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Michelon I, Vilbert M, Pinheiro IS, Costa IL, Lorea CF, Castonguay M, Tran TH, Forté S. COVID-19 outcomes in patients with sickle cell disease and sickle cell trait compared with individuals without sickle cell disease or trait: a systematic review and meta-analysis. EClinicalMedicine 2023; 66:102330. [PMID: 38162948 PMCID: PMC10755716 DOI: 10.1016/j.eclinm.2023.102330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 11/06/2023] [Accepted: 11/07/2023] [Indexed: 01/03/2024] Open
Abstract
Background Clinical manifestations and severity of SARS-CoV-2 infection in individuals with sickle cell disease (SCD) and sickle cell trait (SCT) are not well understood yet. Methods We performed a systematic review and meta-analysis to assess COVID-19 outcomes in individuals with SCD or SCT compared to individuals without sickle cell disease or trait. An electronic search on PubMed, Embase, and Cochrane Library was performed on August 3, 2023. Two authors (IFM and ISP) independently screened (IFM and ISP) and extracted data (IFM and ILC) from included studies. Main exclusion criterion was the absence of the non-SCD/SCT group. Exposure effects for binary endpoints were compared using pooled odds ratio (OR) with 95% confidence intervals (CI). I2 statistics was used to assess the heterogeneity and DerSimonian and Laird random-effects models were applied for all analyses to minimize the impact of differences in methods and outcomes definitions between studies. The overall quality of evidence was assessed using the GRADE system. Review Manager 5.4 and R software (v4.2.2) were used for statistical analyses. Registered with PROSPERO, CRD42022366015. Findings Overall, 22 studies were included, with a total of 1892 individuals with SCD, 8677 individuals with SCT, and 1,653,369 individuals without SCD/SCT. No difference in all-cause mortality was seen between SCD/SCT and non-SCD/SCT (OR 1.18; 95% CI 0.78-1.77; p = 0.429; I2 = 82%). When considering only studies adjusted for confounders (8 studies), patients with SCD/SCT were shown to be at increased risk of death (OR 1.86; 95% CI 1.30-2.66; p = 0.0007; I2 = 34%). No significant difference was seen between individuals with SCD and SCT (p = 0.863). The adjusted for confounders analysis for hospitalisation revealed higher rates for the SCD (OR 5.44; 95% CI 1.55-19.13; p = 0.008; I2 = 97%) and the SCT groups (OR 1.31; 95% CI 1.10-1.55; p = 0.002; I2 = 0) compared to the non-SCD/SCT population. Moreover, it was significantly higher for the SCD group (test for subgroup difference; p = 0.028). Interpretation Our findings suggest that patients with SCD or SCT may present with a higher mortality and hospitalisation rates due to COVID-19 infection. Funding None.
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Affiliation(s)
- Isabella Michelon
- Department of Medicine, School of Medicine, Catholic University of Pelotas, Pelotas, Brazil
| | - Maysa Vilbert
- Department of Medicine, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | | | - Isabela Lino Costa
- Department of Medicine, School of Medicine, Federal University of Mineiro Triangle, Uberaba, Brazil
| | | | - Mathias Castonguay
- Department of Medicine, Centre Hospitalier de l’Université de Montréal, Quebec, Canada
| | - Thai Hoa Tran
- Division of Paediatric Hematology and Oncology, Department of Pediatrics, Centre Hospitalier Universitaire de Sainte-Justine, Montréal, Quebec, Canada
| | - Stéphanie Forté
- Division of Hematology and Medical Oncology, Departement of Medicine, Centre Hospitalier de l’Université de Montréal, Montréal, Canada
- Carrefour de l'Innovation, Centre de Recherche du CHUM (CRCHUM), Montréal, Canada
- Division of Hematology and Medical Oncology, Department of Medicine, Centre Hospitalier de l'Université de Montréal, Montréal, Canada
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Karavanaki K, Rodolaki K, Soldatou A, Karanasios S, Kakleas K. Covid-19 infection in children and adolescents and its association with type 1 diabetes mellitus (T1d) presentation and management. Endocrine 2023; 80:237-252. [PMID: 36462147 PMCID: PMC9734866 DOI: 10.1007/s12020-022-03266-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 11/17/2022] [Indexed: 12/04/2022]
Abstract
Children seem to be affected by the new SARS-CoV-2 virus less severely than adults, with better prognosis and low mortality. Serious complications of COVID-19 infection in children include multisystem inflammatory response syndrome in COVID-19 infection (MIS-C), myo-or pericarditis and, less frequently, long COVID syndrome. On the other hand, adults with type 1 (T1D) or type 2 diabetes (T2D) are among the most vulnerable groups affected by COVID-19, with increased morbidity and mortality. Moreover, an association of SARS-CoV-2 with diabetes has been observed, possibly affecting the frequency and severity of the first clinical presentation of T1D or T2D, as well as the development of acute diabetes after COVID-19 infection. The present review summarizes the current data on the incidence of T1D among children and adolescents during the COVID-19 pandemic, as well as its severity. Moreover, it reports on the types of newly diagnosed diabetes after COVID infection and the possible pathogenetic mechanisms. Additionally, this study presents current data on the effect of SARS-CoV-2 on diabetes control in patients with known T1D and on the severity of clinical presentation of COVID infection in these patients. Finally, this review discusses the necessity of immunization against COVID 19 in children and adolescents with T1D.
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Affiliation(s)
- Kyriaki Karavanaki
- Diabetes and Metabolism Unit, 2nd Department of Pediatrics, National and Kapodistrian University of Athens,"P&A Kyriakou" Children's Hospital, Athens, Greece
| | - Kalliopi Rodolaki
- First Department of Pediatrics, National and Kapodistrian University of Athens,"Aghia Sophia" Children's Hospital, Athens, Greece
| | - Alexandra Soldatou
- Diabetes and Metabolism Unit, 2nd Department of Pediatrics, National and Kapodistrian University of Athens,"P&A Kyriakou" Children's Hospital, Athens, Greece
| | - Spyridon Karanasios
- Diabetes and Metabolism Unit, 2nd Department of Pediatrics, National and Kapodistrian University of Athens,"P&A Kyriakou" Children's Hospital, Athens, Greece
| | - Kostas Kakleas
- First Department of Pediatrics, National and Kapodistrian University of Athens,"Aghia Sophia" Children's Hospital, Athens, Greece.
