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Kulkarni D, Ismail NF, Zhu F, Wang X, del Carmen Morales G, Srivastava A, Allen KE, Spinardi J, Rahman AE, Kyaw MH, Nair H. Epidemiology and clinical features of SARS-CoV-2 infection in children and adolescents in the pre-Omicron era: A global systematic review and meta-analysis. J Glob Health 2024; 14:05003. [PMID: 38419461 PMCID: PMC10902805 DOI: 10.7189/jogh.14.05003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024] Open
Abstract
Methods We searched MEDLINE, Embase, Global Health, CINAHL, China National Knowledge Infrastructure, Wanfang, CQvip, and the World Health Organization (WHO) COVID-19 global literature databases for primary studies recruiting children aged ≤18 years with a diagnosis of SARS-CoV-2 infection confirmed either by molecular or antigen tests. We used the Joanna Briggs Institute critical appraisal tools to appraise the study quality and conducted meta-analyses using the random effects model for all outcomes except for race/ethnicity as risk factors of SARS-CoV-2 infection. Results We included 237 studies, each reporting at least one of the study outcomes. Based on data from 117 studies, the pooled SARS-CoV-2 positivity rate was 9.30% (95% confidence interval (CI) = 7.15-11.73). Having a comorbidity was identified as a risk factor for SARS-CoV-2 infection (risk ratio (RR) = 1.33; 95% CI = 1.04-1.71) based on data from 49 studies. Most cases in this review presented with mild disease (n = 50; 52.47% (95% CI = 44.03-60.84)). However, 20.70% of paediatric SARS-CoV-2 infections were hospitalised (67 studies), 7.19% required oxygen support (57 studies), 4.26% required intensive care (93 studies), and 2.92% required assisted ventilation (63 studies). The case fatality ratio (n = 119) was 0.87% (95% CI = 0.54-1.28), which included in-hospital and out-of-hospital deaths. Conclusions Our data showed that children were at risk for SARS-CoV-2 infections and severe outcomes in the pre-Omicron era. These findings underscore the need for effective vaccination strategies for the paediatric population to protect against the acute and long-term sequelae of COVID-19. Registration PROSPERO: CRD42022327680.
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Affiliation(s)
- Durga Kulkarni
- Centre for Global Health, University of Edinburgh, Edinburgh, United Kingdom
| | - Nabihah Farhana Ismail
- Centre for Global Health, University of Edinburgh, Edinburgh, United Kingdom
- Communicable Disease Control Unit, Public Health Department, Johor State, Malaysia
| | - Fuyu Zhu
- Schol of Public Health, Nanjing Medical University, China
| | - Xin Wang
- Schol of Public Health, Nanjing Medical University, China
| | | | | | | | | | - Ahmed Ehsanur Rahman
- Centre for Global Health, University of Edinburgh, Edinburgh, United Kingdom
- International Centre for Diarrhoeal Diseases Research, Bangladesh
| | | | - Harish Nair
- Centre for Global Health, University of Edinburgh, Edinburgh, United Kingdom
- Schol of Public Health, Nanjing Medical University, China
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Pokorska-Śpiewak M, Pawłowska M, Ciechanowski P, Peregrym M, Dobrzeniecka A, Sobolewska-Pilarczyk M, Franczak J, Majda-Stanisławska E, Szczepańska B, Zaleska I, Flisiak R. Differences in Clinical Presentation of COVID-19 in Children Hospitalized During Domination of Early (BA.1, BA.2) and Late (BA.5, BA.2.75, BQ.1 and XBB.1.5) SARS-CoV-2 Omicron Subvariants. Pediatr Infect Dis J 2024; 43:149-154. [PMID: 37922516 DOI: 10.1097/inf.0000000000004167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2023]
Abstract
This study analyzed data for 1098 children: 575 diagnosed with COVID-19 between January and June 2022 (early Omicron) and 523 hospitalized from July 2022 to April 2023 (late Omicron). New Omicron subvariants lead to similar recovery rates without deaths and acute respiratory distress syndrome in children as BA.1 and BA.2, however, they more often cause fever and croup. Children suffering from comorbidities, presenting with pulmonary lesions and older, may be prone to a more severe consequences of COVID-19 in terms of the currently dominating Omicron subvariants.
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Affiliation(s)
- Maria Pokorska-Śpiewak
- Department of Pediatric Infectious Diseases, Regional Hospital of Infectious Diseases in Warsaw, Warsaw, Poland
- Department of Pediatrics and Infectious Diseases, Wroclaw Medical University, Wroclaw, Poland
| | - Małgorzata Pawłowska
- Department of Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Przemysław Ciechanowski
- Department of Pediatrics and Infectious Diseases, Regional Hospital in Szczecin, Szczecin, Poland
| | - Michał Peregrym
- Department of Pediatrics and Infectious Diseases, Regional Hospital in Szczecin, Szczecin, Poland
| | - Anna Dobrzeniecka
- Department of Pediatric Infectious Diseases, Regional Hospital of Infectious Diseases in Warsaw, Warsaw, Poland
| | - Małgorzata Sobolewska-Pilarczyk
- Department of Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Justyna Franczak
- Department of Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | | | - Barbara Szczepańska
- Department of Pediatrics, Pediatric Surgery and Otorhinolaryngology, Collegium Medicum Jan Kochanowski University, Kielce, Poland
| | - Izabela Zaleska
- Department of Pediatrics and Infectious Diseases, Wroclaw Medical University, Wroclaw, Poland
| | - Robert Flisiak
- Department of Infectious Diseases and Hepatology, Medical University of Bialystok, Bialystok, Poland
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Wypych-Ślusarska A, Krupa-Kotara K, Oleksiuk K, Głogowska-Ligus J, Słowiński J, Niewiadomska E. Socioeconomic and Health Determinants of the Prevalence of COVID-19 in a Population of Children with Respiratory Diseases and Symptoms. CHILDREN (BASEL, SWITZERLAND) 2024; 11:88. [PMID: 38255401 PMCID: PMC10814875 DOI: 10.3390/children11010088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 01/08/2024] [Accepted: 01/10/2024] [Indexed: 01/24/2024]
Abstract
BACKGROUND Most epidemiological studies indicate that bronchial asthma is not a risk factor for COVID-19, but previous analyses have not additionally focused on the socioeconomic determinants of SARS-CoV-2 infection in children with asthma, bronchitis, and respiratory symptoms. AIMS This research aimed to investigate the correlation between the socioeconomic status of families and the prevalence of respiratory conditions such as asthma, bronchitis, and respiratory symptoms in children, in addition to exploring their association with the prevalence of COVID-19. The study involved a cross-sectional epidemiological investigation conducted in 2022, encompassing 2454 students from elementary schools in Poland. The parents of the students completed a questionnaire modeled after the International Study on Asthma and Allergies in Childhood (ISAAC). Socioeconomic status (SES) indicators were determined based on parental education, self-reported economic status, and housing conditions. To assess the impact of social factors and health on the occurrence of COVID-19, odds ratios (ORs) were calculated. The findings revealed several COVID-19 risk factors, including higher maternal (OR 2.2; 95%CI: 1.3-3.0) and paternal education (OR 1.9; 95%CI: 1.3-2.4), urban residence (OR 1.7; 95%CI: 1.3-2.1), the presence of mold in residences (OR 1.7; 95%CI: 1.0-2.3), bronchitis (OR 1.5; 95%CI: 1.2-2.0), and chronic cough (OR 1.8; 95%CI: 1.3-2.4). Further analysis, stratifying children based on their baseline health status (i.e., presence or absence of asthma, bronchitis, and chronic cough), indicated that higher parental education increased the risk of COVID-19 solely for children without pre-existing conditions. The occurrence of SARS-CoV-2 infections was found to be notably associated with mold exposure in children who did not have bronchial asthma. Rigorous multivariate analyses substantiated the collective impact of factors such as residential environment, the existence of mold and moisture, and a history of bronchitis. This study's conclusions highlight a higher frequency of SARS-CoV-2 infections in cases where bronchitis had been diagnosed previously and chronic cough was prevalent. Interestingly, the initially hypothesized higher prevalence of COVID-19 among children with bronchial asthma did not receive confirmation in our findings. This study highlights the importance of urban residence, exposure to mold or dampness, and higher parental education in the incidence of COVID-19. Higher parental education was a significant factor in increasing the risk of COVID-19 among children without bronchitis, chronic cough, and asthma.
