight the different mechanisms and potential intervention measures of COVID-19.
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Affiliation(s)
- Hongliang Chen
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
- Department of Clinical Microbiology Laboratory, The First People's Hospital of Chenzhou, Chenzhou, China
| | - Yuan Li
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Liping Yuan
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Fen Liu
- Department of Clinical Microbiology Laboratory, The First People's Hospital of Chenzhou, Chenzhou, China
| | - Qian Sun
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
- Wenzhou Center for Disease Control and Prevention, Wenzhou, Zhejiang, China
| | - Qingkai Luo
- Department of Clinical Microbiology Laboratory, The First People's Hospital of Chenzhou, Chenzhou, China
| | - Yefei Lei
- Department of Clinical Microbiology Laboratory, The First People's Hospital of Chenzhou, Chenzhou, China
| | - Yinglan Hou
- Department of Clinical Microbiology Laboratory, The First People's Hospital of Chenzhou, Chenzhou, China
| | - Jiayan Li
- Department of Clinical Microbiology Laboratory, The First People's Hospital of Chenzhou, Chenzhou, China
| | - Liang Cai
- Hunan Provincial Center for Disease Control and Prevention, Hunan, China
| | - Shixing Tang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
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Waghmare A, Hijano DR. SARS-CoV-2 Infection and COVID-19 in Children. Rheum Dis Clin North Am 2025; 51:139-156. [PMID: 39550102 DOI: 10.1016/j.rdc.2024.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2024]
Abstract
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection is common in children, and clinical manifestations can vary depending on age, underlying disease, and vaccination status. Most children will have asymptomatic or mild infection, but certain baseline characteristics can increase the risk of moderate to severe disease. The following article will provide an overview of the clinical manifestations of coronavirus disease 2019 in children, including the post-infectious phenomenon called multisystem inflammatory syndrome in children. Currently available treatment and prophylaxis strategies will be outlined, with the caveat that new therapeutics and clinical efficacy data are constantly on the horizon.
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Affiliation(s)
- Alpana Waghmare
- Department of Pediatrics, University of Washington, Fred Hutchinson Cancer Research Center Vaccine, 1100 Fairview Avenue North, Seattle, WA 98109, USA; Department of Infectious Diseases, Division Seattle Children's Hospital, Seattle, WA, USA
| | - Diego R Hijano
- St. Jude Children's Research Hospital, 262 Danny Thomas Place Mail Stop 230, Memphis, TN 38105, USA.
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Kim HY, Shin SH, Lee H, Kim J. Changes in metrics of continuous glucose monitoring during COVID-19 in Korean children and adolescents with type 1 diabetes mellitus. Ann Pediatr Endocrinol Metab 2025; 30:38-44. [PMID: 40049674 PMCID: PMC11917402 DOI: 10.6065/apem.2448036.018] [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: 02/08/2024] [Accepted: 05/13/2024] [Indexed: 03/20/2025] Open
Abstract
PURPOSE There are limited data regarding changes in glucose control in pediatric patients with type 1 diabetes (T1D) affected by coronavirus disease 2019 (COVID-19). This study aimed to evaluate changes in the metrics of a continuous glucose monitoring (CGM) system during COVID-19 infection in children and adolescents with T1D. METHODS Eighteen patients with T1D (<18 years of age) were included in this retrospective study. The effects of COVID-19 on CGM metrics were assessed at 5 time points (2 weeks before COVID-19 [time 1], 1 week before COVID-19 [time 2], during COVID-19 [time 3], 1 week after COVID-19 [time 4], and 2 weeks after COVID-19 [time 5]). RESULTS All participants had at least 1 symptom of COVID-19 and did not need to be hospitalized. The glucose management indicator (GMI) was higher at time 3 (7.7%±1.4%) compared to time 1 (7.1%±1.1%; P=0.016) and time 5 (7.0%±1.2%; P=0.008). According to the insulin delivery method, the GMI at time 3 was significantly higher than that at time 5 in patients treated with multiple daily injections (MDI) (median and interquartile range, 8.0% [6.1%-8.5%] vs. 7.1% [5.8%-7.9%]; P=0.020) but not in those treated with continuous subcutaneous insulin infusion (CSII). CONCLUSION Pediatric patients with T1D and mild COVID-19 showed worsening glycemic control during COVID-19 infection, but it returned to preinfection levels within 2 weeks of infection. CSII is more effective in maintaining stable glycemic control during COVID-19 infection than is MDI therapy.
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Affiliation(s)
- Hwa Young Kim
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - So Hyun Shin
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hyunju Lee
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Jaehyun Kim
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
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Figueroa AL, Torres D, Reyes-Acuna C, Matherne P, Yeakey A, Deng W, Xu W, Sigal Y, Chambers G, Olsen M, Girard B, Miller JM, Das R, Priddy F. Safety and immunogenicity of a single-dose omicron-containing COVID-19 vaccination in adolescents: an open-label, single-arm, phase 2/3 trial. THE LANCET. INFECTIOUS DISEASES 2025; 25:208-217. [PMID: 39332418 DOI: 10.1016/s1473-3099(24)00501-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 07/12/2024] [Accepted: 07/26/2024] [Indexed: 09/29/2024]
Abstract
BACKGROUND Most individuals show immunity to SARS-CoV-2 from vaccination or infection, or both. We aimed to determine the safety and immunogenicity of an omicron-containing COVID-19 vaccine (mRNA-1273.222) in vaccine-naive adolescents who were SARS-CoV-2 positive. METHODS Part 3 of the phase 2/3 TeenCOVE trial was a phase 3, open-label, single-arm part done in the USA and the Dominican Republic that enrolled healthy, vaccine-naive adolescents (aged 12-17 years) to receive two 50 μg doses of mRNA-1273.222 (ancestral strain Wuhan-Hu-1 and omicron subvariants BA.4 and BA.5), 6 months apart. Primary reactogenicity and safety outcomes included assessment of solicited local or systemic adverse reactions 7 days after vaccination, and unsolicited and prespecified adverse events throughout study participation. Inferred effectiveness (primary immunogenicity outcome) was established by comparing neutralising antibody responses 28 days after dose 1 of mRNA-1273.222 in SARS-CoV-2-positive adolescents with responses 28 days after dose 2 of mRNA-1273 100 μg primary series in SARS-CoV-2-negative young adults (aged 18-25 years) from the COVE trial. This study is registered with ClinicalTrials.gov (NCT04649151). FINDINGS Between Dec 21, 2022, and June 5, 2023, 379 adolescents (378 of whom were SARS-CoV-2 positive) received at least one mRNA-1273.222 dose and were included in the safety analysis set. The reactogenicity profile was favourable compared with the mRNA-1273 primary series, with no new safety concerns identified. Unsolicited adverse events were reported in 49 (13%) of 379 participants; no deaths or adverse events leading to study discontinuation were reported. The immunogenicity set included 245 adolescents from the per-protocol immunogenicity subset who were SARS-CoV-2 positive at baseline and 296 young adults who were SARS-CoV-2 negative. Compared with the mRNA-1273 primary series in SARS-CoV-2-negative young adults, a single dose of mRNA-1273.222 induced superior (geometric mean ratio [GMR] 95% CI lower bound >1) neutralising antibody responses against omicron BA.4 and BA.5 (GMR 48·95 [95% CI 44·21-54·21]) and non-inferior (GMR 95% CI lower bound >0·667) neutralising antibody responses against ancestral SARS-CoV-2 (GMR 4·25 [95% CI 3·69-4·88]) in SARS-CoV-2-positive adolescents. INTERPRETATION In vaccine-naive, SARS-CoV-2-positive adolescents, single-dose mRNA-1273.222 was effective against COVID-19 based on successful immunobridging to the two-dose mRNA-1273 primary series in young adults. The findings support a simplified single-dose vaccination schedule with variant-containing mRNA vaccines, regardless of previous vaccination status. FUNDING Moderna.
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Affiliation(s)
| | - Dania Torres
- Hospital General Regional Dr Marcelino Velez Santana, Santo Domingo, Dominican Republic
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30
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Yang Y, Jiang J, Zhou J, Wang S, Chen G, Zheng S. Clinical Course and Outcome of COVID-19 in Children With Biliary Atresia: A Retrospective Study. Health Sci Rep 2025; 8:e70462. [PMID: 39931263 PMCID: PMC11808391 DOI: 10.1002/hsr2.70462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 12/21/2024] [Accepted: 01/16/2025] [Indexed: 02/13/2025] Open
Abstract
Background and Aims To investigate the infection status and outcomes of biliary atresia (BA) patients during the coronavirus disease 2019 (COVID-19) pandemic in Chinese population. Methods This retrospective study involved Kasai-postoperative BA patients who had achieved jaundice-free during the SARS-CoV-2 outbreak from December 1, 2022 to February 28, 2023. Children without hepatobiliary diseases hospitalized during the same period were as control group. Data collected included nutritional status, comorbidities, epidemiologic characteristics, fever symptoms (duration, max), respiratory symptoms (cough, runny nose and shortness of breath), and gastrointestinal symptoms (diarrhea and vomiting). All cases infected with SARS-CoV-2 were followed up for 3 months. Results A total of 128 BA patients were enrolled, ranged in age from 6 months to 12 years old (median age: 1.8 years). A total of 51 (39.8%) and 49 BA patients (38.3%) were classified as confirmed and suspected COVID-19 cases, respectively. Only two confirmed cases presented with moderate symptoms, while the rest developed asymptomatic or mild cases. Compared to the 115 control groups, the proportion of symptomatic cases in BA was slightly higher (78.1% vs. 67.8%) without significant difference (p = 0.07). Similarly, no differences were found in proportion of fever, respiratory tract symptoms and gastrointestinal symptoms between BA and control groups. However, it is worth noting that 7 BA patients developed symptoms of cholangitis during SARS-CoV-2 infection, who experienced pale stool and elevated bilirubin levels. After hospitalization, six patients achieved jaundice-free survival, but one child finally had to undergo liver transplantation due to hepatic failure. Conclusions The symptoms and course of COVID-19 in BA patients were similar to those in healthy population. The vast majority of BA patients made a good recovery from COVID-19.