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Corvol H, Prevost B, Aubertin G, Thouvenin G, Taytard J, Nathan N. COVID-19 and pediatric pulmonology: Feedback from an expert center after the first year of the pandemic. Pediatr Pulmonol 2023; 58:392-397. [PMID: 36353967 PMCID: PMC9878247 DOI: 10.1002/ppul.26235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 10/14/2022] [Accepted: 11/04/2022] [Indexed: 11/11/2022]
Abstract
The coronavirus disease 2019 (COVID-19) outbreak has evolved with different waves corresponding to subsequent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mutations. While the most severe cases have been observed in the elderly and in individuals with underlying comorbidities, severe pediatric and young adult cases have been observed, as well as post-infectious inflammatory syndromes and persistent symptoms leading to long-COVID. This manuscript describes the experience of a pediatric respiratory unit during the first year of the pandemic and reviews the corresponding literature with a special emphasis on children and young people with underlying conditions, such as immunosuppression, sickle cell disease, and cystic fibrosis.
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Affiliation(s)
- Harriet Corvol
- Service de Pneumologie Pédiatrique, Centre de Référence des Maladies Respiratoires Rares RespiRare et Centre de Ressources et de Compétences pour la Mucoviscidose, Sorbonne Université et APHP, Hôpital Armand Trousseau, Paris, France.,Centre de recherche Saint Antoine (CRSA), Paris, France
| | - Blandine Prevost
- Service de Pneumologie Pédiatrique, Centre de Référence des Maladies Respiratoires Rares RespiRare et Centre de Ressources et de Compétences pour la Mucoviscidose, Sorbonne Université et APHP, Hôpital Armand Trousseau, Paris, France.,Centre de recherche Saint Antoine (CRSA), Paris, France
| | - Guillaume Aubertin
- Service de Pneumologie Pédiatrique, Centre de Référence des Maladies Respiratoires Rares RespiRare et Centre de Ressources et de Compétences pour la Mucoviscidose, Sorbonne Université et APHP, Hôpital Armand Trousseau, Paris, France.,Centre de recherche Saint Antoine (CRSA), Paris, France
| | - Guillaume Thouvenin
- Service de Pneumologie Pédiatrique, Centre de Référence des Maladies Respiratoires Rares RespiRare et Centre de Ressources et de Compétences pour la Mucoviscidose, Sorbonne Université et APHP, Hôpital Armand Trousseau, Paris, France.,Centre de recherche Saint Antoine (CRSA), Paris, France
| | - Jessica Taytard
- Service de Pneumologie Pédiatrique, Centre de Référence des Maladies Respiratoires Rares RespiRare et Centre de Ressources et de Compétences pour la Mucoviscidose, Sorbonne Université et APHP, Hôpital Armand Trousseau, Paris, France.,Inserm UMRS_S1158, Paris, France
| | - Nadia Nathan
- Service de Pneumologie Pédiatrique, Centre de Référence des Maladies Respiratoires Rares RespiRare et Centre de Ressources et de Compétences pour la Mucoviscidose, Sorbonne Université et APHP, Hôpital Armand Trousseau, Paris, France.,Inserm UMR_S933, Paris, France
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Pathobiology, Severity, and Risk Stratification of Pediatric Acute Respiratory Distress Syndrome: From the Second Pediatric Acute Lung Injury Consensus Conference. Pediatr Crit Care Med 2023; 24:S12-S27. [PMID: 36661433 DOI: 10.1097/pcc.0000000000003156] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVES To review the literature for studies published in children on the pathobiology, severity, and risk stratification of pediatric acute respiratory distress syndrome (PARDS) with the intent of guiding current medical practice and identifying important areas for future research related to severity and risk stratification. DATA SOURCES Electronic searches of PubMed and Embase were conducted from 2013 to March 2022 by using a combination of medical subject heading terms and text words to capture the pathobiology, severity, and comorbidities of PARDS. STUDY SELECTION We included studies of critically ill patients with PARDS that related to the severity and risk stratification of PARDS using characteristics other than the oxygenation defect. Studies using animal models, adult only, and studies with 10 or fewer children were excluded from our review. DATA EXTRACTION Title/abstract review, full-text review, and data extraction using a standardized data collection form. DATA SYNTHESIS The Grading of Recommendations Assessment, Development, and Evaluation approach was used to identify and summarize relevant evidence and develop recommendations for clinical practice. There were 192 studies identified for full-text extraction to address the relevant Patient/Intervention/Comparator/Outcome questions. One clinical recommendation was generated related to the use of dead space fraction for risk stratification. In addition, six research statements were generated about the impact of age on acute respiratory distress syndrome pathobiology and outcomes, addressing PARDS heterogeneity using biomarkers to identify subphenotypes and endotypes, and use of standardized ventilator, physiologic, and nonpulmonary organ failure measurements for future research. CONCLUSIONS Based on an extensive literature review, we propose clinical management and research recommendations related to characterization and risk stratification of PARDS severity.
