1
|
Cutrera R, Ciofi Degli Atti ML, Dotta A, D'Amore C, Ravà L, Perno CF, Villani A. Epidemiology of respiratory syncytial virus in a large pediatric hospital in Central Italy and development of a forecasting model to predict the seasonal peak. Ital J Pediatr 2024; 50:65. [PMID: 38589886 PMCID: PMC11003041 DOI: 10.1186/s13052-024-01624-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 02/25/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Respiratory Syncytial Virus (RSV) is responsible for the majority of acute lower respiratory infections in infants and can affect also older age groups. Restrictions linked to the emergence of the SARS-CoV-2 pandemic and their subsequent lifting caused a change in the dynamics of RSV circulation. It is therefore fundamental to monitor RSV seasonal trends and to be able to predict its seasonal peak to be prepared to the next RSV epidemics. METHODS We performed a retrospective descriptive study on laboratory-confirmed RSV infections from Bambino Gesù Children's Hospital in Rome from 1st January 2018 to 31st December 2022. Data on RSV-positive respiratory samples (n = 3,536) and RSV-confirmed hospitalizations (n = 1,895) on patients aged 0-18 years were analyzed. In addition to this, a SARIMA (Seasonal AutoRegressive Integrated Moving Average) forecasting model was developed to predict the next peak of RSV. RESULTS Findings show that, after the 2020 SARS-CoV-2 pandemic season, where RSV circulation was almost absent, RSV infections presented with an increased and anticipated peak compared to pre-pandemic seasons. While mostly targeting infants below 1 year of age, there was a proportional increase in RSV infections and hospitalizations in older age groups in the post-pandemic period. A forecasting model built using RSV weekly data from 2018 to 2022 predicted the RSV peaks of 2023, showing a reasonable level of accuracy (MAPE 33%). Additional analysis indicated that the peak of RSV cases is expected to be reached after 4-5 weeks from case doubling. CONCLUSION Our study provides epidemiological evidence on the dynamics of RSV circulation before and after the COVID-19 pandemic. Our findings highlight the potential of combining surveillance and forecasting to promote preparedness for the next RSV epidemics.
Collapse
Affiliation(s)
- Renato Cutrera
- Pediatric Pulmonology and Cystic Fibrosis Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Marta Luisa Ciofi Degli Atti
- Epidemiology, Clinical Pathways and Clinical Risk Unit, Medical Direction, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
| | - Andrea Dotta
- Neonatal Intensive Care Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Carmen D'Amore
- Epidemiology, Clinical Pathways and Clinical Risk Unit, Medical Direction, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Lucilla Ravà
- Epidemiology, Clinical Pathways and Clinical Risk Unit, Medical Direction, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Carlo Federico Perno
- Department of Diagnostic and Laboratory Medicine, Unit of Microbiology and Diagnostic Immunology, Multimodal Laboratory Medicine Research Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Alberto Villani
- Hospital University Pediatric Clinical Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
- Systems Department, University of Rome Tor Vergata, Rome, Italy
| |
Collapse
|
2
|
Palmas G, Resti M, Indolfi G. Hospitalisation trends from 2019 to 2023 illustrate the persistent resurgence of bronchiolitis in Italy. Acta Paediatr 2024; 113:547-549. [PMID: 38242864 DOI: 10.1111/apa.17098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 12/27/2023] [Accepted: 12/29/2023] [Indexed: 01/21/2024]
Affiliation(s)
| | | | - Giuseppe Indolfi
- Meyer Children's Hospital IRCCS, Florence, Italy
- Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| |
Collapse
|
3
|
Gauthier TW, Ping XD, Harris FL, Brown LAS. Liposomal Glutathione Augments Immune Defenses against Respiratory Syncytial Virus in Neonatal Mice Exposed in Utero to Ethanol. Antioxidants (Basel) 2024; 13:137. [PMID: 38397736 PMCID: PMC10886408 DOI: 10.3390/antiox13020137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 01/18/2024] [Accepted: 01/20/2024] [Indexed: 02/25/2024] Open
