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Teich P, Arntz F, Wöhrl T, Bähr F, Golle K, Kliegl R. Association of School Social Status with COVID-19 Pandemic-Related Changes and Post-Pandemic Rebounds of Children's Physical Fitness. SPORTS MEDICINE - OPEN 2025; 11:41. [PMID: 40268818 PMCID: PMC12018658 DOI: 10.1186/s40798-025-00838-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2024] [Accepted: 03/18/2025] [Indexed: 04/25/2025]
Abstract
BACKGROUND In a recent study, we examined Covid-19 pandemic effects on the physical fitness of German third-graders tested between 2016 and 2022. The present report includes new data from 2023 to examine whether there were post-pandemic rebounds in the negatively affected fitness components, and whether pandemic and potential rebound effects differed by school social status. METHODS The EMOTIKON project annually tests the fitness of all third-graders in the Federal State of Brandenburg, Germany. Tests assess cardiorespiratory endurance (6-min-run), coordination (star-run), speed (20-m linear sprint), lower (powerLOW, standing long jump), and upper (powerUP, ball-push test) limbs muscle power, and static balance (one-legged-stance test). A total of 108,308 third-graders aged between 8 and 9.2 years from 444 schools were tested in the falls from 2016 to 2023. Linear mixed models, specified for a regression discontinuity design with random factors for child and school, estimated pandemic effects on the first day of school in the school year 2020/21 (i.e., the critical date), as well as cohort trends before and after the pandemic onset. RESULTS Higher school social status was associated with better cardiorespiratory endurance, coordination, speed, and powerLOW. At the critical date, there were small negative pandemic effects in cardiorespiratory endurance, coordination, speed, and powerUP. Pandemic effects in speed and coordination were larger in schools with higher social status. Coordination and powerUP were characterized by a post-pandemic rebound, with slightly larger coordination rebounds for schools with higher social status. There was no evidence for rebounds of cardiorespiratory endurance and speed. CONCLUSIONS Absence of evidence for task-specific rebounds may indicate long-term consequences of pandemic-related movement restrictions. Lower cardiorespiratory endurance, coordination, speed, and powerLOW in schools with low social status may indicate the need for improved access to sports opportunities in these schools.
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Affiliation(s)
- Paula Teich
- Faculty of Human Sciences, Research Focus Cognitive Sciences, University of Potsdam, Am Neuen Palais 10, 14469, Potsdam, Germany.
| | - Fabian Arntz
- Faculty of Human Sciences, Research Focus Cognitive Sciences, University of Potsdam, Am Neuen Palais 10, 14469, Potsdam, Germany
| | - Toni Wöhrl
- Faculty of Educational Sciences, Division of Sports and Movement Sciences, University of Erfurt, Erfurt, Germany
| | - Florian Bähr
- Faculty of Educational Sciences, Division of Sports and Movement Sciences, University of Erfurt, Erfurt, Germany
| | - Kathleen Golle
- Faculty of Human Sciences, Research Focus Cognitive Sciences, University of Potsdam, Am Neuen Palais 10, 14469, Potsdam, Germany
| | - Reinhold Kliegl
- Faculty of Human Sciences, Research Focus Cognitive Sciences, University of Potsdam, Am Neuen Palais 10, 14469, Potsdam, Germany
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Pasculli P, Zingaropoli MA, Dominelli F, Solimini AG, Masci GM, Birtolo LI, Pasquariello L, Paribeni F, Iafrate F, Panebianco V, Galardo G, Mancone M, Catalano C, Pugliese F, Palange P, Mastroianni CM, Ciardi MR. Insights into Long COVID: Unraveling Risk Factors, Clinical Features, Radiological Findings, Functional Sequelae and Correlations: A Retrospective Cohort Study. Am J Med 2025; 138:721-731. [PMID: 39299642 DOI: 10.1016/j.amjmed.2024.09.006] [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: 02/07/2024] [Revised: 09/05/2024] [Accepted: 09/09/2024] [Indexed: 09/22/2024]
Abstract
BACKGROUND The long-term symptomatology of COVID-19 has yet to be comprehensively described. The aim of the study was to describe persistent COVID-19 symptoms in a cohort of hospitalized and home-isolated patients. METHODS A retrospective cohort study was conducted on long COVID patients. Long COVID symptoms were identified, and patients were divided into hospitalized (in-patients) and home-isolated (out-patients), as well as according to the number of symptoms. Patients were examined by a multidisciplinary medical team. Blood tests, high resolution chest computed tomography (CT), and physical and infectious examinations were performed. Finally, in-patients were evaluated at 2 time-points: on hospital admission (T0) and 3 months after discharge (Tpost). RESULTS There were 364 COVID-19 patients enrolled; 82% of patients reported one or more symptoms. The most reported symptom was fatigue. Chest CT showed alteration in 76% of patients, and pulmonary function alterations were observed in 44.7% of patients. A higher risk of presenting at least one symptom was seen in patients treated with corticosteroid, and a higher risk of presenting chest CT residual lesion was observed in hospitalized patients and in patients that received hydroxychloroquine treatment. Moreover, a higher risk of altered pulmonary function was observed in older patients. CONCLUSION Long-term sequelae are present in a remarkable number of long COVID patients and pose a new challenge to the health care system to identify long-lasting effects and improve patients' well-being. Multidisciplinary teams are crucial to develop preventive measures, and clinical management strategies.
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Affiliation(s)
| | | | | | | | - Giorgio Maria Masci
- Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I, Rome, Italy
| | - Lucia Ilaria Birtolo
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Lara Pasquariello
- Department of Public Health and Infectious Diseases, Division of Pulmonary Medicine, Policlinico Umberto I Hospital, Rome, Italy
| | - Filippo Paribeni
- Department of Specialist Surgery and Organ Transplantation "Paride Stefanini", Policlinico Umberto I, Rome, Italy
| | - Franco Iafrate
- Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I, Rome, Italy
| | - Valeria Panebianco
- Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I, Rome, Italy
| | - Gioacchino Galardo
- Medical Emergency Unit, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Massimo Mancone
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Carlo Catalano
- Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I, Rome, Italy
| | - Francesco Pugliese
- Department of Specialist Surgery and Organ Transplantation "Paride Stefanini", Policlinico Umberto I, Rome, Italy
| | - Paolo Palange
- Department of Public Health and Infectious Diseases, Division of Pulmonary Medicine, Policlinico Umberto I Hospital, Rome, Italy
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Caliman-Sturdza OA, Gheorghita R, Lobiuc A. Neuropsychiatric Manifestations of Long COVID-19: A Narrative Review of Clinical Aspects and Therapeutic Approaches. Life (Basel) 2025; 15:439. [PMID: 40141784 PMCID: PMC11943530 DOI: 10.3390/life15030439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2025] [Revised: 03/06/2025] [Accepted: 03/06/2025] [Indexed: 03/28/2025] Open
Abstract
The COVID-19 (C-19) pandemic has highlighted the significance of understanding the long-term effects of this disease on the quality of life of those infected. Long COVID-19 (L-C19) presents as persistent symptoms that continue beyond the main illness period, usually lasting weeks to years. One of the lesser-known but significant aspects of L-C19 is its impact on neuropsychiatric manifestations, which can have a profound effect on an individual's quality of life. Research shows that L-C19 creates neuropsychiatric issues such as mental fog, emotional problems, and brain disease symptoms, along with sleep changes, extreme fatigue, severe head pain, tremors with seizures, and pain in nerves. People with cognitive problems plus fatigue and mood disorders experience great difficulty handling everyday activities, personal hygiene, and social interactions. Neuropsychiatric symptoms make people withdraw from social activity and hurt relationships, thus causing feelings of loneliness. The unpredictable state of L-C19 generates heavy psychological pressure through emotional suffering, including depression and anxiety. Neuropsychiatric changes such as cognitive impairment, fatigue, and mood swings make it hard for people to work or study effectively, which decreases their output at school or work and lowers their job contentment. The purpose of this narrative review is to summarize the clinical data present in the literature regarding the neuropsychiatric manifestations of L-C19, to identify current methods of diagnosis and treatment that lead to correct management of the condition, and to highlight the impact of these manifestations on patients' quality of life.
