Data on mortality and on excess of mortality during pandemic are critical to be investigated as there is an agreement on their role in the understanding of the dynamic of pandemic. The paper shows differences in Italy: while some regions showed an excess of mortality, other regions did not show differences. The paper discusses possible reasons for the excess of mortality (high pressure on Italian public health system during the acute phase of pandemic could have had the indirect effect of increase other causes of death, like the ones related to other disorders or diseases for which individuals had difficulty to access to care during the more critical phases of pandemic. From an intervention perspective, it proposes some practical suggestions for planning and implementing specific interventions during current and future steps of the COVID-19 Pandemic, aiming to prevent excess of deaths.
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Affiliation(s)
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1
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Chan OW, Lee EP, Chou CC, Lai SH, Chung HT, Lee J, Lin JJ, Hsieh KS, Hsia SH. In-hospital care of children with COVID-19. Pediatr Neonatol 2024; 65:2-10. [PMID: 37989708 DOI: 10.1016/j.pedneo.2023.02.009] [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: 06/09/2022] [Revised: 01/18/2023] [Accepted: 02/01/2023] [Indexed: 11/23/2023] Open
Abstract
Children have been reported to be less affected and to have milder severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection than adults during the coronavirus disease 2019 (COVID-19) pandemic. However, children, and particularly those with underlying disorders, are still likely to develop critical illnesses. In the case of SARS-CoV-2 infection, most previous studies have focused on adult patients. To aid in the knowledge of in-hospital care of children with COVID-19, this study presents an expert review of the literature, including the management of respiratory distress or failure, extracorporeal membrane oxygenation (ECMO), multisystem inflammatory syndrome in children (MIS-C), hemodynamic and other organ support, pharmaceutical therapies (anti-viral drugs, anti-inflammatory or antithrombotic therapies) and management of cardiopulmonary arrest.
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Affiliation(s)
- Oi-Wa Chan
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - En-Pei Lee
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Cheng-Che Chou
- Division of Paediatric Neurology, Taipei Medical University Shuang Ho Hospital, New Taipei City, Taiwan
| | - Shen-Hao Lai
- Chang Gung University College of Medicine, Taoyuan, Taiwan; Division of Pediatric Pulmonology, Department of Pediatrics, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Hung-Tao Chung
- Chang Gung University College of Medicine, Taoyuan, Taiwan; Division of Pediatric Cardiovascular Internal Medicine, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, China
| | - Jung Lee
- Chang Gung University College of Medicine, Taoyuan, Taiwan; Division of Pediatric General Medicine, Department of Pediatrics, Chang Gung Memorial Hospital at Linko, Kweishan, Taoyuan, Taiwan, ROC
| | - Jainn-Jim Lin
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Kai-Sheng Hsieh
- Center of Structure and Congenital Heart Disease/Ultrasound and Department of Cardiology, Children's Hospital, China Medical University, Taichung, Taiwan; Department of Pediatrics and Structural, Congenital Heart and Echocardiography Center, School of Medicine, China Medical University, Taichung, Taiwan.
| | - Shao-Hsuan Hsia
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; Chang Gung University College of Medicine, Taoyuan, Taiwan.
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2
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Sun J, Yang ZD, Xie X, Li L, Zeng HS, Gong B, Xu JQ, Wu JH, Qu BB, Song GW. Clinical application of SARS-CoV-2 antibody detection and monoclonal antibody therapies against COVID-19. World J Clin Cases 2023; 11:2168-2180. [PMID: 37122515 PMCID: PMC10131020 DOI: 10.12998/wjcc.v11.i10.2168] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/17/2023] [Accepted: 03/10/2023] [Indexed: 03/30/2023] Open
Abstract
The purpose of this study was to investigate the clinical application of severe acute respiratory distress syndrome coronavirus-2 (SARS-CoV-2) specific antibody detection and anti-SARS-CoV-2 specific monoclonal antibodies (mAbs) in the treatment of coronavirus infectious disease 2019 (COVID-19). The dynamic changes of SARS-CoV-2 specific antibodies during COVID-19 were studied. Immunoglobulin M (IgM) appeared earlier and lasted for a short time, while immunoglobulin G (IgG) appeared later and lasted longer. IgM tests can be used for early diagnosis of COVID-19, and IgG tests can be used for late diagnosis of COVID-19 and identification of asymptomatic infected persons. The combination of antibody testing and nucleic acid testing, which complement each other, can improve the diagnosis rate of COVID-19. Monoclonal anti-SARS-CoV-2 specific antibodies can be used to treat hospitalized severe and critically ill patients and non-hospitalized mild to moderate COVID-19 patients. COVID-19 convalescent plasma, highly concentrated immunoglobulin, and anti-SARS-CoV-2 specific mAbs are examples of anti-SARS-CoV-2 antibody products. Due to the continuous emergence of mutated strains of the novel coronavirus, especially omicron, its immune escape ability and infectivity are enhanced, making the effects of authorized products reduced or invalid. Therefore, the optimal application of anti-SARS-CoV-2 antibody products (especially anti-SARS-CoV-2 specific mAbs) is more effective in the treatment of COVID-19 and more conducive to patient recovery.
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Affiliation(s)
- Jin Sun
- Medical Innovation Research Office, Sinopharm Gezhouba Central Hospital, Third Clinical Medical College of Three Gorges University, Yichang 443002, Hubei Province, China
| | - Zhen-Dong Yang
- Department of Respiratory, Beijing Jindu Children Hospital, Beijing 102208, China
- Innovative Medicine Working Committee of the Chinese Society of Water Resources and Electric Power Medical Science and Technology, Beijing 100053, China
- Department of Pediatrics, Sinopharm Gezhouba Central Hospital, Third Clinical Medical College of Three Gorges University, Yichang 443002, Hubei Province, China
| | - Xiong Xie
- Department of Pediatrics, Sinopharm Gezhouba Central Hospital, Third Clinical Medical College of Three Gorges University, Yichang 443002, Hubei Province, China
| | - Li Li
- Department of Intensive Care, First Clinical Medical College of Three Gorges University, Yichang 443000, Hubei Province, China
| | - Hua-Song Zeng
- Department of Allergy Immunology and Rheumatology, Guangzhou Children's Hospital, Women's and Children's Medical Center Affiliated with Guangzhou Medical University, Guangzhou 510000, Guangdong Province, China
| | - Bo Gong
- Central Laboratory, Shanghai Changning District Maternal and Child Health, Maternal and Child Health Hospital Affiliated with Shanghai East China Normal University, Shanghai 210000, China
| | - Jian-Qiang Xu
- Department of Respiratory and Critical Care Medicine, Sinopharm Gezhouba Central Hospital, Third Clinical Medical College of Three Gorges University, Yichang 443002, Hubei Province, China
| | - Ji-Hong Wu
- School of Clinical Medicine, Beijing Tsinghua Chang Gung Hospital Affiliated to Tsinghua University, Beijing 102218, China
| | - Bei-Bei Qu
- Medical Innovation Research Office, Sinopharm Gezhouba Central Hospital, Third Clinical Medical College of Three Gorges University, Yichang 443002, Hubei Province, China
| | - Guo-Wei Song
- Department of Emergency, Children's Hospital Affiliated with Beijing Capital Institute of Pediatrics, Beijing 100020, China
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3
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Clinical and Cytokine Profile of Children With COVID-19: A Report From Turkey. Cureus 2023; 15:e37139. [PMID: 37034144 PMCID: PMC10078166 DOI: 10.7759/cureus.37139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2023] [Indexed: 04/07/2023] Open
Abstract
Background We aimed to analyze the expression of infection-related biomarkers and inflammatory cytokines in laboratory-confirmed cases and compare the differences between clinically severe and non-severe ones. Method We randomly selected 35 patients who were hospitalized with the diagnosis of coronavirus disease 2019 (COVID-19). Blood serum was obtained at the time of admission to the hospital, on the third to the fifth day, and at the time of discharge. Result The median age of our patients was 56.5±69.7 months (range: 1-205 months). The mean pro-B-type natriuretic peptide (pro-BNP) was significantly higher at the time of admission than on the third to the fifth day of illness. The mean pro-B-type natriuretic peptide levels at three time points were significantly higher in patients with severe cases than in mild-moderate cases. However, there was no significant difference between the clinical severity with regard to the cytokine levels at disease onset and recovery. Conclusion In the study, it was shown that cytokines play an important role in the pathogenesis of COVID-19. Therefore, it may be beneficial to use agents such as tocilizumab in the treatment.
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4
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Cousin L, Roberts S, Brownstein NC, Whiting J, Kasting ML, Head KJ, Vadaparampil ST, Giuliano AR, Gwede CK, Meade CD, Christy SM. Factors associated with parental COVID-19 vaccine attitudes and intentions among a national sample of United States adults ages 18-45. J Pediatr Nurs 2023; 69:108-115. [PMID: 36716520 PMCID: PMC9852321 DOI: 10.1016/j.pedn.2023.01.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 11/27/2022] [Accepted: 01/17/2023] [Indexed: 01/21/2023]
Abstract
PURPOSE This study explored factors associated with parents' attitudes and intentions to seek information about the COVID-19 vaccine for their children (ages 0-18) and intentions to vaccinate their age-eligible children. DESIGN AND METHODS As part of an anonymous online cross-sectional survey, parents' vaccine attitudes, COVID-19 vaccine intentions for their children, health literacy, health numeracy, and sociodemographic variables were assessed. Multivariable ordered logistic regression models identified factors associated with parents' COVID-19 vaccine intentions for their children. RESULTS Parents/guardians (n = 963) were mostly White (82.3%), insured (88.0%), and college graduates (57.3%). Men reported higher intentions than women to seek information about the COVID-19 vaccine for their children (p = 0.003) and higher intentions to vaccinate their children (p = 0.049). Parental characteristics associated with increased intentions to have their children vaccinated included higher educational attainment (p < 0.001), more positive general vaccine attitudes (p < 0.001), preference for health information in a language other than English (p = 0.006), higher income (p = 0.048), having health insurance (p = 0.05), health literacy (p = 0.024), and health numeracy (p = 0.049). CONCLUSIONS Multiple sociodemographic characteristics including male gender, higher health literacy and numeracy, and language preference are noteworthy factors associated with parental COVID-19 vaccine intentions that could inform the planning and implementation of educational interventions. PRACTICE IMPLICATIONS Nurses are important sources of trusted information and play an important role in parent/family health education and in understanding myriad factors that may improve attitudes and enhance readiness toward vaccine uptake. Our findings emphasize the potential value of examining tailored/targeted COVID-19 vaccine education according to key influencing factors.
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Affiliation(s)
- Lakeshia Cousin
- College of Nursing, University of Florida, Gainesville, FL, United States of America
| | - Stephanie Roberts
- Morsani College of Medicine, University of South Florida, Tampa, FL, United States of America
| | - Naomi C Brownstein
- Dept. of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL, United States of America
| | - Junmin Whiting
- Dept. of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL, United States of America
| | - Monica L Kasting
- Dept. of Public Health, Purdue University, West Lafayette, IN, United States of America; Cancer Prevention and Control Program, Indiana University Simon Comprehensive Cancer Center, Indianapolis, IN, United States of America
| | - Katharine J Head
- Dept. of Communication Studies, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States of America
| | - Susan T Vadaparampil
- Morsani College of Medicine, University of South Florida, Tampa, FL, United States of America; Dept. of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States of America; Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL, United States of America
| | - Anna R Giuliano
- Morsani College of Medicine, University of South Florida, Tampa, FL, United States of America; Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL, United States of America; Dept. of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, United States of America
| | - Clement K Gwede
- Morsani College of Medicine, University of South Florida, Tampa, FL, United States of America; Dept. of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States of America; Dept. of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, FL, United States of America
| | - Cathy D Meade
- Morsani College of Medicine, University of South Florida, Tampa, FL, United States of America; Dept. of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States of America; Dept. of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, FL, United States of America
| | - Shannon M Christy
- Morsani College of Medicine, University of South Florida, Tampa, FL, United States of America; Dept. of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States of America; Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL, United States of America; Dept. of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, FL, United States of America.
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5
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Albavera-Hernández C, Rodríguez-Hernández JM, Piñeros-Garzón FS, Montoya-Sanabria SM. The challenge of asymptomatic carriers of COVID-19: A rapid review of literature. Rev Salud Publica (Bogota) 2023; 22:649-657. [PMID: 36753084 DOI: 10.15446/rsap.v22n6.91181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 11/10/2020] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES To describe the epidemiological and sociodemographic characteristics of asymptomatic carriers reported in the literature, and to review the strategies used for diagnosis and control. METHODS Systematic literature review approach. As inclusion criteria, all studies published between January 1 and June 26, 2020, conducted in humans, that reported people who remained asymptomatic of COVID-19. Descriptors were adapted to the interfaces of eight bibliographic databases were configured: PubMed, Ovid, SciELO, Ebsco, Scopus, LILACS, Epistemonikos and Embase. RESULTS About 45% of the articles reported adult population, thirteen reported mixed population (adult and pediatric). 3 525 asymptomatic people were reported, with an average of 37,1 years [0.5-82 years]. Although the effectiveness of the control and prevention measures was not reported, the identification, isolation and follow-up of contacts stands out as a potential effective mechanism to prevent the transmission. CONCLUSIONS The use of this information could be relevant to guide evidence-based public health policies and the protection of populations and the improvement of health care that contributes to stopping this pandemic.
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Affiliation(s)
- Cidronio Albavera-Hernández
- CA: MD. Family Medicine Specialist. M.Sc.; D.Sc. Epidemiology. Mexican Institute of Social Security. Regional General Hospital with Family Medicine No.1. Cuernavaca, Mexico.
| | - Jorge M Rodríguez-Hernández
- JR: MD. M.Sc.; D.Sc. Epidemiology. Institute of Public Health. Pontificia Universidad Javeriana. Bogotá, Colombia.
| | | | - Sandra M Montoya-Sanabria
- SM: RN. M.Sc.; Ph.D.(c). Public Health. Institute of Public Health. Pontificia Universidad Javeriana. Bogotá, Colombia.
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Mohammadi M, Bid-Hendi S, Baghershiroodi M, Chehrazi M, Yahyapour Y, Gouranourimi A, Sadeghi F. Detection of human adenovirus among Iranian pediatric hospitalized patients suspected of COVID-19: epidemiology and comparison of clinical features. LE INFEZIONI IN MEDICINA 2022; 30:563-569. [PMID: 36482963 PMCID: PMC9715001 DOI: 10.53854/liim-3004-11] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 10/26/2022] [Indexed: 06/17/2023]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children typically results in similar symptoms with other viral respiratory agents including human adenoviruses (HAdVs). Mixed HAdV and SARS-CoV-2 infection (co-infection) in children might result in enhanced or reduced disease severity compared with single infections. The present study aims to investigate the rate of SARS-CoV2 and HAdV infection and also their coinfection and compare the two infections regarding their laboratory and clinical characteristics at hospital admission. A total of 360 combined oropharyngeal and nasopharyngeal swab samples from hospitalized children were examined by real-time PCR for the existence of the SARS-CoV-2 and HAdVs. The symptoms, the clinical characteristics and laboratory findings were retrieved and compared in SARS-CoV-2 and HAdVs positive cases. Of the total 360 suspected COVID-19 hospitalized children, 45 (12.5%) and 19 (5.3%) specimens were PCR-positive for SARS-CoV-2 and HAdV respectively. SARS-CoV-2 and HAdV co-infection was detected in 4 cases (1.1%). Regarding symptoms at hospital admission, fever in SARS-CoV-2 positive group was significantly higher than that in HAdV positive group [34 (85%) vs. 7 (46.7%), p = 0.012]. However, percentages of cases with sore throat, headache, fatigue, lymphadenopathy and conjunctivitis in HAdV positive group were significantly higher than those in SARS-CoV-2 positive group. SARS-CoV-2 and HAdV co-infected children showed mild respiratory symptoms. The present study revealed that SARS-CoV-2 positive children often appear to have a milder clinical course than children with respiratory HAdV infection and children co-infected with SARSCoV-2 and HAdV had less-severe disease on presentation.