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Affiliation(s)
- Yifan Yang
- Department of Pediatric SurgeryChildren's Hospital of Fudan University, and Key Laboratory of Neonatal Disease, Ministry of HealthShanghaiChina
| | - Jingying Jiang
- Department of Pediatric SurgeryChildren's Hospital of Fudan University, and Key Laboratory of Neonatal Disease, Ministry of HealthShanghaiChina
| | - Jin Zhou
- Department of Pediatric SurgeryChildren's Hospital of Fudan University, and Key Laboratory of Neonatal Disease, Ministry of HealthShanghaiChina
| | - Shuxin Wang
- Department of Pediatric SurgeryChildren's Hospital of Fudan University, and Key Laboratory of Neonatal Disease, Ministry of HealthShanghaiChina
| | - Gong Chen
- Department of Pediatric SurgeryChildren's Hospital of Fudan University, and Key Laboratory of Neonatal Disease, Ministry of HealthShanghaiChina
| | - Shan Zheng
- Department of Pediatric SurgeryChildren's Hospital of Fudan University, and Key Laboratory of Neonatal Disease, Ministry of HealthShanghaiChina
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Abstract
Parental vaccine hesitancy has been a hotly debated issue long before the COVID-19 pandemic. Still, the emergence of a new vaccine during this public health crisis made even pro-vaccine individuals reconsider vaccines for their children. This scoping review was conducted to understand why parents expressed hesitancy towards the COVID-19 vaccine for children under 12 years old. The search included primary sources of evidence published in English from 2020-2022. A final 41 articles met the criteria. Overall, more vaccine-hesitant characteristics were non-white, female, lower education level, lower income, on public insurance, conservative political affiliation, younger age, and rural residence. Concerns affecting confidence in the vaccine were the risk of possible side effects and lack of trust in the development of the emergency approval of the vaccine. School nurses can acknowledge parental fears and provide parents with evidence-based information when communicating with them about vaccinations.
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Affiliation(s)
- Christina Baker
- College of Nursing, University of Colorado, Anschutz Medical Campus, USA
| | - Paul F Cook
- College of Nursing, University of Colorado, Anschutz Medical Campus, USA
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32
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Márquez AC, Tanunliong G, Kabir M, Alam M, Hossain B, Rashid H, Jassem AN, Sekirov I, Haque R, Morshed M. Antibodies Against SARS-CoV-2 Do Not Cross-React with Endemic Coronaviruses in a Pediatric Population: Data from a Bangladesh Cohort. Viruses 2025; 17:161. [PMID: 40006916 PMCID: PMC11860448 DOI: 10.3390/v17020161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2024] [Revised: 01/15/2025] [Accepted: 01/17/2025] [Indexed: 02/27/2025] Open
Abstract
There is a limited understanding of the immunological differences between children and adults that protect children from developing severe coronavirus disease 2019 (COVID-19) following SARS-CoV-2 infection. Previous infection with endemic human coronaviruses (HCoVs) has been suggested as a factor. In this study, we used 100 paired residual samples collected before and during the COVID-19 pandemic from children in Bangladesh. We compared the changes in their sero-status (no COVID-19 vs. COVID-19) and quantified antibody levels to HCoVs. We found that although 45% of the children seroconverted for IgG antibodies against SARS-CoV-2, there was no correlation between evidence of previous infection with HCoVs and the magnitude of SARS-CoV-2 antibody responses post-infection. Moreover, no differences in the anti-HCoV antibody levels were found pre- and post-SARS-CoV-2 infection.
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Affiliation(s)
| | - Guadalein Tanunliong
- BCCDC Public Health Laboratory, Vancouver, BC V5Z 4R4, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Mamun Kabir
- International Centre for Diarrhoeal Disease Research, Dhaka 1212, Bangladesh
| | - Masud Alam
- International Centre for Diarrhoeal Disease Research, Dhaka 1212, Bangladesh
| | - Biplob Hossain
- International Centre for Diarrhoeal Disease Research, Dhaka 1212, Bangladesh
| | - Humaira Rashid
- International Centre for Diarrhoeal Disease Research, Dhaka 1212, Bangladesh
| | - Agatha N. Jassem
- BCCDC Public Health Laboratory, Vancouver, BC V5Z 4R4, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Inna Sekirov
- BCCDC Public Health Laboratory, Vancouver, BC V5Z 4R4, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Rashidul Haque
- International Centre for Diarrhoeal Disease Research, Dhaka 1212, Bangladesh
| | - Muhammad Morshed
- BCCDC Public Health Laboratory, Vancouver, BC V5Z 4R4, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
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Babata K, Sultana R, Hascoët JM, Albert R, Chan C, Mazzarella K, Muhamed T, Yeo KT, Kong JY, Brion LP. Neonatal Feeding Practices and SARS-CoV-2 Transmission in Neonates with Perinatal SARS-CoV-2 Exposure: A Systematic Review and Meta-Analysis. J Clin Med 2025; 14:280. [PMID: 39797362 PMCID: PMC11722486 DOI: 10.3390/jcm14010280] [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: 12/05/2024] [Revised: 12/25/2024] [Accepted: 12/31/2024] [Indexed: 01/13/2025] Open
Abstract
Background: The risk of neonatal SARS-CoV-2 infection from the mother's own milk (MoM) in neonates who are exposed to maternal SARS-CoV-2 during the perinatal period remains unclear. We conducted a systematic review to assess the association between MoM feeding and neonatal SARS-CoV-2 infection in neonates who were born to SARS-CoV-2-positive pregnant persons. Methods: PubMed Central and Google Scholar were searched for studies published by 14 March 2024 that reported neonatal SARS-CoV-2 infection by feeding type. This search, including Scopus, was updated on 17 December 2024. The primary outcome was neonatal SARS-CoV-2 infection. The meta-analysis was conducted using a random effects model with two planned subgroup analyses: time of maternal PCR testing (at admission vs. previous 2 weeks) and dyad handling (isolation vs. some precautions vs. variable/NA). Results: The primary outcome was available in both arms of nine studies, including 5572 neonates who received MoM and 2215 who received no MoM. The GRADE rating was low quality, because the studies were observational (cohorts). The frequency of SARS-CoV-2 infection was similar in both arms (2.7% MoM vs. 2.2% no MoM), with a common risk ratio of 0.82 (95% confidence interval 0.44, 1.53, p = 0.54). No significant differences were observed in the subgroup analyses. Limitations include observational and incomplete data, other possible infection sources, small sample sizes for subgroup analyses, and neonates with more than one feeding type. Conclusions: Feeding MoM was not associated with an increased risk of neonatal SARS-CoV-2 infection among neonates who were born to mothers with perinatal infection. These data, along with reports showing a lack of active replicating SARS-CoV-2 virus in MoM, further support women with perinatal SARS-CoV-2 infection feeding MoM. Registration: PROSPERO ID CRD42021268576.
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Affiliation(s)
- Kikelomo Babata
- Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Texas, Southwestern Medical Center, Dallas, TX 75390, USA; (R.A.); (C.C.); (K.M.); (L.P.B.)
| | - Rehena Sultana
- Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore 169857, Singapore;
| | | | - Riya Albert
- Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Texas, Southwestern Medical Center, Dallas, TX 75390, USA; (R.A.); (C.C.); (K.M.); (L.P.B.)
| | - Christina Chan
- Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Texas, Southwestern Medical Center, Dallas, TX 75390, USA; (R.A.); (C.C.); (K.M.); (L.P.B.)
| | - Kelly Mazzarella
- Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Texas, Southwestern Medical Center, Dallas, TX 75390, USA; (R.A.); (C.C.); (K.M.); (L.P.B.)
| | - Tanaz Muhamed
- Thayer School of Engineering Dartmouth College, Hanover, NH 03755, USA;
| | - Kee Thai Yeo
- Department of Neonatology, KK Women’s and Children’s Hospital, Singapore 229899, Singapore; (K.T.Y.); (J.Y.K.)
| | - Juin Yee Kong
- Department of Neonatology, KK Women’s and Children’s Hospital, Singapore 229899, Singapore; (K.T.Y.); (J.Y.K.)
| | - Luc P. Brion
- Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Texas, Southwestern Medical Center, Dallas, TX 75390, USA; (R.A.); (C.C.); (K.M.); (L.P.B.)