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Al-Qahtani MH, Bukhamseen FM, Al-Qassab AT, Yousef AA, Awary BH, Albuali WH, Alkhalifa ZM, Yousef HA. The Impact of COVID-19 Lockdown on the Incidence of Type 1 DM and the Glycemic Control of Diabetic Children: Findings from a Teaching Hospital, Saudi Arabia. Rev Diabet Stud 2022; 18:152-156. [PMID: 36309774 PMCID: PMC9652708 DOI: 10.1900/rds.2022.18.152] [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] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE: We evaluated glycemic control among T1DM pediatric patients attending the endocrinology pediatrics clinics at King Fahd Hospital of the University (KFHU) prior to and during COVID-19 restraining regulations. In addition, we assessed the trends and variations in the incidence of T1DM during 2017-2021, including the COVID-19 years by identifying newly diagnosed patients presenting to pediatrics emergency department (ED) in KFHU. METHODS: To estimate the effect of COVID-19 on the incidence of T1DM, we identified newly diagnosed cases of T1DM among pediatric patients attending the ED during the years 2017- 2021. The participants' data were collected through electronic medical records. Information collected included patient age, sex, and HbA1c readings. Three HbA1c readings of interest that were defined and collected are pre-COVID reading, in-COVID reading, and post-COVID reading. RESULTS: The difference of female participants' readings was statistically non-significant (Z= -0.416, p = 0.678), with a pre- and post-COVID median of 10.70 (Q1= 9.00, Q3= 12.15), and 10.50 (Q1= 8.80, Q3= 12.35), respectively. In contrast, the difference was statistically significant among male participants (Z= -2.334, p = 0.02), with a pre- and post-COVID median of 10.20 (Q1= 8.70, Q3= 11.80), and 10.65 (Q1= 9.00, Q3= 12.70), respectively. There was a statistically significant increase in HbA1c of persons > 11 years old (Z= -2.471, p= 0.013), with a pre- and post-COVID median of 10.40 (Q1= 9.00, Q3= 12.10), and 10.90 (Q1= 9.00, Q3= 12.60), respectively. Conversely, persons ≤ 11 years old showed no statistically significant change in HbA1c (Z= -.457, p= 0.648), with a pre- and post-COVID median of 10.45 (Q1= 8.70, Q3= 11.85), and 10.20 (Q1= 8.40, Q3= 12.075), respectively. Disregarding any influence of time, the effect of sex showed no statistically significant difference in HbA1c between males and females [F (1,125) = 0.008, p = 0.930]. Meanwhile, the age effect on HbA1c, regardless of time influence, was statistically significant [F (1,125) = 4.993, p = 0.027]. There was no statistically significant interaction between time and sex on HbA1c levels [F (1.74, 217) = 0.096, p = 0.883] and between age and time [F (3.92,289.57) = 1.693, p = 0.190]. CONCLUSIONS: The number of visits to healthcare facilities dropped significantly during the COVID-19 pandemic, but the rate of newly diagnosed T1DM increased. There was a variable effect on HbA1c levels of those patients, which suggests that each demographic group in the population might have been affected differently by the pandemic. Future research should determine factors associated with better glycemic control and measures to sustain these changes the pandemic might have created.
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Affiliation(s)
- Mohammad Hussain Al-Qahtani
- Department of Pediatrics, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia,,Address correspondence to: Mohammad Hussain Al-Qahtani, e-mail:
| | | | | | - Abdullah Abdulsalam Yousef
- Department of Pediatrics, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Bassam Hassan Awary
- Department of Pediatrics, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Waleed Hamad Albuali
- Department of Pediatrics, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | | | - Haneen Abdulsalam Yousef
- Department of Family Medicine, College of Medicine, Imam Abdulrahman Bin Faisal university, Dammam, Saudi Arabia
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A systematic review and meta-analysis of otorhinolaryngological manifestations of coronavirus disease 2019 in paediatric patients. The Journal of Laryngology & Otology 2022; 136:588-603. [PMID: 35172911 DOI: 10.1017/s0022215122000536] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND This meta-analysis provides a quantitative measure of the otorhinolaryngological manifestations of coronavirus disease 2019 in children. METHODS A structured literature review was carried out using PubMed, Embase and Cochrane Central, employing pertinent search terms. The statistical analysis was performed using Stata version 14.2 software, and the analysed data were expressed as the pooled prevalence of the symptoms with 95 per cent confidence intervals. RESULTS The commonest symptoms noted were cough (38 per cent (95 per cent confidence interval = 33-42; I2 = 97.5 per cent)), sore throat (12 per cent (95 per cent confidence interval =10-14; I2 = 93.7 per cent)), and nasal discharge (15 per cent (95 per cent confidence interval = 12-19; I2 = 96.9 per cent)). Anosmia and taste disturbances showed a pooled prevalence of 8 per cent each. Hearing loss, vertigo and hoarseness were rarely reported. CONCLUSION Cough, sore throat and nasal discharge were the commonest otorhinolaryngological symptoms in paediatric patients with coronavirus disease 2019. Compared with adults, anosmia and taste disturbances were infrequently reported in children.
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Multisystem inflammatory syndrome (MIS-C): a systematic review and meta-analysis of clinical characteristics, treatment, and outcomes. J Pediatr (Rio J) 2022; 98:338-349. [PMID: 34863701 PMCID: PMC9432310 DOI: 10.1016/j.jped.2021.08.006] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 08/27/2021] [Accepted: 10/28/2021] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE The clinical cases of patients with multisystem inflammatory syndrome (MIS-C) were analyzed via a systematic review and meta-analysis of the clinical findings, treatments, and possible outcomes of articles retrieved via database searches. SOURCES The authors searched the PubMed, Scielo, Web of Science, Science Direct, EMBASA, EBSCO, and Scopus databases for articles containing the keywords "multisystem inflammatory syndrome in children" or "MIS-C" or "PIMS-TS" or "SIMP" and "COVID-19" or "SARS-CoV-2" published between December 1st, 2019 and July 10th, 2021. Patient characteristics, tissue and organ comorbidities, the incidence of symptoms after COVID-19 infection, treatment, and patient evolution in the articles found were evaluated. The data were abstracted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and Newcastle-Ottawa Scale (NOS). FINDINGS In total, 98 articles (2275 patients) were selected for demographics, clinical treatment, and outcomes of patients diagnosed with MIS-C. The average age of children with MIS-C, 56.8% of whom were male, was of nine years. Fever (100%), gastrointestinal (GI) (82%), and abdominal pain (68%) were the decisive symptoms for the diagnosis of MIS-C. Shock and/or hypotension were common in patients with MIS-C. Cardiac symptoms (66%) predominated over respiratory (39%) and neurological (28%) symptoms. MIS-C treatment followed the common guidelines for treating children with septic shock and Kawasaki disease (KD) and proved to be effective. CONCLUSIONS This meta-analysis highlights the main clinical symptoms used for the diagnosis of MIS-C, the differences between MIS-C and KD, and the severity of the inflammatory process and urgency for hospital care.