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Affiliation(s)
- Mohsen Mohammadi
- Non-Communicable Pediatric Research Center, Babol University of Medical Sciences, Babol,
Iran
| | - Shadi Bid-Hendi
- Student Research Committee, Babol University of Medical Sciences, Babol,
Iran
| | - Mahnaz Baghershiroodi
- Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol,
Iran
| | - Mohammad Chehrazi
- Department of Biostatistics and Epidemiology, School of Public Health, Babol University of Medical Sciences, Babol,
Iran
| | - Yousef Yahyapour
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol,
Iran
| | - Azin Gouranourimi
- Student Research Committee, Babol University of Medical Sciences, Babol,
Iran
| | - Farzin Sadeghi
- Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol,
Iran
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7
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Iervasi E, Zarcone D, Saverino D. COVID-19: why did Italy decide to keep schools closed? Minerva Pediatr (Torino) 2022; 74:806-808. [PMID: 33820404 DOI: 10.23736/s2724-5276.21.05897-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- Erika Iervasi
- Department of Experimental Medicine, University of Genoa, Genoa, Italy
| | - Daniele Zarcone
- Department of Experimental Medicine, University of Genoa, Genoa, Italy
| | - Daniele Saverino
- Department of Experimental Medicine, University of Genoa, Genoa, Italy - .,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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8
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Pasaribu AP, Saragih RH, Fahmi F, Pasaribu S. Transmission and Profile of COVID-19 in Children in North Sumatera, Indonesia. ARCHIVES OF IRANIAN MEDICINE 2022; 25:737-741. [PMID: 37543898 PMCID: PMC10685854 DOI: 10.34172/aim.2022.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 12/07/2021] [Indexed: 08/08/2023]
Abstract
BACKGROUND In December 2019, a cluster of viral pneumonia cases, later identified as coronavirus disease 2019 (COVID-19), was first reported in Wuhan, China, and then continued to spread to other parts of the world. COVID-19 is thought to be more prevalent in adults than children; therefore, information about COVID-19 burden and characteristics in children is lacking. METHODS We gathered data on the profile and transmission in children with COVID-19 from data collected by the North Sumatera Provincial Health Office team. Data were presented as mean±SD and percentage. Statistical analysis was performed using STATA version 15.0. RESULTS From April to October 2020, there were 1125 confirmed COVID-19 cases in children in North Sumatera, representing approximately 8.9% of all cases. Death occurred in 0.62% of the patients, and the children who died had underlying diseases. Four major clusters of COVID-19 infection in children were found in three Islamic boarding schools and one refugee shelter. CONCLUSION A high number of children in North Sumatera were affected by COVID-19, and mortality was found to be higher in children with underlying diseases. Major clusters were found in places with prolonged and repeated activities in close contact, such as boarding schools and a refugee shelter.
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Affiliation(s)
- Ayodhia Pitaloka Pasaribu
- Department of Child Health, Medical Faculty, Universitas Sumatera Utara, Medan, Indonesia
- Emerging Infectious Diseases Team, North Sumatera COVID-19 Task Force, Medan, Indonesia
| | - Restuti Hidayani Saragih
- Emerging Infectious Diseases Team, North Sumatera COVID-19 Task Force, Medan, Indonesia
- Department of Internal Medicine, Medical Faculty, Universitas Sumatera Utara, Medan, Indonesia
| | - Fahmi Fahmi
- Department of Electrical Engineering, Engineering Faculty, Universitas Sumatera Utara, Medan, Indonesia
| | - Syahril Pasaribu
- Department of Child Health, Medical Faculty, Universitas Sumatera Utara, Medan, Indonesia
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9
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Goswami GG, Labib T. Modeling COVID-19 Transmission Dynamics: A Bibliometric Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14143. [PMID: 36361019 PMCID: PMC9655715 DOI: 10.3390/ijerph192114143] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 10/15/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
A good amount of research has evolved just in three years in COVID-19 transmission, mortality, vaccination, and some socioeconomic studies. A few bibliometric reviews have already been performed in the literature, especially on the broad theme of COVID-19, without any particular area such as transmission, mortality, or vaccination. This paper fills this gap by conducting a bibliometric review on COVID-19 transmission as the first of its kind. The main aim of this study is to conduct a bibliometric review of the literature in the area of COVID-19 transmission dynamics. We have conducted bibliometric analysis using descriptive and network analysis methods to review the literature in this area using RStudio, Openrefine, VOSviewer, and Tableau. We reviewed 1103 articles published in 2020-2022. The result identified the top authors, top disciplines, research patterns, and hotspots and gave us clear directions for classifying research topics in this area. New research areas are rapidly emerging in this area, which needs constant observation by researchers to combat this global epidemic.
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10
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Concas G, Barone M, Francavilla R, Cristofori F, Dargenio VN, Giorgio R, Dargenio C, Fanos V, Marcialis MA. Twelve Months with COVID-19: What Gastroenterologists Need to Know. Dig Dis Sci 2022; 67:2771-2791. [PMID: 34333726 PMCID: PMC8325547 DOI: 10.1007/s10620-021-07158-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 07/06/2021] [Indexed: 02/07/2023]
Abstract
Corona virus disease-19 (COVID-19) is the latest global pandemic. COVID-19 is mainly transmitted through respiratory droplets and, apart from respiratory symptoms, patients often present with gastrointestinal symptoms and liver involvement. Given the high percentage of COVID-19 patients that present with gastrointestinal symptoms (GIS), in this review, we report a practical up-to-date reference for the physician in their clinical practice with patients affected by chronic gastrointestinal (GI) diseases (inflammatory bowel disease, coeliac disease, chronic liver disease) at the time of COVID-19. First, we summarised data on the origin and pathogenetic mechanism of SARS-CoV-2. Then, we performed a literature search up to December 2020 examining clinical manifestations of GI involvement. Next, we illustrated and summarised the most recent guidelines on how to adhere to GI procedures (endoscopy, liver biopsy, faecal transplantation), maintaining social distance and how to deal with immunosuppressive treatment. Finally, we focussed on some special conditions such as faecal-oral transmission and gut microbiota. The rapid accumulation of information relating to this condition makes it particularly essential to revise the literature to take account of the most recent publications for medical consultation and patient care.
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Affiliation(s)
- Giulia Concas
- School of Paediatrics, University of Cagliari, 09124 Cagliari, Italy
| | - Michele Barone
- Gastroenterology Unit, Department of Emergency and Organ Transplantation, University of Bari, University Hospital “Policlinico”, Piazza G. Cesare 11, 70124 Bari, Italy
| | - Ruggiero Francavilla
- Department of Biomedical Science and Human Oncology, Children’s Hospital “Giovanni XXIII”, University of Bari, 70126 Bari, Italy
| | - Fernanda Cristofori
- Department of Biomedical Science and Human Oncology, Children’s Hospital “Giovanni XXIII”, University of Bari, 70126 Bari, Italy
| | - Vanessa Nadia Dargenio
- Department of Biomedical Science and Human Oncology, Children’s Hospital “Giovanni XXIII”, University of Bari, 70126 Bari, Italy
| | - Rossella Giorgio
- Department of Biomedical Science and Human Oncology, Children’s Hospital “Giovanni XXIII”, University of Bari, 70126 Bari, Italy
| | - Costantino Dargenio
- Department of Biomedical Science and Human Oncology, Children’s Hospital “Giovanni XXIII”, University of Bari, 70126 Bari, Italy
| | - Vassilios Fanos
- Neonatal Intensive Care Unit, Azienda Ospedaliero Universitaria, University of Cagliari, Cagliari, 09124 Cagliari, Italy
| | - Maria Antonietta Marcialis
- Neonatal Intensive Care Unit, Azienda Ospedaliero Universitaria, University of Cagliari, Cagliari, 09124 Cagliari, Italy
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11
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Chu DT, Singh V, Vu Ngoc SM, Nguyen TL, Barceló D. Transmission of SARS-CoV-2 infections and exposure in surfaces, points and wastewaters: A global one health perspective. CASE STUDIES IN CHEMICAL AND ENVIRONMENTAL ENGINEERING 2022; 5:100184. [PMID: 37520285 PMCID: PMC8785403 DOI: 10.1016/j.cscee.2022.100184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 01/20/2022] [Accepted: 01/22/2022] [Indexed: 05/06/2023]
Abstract
The persistence of SARS-CoV-2 or its RNA on surfaces, points, or wastewaters may increase the risk of transmission of this virus. Therefore, we conducted this review to discuss the places and surfaces with the highest potential for infection and spread of the SARS-CoV-2 virus. Several common and public areas, hospitals, elevators, public transport, local markets, and surfaces such as public toilets, door handles, untreated and treated wastewaters, wastewater plants, and public washrooms are also considered major points for spreading of SARS-CoV-2. Highly contaminated surfaces or places often have materials or contain items made of materials on which the SARS-CoV-2 virus can persist (e.g., metal, wood, and plastic). For example, SARS-CoV-2 can exist up to 4 days on doorknobs made by those materials. For public places such as public transports, elevators, and local markets, crowding and enclosed spaces are major source for transmission. Several measures such as using copper alloy surfaces instead of metal surfaces, disinfectants, and suitable personal protective equipment have been suggested. Our research could be the basis to help develop studies on the existence and transmissibility of SARS-CoV-2 as well as its RNA to take measures to prevent and limit the harmful effects of COVID-19 pandemic.
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Affiliation(s)
- Dinh-Toi Chu
- Center for Biomedicine and Community Health, International School, Vietnam National University, Hanoi, Viet Nam
- Department of Natural Science and Technology, International School, Vietnam National University, Hanoi, Viet Nam
| | - Vijai Singh
- Department of Biosciences, School of Science, Indrashil University, Rajpur, Mehsana, 382715, Gujarat, India
| | - Suong-Mai Vu Ngoc
- Center for Biomedicine and Community Health, International School, Vietnam National University, Hanoi, Viet Nam
| | - Thanh-Lam Nguyen
- Center for Biomedicine and Community Health, International School, Vietnam National University, Hanoi, Viet Nam
| | - Damià Barceló
- Catalan Institute for Water Research (ICRA-CERCA), Scientific and Technological Park of the University of Girona, Girona, Spain
- Water and Soil Quality Research Group, Department of Environmental Chemistry, IDAEA-CSIC, Barcelona, Spain
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12
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Zhao S, Feng P, Meng W, Jin W, Li X, Li X. Modulated Gut Microbiota for Potential COVID-19 Prevention and Treatment. Front Med (Lausanne) 2022; 9:811176. [PMID: 35308540 PMCID: PMC8927624 DOI: 10.3389/fmed.2022.811176] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 02/08/2022] [Indexed: 12/12/2022] Open
Abstract
COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has gained global attention. SARS-CoV-2 identifies and invades human cells via angiotensin-converting enzyme 2 receptors, which is highly expressed both in lung tissues and intestinal epithelial cells. The existence of the gut-lung axis in disease could be profoundly important for both disease etiology and treatment. Furthermore, several studies reported that infected patients suffer from gastrointestinal symptoms. The gut microbiota has a noteworthy effect on the intestinal barrier and affects many aspects of human health, including immunity, metabolism, and the prevention of several diseases. This review highlights the function of the gut microbiota in the host's immune response, providing a novel potential strategy through the use of probiotics, gut microbiota metabolites, and dietary products to enhance the gut microbiota as a target for COVID-19 prevention and treatment.
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Affiliation(s)
- Shuai Zhao
- Intersection Laboratory of Life Medicine, School of Life Sciences, Lanzhou University, Lanzhou, China
| | - Pengya Feng
- Intersection Laboratory of Life Medicine, School of Life Sciences, Lanzhou University, Lanzhou, China
| | - Wenbo Meng
- Medical Frontier Innovation Research Center, Institute of Cancer Neuroscience, The First Hospital of Lanzhou University, The First Clinical Medical College of Lanzhou University, Lanzhou, China
| | - Weilin Jin
- Medical Frontier Innovation Research Center, Institute of Cancer Neuroscience, The First Hospital of Lanzhou University, The First Clinical Medical College of Lanzhou University, Lanzhou, China
| | - Xun Li
- Medical Frontier Innovation Research Center, Institute of Cancer Neuroscience, The First Hospital of Lanzhou University, The First Clinical Medical College of Lanzhou University, Lanzhou, China
| | - Xiangkai Li
- Intersection Laboratory of Life Medicine, School of Life Sciences, Lanzhou University, Lanzhou, China
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13
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Clyne B, Jordan K, Ahern S, Walsh KA, Byrne P, Carty PG, Drummond L, O'Brien KK, Smith SM, Harrington P, Ryan M, O'Neill M. Transmission of SARS-CoV-2 by children: a rapid review, 30 December 2019 to 10 August 2020. Euro Surveill 2022; 27. [PMID: 35115076 PMCID: PMC8815097 DOI: 10.2807/1560-7917.es.2022.27.5.2001651] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2023] Open
Abstract
BackgroundThe role of children in the transmission of SARS-CoV-2 during the early pandemic was unclear.AimWe aimed to review studies on the transmission of SARS-CoV-2 by children during the early pandemic.MethodsWe searched MEDLINE, Embase, the Cochrane Library, Europe PubMed Central and the preprint servers medRxiv and bioRxiv from 30 December 2019 to 10 August 2020. We assessed the quality of included studies using a series of questions adapted from related tools. We provide a narrative synthesis of the results.ResultsWe identified 28 studies from 17 countries. Ten of 19 studies on household and close contact transmission reported low rates of child-to-adult or child-to-child transmission. Six studies investigated transmission of SARS-CoV-2 in educational settings, with three studies reporting 183 cases from 14,003 close contacts who may have contracted COVID-19 from children index cases at their schools. Three mathematical modelling studies estimated that children were less likely to infect others than adults. All studies were of low to moderate quality.ConclusionsDuring the early pandemic, it appeared that children were not substantially contributing to household transmission of SARS-CoV-2. School-based studies indicated that transmission rates in this setting were low. Large-scale studies of transmission chains using data collected from contact tracing and serological studies detecting past evidence of infection would be needed to verify our findings.
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Affiliation(s)
- Barbara Clyne
- Health Information and Quality Authority, Dublin, Ireland
- Department of General Practice, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Karen Jordan
- Health Information and Quality Authority, Dublin, Ireland
| | - Susan Ahern
- Health Information and Quality Authority, Dublin, Ireland
| | - Kieran A Walsh
- Health Information and Quality Authority, Dublin, Ireland
| | - Paula Byrne
- Health Information and Quality Authority, Dublin, Ireland
| | - Paul G Carty
- Health Information and Quality Authority, Dublin, Ireland
| | - Linda Drummond
- Health Information and Quality Authority, Dublin, Ireland
| | | | - Susan M Smith
- Department of General Practice, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | | | - Máirín Ryan
- Health Information and Quality Authority, Dublin, Ireland
- Department of Pharmacology & Therapeutics, Trinity College Dublin, Trinity Health Sciences, St James's Hospital, Dublin, Ireland
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14
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Nahari AD, Son MBF, Newburger JW, Reis BY. An integrated framework for identifying clinical-laboratory indicators for novel pandemics: COVID-19 and MIS-C. NPJ Digit Med 2022; 5:9. [PMID: 35058541 PMCID: PMC8776774 DOI: 10.1038/s41746-021-00547-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 11/28/2021] [Indexed: 12/05/2022] Open
Abstract
During the critical early stages of an emerging pandemic, limited availability of pathogen-specific testing can severely inhibit individualized risk screening and pandemic tracking. Standard clinical laboratory tests offer a widely available complementary data source for first-line risk screening and pandemic surveillance. Here, we propose an integrated framework for developing clinical-laboratory indicators for novel pandemics that combines population-level and individual-level analyses. We apply this framework to 7,520,834 clinical laboratory tests recorded over five years and find clinical-lab-test combinations that are strongly associated with SARS-CoV-2 PCR test results and Multisystem Inflammatory Syndrome in Children (MIS-C) diagnoses: Interleukin-related tests (e.g. IL4, IL10) were most strongly associated with SARS-CoV-2 infection and MIS-C, while other more widely available tests (ferritin, D-dimer, fibrinogen, alanine transaminase, and C-reactive protein) also had strong associations. When novel pandemics emerge, this framework can be used to identify specific combinations of clinical laboratory tests for public health tracking and first-line individualized risk screening.