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Affiliation(s)
- Agata Wypych-Ślusarska
- Department of Epidemiology, Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, 41-902 Katowice, Poland; (A.W.-Ś.); (K.O.); (J.G.-L.); (J.S.)
| | - Karolina Krupa-Kotara
- Department of Biostatistics, Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, 41-902 Katowice, Poland;
| | - Klaudia Oleksiuk
- Department of Epidemiology, Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, 41-902 Katowice, Poland; (A.W.-Ś.); (K.O.); (J.G.-L.); (J.S.)
| | - Joanna Głogowska-Ligus
- Department of Epidemiology, Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, 41-902 Katowice, Poland; (A.W.-Ś.); (K.O.); (J.G.-L.); (J.S.)
| | - Jerzy Słowiński
- Department of Epidemiology, Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, 41-902 Katowice, Poland; (A.W.-Ś.); (K.O.); (J.G.-L.); (J.S.)
| | - Ewa Niewiadomska
- Department of Biostatistics, Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, 41-902 Katowice, Poland;
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Shurko JF, Page RB, Mares CA, Nguyen V, Lopez K, Vanee N, Mishra PK. Use of RT-PCR in conjunction with a respiratory pathogen assay to concurrently determine the prevalence of bacteria and SARS-CoV-2 from the nasopharynx of outpatients. FRONTIERS IN EPIDEMIOLOGY 2023; 3:1274800. [PMID: 38455907 PMCID: PMC10910948 DOI: 10.3389/fepid.2023.1274800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 10/11/2023] [Indexed: 03/09/2024]
Abstract
Introduction COVID-19 has emerged as a highly contagious and debilitating disease caused by the SARS-CoV-2 virus and has claimed the lives of over 7.7 million people worldwide. Bacterial co-infections are one of many co-morbidities that have been suggested to impact the outcome of COVID-19 in patients. The goals of this study are to elucidate the presence of bacteria in the nasopharynx of SARS-CoV-2 positive and negative patients and to describe demographic categories that may be associated with the detection of these organisms during one of the initial waves of the COVID-19 pandemic. Methods To this end, we investigated SARS-CoV-2 and bacterial co-detection from outpatient RT-PCR testing in Texas. Results The results indicate that Staphylococcus aureus, Streptococcus pneumoniae, Klebsiella pneumoniae, Moraxella catarrhalis, and Haemophilus influenzae were the most frequently detected bacteria in both SARS-CoV-2 positive and SARS-CoV-2 negative patients and that these bacteria were present in these two patient populations at similar proportions. We also detected Staphylococcus aureus in a significantly larger proportion of males relative to females and people under 65 years of age relative to those 65 and over. Finally, we observed that SARS-CoV-2 was more commonly detected in Hispanics compared to non-Hispanics; however, low disclosure rates make volunteer bias a concern when interpreting the effects of demographic variables. Discussion This study describes the bacteria present in the nasopharynx of SARS-CoV-2 positive and negative patients, highlights associations between patient demographics and SARS-CoV-2 as well as bacterial co-detection. In addition, this study highlights RT-PCR based molecular testing as a tool to detect bacteria simultaneously when SARS-CoV-2 tests are performed.