Abstract
We previously reported that maternal alcohol use increased the risk of sepsis in premature and term newborns. In the neonatal mouse, fetal ethanol (ETOH) exposure depleted the antioxidant glutathione (GSH), which promoted alveolar macrophage (AM) immunosuppression and respiratory syncytial virus (RSV) infections. In this study, we explored if oral liposomal GSH (LGSH) would attenuate oxidant stress and RSV infections in the ETOH-exposed mouse pups. C57BL/6 female mice were pair-fed a liquid diet with 25% of calories from ethanol or maltose-dextrin. Postnatal day 10 pups were randomized to intranasal saline, LGSH, and RSV. After 48 h, we assessed oxidant stress, AM immunosuppression, pulmonary RSV burden, and acute lung injury. Fetal ETOH exposure increased oxidant stress threefold, lung RSV burden twofold and acute lung injury threefold. AMs were immunosuppressed with decreased RSV clearance. However, LGSH treatments of the ETOH group normalized oxidant stress, AM immune phenotype, the RSV burden, and acute lung injury. These studies suggest that the oxidant stress caused by fetal ETOH exposure impaired AM clearance of infectious agents, thereby increasing the viral infection and acute lung injury. LGSH treatments reversed the oxidative stress and restored AM immune functions, which decreased the RSV infection and subsequent acute lung injury.
Collapse
Affiliation(s)
- Theresa W. Gauthier
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, Emory University, Atlanta, GA 30322, USA; (X.-D.P.); (F.L.H.); (L.A.S.B.)
| | | | | | | |
Collapse
|
4
|
Miron VD, Raianu RO, Filimon C, Craiu M. Clinical Differences between SARS-CoV-2 and RSV Infections in Infants: Findings from a Case-Control Study. Viruses 2023; 16:63. [PMID: 38257763 PMCID: PMC10819890 DOI: 10.3390/v16010063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 12/27/2023] [Accepted: 12/29/2023] [Indexed: 01/24/2024] Open
Abstract
Infants are a unique pediatric group due to their high hospitalization rates and unfavorable outcomes from acute infectious diseases. Understanding the clinical differences and aftereffects of SARS-CoV-2 in comparison to other prevalent viruses in this age group, like RSV, is crucial for effective management. We conducted a retrospective case-control study of infants hospitalized with SARS-CoV-2 or respiratory syncytial virus (RSV) infection in one year, in a tertiary pediatric hospital in Bucharest, Romania. A total of 188 infants were included in the analysis in a 1:1 ratio (94 with SARS-CoV-2 infection and 94 with RSV infection). Infants with COVID-19 were 10.2 times more likely to have fever (p < 0.001) and 2.4 times more likely to have diarrhea (p = 0.016). Conversely, infants with RSV were 2.5 times more likely to have a cough (p < 0.001), 3.0 times more likely to have nasal congestion (p < 0.001), and 14.7 times more likely to present with dyspnea (p < 0.001). Increased lymphocyte count was more common in infants with RSV (p = 0.008), while lymphopenia was more frequent in infants with SARS-CoV-2 (p = 0.011). The median length of hospital stay was one day longer in infants with RSV infection (5 days vs. 4 days). Overall, infants with RSV infection had a 27.3-fold increased risk of developing respiratory failure (p < 0.001), while infants with COVID-19 had a 5.8-fold increased risk of laryngitis (p = 0.003). Our findings suggest that infants with SARS-CoV-2 infection may present with polymorphic symptoms, mostly dominated by fever, whereas infants with RSV often present with respiratory symptoms. Laboratory differentiation between the two infections is challenging; therefore, the use of rapid antigen or molecular diagnostic tests is crucial for accurate diagnosis, epidemiologically appropriate measures, and effective management. Continued surveillance of both viruses in infants, and beyond, and the implementation of specific control measures are needed to mitigate their impact on this vulnerable pediatric group.