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Affiliation(s)
- Olga Adriana Caliman-Sturdza
- Faculty of Medicine and Biological Sciences, Stefan cel Mare University of Suceava, 720229 Suceava, Romania; (O.A.C.-S.); (A.L.)
- Emergency Clinical Hospital Suceava, 720224 Suceava, Romania
| | - Roxana Gheorghita
- Faculty of Medicine and Biological Sciences, Stefan cel Mare University of Suceava, 720229 Suceava, Romania; (O.A.C.-S.); (A.L.)
| | - Andrei Lobiuc
- Faculty of Medicine and Biological Sciences, Stefan cel Mare University of Suceava, 720229 Suceava, Romania; (O.A.C.-S.); (A.L.)
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Basaca DG, Jugănaru I, Belei O, Nicoară DM, Asproniu R, Stoicescu ER, Mărginean O. Long COVID in Children and Adolescents: Mechanisms, Symptoms, and Long-Term Impact on Health-A Comprehensive Review. J Clin Med 2025; 14:378. [PMID: 39860384 PMCID: PMC11766386 DOI: 10.3390/jcm14020378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2024] [Revised: 12/15/2024] [Accepted: 01/06/2025] [Indexed: 01/27/2025] Open
Abstract
Long COVID, also known as post-acute sequelae of SARS-CoV-2 infection (PASC), is increasingly recognized as a condition affecting not only adults but also children and adolescents. While children often experience milder acute COVID-19 symptoms compared to adults, some develop persistent physical, psychological, and neurological symptoms lasting for weeks or months after initial infection. The most commonly reported symptoms include debilitating fatigue, respiratory issues, headaches, muscle pain, gastrointestinal disturbances, and cognitive difficulties, which significantly impact daily activities, schooling, and social interactions. Additionally, many children with long COVID experience psychological symptoms, such as anxiety, depression, mood swings, and irritability, likely exacerbated by prolonged illness and lifestyle disruptions. Risk factors for long COVID in children include pre-existing health conditions such as asthma, obesity, and neurological disorders, with adolescents and females seemingly more affected. Hypothesized mechanisms underlying long COVID include chronic immune dysregulation, persistent viral particles stimulating inflammation, autonomic nervous system dysfunction, and mitochondrial impairment, which may collectively contribute to the variety of observed symptoms. Long-term outcomes remain uncertain; however, long COVID can lead to school absenteeism, social withdrawal, and psychological distress, potentially affecting cognitive development. Severe cases may develop chronic conditions such as postural orthostatic tachycardia syndrome (POTS) and reduced exercise tolerance. This review synthesizes the existing literature on long COVID in children, examining its prevalence, symptomatology, risk factors, and potential mechanisms, with an emphasis on the need for further clinical studies. While existing research largely relies on surveys and self-reported data, clinical assessments are essential to accurately characterize long COVID in pediatric populations and to guide effective management strategies.
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Affiliation(s)
- Diana-Georgiana Basaca
- Disturbances of Growth and Development on Children Research Center, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania; (D.-G.B.); (O.B.); (O.M.)
- Ph.D. School Department, ‘Victor Babeş’ University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania;
- Department XI Pediatrics, Discipline I Pediatrics, ‘Victor Babeş’ University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania;
| | - Iulius Jugănaru
- Disturbances of Growth and Development on Children Research Center, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania; (D.-G.B.); (O.B.); (O.M.)
- Department XI Pediatrics, Discipline I Pediatrics, ‘Victor Babeş’ University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania;
- Department of Pediatrics I, Children’s Emergency Hospital “Louis Turcanu”, 300011 Timisoara, Romania
| | - Oana Belei
- Disturbances of Growth and Development on Children Research Center, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania; (D.-G.B.); (O.B.); (O.M.)
- Department XI Pediatrics, Discipline I Pediatrics, ‘Victor Babeş’ University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania;
- Department of Pediatrics I, Children’s Emergency Hospital “Louis Turcanu”, 300011 Timisoara, Romania
| | - Delia-Maria Nicoară
- Department XI Pediatrics, Discipline I Pediatrics, ‘Victor Babeş’ University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania;
| | - Raluca Asproniu
- Ph.D. School Department, ‘Victor Babeş’ University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania;
- Department XI Pediatrics, Discipline I Pediatrics, ‘Victor Babeş’ University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania;
- Department of Pediatrics I, Children’s Emergency Hospital “Louis Turcanu”, 300011 Timisoara, Romania
| | - Emil Robert Stoicescu
- Research Center for Medical Communication, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania;
- Department of Radiology and Medical Imaging, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
| | - Otilia Mărginean
- Disturbances of Growth and Development on Children Research Center, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania; (D.-G.B.); (O.B.); (O.M.)
- Department XI Pediatrics, Discipline I Pediatrics, ‘Victor Babeş’ University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania;
- Department of Pediatrics I, Children’s Emergency Hospital “Louis Turcanu”, 300011 Timisoara, Romania
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Ha EK, Kim JH, Han B, Shin J, Lee E, Rhie S, Lee WS, Lee S, Han MY. Rotavirus Hospitalization in Early Childhood: Fine Motor Skills and Cognition at 6 Years Old in a Population-Based Cohort Study. J Infect Dis 2024; 230:1167-1176. [PMID: 38679784 DOI: 10.1093/infdis/jiae218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 03/19/2024] [Accepted: 04/24/2024] [Indexed: 05/01/2024] Open
Abstract
Rotavirus is linked to severe childhood gastroenteritis and neurological complications, but its impact on neurodevelopment remains uncertain. We examined data from 1 420 941 Korean children born between 2009 and 2011, using the Korean National Health Insurance System. We assessed neurodevelopmental outcomes at age 6 years using the validated Korean Developmental Test, covering 6 major domains, with propensity score-based inverse probability weighting including consideration of covariates sex, birth weight, changes in body weight from birth to 4-6 months of age, head circumference at 4-6 months of age, residence at birth, economic status, infant feeding types, and birth year. The main analysis that encompassed 5451 children with rotavirus hospitalization and 310 874 unexposed individuals revealed heightened odds of suspected delays in fine motor skills and cognition among exposed children. Our results suggest an association between rotavirus-related hospitalization in infancy and suspected delays in fine motor function and cognition in 6 year olds.