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Affiliation(s)
- James F. Shurko
- Molecular Diagnostics Division, iGenomeDx, San Antonio, TX, United States
| | - Robert B. Page
- Department of Life Sciences, Texas A&M University-San Antonio, San Antonio, TX, United States
- Lousiana Scholars’ College, Northwestern State University, Natchitoches, LA, United States
| | - Chris A. Mares
- Department of Life Sciences, Texas A&M University-San Antonio, San Antonio, TX, United States
| | - Vivian Nguyen
- Molecular Diagnostics Division, iGenomeDx, San Antonio, TX, United States
| | - Kristina Lopez
- Molecular Diagnostics Division, iGenomeDx, San Antonio, TX, United States
| | - Niti Vanee
- Molecular Diagnostics Division, iGenomeDx, San Antonio, TX, United States
| | - Pramod K. Mishra
- Molecular Diagnostics Division, iGenomeDx, San Antonio, TX, United States
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Pokorska-Śpiewak M, Talarek E, Pawłowska M, Mania A, Hasiec B, Żwirek-Pytka E, Stankiewicz M, Stani M, Frańczak-Chmura P, Szenborn L, Zaleska I, Chruszcz J, Majda-Stanisławska E, Dryja U, Gąsiorowska K, Figlerowicz M, Mazur-Melewska K, Faltin K, Ciechanowski P, Peregrym M, Łasecka-Zadrożna J, Rudnicki J, Szczepańska B, Pałyga-Bysiecka I, Rogowska E, Hudobska-Nawrot D, Domańska-Granek K, Sybilski A, Kucharek I, Franczak J, Sobolewska-Pilarczyk M, Kuchar E, Wronowski M, Paryż M, Kalicki B, Toczyłowski K, Sulik A, Niedźwiecka S, Gorczyca A, Marczyńska M. The Influence of SARS-CoV-2 Variants B.1.1.7 and B.1.617.2 on a Different Clinical Course and Severity of COVID-19 in Children Hospitalized in 2021 Compared With 2020. Pediatr Infect Dis J 2023; 42:584-589. [PMID: 37053572 PMCID: PMC10289062 DOI: 10.1097/inf.0000000000003918] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/20/2023] [Indexed: 04/15/2023]
Abstract
BACKGROUND This study aimed to analyze the differences in the epidemiologic and clinical characteristics of coronavirus disease 2019 (COVID-19) in children hospitalized in 2021, when the severe acute respiratory syndrome coronavirus 2 variants B.1.1.7 (alpha) and B.1.617.2 (delta) dominated, compared with 2020. METHODS In this multicenter study based on the pediatric part of the national SARSTer register (SARSTer-PED), we included 2771 children (0-18 years) with COVID-19 diagnosed between March 1, 2020, and December 31, 2021, from 14 Polish inpatient centers. An electronic questionnaire, which addressed epidemiologic and clinical data, was used. RESULTS Children hospitalized in 2021 were younger compared with those reported in 2020 (mean 4.1 vs. 6.8 years, P = 0 .01). Underlying comorbidities were reported in 22% of the patients. The clinical course was usually mild (70%). A significant difference in the clinical course assessment between 2020 and 2021 was found, with more asymptomatic patients in 2020 and more severely ill children in 2021. In total, 5% of patients were severely or critically ill, including <3% of the participants in 2020 and 7% in 2021. The calculated mortality rate was 0.1% in general and 0.2% in 2021. CONCLUSION Infections with severe acute respiratory syndrome coronavirus 2 variants alpha and delta lead to a more severe course of COVID-19 with more pronounced clinical presentation and higher fatality rates than infection with an original strain. Most of the children requiring hospitalization due to COVID-19 do not have underlying comorbidities.
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Affiliation(s)
- Maria Pokorska-Śpiewak
- From the Department of Children’s Infectious Diseases, Medical University of Warsaw; Regional Hospital of Infectious Diseases in Warsaw
| | - Ewa Talarek
- From the Department of Children’s Infectious Diseases, Medical University of Warsaw; Regional Hospital of Infectious Diseases in Warsaw
| | - Małgorzata Pawłowska
- Department of Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz
| | - Anna Mania
- Department of Infectious Diseases and Child Neurology, Poznan University of Medical Sciences
| | - Barbara Hasiec
- Department of Children’s Infectious Diseases, Provincial Jan Boży Hospital in Lublin
| | - Elżbieta Żwirek-Pytka
- Department of Children’s Infectious Diseases, Provincial Jan Boży Hospital in Lublin
| | - Magdalena Stankiewicz
- Department of Children’s Infectious Diseases, Provincial Jan Boży Hospital in Lublin
| | - Martyna Stani
- Department of Children’s Infectious Diseases, Provincial Jan Boży Hospital in Lublin
| | | | - Leszek Szenborn
- Department of Pediatrics and Infectious Diseases, Wroclaw Medical University
| | - Izabela Zaleska
- Department of Pediatrics and Infectious Diseases, Wroclaw Medical University
| | - Joanna Chruszcz
- Department of Pediatrics and Infectious Diseases, Wroclaw Medical University
| | | | - Urszula Dryja
- Department of Pediatric Infectious Diseases, Medical University of Lodz
| | | | - Magdalena Figlerowicz
- Department of Infectious Diseases and Child Neurology, Poznan University of Medical Sciences
| | | | - Kamil Faltin
- Department of Infectious Diseases and Child Neurology, Poznan University of Medical Sciences
| | | | - Michał Peregrym
- Department of Pediatrics and Infectious Diseases, Regional Hospital in Szczecin
| | | | - Józef Rudnicki
- Department of Pediatrics and Infectious Diseases, Regional Hospital in Szczecin
| | | | | | | | | | | | - Adam Sybilski
- 2nd Department of Pediatrics, Centre of Postgraduate Medical Education, Warsaw
- Department of Pediatrics and Neonatology with Allergology Center, Central Clinical Hospital of the Ministry of the Interior, Warsaw
| | - Izabela Kucharek
- 2nd Department of Pediatrics, Centre of Postgraduate Medical Education, Warsaw
- Department of Pediatrics and Neonatology with Allergology Center, Central Clinical Hospital of the Ministry of the Interior, Warsaw
| | - Justyna Franczak
- Department of Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz
| | - Małgorzata Sobolewska-Pilarczyk
- Department of Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz
| | - Ernest Kuchar
- Department of Pediatrics with Clinical Assessment Unit, Medical University of Warsaw
| | - Michał Wronowski
- Department of Pediatrics with Clinical Assessment Unit, Medical University of Warsaw
| | - Maria Paryż
- Department of Pediatrics, Pediatric Nephrology and Allergology, Military Institute of Medicine, Warsaw
| | - Bolesław Kalicki
- Department of Pediatrics, Pediatric Nephrology and Allergology, Military Institute of Medicine, Warsaw
| | - Kacper Toczyłowski
- Department of Pediatric Infectious Diseases, Medical University of Bialystok
| | - Artur Sulik
- Department of Pediatric Infectious Diseases, Medical University of Bialystok
| | - Sławomira Niedźwiecka
- Department of Pediatric Infectious Diseases, Pomeranian Center of Infectious Diseases and Tuberculosis in Gdańsk
| | - Anna Gorczyca
- The Ward of Pediatric Infectious Diseases and Hepatology, The John Paul II Hospital in Krakow
| | - Magdalena Marczyńska
- From the Department of Children’s Infectious Diseases, Medical University of Warsaw; Regional Hospital of Infectious Diseases in Warsaw
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Malveste Ito CR, Moreira ALE, Silva PAND, Santos MDO, Santos APD, Rézio GS, Brito PND, Rezende APC, Fonseca JG, Peixoto FADO, Wastowski IJ, Goes VM, Estrela MC, Souza PZD, Carneiro LC, Avelino MAG. Viral Coinfection of Children Hospitalized with Severe Acute Respiratory Infections during COVID-19 Pandemic. Biomedicines 2023; 11:biomedicines11051402. [PMID: 37239073 DOI: 10.3390/biomedicines11051402] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 04/24/2023] [Accepted: 04/26/2023] [Indexed: 05/28/2023] Open