Collapse
Affiliation(s)
| | - Raluca-Oana Raianu
- Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Claudiu Filimon
- Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Mihai Craiu
- Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
- National Institute for Mother and Child Health “Alessandrescu-Rusescu”, 020395 Bucharest, Romania
| |
Collapse
|
5
|
Meslé MMI, Sinnathamby M, Mook P, Pebody R. Seasonal and inter-seasonal RSV activity in the European Region during the COVID-19 pandemic from autumn 2020 to summer 2022. Influenza Other Respir Viruses 2023; 17:e13219. [PMID: 38025589 PMCID: PMC10661829 DOI: 10.1111/irv.13219] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 10/10/2023] [Accepted: 10/11/2023] [Indexed: 12/01/2023] Open
Abstract
Background The emergence of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in early 2020 and subsequent implementation of public health and social measures (PHSM) disrupted the epidemiology of respiratory viruses. This work describes the epidemiology of respiratory syncytial virus (RSV) observed during two winter seasons (weeks 40-20) and inter-seasonal periods (weeks 21-39) during the pandemic between October 2020 and September 2022. Methods Using data submitted to The European Surveillance System (TESSy) by countries or territories in the World Health Organization (WHO) European Region between weeks 40/2020 and 39/2022, we aggregated country-specific weekly RSV counts of sentinel, non-sentinel and Severe Acute Respiratory Infection (SARI) surveillance specimens and calculated percentage positivity. Results for both 2020/21 and 2021/22 seasons and inter-seasons were compared with pre-pandemic 2016/17 to 2019/20 seasons and inter-seasons. Results Although more specimens were tested than in pre-COVID-19 pandemic seasons, very few RSV detections were reported during the 2020/21 season in all surveillance systems. During the 2021 inter-season, a gradual increase in detections was observed in all systems. In 2021/22, all systems saw early peaks of RSV infection, and during the 2022 inter-seasonal period, patterns of detections were closer to those seen before the COVID-19 pandemic. Conclusion RSV surveillance continued throughout the COVID-19 pandemic, with an initial reduction in transmission, followed by very high and out-of-season RSV circulation (summer 2021) and then an early start of the 2021/22 season. As of the 2022/23 season, RSV circulation had not yet normalised.
Collapse
Affiliation(s)
| | - Mary Sinnathamby
- World Health Organization (WHO) Regional Office for EuropeCopenhagenDenmark
| | - Piers Mook
- World Health Organization (WHO) Regional Office for EuropeCopenhagenDenmark
| | | | - Richard Pebody
- World Health Organization (WHO) Regional Office for EuropeCopenhagenDenmark
| |
Collapse
|
6
|
Zuniga LM, Schuh A, Schwartz A, Seo-Mayer P, Cramton R, Sieplinga K, Kaushik R, Nassetta L, Homme JH, Babal J, Mahan JD, Batra M. Burnout During the COVID-19 Pandemic: A Report on Pediatric Residents. Acad Pediatr 2023; 23:1620-1627. [PMID: 37207966 PMCID: PMC10191699 DOI: 10.1016/j.acap.2023.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 05/01/2023] [Accepted: 05/04/2023] [Indexed: 05/21/2023]
Abstract
BACKGROUND AND OBJECTIVE The Pediatric Resident Burnout and Resilience Consortium (PRB-RSC) has described the epidemiology of burnout in pediatric residents since 2016. We hypothesized burnout rates during the pandemic would increase. We explored resident burnout during the COVID-19 pandemic and its relationship to resident perception of workload, training, personal life, and local COVID burden. METHODS Since 2016, PRB-RSC has sent an annual, confidential survey to over 30 pediatric and medicine-pediatrics residencies. In 2020 and 2021, seven questions were added to explore the relationship of COVID-19 and perceptions of workload, training, and personal life. RESULTS In 2019, 46 programs participated, 22 in 2020, and 45 in 2021. Response rates in 2020 (n = 1055, 68%) and 2021(n = 1702, 55%) were similar to those of previous years (P = .09). Burnout rates in 2020 were significantly lower than in 2019 (54% vs 66%, P < .001) but returned to pre-COVID levels in 2021 (65%, P = .90). In combined 2020-2021 data, higher rates of burnout were associated with reported increased workload (Adjusted Odds Ratio (AOR) 1.38, 95% CI 1.19-1.6) and concerns regarding the effect of COVID on training (AOR 1.35, 95% CI 1.2-1.53). Program-level county COVID burden in combined 2020-2021 data was not associated with burnout in this model (AOR=1.03, 95% CI 0.70-1.52). CONCLUSIONS Burnout rates within reporting programs decreased significantly in 2020 and returned to prepandemic levels in 2021. Increased burnout was associated with perceived increases in workload and concerns regarding effect of the pandemic on training. Given these findings, programs should consider further investigation into workload and training uncertainty on burnout.