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Affiliation(s)
- Eun Kyo Ha
- Department of Pediatrics, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Ju Hee Kim
- Department of Pediatrics, College of Medicine, Kyung Hee University Medical Center, Kyung Hee University, Seoul, Korea
| | - Boeun Han
- Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Jeewon Shin
- Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Eun Lee
- Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Seonkyeong Rhie
- Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Won Seok Lee
- Department of Pediatrics, CHA Ilsan Medical Center, CHA University College of Medicine, Goyang, Korea
| | - Soonchul Lee
- Department of Orthopedic Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Man Yong Han
- Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
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Sarani M, Motamed N, Hatami G, Namvar A, Ravanipour M. Long COVID in children and adolescents: a historical cohort study with a population-based control group from Iran. BMC Infect Dis 2024; 24:1074. [PMID: 39350082 PMCID: PMC11440681 DOI: 10.1186/s12879-024-09997-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Accepted: 09/24/2024] [Indexed: 10/04/2024] Open
Abstract
BACKGROUND After recovering from the acute phase of COVID-19, some of the infected children manifest long COVID symptoms. The present study aims to identify long COVID symptoms in children and adolescents admitted to hospitals in Bushehr, Iran, during 2021 to 2023, and compare them with the non-affected group. METHODS This historical cohort study with a population-based control group was conducted on 141 children and adolescents with COVID-19 hospitalized in Bushehr city hospitals and 141 non-affected peers. Out of 10 comprehensive health service centers in Bushehr city, 5 centers were selected by random sampling and the non-Covid-19 group was chosen from them (matched by gender and age with the affected group). The data were collected using the data recorded in the patients' records, conducting telephone interviews and completing the prevalent long COVID symptom form. Data were analyzed using SPSS version 18. Descriptive statistics, Chi-square/Fisher's exact tests, and stepwise logistic regression were used. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated, with p < 0.05 as the significance level. RESULTS The mean age of the hospitalized children with COVID-19 was 79 ± 5.24 months old, 57.4% of whom were boys. Also, 46 individuals of the COVID-19 group (32.6%) manifested long COVID symptoms. The most prevalent symptoms included fatigue (54.3%), impaired attention or concentration (41.3%) and depression or anxiety symptoms (34.7%). Among the hospitalized children experiencing long-term COVID symptoms, 65.2% exhibited moderate disease severity. A significant relationship was identified between disease severity and muscle and joint pain (P = 0.025), as well as between the length of hospital stay and cough (P = 0.022), weight loss (P = 0.047), and symptoms of depression or anxiety (P = 0.008). Older age [(6-11 y; OR = 3.18, CI = 1.03-9.88); (12 ≥ y; OR = 4.57, CI = 1.40-14.96)] and having history of smoking or being exposed to secondhand smoke (OR = 12.45, CI = 3.14-49.36) were considered as risk factors for long COVID. CONCLUSIONS The variables of age and history of exposure to tobacco smoke exhibited a significant independent relationship with the occurrence of long-term COVID symptoms in children hospitalized due to COVID-19. Specifically, as age increases and the history of tobacco smoke exposure rises, the likelihood of experiencing long-term COVID symptoms also increases.
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Affiliation(s)
- Mohsen Sarani
- Department of Nursing, School of Nursing and Midwifery, Bushehr university of Medical Sciences, Bushehr, Iran
| | - Niloofar Motamed
- Department of Community Medicine, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran.
| | - Gisou Hatami
- Department of Pediatrics, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Akbar Namvar
- BSc. In Nursing, Infection control expert nurse, Tamin Ejtemayi Hospital, Bushehr, Iran
| | - Maryam Ravanipour
- The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research, Department of Nursing, School of Nursing and Midwifery Institute, Bushehr university of Medical Sciences, Rishehr Street, P.O.Box: 7518759577, Bushehr, Iran.
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Ha EK, Kim JH, Han B, Shin J, Lee E, Lee KJ, Shin YH, Han MY. Viral respiratory infections requiring hospitalization in early childhood related to subsequent asthma onset and exacerbation risks. J Med Virol 2024; 96:e29876. [PMID: 39233491 DOI: 10.1002/jmv.29876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 07/19/2024] [Accepted: 08/13/2024] [Indexed: 09/06/2024]
Abstract
Viral lower respiratory tract infections (LRTIs), including rhinovirus and respiratory syncytial virus during early childhood, have been linked to subsequent asthma. However, the impact of other respiratory viruses remains unclear. We analyzed nationwide Korean data from January 1, 2008, to December 31, 2018, utilizing the national health insurance database. Our study focused on 19 169 meticulously selected children exposed to severe respiratory infections requiring hospitalization with documented viral pathogens, matched with 191 690 unexposed children at a ratio of 1:10 using incidence density sampling. Our findings demonstrate that asthma exacerbation rates were higher among the exposed cohort than the unexposed cohort over a mean follow-up of 7.8 years. We observed elevated risks of asthma exacerbation and newly developed asthma compared to the unexposed cohort. Hospitalization due to rhinovirus, respiratory syncytial virus, influenza, metapneumovirus, and adenovirus was related to increased asthma exacerbations. Notably, we found a stronger association in cases of multiple LRTI hospitalizations. In conclusion, our study shows that early childhood respiratory viral infections are related to subsequent asthma exacerbations and new asthma diagnoses.
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Affiliation(s)
- Eun Kyo Ha
- Department of Pediatrics, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - Ju Hee Kim
- Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Boeun Han
- Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea
| | - Jeewon Shin
- Department of Pediatrics, CHA Ilsan Medical Center, CHA University, Goyang, South Korea
| | - Eun Lee
- Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea
| | - Kee-Jae Lee
- Department of Information and Statistics, Korea National Open University, Seoul, South Korea
| | - Youn Ho Shin
- Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Man Yong Han
- Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea
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Fadlyana E, Rusmil K, Dwi Putra MG, Fulendry FP, Somantri NK, Putri AD, Sari RM, Puspita M, Dewi GP. Immunogenicity and Safety of SARS-CoV-2 Protein Subunit Recombinant Vaccine (IndoVac ®) as a Heterologous Booster Dose against COVID-19 in Indonesian Adolescents. Vaccines (Basel) 2024; 12:938. [PMID: 39204062 PMCID: PMC11360245 DOI: 10.3390/vaccines12080938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Revised: 08/17/2024] [Accepted: 08/20/2024] [Indexed: 09/03/2024] Open
Abstract
Adolescents are vulnerable to Coronavirus disease 2019 (COVID-19) infections; thus, their antibodies should be maintained above the protective value. This study aimed to evaluate the immune response and safety to the SARS-CoV-2 protein subunit recombinant vaccine (IndoVac®) as a heterologous booster dose against COVID-19 in Indonesian adolescents. This open-label prospective intervention study enrolled 150 clinically healthy adolescents aged 12-17 years who had received complete primary doses of the CoronaVac® vaccine from Garuda Primary Care Centres in Bandung City. The result of immunogenicity was presented with a 95% confidence interval (CI) and analyzed with t-tests from 14 days and 3, 6, and 12 months. The neutralizing antibody geometric mean titers (GMTs) (IU/mL) at baseline and 14 days after booster dose were 303.26 and 2661.2, respectively. The geometric mean fold rises (GMFR) at 3, 6, and 12 months after booster dose were 6.67 (5.217-8.536), 3.87 (3.068-4.886), and 2.87 (2.232-3.685), respectively. Both the neutralizing antibody and IgG antibody were markedly higher in the adolescents than in the adults at every timepoint. The incidence rate of adverse effects (AEs) until 28 days after booster dose was 82.7%, with a higher number of local events reported. Most reported solicited AEs were local pain followed by myalgia with mild intensity. Unsolicited AEs varied with each of the incidence rates < 10%, mostly with mild intensity. Adverse events of special interest (AESI) were not observed. At the 12-month follow-up after the booster dose, four serious adverse events (SAEs) not related to investigational products and research procedures were noted. This study showed that IndoVac® has a favorable immunogenicity and safety profile as a booster in adolescents and that the antibody titer decreases over time.