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Fatigue muss nicht immer SARS-CoV-2-bedingt sein – eine Kasuistik. PÄDIATRIE & PÄDOLOGIE 2022; 57:141-145. [PMID: 35611157 PMCID: PMC9118809 DOI: 10.1007/s00608-022-00989-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 04/29/2022] [Indexed: 12/01/2022]
Abstract
Wir berichten über eine durch ausgeprägte Fatigue vorstellig gewordene 17-jährige Jugendliche. Die Ursache dafür konnte in einer Epstein-Barr-Virus(EBV)-Infektion (Mononucleosis infectiosa) gefunden werden. Fatigue muss auch in einer Zeit der Covid-19-Pandemie nicht immer durch SARS-CoV‑2 bedingt sein, sondern kann auch andere im Jugendalter angesiedelte Erkrankungen (EBV) als Ursache haben. Bis zu 13,5 % der EBV-Erkrankten entwickeln ein chronisches Fatigue-Syndrom (CFS), weswegen die genaue Abklärung der Ursache sinnvoll erscheint. Diagnostik, Therapie und Prognose der Mononucleosis infectiosa werden abgehandelt.
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Hoogenboom WS, Alamuri TT, McMahon DM, Balanchivadze N, Dabak V, Mitchell WB, Morrone KB, Manwani D, Duong TQ. Clinical outcomes of COVID-19 in patients with sickle cell disease and sickle cell trait: A critical appraisal of the literature. Blood Rev 2022; 53:100911. [PMID: 34838342 PMCID: PMC8605823 DOI: 10.1016/j.blre.2021.100911] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 10/18/2021] [Accepted: 11/15/2021] [Indexed: 01/08/2023]
Abstract
Individuals with sickle cell disease (SCD) and sickle cell trait (SCT) have many risk factors that could make them more susceptible to COVID-19 critical illness and death compared to the general population. With a growing body of literature in this field, a comprehensive review is needed. We reviewed 71 COVID-19-related studies conducted in 15 countries and published between January 1, 2020, and October 15, 2021, including a combined total of over 2000 patients with SCD and nearly 2000 patients with SCT. Adults with SCD typically have a mild to moderate COVID-19 disease course, but also a 2- to 7-fold increased risk of COVID-19-related hospitalization and a 1.2-fold increased risk of COVID-19-related death as compared to adults without SCD, but not compared to controls with similar comorbidities and end-organ damage. There is some evidence that persons with SCT have increased risk of COVID-19-related hospitalization and death although more studies with risk-stratification and properly matched controls are needed to confirm these findings. While the literature suggests that most children with SCD and COVID-19 have mild disease and low risk of death, some children with SCD, especially those with SCD-related comorbidities, are more likely to be hospitalized and require escalated care than children without SCD. However, children with SCD are less likely to experience COVID-19-related severe illness and death compared to adults with or without SCD. SCD-directed therapies such as transfusion and hydroxyurea may be associated with better COVID-19 outcomes, but prospective studies are needed for confirmation. While some studies have reported favorable short-term outcomes for COVID-19 patients with SCD and SCT, the long-term effects of SARS-CoV-2 infection are unknown and may affect individuals with SCD and SCT differently from the general population. Important focus areas for future research should include multi-center studies with larger sample sizes, assessment of hemoglobin genotype and SCD-modifying therapies on COVID-19 outcomes, inclusion of case-matched controls that account for the unique sample characteristics of SCD and SCT populations, and longitudinal assessment of post-COVID-19 symptoms.
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Affiliation(s)
- Wouter S. Hoogenboom
- Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461, USA,Corresponding authors at: Albert Einstein College of Medicine and Montefiore Medical Center, Department of Radiology, 1300 Morris Park Avenue, Bronx, New York 10461, USA
| | - Tharun T. Alamuri
- Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461, USA
| | - Daniel M. McMahon
- Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461, USA
| | - Nino Balanchivadze
- Department of Hematology and Oncology, Henry Ford Hospital, Detroit, MI 48202, USA
| | - Vrushali Dabak
- Department of Hematology and Oncology, Henry Ford Hospital, Detroit, MI 48202, USA
| | - William B. Mitchell
- Department of Pediatrics, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461, USA
| | - Kerry B. Morrone
- Department of Pediatrics, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461, USA
| | - Deepa Manwani
- Department of Pediatrics, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461, USA
| | - Tim Q. Duong
- Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461, USA,Corresponding authors at: Albert Einstein College of Medicine and Montefiore Medical Center, Department of Radiology, 1300 Morris Park Avenue, Bronx, New York 10461, USA
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Corvol H, de Miranda S, Dehillotte C, Lemonnier L, Chiron R, Danner-Boucher I, Hamidfar R, Houdouin V, Macey J, Marguet C, Murris-Espin M, Reynaud Q, Reix P, Gaubert MR, Kemgang A, Burgel PR. Cumulative Incidence and Risk Factors for Severe COVID-19 in French People with Cystic Fibrosis. Clin Infect Dis 2022; 75:2135-2144. [PMID: 35475917 PMCID: PMC9129125 DOI: 10.1093/cid/ciac333] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 04/08/2022] [Accepted: 04/25/2022] [Indexed: 11/30/2022] Open
Abstract
Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections are closely monitored in people with cystic fibrosis (pwCF), with a special emphasis on severe cases. Previous studies used hospitalization rates as proxy for severity. Methods We evaluated data from coronavirus disease 2019 (COVID-19) cases diagnosed in French pwCF followed in one of the 47 French CF center over the first year of the pandemic. Objective criteria were applied for defining severity (e.g., respiratory failure and/or death). Data were compared to those from all French pwCF using the French CF Registry. Results As of April 30, 2021, 223 pwCF were diagnosed with COVID-19, with higher risks in adults (≥18 years, odds ratio [OR] = 2.52, 95% confidence interval [CI] = 1.82-3.48) and post-transplant individuals (OR = 2.68, 95% CI = 1.98-3.63). Sixty (26.9%) patients were hospitalized, with an increased risk in post-transplant individuals (OR = 4.74, 95% CI = 2.49-9.02). In 34 (15%) cases, COVID-19 was considered severe; 28/60 (46.7%) hospitalizations occurred in patients without objective criteria of severity. Severe cases occurred mostly in adults (85.3%) and post-transplant pwCF (61.8%, OR = 6.02, 95% CI = 2.77-13.06). In non-transplanted pwCF, risk factors for severity included low lung function (median ppFEV1 54.6% vs. 75.1%, OR = 1.04, 95% CI = 1.01-1.08) and CF-associated diabetes (OR = 3.26, 95% CI = 1.02-10.4). While most cases recovered without sequelae (n = 204, 91.5%), 16 (13%) were followed for possible sequelae, and three post-transplant females died. Conclusions Severe COVID-19 cases occurred infrequently during the first year of the pandemic in French pwCF. Non-transplanted adults with severe respiratory disease or diabetes and post-transplant individuals were at risk for severe COVID-19. Thus, specific preventive measures should be proposed.