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Yasar Y, Coskun M, Yasar E, Cem E, Celebi-Yilmaz M, Sahinkaya S, Sarac-Sandal O, Agin H. The association between abdominal ultrasound findings and clinical severity in MIS-C children with extracardiac symptoms. Eur J Pediatr 2025; 184:117. [PMID: 39760763 DOI: 10.1007/s00431-024-05950-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2024] [Revised: 12/03/2024] [Accepted: 12/19/2024] [Indexed: 01/07/2025]
Abstract
This study aimed to evaluate pathological findings on abdominal ultrasonography upon admission of children diagnosed with Multisystem Inflammatory Syndrome in Children (MIS-C) that were associated with a more severe disease course and the need for intensive care unit (ICU) admission. This retrospective and observational study was conducted between March 2020 and May 2022. Abdominal ultrasonography findings were evaluated in children diagnosed with MIS-C associated with SARS-CoV-2. Ultrasound examinations were conducted within the first 24 h following hospital admission. Clinical severity was categorized as mild-moderate or severe based on the highest clinical severity score observed at any point during hospitalization, using the criteria of dehydration, oxygen or inotropic requirements, cardiac involvement, and respiratory support. The indications of ICU admission were decreased ejection fraction, pulmonary involvement, and any signs of shock. We compared the presence of any individual ultrasonography findings with clinical severity and the need for ICU admission. Multivariable logistic regression analysis was performed to identify independent sonographic predictors of clinical severity and ICU admission. A total of 70 children were included in the study, 16 of whom (23%) were categorized as having severe diseases. ICU admission was required for 14 children (20%), 13 of whom had severe disease. Notably, three children with severe clinical scores did not require ICU admission. The most common ultrasonography findings were intra-abdominal free fluid (41%), hepatomegaly (36%), splenomegaly (33%), mesenteric inflammation (21%) and mesenteric lymphadenopathy (%19). Intra-abdominal free fluid (p < 0.001; OR = 18.20; 95% CI, 3.69-89.86), mesenteric inflammation (p < 0.001; OR = 10.29; 95% CI, 2.80-37.83), mesenteric lymphadenopathy (p = 0.007; OR = 6.22; 95% CI; 1.69-22.88), and hepatosplenomegaly (p = 0.039; OR = 3.89; 95% CI, 1.15-13.17) were substantially associated with severe clinical outcomes. Intra-abdominal free fluid (p < 0.001; OR = 13.76; 95% CI, 2.77-68.29) and hepatosplenomegaly (p = 0.002; OR = 8.00; 95% CI, 2.19-29.25) were significantly more common in children who required ICU admission. Multivariable logistic regression analysis revealed that intra-abdominal free fluid was an independent predictor of severe disease (p = 0.026; OR = 7.41; 95% CI, 1.28-43.00) and ICU admission (p = 0.007; OR = 9.80; 95% CI, 1.88-51.04). CONCLUSION Abdominal ultrasonography findings may indicate clinical severity in children with MIS-C. Intra-abdominal free fluid strongly correlates with severe clinical outcomes and the need for intensive care. WHAT IS KNOWN • Abdominal ultrasonography findings in children with MIS-C are non-specific and include intra-abdominal free fluid, mesenteric lymphadenopathy, and hepatosplenomegaly. • MIS-C is associated with significant systemic inflammation and can present with a variety of extracardiac symptoms, often overlapping with acute abdominal conditions. WHAT IS NEW • Intra-abdominal free fluid on ultrasonography is strongly associated with severe clinical outcomes and the need for ICU admission in MIS-C patients • This study identifies intra-abdominal free fluid as an independent sonographic predictor of disease severity and intensive care needs, emphasizing the importance of early abdominal ultrasonography in MIS-C management.
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Affiliation(s)
- Yunus Yasar
- Department of Radiology, Umraniye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.
| | - Mehmet Coskun
- Department of Radiology, Dr. Behçet Uz Children Disease and Surgery Training and Research Hospital, University of Health Sciences, Izmir, Turkey
| | - Elif Yasar
- Department of Radiology, Sancaktepe Şehit Prof. Dr. İlhan Varank Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Ela Cem
- Department of Pediatric Infectious Diseases, Dr. Behçet Uz Children Disease and Surgery Training and Research Hospital, University of Health Sciences, Izmir, Turkey
| | - Miray Celebi-Yilmaz
- Department of Pediatric Infectious Diseases, Dr. Behçet Uz Children Disease and Surgery Training and Research Hospital, University of Health Sciences, Izmir, Turkey
| | - Sahika Sahinkaya
- Department of Pediatric Infectious Diseases, Dr. Behçet Uz Children Disease and Surgery Training and Research Hospital, University of Health Sciences, Izmir, Turkey
| | - Ozlem Sarac-Sandal
- Department of Pediatric Intensive Care Unit, Dr. Behçet Uz Children Disease and Surgery Training and Research Hospital, University of Health Sciences, Izmir, Turkey
| | - Hasan Agin
- Department of Pediatric Intensive Care Unit, Dr. Behçet Uz Children Disease and Surgery Training and Research Hospital, University of Health Sciences, Izmir, Turkey
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Zar HJ, Workman L, MacGinty R, Botha M, Johnson M, Hunt A, Burd T, Nicol MP, Flasche S, Quilty BJ, Goldblatt D. Natural immunity and protection against variants in South African children through five COVID-19 waves: A prospective study. Int J Infect Dis 2025; 150:107300. [PMID: 39547328 DOI: 10.1016/j.ijid.2024.107300] [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: 08/22/2024] [Revised: 11/07/2024] [Accepted: 11/08/2024] [Indexed: 11/17/2024] Open
Abstract
OBJECTIVES Children have been largely spared from serious disease through the COVID-19 pandemic despite a high exposure to SARS-CoV-2. Antibody responses to exposure and their role in protecting children from subsequent variant infection remain poorly understood. METHODS This is a prospective cohort study of children in a South African community through ancestral/Beta/Delta/Omicron BA.1/BA.2 and BA.4/BA.5 SARS-CoV-2 waves (March 2020-October 2022). Health seeking behavior/illness was recorded and postwave serum samples measured for immunoglobulin (Ig) G to spike (S) (CoV2-S-IgG) by electrochemiluminescent immunosorbent assay. To estimate the protective CoV2-S-IgG threshold levels, logistic functions were fit to describe the correlation of CoV2-S-IgG measured before a wave and the probability for seroconversion/boosting thereafter. RESULTS Despite little disease, 125 per 366 (34.2%) children (median age 6.7 years [interquartile range 5.99-7.4 years]) were seropositive after wave I, rising to 53.6%, 76.0%, and 96.2% and 99.2% after waves II (Beta), III (Delta), and IV and V (Omicron variants), respectively. CoV2-S-IgG induced by natural exposure protected against subsequent SARS-CoV-2 infection, with the greatest protection for Beta and least for Omicron. The levels of IgG specific for ancestral S antigen that provided a 50% protective threshold for the subsequent wave were lowest for the Beta and highest for the Omicron BA.1/BA.2 wave. In the multivariate analysis, maternal seropositivity (adjusted odds ratio = 2.57 [95% confidence interval: 1.72-3.82]) was strongly associated with child seropositivity. CONCLUSION Children responded robustly to successive waves of SARS-CoV-2, mounting IgG responses to S antigen that were protective against subsequent waves. In the absence of vaccination, almost all children were seropositive after wave V but none were hospitalized, suggesting that natural immunity alone may be sufficient to protect children in a pandemic setting.
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Affiliation(s)
- Heather J Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and SA-MRC Unit on Child & Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - Lesley Workman
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and SA-MRC Unit on Child & Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - Rae MacGinty
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and SA-MRC Unit on Child & Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - Maresa Botha
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and SA-MRC Unit on Child & Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - Marina Johnson
- Great Ormond Street Institute of Child Health Biomedical Research Centre, University College London & Great Ormond Street Children's Hospital NHS Foundation Trust, London, UK
| | - Adam Hunt
- Great Ormond Street Institute of Child Health Biomedical Research Centre, University College London & Great Ormond Street Children's Hospital NHS Foundation Trust, London, UK
| | - Tiffany Burd
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and SA-MRC Unit on Child & Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - Mark P Nicol
- Marshall Centre, Division of Infection and Immunity, School of Biomedical Sciences, University of Western Australia, Perth, Australia; Division of Medical Microbiology and Institute for Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Stefan Flasche
- Centre for Mathematical Modelling of Infectious Disease, London School of Hygiene and Tropical Medicine, London, UK
| | - Billy J Quilty
- Centre for Mathematical Modelling of Infectious Disease, London School of Hygiene and Tropical Medicine, London, UK
| | - David Goldblatt
- Great Ormond Street Institute of Child Health Biomedical Research Centre, University College London & Great Ormond Street Children's Hospital NHS Foundation Trust, London, UK.