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Affiliation(s)
- Adam D Nahari
- Predictive Medicine Group, Computational Health Informatics Program, Boston Children's Hospital, Boston, MA, USA
| | - Mary Beth F Son
- Division of Immunology, Boston Children's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Jane W Newburger
- Harvard Medical School, Boston, MA, USA
- Department of Cardiology, Boston Children's Hospital, Boston, MA, USA
| | - Ben Y Reis
- Predictive Medicine Group, Computational Health Informatics Program, Boston Children's Hospital, Boston, MA, USA.
- Harvard Medical School, Boston, MA, USA.
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15
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Howard‐Jones AR, Bowen AC, Danchin M, Koirala A, Sharma K, Yeoh DK, Burgner DP, Crawford NW, Goeman E, Gray PE, Hsu P, Kuek S, McMullan BJ, Tosif S, Wurzel D, Britton PN. COVID-19 in children: I. Epidemiology, prevention and indirect impacts. J Paediatr Child Health 2022; 58:39-45. [PMID: 34643307 PMCID: PMC8662210 DOI: 10.1111/jpc.15791] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 09/21/2021] [Accepted: 09/30/2021] [Indexed: 01/06/2023]
Abstract
Children globally have been profoundly impacted by the coronavirus disease 2019 (COVID-19) pandemic. This review explores the direct and indirect public health impacts of COVID-19 on children. We discuss in detail the transmission dynamics, vaccination strategies and, importantly, the 'shadow pandemic', encompassing underappreciated indirect impacts of the pandemic on children. The indirect effects of COVID-19 will have a long-term impact beyond the immediate pandemic period. These include the mental health and wellbeing risks, disruption to family income and attendant stressors including increased family violence, delayed medical attention and the critical issue of prolonged loss of face-to-face learning in a normal school environment. Amplification of existing inequities and creation of new disadvantage are likely additional sequelae, with children from vulnerable families disproportionately affected. We emphasise the responsibility of paediatricians to advocate on behalf of this vulnerable group to ensure the longer-term effects of COVID-19 public health responses on the health and wellbeing of children are fully considered.
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Affiliation(s)
- Annaleise R Howard‐Jones
- Sydney Medical SchoolUniversity of SydneySydneyNew South WalesAustralia,NSW Health Pathology‐NepeanNepean HospitalSydneyNew South WalesAustralia
| | - Asha C Bowen
- Department of Infectious DiseasesPerth Children's HospitalPerthWestern AustraliaAustralia,Wesfarmers Centre for Vaccines and Infectious DiseasesTelethon Kids Institute, University of Western AustraliaPerthWestern AustraliaAustralia
| | - Margie Danchin
- Department of PaediatricsThe University of MelbourneMelbourneVictoriaAustralia,Infection and Immunity ThemeMurdoch Children's Research InstituteMelbourneVictoriaAustralia,Department of General MedicineRoyal Children's HospitalMelbourneVictoriaAustralia
| | - Archana Koirala
- Sydney Medical SchoolUniversity of SydneySydneyNew South WalesAustralia,National Centre for Immunisation Research and SurveillanceThe Children's Hospital at WestmeadSydneyNew South WalesAustralia,Department of Infectious DiseasesNepean HospitalPenrithNew South WalesAustralia
| | - Ketaki Sharma
- Sydney Medical SchoolUniversity of SydneySydneyNew South WalesAustralia,National Centre for Immunisation Research and SurveillanceThe Children's Hospital at WestmeadSydneyNew South WalesAustralia
| | - Daniel K Yeoh
- Department of Infectious DiseasesPerth Children's HospitalPerthWestern AustraliaAustralia,Sir Peter MacCallum Department of OncologyThe University of MelbourneMelbourneVictoriaAustralia
| | - David P Burgner
- Department of PaediatricsThe University of MelbourneMelbourneVictoriaAustralia,Infection and Immunity ThemeMurdoch Children's Research InstituteMelbourneVictoriaAustralia,Infectious Diseases Unit, Department of General MedicineRoyal Children's HospitalMelbourneVictoriaAustralia
| | - Nigel W Crawford
- Department of PaediatricsThe University of MelbourneMelbourneVictoriaAustralia,Infection and Immunity ThemeMurdoch Children's Research InstituteMelbourneVictoriaAustralia,Department of General MedicineRoyal Children's HospitalMelbourneVictoriaAustralia
| | - Emma Goeman
- Department of Infectious Diseases and MicrobiologyRoyal Prince Alfred HospitalSydneyNew South WalesAustralia
| | - Paul E Gray
- Department of Immunology and Infectious DiseasesSydney Children's HospitalSydneyNew South WalesAustralia,School of Women's and Children's HealthUniversity of New South WalesSydneyNew South WalesAustralia
| | - Peter Hsu
- Sydney Medical SchoolUniversity of SydneySydneyNew South WalesAustralia,Department of ImmunologyThe Children's Hospital at WestmeadSydneyNew South WalesAustralia
| | - Stephanie Kuek
- Department of Respiratory and Sleep MedicineThe Royal Children's HospitalMelbourneVictoriaAustralia
| | - Brendan J McMullan
- Department of Immunology and Infectious DiseasesSydney Children's HospitalSydneyNew South WalesAustralia,School of Women's and Children's HealthUniversity of New South WalesSydneyNew South WalesAustralia
| | - Shidan Tosif
- Department of PaediatricsThe University of MelbourneMelbourneVictoriaAustralia,Infection and Immunity ThemeMurdoch Children's Research InstituteMelbourneVictoriaAustralia,Department of General MedicineRoyal Children's HospitalMelbourneVictoriaAustralia
| | - Danielle Wurzel
- Infection and Immunity ThemeMurdoch Children's Research InstituteMelbourneVictoriaAustralia,Department of Respiratory and Sleep MedicineThe Royal Children's HospitalMelbourneVictoriaAustralia,School of Population and Global HealthThe University of MelbourneMelbourneVictoriaAustralia
| | - Philip N Britton
- Sydney Medical SchoolUniversity of SydneySydneyNew South WalesAustralia,Department of Infectious Diseases and MicrobiologyThe Children's Hospital at WestmeadSydneyNew South WalesAustralia
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16
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Ramirez-Suarez KI, Miranda-Schaeubinger M, Rapp JB, Sodhi KS, Saul D, Andronikou S. Publication timeline of chest imaging reporting in children with coronavirus disease 2019 (COVID-19): a systematic review spanning 2020. Pediatr Radiol 2022; 52:1998-2008. [PMID: 35953542 PMCID: PMC9371962 DOI: 10.1007/s00247-022-05466-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 06/14/2022] [Accepted: 07/21/2022] [Indexed: 11/30/2022]
Abstract
Amid the coronavirus disease 2019 (COVID-19) pandemic, numerous publications of imaging findings in children have surfaced in a very short time. Publications discuss populations of overlapping age groups and describe different imaging patterns. We aim to present an overview of the quantity and type of literature available regarding COVID-19 chest imaging findings in children according to a 2020 publication timeline. We conducted a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. We searched terminology related to COVID-19, chest, children and imaging modalities in PubMed and Embase. The included papers were published online in 2020 and described imaging findings specific to children and reported five or more cases. Two researchers reviewed each abstract to determine inclusion or exclusion, and a radiologist reconciled any disagreements. Then we reviewed full articles for the main analysis. Eligible study designs included original articles, case series (≥5 cases), systematic reviews and meta-analyses. We excluded non-English manuscripts, retracted articles, and those without available full text. The remaining articles were distributed to four pediatric radiologists (on the Society for Pediatric Radiology Thoracic Committee), who summarized chest imaging findings. Eighty-two articles were included in the final analysis - 28% in radiology journals and 71% in non-radiology journals; 71% contained original data and 29% were review-style papers. There was a disproportionate contribution of review-style papers in April (55%), considering the paucity of preceding publications with original data in March (5 papers). June had the highest number of publications (n=14), followed by April (n=11) and July (n=11). Most (52%) original papers were from China and most individual pediatric imaging descriptions were from China (57%), while the majority of review papers (83%) were international. Imaging descriptions were available for 2,199 children (1,678 CT descriptions and 780 chest radiography descriptions). Findings included a 25% normal CT scan reports vs. 40% normal chest radiography reports. Ground-glass opacification was the most common CT finding (33%) and was reported in only a minority of chest radiographs (9%). A significant amount of information on pediatric COVID-19 chest imaging has become rapidly available over a short period. Most publications in 2020 were original articles, but they were published more often in non-radiology journals. A disproportionate number of review articles were published early on and were based on little original pediatric imaging data. CT scan reports, which represent the standard, outnumbered radiographic reports and indicated that ground-glass opacification is the main imaging finding and that only a quarter of scans are normal in children with COVID-19.
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Affiliation(s)
- Karen I. Ramirez-Suarez
- Department of Radiology, Children’s Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA 19104 USA
| | - Monica Miranda-Schaeubinger
- Department of Radiology, Children’s Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA 19104 USA
| | - Jordan B. Rapp
- Department of Radiology, Children’s Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA 19104 USA ,Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA USA
| | - Kushaljit Singh Sodhi
- Department of Radio Diagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - David Saul
- Department of Medical Imaging, Nemours/Alfred I. DuPont Hospital for Children, Wilmington, DE USA
| | - Savvas Andronikou
- Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA. .,Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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17
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Akangire G, Begley A, Lachica C, Jensen DR, Manimtim W. Impact of the COVID-19 Pandemic on Children <5 Years of Age With Tracheostomy and Home Ventilator Dependence. Clin Pediatr (Phila) 2021; 60:549-553. [PMID: 34541923 DOI: 10.1177/00099228211046697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Gangaram Akangire
- Children's Mercy Kansas City, MO, USA.,University of Missouri Kansas City, MO, USA
| | | | - Charisse Lachica
- Children's Mercy Kansas City, MO, USA.,University of Missouri Kansas City, MO, USA
| | - Daniel R Jensen
- Children's Mercy Kansas City, MO, USA.,University of Missouri Kansas City, MO, USA
| | - Winston Manimtim
- Children's Mercy Kansas City, MO, USA.,University of Missouri Kansas City, MO, USA
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18
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Nicotra EF, Pili R, Gaviano L, Carrogu GP, Berti R, Grassi P, Petretto DR. COVID-19 and the excess of mortality in Italy from January to April 2020: what are the risks for oldest old? J Public Health Res 2021; 11. [PMID: 34544221 PMCID: PMC8874849 DOI: 10.4081/jphr.2021.2399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 07/28/2021] [Indexed: 11/23/2022] Open
Abstract
In February 2020, Italy has been the first country in Europe fighting against COVID-19. In March 2020, Italian government declared national lockdown. Until May 4th, people stayed in home confinement and only the so-called essential works and activities were continued. Like in other countries, both for the disease severity and for the risk of death, the higher the age of people the higher the risk. In the first months of 2020, Italy saw a very high number of deaths related to COVID-19, with a huge age effect. There is an agreement on the view that there had been also an excess of mortality and on the role of mortality as a correct way to reflect the dynamics of the virus’s spread. In this paper we briefly discuss the trends of mortality during the first 4 months of 2020 according to the data by the Italian National Institute of Statistics.
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Significance for public health
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- Luca Gaviano
- Department of Education, Psychology and Philosophy, University of Cagliari; Global Community on Longevity, Cagliari.
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- Gian Pietro Carrogu
- Department of Education, Psychology and Philosophy, University of Cagliari; Global Community on Longevity, Cagliari.
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- Roberta Berti
- Department of Education, Psychology and Philosophy, University of Cagliari; Global Community on Longevity, Cagliari.
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- Paola Grassi
- Department of Education, Psychology and Philosophy, University of Cagliari.
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19
Mora AM, Lewnard JA, Kogut K, Rauch SA, Hernandez S, Wong MP, Huen K, Chang C, Jewell NP, Holland N, Harris E, Cuevas M, Eskenazi B. Risk Factors Associated With SARS-CoV-2 Infection Among Farmworkers in Monterey County, California.
JAMA Netw Open 2021;
4:e2124116. [PMID:
34524438 PMCID:
PMC8444020 DOI:
10.1001/jamanetworkopen.2021.24116]
[Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 07/06/2021] [Indexed: 02/06/2023] Open
Abstract
Importance
Essential workers in agriculture and food production have been severely affected by the ongoing COVID-19 pandemic.
Objective
To identify risk factors associated with SARS-CoV-2 infection among farmworkers in California.
Design, Setting, and Participants
This cross-sectional study invited farmworkers in California's Salinas Valley (Monterey County) receiving transcription-mediated amplification (TMA) tests for SARS-CoV-2 infection at federally qualified community clinics and community sites to participate. Individuals were eligible if they were not pregnant, were 18 years or older, had conducted farmwork since the pandemic started, and were proficient in English or Spanish. Survey data were collected and SARS-CoV-2 tests were conducted among participants from July 16 to November 30, 2020.
Exposures
Sociodemographic, household, community, and workplace characteristics.
Main Outcomes and Measures
TMA- and immunoglobulin G (IgG)-positive SARS-CoV-2 infection.
Results
A total of 1107 farmworkers (581 [52.5%] women; mean [SD] age, 39.7 [12.6] years) were included in these analyses. Most participants were born in Mexico (922 [83.3%]), were married or living with a partner (697 [63.0%]), and worked in the fields (825 [74.5%]). Overall, 118 of 911 (13.0%) had a positive result on their TMA test for SARS-CoV-2 infection, whereas 201 of 1058 (19.0%) had antibody evidence of infection. In multivariable analyses accounting for recruitment venue and enrollment period, the incidence of TMA-positive SARS-CoV-2 infection was higher among those with lower than primary school-level education (adjusted relative risk [aRR], 1.32; 95% CI, 0.99-1.76; non-statistically significant finding), who spoke an Indigenous language at home (aRR, 1.30; 95% CI, 0.97-1.73; non-statistically significant finding), who worked in the fields (aRR, 1.60; 95% CI, 1.03-2.50), and who were exposed to a known or suspected COVID-19 case at home (aRR, 2.98; 95% CI, 2.06-4.32) or in the workplace (aRR, 1.59; 95% CI, 1.18-2.14). Positive results on IgG tests for SARS-CoV-2 infection were more common among those who lived in crowded housing (aRR, 1.23; 95% CI, 0.98-1.53; non-statistically significant finding), with children aged 5 years or younger (aRR, 1.40; 95% CI, 1.11-1.76), with unrelated roommates (aRR, 1.40; 95% CI, 1.19-1.64), and with an individual with known or suspected COVID-19 (aRR, 1.59; 95% CI, 1.13-2.24). The risk of IgG positivity was also higher among those with body mass index of 30 or greater (aRR, 1.65; 95% CI, 1.01-2.70) or diabetes (aRR, 1.31; 95% CI, 0.98-1.75; non-statistically significant finding).
Conclusions and Relevance
In this cross-sectional study of farmworkers in California, both residential and workplace exposures were associated with SARS-CoV-2 infection. Urgent distribution of COVID-19 vaccines and intervention on modifiable risk factors are warranted given this population's increased risk of infection and the essential nature of their work.
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Affiliation(s)
- Ana M. Mora
- Center for Environmental Research and Children’s Health, School of Public Health, University of California, Berkeley
- Central American Institute for Studies on Toxic Substances, Universidad Nacional, Heredia, Costa Rica
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- Joseph A. Lewnard
- Center for Computational Biology, College of Engineering, University of California, Berkeley
- Division of Epidemiology, School of Public Health, University of California, Berkeley
- Division of Infectious Diseases & Vaccinology, School of Public Health, University of California, Berkeley
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- Katherine Kogut
- Center for Environmental Research and Children’s Health, School of Public Health, University of California, Berkeley
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- Stephen A. Rauch
- Center for Environmental Research and Children’s Health, School of Public Health, University of California, Berkeley
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- Samantha Hernandez
- Division of Infectious Diseases & Vaccinology, School of Public Health, University of California, Berkeley
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- Marcus P. Wong
- Division of Infectious Diseases & Vaccinology, School of Public Health, University of California, Berkeley
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- Karen Huen
- Center for Environmental Research and Children’s Health, School of Public Health, University of California, Berkeley
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- Cynthia Chang
- Center for Environmental Research and Children’s Health, School of Public Health, University of California, Berkeley
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- Nicholas P. Jewell
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Division of Biostatistics, School of Public Health, University of California, Berkeley
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- Nina Holland
- Center for Environmental Research and Children’s Health, School of Public Health, University of California, Berkeley
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- Eva Harris
- Division of Infectious Diseases & Vaccinology, School of Public Health, University of California, Berkeley
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- Brenda Eskenazi
- Center for Environmental Research and Children’s Health, School of Public Health, University of California, Berkeley
- Division of Epidemiology, School of Public Health, University of California, Berkeley
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20
Kühn MJ, Abele D, Mitra T, Koslow W, Abedi M, Rack K, Siggel M, Khailaie S, Klitz M, Binder S, Spataro L, Gilg J, Kleinert J, Häberle M, Plötzke L, Spinner CD, Stecher M, Zhu XX, Basermann A, Meyer-Hermann M. Assessment of effective mitigation and prediction of the spread of SARS-CoV-2 in Germany using demographic information and spatial resolution.