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Affiliation(s)
- Harriet Corvol
- Pediatric Respiratory Department and Pediatric CF Center, Assistance Publique Hôpitaux de Paris (APHP), Hôpital Trousseau, Paris, France.,Sorbonne Université, Centre de Recherche Saint-Antoine, Paris, France
| | - Sandra de Miranda
- Pulmonology Department and CF Center, Hôpital Foch, Suresnes, France
| | | | | | - Raphael Chiron
- CF Center, Hôpital Arnaud de Villeneuve, CHU de Montpellier, Montpellier, France
| | - Isabelle Danner-Boucher
- Pulmonology Department and Adult CF Center, Institut du Thorax, CHU de Nantes, Nantes, France
| | | | - Véronique Houdouin
- Pediatric Pulmonology Department and Pediatric CF Center, APHP, Hôpital Robert Debré, Paris, France
| | - Julie Macey
- Respiratory Medicine and CF Center, CHU de Bordeaux, Bordeaux, France
| | - Christophe Marguet
- Pediatric Respiratory Disease and CF Center, CIC Inserm 1404, Inserm U3111, FHU RESPIR, Rouen University Hospital, Rouen, France
| | - Marlène Murris-Espin
- CF Center and Service de Pneumologie Pôle des Voies Respiratoires, CHU de Toulouse, Toulouse, France
| | - Quitterie Reynaud
- Internal Medicine Department and adult CF center, Hospices Civils de Lyon, Research on Healthcare Performance (RESHAPE), INSERM U1290, Université de Lyon, Lyon, France.,ERN-Lung CF Network, Frankfurt, Germany
| | - Philippe Reix
- Pediatric CF Center, Hospices Civils de Lyon, UMR 5558 CNRS Equipe EMET, Université Claude Bernard Lyon 1, Lyon, France
| | - Martine Reynaud Gaubert
- Respiratory Medicine and adult CF center, Assistance Publique Hôpitaux de Marseille, Aix-Marseille Université UM63, Institut de Recherche pour le Développement, Marseille, France
| | - Astrid Kemgang
- Sorbonne Université, Centre de Recherche Saint-Antoine, Paris, France
| | - Pierre-Régis Burgel
- Respiratory Medicine and National Reference CF Center, AP-HP, Hôpital Cochin, Paris, France.,Université de Paris, Institut Cochin, Inserm U-1016, Paris, France.,ERN-Lung CF Network, Frankfurt, Germany
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11
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Octavius GS, Tan R, Pratama TA, Budiputri CL, Meliani F, Heriyanto RS, Muljadi R, Juliansen A. Cardiac manifestations and diagnostic imaging in pediatric inflammatory multisystem syndrome temporally associated with COVID-19: a systematic review. MEDICAL JOURNAL OF INDONESIA 2022. [DOI: 10.13181/mji.oa.225754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND Several studies have reported pediatric inflammatory multisystem syndrome temporally associated with COVID-19 (PIMS-TS) cases with their cardiac manifestations, but only few studies synthesize the cardiovascular characteristics in children with PIMS-TS. However, detecting cardiac abnormalities is crucial in improving patients' outcomes and reducing mortality. This review aimed to summarize the overall symptoms, laboratory, and workup findings in PIMS-TS patients, focusing on cardiovascular manifestations.
METHODS We searched 4 medical databases (PubMed, Science Direct, Medline, and Scielo) and 4 preprint databases (Medrxiv, Research Square, SSRN, and Biorxiv). The literature search was done on November 8, 2021. All case reports, case series, cross-sectional studies, cohort studies, and possible clinical trials published from December 2020 onward that studied PIMS-TS on cardiac manifestation (aged 0–18 years) were included. Studies on multisystem inflammatory syndrome in children, animal studies, and studies without full-text availability were excluded. This review was registered in PROSPERO (CRD42021194468).
RESULTS 59 studies were included with a total of 698 patients. The most common cardiovascular findings were the presence of cardiogenic shock (37%) and hypotension (8.5%). Almost all laboratory values were deranged. Cardiac computed tomography scan mostly showed normal results (56%), followed by cardiomegaly with pericardial effusion (14%). Electrocardiography showed normal findings (46%), ST-segment abnormalities (32%), and abnormal T wave (12%). Echocardiography findings showed left ventricle dysfunction (40.6%), which can be considered most significant, followed by pericardial effusion together with pericarditis (11.4%) and tricuspid regurgitation (6.9%).
CONCLUSIONS This review found various cardiac abnormalities that may develop during PIMS-TS. Due to these findings, we should be more vigilant and not underestimate the consequences in pediatric COVID-19 patients.
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12
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Mania A, Pokorska-Śpiewak M, Figlerowicz M, Pawłowska M, Mazur-Melewska K, Faltin K, Talarek E, Zawadka K, Dobrzeniecka A, Ciechanowski P, Łasecka-Zadrożna J, Rudnicki J, Hasiec B, Stani M, Frańczak-Chmura P, Zaleska I, Szenborn L, Horecka P, Sulik A, Szczepańska B, Pałyga-Bysiecka I, Kucharek I, Sybilski A, Sobolewska-Pilarczyk M, Dryja U, Majda-Stanisławska E, Niedźwiecka S, Kuchar E, Kalicki B, Gorczyca A, Marczyńska M. Pneumonia, gastrointestinal symptoms, comorbidities, and coinfections as factors related to a lengthier hospital stay in children with COVID-19-analysis of a paediatric part of Polish register SARSTer. Infect Dis (Lond) 2022; 54:196-204. [PMID: 34711132 PMCID: PMC8567279 DOI: 10.1080/23744235.2021.1995628] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 10/11/2021] [Accepted: 10/14/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Although COVID-19 is associated with a mild course in children, a certain proportion requires admission to hospital due to SARS-CoV-2 infection and coexisting diseases. The prospective multicenter study aimed to analyze clinical factors influencing the length of the hospital stay (LoHS) in children with COVID-19. METHODS The study included 1283 children from 14 paediatric infectious diseases departments with diagnosed SARS-CoV-2 infection. Children were assessed in respective centres regarding indications for admission to hospital and clinical condition. History data, clinical findings, laboratory parameters, treatment, and outcome, were collected in the paediatric SARSTer register. The group of children with a hospital stays longer than seven days was compared to the remaining patients. Parameters with a statistically significant difference were included in further logistic regression analysis. RESULTS One thousand one hundred and ten children were admitted to the hospital, 763 children were hospitalized >24 h and 173 children >7 days. 268 children had comorbidities. Two hundred and eleven children had an additional diagnosis with coinfections present in 135 children (11%). Factors increasing the risk of higher LoHS included pneumonia [odds ratio-OR 3.028; 95% confidence interval-CI (1.878-4.884)], gastrointestinal symptoms [OR = 1.556; 95%CI (1.049-2.322)], or rash [OR = 2.318; 95%CI (1.216-4.418)] in initial clinical findings. Comorbidities [OR = 2.433; 95%CI (1.662-3.563)], an additional diagnosis [OR = 2.594; 95%CI (1.679-4.007)] and the necessity of the empirical antibiotic treatment [OR = 2.834; 95%CI (2.834-6.713)] were further factors related to higher LoHS. CONCLUSIONS The clinical course of COVID-19 was mild to moderate in most children. Factors increasing the risk of higher LoHS included pneumonia, gastrointestinal symptoms, comorbidities, an additional diagnosis, and the empirical antibiotic treatment.