Abstract
The main pathogens of severe respiratory infection in children are respiratory viruses, and the current molecular technology allows for a rapid and simultaneous detection of a wide spectrum of these viral pathogens, facilitating the diagnosis and evaluation of viral coinfection. METHODS This study was conducted between March 2020 and December 2021. All children admitted to the ICU with a diagnosis of SARI and who were tested by polymerase chain reaction on nasopharyngeal swabs for SARS-CoV-2 and other common respiratory viral pathogens were included in the study. RESULTS The result of the viral panel identified 446 children, with one infected with a single virus and 160 co-infected with two or more viruses. This study employed descriptive analyses, where a total of twenty-two coinfections among SARI-causing viruses were identified. Thus, the five most frequent coinfections that were selected for the study are: hRV/SARS-CoV-2 (17.91%), hRV/RSV (14.18%), RSV/SARS-CoV-2 (12.69%), hRV/BoV (10.45%), and hRV/AdV (8.21%). The most significant age group was 38.1%, representing patients aged between 24 and 59 months (61 individuals). Patients older than 59 months represented a total of 27.5%, comprising forty-four patients. The use of oxygen therapy was statistically significant in coinfections with Bocavirus, other CoVs, Metapneumovirus, and RSV. Coinfections with SARS-CoV-2 and the other different coinfections presented a similar time of use of oxygen therapy with a value of (p > 0.05). In the year 2020, hRV/BoV was more frequent in relation to other types of coinfections, representing a total of 35.1%. The year 2021 presented a divergent profile, with hRV/SARS-CoV-2 coinfection being the most frequent (30.8%), followed by hRV/RSV (28.2%). Additionally, 25.6% and 15.4% represented coinfections between RSV/SARS-CoV-2 and hRV/AdV, respectively. We saw that two of the patients coinfected with hRV/SARS-CoV-2 died, representing 9.52% of all deaths in the study. In addition, both hRV/hBoV and hRV/RSV had death records for each case, representing 8.33% and 6.67% of all deaths, respectively. CONCLUSION Coinfections with respiratory viruses, such as RSV and hBoV, can increase the severity of the disease in children with SARI who are admitted to the ICU, and children infected with SARS-CoV-2 have their clinical condition worsened when they have comorbidities.
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Affiliation(s)
- Célia Regina Malveste Ito
- Microorganism Biotechnology Laboratory, Institute of Tropical Pathology and Public Health, Federal University of Goiás, 235 St. Leste Universitário, Goiânia 74605-050, GO, Brazil
| | - André Luís Elias Moreira
- Microorganism Biotechnology Laboratory, Institute of Tropical Pathology and Public Health, Federal University of Goiás, 235 St. Leste Universitário, Goiânia 74605-050, GO, Brazil
| | - Paulo Alex Neves da Silva
- Microorganism Biotechnology Laboratory, Institute of Tropical Pathology and Public Health, Federal University of Goiás, 235 St. Leste Universitário, Goiânia 74605-050, GO, Brazil
| | - Mônica de Oliveira Santos
- Microorganism Biotechnology Laboratory, Institute of Tropical Pathology and Public Health, Federal University of Goiás, 235 St. Leste Universitário, Goiânia 74605-050, GO, Brazil
| | - Adailton Pereira Dos Santos
- Microorganism Biotechnology Laboratory, Institute of Tropical Pathology and Public Health, Federal University of Goiás, 235 St. Leste Universitário, Goiânia 74605-050, GO, Brazil
| | - Geovana Sôffa Rézio
- State Emergency Hospital of the Northwest Region of Goiânia Governador Otávio Lage de Siqueira (HUGOL), Anhanguera Avenue, 14.527-Santos Dumont, Goiânia 74463-350, GO, Brazil
| | - Pollyanna Neta de Brito
- State Emergency Hospital of the Northwest Region of Goiânia Governador Otávio Lage de Siqueira (HUGOL), Anhanguera Avenue, 14.527-Santos Dumont, Goiânia 74463-350, GO, Brazil
| | - Alana Parreira Costa Rezende
- State Emergency Hospital of the Northwest Region of Goiânia Governador Otávio Lage de Siqueira (HUGOL), Anhanguera Avenue, 14.527-Santos Dumont, Goiânia 74463-350, GO, Brazil
| | - Jakeline Godinho Fonseca
- State Emergency Hospital of the Northwest Region of Goiânia Governador Otávio Lage de Siqueira (HUGOL), Anhanguera Avenue, 14.527-Santos Dumont, Goiânia 74463-350, GO, Brazil
| | | | - Isabela Jubé Wastowski
- Molecular Immunology Laboratory, Goiás State University, Laranjeiras Unity Prof. Alfredo de Castro St., 9175, Parque das Laranjeiras, Goiânia 74855-130, GO, Brazil
| | - Viviane Monteiro Goes
- Institute of Molecular Biology of Paraná (IBMP), Professor Algacyr Munhoz Mader St, 3775-Industrial City of Curitiba, Curitiba 81350-010, PR, Brazil
| | - Mariely Cordeiro Estrela
- Institute of Molecular Biology of Paraná (IBMP), Professor Algacyr Munhoz Mader St, 3775-Industrial City of Curitiba, Curitiba 81350-010, PR, Brazil
| | - Priscila Zanette de Souza
- Institute of Molecular Biology of Paraná (IBMP), Professor Algacyr Munhoz Mader St, 3775-Industrial City of Curitiba, Curitiba 81350-010, PR, Brazil
| | - Lilian Carla Carneiro
- Microorganism Biotechnology Laboratory, Institute of Tropical Pathology and Public Health, Federal University of Goiás, 235 St. Leste Universitário, Goiânia 74605-050, GO, Brazil
| | - Melissa Ameloti Gomes Avelino
- Departament of Pediatrics, Federal University of Goiás, Universitaria Avenue, Leste Universitário, Goiânia 74605-050, GO, Brazil
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7
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Bogusławski S, Strzelak A, Gajko K, Peradzyńska J, Popielska J, Marczyńska M, Kulus M, Krenke K. The outcomes of COVID-19 pneumonia in children-clinical, radiographic, and pulmonary function assessment. Pediatr Pulmonol 2023; 58:1042-1050. [PMID: 36562653 PMCID: PMC9880754 DOI: 10.1002/ppul.26291] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 12/15/2022] [Accepted: 12/20/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The goal of this study was to assess the pulmonary sequelae of COVID-19 pneumonia in children. STUDY DESIGN Children (0-18 years old) diagnosed with COVID-19 pneumonia hospitalized between March 2020 and March 2021 were included in this observational study. All children underwent follow-up visits 3 months postdischarge, and if any abnormalities were stated, a second visit after the next 3 months was scheduled. Clinical assessment included medical history, physical examination, lung ultrasound (LUS) using a standardized protocol, and pulmonary function tests (PFTs). PFTs results were compared with healthy children. RESULTS Forty-one patients with COVID-19 pneumonia (severe disease n = 3, mechanical ventilation, n = 0) were included in the study. Persistent symptoms were reported by seven (17.1%) children, the most common was decreased exercise tolerance (57.1%), dyspnea (42.9%), and cough (42.9%). The most prevalent abnormalities in LUS were coalescent B-lines (37%) and small subpleural consolidations (29%). The extent of LUS abnormalities was significantly greater at the first than at the second follow-up visit (p = 0.03). There were no significant differences in PFTs results neither between the study group and healthy children nor between the two follow-up visits in the study group. CONCLUSIONS Our study shows that children might experience long-term sequelae following COVID-19 pneumonia. In the majority of cases, these are mild and resolve over time.