Collapse
Affiliation(s)
- Linessa M Zuniga
- Baylor College of Medicine and Texas Children's Hospital (LM Zuniga), Houston, Tex.
| | - Abigail Schuh
- Medical College of Wisconsin and Children's Wisconsin (A Schuh), Milwaukee, Wis.
| | - Alan Schwartz
- University of Illinois College of Medicine (A Schwartz), Chicago, Ill.
| | | | - Rachel Cramton
- University of Arizona College of Medicine (R Cramton), Tucson, Ariz.
| | - Kira Sieplinga
- Spectrum Health/Michigan State University College of Human Medicine and Helen DeVos Children's Hospital (K Sieplinga), Grand Rapids, Mich.
| | - Ruchi Kaushik
- Baylor College of Medicine and The Children's Hospital of San Antonio (R Kaushik), San Antonio, Tex.
| | - Lauren Nassetta
- UAB Medicine and Children's of Alabama (L Nassetta), Birmingham, Ala.
| | - Jason H Homme
- Mayo Clinic Children's Center (JH Homme), Rochester, Minn.
| | - Jessica Babal
- University of Wisconsin School of Medicine (J Babal), Madison, Wis.
| | - John D Mahan
- The Ohio State University College of Medicine and Nationwide Children's Hospital (JD Mahan), Columbus, Ohio.
| | - Maneesh Batra
- University of Washington and Seattle Childrens, Neonatology (M Batra).
| |
Collapse
|
7
|
Viñeta Paramo M, Ngo LP, Abu-Raya B, Reicherz F, Xu RY, Bone JN, Srigley JA, Solimano A, Goldfarb DM, Skowronski DM, Lavoie PM. Respiratory syncytial virus epidemiology and clinical severity before and during the COVID-19 pandemic in British Columbia, Canada: a retrospective observational study. LANCET REGIONAL HEALTH. AMERICAS 2023; 25:100582. [PMID: 37705884 PMCID: PMC10495630 DOI: 10.1016/j.lana.2023.100582] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 07/10/2023] [Accepted: 08/17/2023] [Indexed: 09/15/2023]
Abstract
Background The COVID-19 pandemic has perturbed the seasonality of respiratory syncytial virus (RSV) infections. However, we lack data on how this impacted the severity of paediatric RSV cases. The objective of this study was to describe the clinical severity of RSV cases before, during and after pandemic measures in British Columbia (BC), Canada. Methods Retrospective study of RSV cases from September 1st, 2017 to May 15th, 2023, with a review of RSV outcomes in children below 18 years old at BC's paediatric hospital. Temporal changes in RSV cases and hospitalisations were quantified using interrupted time series. Findings BC experienced only 11 RSV cases (from 95,266 tests) between September 2020 and August 2021. This was followed by a resurgence of 9,529 RSV cases (219,566 tests [4.3% positive tests]) in 2021-22 and 8,215 cases (124,449 tests [6.6% positive tests]) in 2022-23, increased compared to 1,750 cases (48,664 tests [3.6% positive tests]) per corresponding yearly period in 2017-20. From September 2017 to May 2023, the median age of children with RSV at BC Children's Hospital increased from 8.7 [IQR: 2.0-26.0] to 19.6 [3.9-43.7] months per yearly period. More children were hospitalised in 2022-23 (n = 360), compared to 2017-20 (n = 168 per period) and 2021-22 (n = 172). However, we detected no increase in hospitalisations or ICU admissions in children born prematurely or with chronic cardiorespiratory conditions. Interpretation The increased detection of symptomatic RSV cases in older children in 2021-22 and increased RSV-related hospitalisations in 2022-23 suggest a gradual increase in the pool of immunologically vulnerable children due to a prolonged lack of viral exposure. Funding Government of Canada via its COVID-19 Immunity Task Force.