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Affiliation(s)
- Eddy Fadlyana
- Clinical Research Unit, Growth and Development–Social Pediatrics Division, Department of Child Health, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin Hospital, Bandung 40161, Indonesia; (K.R.); (M.G.D.P.); (F.P.F.); (A.D.P.)
| | - Kusnandi Rusmil
- Clinical Research Unit, Growth and Development–Social Pediatrics Division, Department of Child Health, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin Hospital, Bandung 40161, Indonesia; (K.R.); (M.G.D.P.); (F.P.F.); (A.D.P.)
| | - Muhammad Gilang Dwi Putra
- Clinical Research Unit, Growth and Development–Social Pediatrics Division, Department of Child Health, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin Hospital, Bandung 40161, Indonesia; (K.R.); (M.G.D.P.); (F.P.F.); (A.D.P.)
| | - Frizka Primadewi Fulendry
- Clinical Research Unit, Growth and Development–Social Pediatrics Division, Department of Child Health, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin Hospital, Bandung 40161, Indonesia; (K.R.); (M.G.D.P.); (F.P.F.); (A.D.P.)
| | | | - Alvira Dwilestarie Putri
- Clinical Research Unit, Growth and Development–Social Pediatrics Division, Department of Child Health, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin Hospital, Bandung 40161, Indonesia; (K.R.); (M.G.D.P.); (F.P.F.); (A.D.P.)
| | - Rini Mulia Sari
- Surveillance and Clinical Trial Division, PT Bio Farma, Bandung 40161, Indonesia; (R.M.S.); (M.P.); (G.P.D.)
| | - Mita Puspita
- Surveillance and Clinical Trial Division, PT Bio Farma, Bandung 40161, Indonesia; (R.M.S.); (M.P.); (G.P.D.)
| | - Gianita Puspita Dewi
- Surveillance and Clinical Trial Division, PT Bio Farma, Bandung 40161, Indonesia; (R.M.S.); (M.P.); (G.P.D.)
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Hsu YL, Chen PC, Tsai YF, Wei CH, Wu LSH, Hsieh KS, Hsieh MH, Lai HC, Lin CH, Lin HC, Chen CH, Chen AC, Lin HC, Chou IC, Soong WJ, Hwang KP, Lu HHS, Pawankar R, Tsai HJ, Wang JY. Clinical Features and Vaccination Effects among Children with Post-Acute Sequelae of COVID-19 in Taiwan. Vaccines (Basel) 2024; 12:910. [PMID: 39204035 PMCID: PMC11359259 DOI: 10.3390/vaccines12080910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 08/04/2024] [Accepted: 08/05/2024] [Indexed: 09/03/2024] Open
Abstract
BACKGROUND Post-acute sequelae of SARS-CoV-2 infection (PASC) affects patients after recovering from acute coronavirus disease 2019 (COVID-19). This study investigates the impact of SARS-CoV-2 vaccination on PASC symptoms in children in Taiwan during the Omicron pandemic. METHODS We enrolled children under 18 years with PASC symptoms persisting for more than 4 weeks. Data collected included demographics, clinical information, vaccination status, and symptom persistence. We used logistic regression models to compare symptoms in the acute and post-COVID-19 phases and to assess the association between vaccination and these symptoms. RESULTS Among 500 PASC children, 292 (58.4%) were vaccinated, 282 (52.8%) were male, and the mean (SD) age was 7.6 (4.6) years. Vaccinated individuals exhibited higher odds of experiencing symptoms in the previous acute phase, such as cough (adjusted odds ratio [AOR] = 1.57; 95% confidence interval [CI]: 1.02-2.42), rhinorrhea/nasal congestion (AOR = 1.74; 95% CI: 1.13-2.67), sneezing (AOR = 1.68; 95% CI: 1.02-2.76), sputum production (AOR = 1.91; 95% CI: 1.15-3.19), headache/dizziness (AOR = 1.73; 95% CI: 1.04-2.87), and muscle soreness (AOR = 2.33; 95% CI: 1.13-4.80). In contrast, there were lower odds of experiencing abdominal pain (AOR = 0.49; 95% CI: 0.25-0.94) and diarrhea (AOR = 0.37; 95% CI: 0.17-0.78) in children who had received vaccination during the post-COVID-19 phase. CONCLUSIONS This study revealed clinical features and vaccination effects in PASC children in Taiwan. Vaccination may reduce some gastrointestinal symptoms in the post-COVID-19 phase.
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Grants
- DMR-112-043 China Medical University Hospital, Taichung, Taiwan
- DMR-112-047 China Medical University Hospital, Taichung, Taiwan
- DMR-112-052 China Medical University Hospital, Taichung, Taiwan
- C1110831002-6 China Medical University Hospital, Taichung, Taiwan
- ANHRF111-03 An-Nan Hospital, China Medical University, Tainan, Taiwan
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Affiliation(s)
- Yu-Lung Hsu
- Division of Pediatric Infectious Diseases, China Medical University Children’s Hospital, China Medical University, Taichung 40447, Taiwan; (Y.-L.H.); (H.-C.L.); (H.-C.L.); (K.-P.H.)
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung 40447, Taiwan;
| | - Pei-Chi Chen
- Center of Allergy, Immunology and Microbiome (A.I.M), China Medical University Hospital, China Medical University Children’s Hospital, Taichung 40447, Taiwan; (P.-C.C.); (M.-H.H.)
- Department of Microbiology & Immunology, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
| | - Yi-Fen Tsai
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan 350401, Taiwan;
| | - Chi-Hung Wei
- Division of Medical Research, China Medical University Children’s Hospital, China Medical University, Taichung 40447, Taiwan; (C.-H.W.); (K.-S.H.)
| | - Lawrence Shi-Hsin Wu
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung 40447, Taiwan;
| | - Kai-Sheng Hsieh
- Division of Medical Research, China Medical University Children’s Hospital, China Medical University, Taichung 40447, Taiwan; (C.-H.W.); (K.-S.H.)
| | - Miao-Hsi Hsieh
- Center of Allergy, Immunology and Microbiome (A.I.M), China Medical University Hospital, China Medical University Children’s Hospital, Taichung 40447, Taiwan; (P.-C.C.); (M.-H.H.)
| | - Huan-Cheng Lai
- Division of Pediatric Infectious Diseases, China Medical University Children’s Hospital, China Medical University, Taichung 40447, Taiwan; (Y.-L.H.); (H.-C.L.); (H.-C.L.); (K.-P.H.)
| | - Chien-Heng Lin
- Division of Pediatric Pulmonology and Intensive Care, China Medical University Children’s Hospital, China Medical University, Taichung 40447, Taiwan; (C.-H.L.); (C.-H.C.); (W.-J.S.)