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Affiliation(s)
- Stanisław Bogusławski
- Department of Pediatric Pneumonology and Allergy, Medical University of Warsaw, Warsaw, Poland
| | - Agnieszka Strzelak
- Department of Pediatric Pneumonology and Allergy, Medical University of Warsaw, Warsaw, Poland
| | - Kacper Gajko
- Department of Pediatric Pneumonology and Allergy, Medical University of Warsaw, Warsaw, Poland
| | - Joanna Peradzyńska
- Department of Pediatric Pneumonology and Allergy, Medical University of Warsaw, Warsaw, Poland.,Department of Epidemiology and Biostatistics, Medical University of Warsaw, Warsaw, Poland
| | - Jolanta Popielska
- Department of Children's Infectious Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Magdalena Marczyńska
- Department of Children's Infectious Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Marek Kulus
- Department of Pediatric Pneumonology and Allergy, Medical University of Warsaw, Warsaw, Poland
| | - Katarzyna Krenke
- Department of Pediatric Pneumonology and Allergy, Medical University of Warsaw, Warsaw, Poland
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8
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Casassola GM, Schmidt CJ, Affeldt GH, Morais DS, Alvarenga LKB, Miller C, Ziegler B. Functional status of hospitalized pediatric patients with COVID-19 in southern Brazil: a prospective cohort study. J Bras Pneumol 2023; 48:e20220153. [PMID: 36651435 PMCID: PMC9747171 DOI: 10.36416/1806-3756/e20220153] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 09/27/2022] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE The present study aimed to assess the functional status of children diagnosed with COVID-19 at the time of hospitalization and the associations with clinical features. METHODS This prospective cohort study was carried out with children diagnosed with COVID-19 admitted to a tertiary hospital. The patients' functioning was assessed using the pediatric Functional Status Scale (FSS). RESULTS A total of 62 children with a median age of 3 years old were included in the study, and 70% had some comorbidity prior to the diagnosis of COVID-19. The median length of stay was nine days, during which period five patients died. The FSS assessment of the sample showed that approximately 55% had some functional alteration. The group of patients with the highest FSS scores presented a lengthier hospital stay (p = 0.016), required more oxygen therapy (p < 0.001), mechanical ventilation (p = 0.001), and intensive care unit admissions (p = 0.019), and had more cardiac (p = 0.007), neurological (p = 0.003), and respiratory (p = 0.013) comorbidities. In the multivariate analysis, there was an association between the dependent variable length of stay and the total FSS score (b = 0.349, p = 0.004) and the presence of comorbidities (b = 0.357, p = 0.004). CONCLUSIONS We observed that more than half of the children hospitalized due to COVID-19 had some level of functional change. Greater alterations in functional status were associated with the presence of previous comorbidities, a greater need for ventilatory support, and longer hospital stays.
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Affiliation(s)
| | | | - Guilherme Hoff Affeldt
- . Programa de Pós-Graduação em Pneumologia, Universidade Federal do Rio Grande do Sul, Porto Alegre (RS), Brasil
| | | | | | - Cristina Miller
- . Hospital de Clínicas de Porto Alegre, Porto Alegre (RS), Brasil
| | - Bruna Ziegler
- . Hospital de Clínicas de Porto Alegre, Porto Alegre (RS), Brasil
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9
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Pavliuk O, Kolesnyk H. Machine-learning method for analyzing and predicting the number of hospitalizations of children during the fourth wave of the COVID-19 pandemic in the Lviv region. JOURNAL OF RELIABLE INTELLIGENT ENVIRONMENTS 2023; 9:17-26. [PMID: 36065343 PMCID: PMC9434091 DOI: 10.1007/s40860-022-00188-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 08/04/2022] [Indexed: 11/13/2022]
Abstract
The purpose of this paper is to develop a machine-learning model for analyzing and predicting the number of hospitalizations of children in the Lviv region during the fourth wave of the COVID-19 pandemic. This wave is characterized by dominance of a new strain of the virus-Omicron-that spreads faster than previous ones and often affects children. Their high sociability and a low level of vaccination in Ukraine resulted in a sharp increase in the number of hospitalizations. The complexity of the research is also related to the geolocation of the Lviv region. This article analyzes and predicts the number of hospitalizations of children during the fourth wave of the COVID-19 pandemic for the first time for the Lviv region. Data were obtained from publicly available resources. Public Domain Software-the Python programming language and the Pandas library-was used for software implementation of the machine-learning method: the developed model consists of two components-analysis and prediction. The analysis of the number of hospitalized children was performed using the Pearson correlation coefficient. Short- and medium-term predictions were made with the use of non-iterative SGTM neural-like structures that were taught in supervised mode and tested in online mode. The RMS and maximum ones that were reduced to the range of error values of short-term (up to a week) and medium-term (up to 2 weeks) predictions did not exceed 0.48% and 0.61% and 1.81% and 2.83%, respectively. The developed model can also be used for predicting other COVID-19 parameters.