Math Biosci 2021;
339:108648. [PMID:
34216635 PMCID:
PMC8243656 DOI:
10.1016/j.mbs.2021.108648]
[Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 05/31/2021] [Accepted: 06/06/2021] [Indexed: 12/16/2022]
Abstract
Non-pharmaceutical interventions (NPIs) are important to mitigate the spread of infectious diseases as long as no vaccination or outstanding medical treatments are available. We assess the effectiveness of the sets of non-pharmaceutical interventions that were in place during the course of the Coronavirus disease 2019 (Covid-19) pandemic in Germany. Our results are based on hybrid models, combining SIR-type models on local scales with spatial resolution. In order to account for the age-dependence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), we include realistic prepandemic and recently recorded contact patterns between age groups. The implementation of non-pharmaceutical interventions will occur on changed contact patterns, improved isolation, or reduced infectiousness when, e.g., wearing masks. In order to account for spatial heterogeneity, we use a graph approach and we include high-quality information on commuting activities combined with traveling information from social networks. The remaining uncertainty will be accounted for by a large number of randomized simulation runs. Based on the derived factors for the effectiveness of different non-pharmaceutical interventions over the past months, we provide different forecast scenarios for the upcoming time.
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Affiliation(s)
- Martin J Kühn
- Institute for Software Technology, Department of High-Performance Computing, German Aerospace Center, Cologne, Germany.
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- Daniel Abele
- Institute for Software Technology, Department of High-Performance Computing, German Aerospace Center, Cologne, Germany
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- Tanmay Mitra
- Department of Systems Immunology and Braunschweig Integrated Centre of Systems Biology (BRICS), Helmholtz Centre for Infection Research, Braunschweig, Germany
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- Wadim Koslow
- Institute for Software Technology, Department of High-Performance Computing, German Aerospace Center, Cologne, Germany
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- Majid Abedi
- Department of Systems Immunology and Braunschweig Integrated Centre of Systems Biology (BRICS), Helmholtz Centre for Infection Research, Braunschweig, Germany
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- Kathrin Rack
- Institute for Software Technology, Department of High-Performance Computing, German Aerospace Center, Cologne, Germany
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- Martin Siggel
- Institute for Software Technology, Department of High-Performance Computing, German Aerospace Center, Cologne, Germany
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- Sahamoddin Khailaie
- Department of Systems Immunology and Braunschweig Integrated Centre of Systems Biology (BRICS), Helmholtz Centre for Infection Research, Braunschweig, Germany
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- Margrit Klitz
- Institute for Software Technology, Department of High-Performance Computing, German Aerospace Center, Cologne, Germany
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- Sebastian Binder
- Department of Systems Immunology and Braunschweig Integrated Centre of Systems Biology (BRICS), Helmholtz Centre for Infection Research, Braunschweig, Germany
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- Luca Spataro
- Institute for Software Technology, Department of High-Performance Computing, German Aerospace Center, Cologne, Germany
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- Jonas Gilg
- Institute for Software Technology, Department of High-Performance Computing, German Aerospace Center, Cologne, Germany
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- Jan Kleinert
- Institute for Software Technology, Department of High-Performance Computing, German Aerospace Center, Cologne, Germany
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- Matthias Häberle
- Earth Observation Center, Department EO Data Science, German Aerospace Center, Weßling, Germany
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- Lena Plötzke
- Institute for Software Technology, Department of High-Performance Computing, German Aerospace Center, Cologne, Germany
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- Christoph D Spinner
- Technical University of Munich, School of Medicine, University Hospital rechts der Isar, Department of Internal Medicine II, Munich, Germany
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- Melanie Stecher
- University Hospital of Cologne, Department I for Internal Medicine, University of Cologne; German Center for Infection Research (DZIF), Cologne, Germany
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- Xiao Xiang Zhu
- Earth Observation Center, Department EO Data Science, German Aerospace Center, Weßling, Germany
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- Achim Basermann
- Institute for Software Technology, Department of High-Performance Computing, German Aerospace Center, Cologne, Germany.
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- Michael Meyer-Hermann
- Department of Systems Immunology and Braunschweig Integrated Centre of Systems Biology (BRICS), Helmholtz Centre for Infection Research, Braunschweig, Germany.
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21
Lin C, Zhong B, Zheng F, Guo X, Guo Y, Deng Z, Zhou C, Guo Y. A Child Infected with COVID-19 in China-A Case Report.
J Trop Pediatr 2021;
67:6353945. [PMID:
34405240 PMCID:
PMC8371410 DOI:
10.1093/tropej/fmaa090]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
A 16-month-old boy was admitted with cough for 2 days and fever for 1 day. Chest computed tomography (CT) scan of the child revealed large areas of ground-glass opacities in both lungs. Nucleic acid amplification tests (NAATs) were performed repeatedly to detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), but the results were all negative. On day 13 of hospitalization, no clinical symptoms except diarrhea were present in the patient, and re-examination by chest CT revealed lesion shrinkage, but the NAAT on throat swabs was positive. On day 22 of hospitalization, the NAAT on throat swabs was negative and the fecal samples were positive. Positive fecal samples nucleic acid lasted for 62 days. Suggesting that pediatric patients may be important sources of infection during the recovery phase of clinical symptoms and whether SARS-CoV-2 has fecal-oral transmission needs further study.
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Affiliation(s)
- Chunxia Lin
- Department of Pediatrics, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, Guangdong 519000, China
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- Beilong Zhong
- Department of Thoracic Surgery, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, Guangdong 519000, China,Correspondence: Fangfang Zheng, Department of Pediatrics, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, Guangdong 519000, China. E-mail: <>.
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- Fangfang Zheng
- Department of Pediatrics, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, Guangdong 519000, China
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- Xinming Guo
- Department of Pharmacy, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, Guangdong 519000, China
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- Yi Guo
- Department of Pediatrics, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, Guangdong 519000, China
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- Zhizhong Deng
- Department of Pediatrics, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, Guangdong 519000, China
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- Chuanxin Zhou
- Department of Pediatrics, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, Guangdong 519000, China
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- Yangbin Guo
- Department of Pediatrics, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, Guangdong 519000, China
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22
Evaluation of Patients with Suspicion of COVID-19 in Pediatric Emergency Department.
MEDICAL BULLETIN OF SISLI ETFAL HOSPITAL 2021;
55:179-187. [PMID:
34349593 PMCID:
PMC8298069 DOI:
10.14744/semb.2021.03360]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 02/09/2020] [Indexed: 01/08/2023]
Abstract
Objectives
Coronavirus disease 2019 (COVID-19) have different clinical presentations in children. Most symptomatic children with suspicion of COVID-19 have fever and respiratory symptoms. In this retrospective study, we aimed to describe demographic features, clinical characteristics, and outcomes of confirmed and probable COVID-19 patients admitted to our pediatric emergency department (ED).
Methods
We identified 135 children (aged 1 month-18 years) with suspicion of the COVID-19 who were admitted to our ED between March 11 and May 12, 2020. The urgency of patients was evaluated according to their Pediatric Assessment Triangle (PAT) and Emergency Severity Index (ESI) scores. Patients were divided into two groups as confirmed cases (Group 1) and probable cases (Group 2). Clinical, laboratory, radiologic features, and the disease severity of patients were analyzed.
Results
According to PAT evaluation, 82 patients (65.6%) were non-urgent. The most frequent ESI triage category level was 3 (n=102, 76.1%). Forty-one (30.4%) patients were identified as laboratory-confirmed cases. Fifty-five (40.7%) patients were between 28 days and 4 years of age. Fever with cough was the most frequent symptoms at the onset of illness in COVID-19 positive patients (n=16, 39%). Sixty-four (47.4%) patients had mild disease and 40 (29.6%) patients had comorbidities. In Group 1, neutropenia was significantly higher than Group 2 (p=0.024). Mean procalcitonin and erythrocyte sedimentation rate levels of Group 2 were significantly higher than Group 1 (p=0.012 and p=0.028, respectively). Twenty-eight of 51 patients had chest computed tomography findings which were compatible with COVID-19. Fifty-one (37.8%) patients were discharged from ED, 81 (60%) were admitted to the ward, and 3 (2.2%) were admitted to the pediatric intensive care unit.
Conclusion
During our study, we confirmed the diagnosis of 45 of 135 probable cases with the SARS-CoV-2 polymerase chain reaction test. Among confirmed COVID-19 cases, most of our patients had mild or moderate disease. The clinic of only confirmed three patients was classified as severe disease, and we had no critically ill patient.
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23
Jia Z, Yan X, Gao L, Ding S, Bai Y, Zheng Y, Cui Y, Wang X, Li J, Lu G, Xu Y, Zhang X, Li J, Chen N, Shang Y, Han M, Liu J, Zhou H, Li C, Lu W, Liu J, Wang L, Fan Q, Wu J, Shen H, Jiao R, Chen C, Gao X, Tian M, Lu W, Yang Y, Wong GWK, Wang T, Jin R, Shen A, Xu B, Shen K. Comparison of Clinical Characteristics Among COVID-19 and Non-COVID-19 Pediatric Pneumonias: A Multicenter Cross-Sectional Study.
Front Cell Infect Microbiol 2021;
11:663884. [PMID:
34277466 PMCID:
PMC8281119 DOI:
10.3389/fcimb.2021.663884]
[Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 05/05/2021] [Indexed: 01/08/2023] Open
Abstract
Background
The pandemic of Coronavirus Disease 2019 (COVID-19) brings new challenges for pediatricians, especially in the differentiation with non-COVID-19 pneumonia in the peak season of pneumonia. We aimed to compare the clinical characteristics of pediatric patients with COVID-19 and other respiratory pathogens infected pneumonias.
Methods
We conducted a multi-center, cross-sectional study of pediatric inpatients in China. Based on pathogenic test results, pediatric patients were divided into three groups, including COVID-19 pneumonia group, Non-COVID-19 viral (NCV) pneumonia group and Non-viral (NV) pneumonia group. Their clinical characteristics were compared by Kruskal-Wallis H test or chi-square test.
Results
A total of 636 pediatric pneumonia inpatients, among which 87 in COVID-19 group, 194 in NCV group, and 355 in NV group, were included in analysis. Compared with NCV and NV patients, COVID-19 patients were older (median age 6.33, IQR 2.00-12.00 years), and relatively fewer COVID-19 patients presented fever (63.2%), cough (60.9%), shortness of breath (1.1%), and abnormal pulmonary auscultation (18.4%). The results were verified by the comparison of COVID-19, respiratory syncytial virus (RSV) and influenza A (IFA) pneumonia patients. Approximately 42.5%, 44.8%, and 12.6% of the COVID-19 patients presented simply ground-glass opacity (GGO), simply consolidation, and the both changes on computed tomography (CT) scans, respectively; the proportions were similar as those in NCV and NV group (p>0.05). Only 47.1% of COVID-19 patients had both lungs pneumonia, which was significantly lower than that proportion of nearly 80% in the other two groups. COVID-19 patients presented lower proportions of increased white blood cell count (16.5%) and abnormal procalcitonin (PCT) (10.7%), and a higher proportion of decreased lymphocyte count (44.0%) compared with the other two groups.
Conclusion
Majority clinical characteristics of pediatric COVID-19 pneumonia patients were milder than non-COVID-19 patients. However, lymphocytopenia remained a prominent feature of COVID-19 pediatric pneumonia.
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Affiliation(s)
- Zhongwei Jia
- School of Public Health, Peking University, Beijing, China.,Center for Intelligent Public Health, Institute for Artificial Intelligence, Peking University, Beijing, China.,Center for Drug Abuse Control and Prevention, National Institute of Health Data Science, Peking University, Beijing, China
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- Xiangyu Yan
- School of Public Health, Peking University, Beijing, China.,Center for Intelligent Public Health, Institute for Artificial Intelligence, Peking University, Beijing, China.,Center for Drug Abuse Control and Prevention, National Institute of Health Data Science, Peking University, Beijing, China
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- Liwei Gao
- China National Clinical Research Center for Respiratory Diseases, Department of Respiratory Medicine, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, China.,Research Unit of Critical Infection in Children, Chinese Academy of Medical Sciences, Beijing, China
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- Shenggang Ding
- Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, Hefei, China
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- Yan Bai
- Pediatric Department, Union Hospital, Tongji Medical College, Huazhong University of Science And Technology, Hubei, China
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- Yuejie Zheng
- Department of Respiratory Medicine, Shenzhen Children's Hospital, Shenzhen, China
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- Yuxia Cui
- Department of Pediatrics, Guizhou Provincial People's Hospital, Guizhou, China
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- Xianfeng Wang
- Department of Pediatrics, Shenzhen Third People's Hospital, Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China
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- Jingfeng Li
- Department of Pediatrics, Taihe Hospital, Shiyan, China
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- Gen Lu
- Department of Pediatric, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
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- Yi Xu
- Department of Pediatric, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
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- Xiangyu Zhang
- School of Public Health, Peking University, Beijing, China.,Center for Intelligent Public Health, Institute for Artificial Intelligence, Peking University, Beijing, China.,Center for Drug Abuse Control and Prevention, National Institute of Health Data Science, Peking University, Beijing, China
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- Junhua Li
- Department of Pediatrics, Xiangyang Central Hospital, Xiangyang, China
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- Ning Chen
- Department of Pediatric, Shengjing Hospital of China Medical University, Liaoning, China
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- Yunxiao Shang
- Department of Pediatric, Shengjing Hospital of China Medical University, Liaoning, China
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- Mingfeng Han
- Department of Respiratory Medicine, The Second People's Hospital of Fuyang, Anhui, China
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- Jun Liu
- Department of Pediatrics, The People Hospital of Bozhou, Anhui, China
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- Hourong Zhou
- Department of General Practice, Guizhou Provincial People's Hospital, Guiyang, Guizhou, China.,Office of Academic Research, Jiangjunshan Hospital, Guizhou, China
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- Cen Li
- Department of Pediatrics, Guizhou Provincial People's Hospital, Guizhou, China
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- Wanqiu Lu
- Department of Pediatrics, The Affiliated Hospital of Guizhou University, Guizhou, China
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- Jun Liu
- China National Clinical Research Center for Respiratory Diseases, Department of Respiratory Medicine, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, China.,Research Unit of Critical Infection in Children, Chinese Academy of Medical Sciences, Beijing, China
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- Lina Wang
- China National Clinical Research Center for Respiratory Diseases, Department of Respiratory Medicine, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, China.,Research Unit of Critical Infection in Children, Chinese Academy of Medical Sciences, Beijing, China
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- Qihong Fan
- Department of Pediatrics, Jingzhou First People's Hospital, Jingzhou, China
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- Jiang Wu
- Department of Pediatrics, Huangshi Maternity and Child Health Care Hospital, Huangshi, China
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- Hanling Shen
- Department of Pediatrics, Suizhou Maternity and Child Health Care Hospital, Suizhou, China
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- Rong Jiao
- Department of Pediatrics, Xiangyang First People's Hospital, Xiangyang, China
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- Chunxi Chen
- Department of Pediatrics, Xishui People's Hospital, Huanggang, China
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- Xiaoling Gao
- Department of Pediatrics, People's Hospital of Tuanfeng County, Huanggang, China
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- Maoqiang Tian
- Department of Pediatrics, Tongren People's Hospital of Guizhou Province, Guizhou, China
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- Wei Lu
- Department of Pediatrics, Yichang Central People's Hospital, Yichang, China
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- Yonghong Yang
- Beijing Pediatric Research Institute, Beijing, China.,Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, China
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- Gary Wing-Kin Wong
- Department of Pediatrics, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
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- Tianyou Wang
- Center of Hematologic Oncology, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, China
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- Runming Jin
- Pediatric Department, Union Hospital, Tongji Medical College, Huazhong University of Science And Technology, Hubei, China
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- Adong Shen
- Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, China
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- Baoping Xu
- China National Clinical Research Center for Respiratory Diseases, Department of Respiratory Medicine, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, China.,Research Unit of Critical Infection in Children, Chinese Academy of Medical Sciences, Beijing, China
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- Kunling Shen
- China National Clinical Research Center for Respiratory Diseases, Department of Respiratory Medicine, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, China
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24
Exploration and Ethical Analysis of Open-Label Pediatric Vaccine Trials in a Pandemic.