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Deng Y, Kim Y, Bratcher A, Jones JM, Simuzingili M, Gundlapalli AV, Hagen MB, Iachan R, Clarke KEN. Ratio of Infections to COVID-19 Cases and Hospitalizations in the United States based on SARS-CoV-2 Seroprevalence Data, September 2021-February 2022. Open Forum Infect Dis 2025; 12:ofae719. [PMID: 39822271 PMCID: PMC11736415 DOI: 10.1093/ofid/ofae719] [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: 10/22/2024] [Indexed: 01/19/2025] Open
Abstract
Background Understanding the risk of hospitalization from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections can guide effective public health interventions and severity assessments. This study calculated infection-hospitalization ratios (IHRs) and infection-case ratios (ICRs) to understand the relationship between SARS-CoV-2 infections, cases, and hospitalizations among different age groups during periods of Delta and Omicron variant predominance. Methods After calculating antinucleocapsid SARS-CoV-2 antibody seroprevalence using residual commercial laboratory serum specimens, 2 ratios were computed: (1) IHRs using coronavirus disease 2019 hospitalization data and (2) ICRs using Centers for Disease Control and Prevention surveillance data. Ratios were calculated across age groups (0-17, 18-49, 50-69, and ≥70 years) for 2 time periods (September-December 2021 [Delta] and December 2021-February 2022 [Omicron]). Results Pediatric IHRs increased from 76.7 during Delta to 258.4 during Omicron. Adult IHRs ranged from 3.0 (≥70 years) to 21.6 (18-49 years) during Delta and from 10.0 (≥70 years) to 119.1 (18-49 years) during Omicron. The pediatric ICR was lower during the Delta period (2.7) compared with the Omicron period (3.7). Adult ICRs (Delta: 1.1 [18-49 years] to 2.1 [70+ years]; Omicron: 2.2 [>70+ years] to 2.9 [50-69 years]) were lower than pediatric ICRs during both time periods. Conclusions All age groups exhibited a lower proportion of infections associated with hospitalization in the Omicron period than the Delta period; the proportion of infections associated with hospitalization increased with each older age group. A lower proportion of SARS-CoV-2 infections were associated with reported cases in the Omicron period than in the Delta period among all age groups.
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Affiliation(s)
| | - Yun Kim
- ICF Macro, inc., Reston, Virginia, USA
| | - Anna Bratcher
- Epidemic Intelligence Service, CDC, Atlanta, Georgia, USA
| | - Jefferson M Jones
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Muloongo Simuzingili
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Adi V Gundlapalli
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Melissa Briggs Hagen
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Kristie E N Clarke
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Shaffer AD, McCoy JL, Dohar JE. Disparities in completing testing for SARS-CoV-2 prior to otolaryngology procedures. Am J Otolaryngol 2025; 46:104543. [PMID: 39637447 DOI: 10.1016/j.amjoto.2024.104543] [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: 08/30/2024] [Accepted: 11/28/2024] [Indexed: 12/07/2024]
Abstract
OBJECTIVES To determine what patient characteristics are associated with completing asymptomatic pre-operative testing for SARS-CoV-2. METHODS Charts from consecutive patients undergoing ambulatory surgery in otolaryngology at a tertiary care children's hospital from May 4 until May 26, 2020, were reviewed. If two or more siblings were scheduled, only the first sibling was included. Demographics, surgical details, and results of asymptomatic pre-operative testing for SARS-CoV-2 were collected. Patients who completed pre-operative testing were compared with those who did not using logistic regression or Wilcoxon rank-sum tests, α = 0.05. RESULTS 216 patients were included. 56.5 % were male, and median age at surgery was 2 years (range 4 months-20 years). 88 patients (40.7 %) had pre-operative SARS-CoV-2 RT-PCR testing. 97.7 % of sampling occurred 2-3 days prior to the procedure, and 98.9 % of results were available within 2 days. The virus was not detected in any cases. In multiple logistic regression, undergoing surgery at the main hospital location rather than a satellite location (OR: 3.13, p = 0.003) and greater median household income for zip (OR: 1.18/$10,000, p = 0.042) were associated with completing pre-operative testing. However, race, insurance type, surgeon, patient age, previous no-show appointments, and household composition did not alter the odds of completing pre-operative testing. CONCLUSIONS Families were less likely to complete testing if surgery was being performed at a satellite location or if they lived in an area with lesser median household income. This work draws attention to the impact of socioeconomic factors on access to and compliance with pandemic mitigation measures, with important implications for future public health crises.
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Affiliation(s)
- Amber D Shaffer
- Division of Pediatric Otolaryngology, Department of Otolaryngology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, United States.
| | - Jennifer L McCoy
- Division of Pediatric Otolaryngology, Department of Otolaryngology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, United States
| | - Joseph E Dohar
- Division of Pediatric Otolaryngology, Department of Otolaryngology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, United States.
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Dassaye R, Chetty T, Daniels B, Gaffoor Z, Spooner E, Ramraj T, Mthethwa N, Nsibande DF, Pillay S, Bhana A, Magasana V, Reddy T, Mohlabi K, Moore PL, Burgers WA, de Oliveira T, Msomi N, Goga A. SARS-CoV-2 Infections in a Triad of Primary School Learners (Grades 1-7), Their Parents, and Teachers in KwaZulu-Natal, South Africa: Protocol for a Cross-Sectional and Nested Case-Cohort Study. JMIR Res Protoc 2024; 13:e52713. [PMID: 39700491 PMCID: PMC11695960 DOI: 10.2196/52713] [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: 09/13/2023] [Revised: 07/29/2024] [Accepted: 09/16/2024] [Indexed: 12/21/2024] Open
Abstract
BACKGROUND In low- and middle-income countries (LMICs) such as South Africa, there is paucity of data on SARS-CoV-2 infections among children attending school, including seroprevalence and transmission dynamics. OBJECTIVE This pilot study aims to assess (1) the prevalence of self-reported or confirmed SARS-CoV-2 prior infections, COVID-19 symptoms (including long COVID), seroprevalence of SARS-CoV-2 antibodies, and general/mental health, (2) longitudinal changes in SARS-CoV-2 seroprevalence, and (3) SARS-CoV-2 acute infections, immune responses, transmission dynamics, and symptomatic versus asymptomatic contacts in a unique cohort of unvaccinated primary school learners, their parents, teachers, and close contacts in semirural primary school settings. METHODS Learners (grades 1-7) from primary schools in KwaZulu-Natal, South Africa, their parents, and teachers will be invited to enroll into the COVID kids school study (CoKiDSS). CoKiDSS comprises 3 parts: a cross-sectional survey (N=640), a follow-up survey (n=300), and a nested case-cohort substudy. Finger-prick blood and saliva samples will be collected for serological and future testing, respectively, in the cross-sectional (451 learners:147 parents:42 teachers) and follow-up (210 learners:70 parents:20 teachers) surveys. The nested case-cohort substudy will include cases from the cross-sectional survey with confirmed current SARS-CoV-2 infection (n=30) and their close contacts (n=up to 10 per infected participant). Finger-prick blood (from all substudy participants), venous blood (from cases), and nasal swabs (from cases and contacts) will be collected for serological testing, immunological testing, and viral genome sequencing, respectively. Questionnaires covering sociodemographic and general and mental health information, prior and current SARS-CoV-2 symptoms and testing information, vaccination status, preventative behavior, and lifestyle will be administered. Statistical methods will include generalized linear mixed models, intracluster correlation, descriptive analysis, and graphical techniques. RESULTS A total of 645 participants were enrolled into the cross-sectional survey between May and August 2023. A subset of 300 participants were followed up in the follow-up survey in October 2023. Screening of the participants into the nested case-cohort substudy is planned between November 2023 and September 2024. Data cleanup and analysis for the cross-sectional survey is complete, while those for the follow-up survey and nested case substudy will be completed by the third quarter of 2024. The dissemination and publication of results is anticipated for the fourth quarter of 2024. CONCLUSIONS This study provides data from an LMIC setting on the impact of SARS-CoV-2 on school-attending learners, their parents, and teachers 3 years after the SARS-CoV-2 pandemic was declared and 21-24 months after resumption of normal school attendance. In particular, this study will provide data on the prevalence of self-reported or confirmed SARS-CoV-2 prior infection, prior and current symptoms, seroprevalence, changes in seroprevalence, SARS-CoV-2 transmission, SARS-CoV-2 adaptive immune responses, and symptoms of long COVID and mental health among a triad of learners, their parents, and teachers. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/52713.