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Affiliation(s)
- Olena Pavliuk
- grid.10067.300000 0001 1280 1647Department of Automated Control Systems, Lviv Polytechnic National University, Stepan Bandera Str., 12, Lviv, 79013 Ukraine
| | - Halyna Kolesnyk
- grid.10067.300000 0001 1280 1647Foreign Languages Department, Lviv Polytechnic National University, Stepan Bandera Str., 12, Lviv, 79013 Ukraine
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10
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Prijić A, Gazibara T, Prijić S, Mandić-Rajčević S, Maksimović N. Factors Associated with the Antibiotic Treatment of Children Hospitalized for COVID-19 during the Lockdown in Serbia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15590. [PMID: 36497665 PMCID: PMC9737727 DOI: 10.3390/ijerph192315590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 11/19/2022] [Accepted: 11/21/2022] [Indexed: 06/17/2023]
Abstract
Unselective use of antibiotics to treat children with COVID-19 is one of the major issues during the pandemic in Serbia. Thus far, there has been no evidence about the predictors of multiple antibiotic use in the treatment of children with COVID-19. The purpose of this study was to assess the prevalence of antibiotic use, as well as to examine demographic and clinical factors associated with a greater number of antibiotics and with a longer antibiotic treatment administered to hospitalized children with COVID-19 during the lockdown in Serbia. This study included all children who were hospitalized from 6 March to 31 May 2020 at the only pediatric COVID-19 hospital, and who were confirmed to have SARS-CoV-2 infection. Demographic, clinical, and laboratory data were collected from medical records. The antibiotic treatment included the use of azithromycin, cephalosporin (ceftriaxone), ampicillin-amikacin, and hydroxychloroquine. The overall prevalence of antibiotics use in children hospitalized with COVID-19 regardless of age was 47.2% (43.3% in children aged 1-5 years and 44.4% in those aged 5-17 years). In children aged 1-5 years, not having a family member affected by COVID-19 (B = -1.38, 95% confidence interval [CI] -2.43, -0.34, p = 0.011), having pneumonia on chest X-ray (B = 0.81, 95%CI 0.34, 1.29, p = 0.002), being a boy (B = -0.65, 95%CI -1.17, -0.13, p = 0.018), and having higher C-reactive protein (CRP) values on admission (B = 0.12, 95%CI 0.07, 0.17, p = 0.001) were associated with the administration of a higher number of antibiotics. These factors, along with having fever (B = 3.20, 95%CI 1.03, 5.37, p = 0.006), were associated with a longer duration of antibiotic treatment in children aged 1-5 years. In children aged 5-17 years, having pharyngeal erythema (B = 1.37, 95%CI 0.61, 2.13, p = 0.001), fever (B = 0.43, 95%CI 0.07, 0.79, p = 0.018), and pneumonia on chest X-ray (B = 0.91, 95%CI 0.53, 1.29, p = 0.001), not having rhinorrhea (B = -1.27, 95%CI -2.47, -0.08, p = 0.037), being a girl (B = 0.52, 95%CI 0.08, 0.97, p = 0.021), and having higher CRP values on admission (B = 0.04, 95%CI 0.01, 0.06, p = 0.006) were associated with the administration of a higher number of antibiotics. These factors, not including the absence of rhinorrhea, were associated with a longer duration of antibiotics treatment in children aged 5-17 years. Demographic, epidemiological, clinical, and laboratory parameters were associated with the use of multiple antibiotics and a longer duration of antibiotic treatment both among children aged 1-5 years and those aged 5-17 years.
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Affiliation(s)
- Andreja Prijić
- Children’s Hospital for Lung Diseases and Tuberculosis, University Clinical Hospital Center “Dr Dragiša Mišović–Dedinje”, 11000 Belgrade, Serbia
| | - Tatjana Gazibara
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Sergej Prijić
- Mother and Child Health Institute of Serbia “Dr Vukan Čupić”, 11000 Belgrade, Serbia
| | - Stefan Mandić-Rajčević
- Institute of Social Medicine, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Nataša Maksimović
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
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11
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Alhumaid S, Alabdulqader M, Al Dossary N, Al Alawi Z, Alnaim AA, Al Mutared KM, Al Noaim K, Al Ghamdi MA, Albahrani SJ, Alahmari AA, Al Hajji Mohammed SM, Almatawah YA, Bayameen OM, Alismaeel AA, Alzamil SK, Alturki SA, Albrahim ZR, Al Bagshi NA, Alshawareb HY, Alhudar JA, Algurairy QA, Alghadeer SM, Alhadab HA, Aljubran TN, Alabdulaly YA, Al Mutair A, Rabaan AA. Global Coinfections with Bacteria, Fungi, and Respiratory Viruses in Children with SARS-CoV-2: A Systematic Review and Meta-Analysis. Trop Med Infect Dis 2022; 7:tropicalmed7110380. [PMID: 36422931 PMCID: PMC9698370 DOI: 10.3390/tropicalmed7110380] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/01/2022] [Accepted: 11/07/2022] [Indexed: 11/18/2022] Open
Abstract
Background: Coinfection with bacteria, fungi, and respiratory viruses has been described as a factor associated with more severe clinical outcomes in children with COVID-19. Such coinfections in children with COVID-19 have been reported to increase morbidity and mortality. Objectives: To identify the type and proportion of coinfections with SARS-CoV-2 and bacteria, fungi, and/or respiratory viruses, and investigate the severity of COVID-19 in children. Methods: For this systematic review and meta-analysis, we searched ProQuest, Medline, Embase, PubMed, CINAHL, Wiley online library, Scopus, and Nature through the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for studies on the incidence of COVID-19 in children with bacterial, fungal, and/or respiratory coinfections, published from 1 December 2019 to 1 October 2022, with English language restriction. Results: Of the 169 papers that were identified, 130 articles were included in the systematic review (57 cohort, 52 case report, and 21 case series studies) and 34 articles (23 cohort, eight case series, and three case report studies) were included in the meta-analysis. Of the 17,588 COVID-19 children who were tested for co-pathogens, bacterial, fungal, and/or respiratory viral coinfections were reported (n = 1633, 9.3%). The median patient age ranged from 1.4 months to 144 months across studies. There was an increased male predominance in pediatric COVID-19 patients diagnosed with bacterial, fungal, and/or viral coinfections in most of the studies (male gender: n = 204, 59.1% compared to female gender: n = 141, 40.9%). The majority of the cases belonged to White (Caucasian) (n = 441, 53.3%), Asian (n = 205, 24.8%), Indian (n = 71, 8.6%), and Black (n = 51, 6.2%) ethnicities. The overall pooled proportions of children with laboratory-confirmed COVID-19 who had bacterial, fungal, and respiratory viral coinfections were 4.73% (95% CI 3.86 to 5.60, n = 445, 34 studies, I2 85%, p < 0.01), 0.98% (95% CI 0.13 to 1.83, n = 17, six studies, I2 49%, p < 0.08), and 5.41% (95% CI 4.48 to 6.34, n = 441, 32 studies, I2 87%, p < 0.01), respectively. Children with COVID-19 in the ICU had higher coinfections compared to ICU and non-ICU patients, as follows: respiratory viral (6.61%, 95% CI 5.06−8.17, I2 = 0% versus 5.31%, 95% CI 4.31−6.30, I2 = 88%) and fungal (1.72%, 95% CI 0.45−2.99, I2 = 0% versus 0.62%, 95% CI 0.00−1.55, I2 = 54%); however, COVID-19 children admitted to the ICU had a lower bacterial coinfection compared to the COVID-19 children in the ICU and non-ICU group (3.02%, 95% CI 1.70−4.34, I2 = 0% versus 4.91%, 95% CI 3.97−5.84, I2 = 87%). The most common identified virus and bacterium in children with COVID-19 were RSV (n = 342, 31.4%) and Mycoplasma pneumonia (n = 120, 23.1%). Conclusion: Children with COVID-19 seem to have distinctly lower rates of bacterial, fungal, and/or respiratory viral coinfections than adults. RSV and Mycoplasma pneumonia were the most common identified virus and bacterium in children infected with SARS-CoV-2. Knowledge of bacterial, fungal, and/or respiratory viral confections has potential diagnostic and treatment implications in COVID-19 children.