Clin Ther 2021;
43:e163-e172. [PMID:
34039479 PMCID:
PMC8141907 DOI:
10.1016/j.clinthera.2021.04.010]
[Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 04/15/2021] [Accepted: 04/16/2021] [Indexed: 12/16/2022]
Abstract
Young children will ultimately need to be vaccinated to stop the spread of coronavirus disease 2019 (COVID-19). Initial studies of vaccine were performed in adults. Randomized controlled trials are the gold standard. In the COVID-19 pandemic, many questions need to be answered about the ethics and feasibility of these trials. Given the harms of the COVID-19 pandemic and the now-known efficacy of the vaccines in adults and teens, the question of whether clinical equipoise exists for a placebo-controlled trial of vaccines in younger children remains. Parents may be reluctant to enroll children in these trials because they want their child to receive the vaccine or because they are worried about vaccines or clinical trials in general. One option for gathering data on tolerability and efficacy in children would be to use a nonrandomized trial to enroll parents willing to vaccinate their children and those who are hesitant. We discuss the advantages and disadvantages of such an open-label trial that could provide guidance for future pandemics. (Clin Ther. 2021;XX:XXX-XXX) © 2021 Elsevier HS Journals, Inc.
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25
Manfredi M, Ragni P, Gargano G. Creation of a specific and separated pediatric intra-hospital pathway in primary level hospitals during the era of COVID-19.
EUR J INFLAMM 2021. [DOI:
10.1177/20587392211010897]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Every new pandemic forces us to start new specific behaviors both in the civil life and within the hospitals trying to contain the spreading of the infection and preserve the more fragile people. In this regard, at the debut of Severe Acute Respiratory Syndrome-CoronaVirus-2 (SARS-CoV-2) pandemic, our Local Health Agency had drastically modified every clinical and organizational pathways in order to limit the diffusion of the infection as well as to maintain a good quality of care and preserve healthcare workers. We report how we have modified the usual pediatric intra-hospital pathways in our primary level hospital to avoid mixing children with suspected and non-suspected symptoms of SARS-CoV-2 infection. Before every hospitalization, regardless of symptoms, each child and him/her parent/caregiver are undergone to rapid antigenic and molecular swab to rule out a SARS-CoV-2 infection; hence, positive patients are transferred to Pediatric Unit of third level hospital equipped by a Pediatric COVID Intensive Unit. We think the healthcare behaviors described in this manuscript can help to reduce the intra-hospital spreading of SARS-CoV-2, although children seem to have a minimal role in the dissemination, but we cannot let down your guard. Simultaneously we observed that the overall children requiring inpatient pediatric evaluation and hospitalization have dramatically decreased from the beginning of pandemic.
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Affiliation(s)
- Marco Manfredi
- Maternal and Child Department, Azienda USL-IRCCS di Reggio Emilia, Pediatric Unit, Sant’Anna Hospital, Castelnovo ne’ Monti, Reggio Emilia, Italy
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- Pietro Ragni
- Infective Risk Control Strategic Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
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- Giancarlo Gargano
- Maternal and Child Department, Azienda USL-IRCCS di Reggio Emilia, ASMN Hospital, Reggio Emilia, Italy
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26
Snider B, Patel B, McBean E. Asymptomatic Cases, the Hidden Challenge in Predicting COVID-19 Caseload Increases.
Infect Dis Rep 2021;
13:340-347. [PMID:
33918578 PMCID:
PMC8167653 DOI:
10.3390/idr13020033]
[Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/03/2021] [Accepted: 04/07/2021] [Indexed: 12/20/2022] Open
Abstract
The numbers of novel coronavirus cases continue to grow at an unprecedented rate across the world. Attempts to control the growth of the virus using masks and social-distancing, and, recently, double-masking as well, continue to be difficult to maintain, in part due to the extent of asymptomatic cases. Analyses of large datasets consisting of 219,075 individual cases in Ontario, indicated that asymptomatic and pre-symptomatic cases are substantial in number. Large numbers of cases in children aged 0-9 were asymptomatic or had only one symptom (35.0% and 31.4% of total cases, respectively) and resulted in fever as the most common symptom (30.6% of total cases). COVID-19 cases in children were more likely to be milder symptomatic with cough not seen as frequently as in adults aged over 40, and past research has shown children to be index cases in familial clusters. These findings highlight the importance of targeting asymptomatic and mild infections in the continuing effort to control the spread of COVID-19. The Pearson correlation coefficient between test positivity rates and asymptomatic rates of -0.729 indicates that estimates of the asymptomatic rates should be obtained when the test positivity rates are lowest as the best approach.
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Affiliation(s)
- Brett Snider
- School of Engineering, University of Guelph, Guelph, ON N1G 2W1, Canada; (B.P.); (E.M.)
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27
Häusler M, van Helden J, Kleines M. Retarded decline of the share of SARS-CoV-2-positive children in North Rhine-Westphalia, Germany.
J Med Virol 2021;
93:2039-2045. [PMID:
32986242 PMCID:
PMC7537067 DOI:
10.1002/jmv.26564]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 09/21/2020] [Accepted: 09/22/2020] [Indexed: 01/10/2023]
Abstract
Knowledge on the mechanisms of viral spread, of time-related changes, and age-specific factors of severe acute respiratory syndrome coronavirus 2 infections is important to develop recommendations aimed at controlling the pandemic. In this context, longitudinal data on proportions of positive results in different age groups are rare. Data on total positive counts and on shares of positive counts deriving from a private (MVZ) and a University (RWTH) laboratory were analyzed retrospectively and compared with public data on total positive counts of the Robert Koch Institute (RKI). Data were covered for Weeks 9-24 of the year 2020 and all patient ages. Total positive counts were lower in children compared to adults. Proportions of children and adults tested positive were 3%-5% and 5%-7%, respectively. RKI and MVZ data showed similar time-related patterns. Patients of 20-60 years of age did account for the initial virus spread (maximum infection rates at Weeks 9-11). Thereafter, infection rates decreased in older patients whereas children did not show a comparable time-related decrease. Pediatric data generated in outpatient settings and hospitals differed markedly which should be considered in further studies. In summary, compared with adults children are less affected by severe acute respiratory syndrome coronavirus 2 infections and are unlikely to account for the initial viral spread. However, children show sustained viral activity and may serve as a viral reservoir.
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Affiliation(s)
- Martin Häusler
- Division of Neuropediatrics and Social Pediatrics, Department of PediatricsUniversity Hospital RWTH AachenAachenGermany
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- Josef van Helden
- MVZ Dr. Stein and Colleagues Mönchengladbach LaboratoryMönchengladbachGermany
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- Michael Kleines
- Laboratory Diagnostic CenterRWTH Aachen University HospitalAachenGermany
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28
Verma HK. Radiological and clinical spectrum of COVID-19: A major concern for public health.
World J Radiol 2021;
13:53-63. [PMID:
33815683 PMCID:
PMC8006056 DOI:
10.4329/wjr.v13.i3.53]
[Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 12/07/2020] [Accepted: 03/12/2021] [Indexed: 02/06/2023] Open
Abstract
The pandemic of novel coronavirus disease 2019 (COVID-19) is an infectious disease caused by +ve strand RNA virus (SARS-CoV-2, severe acute respiratory syndrome coronavirus 2) that belongs to the corona viridae family. In March, the World Health Organization declared the outbreak of novel coronavirus for the public health emergency. Although SARS-CoV-2 infection presents with respiratory symptoms, it affects other organs such as the kidneys, liver, heart and brain. Early-stage laboratory disease testing shows many false positive or negative outcomes such as less white blood cell count and a low number of lymphocyte count. However, radiological examination and diagnosis are among the main components of the diagnosis and treatment of COVID-19. In particular, for COVID-19, chest computed tomography developed vigorous initial diagnosis and disease progression assessment. However, the accuracy is limited. Although real-time reverse transcription-polymerase chain reaction is the gold standard method for the diagnosis of COVID-19, sometimes it may give false-negative results. Due to the consequences of the missing diagnosis. This resulted in a discrepancy between the two means of examination. Conversely, based on currently available evidence, we summarized the possible understanding of the various patho-physiology, radio diagnostic methods in severe COVID-19 patients. As the information on COVID-19 evolves rapidly, this review will provide vital information for scientists and clinicians to consider novel perceptions for the comprehensive knowledge of the diagnostic approaches based on current experience.
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Affiliation(s)
- Henu Kumar Verma
- Developmental and Stem Cell Biology Lab, Institute of Experimental Endocrinology and Oncology CNR, Naples 80131, Campania, Italy
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29
Caracciolo M, Correale P, Mangano C, Foti G, Falcone C, Macheda S, Cuzzola M, Conte M, Falzea AC, Iuliano E, Morabito A, Caraglia M, Polimeni N, Ferrarelli A, Labate D, Tescione M, Di Renzo L, Chiricolo G, Romano L, De Lorenzo A. Efficacy and Effect of Inhaled Adenosine Treatment in Hospitalized COVID-19 Patients.
Front Immunol 2021;
12:613070. [PMID:
33815368 PMCID:
PMC8012541 DOI:
10.3389/fimmu.2021.613070]
[Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 02/24/2021] [Indexed: 01/08/2023] Open
Abstract
Lack of specific antiviral treatment for COVID-19 has resulted in long hospitalizations and high mortality rate. By harnessing the regulatory effects of adenosine on inflammatory mediators, we have instituted a new therapeutic treatment with inhaled adenosine in COVID-19 patients, with the aim of reducing inflammation, the onset of cytokine storm, and therefore to improve prognosis. The use of inhaled adenosine in COVID19 patients has allowed reduction of length of stay, on average 6 days. This result is strengthened by the decrease in SARS-CoV-2 positive days. In treated patients compared to control, a clear improvement in PaO2/FiO2 was observed together with a reduction in inflammation parameters, such as the decrease of CRP level. Furthermore, the efficacy of inhaled exogenous adenosine led to an improvement of the prognosis indices, NLR and PLR. The treatment seems to be safe and modulates the immune system, allowing an effective response against the viral infection progression, reducing length of stay and inflammation parameters.
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Affiliation(s)
- Massimo Caracciolo
- Unit of Post-Surgery Intensive Therapy (USDO), Grand Metropolitan Hospital, Reggio Calabria, Italy
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- Pierpaolo Correale
- Medical Oncology Unit, Grand Metropolitan Hospital, Reggio Calabria, Italy
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- Carmelo Mangano
- Unit of Infectious Disease, Grand Metropolitan Hospital, Reggio Calabria, Italy
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- Giuseppe Foti
- Unit of Infectious Disease, Grand Metropolitan Hospital, Reggio Calabria, Italy
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- Carmela Falcone
- Unit of Radiology, Grand Metropolitan Hospital, Reggio Calabria, Italy
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- Sebastiano Macheda
- Unit of Intensive Care Medicine and Anaesthesia, Grand Metropolitan Hospital, Reggio Calabria, Italy
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- Maria Cuzzola
- Microbiology Unit, Grand Metropolitan Hospital, Reggio Calabria, Italy
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- Marco Conte
- Microbiology Unit, Grand Metropolitan Hospital, Reggio Calabria, Italy
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- Eleonora Iuliano
- Medical Oncology Unit, Grand Metropolitan Hospital, Reggio Calabria, Italy
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- Michele Caraglia
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy.,Biogem Scarl, Institute of Genetic Research, Laboratory of Precision and Molecular Oncology, Ariano Irpino, Italy
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- Nicola Polimeni
- Unit of Intensive Care Medicine and Anaesthesia, Grand Metropolitan Hospital, Reggio Calabria, Italy
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- Anna Ferrarelli
- Unit of Radiology, Grand Metropolitan Hospital, Reggio Calabria, Italy
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- Demetrio Labate
- Unit of Intensive Care Medicine and Anaesthesia, Grand Metropolitan Hospital, Reggio Calabria, Italy
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- Marco Tescione
- Unit of Intensive Care Medicine and Anaesthesia, Grand Metropolitan Hospital, Reggio Calabria, Italy
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- Laura Di Renzo
- Section of Clinical Nutrition and Nutrigenomics, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
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- Gaetano Chiricolo
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
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- Lorenzo Romano
- PhD School of Applied Medical, Surgical Sciences, University of Rome Tor Vergata, Rome, Italy
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- Antonino De Lorenzo
- Section of Clinical Nutrition and Nutrigenomics, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
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30
Kilani MM, Odeh MM, Shalabi M, Al Qassieh R, Al-Tamimi M. Clinical and laboratory characteristics of SARS-CoV2-infected paediatric patients in Jordan: serial RT-PCR testing until discharge.
Paediatr Int Child Health 2021;
41:83-92. [PMID:
32894032 DOI:
10.1080/20469047.2020.1804733]
[Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND
Data on COVID-19 in children are limited. This study aimed to identify the clinical characteristics, laboratory results and longitudinal RT-PCR- testing pattern in children infected with theSARS-CoV2 virus and admitted to a hospital in Jordan.
METHODS
The study is a retrospective chart review of patients admitted between 16 March and 23 April 2020. All infected children in Jordan were hospitalised. Serial RT-PCR testing was undertaken 7 days after the first test and then on alternate days until discharge. The association between patient symptoms and laboratory results and whether there was a statistically significant median difference in the number of days until negative RT-PCR results between patients was studied.
RESULTS
Sixty-one patients with positive SARS-CoV2 swabs were admitted, 34 (55.7%) of whom were symptomatic. The most common symptom was nasal congestion (21/61, 34.3%), followed by generalised malaise and headache (12/6, 19.7%). A rash was detected in 5/61 (8.2%) of them. Fifty-five patients (90.1%) underwent investigations: 4 (7.4%) of them had lymphopenia, 4 (7.4%) had eosinopenia, 8 (14.5%) had eosinophilia, and platelets were elevated in 5 (9.1%) children. CRP was measured in 33/61 (54.1%) patients and all were normal. ESR levels were available for 11/61 (18%) patients and were elevated in 5 (45.5%). There was a statistically significant association between laboratory results and symptom expression (p = 0.011). The longest time until the first negative RT-PCR result was 39 days.
CONCLUSION
All children admitted who tested positive for SARS-CoV2 had mild symptoms and five had cutaneous manifestations. RT-PCR may remain positive for over one month.
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Affiliation(s)
- Muna M Kilani
- Department of Paediatrics, Faculty of Medicine, Hashemite University, Zarqa, Jordan
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- Mohanad M Odeh
- Clinical Pharmacy, Pharmacy Management, and Pharmaceutical Care Innovation Centre, Pharmacy School, Hashemite University, Zarqa, Jordan
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- Marwan Shalabi
- Department of Paediatrics, Faculty of Medicine, Hashemite University, Zarqa, Jordan
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- Rami Al Qassieh
- Department of Anaesthesiology, Faculty of Medicine, Hashemite University, Zarqa, Jordan
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- Mohammad Al-Tamimi
- Department of Basic Medical Sciences, Faculty of Medicine, Hashemite University, Zarqa, Jordan
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31
King JA, Whitten TA, Bakal JA, McAlister FA. Symptômes associés au frottis SRAS-CoV-2-positif chez des enfants de l’Alberta.
CMAJ 2021;
193:E177-E185. [PMID:
33526549 PMCID:
PMC7954568 DOI:
10.1503/cmaj.202065-f]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2020] [Indexed: 11/15/2022] Open
Abstract
CONTEXTE:
La recherche sur les enfants atteints d’une infection à coronavirus du syndrome respiratoire aigu sévère 2 (SRAS-CoV-2) a principalement porté sur les enfants amenés aux services des urgences. Nous avons voulu identifier les symptômes plus souvent associés à un frottis SRAS-CoV-2-positif chez les enfants non hospitalisés.