| | - Hsiao-Chuan Lin
- Division of Pediatric Infectious Diseases, China Medical University Children’s Hospital, China Medical University, Taichung 40447, Taiwan; (Y.-L.H.); (H.-C.L.); (H.-C.L.); (K.-P.H.)
| | - Chieh-Ho Chen
- Division of Pediatric Pulmonology and Intensive Care, China Medical University Children’s Hospital, China Medical University, Taichung 40447, Taiwan; (C.-H.L.); (C.-H.C.); (W.-J.S.)
| | - An-Chyi Chen
- Division of Pediatric Gastroenterology, China Medical University Children’s Hospital, China Medical University, Taichung 40447, Taiwan;
| | - Hung-Chih Lin
- Division of Neonatology, China Medical University Children’s Hospital, China Medical University, Taichung 40447, Taiwan;
| | - I-Ching Chou
- Division of Pediatric Neurology, China Medical University Children’s Hospital, China Medical University, Taichung 40447, Taiwan;
| | - Wen-Jue Soong
- Division of Pediatric Pulmonology and Intensive Care, China Medical University Children’s Hospital, China Medical University, Taichung 40447, Taiwan; (C.-H.L.); (C.-H.C.); (W.-J.S.)
| | - Kao-Pin Hwang
- Division of Pediatric Infectious Diseases, China Medical University Children’s Hospital, China Medical University, Taichung 40447, Taiwan; (Y.-L.H.); (H.-C.L.); (H.-C.L.); (K.-P.H.)
| | - Henry Horng-Shing Lu
- Institute of Statistics, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan;
| | - Ruby Pawankar
- Department of Pediatrics, Nippon Medical School, Tokyo 8602, Japan;
| | - Hui-Ju Tsai
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan 350401, Taiwan;
- Department of Medical Science, National Tsing-Hua University, Hsinchu 300044, Taiwan
| | - Jiu-Yao Wang
- Center of Allergy, Immunology and Microbiome (A.I.M), China Medical University Hospital, China Medical University Children’s Hospital, Taichung 40447, Taiwan; (P.-C.C.); (M.-H.H.)
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10
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Yin Y, Yang G, Wang N, Zeng M, Jiang H, Yuan S, Wu J, Zhang J, Cui J, Zhou G, Yang X, Zhang Y, Sun Z, Yuan J, Lin J, Chen J, Tang M, Chen J. Exploring the prevalence and chest CT predictors of Long COVID in children: a comprehensive study from Shanghai and Linyi. Front Pediatr 2024; 12:1420196. [PMID: 39170602 PMCID: PMC11335557 DOI: 10.3389/fped.2024.1420196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Accepted: 07/23/2024] [Indexed: 08/23/2024] Open
Abstract
Introduction COVID-19 constitutes a pandemic of significant detriment to human health. This study aimed to investigate the prevalence of Long COVID following SARS-CoV-2 infection, analyze the potential predictors of chest CT for the development of Long COVID in children. Methods A cohort of children who visited the respiratory outpatient clinics at Shanghai Children's Medical Center or Linyi Maternal and Child Health Care Hospital from December 2022 to February 2023 and underwent chest CT scans within 1 week was followed up. Data on clinical characteristics, Long COVID symptoms, and chest CT manifestations were collected and analyzed. Multivariate logistic regression models and decision tree models were employed to identify factors associated with Long COVID. Results A total of 416 children were included in the study. Among 277 children who completed the follow-up, the prevalence of Long COVID was 23.1%. Chronic cough, fatigue, brain fog, and post-exertional malaise were the most commonly reported symptoms. In the decision tree model for Long COVID, the presence of increased vascular markings, the absence of normal CT findings, and younger age were identified as predictors associated with a higher likelihood of developing Long COVID in children. However, no significant correlation was found between chest CT abnormality and the occurrence of Long COVID. Discussion Long COVID in children presents a complex challenge with a significant prevalence rate of 23.1%. Chest CT scans of children post-SARS-CoV-2 infection, identified as abnormal with increased vascular markings, indicate a higher risk of developing Long COVID.
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Affiliation(s)
- Yong Yin
- Department of Respiratory Medicine, Linyi Maternal and Child Health Care Hospital, Linyi Branch of Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Linyi, Shandong, China
- Department of Respiratory Medicine, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Children’s Medical Center Pediatric Medical Complex (Pudong), Shanghai, China
- Pediatric AI Clinical Application and Research Center, Shanghai Children’s Medical Center, Shanghai, China
- Shanghai Engineering Research Center of Intelligence Pediatrics (SERCIP), Shanghai, China
- Child Health Advocacy Institute, China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Guijun Yang
- Department of Respiratory Medicine, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Na Wang
- Department of Respiratory Medicine, Linyi Maternal and Child Health Care Hospital, Linyi Branch of Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Linyi, Shandong, China
| | - Mei Zeng
- Department of Respiratory Medicine, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hejun Jiang
- Department of Respiratory Medicine, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shuhua Yuan
- Department of Respiratory Medicine, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jinhong Wu
- Department of Respiratory Medicine, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jing Zhang
- Department of Respiratory Medicine, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Juan Cui
- Department of Respiratory Medicine, Linyi Maternal and Child Health Care Hospital, Linyi Branch of Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Linyi, Shandong, China
| | - Guifang Zhou
- Department of Respiratory Medicine, Linyi Maternal and Child Health Care Hospital, Linyi Branch of Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Linyi, Shandong, China
| | - Xin Yang
- Department of Respiratory Medicine, Linyi Maternal and Child Health Care Hospital, Linyi Branch of Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Linyi, Shandong, China
| | - Yunqin Zhang
- Department of Respiratory Medicine, Linyi Maternal and Child Health Care Hospital, Linyi Branch of Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Linyi, Shandong, China
| | - Zhichao Sun
- Department of Respiratory Medicine, Linyi Maternal and Child Health Care Hospital, Linyi Branch of Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Linyi, Shandong, China
| | - Jiajun Yuan
- Pediatric AI Clinical Application and Research Center, Shanghai Children’s Medical Center, Shanghai, China
- Shanghai Engineering Research Center of Intelligence Pediatrics (SERCIP), Shanghai, China
- Medical Department of Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jilei Lin
- Department of Respiratory Medicine, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Pediatric AI Clinical Application and Research Center, Shanghai Children’s Medical Center, Shanghai, China
- Shanghai Engineering Research Center of Intelligence Pediatrics (SERCIP), Shanghai, China
- Child Health Advocacy Institute, China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Jiande Chen
- Department of Respiratory Medicine, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Mingyu Tang
- Department of Respiratory Medicine, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jing Chen
- Department of Respiratory Medicine, Linyi Maternal and Child Health Care Hospital, Linyi Branch of Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Linyi, Shandong, China
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11
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Gusev E, Sarapultsev A. Exploring the Pathophysiology of Long COVID: The Central Role of Low-Grade Inflammation and Multisystem Involvement. Int J Mol Sci 2024; 25:6389. [PMID: 38928096 PMCID: PMC11204317 DOI: 10.3390/ijms25126389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 06/05/2024] [Accepted: 06/07/2024] [Indexed: 06/28/2024] Open
Abstract
Long COVID (LC), also referred to as Post COVID-19 Condition, Post-Acute Sequelae of SARS-CoV-2 Infection (PASC), and other terms, represents a complex multisystem disease persisting after the acute phase of COVID-19. Characterized by a myriad of symptoms across different organ systems, LC presents significant diagnostic and management challenges. Central to the disorder is the role of low-grade inflammation, a non-classical inflammatory response that contributes to the chronicity and diversity of symptoms observed. This review explores the pathophysiological underpinnings of LC, emphasizing the importance of low-grade inflammation as a core component. By delineating the pathogenetic relationships and clinical manifestations of LC, this article highlights the necessity for an integrated approach that employs both personalized medicine and standardized protocols aimed at mitigating long-term consequences. The insights gained not only enhance our understanding of LC but also inform the development of therapeutic strategies that could be applicable to other chronic conditions with similar pathophysiological features.