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Affiliation(s)
- Saad Alhumaid
- Administration of Pharmaceutical Care, Al-Ahsa Health Cluster, Ministry of Health, Al-Ahsa 31982, Saudi Arabia
- Correspondence: ; Tel.: +966-561-522-581
| | - Muneera Alabdulqader
- Pediatric Nephrology Specialty, Pediatric Department, Medical College, King Faisal University, Al-Ahsa 31982, Saudi Arabia
| | - Nourah Al Dossary
- General Surgery Department, Alomran General Hospital, Ministry of Health, Al-Ahsa 36358, Saudi Arabia
| | - Zainab Al Alawi
- Division of Allergy and Immunology, College of Medicine, King Faisal University, Al-Ahsa 31982, Saudi Arabia
| | - Abdulrahman A. Alnaim
- Department of Pediatrics, College of Medicine, King Faisal University, Al-Ahsa 31982, Saudi Arabia
| | - Koblan M. Al Mutared
- Administration of Pharmaceutical Care, Ministry of Health, Najran 66255, Saudi Arabia
| | - Khalid Al Noaim
- Department of Pediatrics, College of Medicine, King Faisal University, Al-Ahsa 31982, Saudi Arabia
| | - Mohammed A. Al Ghamdi
- Department of Pediatrics, King Fahad Hospital of the University, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 34212, Saudi Arabia
| | - Suha Jafar Albahrani
- Division of Diabetology, Family Medicine Department, College of Medicine, King Faisal University, Al-Ahsa 36364, Saudi Arabia
| | - Abdulaziz A. Alahmari
- Department of Pediatrics, King Fahad Hospital of the University, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 34212, Saudi Arabia
| | | | - Yameen Ali Almatawah
- Division of Infectious Diseases and Infection Control, Pediatric Department, Maternity and Children Hospital, Ministry of Health, Al-Ahsa 36422, Saudi Arabia
| | - Omar Musa Bayameen
- Public Health Administration, Directorate of Health Affairs, Ministry of Health, Al-Ahsa 36441, Saudi Arabia
| | - Ahmed Abdulwhab Alismaeel
- Public Health Administration, Directorate of Health Affairs, Ministry of Health, Al-Ahsa 36441, Saudi Arabia
| | - Sherifah Khaled Alzamil
- Public Health Administration, Directorate of Health Affairs, Ministry of Health, Al-Ahsa 36441, Saudi Arabia
| | - Samiah Ahmad Alturki
- Public Health Administration, Directorate of Health Affairs, Ministry of Health, Al-Ahsa 36441, Saudi Arabia
| | - Zahra’a Radi Albrahim
- Public Health Administration, Directorate of Health Affairs, Ministry of Health, Al-Ahsa 36441, Saudi Arabia
| | - Nasreen Ahmad Al Bagshi
- Public Health Administration, Directorate of Health Affairs, Ministry of Health, Al-Ahsa 36441, Saudi Arabia
| | - Hesham Yousef Alshawareb
- Southern Sector, Primary Care Medicine, Al-Ahsa Health Cluster, Ministry of Health, Al-Ahsa 36421, Saudi Arabia
| | - Jaafar Abdullah Alhudar
- Regional Medical Supply, Al-Ahsa Health Cluster, Ministry of Health, Al-Ahsa 36361, Saudi Arabia
| | | | - Samirah Mansour Alghadeer
- Infection Prevention and Control Administration, Al-Ahsa Health Cluster, Ministry of Health, Al-Ahsa 36421, Saudi Arabia
| | - Hassan Ali Alhadab
- Ambulatory Transportation Administration, Al-Ahsa Health Cluster, Ministry of Health, Al-Ahsa 36421, Saudi Arabia
| | | | - Yousif Ahmad Alabdulaly
- Quality Assurance and Patient Safety Administration, Directorate of Health Affairs, Ministry of Health, Al-Ahsa 36441, Saudi Arabia
| | - Abbas Al Mutair
- Research Center, Almoosa Specialist Hospital, Al-Ahsa 36342, Saudi Arabia
- College of Nursing, Princess Norah Bint Abdulrahman University, Riyadh 11564, Saudi Arabia
- School of Nursing, Wollongong University, Wollongong, NSW 2522, Australia
- Department of Nursing, Prince Sultan Military College, Dhahran 34313, Saudi Arabia
| | - Ali A. Rabaan
- Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia
- College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia
- Department of Public Health/Nutrition, The University of Haripur, Haripur 22620, Khyber Pakhtunkhwa, Pakistan
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12
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Rzymski P, Poniedziałek B, Rosińska J, Ciechanowski P, Peregrym M, Pokorska-Śpiewak M, Talarek E, Zaleska I, Frańczak-Chmura P, Pilarczyk M, Figlerowicz M, Kucharek I, Flisiak R. Air pollution might affect the clinical course of COVID-19 in pediatric patients. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 239:113651. [PMID: 35594828 PMCID: PMC9110326 DOI: 10.1016/j.ecoenv.2022.113651] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 04/29/2022] [Accepted: 05/12/2022] [Indexed: 05/05/2023]
Abstract
Air pollution, to which children are more susceptible than adults, can promote airway inflammation, potentially exaggerating the effects of respiratory viral infection. This study examined the association between the clinical manifestation of COVID-19 in unvaccinated pediatric patients hospitalized in Poland (n = 766) and levels of particulate matter 2.5 (PM2.5) and benzo(a)pyrene (B(a)P) within a week before hospitalization. Children aged ≤ 12 years exposed to mean and max 24 h B(a)P levels > 1 ng/m3 revealed higher odds of cough, dyspnea, fever, and increased concentrations of inflammatory markers (C-reactive protein, interleukin-6, procalcitonin, white blood cell count). In older patients (13-17 years), elevated mean 24 h B(a)P levels increased odds of dyspnea, fever, and diarrhea, and higher concentrations of C-reactive protein and procalcitonin. Exposure to max 24 h PM2.5 levels > 20 µg/m3 was associated with higher odds of cough, increased concentrations of C-reactive protein (group ≤12 years), and increased procalcitonin concentration (groups ≤12 years and 13-17 years). In both age groups, length of stay was extended in patients exposed to elevated levels of max 24 h PM2.5, mean and max 24 h B(a)P. This study suggests that worse air quality, particularly reflected in increased B(a)P levels, might affect the clinical course of COVID-19 in pediatric patients and adds to the disease burden during a pandemic.