MÉTHODES:
Nous avons procédé à une étude observationnelle chez des enfants soumis au dépistage et suivis pour une infection à SRAS-CoV-2 confirmée sur des prélèvements de sécrétions nasales, nasopharyngées, de la gorge et autres (p. ex., aspiration nasopharyngée, sécrétions trachéales ou non spécifiées) entre le 13 avril et le 30 septembre 2020 en Alberta. Nous avons calculé les rapports de vraisemblance (RV) positifs entre les symptômes autodéclarés et les frottis SRAS-CoV-2-positifs dans la cohorte entière et dans 3 analyses de sensibilité : tous les enfants présentant au moins 1 symptôme, tous les enfants, symptomatiques ou non, soumis au dépistage par suite d’une recherche de contacts, et tous les enfants de 5 ans et plus.
RÉSULTATS:
Nous avons analysé les résultats chez 2463 enfants soumis au dépistage de l’infection à SRAS-CoV-2; 1987 enfants se sont révélés positifs et 476 négatifs. Parmi les enfants SRAS-CoV-2-positifs, 714 (35,9 %) n’ont déclaré aucun symptôme. Même si la toux (24,5 %) et la rhinorrhée (19,3 %) étaient les 2 symptômes les plus fréquents chez les enfants ayant contracté le SRAS-CoV-2, elles étaient fréquentes également chez ceux dont les résultats étaient négatifs et ne permettaient pas de prédire un résultat positif (RV positif 0,96, intervalle de confiance [IC] à 95 % 0,81–1,14 et 0,87, IC à 95 % 0,72–1,06, respectivement). L’anosmie/agueusie (RV positif 7,33, IC à 95 % 3,03–17,76), les nausées et vomissements (RV positif 5,51, IC à 95 % 1,74–17,43), les céphalées (RV positif 2,49, IC à 95 % 1,74–3,57) et la fièvre (RV positif 1,68, IC à 95 % 1,34–2,11) ont été les symptômes les plus prédictifs d’un résultat SRAS-CoV-2-positif. Le RV positif pour la combinaison anosmie et agueusie, nausées et vomissements, et céphalées était de 65,92 (IC à 95 % 49,48–91,92).
INTERPRÉTATION:
Environ les deux tiers des enfants déclarés SRAS-CoV-2-positifs ont manifesté des symptômes, et les symptômes les plus étroitement associés à un frottis SRAS-CoV-2-positif étaient l’anosmie/agueusie, les nausées et les vomissements, les céphalées et la fièvre.
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Affiliation(s)
- James A King
- Alberta Strategy for Patient Oriented Research Support Unit Data Platform et Provincial Research Data Services (King, Whitten), Services de santé de l'Alberta, Calgary, Alb.; Alberta Strategy for Patient Oriented Research Support Unit Data Platform (Bakal, McAlister) et Provincial Research Data Services (Bakal), Services de santé de l'Alberta, Edmonton, Alb.; Division de médecine interne générale (McAlister), Université de l'Alberta, Edmonton, Alb
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- Tara A Whitten
- Alberta Strategy for Patient Oriented Research Support Unit Data Platform et Provincial Research Data Services (King, Whitten), Services de santé de l'Alberta, Calgary, Alb.; Alberta Strategy for Patient Oriented Research Support Unit Data Platform (Bakal, McAlister) et Provincial Research Data Services (Bakal), Services de santé de l'Alberta, Edmonton, Alb.; Division de médecine interne générale (McAlister), Université de l'Alberta, Edmonton, Alb
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- Jeffrey A Bakal
- Alberta Strategy for Patient Oriented Research Support Unit Data Platform et Provincial Research Data Services (King, Whitten), Services de santé de l'Alberta, Calgary, Alb.; Alberta Strategy for Patient Oriented Research Support Unit Data Platform (Bakal, McAlister) et Provincial Research Data Services (Bakal), Services de santé de l'Alberta, Edmonton, Alb.; Division de médecine interne générale (McAlister), Université de l'Alberta, Edmonton, Alb
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- Finlay A McAlister
- Alberta Strategy for Patient Oriented Research Support Unit Data Platform et Provincial Research Data Services (King, Whitten), Services de santé de l'Alberta, Calgary, Alb.; Alberta Strategy for Patient Oriented Research Support Unit Data Platform (Bakal, McAlister) et Provincial Research Data Services (Bakal), Services de santé de l'Alberta, Edmonton, Alb.; Division de médecine interne générale (McAlister), Université de l'Alberta, Edmonton, Alb.
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32
Abstract
Despite the worldwide spread of SARS-CoV-2 infection (COVID-19), knowledge of the different clinical presentations, ways of transmission, severity and prognosis in children and adolescents is limited. An increasing number of reports describe some of these characteristics in this age range. A non-systematic review was undertaken using MEDLINE (PubMed), LILACS (VHL), Scopus, Web of Science, Cochrane and CAPES Portal databases from 1 January until 30 September 2020 [103] with the search terms SARS-CoV-2, COVID-19, child, children, youth, adolescent and newborn to identify the more recent clinical aspects of SARS-CoV-2 infection in children. In general, SARS-CoV-2 infection in children tends to be asymptomatic or to have mild or moderate signs, and most young ones are infected by family members. Recent reports offer new insights into the disease. Current evidence on SARS-CoV-2 infection in children and adolescents is presented, especially concerning the clinical presentation, imaging and uncommon severe forms of the disease, particularly the COVID-19-associated multisystem inflammatory syndrome. The impact of COVID-19 infection in the perinatal period is described in detail. Knowledge of the various clinical presentations of SARS-CoV-2 in children and adolescents allows the paediatrician to diagnose earlier, monitor warnings signs, implement treatment and, especially, establish preventive measures.Abbreviations : ACE-2, angiotensin-converting enzyme 2; ARDS, acute respiratory distress syndrome; ARF, acute rheumatic fever; CAA, coronary artery aneurysms; CK-MB, creatine kinase-MB; COVID-19, coronavirus disease-2019; HLA, specific human leucocyte antigen; IPC, infection prevention and control; IVIG, intravenous immunoglobulin; KD, Kawasaki disease; MIS-C, COVID-19-associated multisystem inflammatory syndrome; RNA, ribonucleic acid; RT-PCR, reserve transcription-polymerase chain reaction; SARS-CoV-2, severe acute respiratory syndrome coronavirus-2; TCT, thoracic computed tomography; TSS, toxic shock syndrome; WHO, World Health Organization.
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Affiliation(s)
- Marlos Melo Martins
- Department of Pediatrics, Institute of Childcare and Pediatrics Martagão Gesteira, Universidade Federal do Rio de Janeiro, Rio De Janeiro, Brazil
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- Arnaldo Prata-Barbosa
- Department of Pediatrics, Intituto d'Or de Pesquisa e Ensino (IDOR), Rio de Janeiro, Brazil
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33
Somekh I, Shohat T, Boker LK, Simões EAF, Somekh E. Reopening Schools and the Dynamics of SARS-CoV-2 Infections in Israel: A Nationwide Study.
Clin Infect Dis 2021;
73:2265-2275. [PMID:
33460434 PMCID:
PMC7929073 DOI:
10.1093/cid/ciab035]
[Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 01/14/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND
The benefits of school reopening must be weighed against the morbidity and mortality risks and the impact of enhancing spread of COVID-19. We investigated the effects of school reopening and easing of social distancing restrictions on the dynamics of SARS-CoV-2 infections in Israel, between March-July 2020.
METHODS
We examined the nationwide agewise weekly incidence, prevalence, SARS-CoV-2 PCR tests, their positivity, COVID-19 hospitalizations and associated mortality. Temporal differences in these parameters following school reopening, school ending, and following easing of restrictions such as permission of large scale gatherings, were examined.
RESULTS
The incidence of SARS-CoV-2 infections gradually increased following school reopening in all age groups, with a significantly higher increase in adults compared to children. Higher relative ratios (RRs) of sample positivity rates 21-27 days following school reopening relative to positivity rates prior to openings were found for the age groups 40-59 (RR: 4.72, 95% CI: 3.26 - 6.83) and 20-39 years (RR: 3.37 [2.51 - 4.53]), but not for children aged 0-9 (RR: 1.46 [0.85 - 2.51]) and 10-19 years (RR: 0.93 [0.65 - 1.34]).No increase was observed in COVID-19 associated hospitalizations and deaths following school reopening. In contrast, permission of large-scale gatherings was accompanied by increases in incidence and positivity rates of samples for all age groups, and increased hospitalizations and mortality.
CONCLUSIONS
This analysis does not support a major role of school reopening in the resurgence of the COVID-19 curve in Israel. Easing restrictions on large scale gatherings was the major influence on this resurgence.
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Affiliation(s)
- Ido Somekh
- Department of Pediatric Hematology Oncology, Schneider Children's Medical Center of Israel, Petach Tikva.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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- Tamy Shohat
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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- Lital Keinan Boker
- Israel Center for Disease Control, Israel Ministry of Health.,School of Public Health, University of Haifa, Haifa, Israel
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- Eli Somekh
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Pediatrics, Mayanei Hayeshuah Medical Center, Bnei Brak, Israel
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34
King JA, Whitten TA, Bakal JA, McAlister FA. Symptoms associated with a positive result for a swab for SARS-CoV-2 infection among children in Alberta.
CMAJ 2021;
193:E1-E9. [PMID:
33234533 PMCID:
PMC7774482 DOI:
10.1503/cmaj.202065]
[Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND
Research involving children with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has primarily focused on those presenting to emergency departments. We aimed to determine the symptoms most commonly associated with a positive result for a SARS-CoV-2 swab among community-based children.
METHODS
We conducted an observational study among children tested and followed for SARS-CoV-2 infection using nasal, nasopharyngeal, throat or other (e.g., nasopharyngeal aspirate or tracheal secretions, or unknown) swabs between Apr. 13 and Sept. 30, 2020, in Alberta. We calculated positive likelihood ratios (LRs) for self-reported symptoms and a positive SARS-CoV-2 swab result in the entire cohort and in 3 sensitivity analyses: all children with at least 1 symptom, all children tested because of contact tracing whether they were symptomatic or not and all children 5 years of age or older.
RESULTS
We analyzed results for 2463 children who underwent testing for SARS-CoV-2 infection; 1987 children had a positive result and 476 had a negative result. Of children with a positive test result for SARS-CoV-2, 714 (35.9%) reported being asymptomatic. Although cough (24.5%) and rhinorrhea (19.3%) were 2 of the most common symptoms among children with SARS-CoV-2 infection, they were also common among those with negative test results and were not predictive of a positive test (positive LR 0.96, 95% confidence interval [CI] 0.81-1.14, and 0.87, 95% CI 0.72-1.06, respectively). Anosmia/ageusia (positive LR 7.33, 95% CI 3.03-17.76), nausea/vomiting (positive LR 5.51, 95% CI 1.74-17.43), headache (positive LR 2.49, 95% CI 1.74- 3.57) and fever (positive LR 1.68, 95% CI 1.34-2.11) were the symptoms most predictive of a positive result for a SARS-CoV-2 swab. The positive LR for the combination of anosmia/ageusia, nausea/vomiting and headache was 65.92 (95% CI 49.48-91.92).
INTERPRETATION
About two-thirds of the children who tested positive for SARS-CoV-2 infection reported symptoms. The symptoms most strongly associated with a positive SARS-CoV-2 swab result were anosmia/ageusia, nausea/vomiting, headache and fever.
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Affiliation(s)
- James A King
- Alberta Strategy for Patient Oriented Research Support Unit Data Platform and Provincial Research Data Services (King, Whitten), Alberta Health Services, Calgary Alta.; Alberta Strategy for Patient Oriented Research Support Unit Data Platform (Bakal, McAlister) and Provincial Research Data Services (Bakal), Alberta Health Services, Edmonton, Alta.; Division of General Internal Medicine (McAlister), University of Alberta, Edmonton, Alta
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- Tara A Whitten
- Alberta Strategy for Patient Oriented Research Support Unit Data Platform and Provincial Research Data Services (King, Whitten), Alberta Health Services, Calgary Alta.; Alberta Strategy for Patient Oriented Research Support Unit Data Platform (Bakal, McAlister) and Provincial Research Data Services (Bakal), Alberta Health Services, Edmonton, Alta.; Division of General Internal Medicine (McAlister), University of Alberta, Edmonton, Alta
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- Jeffrey A Bakal
- Alberta Strategy for Patient Oriented Research Support Unit Data Platform and Provincial Research Data Services (King, Whitten), Alberta Health Services, Calgary Alta.; Alberta Strategy for Patient Oriented Research Support Unit Data Platform (Bakal, McAlister) and Provincial Research Data Services (Bakal), Alberta Health Services, Edmonton, Alta.; Division of General Internal Medicine (McAlister), University of Alberta, Edmonton, Alta
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- Finlay A McAlister
- Alberta Strategy for Patient Oriented Research Support Unit Data Platform and Provincial Research Data Services (King, Whitten), Alberta Health Services, Calgary Alta.; Alberta Strategy for Patient Oriented Research Support Unit Data Platform (Bakal, McAlister) and Provincial Research Data Services (Bakal), Alberta Health Services, Edmonton, Alta.; Division of General Internal Medicine (McAlister), University of Alberta, Edmonton, Alta.
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35
Pitlick MM, Joshi AY. Considerations for asthma management and viral transmission in the era of COVID-19.
Allergy Asthma Proc 2021;
42:93-96. [PMID:
33357281 DOI:
10.2500/aap.2021.42.200111]
[Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Background: As the global COVID-19 pandemic has unfolded, there has been much debate surrounding the optimal management of patients with asthma who are at risk of or contract COVID-19, whether asthma and steroids are risk factors for severe COVID-19, and how transmissible the virus is among children. Objective: The objective of this study is to provide allergists and other clinicians with pearls pertaining to the management of patients with asthma in the setting of the COVID-19 pandemic and to provide some information regarding the risk of transmission among the pediatric population. Methods: Utilizing the case of one of our own patients with asthma who developed COVID-19 as context, we review the recent literature discussing the risk of COVID-19 in patients with asthma, the management of asthma medications in the time of the pandemic, and the risk of viral transmission. Results: Despite initial reports that asthma was a risk factor for developing severe COVID-19, subsequent investigation has shown that this is likely not true. Additionally, the use of systemic or inhaled glucocorticoids does not appear to increase the risk of severe COVID-19, but there is no evidence guiding the use of biologic therapy. There is conflicting evidence regarding the ability of children to transmit the virus. Conclusion: We provide pearls that asthma does not appear to be associated with an increased risk of COVID-19 and continued use of inhaled corticosteroids appears to be safe. While there is no evidence guiding the use of biologic therapies, a recent position paper suggests that they should be continued unless a patient contracts COVID-19, at which point they should be held until clinical recovery occurs.
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Affiliation(s)
- Mitchell M. Pitlick
- From the Division of Allergic Disease, Department of Medicine, Mayo Clinic, Rochester, Minnesota; and
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- Avni Y. Joshi
- From the Division of Allergic Disease, Department of Medicine, Mayo Clinic, Rochester, Minnesota; and
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36
Freeman MC, Gaietto K, DiCicco LA, Rauenswinter S, Squire JR, Aldewereld Z, Rapsinski G, Iagnemma J, Campfield BT, Wolfson D, Kazmerski TM, Forno E. A Comprehensive Clinical Description of Pediatric SARS-CoV-2 Infection in Western Pennsylvania.
MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2020:2020.12.14.20248192. [PMID:
33354687 PMCID:
PMC7755149 DOI:
10.1101/2020.12.14.20248192]
[Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Objective
We sought to characterize clinical presentation and healthcare utilization for pediatric COVID-19 in Western Pennsylvania (PA).
Methods
We established and analyzed a registry of pediatric COVID-19 in Western PA that includes cases in patients <22 years of age cared for by the pediatric quaternary medical center in the area and its associated pediatric primary care network from March 11 through August 20, 2020.