Collapse
Affiliation(s)
- Marina Viñeta Paramo
- Department of Paediatrics, University of British Columbia, Vancouver, Canada
- Women+ and Children’s Health Sciences, Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, Canada
- British Columbia Children's Hospital Research Institute, Vancouver, Canada
| | - Lilian P.L. Ngo
- Department of Paediatrics, University of British Columbia, Vancouver, Canada
| | - Bahaa Abu-Raya
- Department of Paediatrics, University of British Columbia, Vancouver, Canada
- British Columbia Children's Hospital Research Institute, Vancouver, Canada
| | - Frederic Reicherz
- Department of Paediatrics, University of British Columbia, Vancouver, Canada
- British Columbia Children's Hospital Research Institute, Vancouver, Canada
| | - Rui Yang Xu
- Department of Paediatrics, University of British Columbia, Vancouver, Canada
- British Columbia Children's Hospital Research Institute, Vancouver, Canada
| | - Jeffrey N. Bone
- Women+ and Children’s Health Sciences, Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, Canada
- British Columbia Children's Hospital Research Institute, Vancouver, Canada
| | - Jocelyn A. Srigley
- British Columbia Children's Hospital Research Institute, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, BC Children’s Hospital and BC Women’s Hospital + Health Centre, Vancouver, Canada
| | - Alfonso Solimano
- Department of Paediatrics, University of British Columbia, Vancouver, Canada
| | - David M. Goldfarb
- British Columbia Children's Hospital Research Institute, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, BC Children’s Hospital and BC Women’s Hospital + Health Centre, Vancouver, Canada
| | - Danuta M. Skowronski
- Immunization Programs and Vaccine Preventable Diseases Service, British Columbia Centre for Disease Control, Vancouver, Canada
| | - Pascal M. Lavoie
- Department of Paediatrics, University of British Columbia, Vancouver, Canada
- Women+ and Children’s Health Sciences, Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, Canada
- British Columbia Children's Hospital Research Institute, Vancouver, Canada
| |
Collapse
|
8
|
Kelabi HM, Alharbi AS, Alshamrani AS, Baqais K, Alenazi AM, Alqwaiee MM. Impact of COVID-19 Pandemic on Respiratory Syncytial Virus (RSV) Prophylaxis Program: A Tertiary-Care Center Experience. Cureus 2023; 15:e42563. [PMID: 37637610 PMCID: PMC10460243 DOI: 10.7759/cureus.42563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2023] [Indexed: 08/29/2023] Open
Abstract
OBJECTIVES The purpose of this investigation was to evaluate the effects of the COVID-19 pandemic on the respiratory syncytial virus (RSV) prevention program at our institution across three time frames: 2019-2020, 2020-2021, and 2021-2022. METHODS We carried out a descriptive, single-site observational study spanning four years, from June 2019 to June 2022. Our study included patients in our institution's RSV program who met our enrollment criteria. We collected information about the number of children receiving immunoprophylaxis, immunoprophylaxis doses, and RSV risk factors. RESULTS The number of patients receiving immunoprophylaxis dropped across the three periods, from 315 patients in the first period (2019-2020) to 176 in the second period (2020-2021), and further decreased to 128 in the third period (2021-2022). Following the COVID-19 pandemic, there was a 50% reduction in the number of patients receiving immunoprophylaxis. The proportion of RSV-infected patients remained relatively similar in the first and second periods (2.86% and 2.27%, respectively) but increased in the third period (5.47%). In the first period, most patients (60.32%) received seven doses, 11.75% got four to six doses, and 27.95% received three doses or fewer. The second period saw 59.66% of patients receiving four to six doses and 40.34% receiving three doses or fewer. In the third period, a mere 9.38% received four to five doses, while 90.63% got three doses or fewer. CONCLUSIONS While preventative measures associated with COVID-19 may have helped reduce the number of RSV cases, the pandemic seems to have caused a significant decrease in the number of children receiving immunoprophylaxis and the doses of immunoprophylaxis. More extensive, multicenter research is needed to understand the impact of the COVID-19 pandemic on RSV immunoprophylaxis, its activity, and seasonal patterns fully.