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Affiliation(s)
- Reshmi Dassaye
- HIV and Other Infectious Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Terusha Chetty
- HIV and Other Infectious Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
- Discipline of Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Brodie Daniels
- HIV and Other Infectious Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Zakir Gaffoor
- HIV and Other Infectious Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Elizabeth Spooner
- HIV and Other Infectious Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Trisha Ramraj
- HIV and Other Infectious Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Ncengani Mthethwa
- HIV and Other Infectious Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Duduzile Faith Nsibande
- HIV and Other Infectious Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Saresha Pillay
- HIV and Other Infectious Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Arvin Bhana
- Center for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
- Health Systems Research Unit, South African Medical Research Council, Durban, South Africa
| | - Vuyolwethu Magasana
- HIV and Other Infectious Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Tarylee Reddy
- Biostatistics Research Unit, South African Medical Research Council, Durban, South Africa
| | - Khanya Mohlabi
- HIV and Other Infectious Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Penelope Linda Moore
- Centre for the AIDS Programme of Research in South Africa, Durban, South Africa
- National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
- South African Medical Research Council Antibody Immunity Research Unit, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Wendy A Burgers
- Wellcome Centre for Infectious Diseases Research in Africa, University of Cape Town, Cape Town, South Africa
- Division of Medical Virology, Department of Pathology, University of Cape Town, Cape Town, South Africa
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Tulio de Oliveira
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
- Centre for Epidemic Response and Innovation, School of Data Science and Computational Thinking, Stellenbosch University, Stellenbosch, South Africa
- KwaZulu-Natal Research Innovation and Sequencing Platform, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
- Department of Global Health, University of Washington, Seattle, WA, United States
| | - Nokukhanya Msomi
- Discipline of Virology, School of Laboratory Medicine and Medical Sciences, University of KwaZulu Natal, Durban, South Africa
- National Health Laboratory Service, Durban, South Africa
| | - Ameena Goga
- HIV and Other Infectious Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
- Department of Paediatrics and Child Health, University of Pretoria, Pretoria, South Africa
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Cocuz ME, Cocuz IG, Rodina L, Filip R, Filip F. Clinical Outcomes and Characteristics of COVID-19 in Neonates: A Single-Center Study in Romania. Life (Basel) 2024; 14:1650. [PMID: 39768357 PMCID: PMC11677269 DOI: 10.3390/life14121650] [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: 10/29/2024] [Revised: 11/30/2024] [Accepted: 12/11/2024] [Indexed: 01/11/2025] Open
Abstract
BACKGROUND SARS-CoV-2 infection is generally associated with less severe forms of disease in children, where most cases only require symptomatic treatment. However, there is a paucity of information regarding the impact and clinical course of COVID-19 in neonate patients. This study aimed to analyze the epidemiological and clinical aspects of COVID-19 in this particular age group who were patients treated in our department. MATERIALS AND METHODS This is a retrospective observational study that includes neonates (aged less than 1 month) who were diagnosed with COVID-19. The patients were admitted between 1 January 2022 and 31 December 2023, to the Infectious Diseases Pediatric Department of the Hospital Clinic of Pneumophthisiology and Infectious Diseases in Brașov, Romania. All the patients were tested for SARS-CoV-2 infection at admission, using either a real-time PCR (RT-PCR) or rapid antigen testing, according to the national COVID-19 protocol in use at the time. We collected the following data: demographic data, clinical picture and laboratory values at presentation, clinical course, complications, and other significant data. All the data were extracted from existing hospital administrative databases or electronic medical records. RESULTS Nine neonates were hospitalized with COVID-19, of which five were boys, and four were girls; the mean age was 18.89 days (ranging between 6 and 28 days). The clinical picture at admission mainly consisted of fever (eight cases) and nasal obstruction and cough (five cases each). Only one patient required oxygen support. Co-infections with Streptococcus pneumoniae and Haemophilus influenzae (one case), respiratory syncytial virus (RSV, one case), and rotavirus (one case) were identified. Complications were represented by acute bronchiolitis in three patients. Biologically, lymphopenia was found in three cases, monocytosis in five cases, and increased ferritin values in five cases. The clinical outcome was favorable in all the cases. The patients were discharged in improved condition after an average stay of 5.11 days (ranging between 3 and 10 days). CONCLUSIONS Our data support the observation that infection with SARS-CoV-2 in neonates is a relatively benign condition with a good prognosis. Our study has several limitations and establishes a foundation for future studies on a larger sample of term and premature neonates with different comorbidities.
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Affiliation(s)
- Maria Elena Cocuz
- Fundamental Prophylactic and Clinical Disciplines Department, Faculty of Medicine, Transilvania University of Brasov, 500003 Brasov, Romania;
- Clinical Pneumology and Infectious Diseases Hospital of Brasov, 500118 Brasov, Romania;
| | - Iuliu-Gabriel Cocuz
- Pathophysiology Department, “George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, 540142 Targu Mures, Romania
- Pathology Department, Mures Clinical County Hospital, 540011 Targu Mures, Romania
| | - Ligia Rodina
- Clinical Pneumology and Infectious Diseases Hospital of Brasov, 500118 Brasov, Romania;
| | - Ruxandra Filip
- Faculty of Medicine, “George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, 540142 Targu Mures, Romania;
| | - Florin Filip
- Emergency Hospital‚ Sf. Ioan Cel Nou’, 720224 Suceava, Romania;
- Faculty of Medicine and Biological Sciences, Stefan Cel Mare University of Suceava, 720229 Suceava, Romania
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Pisolkar V, Dena I, Green KL, Palmer-Clarke Y, Hinz T, Muhajarine N. See us, hear us! children, adolescents and families in Saskatchewan coping with mental health during the COVID-19 pandemic. Int J Qual Stud Health Well-being 2024; 19:2361494. [PMID: 38824661 PMCID: PMC11146264 DOI: 10.1080/17482631.2024.2361494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 05/24/2024] [Indexed: 06/04/2024] Open
Abstract
PURPOSE To examine the lived experiences of children and adolescents coping with mental health issues and seeking mental health services in Saskatchewan during the COVID-19 pandemic. METHODS In our descriptive phenomenological qualitative study, we interviewed forty-six individuals, including children aged 8-15 and their parents. Thematic analysis was applied to interpret the interview data. RESULTS Our analysis identified three key themes: pyscho-behavioural impact, academic impact, and social impact. The pandemic adversely affected children due to factors like changes in behaviours such as increased screen time and decreased physical activity, limited access to mental health services, and disruptions to schooling and social interactions. Coping mechanisms varied, ranging from the utilization of available mental health supports and services to individual and family-based strategies. Disparities in timely access to mental health services were evident, with financially stable families accessing private services, while others struggled, particularly in rural areas. Families demonstrated resilience through parental efforts to seek balance and prioritize safety amidst COVID-19 challenges. CONCLUSIONS Social connectedness served as a crucial buffer against pandemic-induced stress. Children faced difficulty in accessing timely mental health services and supports. Echoing participant experiences, our findings emphasize the urgency of targeted interventions and policy adjustments to address existing gaps in mental health service accessibility and availability.
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Affiliation(s)
- Vaidehi Pisolkar
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Isabelle Dena
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Kathryn L. Green
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Yolanda Palmer-Clarke
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
- Saskatchewan Population Health and Evaluation Research Unit (SPHERU), Saskatoon, SK, Canada
| | - Tamara Hinz
- Department of Psychiatry, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Nazeem Muhajarine
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
- Saskatchewan Population Health and Evaluation Research Unit (SPHERU), Saskatoon, SK, Canada
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Goussard P, Van Wyk L, Venkatakrishna S, Rabie H, Schubert P, Frigati L, Walzl G, Burger C, Doruyter A, Andronikou S, Gie AG, Rhode D, Jacobs C, Van der Zalm M. SARS-CoV-2 coinfection in children with severe airway obstruction due to pulmonary tuberculosis. Pediatr Pulmonol 2024; 59:3446-3456. [PMID: 39185631 PMCID: PMC11601029 DOI: 10.1002/ppul.27232] [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: 06/11/2024] [Revised: 08/06/2024] [Accepted: 08/17/2024] [Indexed: 08/27/2024]
Abstract
INTRODUCTION The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic had a significant impact on tuberculosis (TB) control globally, with the number of new TB diagnoses decreasing. Coinfection with some viruses, especially measles, could aggravate TB in children. This is presumably a result of depressed cellular immunity. Reports on children with TB and SARS-CoV-2 coinfection are limited. METHODS A retrospective analysis of children up to 13 years old admitted to Tygerberg Hospital, Cape Town, South Africa, from March 2020 to December 2022 with suspected TB-induced airway compression requiring bronchoscopy. Children were included if they presented with severe intrathoracic airway obstruction and/or radiographic evidence of complicated TB. The patients were divided into two groups based on SARS-CoV-2 respiratory polymerase chain reaction results. Demographics, TB exposure, microbiology, SARS-CoV-2 laboratory data, imaging, inflammatory cytokine levels, and bronchoscopy data were collected. Statistical analyses compared SARS-CoV-2 positive and negative groups. RESULTS Of the 50 children undergoing bronchoscopy for TB airway obstruction, 7 (14%) were SARS-CoV-2 positive. Cough was more prevalent in the SARS-CoV-2 positive group (p = 0.04). There was no difference in TB culture yield between groups. However, SARS-CoV-2 positive children showed slower radiological improvement at 1 month (p = 0.01), pleural effusions (p < 0.001), and a higher need for endoscopic enucleation (p < 0.001). FDG PET/CT scans indicated an ongoing inflammation in the SARS-CoV-2 positive group. CONCLUSIONS Coinfection with SARS-CoV-2 in children with TB airway obstruction appears to complicate the disease course, necessitating more medical interventions and demonstrating a longer duration of the TB inflammatory process. Further research is needed to understand the impact of viral infections on TB progression and outcomes in pediatric patients.