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Affiliation(s)
- Anna Mania
- Department of Infectious Diseases and Child Neurology, Poznan University of Medical Sciences, Poznan, Poland
| | - Maria Pokorska-Śpiewak
- Department of Children's Infectious Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Magdalena Figlerowicz
- Department of Infectious Diseases and Child Neurology, Poznan University of Medical Sciences, Poznan, Poland
| | - Małgorzata Pawłowska
- Department of Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Katarzyna Mazur-Melewska
- Department of Infectious Diseases and Child Neurology, Poznan University of Medical Sciences, Poznan, Poland
| | - Kamil Faltin
- Department of Infectious Diseases and Child Neurology, Poznan University of Medical Sciences, Poznan, Poland
| | - Ewa Talarek
- Department of Children's Infectious Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Konrad Zawadka
- Department of Children's Infectious Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Anna Dobrzeniecka
- Department of Children's Infectious Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Przemysław Ciechanowski
- Department of Paediatrics and Infectious Diseases, Regional Hospital in Szczecin, Szczecin, Poland
| | - Joanna Łasecka-Zadrożna
- Department of Paediatrics and Infectious Diseases, Regional Hospital in Szczecin, Szczecin, Poland
| | - Józef Rudnicki
- Department of Paediatrics and Infectious Diseases, Regional Hospital in Szczecin, Szczecin, Poland
| | - Barbara Hasiec
- Department of Children's Infectious Diseases, Provincial Jan Boży Hospital in Lublin, Lublin, Poland
| | - Martyna Stani
- Department of Children's Infectious Diseases, Provincial Jan Boży Hospital in Lublin, Lublin, Poland
| | - Paulina Frańczak-Chmura
- Department of Children's Infectious Diseases, Provincial Jan Boży Hospital in Lublin, Lublin, Poland
| | - Izabela Zaleska
- Department of Paediatrics and Infectious Diseases, Wroclaw Medical University, Wroclaw, Poland
| | - Leszek Szenborn
- Department of Paediatrics and Infectious Diseases, Wroclaw Medical University, Wroclaw, Poland
| | - Paulina Horecka
- Department of Pediatric Infectious Diseases, Medical University of Bialystok, Bialystok, Poland
| | - Artur Sulik
- Department of Pediatric Infectious Diseases, Medical University of Bialystok, Bialystok, Poland
| | | | | | - Izabela Kucharek
- 2nd Department of Paediatrics, Centre of Postgraduate Medical Education, Warsaw, Poland
- Department of Paediatrics and Neonatology with Allergology Center, Central Clinical Hospital of the Ministry of the Interior, Warsaw, Poland
| | - Adam Sybilski
- 2nd Department of Paediatrics, Centre of Postgraduate Medical Education, Warsaw, Poland
- Department of Paediatrics and Neonatology with Allergology Center, Central Clinical Hospital of the Ministry of the Interior, Warsaw, Poland
| | - Małgorzata Sobolewska-Pilarczyk
- Department of Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Urszula Dryja
- Department of Paediatric Infectious Diseases, Medical University of Lodz, Lodz, Poland
| | | | - Sławomira Niedźwiecka
- Department of Paediatric Infectious Diseases, Pomeranian Center of Infectious Diseases and Tuberculosis in Gdańsk, Gdańsk, Poland
| | - Ernest Kuchar
- Department of Paediatrics with Clinical Assessment Unit, Medical University of Warsaw, Warsaw, Poland
| | - Bolesław Kalicki
- Department of Paediatrics, Paediatric Nephrology and Allergology, Military Institute of Medicine, Warsaw, Poland
| | - Anna Gorczyca
- The Ward of Pediatric Infectious Diseases and Hepatology, The John Paul II Hospital in Krakow, Krakow, Poland
| | - Magdalena Marczyńska
- Department of Children's Infectious Diseases, Medical University of Warsaw, Warsaw, Poland
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13
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Childhood obesity and risk of SARS-CoV-2 infection. Int J Obes (Lond) 2022; 46:1155-1159. [PMID: 35173279 PMCID: PMC8853122 DOI: 10.1038/s41366-022-01094-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 01/28/2022] [Accepted: 02/03/2022] [Indexed: 11/26/2022]
Abstract
Objective To estimate the association between childhood obesity and the risk of SARS-CoV-2 infection in a cohort followed from 4 to 12 years of age. Methods The data were obtained from two independent sources: the Longitudinal Childhood Obesity Study (ELOIN) and the epidemiological surveillance system data from the Community of Madrid (Spain), which served to identify the population within the cohort with confirmed SARS-CoV-2 infection. The SARS-CoV-2 registry was cross-checked with the cohort population at 11–12 years of age. A total of 2018 eligible participants were identified in the cohort, who underwent physical examinations at 4, 6, and 9 years of age during which weight, height, and waist circumference were recorded. General obesity (GO) was determined according to the WHO-2007 criteria whereas abdominal obesity (AO) was defined based on the International Diabetes Federation (IDF) criteria. The relative risks (RRs) of infection were estimated using a Poisson regression model and adjusted by sociodemographic variables, physical activity, and perceived health reported by the parents. Results The accumulated incidence of SARS-CoV-2 infection was 8.6% (95% CI: 7.3–9.8). The estimated RR of SARS-CoV-2 infection was 2.53 (95% CI: 1.56–4.10) and 2.56 (95% CI: 1.55–4.21) for children 4–9 years old with stable GO and AO, respectively, compared with those who did not present GO. Conclusions Childhood obesity is an independent risk factor for SARS-CoV-2 infection. This study provides new evidence that indicates that obesity increases the vulnerability of the paediatric population to infectious diseases.