Results
Our cohort included 424 pediatric COVID-19 cases (mean age 12.5 years, 47.4% female); 65% reported exposure and 79% presented with symptoms. The most common initial healthcare contact was through telehealth (45%). Most cases were followed as outpatients, but twenty-two patients (4.5%) were hospitalized: 19 with acute COVID-19 disease, and three for multisystem inflammatory syndrome of children (MIS-C). Admitted patients were younger (p<0.001) and more likely to have pre-existing conditions (p<0.001). Black/Hispanic patients were 5.8 times more likely to be hospitalized than white patients (p=0.012). Five patients (1.2%) were admitted to the PICU, including all three MIS-C cases; two required BiPAP and one mechanical ventilation. All patients survived.
Conclusions
We provide a comprehensive snapshot of pediatric COVID-19 disease in an area with low to moderate incidence. In this cohort, COVID-19 was generally a mild disease; however, ~5% of children were hospitalized. Pediatric patients can be critically ill with this infection, including those presenting with MIS-C.
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Affiliation(s)
- Megan Culler Freeman
- Division of Infectious Diseases, UPMC Children's Hospital of Pittsburgh, and Department of Pediatrics, University of Pittsburgh, Pittsburgh, PA
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- Kristina Gaietto
- Division of Pulmonary Medicine, UPMC Children's Hospital of Pittsburgh, and Department of Pediatrics, University of Pittsburgh, Pittsburgh, PA
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- Leigh Anne DiCicco
- Division of Hospital Medicine, UPMC Children's Hospital of Pittsburgh, and Department of Pediatrics, University of Pittsburgh, Pittsburgh, PA
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- Zachary Aldewereld
- Division of Infectious Diseases, UPMC Children's Hospital of Pittsburgh, and Department of Pediatrics, University of Pittsburgh, Pittsburgh, PA
- Division of Pediatric Critical Care Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA
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- Glenn Rapsinski
- Division of Infectious Diseases, UPMC Children's Hospital of Pittsburgh, and Department of Pediatrics, University of Pittsburgh, Pittsburgh, PA
- Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, PA
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- Brian T Campfield
- Division of Infectious Diseases, UPMC Children's Hospital of Pittsburgh, and Department of Pediatrics, University of Pittsburgh, Pittsburgh, PA
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- Traci M Kazmerski
- Division of Pulmonary Medicine, UPMC Children's Hospital of Pittsburgh, and Department of Pediatrics, University of Pittsburgh, Pittsburgh, PA
- Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, and Department of Pediatrics, University of Pittsburgh, Pittsburgh, PA
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- Erick Forno
- Division of Pulmonary Medicine, UPMC Children's Hospital of Pittsburgh, and Department of Pediatrics, University of Pittsburgh, Pittsburgh, PA
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37
Li K, Li L, Wang X, Li H, Chen J, Liu L, Shao J, Xu Y, He L, Gong S, Xia H, Liang H. Comparative analysis of clinical features of SARS-CoV-2 and adenovirus infection among children.
Virol J 2020;
17:193. [PMID:
33302983 PMCID:
PMC7726278 DOI:
10.1186/s12985-020-01461-4]
[Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 12/01/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND
The new emerging coronavirus disease 2019 (COVID-19) overall shares similar symptoms with other common respiratory viral infections. We aimed in this study to compare COVID-19 and human adenovirus (HAdV) infections in pediatric patients regarding the frequencies of major clinical symptoms and the potential disparities in laboratory and imaging parameters.
METHODS
Following a case-control-like design, we built 72 age-matched pediatric COVID-19 and HAdV patient pairs. Their early symptoms and laboratory and imaging characteristics were then retrieved and compared.
RESULTS
Fever and cough were the most common symptoms for both infections but were seen more often in HAdV than in COVID-19 patients (92% vs. 66% and 60% vs. 18%, respectively). Compared with COVID-19 patients, children with HAdV infection had statistically significantly higher values of neutrophil count, neutrophil percentage, activated partial thromboplastin time, prothrombin time, lactate dehydrogenase, C-reactive protein, procalcitonin but lower values of lymphocyte percentage, total bilirubin, potassium and sodium. Thoracic computed tomography also revealed more anomalies in HAdV patients than in COVID-19 patients (95% vs. 67%).
CONCLUSIONS
COVID-19 is an overall less symptomatic and less severe infection at admission compared to HAdV respiratory infection in pediatric population.
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Affiliation(s)
- Kuanrong Li
- Clinical Data Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Jinsui Road, Guangzhou, 510623, Guangdong, China
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- Ling Li
- Clinical Data Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Jinsui Road, Guangzhou, 510623, Guangdong, China
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- Xianfeng Wang
- Department of Pediatric, Third People's Hospital of Shenzhen, Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, Guangdong, China
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- Hui Li
- Department of Pediatric, Wuhan Children's Hospital, Wuhan, Hubei, China
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- Jun Chen
- Department of Pediatric, Third People's Hospital of Shenzhen, Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, Guangdong, China
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- Lei Liu
- Department of Infectious Disease, Third People's Hospital of Shenzhen, Shenzhen, Guangdong, China
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- Jianbo Shao
- Department of Pediatric, Wuhan Children's Hospital, Wuhan, Hubei, China
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- Yi Xu
- Department of Pediatric, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China
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- Liya He
- Department of Pediatric, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China.,Guangdong Provincial Children's Medical Research Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China
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- Sitang Gong
- Department of Pediatric, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China.,Guangdong Provincial Children's Medical Research Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China
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- Huimin Xia
- Clinical Data Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Jinsui Road, Guangzhou, 510623, Guangdong, China.,Guangdong Provincial Children's Medical Research Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China
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- Huiying Liang
- Clinical Data Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Jinsui Road, Guangzhou, 510623, Guangdong, China.
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38
SARS-CoV-2 in children: spectrum of disease, transmission and immunopathological underpinnings.
Pathology 2020;
52:801-808. [PMID:
32888706 PMCID:
PMC7437539 DOI:
10.1016/j.pathol.2020.08.001]
[Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 08/05/2020] [Accepted: 08/10/2020] [Indexed: 02/08/2023]
Abstract
As the SARS-CoV-2 pandemic unfolds across the globe, consistent themes are emerging with regard to aspects of SARS-CoV-2 infection and its associated disease entities in children. Overall, children appear to be less frequently infected by, and affected by, SARS-CoV-2 virus and the clinical disease COVID-19. Large epidemiological studies have revealed children represent less than 2% of the total confirmed COVID-19 cases, of whom the majority experience minimal or mild disease that do not require hospitalisation. Children do not appear to be major drivers of SARS-CoV-2 transmission, with minimal secondary virus transmission demonstrated within families, schools and community settings. There are several postulated theories regarding the relatively low SARS-CoV-2 morbidity and mortality seen in children, which largely relate to differences in immune responses compared to adults, as well as differences in angiotensin converting enzyme 2 distribution that potentially limits viral entry and subsequent inflammation, hypoxia and tissue injury. The recent emergence of a multisystem inflammatory syndrome bearing temporal and serological plausibility for an immune-mediated SARS-CoV-2-related disease entity is currently under investigation. This article summarises the current available data regarding SARS-CoV-2 and the paediatric population, including the spectrum of disease in children, the role of children in virus transmission, and host-virus factors that underpin the unique aspects of SARS-CoV-2 pathogenicity in children.
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39
Children and Adolescents With SARS-CoV-2 Infection: Epidemiology, Clinical Course and Viral Loads.
Pediatr Infect Dis J 2020;
39:e388-e392. [PMID:
33031141 DOI:
10.1097/inf.0000000000002899]
[Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND
There is limited information on severe acute respiratory syndrome virus 2 (SARS-CoV-2) infection in children.
METHODS
We retrieved data from the national database on SARS-CoV-2 infections. We studied in-family transmission. The level of viral load was categorized as high, moderate, or low based on the cycle threshold values.
RESULTS
We studied 203 SARS-CoV-2-infected children (median age: 11 years; range: 6 days to 18.4 years); 111 (54.7%) had an asymptomatic infection. Among the 92 children (45.3%) with coronavirus disease 2019 (COVID-19), 24 (26.1%) were hospitalized. Infants <1 year were more likely to develop COVID-19 (19.5% of all COVID-19 cases) (P-value = 0.001). There was no significant difference between viral load and age, sex, underlying condition, fever and hospitalization, as well as between type of SARS-CoV-2 infection and age, sex, underlying condition and viral load. Transmission from a household member accounted for 132 of 178 (74.2%) children for whom the source of infection was identified. An adult member with COVID-19 was the first case in 125 (66.8%) family clusters. Child-to-adult transmission was found in one occasion only.
CONCLUSIONS
SARS-CoV-2 infection is mainly asymptomatic or mild during childhood. Adults appear to play a key role in spread of the virus in families. Most children have moderate or high viral loads regardless of age, symptoms or severity of infection. Further studies are needed to elucidate the role of children in the ongoing pandemic and particularly in light of schools reopening and the need to prioritize groups for vaccination, when COVID-19 vaccines will be available.
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40
Pan P, Li Y, Xiao Y, Han B, Su L, Su M, Li Y, Zhang S, Jiang D, Chen X, Zhou F, Ma L, Bao P, Xie L. Prognostic Assessment of COVID-19 in the Intensive Care Unit by Machine Learning Methods: Model Development and Validation.
J Med Internet Res 2020;
22:e23128. [PMID:
33035175 PMCID:
PMC7661105 DOI:
10.2196/23128]
[Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 09/06/2020] [Accepted: 10/08/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND
Patients with COVID-19 in the intensive care unit (ICU) have a high mortality rate, and methods to assess patients' prognosis early and administer precise treatment are of great significance.
OBJECTIVE
The aim of this study was to use machine learning to construct a model for the analysis of risk factors and prediction of mortality among ICU patients with COVID-19.
METHODS
In this study, 123 patients with COVID-19 in the ICU of Vulcan Hill Hospital were retrospectively selected from the database, and the data were randomly divided into a training data set (n=98) and test data set (n=25) with a 4:1 ratio. Significance tests, correlation analysis, and factor analysis were used to screen 100 potential risk factors individually. Conventional logistic regression methods and four machine learning algorithms were used to construct the risk prediction model for the prognosis of patients with COVID-19 in the ICU. The performance of these machine learning models was measured by the area under the receiver operating characteristic curve (AUC). Interpretation and evaluation of the risk prediction model were performed using calibration curves, SHapley Additive exPlanations (SHAP), Local Interpretable Model-Agnostic Explanations (LIME), etc, to ensure its stability and reliability. The outcome was based on the ICU deaths recorded from the database.
RESULTS
Layer-by-layer screening of 100 potential risk factors finally revealed 8 important risk factors that were included in the risk prediction model: lymphocyte percentage, prothrombin time, lactate dehydrogenase, total bilirubin, eosinophil percentage, creatinine, neutrophil percentage, and albumin level. Finally, an eXtreme Gradient Boosting (XGBoost) model established with the 8 important risk factors showed the best recognition ability in the training set of 5-fold cross validation (AUC=0.86) and the verification queue (AUC=0.92). The calibration curve showed that the risk predicted by the model was in good agreement with the actual risk. In addition, using the SHAP and LIME algorithms, feature interpretation and sample prediction interpretation algorithms of the XGBoost black box model were implemented. Additionally, the model was translated into a web-based risk calculator that is freely available for public usage.
CONCLUSIONS
The 8-factor XGBoost model predicts risk of death in ICU patients with COVID-19 well; it initially demonstrates stability and can be used effectively to predict COVID-19 prognosis in ICU patients.
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Affiliation(s)
- Pan Pan
- Chinese PLA General Hospital, Medical School Of Chinese PLA, College of Pulmonary and Critical Care Medicine, Beijing, China
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- Yichao Li
- DHC Mediway Technology Co Ltd, Beijing, China
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- Yongjiu Xiao
- The 940th Hospital of Jiont Logistics Support Force of Chinese People's Liberation Army, Lanzhou, China
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- Bingchao Han
- The 980th Hospital of Jiont Logistics Support Force of Chinese People's Liberation Army, Shijiazhuang, China
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- Longxiang Su
- Peking Union Medical College Hospital, Beijing, China
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- Yansheng Li
- DHC Mediway Technology Co Ltd, Beijing, China
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- Siqi Zhang
- DHC Mediway Technology Co Ltd, Beijing, China
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- Xia Chen
- DHC Mediway Technology Co Ltd, Beijing, China
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- Fuquan Zhou
- DHC Mediway Technology Co Ltd, Beijing, China
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- Ling Ma
- The 940th Hospital of Jiont Logistics Support Force of Chinese People's Liberation Army, Lanzhou, China
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- Pengtao Bao
- College of Pulmonary and Critical Care Medicine, Chinese PLA General Hospital, Beijing, China
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- Lixin Xie
- College of Pulmonary and Critical Care Medicine, Chinese PLA General Hospital, Beijing, China
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41
Nikolai LA, Meyer CG, Kremsner PG, Velavan TP. Asymptomatic SARS Coronavirus 2 infection: Invisible yet invincible.
Int J Infect Dis 2020;
100:112-116. [PMID:
32891737 PMCID:
PMC7470698 DOI:
10.1016/j.ijid.2020.08.076]
[Citation(s) in RCA: 204] [Impact Index Per Article: 40.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 08/26/2020] [Accepted: 08/28/2020] [Indexed: 02/07/2023] Open
Abstract
While successful containment measures of COVID-19 in China and many European countries have led to flattened curves, case numbers are rising dramatically in other countries, with the emergence of a second wave expected. Asymptomatic individuals carrying SARS-CoV-2 are hidden drivers of the pandemic, and infectivity studies confirm the existence of transmission by asymptomatic individuals. The data addressed here show that characteristics of asymptomatic and presymptomatic infection are not identical. Younger age correlates strongly with asymptomatic and mild infections and children as hidden drivers. The estimated proportion of asymptomatic infections ranges from 18% to 81%. The current perception of asymptomatic infections does not provide clear guidance for public-health measures. Asymptomatic infections will be a key contributor in the spread of COVID-19. Asymptomatic cases should be reported in official COVID-19 statistics.
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Affiliation(s)
- Lea A Nikolai
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany
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- Christian G Meyer
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany; Vietnamese-German Center for Medical Research, Hanoi, Viet Nam; Faculty of Medicine, Duy Tan University, Da Nang, Viet Nam
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- Peter G Kremsner
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany; Centre de Recherches Medicales de Lambarene, Gabon
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- Thirumalaisamy P Velavan
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany; Vietnamese-German Center for Medical Research, Hanoi, Viet Nam; Faculty of Medicine, Duy Tan University, Da Nang, Viet Nam.
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42
Solano-Sandí LA, Cambronero-Valverde M, Herrera-Watson G. Identification and analysis of ongoing registered clinical intervention trials on COVID-19.
Medwave 2020;
20:e8051. [PMID:
33141813 DOI:
10.5867/medwave.2020.09.8051]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 09/25/2020] [Indexed: 11/27/2022] Open
Abstract
Introduction
The World Health Organization declared the disease caused by the novel coronavirus (SARS-CoV-2), a pandemic on March 11, 2020. Several studies have been proposed and started since then, mainly covering prevention, diagnosis, management, and treatment.
Objective
To identify and categorize all intervention studies up to the end of May related to SARS-CoV-2 infection, according to population and geo-graphical location (emphasis in Latin America) and to verify if there is any correlation according to purpose, phase, and recruitment status.
Methods
One thousand six hundred seventy-two trials were selected from 1705 until May 24 on the World Health Organization clinical trials platform related to COVID-19. Jupyter and Python tools were used for data processing and cleaning.
Results
One thousand six hundred seventy-two intervention studies related to SARS-CoV-2 infection were found. China, The United States, Iran, France, and Spain are the countries participating in the largest number of studies, while only 4,1% are from Latin America (mostly Brazilian). 28 studies are focusing only on older adults, and ten studies are based exclusively on populations under 19 years of age.
Conclusion
The worldwide interest in this new disease is reflected in the increasing number of intervention studies that are being carried out to date. How-ever, the studies analyzed do not cover the most vulnerable age groups proportionally and do not have equitable participation of all the coun-tries. In Latin America, this problem is exacerbated by the region's social, economic, and political limitations. Because it is an emerging disease, there is still not enough information to establish strong correlations between the analyzed variables, and the standardization of protocols is not yet definite because most of the studies are in progress.