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Affiliation(s)
- P. Goussard
- Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Tygerberg HospitalStellenbosch UniversityCape TownSouth Africa
| | - L. Van Wyk
- Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Tygerberg HospitalStellenbosch UniversityCape TownSouth Africa
| | - S. Venkatakrishna
- Department of Pediatric RadiologyThe Children's Hospital of PhiladelphiaPhiladelphiaPennsylvaniaUSA
| | - H. Rabie
- Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Tygerberg HospitalStellenbosch UniversityCape TownSouth Africa
| | - P. Schubert
- National Health Laboratory Service, Department of Pathology, Division of Anatomical Pathology, Tygerberg Hospital, Faculty of Medicine and Health ScienceStellenbosch UniversityCape TownSouth Africa
| | - L. Frigati
- Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Tygerberg HospitalStellenbosch UniversityCape TownSouth Africa
| | - G. Walzl
- DSI‐NRF Centre of Excellence for Biomedical Tuberculosis Research and South African Medical Research Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health SciencesStellenbosch UniversityCape TownSouth Africa
| | - C. Burger
- Division of Nuclear Medicine, Faculty of Medicine and Health SciencesStellenbosch UniversitySouth Africa
| | - A. Doruyter
- Division of Nuclear Medicine, Faculty of Medicine and Health SciencesStellenbosch UniversitySouth Africa
- NuMeRI Node for Infection Imaging, Central Analytical FacilitiesStellenbosch UniversityCape TownSouth Africa
| | - S. Andronikou
- Department of Pediatric RadiologyThe Children's Hospital of PhiladelphiaPhiladelphiaPennsylvaniaUSA
- Department of Radiology, Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - A. G. Gie
- Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Tygerberg HospitalStellenbosch UniversityCape TownSouth Africa
| | - D. Rhode
- Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Tygerberg HospitalStellenbosch UniversityCape TownSouth Africa
| | - C. Jacobs
- Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Tygerberg HospitalStellenbosch UniversityCape TownSouth Africa
| | - M. Van der Zalm
- Department of Paediatrics and Child Health, Desmond Tutu TB Centre, Faculty of Medicine and Health SciencesStellenbosch UniversityCape TownSouth Africa
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Kovács F, Posvai T, Zsáry E, Kolonics F, Garai R, Herczeg V, Czárán D, Takács J, Szabó AJ, Krivácsy P, Csépányi-Kömi R. Long COVID syndrome in children: neutrophilic granulocyte dysfunction and its correlation with disease severity. Pediatr Res 2024:10.1038/s41390-024-03731-1. [PMID: 39592773 DOI: 10.1038/s41390-024-03731-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 10/18/2024] [Accepted: 10/28/2024] [Indexed: 11/28/2024]
Abstract
BACKGROUND Many children suffer from lingering symptoms after COVID-19, known as long COVID syndrome (LCS), otherwise called Post COVID-19 Condition (PCC). Despite extensive research, the prevalence of symptoms, its impact on quality of life, and underlying mechanisms still need to be fully understood. As neutrophilic granulocytes play an essential role in COVID-19, and their prolonged disruption was found to cause immunological diseases, we hypothesized their ongoing disturbed functionality in LCS. METHODS We studied 129 children with LCS, 32 convalescent children (CG+), and 8 uninfected children (CG-). Online questionnaires and in-person examinations assessed symptoms, quality of life, and functioning (QoL-F). Effector functions of neutrophilic granulocytes obtained from the venous blood of 29 LCS and 17 CG+ children were also investigated. RESULTS Persistent fatigue was the most common symptom in children with LCS, while both control groups complained about anxiety most frequently. LCS children experienced significantly more symptoms, impairing their QoL-F compared to CG+. Neutrophilic granulocyte dysfunction was found in LCS children, with decreased superoxide-producing activity and phagocytosis compared to CG+. The number of complaints of children with LCS correlated significantly with altered neutrophil effector functions. CONCLUSION Neutrophil dysfunction in children with LCS may be part of the disease pathogenesis or a predisposing factor. IMPACT Using online questionnaires validated during in-person medical examinations and including two different control groups, our study compellingly supports and adds to previous clinical observations in the field. Our study provides valuable insights into the prevalence and characteristics of pediatric LCS, highlighting the significant quality of life and functioning impairment compared to control groups. By detecting neutrophilic granulocyte dysfunction in children with LCS, we shed light on a previously overlooked pathophysiological component of the condition. We demonstrate a significant correlation between clinical symptoms and superoxide production, further enhancing our understanding of the underlying mechanisms of pediatric LCS.
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Affiliation(s)
- Fanni Kovács
- Pediatric Center, MTA Center of Excellence, Semmelweis University, Bókay Unit, Bókay János Street 53-54, 1083, Budapest, Hungary
| | - Tamás Posvai
- Department of Physiology, Semmelweis University, Budapest, Hungary
| | - Eszter Zsáry
- Pediatric Center, MTA Center of Excellence, Semmelweis University, Bókay Unit, Bókay János Street 53-54, 1083, Budapest, Hungary
| | - Ferenc Kolonics
- Department of Physiology, Semmelweis University, Budapest, Hungary
| | - Réka Garai
- Pediatric Center, MTA Center of Excellence, Semmelweis University, Bókay Unit, Bókay János Street 53-54, 1083, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Vivien Herczeg
- Pediatric Center, MTA Center of Excellence, Semmelweis University, Bókay Unit, Bókay János Street 53-54, 1083, Budapest, Hungary
| | - Domonkos Czárán
- Department of Physiology, Semmelweis University, Budapest, Hungary
| | - Johanna Takács
- Department of Social Sciences, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary
| | - Attila József Szabó
- Pediatric Center, MTA Center of Excellence, Semmelweis University, Bókay Unit, Bókay János Street 53-54, 1083, Budapest, Hungary
| | - Péter Krivácsy
- Pediatric Center, MTA Center of Excellence, Semmelweis University, Bókay Unit, Bókay János Street 53-54, 1083, Budapest, Hungary
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Zhang P, Zhu B, Wang L. Assessing differences among persistent, episodic, and non- high-need high-cost hospitalized children in China after categorization by an unsupervised learning algorithm. Arch Public Health 2024; 82:218. [PMID: 39568040 PMCID: PMC11577634 DOI: 10.1186/s13690-024-01442-x] [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: 07/17/2024] [Accepted: 11/05/2024] [Indexed: 11/22/2024] Open
Abstract
BACKGROUND High-need, high-cost (HNHC) patients are a major focus of international healthcare reform. However, research on HNHC children in China remains limited. This study aims to classify HNHC pediatric patients, analyze the differences among groups, and explore the factors influencing HNHC status. METHODS Data were obtained from a retrospective observational cohort of hospitalized children in Shanghai, China from 2017 to 2023. K-means clustering, one of the unsupervised learning algorithms, was employed to classify patients according to their HNHC status. Descriptive statistical analysis and the Kruskal-Wallis H test were used to describe and test the differences among different groups, with the logit regression models to analyze the predictors. RESULTS 688,131 hospitalized children were classified into three groups: 1,871 persistent HNHC, 32,539 episodic HNHC, and 653,721 non-HNHC. Significant differences were observed among these groups. Persistent HNHC patients have significantly higher costs and longer HNHC durations compared to episodic and non-HNHC patients, who were more likely to be aged 30 days to 1 year or 13-18 years, female with only one type of health insurance, and leukemia was the most prevalent and costly disease. They exhibited distinct healthcare utilization patterns, including emergency admissions, higher surgery rates, longer hospital stays, more frequent hospitalizations, and a preference for tertiary and specialized hospitals in city centers. Multiple influencing factors of persistent HNHC versus episodic HNHC and non-HNHC were identified. CONCLUSION This study provides valuable insights into the classification, characteristics, and influencing factors of persistent, episodic, and non-HNHC hospitalized children in China. Persistent HNHC patients warrant targeted interventions to improve health outcomes and reduce healthcare costs. Enhanced medical coverage for key diseases, high-quality healthcare services tailored to their needs, and early interventions are crucial.
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Affiliation(s)
- Peng Zhang
- School of Humanities, Shanghai Institute of Technology, Haiquan Road 100, Fengxian District, Shanghai, China
| | - Bifan Zhu
- Shanghai Health Development Research Center, Shanghai, 20040, China
| | - Linan Wang
- Shanghai Health Development Research Center, Shanghai, 20040, China.
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Korchinski I, Marquez C, McClymont E, Av-Gay G, Andrade J, Elwood C, Jassem A, Krajden M, Morshed M, Sadarangani M, Tanunliong G, Sekirov I, Money D. Maternal-infant transfer of SARS-CoV-2 antibodies following vaccination in pregnancy: A prospective cohort study. Vaccine 2024; 42:126123. [PMID: 38981741 DOI: 10.1016/j.vaccine.2024.07.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 04/29/2024] [Accepted: 07/05/2024] [Indexed: 07/11/2024]
Abstract
OBJECTIVES To measure and evaluate the impact of receiving severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines in pregnancy on immunoglobulin G (IgG) and immunoglobulin A (IgA) titres in maternal and infant samples. DESIGN Prospective cohort study. SETTING Tertiary obstetric centre. POPULATION OR SAMPLE 52 pregnant women who received one or more SARS-CoV-2 vaccine doses during pregnancy and their neonates. METHODS IgG and IgA concentrations against SARS-CoV-2 antigens were measured from samples collected at delivery and 4-6 weeks postpartum and compared using Spearman correlations. MAIN OUTCOME MEASURES Maternal and infant IgG and IgA titres in response to vaccination and infection in pregnancy. RESULTS In maternal serum collected at delivery, participants without evidence of prior infection who received 3 + doses of a SARS-CoV-2 vaccine had higher Anti-Spike (S) IgG geometric mean concentrations (log10 AU/mL)(GMC) than those who received 2 doses (3 + Doses = 5.00, 2 Doses = 4.60, p = 0.08). The differences in IgG Anti-S GMC were statistically significant in cord serum, and in postpartum samples of maternal serum, infant serum and breast milk (Cord GMCs: 3 + Doses = 5.32, 2 Doses = 4.98, p < 0.05; Postpartum maternal serum GMCs: 3 + Doses = 5.25, 2 Doses = 4.57, p < 0.001; Postpartum infant serum GMCs: 3 + Doses = 5.10, 2 Doses = 4.72, p = 0.03; Postpartum breast milk GMCs: 3 + Doses = 2.61, 2 Doses = 1.94, p < 0.0001). Among participants with 3 + Doses, those with evidence of SARS-CoV-2 infection had statistically significant higher anti-S IgG GMCs than those without prior infection (Maternal serum at delivery: SARS-CoV-2+=5.65, SARS-CoV-2-=5.00, p = 0.004; Cord: SARS-CoV-2+=5.68, SARS-CoV-2-=5.32, p = 0.02; Postpartum maternal serum: SARS-CoV-2+=5.66, SARS-CoV-2-=5.25, p < 0.001; postpartum infant serum: SARS-CoV-2+=5.50, SARS-CoV-2-=5.10, p = 0.003; Postpartum breast milk: SARS-COV-2+=3.25, SARS-COV-2-=2.61, p = 0.009). Significant positive correlations were found for anti-S IgG titres between paired maternal and infant samples at delivery and postpartum (Delivery: R = 0.91, p < 0.001; postpartum: R = 0.86, p < 0.001). CONCLUSIONS Receipt of a SARS-CoV-2 vaccine and SARS-CoV-2 infection elicit strong IgG and IgA antibody responses in pregnant women with evidence of transplacental transfer to the fetus.