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14
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Prévost B, Retbi A, Binder-Foucard F, Borde A, Bruandet A, Corvol H, Gilleron V, Le Bourhis-Zaimi M, Lenne X, Muller J, Ouattara E, Séguret F, Tran Ba Loc P, Tezenas du Montcel S. Risk factors for admission to the pediatric critical care unit among children hospitalized with COVID-19 in France. Front Pediatr 2022; 10:975826. [PMID: 36160797 PMCID: PMC9489832 DOI: 10.3389/fped.2022.975826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 08/01/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND COVID-19 infection is less severe among children than among adults; however, some patients require hospitalization and even critical care. Using data from the French national medico-administrative database, we estimated the risk factors for critical care unit (CCU) admissions among pediatric COVID-19 hospitalizations, the number and characteristics of the cases during the successive waves from January 2020 to August 2021 and described death cases. METHODS We included all children (age < 18) hospitalized with COVID-19 between January 1st, 2020, and August 31st, 2021. Follow-up was until September 30th, 2021 (discharge or death). Contiguous hospital stays were gathered in "care sequences." Four epidemic waves were considered (cut off dates: August 11th 2020, January 1st 2021, and July 4th 2021). We excluded asymptomatic COVID-19 cases, post-COVID-19 diseases, and 1-day-long sequences (except death cases). Risk factors for CCU admission were assessed with a univariable and a multivariable logistic regression model in the entire sample and stratified by age, whether younger than 2. RESULTS We included 7,485 patients, of whom 1988 (26.6%) were admitted to the CCU. Risk factors for admission to the CCU were being younger than 7 days [OR: 3.71 95% CI (2.56-5.39)], being between 2 and 9 years old [1.19 (1.00-1.41)], pediatric multisystem inflammatory syndrome (PIMS) [7.17 (5.97-8.6)] and respiratory forms [1.26 (1.12-1.41)], and having at least one underlying condition [2.66 (2.36-3.01)]. Among hospitalized children younger than 2 years old, prematurity was a risk factor for CCU admission [1.89 (1.47-2.43)]. The CCU admission rate gradually decreased over the waves (from 31.0 to 17.8%). There were 32 (0.4%) deaths, of which the median age was 6 years (IQR: 177 days-15.5 years). CONCLUSION Some children need to be more particularly protected from a severe evolution: newborns younger than 7 days old, children aged from 2 to 13 years who are more at risk of PIMS forms and patients with at least one underlying medical condition.
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Affiliation(s)
- Blandine Prévost
- Department of Pediatric Pulmonology, APHP Hôpital Trousseau, Sorbonne Université, Paris, France.,Sorbonne Université, Centre de Recherche Saint Antoine (CRSA), Inserm UMR_S938, Paris, France
| | - Aurélia Retbi
- Department of Medical Information, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Sorbonne Université, Paris, France
| | | | - Aurélie Borde
- Department of Medical Information, Medical Information Analysis and Coordination Unit (UCAIM - DIM), University Hospital Center Bordeaux, Bordeaux, France
| | - Amélie Bruandet
- Department of Medical Information, Lille University Hospital Center, Lille, France
| | - Harriet Corvol
- Department of Pediatric Pulmonology, APHP Hôpital Trousseau, Sorbonne Université, Paris, France.,Sorbonne Université, Centre de Recherche Saint Antoine (CRSA), Inserm UMR_S938, Paris, France
| | - Véronique Gilleron
- Department of Medical Information, Medical Information Analysis and Coordination Unit (UCAIM - DIM), University Hospital Center Bordeaux, Bordeaux, France.,Inserm U1219/Bordeaux Population Health Research Center, Population Health trAnslational Research (PHARes), University of Bordeaux, Bordeaux, France
| | | | - Xavier Lenne
- Department of Medical Information, Lille University Hospital Center, Lille, France
| | - Joris Muller
- Department of Public Health, Strasbourg University Hospital, Strasbourg, France
| | - Eric Ouattara
- Department of Medical Information, Medical Information Analysis and Coordination Unit (UCAIM - DIM), University Hospital Center Bordeaux, Bordeaux, France
| | - Fabienne Séguret
- Unit of Evaluation and Epidemiologic Studies on National Hospitalization Databases, Department of Epidemiology, Biostatistics and Medical Information, University Hospital Center Montpellier, Montpellier, France
| | - Pierre Tran Ba Loc
- Department of Public Health, Strasbourg University Hospital, Strasbourg, France
| | - Sophie Tezenas du Montcel
- Department of Medical Information, Sorbonne Université, Institut du Cerveau-Paris Brain Institute-ICM, CNRS, Inria, Inserm, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Sorbonne Université, Paris, France
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15
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Taytard J, Prevost B, Schnuriger A, Aubertin G, Berdah L, Bitton L, Dupond-Athenor A, Thouvenin G, Nathan N, Corvol H. SARS-CoV-2 B.1.1.529 (Omicron) Variant Causes an Unprecedented Surge in Children Hospitalizations and Distinct Clinical Presentation Compared to the SARS-CoV-2 B.1.617.2 (Delta) Variant. Front Pediatr 2022; 10:932170. [PMID: 35832582 PMCID: PMC9271577 DOI: 10.3389/fped.2022.932170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 06/06/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND In the midst of successive waves of SARS-CoV-2 variants, the B.1.1.529 (omicron) variant has recently caused a surge in pediatric infections and hospitalizations. This study aimed to describe and compare the symptoms, explorations, treatment and evolution of COVID-19 in hospitalized children during the successive B.1.617.2 (delta) and B.1.1.529 (omicron) waves. METHODS This observational study was performed in the Pediatric Pulmonology Department of a University Hospital in Paris, France. All hospitalized children aged between 0 and 18 years who tested positive for SARS-CoV-2 using reverse transcription polymerase chain reaction (RT-PCR) in nasopharyngeal swabs from July 15th to December 15th 2021 (delta wave), and from December 15th 2021 to February 28th 2022 (omicron wave) were included. RESULTS In total, 53 children were included, 14 (26.4%) during the delta wave and 39 (73.6%) during the omicron wave (almost three times as many hospitalizations in half the time during the latter wave). During the omicron wave, hospitalized patients were mostly aged < 5 years (90 vs. 71% of all the children during omicron and delta waves, respectively), and tended to have fewer underlying conditions (56 vs. 79% during omicron and delta waves, respectively, p = 0.20). The omicron variant was also responsible for a different clinical presentation when compared to the delta variant, with significantly higher and often poorly tolerated temperatures (p = 0.03) and increased digestive symptoms (p = 0.01). None of the three patients who were older than 12 years were fully vaccinated. CONCLUSION The dramatic increase in the hospitalization of children with COVID-19 and the modification of the clinical presentation between the latest delta and omicron waves require pediatricians to remain vigilant. It should also encourage caregivers to ensure vaccination in children older than 5 years, for whom the BNT162b2 COVID-19 vaccine has been deemed safe, immunogenic, and effective.