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Affiliation(s)
| | - Alexey Sarapultsev
- Institute of Immunology and Physiology, Ural Branch of the Russian Academy of Science, 620049 Ekaterinburg, Russia;
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12
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Qaqish A, Abbas MM, Alkhateeb M, Al-Tamimi M, Mustafa M, Al-Shudifat AE, Tarawneh S, Dawoud R, Mryyian A, Al-Ajaleen M. Anti_spike and anti_nucleocapsid IgG responses to SARS-CoV-2 in children of Jordan. Heliyon 2024; 10:e30631. [PMID: 38765100 PMCID: PMC11101777 DOI: 10.1016/j.heliyon.2024.e30631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 04/30/2024] [Accepted: 05/01/2024] [Indexed: 05/21/2024] Open
Abstract
Background It is proven that children have significantly milder COVID-19 disease compared to adults. Various immunological characteristics influence this age-related difference in protection against COVID-19. Pediatric COVID-19 in Jordan is extremely under reported. Objectives The primary goal of this work is to identify the anti_S and anti_N antibody responses in a random group of children in Jordan and compare it to that of naturally infected-unvaccinated adults. Methods 151 unvaccinated children, 4 days to 18 years old, were screened for anti_S and anti_N antibodies. History of COVID-19 infection or exposure to infection and symptom severity were reported by parents on a special questionnaire. Results 78.9 % and 65.3 % of participants were seropositive for anti_S IgG and anti_N Abs, respectively. There was a remarkable association between age and anti_S IgG and anti_N IgG antibody titers, as children aged 12 years or older had increased anti_S IgG titers (mean = 19.3 BAU/mL) compared to younger groups (means of 10.15, 9.24, 7.91 BAU/mL for age groups 6-12, 1-6, less than 1 year, respectively). Gender did not show a statistically important role in anti_S and anti_N IgG seropositivity rates or titers. Children displayed significantly elevated anti_S titers (mean = 13.23 BAU/mL) compared to naturally infected adults (mean = 9.72 BAU/mL), in contrast, adults' anti_N titers (mean = 39.64 U/mL) were significantly higher compared to those of children (mean = 10.77 U/mL). Conclusions The current work provides evidence of distinctly robust and persistent humoral immunity displayed by high anti_S and anti_N IgG in children, even >12 months post-infection. Age was the only factor that had a significant statistical impact on anti_S and anti_N Ab levels among the pediatric group in this study. Children exhibited significantly higher anti_S titers than naturally infected adults. In contrast, adults' anti_N titers were significantly higher. Such information can assist direct pediatric SARS-CoV-2 immunization programs, with implications for creating age-targeted strategies for diagnostic and population protection measures.
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Affiliation(s)
- Arwa Qaqish
- Department of Biology and Biotechnology, Faculty of Science, The Hashemite University, Zarqa, Jordan
- Department of Cellular Therapy and Applied Genomics, King Hussein Cancer Center (KHCC), Amman, Jordan
| | - Manal Mohammad Abbas
- Department of Medical Laboratory Sciences, Faculty of Allied Medical Sciences, Al-Ahliyya Amman University, Amman, Jordan
| | - Mohammad Alkhateeb
- Department of Internal Medicine, King Hussein Cancer Center (KHCC), Amman, Jordan
| | - Mohammad Al-Tamimi
- Department of Microbiology, Pathology and Forensic Medicine, Faculty of Medicine, The Hashemite University, Zarqa, Jordan
| | - Minas Mustafa
- Department of Medical Laboratory Sciences, Faculty of Applied Health Sciences, The Hashemite University, Zarqa, Jordan
| | - Abdel-Ellah Al-Shudifat
- Department of Internal and Family Medicine, Faculty of Medicine, The Hashemite University, Zarqa, Jordan
| | - Shahd Tarawneh
- Department of Microbiology, Pathology and Forensic Medicine, Faculty of Medicine, The Hashemite University, Zarqa, Jordan
| | - Rand Dawoud
- Institute for Family Health, King Hussein Foundation, Amman, Jordan
| | - Amel Mryyian
- Department of Pediatrics, King Hussein Cancer Center (KHCC), Amman, Jordan
| | - Mu'ath Al-Ajaleen
- Department of Biology and Biotechnology, Faculty of Science, The Hashemite University, Zarqa, Jordan
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13
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Calcaterra V, Zanelli S, Foppiani A, Verduci E, Benatti B, Bollina R, Bombaci F, Brucato A, Cammarata S, Calabrò E, Cirnigliaro G, Della Torre S, Dell’osso B, Moltrasio C, Marzano AV, Nostro C, Romagnuolo M, Trotta L, Savasi V, Smiroldo V, Zuccotti G. Long COVID in Children, Adults, and Vulnerable Populations: A Comprehensive Overview for an Integrated Approach. Diseases 2024; 12:95. [PMID: 38785750 PMCID: PMC11120262 DOI: 10.3390/diseases12050095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 04/27/2024] [Accepted: 05/03/2024] [Indexed: 05/25/2024] Open
Abstract
Long COVID affects both children and adults, including subjects who experienced severe, mild, or even asymptomatic SARS-CoV-2 infection. We have provided a comprehensive overview of the incidence, clinical characteristics, risk factors, and outcomes of persistent COVID-19 symptoms in both children and adults, encompassing vulnerable populations, such as pregnant women and oncological patients. Our objective is to emphasize the critical significance of adopting an integrated approach for the early detection and appropriate management of long COVID. The incidence and severity of long COVID symptoms can have a significant impact on the quality of life of patients and the course of disease in the case of pre-existing pathologies. Particularly, in fragile and vulnerable patients, the presence of PASC is related to significantly worse survival, independent from pre-existing vulnerabilities and treatment. It is important try to achieve an early recognition and management. Various mechanisms are implicated, resulting in a wide range of clinical presentations. Understanding the specific mechanisms and risk factors involved in long COVID is crucial for tailoring effective interventions and support strategies. Management approaches involve comprehensive biopsychosocial assessments and treatment of symptoms and comorbidities, such as autonomic dysfunction, as well as multidisciplinary rehabilitation. The overall course of long COVID is one of gradual improvement, with recovery observed in the majority, though not all, of patients. As the research on long-COVID continues to evolve, ongoing studies are likely to shed more light on the intricate relationship between chronic diseases, such as oncological status, cardiovascular diseases, psychiatric disorders, and the persistent effects of SARS-CoV-2 infection. This information could guide healthcare providers, researchers, and policymakers in developing targeted interventions.