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Affiliation(s)
- I Korchinski
- Women's Health Research Institute, Vancouver, Canada
| | - C Marquez
- British Columbia Center for Disease Control Public Health Laboratory, Vancouver, Canada
| | - E McClymont
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, Canada; Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - G Av-Gay
- Women's Health Research Institute, Vancouver, Canada; Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, Canada
| | - J Andrade
- Women's Health Research Institute, Vancouver, Canada
| | - C Elwood
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, Canada
| | - A Jassem
- British Columbia Center for Disease Control Public Health Laboratory, Vancouver, Canada; Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - M Krajden
- British Columbia Center for Disease Control Public Health Laboratory, Vancouver, Canada; Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - M Morshed
- British Columbia Center for Disease Control Public Health Laboratory, Vancouver, Canada; Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - M Sadarangani
- Department of Pediatrics, University of British Columbia, Vancouver, Canada; Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, Canada
| | - G Tanunliong
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - I Sekirov
- British Columbia Center for Disease Control Public Health Laboratory, Vancouver, Canada; Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - D Money
- Women's Health Research Institute, Vancouver, Canada; Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, Canada.
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Başbulut E, Bilgin M, Işler H, Şen A, Kılıç SS, Çubukçu M. Analysis of Measles and Rubella Immunoglobulin G Titers in COVID-19 Patients. Risk Manag Healthc Policy 2024; 17:2789-2801. [PMID: 39558910 PMCID: PMC11572050 DOI: 10.2147/rmhp.s472872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 11/05/2024] [Indexed: 11/20/2024] Open
Abstract
Background The objective of this study is to compare the measles immunoglobulin G (IgG) and rubella IgG levels in patient groups with mild and severe COVID-19 disease and reveal the possible relationship. Methods This study was conducted among COVID-19-confirmed patients over 18, under 65 years of age. This study involved 75 participants- divided into two groups. The first group usually comprised asymptomatic patients who did not require hospitalization (n=43), and the second group consisted of patients who had diffuse pneumonia on thoracic CT and required hospitalization (n=32). Results Anti-measles and anti-rubella IgG titers were detected to be higher in the group with severe disease compared to the group with mild disease (p=0.001 and p=0.001, respectively). The analyses were repeated by taking n=27 in Group 1 and n=27 in Group 2, which were similar in terms of age, gender and number. In the analysis performed without any age difference between the groups, no significant difference was found between the two groups in terms of Anti Measles IgG antibody titers (p=0.068). However, Anti Rubella antibody titers were found to be higher in the group with severe COVID-19 disease than in those with mild disease (p=0.03). Regardless of the severity of the disease, there was a positive correlation between Anti Rubella and Anti Measles IgG antibody titers and age (p=<0.001 Spearman's rho 0.517; p=0.008 Spearman's rho 0.304, respectively). Conclusion We believe that the pre-existing Anti-Rubella IgG antibodies in the patient may increase in parallel with the patient's viral load by recognizing the common macrodomain of SARS-CoV-2 and Rubella viruses. The common macrodomain of SARS-CoV-2 and Rubella viruses is also present in the attenuated rubella virus used in the MMR vaccine4. In this case, we predict that previously administered MMR vaccine may be protective for COVID-19 patients. disease compared to those with mild disease.
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Affiliation(s)
- Eşe Başbulut
- Department of Medical Microbiology, Samsun Training and Research Hospital, Samsun, Turkey
| | - Melek Bilgin
- Department of Medical Microbiology, Samsun Training and Research Hospital, Samsun, Turkey
| | - Hacer Işler
- Department of Medical Microbiology, Samsun Training and Research Hospital, Samsun, Turkey
| | - Ahmet Şen
- Department of Anesthesia and Reanimation, Trabzon Faculty of Medicine, Trabzon, Turkey
| | - Süleyman Sırrı Kılıç
- Department of Infectious Disease and Clinical Microbiology, Samsun Training and Research Hospital, Samsun, Turkey
| | - Mahcube Çubukçu
- Department of Family Medicine, Samsun University Faculty of Medicine, Samsun, Turkey
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Durá-Travé T, Gallinas-Victoriano F. COVID-19 in Children and Vitamin D. Int J Mol Sci 2024; 25:12205. [PMID: 39596272 PMCID: PMC11594876 DOI: 10.3390/ijms252212205] [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: 10/13/2024] [Revised: 11/11/2024] [Accepted: 11/13/2024] [Indexed: 11/28/2024] Open
Abstract
In December 2019, the so-called "coronavirus disease 2019" (COVID-19) began. This disease is characterized by heterogeneous clinical manifestations, ranging from an asymptomatic process to life-threatening conditions associated with a "cytokine storm". This article (narrative review) summarizes the epidemiologic characteristics and clinical manifestations of COVID-19 and multi-system inflammatory syndrome in children (MIS-C). The effect of the pandemic confinement on vitamin D status and the hypotheses proposed to explain the age-related difference in the severity of COVID-19 are discussed. The role of vitamin D as a critical regulator of both innate and adaptive immune responses and the COVID-19 cytokine storm is analyzed. Vitamin D and its links to both COVID-19 (low levels of vitamin D appear to worsen COVID-19 outcomes) and the cytokine storm (anti-inflammatory activity) are detailed. Finally, the efficacy of vitamin D supplementation in COVID-19 is evaluated, but the evidence supporting vitamin D supplementation as an adjuvant treatment for COVID-19 remains uncertain.
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Affiliation(s)
- Teodoro Durá-Travé
- Department of Pediatrics, School of Medicine, University of Navarra, 31008 Pamplona, Spain
- Navarrabiomed (Biomedical Research Center), 31008 Pamplona, Spain;
| | - Fidel Gallinas-Victoriano
- Navarrabiomed (Biomedical Research Center), 31008 Pamplona, Spain;
- Department of Pediatrics, Navarra Hospital Universitary, 31008 Pamplona, Spain
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Roshanzamir Z, Mohammadi F, Yadegar A, Naeini AM, Hojabri K, Shirzadi R. An Overview of Pediatric Pulmonary Complications During COVID-19 Pandemic: A Lesson for Future. Immun Inflamm Dis 2024; 12:e70049. [PMID: 39508631 PMCID: PMC11542302 DOI: 10.1002/iid3.70049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 09/22/2024] [Accepted: 10/08/2024] [Indexed: 11/15/2024] Open
Abstract
BACKGROUND The pediatric community is considered a suitable target for controlling the spread and mortality of viral diseases. In late December 2019, a respiratory disease due to the novel coronavirus, later COVID-19, hit the globe. The COVID-19 global disruption had direct and indirect impacts on different aspects of child health. Therefore, surveillance, preventive approaches, and treatment plans for children came into the spotlight. OBJECTIVE This study aims to discuss the clinical pictures as well as laboratory and radiological findings of the infected children during the COVID-19 pandemic. The focus of this study is to express the clinical manifestations of respiratory disease in pediatric SARS-CoV-2, available therapeutic options, vaccine recommendations, and long COVID sequelae in affected children. This review could serve as a hint for upcoming challenges in pediatric care during future pandemics. RESULTS The clinical presentation of COVID-19 in pediatrics can range from mild pulmonary disease to acute respiratory distress syndrome (ARDS). Supportive care is a crucial component of the management of pediatric COVID-19. However, the importance of specializing in how to treat patients with more severe conditions cannot be overstated. Additionally, clinicians must consider prevention strategies as well as potential complications. CONCLUSION Although the infected patients are dipping day by day, there is a lack of clinical guidelines for pediatric SARS-CoV-2-associated pulmonary diseases. Understanding of the physicians about all aspects of pediatric care during the COVID-19 pandemic could lead to enhanced quality of future patient care and safety, reduced costs of health policies, and surveil the risk that patients with respiratory viruses can expose to society.