Collapse
Affiliation(s)
- Hamza M Kelabi
- Department of Pediatrics, Prince Sultan Military Medical City, Ministry of Defense, Riyadh, SAU
| | - Adel S Alharbi
- Department of Pediatrics, Prince Sultan Military Medical City, Ministry of Defense, Riyadh, SAU
| | - Abdullah S Alshamrani
- Department of Pediatrics, Prince Sultan Military Medical City, Ministry of Defense, Riyadh, SAU
| | - Khaled Baqais
- Department of Pediatrics, Prince Sultan Military Medical City, Ministry of Defense, Riyadh, SAU
| | - Ayed M Alenazi
- Department of Pediatrics, Prince Sultan Military Medical City, Ministry of Defense, Riyadh, SAU
| | - Mansour M Alqwaiee
- Department of Pediatrics, Prince Sultan Military Medical City, Ministry of Defense, Riyadh, SAU
| |
Collapse
|
9
|
Beijnen EMS, Odumade OA, Haren SDV. Molecular Determinants of the Early Life Immune Response to COVID-19 Infection and Immunization. Vaccines (Basel) 2023; 11:vaccines11030509. [PMID: 36992093 DOI: 10.3390/vaccines11030509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/11/2023] [Accepted: 02/18/2023] [Indexed: 02/25/2023] Open
Abstract
Clinical manifestations from primary COVID infection in children are generally less severe as compared to adults, and severe pediatric cases occur predominantly in children with underlying medical conditions. However, despite the lower incidence of disease severity, the burden of COVID-19 in children is not negligible. Throughout the course of the pandemic, the case incidence in children has substantially increased, with estimated cumulative rates of SARS-CoV-2 infection and COVID-19 symptomatic illness in children comparable to those in adults. Vaccination is a key approach to enhance immunogenicity and protection against SARS-CoV-2. Although the immune system of children is functionally distinct from that of other age groups, vaccine development specific for the pediatric population has mostly been limited to dose-titration of formulations that were developed primarily for adults. In this review, we summarize the literature pertaining to age-specific differences in COVID-19 pathogenesis and clinical manifestation. In addition, we review molecular distinctions in how the early life immune system responds to infection and vaccination. Finally, we discuss recent advances in development of pediatric COVID-19 vaccines and provide future directions for basic and translational research in this area.
Collapse
Affiliation(s)
- Elisabeth M S Beijnen
- Precision Vaccines Program, Division of Infectious Diseases, Boston Children's Hospital, Boston, MA 02115, USA
- Harvard Medical School, Boston, MA 02115, USA
| | - Oludare A Odumade
- Precision Vaccines Program, Division of Infectious Diseases, Boston Children's Hospital, Boston, MA 02115, USA
- Harvard Medical School, Boston, MA 02115, USA
- Department of Pediatrics, Division of Medicine Critical Care, Boston Children's Hospital, Boston, MA 02115, USA
| | - Simon D van Haren
- Precision Vaccines Program, Division of Infectious Diseases, Boston Children's Hospital, Boston, MA 02115, USA
- Harvard Medical School, Boston, MA 02115, USA
| |
Collapse
|