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Affiliation(s)
- Valeria Calcaterra
- Department of Internal Medicine and Therapeutics, Università degli Sudi di Pavia, 27100 Pavia, Italy;
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milano, Italy; (S.Z.); (E.V.)
| | - Sara Zanelli
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milano, Italy; (S.Z.); (E.V.)
| | - Andrea Foppiani
- International Center for the Assessment of Nutritional Status and the Development of Dietary Intervention Strategies (ICANS-DIS), Department of Food, Environmental and Nutritional Sciences (DeFENS), Università degli Studi di Milano, 20157 Milano, Italy;
- IRCCS Istituto Auxologico Italiano, Department of Endocrine and Metabolic Medicine, Clinical Nutrition Unit, 20145 Milano, Italy
| | - Elvira Verduci
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milano, Italy; (S.Z.); (E.V.)
- Department of Health Sciences, Università degli Studi di Milano, 20157 Milano, Italy
| | - Beatrice Benatti
- “Aldo Ravelli” Center for Nanotechnology and Neurostimulation, Università degli Studi di Milano, 20157 Milano, Italy; (B.B.); (B.D.)
- Department of Psychiatry, ASST Fatebenefratelli-Sacco, University of Milano, 20154 Milano, Italy; (G.C.); (C.N.)
| | - Roberto Bollina
- Department of Medical Oncology, ASST Rhodense, 20024 Milano, Italy; (R.B.); (S.D.T.); (V.S.)
| | - Francesco Bombaci
- Department of Radiology, ASST Fatebenefratelli Sacco, 20154 Milano, Italy;
| | - Antonio Brucato
- Department of Internal Medicine, ASST Fatebenefratelli-Sacco, 20154 Milano, Italy; (A.B.); (E.C.); (L.T.)
| | - Selene Cammarata
- Department of Woman, Mother and Neonate, Luigi Sacco Hospital, ASST Fatebenefratelli-Sacco, 20154 Milano, Italy; (S.C.); (V.S.)
| | - Elisa Calabrò
- Department of Internal Medicine, ASST Fatebenefratelli-Sacco, 20154 Milano, Italy; (A.B.); (E.C.); (L.T.)
| | - Giovanna Cirnigliaro
- Department of Psychiatry, ASST Fatebenefratelli-Sacco, University of Milano, 20154 Milano, Italy; (G.C.); (C.N.)
| | - Silvia Della Torre
- Department of Medical Oncology, ASST Rhodense, 20024 Milano, Italy; (R.B.); (S.D.T.); (V.S.)
| | - Bernardo Dell’osso
- “Aldo Ravelli” Center for Nanotechnology and Neurostimulation, Università degli Studi di Milano, 20157 Milano, Italy; (B.B.); (B.D.)
- Department of Psychiatry, ASST Fatebenefratelli-Sacco, University of Milano, 20154 Milano, Italy; (G.C.); (C.N.)
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305, USA
- Centro per lo Studio dei Meccanismi Molecolari alla Base delle Patologie Neuro-Psico-Geriatriche, Università degli Studi di Milano, 20157 Milano, Italy
| | - Chiara Moltrasio
- Dermatology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy; (C.M.); (A.V.M.); (M.R.)
| | - Angelo Valerio Marzano
- Dermatology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy; (C.M.); (A.V.M.); (M.R.)
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, 20122 Milano, Italy
| | - Chiara Nostro
- Department of Psychiatry, ASST Fatebenefratelli-Sacco, University of Milano, 20154 Milano, Italy; (G.C.); (C.N.)
| | - Maurizio Romagnuolo
- Dermatology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy; (C.M.); (A.V.M.); (M.R.)
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, 20122 Milano, Italy
| | - Lucia Trotta
- Department of Internal Medicine, ASST Fatebenefratelli-Sacco, 20154 Milano, Italy; (A.B.); (E.C.); (L.T.)
| | - Valeria Savasi
- Department of Woman, Mother and Neonate, Luigi Sacco Hospital, ASST Fatebenefratelli-Sacco, 20154 Milano, Italy; (S.C.); (V.S.)
- Department of Biomedical and Clinical Science, Università degli Studi di Milano, 20157 Milano, Italy
| | - Valeria Smiroldo
- Department of Medical Oncology, ASST Rhodense, 20024 Milano, Italy; (R.B.); (S.D.T.); (V.S.)
| | - Gianvincenzo Zuccotti
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milano, Italy; (S.Z.); (E.V.)
- Department of Biomedical and Clinical Science, Università degli Studi di Milano, 20157 Milano, Italy
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14
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Marcotullio C, Attanasi M, Porreca A, Di Filippo P, Matricardi S, Venanzi A, Schiavo M, Paone A, Rossi N, Chiarelli F, Prezioso G. Neuropsychological Symptoms and Quality of Life during the COVID-19 Pandemic in Children: A Survey in a Pediatric Population in the Abruzzo Region, Italy. CHILDREN (BASEL, SWITZERLAND) 2024; 11:532. [PMID: 38790527 PMCID: PMC11119843 DOI: 10.3390/children11050532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Revised: 04/08/2024] [Accepted: 04/23/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND The SARS-CoV-2 pandemic has significantly affected the pediatric population. Long-term sequelae (Long COVID-19) may particularly involve the central nervous system, with possible effects on psychological well-being and quality of life (QoL), aspects that were already influenced by the restrictive measures and general social impact of the pandemic. METHODS We conducted a cross-sectional survey that aims at investigating the neuropsychological effects and the QoL impairment of SARS-CoV-2 on a cohort of children and adolescents in the Abruzzo region (Italy). A questionnaire was submitted to caregivers with the help of the PEDIATOTEM platform. A control group of healthy subjects was also included to distinguish between the effects of infection from the general influence of the pandemic. RESULTS A total of 569 subjects responded: 396 COVID-19 patients (99 of whom had Long COVID-19) and 111 controls. After the pandemic, when compared with the COVID-19 group, the controls reported significantly increased appetite, sleeping habits, and time spent remotely with friends and a reduction in physical activity and time spent in person with friends. A significant higher rate of controls asked for psychological/medical support for emotional problems. On the other hand, the Long COVID-19 group showed more fatigue and emotional instability with respect to non-Long-COVID-19 subjects. No differences in QoL results (EuroQOL) were found between the COVID-19 patients and controls, while the Long-COVID-19 subgroup showed significantly higher rates of pain/discomfort and mood instability, as confirmed by the analysis of variation of responses from the pre-COVID-19 to the post-COVID-19 period. CONCLUSIONS Among COVID-19 patients, neuropsychological and QoL impairment was more evident in the Long COVID-19 subgroup, although emotional and relational issues were also reported by uninfected patients, with a growing request for specialist support as a possible consequence of social restriction.