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Affiliation(s)
- Piotr Rzymski
- Department of Environmental Medicine, Poznan University of Medical Sciences, 60-806 Poznań, Poland; Integrated Science Association (ISA), Universal Scientific Education and Research Network (USERN), 60-806 Poznań, Poland.
| | - Barbara Poniedziałek
- Department of Environmental Medicine, Poznan University of Medical Sciences, 60-806 Poznań, Poland.
| | - Joanna Rosińska
- Department of Environmental Medicine, Poznan University of Medical Sciences, 60-806 Poznań, Poland.
| | - Przemysław Ciechanowski
- Department of Paediatrics and Infectious Diseases, Regional Hospital in Szczecin, 71-455 Szczecin, Poland.
| | - Michał Peregrym
- Department of Paediatrics and Infectious Diseases, Regional Hospital in Szczecin, 71-455 Szczecin, Poland.
| | - Maria Pokorska-Śpiewak
- Department of Children's Infectious Diseases, Medical University of Warsaw, Regional Hospital of Infectious Diseases in Warsaw, 01-201 Warsaw, Poland.
| | - Ewa Talarek
- Department of Children's Infectious Diseases, Medical University of Warsaw, Regional Hospital of Infectious Diseases in Warsaw, 01-201 Warsaw, Poland.
| | - Izabela Zaleska
- Department of Paediatrics and Infectious Diseases, Wroclaw Medical University, 50-368 Wroclaw, Poland.
| | - Paulina Frańczak-Chmura
- Department of Children's Infectious Diseases, Provincial Jan Boży Hospital in Lublin, 20-089 Lublin, Poland.
| | - Małgorzata Pilarczyk
- Department of Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum, Nicolaus Copernicus University, 85-030 Bydgoszcz, Poland.
| | - Magdalena Figlerowicz
- Department of Infectious Diseases and Child Neurology, Poznan University of Medical Sciences, 60-572 Poznan, Poland.
| | - Izabela Kucharek
- 2nd Department of Paediatrics, Centre of Postgraduate Medical Education, Department of Paediatrics and Neonatology with Allergology Center, Central Clinical Hospital of the Ministry of the Interior, 02-507 Warsaw, Poland.
| | - Robert Flisiak
- Department of Infectious Diseases and Hepatology, Medical University of Białystok, 15-089 Białystok, Poland.
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13
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Sansotta N, Norsa L, D'Antiga L. Gastrointestinal coronavirus disease 2019 manifestations in childhood. Curr Opin Clin Nutr Metab Care 2022; 25:195-202. [PMID: 35199658 DOI: 10.1097/mco.0000000000000825] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE OF THE REVIEW The pandemic of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has emerged and caused a massive global health crisis. The aim of this review is first, to provide the latest evidence on what is known about the pathophysiology and the transmission of SARS-CoV-2 and then to focus on the manifestations of the gastrointestinal (GI) tract in children with COVID-19. Lastly, we summarise the impact of COVID-19 on patients with preexisting GI diseases. RECENT FINDINGS Even though the virus is mostly transmitted from human to human via respiratory droplets, ACE2 is known to be expressed throughout the GI tract, and SARS-CoV-2 ribonucleic acid has been isolated from patients' stools. GI symptoms including abdominal pain, diarrhoea and vomiting are frequently reported in paediatric patients. Interestingly, a small number of patients seem to exhibit solely GI symptoms. In addition, a multisystem inflammatory syndrome in children (MIS-C) related to SARS-COV-2 described in children, has a high rate of GI involvement. Several etiopathogenetic mechanisms have been postulated to explain the GI involvement of COVID-19. SUMMARY Clinicians should not underestimate or disregard these early or mild GI symptoms, because the patients may be infected and transmit the virus, or develop a more severe condition such as MIS-C.
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Affiliation(s)
- Naire Sansotta
- Paediatric Hepatology Gastroenterology and Transplantation, Papa Giovanni XXIII Hospital, Bergamo, Italy
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14
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Clinical Picture and Risk Factors of Severe Respiratory Symptoms in COVID-19 in Children. Viruses 2021; 13:v13122366. [PMID: 34960635 PMCID: PMC8703640 DOI: 10.3390/v13122366] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 11/23/2021] [Accepted: 11/24/2021] [Indexed: 11/17/2022] Open
Abstract
Children with COVID-19 develop moderate symptoms in most cases. Thus, a proportion of children requires hospital admission. The study aimed to assess the history, clinical and laboratory parameters in children with COVID-19 concerning the severity of respiratory symptoms. The study included 332 children (median age 57 months) with COVID-19. History data, clinical findings, laboratory parameters, treatment, and outcome, were evaluated. Children were compared in the groups that varied in the severity of symptoms of respiratory tract involvement. Children who required oxygen therapy represented 8.73%, and intensive care 1.5% of the whole cohort. Comorbidities were present in 126 patients (37.95%). Factors increasing the risk of oxygen therapy included comorbidities (odds ratio (OR) = 92.39; 95% confidence interval (95% CI) = (4.19; 2036.90); p < 0.00001), dyspnea (OR = 45.81; 95% CI (4.05; 518.21); p < 0.00001), auscultation abnormalities (OR = 34.33; 95% CI (2.59; 454.64); p < 0.00001). Lactate dehydrogenase (LDH) > 280 IU/L and creatinine kinase > 192 IU/L were parameters with a good area under the curve (0.804-LDH) and a positive predictive value (42.9%-CK). The clinical course of COVID-19 was mild to moderate in most patients. Children with comorbidities, dyspnea, or abnormalities on auscultation are at risk of oxygen therapy. Laboratory parameters potentially useful in patients evaluated for the severe course are LDH > 200 IU/L and CK > 192 IU/L.
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