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Affiliation(s)
- Luis Armando Solano-Sandí
- Centro Especializado de Atención de Pacientes con COVID-19, Caja Costarricense del Seguro Social, San José, Costa Rica. . Address: CENARE, La Uruca, detrás del Hospital México, San José, Costa Rica. ORCID: 0000-0001-5212-8311
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- Mónica Cambronero-Valverde
- Hospital Rafael Ángel Calderón Guardia, Caja Costarricense del Seguro Social, San José, Costa Rica. ORCID:0000-0002-0916-1340
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- Guadalupe Herrera-Watson
- Hospital Enrique Baltodano Briceño, Caja Costarricense del Seguro Social, Guanacaste, Costa Rica. ORCID: 0000-0002-8614-2768
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43
Velavan TP, Pollard AJ, Kremsner PG. Herd immunity and vaccination of children for COVID-19.
Int J Infect Dis 2020;
98:14-15. [PMID:
32585285 PMCID:
PMC7308740 DOI:
10.1016/j.ijid.2020.06.065]
[Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 06/17/2020] [Accepted: 06/18/2020] [Indexed: 12/15/2022] Open
Affiliation(s)
- Thirumalaisamy P Velavan
- Institute of Tropical Medicine, Universitätsklinikum Tübingen, Germany; Vietnamese-German Center for Medical Research, Hanoi, Viet Nam; Faculty of Medicine, Duy Tan University, Da Nang, Viet Nam.
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- Andrew J Pollard
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, NIHR Oxford Biomedical Research Centre, Oxford, UK
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- Peter G Kremsner
- Institute of Tropical Medicine, Universitätsklinikum Tübingen, Germany; Centre de Recherches Medicales de Lambarene, Gabon
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44
Rousseau A, Fenolland JR, Labetoulle M. [SARS-CoV-2, COVID-19 and the eye: An update on published data].
J Fr Ophtalmol 2020;
43:642-652. [PMID:
32631687 PMCID:
PMC7260525 DOI:
10.1016/j.jfo.2020.05.003]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 05/18/2020] [Accepted: 05/19/2020] [Indexed: 01/08/2023]
Abstract
The COVID-19 pandemic has dramatically changed our daily lives as ophthalmologists. This general review firstly provides a better understanding of the virus responsible for the pandemic: the SARS-CoV-2, and the clinical manifestations of the COVID-19 disease. The second part is detailing the pathophysiology, clinical signs and challenges of ocular involvement, which seems rare and not functionally severe, but which may be a potential source of contamination. Finally, we discuss the preventive measures that need to be implemented in our daily practice to avoid any viral dissemination.
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MESH Headings
- Betacoronavirus/genetics
- Betacoronavirus/ultrastructure
- COVID-19
- Coronavirus Infections/complications
- Coronavirus Infections/epidemiology
- Coronavirus Infections/physiopathology
- Coronavirus Infections/prevention & control
- Diagnostic Techniques, Ophthalmological
- Eye/virology
- Eye Infections, Viral/physiopathology
- Eye Infections, Viral/prevention & control
- Eye Infections, Viral/virology
- Genome, Viral
- Humans
- Microscopy, Electron
- Pandemics/prevention & control
- Pneumonia, Viral/complications
- Pneumonia, Viral/epidemiology
- Pneumonia, Viral/physiopathology
- Pneumonia, Viral/prevention & control
- SARS-CoV-2
- Virus Integration
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Affiliation(s)
- A Rousseau
- Service d'ophtalmologie, CHU Bicêtre, hôpital Bicêtre, Assistance publique-Hôpitaux de Paris, université Paris-Saclay, réseau OPHTARA : maladies rares en ophtalmologie, Le Kremlin-Bicêtre, France; Département immunologie des maladies virales, auto-immunes, bactériennes et hématologiques. UMR 1184, CEA, Fontenay-Aux-Roses, France.
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- J-R Fenolland
- Service d'ophtalmologie, hôpital d'instruction des Armées Bégin, Saint-Mandé, France
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- M Labetoulle
- Service d'ophtalmologie, CHU Bicêtre, hôpital Bicêtre, Assistance publique-Hôpitaux de Paris, université Paris-Saclay, réseau OPHTARA : maladies rares en ophtalmologie, Le Kremlin-Bicêtre, France; Département immunologie des maladies virales, auto-immunes, bactériennes et hématologiques. UMR 1184, CEA, Fontenay-Aux-Roses, France
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45
Maltezou HC, Vorou R, Papadima K, Kossyvakis A, Spanakis N, Gioula G, Exindari M, Metallidis S, Lourida AN, Raftopoulos V, Froukala E, Martinez-Gonzalez B, Mitsianis A, Roilides E, Mentis A, Tsakris A, Papa A. Transmission dynamics of SARS-CoV-2 within families with children in Greece: A study of 23 clusters.
J Med Virol 2020;
93:1414-1420. [PMID:
32767703 PMCID:
PMC7441283 DOI:
10.1002/jmv.26394]
[Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 07/27/2020] [Accepted: 08/02/2020] [Indexed: 11/22/2022]
Abstract
There is limited information on severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection clustering within families with children. We aimed to study the transmission dynamics of SARS‐CoV‐2 within families with children in Greece. We studied 23 family clusters of coronavirus disease 2019 (COVID‐19). Infection was diagnosed by reverse‐transcriptase polymerase chain reaction in respiratory specimens. The level of viral load was categorized as high, moderate, or low based on the cycle threshold values. There were 109 household members (66 adults and 43 children). The median attack rate per cluster was 60% (range: 33.4%‐100%). An adult member with COVID‐19 was the first case in 21 (91.3%) clusters. Transmission of infection occurred from an adult to a child in 19 clusters and/or from an adult to another adult in 12 clusters. There was no evidence of child‐to‐adult or child‐to‐child transmission. In total 68 household members (62.4%) tested positive. Children were more likely to have an asymptomatic SARS‐CoV‐2 infection compared to adults (40% vs 10.5%; P = .021). In contrast, adults were more likely to develop a severe clinical course compared with children (8.8% vs 0%; P = .021). In addition, infected children were significantly more likely to have a low viral load while adults were more likely to have a moderate viral load (40.7% and 18.6% vs 13.8% and 51.7%, respectively; P = .016). In conclusion, while children become infected by SARS‐CoV‐2, they do not appear to transmit infection to others. Furthermore, children more frequently have an asymptomatic or mild course compared to adults. Further studies are needed to elucidate the role of viral load on these findings.
We studied 23 family clusters; an adult was the first case in 21 (91.3%) of them.
The median attach rate per family cluster was 60% (range: 33.4%‐100%).
There was no evidence of child‐to‐adult or child‐to‐child transmission.
Children more often were asymptomatic or had a mild illness compared to adults.
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Affiliation(s)
- Helena C Maltezou
- Directorate of Epidemiological Surveillance and Interventions for Infectious Diseases, National Public Health Organization, Athens, Greece
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- Rengina Vorou
- Directorate of Epidemiological Surveillance and Interventions for Infectious Diseases, National Public Health Organization, Athens, Greece
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- Kalliopi Papadima
- Directorate of Epidemiological Surveillance and Interventions for Infectious Diseases, National Public Health Organization, Athens, Greece
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- Athanasios Kossyvakis
- National Reference Laboratory for Influenza and other Respiratory Viruses, Hellenic Pasteur Institute, Athens, Greece
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- Nikolaos Spanakis
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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- Georgia Gioula
- Department of Microbiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
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- Maria Exindari
- Department of Microbiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
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- Symeon Metallidis
- Infectious Diseases Division, First Internal Medicine Department, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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- Athanasia N Lourida
- Infection Prevention and Control Committee, Aghia Sofia Children's Hospital, Athens, Greece
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- Vasilios Raftopoulos
- Epidemiological Surveillance of HIV/AIDS Department, National Public Health Organization, Athens, Greece
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- Elisavet Froukala
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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- Beatriz Martinez-Gonzalez
- National Reference Laboratory for Influenza and other Respiratory Viruses, Hellenic Pasteur Institute, Athens, Greece
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- Athanasios Mitsianis
- Internal Medicine Department, Mpodosakeio General Prefecture Hospital of Ptolemaida, Ptolemaida, Greece
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- Emmanuel Roilides
- Third Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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- Andreas Mentis
- National Reference Laboratory for Influenza and other Respiratory Viruses, Hellenic Pasteur Institute, Athens, Greece
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- Athanasios Tsakris
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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- Anna Papa
- Department of Microbiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
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46
Petretto DR, Masala I, Masala C. School Closure and Children in the Outbreak of COVID-19.
Clin Pract Epidemiol Ment Health 2020;
16:189-191. [PMID:
32944059 PMCID:
PMC7476239 DOI:
10.2174/1745017902016010189]
[Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 05/16/2020] [Indexed: 12/18/2022]
Abstract
School closure and home confinement are two of the measures of lockdown chosen by governments and policymakers all over the world to prevent and limit the spread of the infection of COVID-19. There is still an open debate about the real effect of school closure on the reduction of risk of infection on children and the risk of infection on with other age groups (parents, grandparents and others). There is an agreement on the effect of school closure in reducing and delaying the peak of the outbreak. In this Editorial, starting from the ongoing Italian experience, we discuss direct and indirect effects of school closure on children’s psychological health and learning. We also highlight the need for an “on peace time” planning of measures and strategies necessary to face the direct and indirect effect of this outbreak and other outbreaks, on children’s psychological health.
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Affiliation(s)
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- Ilaria Masala
- Department of Pedagogy, Philosophy and Psychology, University of Cagliari, Cagliari, Italy
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- Carmelo Masala
- Department of Pedagogy, Philosophy and Psychology, University of Cagliari, Cagliari, Italy.,Studio Medico Neuropsicologico Masala Pistis, Piras, 09047Selargius, Italy
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47
Ludvigsson JF. Children are unlikely to be the main drivers of the COVID-19 pandemic - A systematic review.
Acta Paediatr 2020;
109:1525-1530. [PMID:
32430964 PMCID:
PMC7280674 DOI:
10.1111/apa.15371]
[Citation(s) in RCA: 155] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 05/18/2020] [Indexed: 01/08/2023]
Abstract
AIM
Many countries have closed schools and kindergartens to minimise COVID-19, but the role that children play in disease transmission is unclear.
METHODS
A systematic literature review of the MEDLINE and EMBASE databases and medRxiv/bioRxiv preprint servers to 11 May 2020 identified published and unpublished papers on COVID-19 transmission by children.
RESULTS
We identified 700 scientific papers and letters and 47 full texts were studied in detail. Children accounted for a small fraction of COVID-19 cases and mostly had social contacts with peers or parents, rather than older people at risk of severe disease. Data on viral loads were scarce, but indicated that children may have lower levels than adults, partly because they often have fewer symptoms, and this should decrease the transmission risk. Household transmission studies showed that children were rarely the index case and case studies suggested that children with COVID-19 seldom caused outbreaks. However, it is highly likely that children can transmit the SARS-COV-2 virus, which causes COVID-19, and even asymptomatic children can have viral loads.
CONCLUSION
Children are unlikely to be the main drivers of the pandemic. Opening up schools and kindergartens is unlikely to impact COVID-19 mortality rates in older people.
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Affiliation(s)
- Jonas F. Ludvigsson
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
- Department of PaediatricsOrebro University HospitalOrebroSweden
- Division of Epidemiology and Public HealthSchool of MedicineUniversity of NottinghamNottinghamUK
- Department of MedicineColumbia University College of Physicians and SurgeonsNew YorkNYUSA
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48
Devrim İ, Bayram N. Infection control practices in children during COVID-19 pandemic: Differences from adults.
Am J Infect Control 2020;
48:933-939. [PMID:
32464297 PMCID:
PMC7247983 DOI:
10.1016/j.ajic.2020.05.022]
[Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 05/20/2020] [Accepted: 05/20/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND
Limited studies have been published on practices and management of Coronavirus Disease 2019 (COVID-19) in children. Despite the fact that COVID-19 rarely caused any severe disease in children, the asymptomatic children might be playing an important role for spreading COVID-19 in healthcare facilities. This review aimed at sharing our experience of how to handle patients with COVID-19 in a pediatric referral and tertiary care hospital to prevent the possible transmissions to the healthcare workers (HCWs).
METHODS
This review sought to identify infection control practices measures during COVID-19 pandemic comes from our daily practice combined with the most recent guidelines with the new experience and information.
RESULTS
Prevention the transmission of COVID-19 to the HCWs, 4 primary themes should be taken into consideration; (1) ongoing education and importance of the organization of the healthcare facility, (2) proper clinical triage and isolation of the suspected or confirmed COVID-19 patients in the outpatient clinics and in the emergency departments, (3) necessity of the organization of the COVID-19 wards, and (4) utilization of personal protective equipment.
CONCLUSIONS
Infection control precautions to prevent the possible transmissions to HCWs as well as the other patients and their caregivers from children with COVID-19 are very critical. If sufficient precautions are not taken, healthcare settings may serve as additional source of transmission and spread of COVID-19 in the society.
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Affiliation(s)
- İlker Devrim
- University of Health Sciences Dr. Behçet Uz Children's Hospital, Department of Pediatric Infectious Diseases, İzmir, Turkey
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- Nuri Bayram
- University of Health Sciences Dr. Behçet Uz Children's Hospital, Department of Pediatric Infectious Diseases, İzmir, Turkey.
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49
Jung J, Hong MJ, Kim EO, Lee J, Kim MN, Kim SH. Investigation of a nosocomial outbreak of coronavirus disease 2019 in a paediatric ward in South Korea: successful control by early detection and extensive contact tracing with testing.
Clin Microbiol Infect 2020;
26:1574-1575. [PMID:
32593744 PMCID:
PMC7315989 DOI:
10.1016/j.cmi.2020.06.021]
[Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/16/2020] [Accepted: 06/19/2020] [Indexed: 12/20/2022]
Affiliation(s)
- J Jung
- Department of Infectious Diseases, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, South Korea; Office for Infection Control, Asan Medical Centre, Seoul, South Korea
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- M J Hong
- Office for Infection Control, Asan Medical Centre, Seoul, South Korea
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- E O Kim
- Office for Infection Control, Asan Medical Centre, Seoul, South Korea
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- J Lee
- Department of Paediatrics, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, South Korea
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- M-N Kim
- Department of Laboratory Medicine, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, South Korea
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- S-H Kim
- Department of Infectious Diseases, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, South Korea; Office for Infection Control, Asan Medical Centre, Seoul, South Korea.
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50
Jalaber C, Lapotre T, Morcet-Delattre T, Ribet F, Jouneau S, Lederlin M. Chest CT in COVID-19 pneumonia: A review of current knowledge.
Diagn Interv Imaging 2020;
101:431-437. [PMID:
32571748 PMCID:
PMC7287482 DOI:
10.1016/j.diii.2020.06.001]
[Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/08/2020] [Accepted: 06/09/2020] [Indexed: 02/07/2023]
Abstract
Unenhanced chest CT is indicated for patients with suspected COVID-19 presenting with dyspnea, polypnea or arterial blood oxygen desaturation.
Most typical CT features of COVID-19 pneumonia include bilateral and multifocal ground-glass opacities predominating in the peripheral, posterior and basal parts of the lungs.
Between 15 and 30% of hospitalized patients with COVID-19 progress to acute respiratory distress syndrome, which is the main cause of mortality.
The current COVID-19 pandemic has highlighted the essential role of chest computed tomography (CT) examination in patient triage in the emergency departments, allowing them to be referred to “COVID” or “non-COVID” wards. Initial chest CT examination must be performed without intravenous administration of iodinated contrast material, but contrast material administration is required when pulmonary embolism is suspected, which seems to be frequent in severe forms of the disease. Typical CT features consist of bilateral ground-glass opacities with peripheral, posterior and basal predominance. Lung disease extent on CT correlates with clinical severity. Artificial intelligence could assist radiologists for diagnosis and prognosis evaluation.
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Affiliation(s)
- C Jalaber
- CHU Saint-Étienne, Department of Radiology, 42270 Saint-Priest-en-Jarez, France
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- T Lapotre
- CHU de Rennes, Department of Radiology, 35033 Rennes, France
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- F Ribet
- CHU de Rennes, Department of Radiology, 35033 Rennes, France
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- S Jouneau
- CHU de Rennes, Department of Respiratory Medicine, 35033 Rennes, France
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- M Lederlin
- CHU de Rennes, Department of Radiology, 35033 Rennes, France; LTSI, INSERM, UMR 1099, Université de Rennes, 35000 Rennes, France.
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