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Affiliation(s)
- Chiara Marcotullio
- Department of Pediatrics, University of Chieti-Pescara, 66100 Chieti, Italy; (C.M.); (M.A.); (P.D.F.); (S.M.); (A.V.); (M.S.); (N.R.); (F.C.)
| | - Marina Attanasi
- Department of Pediatrics, University of Chieti-Pescara, 66100 Chieti, Italy; (C.M.); (M.A.); (P.D.F.); (S.M.); (A.V.); (M.S.); (N.R.); (F.C.)
| | - Annamaria Porreca
- Laboratory of Biostatistics, Department of Medical, Oral and Biotechnological Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy;
| | - Paola Di Filippo
- Department of Pediatrics, University of Chieti-Pescara, 66100 Chieti, Italy; (C.M.); (M.A.); (P.D.F.); (S.M.); (A.V.); (M.S.); (N.R.); (F.C.)
| | - Sara Matricardi
- Department of Pediatrics, University of Chieti-Pescara, 66100 Chieti, Italy; (C.M.); (M.A.); (P.D.F.); (S.M.); (A.V.); (M.S.); (N.R.); (F.C.)
| | - Annamaria Venanzi
- Department of Pediatrics, University of Chieti-Pescara, 66100 Chieti, Italy; (C.M.); (M.A.); (P.D.F.); (S.M.); (A.V.); (M.S.); (N.R.); (F.C.)
| | - Marco Schiavo
- Department of Pediatrics, University of Chieti-Pescara, 66100 Chieti, Italy; (C.M.); (M.A.); (P.D.F.); (S.M.); (A.V.); (M.S.); (N.R.); (F.C.)
| | - Antonio Paone
- Department of Neuroscience, Imaging and Clinical Science, University of Chieti-Pescara, 66100 Chieti, Italy;
| | - Nadia Rossi
- Department of Pediatrics, University of Chieti-Pescara, 66100 Chieti, Italy; (C.M.); (M.A.); (P.D.F.); (S.M.); (A.V.); (M.S.); (N.R.); (F.C.)
| | - Francesco Chiarelli
- Department of Pediatrics, University of Chieti-Pescara, 66100 Chieti, Italy; (C.M.); (M.A.); (P.D.F.); (S.M.); (A.V.); (M.S.); (N.R.); (F.C.)
| | - Giovanni Prezioso
- Department of Pediatrics, University of Chieti-Pescara, 66100 Chieti, Italy; (C.M.); (M.A.); (P.D.F.); (S.M.); (A.V.); (M.S.); (N.R.); (F.C.)
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15
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Toepfner N, Brinkmann F, Augustin S, Stojanov S, Behrends U. Long COVID in pediatrics-epidemiology, diagnosis, and management. Eur J Pediatr 2024; 183:1543-1553. [PMID: 38279014 PMCID: PMC11001657 DOI: 10.1007/s00431-023-05360-y] [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: 08/02/2023] [Revised: 11/24/2023] [Accepted: 11/29/2023] [Indexed: 01/28/2024]
Abstract
This review summarizes current knowledge on post-acute sequelae of COVID-19 (PASC) and post-COVID-19 condition (PCC) in children and adolescents. A literature review was performed to synthesize information from clinical studies, expert opinions, and guidelines. PASC also termed Long COVID - at any age comprise a plethora of unspecific symptoms present later than 4 weeks after confirmed or probable infection with severe respiratory syndrome corona virus type 2 (SARS-CoV-2), without another medical explanation. PCC in children and adolescents was defined by the WHO as PASC occurring within 3 months of acute coronavirus disease 2019 (COVID-19), lasting at least 2 months, and limiting daily activities. Pediatric PASC mostly manifest after mild courses of COVID-19 and in the majority of cases remit after few months. However, symptoms can last for more than 1 year and may result in significant disability. Frequent symptoms include fatigue, exertion intolerance, and anxiety. Some patients present with postural tachycardia syndrome (PoTS), and a small number of cases fulfill the clinical criteria of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). To date, no diagnostic marker has been established, and differential diagnostics remains challenging. Therapeutic approaches include appropriate self-management as well as the palliation of symptoms by non-pharmaceutical and pharmaceutical strategies. Conclusion: PASC in pediatrics present with heterogenous severity and duration. A stepped, interdisciplinary, and individualized approach is essential for appropriate clinical management. Current health care structures have to be adapted, and research was extended to meet the medical and psychosocial needs of young people with PASC or similar conditions. What is Known: • Post-acute sequelae of coronavirus 2019 (COVID-19) (PASC) - also termed Long COVID - in children and adolescents can lead to activity limitation and reduced quality of life. • PASC belongs to a large group of similar post-acute infection syndromes (PAIS). Specific biomarkers and causal treatment options are not yet available. What is New: • In February 2023, a case definition for post COVID-19 condition (PCC) in children and adolescents was provided by the World Health Organization (WHO), indicating PASC with duration of at least 2 months and limitation of daily activities. PCC can present as myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). • Interdisciplinary collaborations are necessary and have been established worldwide to offer harmonized, multimodal approaches to diagnosis and management of PASC/PCC in children and adolescents.
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Affiliation(s)
- Nicole Toepfner
- Department of Pediatrics, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
| | - Folke Brinkmann
- Division of Pediatric Pulmonology and Allergology, University Children's Hospital, Airway Research Center North (ARCN), German Center for Lung Research (DZL), Luebeck, Germany
| | - Silvia Augustin
- MRI Chronic Fatigue Center for Young People, Pediatrics, Children's Hospital, Technical University Munich and Munich Municipal Hospital, Munich, Germany
| | - Silvia Stojanov
- MRI Chronic Fatigue Center for Young People, Child and Adolescent Psychosomatics, Children's Hospital, Technical University Munich and Munich Municipal Hospital, Munich, Germany
| | - Uta Behrends
- MRI Chronic Fatigue Center for Young People, Pediatrics, Children's Hospital, Technical University Munich and Munich Municipal Hospital, Munich, Germany
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16
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Mogensen I, Ekström S, Hallberg J, Georgelis A, Melén E, Bergström A, Kull I. Post COVID-19 symptoms are common, also among young adults in the general population. Sci Rep 2023; 13:11300. [PMID: 37438424 PMCID: PMC10338459 DOI: 10.1038/s41598-023-38315-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 07/06/2023] [Indexed: 07/14/2023] Open
Abstract
Post coronavirus disease-19 (post COVID-19) is mainly studied in clinical populations and less is known about post COVID-19 in a young general population. The aim of the study is to investigate the prevalence and symptoms of post COVID-19 and its potential risk factors in young adults. Participants from the Swedish population-based birth cohort BAMSE were included (n = 2022, mean age 26.5 years). Post COVID-19 was assessed through a questionnaire and defined as symptoms after confirmed COVID-19 (registry-based or self-reported positive test) lasting for ≥ 2 months. In total, 681 participants had had confirmed COVID-19. Among them, 112 (16.5%) fulfilled the definition of post COVID-19 (17.8% in females, 14.5% in males, p = 0.26). The most common post COVID-19 symptoms were altered smell and taste (68.8%), dyspnea (33.7%) and fatigue (30.4%). Overall, no major risk factors for post COVID-19 were identified except for being bedbound during COVID-19. However, asthma and rhinitis were associated with the post COVID-19 symptom dyspnea, migraine with altered smell and taste, and lower self-rated health with fatigue. In conclusion, post COVID-19 symptoms are common, also among young adults in the general population. Although not life-threatening, it could have a considerable impact on public health due to the high prevalence and long-term symptoms.
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Affiliation(s)
- Ida Mogensen
- Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
- Center for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Sandra Ekström
- Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
- Center for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden.
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Jenny Hallberg
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
| | - Antonios Georgelis
- Center for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Erik Melén
- Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
| | - Anna Bergström
- Center for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Inger Kull
- Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
- Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
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