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Affiliation(s)
- Zahra Roshanzamir
- Pediatric Respiratory and Sleep Medicine Research CenterShiraz University of Medical SciencesShirazIran
| | - Fatemeh Mohammadi
- Pediatric Respiratory and Sleep Medicine Research Center, Children's Medical Center, Tehran University of Medical SciencesTehranIran
| | - Amirhossein Yadegar
- Pediatric Respiratory and Sleep Medicine Research Center, Children's Medical Center, Tehran University of Medical SciencesTehranIran
| | | | - Katayoon Hojabri
- Pediatric Intensive Care Unit, Shiraz University of Medical SciencesShirazIran
| | - Rohola Shirzadi
- Pediatric Respiratory and Sleep Medicine Research Center, Children's Medical Center, Tehran University of Medical SciencesTehranIran
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Puthusseril J, Lowes A, Heksch R. New Onset Diabetes Mellitus With COVID-19 Infection in a 5-Month Old. Clin Pediatr (Phila) 2024; 63:1489-1493. [PMID: 38205740 PMCID: PMC11462772 DOI: 10.1177/00099228231224845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Affiliation(s)
- Jubel Puthusseril
- Graduate Medical Education, Department of Pediatrics, Akron Children’s Hospital, Akron, OH, USA
| | - Alicia Lowes
- Division of Pediatric Endocrinology, Akron Children’s Hospital, Akron, OH, USA
| | - Ryan Heksch
- Graduate Medical Education, Department of Pediatrics, Akron Children’s Hospital, Akron, OH, USA
- Division of Pediatric Endocrinology, Akron Children’s Hospital, Akron, OH, USA
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Mirkarimi M, Heidari S, Shamsizadeh A, Tahouri K, Alisamir M, Fathi M, Mohammadi S. Clinical and Epidemiological Features of Pediatric COVID-19: A Retrospective Study. Health Sci Rep 2024; 7:e70181. [PMID: 39512246 PMCID: PMC11540839 DOI: 10.1002/hsr2.70181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 10/05/2024] [Accepted: 10/21/2024] [Indexed: 11/15/2024] Open
Abstract
Background and Aims There is a demand for additional data regarding the impact of coronavirus disease 2019 (COVID-19) on the pediatric population. This study sought to determine the clinical and epidemiological features of pediatric COVID-19 in Iran. Methods A retrospective study was performed to assess medical records of children with COVID-19 admitted to Abuzar Hospital in Ahvaz (Iran). Their clinical and demographic data were recorded. Results In this study, 600 medical records of pediatric COVID-19 patients were evaluated. Over 50% of them were boys. Mild, moderate, and severe manifestations of COVID-19 were identified in 250, 200, and 150 children, respectively. Patients with severe or moderate COVID-19 had substantially higher levels of various inflammatory markers (C-reactive protein (CRP), fibrinogen, and d-dimer), alanine transaminase (ALT), creatine kinase (CPK), blood urea nitrogen (BUN), neutrophils, lactate dehydrogenase (LDH), aspartate aminotransferase (AST), creatinine (Cr), bilirubin, and gamma-glutamyl transferase (GGT) compared to children with mild COVID-19 (p < 0.001); they also had lower levels of lymphocytes, hemoglobin (Hb), and vitamin D than patients with mild COVID-19 (p < 0.001). In addition, children with severe or moderate COVID-19 had a notably higher incidence of fever or dry cough and longer hospital stays than those with mild COVID-19 (p < 0.001). The prevalence of malnutrition and anemia in patients was 50.6% and 31.5%, respectively. A significant proportion of children who were underweight and stunted experienced moderate to severe COVID-19. Furthermore, there was a considerably higher prevalence of malnutrition, anemia, and vitamin D insufficiency, or deficiency in children with moderate-to-severe COVID-19 compared to patients with mild COVID-19 (p < 0.001). Conclusion The outcomes of this study revealed a significantly higher prevalence of malnutrition, anemia, vitamin D insufficiency or deficiency, elevated liver and kidney function test results, and increased inflammatory markers in children with moderate to severe COVID-19 compared to those with mild COVID-19.
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Affiliation(s)
- Mohammadreza Mirkarimi
- Department of Pediatrics, Faculty of MedicineAhvaz Jundishapur University of Medical SciencesAhvazIran
| | - Solmaz Heidari
- Department of Pediatrics, Faculty of MedicineAhvaz Jundishapur University of Medical SciencesAhvazIran
| | - Ahmad Shamsizadeh
- Department of Pediatrics, Faculty of MedicineAhvaz Jundishapur University of Medical SciencesAhvazIran
| | - Kia Tahouri
- Department of Pediatrics, Faculty of MedicineAhvaz Jundishapur University of Medical SciencesAhvazIran
| | - Mohsen Alisamir
- Department of Pediatrics, Faculty of MedicineAhvaz Jundishapur University of Medical SciencesAhvazIran
| | - Mohammadreza Fathi
- Department of Pediatrics, Faculty of MedicineAhvaz Jundishapur University of Medical SciencesAhvazIran
| | - Shooka Mohammadi
- Department of Pediatrics, Faculty of MedicineAhvaz Jundishapur University of Medical SciencesAhvazIran
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Santella B, Aliberti SM, Fortino L, Donato A, Andretta V, Santoro E, Franci G, Capunzo M, Boccia G. Age Differences and Prevalence of Comorbidities for Death and Survival in Patients with COVID-19: A Single-Center Observational Study in a Region of Southern Italy. Life (Basel) 2024; 14:1376. [PMID: 39598175 PMCID: PMC11595941 DOI: 10.3390/life14111376] [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: 09/23/2024] [Revised: 10/21/2024] [Accepted: 10/24/2024] [Indexed: 11/29/2024] Open
Abstract
The SARS-CoV-2 outbreak has resulted in a considerable number of deaths worldwide. The virus damages the pulmonary artery endothelium, leading to a condition known as microvascular pulmonary inflammatory thrombotic syndrome (MPITS), which can be fatal and cause multiple organ failure. The presence of preexisting comorbidities has been shown to significantly impact the severity and prognosis of patients with SARS-CoV-2 infection. The objective of this study was to compare the age groups of patients with coronavirus disease 2019 (COVID-19) and to identify the prevalence of comorbidities associated with death and survival in an area of southern Italy. The data set consisted of 1985 patients with confirmed cases of SARS-CoV-2 infection who were admitted to the A.O.U. San Giovanni di Dio e Ruggi d'Aragona Hospital in Salerno between January 2021 and December 2022. The results were presented for the overall population and stratified by outcome and age group. All analyses were performed using the XLSTAT (Lumivero, 2024, Paris, France) and STATA software (release 16.1, StataCorp LLG, College Station, TX, USA, 2019) packages. In the study, population, 636 cases (32%) resulted in death, with a higher prevalence in the 60-79 age group, followed by the ≥80 and 30-59 age groups. The most prevalent diseases among deceased and surviving patients with confirmed cases of SARS-CoV-2 infection were those affecting the circulatory system (61.5% vs. 55.5%), the respiratory system (55.8% vs. 26.2%), and the metabolic system (25.9% vs. 25.4%). In patients aged 30-79, respiratory diseases were the primary cause of mortality, whereas in those aged ≥80, circulatory system diseases were more prevalent. Among survivors, cardiovascular diseases were the most common comorbidities across all age groups, followed by respiratory diseases and endocrine, metabolic, and immune disorders. Moreover, these comorbidities were associated with an elevated risk of mortality. The study emphasizes the substantial influence of age and comorbidities on the mortality associated with SARS-CoV-2 infection. These findings highlight the necessity for targeted interventions to manage comorbid conditions in patients with SARS-CoV-2 infection, particularly in older adults.
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Affiliation(s)
- Biagio Santella
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Salerno, Italy; (B.S.); (S.M.A.); (L.F.); (A.D.); (V.A.); (E.S.); (G.F.); (M.C.)
| | - Silvana Mirella Aliberti
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Salerno, Italy; (B.S.); (S.M.A.); (L.F.); (A.D.); (V.A.); (E.S.); (G.F.); (M.C.)
| | - Luigi Fortino
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Salerno, Italy; (B.S.); (S.M.A.); (L.F.); (A.D.); (V.A.); (E.S.); (G.F.); (M.C.)
| | - Antonio Donato
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Salerno, Italy; (B.S.); (S.M.A.); (L.F.); (A.D.); (V.A.); (E.S.); (G.F.); (M.C.)
| | - Vincenzo Andretta
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Salerno, Italy; (B.S.); (S.M.A.); (L.F.); (A.D.); (V.A.); (E.S.); (G.F.); (M.C.)
- DAI Department of Health Hygiene and Evaluative Medicine, A.O.U. San Giovanni di Dio e Ruggi d’Aragona, 84131 Salerno, Italy
| | - Emanuela Santoro
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Salerno, Italy; (B.S.); (S.M.A.); (L.F.); (A.D.); (V.A.); (E.S.); (G.F.); (M.C.)
| | - Gianluigi Franci
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Salerno, Italy; (B.S.); (S.M.A.); (L.F.); (A.D.); (V.A.); (E.S.); (G.F.); (M.C.)
- DAI Department of Health Hygiene and Evaluative Medicine, A.O.U. San Giovanni di Dio e Ruggi d’Aragona, 84131 Salerno, Italy
| | - Mario Capunzo
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Salerno, Italy; (B.S.); (S.M.A.); (L.F.); (A.D.); (V.A.); (E.S.); (G.F.); (M.C.)
- DAI Department of Health Hygiene and Evaluative Medicine, A.O.U. San Giovanni di Dio e Ruggi d’Aragona, 84131 Salerno, Italy
| | - Giovanni Boccia
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Salerno, Italy; (B.S.); (S.M.A.); (L.F.); (A.D.); (V.A.); (E.S.); (G.F.); (M.C.)
- DAI Department of Health Hygiene and Evaluative Medicine, A.O.U. San Giovanni di Dio e Ruggi d’Aragona, 84131 Salerno, Italy
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