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Affiliation(s)
- Jessica Taytard
- Pediatric Pulmonology Department, APHP Hôpital Trousseau, Sorbonne Université, Paris, France.,Sorbonne Université, Inserm UMR_S 1158, Paris, France
| | - Blandine Prevost
- Pediatric Pulmonology Department, APHP Hôpital Trousseau, Sorbonne Université, Paris, France.,Sorbonne Université, Centre de Recherche Saint Antoine (CRSA), Inserm UMR_S938, Paris, France
| | - Aurélie Schnuriger
- Sorbonne Université, Centre de Recherche Saint Antoine (CRSA), Inserm UMR_S938, Paris, France.,Virology Department, APHP Hôpital Trousseau, Sorbonne Université, Paris, France
| | - Guillaume Aubertin
- Pediatric Pulmonology Department, APHP Hôpital Trousseau, Sorbonne Université, Paris, France.,Sorbonne Université, Centre de Recherche Saint Antoine (CRSA), Inserm UMR_S938, Paris, France
| | - Laura Berdah
- Pediatric Pulmonology Department, APHP Hôpital Trousseau, Sorbonne Université, Paris, France.,Sorbonne Université, Centre de Recherche Saint Antoine (CRSA), Inserm UMR_S938, Paris, France
| | - Lauren Bitton
- Pediatric Pulmonology Department, APHP Hôpital Trousseau, Sorbonne Université, Paris, France
| | - Audrey Dupond-Athenor
- Pediatric Pulmonology Department, APHP Hôpital Trousseau, Sorbonne Université, Paris, France.,Sorbonne Université, Centre de Recherche Saint Antoine (CRSA), Inserm UMR_S938, Paris, France
| | - Guillaume Thouvenin
- Pediatric Pulmonology Department, APHP Hôpital Trousseau, Sorbonne Université, Paris, France.,Sorbonne Université, Centre de Recherche Saint Antoine (CRSA), Inserm UMR_S938, Paris, France
| | - Nadia Nathan
- Pediatric Pulmonology Department, APHP Hôpital Trousseau, Sorbonne Université, Paris, France.,Sorbonne Université, Inserm UMR_S933, Paris, France
| | - Harriet Corvol
- Pediatric Pulmonology Department, APHP Hôpital Trousseau, Sorbonne Université, Paris, France.,Sorbonne Université, Centre de Recherche Saint Antoine (CRSA), Inserm UMR_S938, Paris, France
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16
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Soomann M, Wendel-Garcia PD, Kaufmann M, Grazioli S, Perez MH, Hilty MP, André MC, Brotschi B. The SARS-CoV-2 Pandemic Impacts the Management of Swiss Pediatric Intensive Care Units. Front Pediatr 2022; 10:761815. [PMID: 35155302 PMCID: PMC8832059 DOI: 10.3389/fped.2022.761815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 01/03/2022] [Indexed: 11/13/2022] Open
Abstract
The impact of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic on pediatric intensive care units (PICUs) is difficult to quantify. We conducted an observational study in all eight Swiss PICUs between 02/24/2020 and 06/15/2020 to characterize the logistical and medical aspects of the pandemic and their impact on the management of the Swiss PICUs. The nine patients admitted to Swiss PICUs during the study period suffering from pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) and constituting 14% (9/63) of all SARS-CoV-2 positive hospitalized patients in Swiss children's hospitals caused a higher workload [total Nine Equivalents of nursing Manpower use Score (NEMS) points, p = 0.0008] and were classified to higher workload categories (p < 0.0001) than regular PICU patients (n = 4,881) admitted in 2019. The comparison of the characteristics of the eight Swiss PICUs shows that they were confronted by different organizational issues arising from temporary regulations put in place by the federal council. These general regulations had different consequences for the eight individual PICUs due to the differences between the PICUs. In addition, the temporal relationship of these different regulations influenced the available PICU resources, dependent on the characteristics of the individual PICUs. As pandemic continues, reflecting and learning from experience is essential to reduce workload, optimize bed occupancy and manage resources in each individual PICU. In a small country as Switzerland, with a relatively decentralized health care local differences between PICUs are considerable and should be taken into account when making policy decisions.
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Affiliation(s)
- Maarja Soomann
- Department of Pediatric and Neonatal Intensive Care, University Children's Hospital Zurich, Zurich, Switzerland.,Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Pedro D Wendel-Garcia
- University of Zurich, Zurich, Switzerland.,Institute of Intensive Care Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Mark Kaufmann
- Department for Anesthesia, Surgical Intensive Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, Basel, Switzerland
| | - Serge Grazioli
- Division of Neonatal and Pediatric Intensive Care, Department of Pediatrics, University Hospital of Geneva, Geneva, Switzerland
| | - Marie-Helene Perez
- Pediatric Intensive Care Unit, Lausanne University Hospital, Lausanne, Switzerland
| | - Matthias P Hilty
- University of Zurich, Zurich, Switzerland.,Institute of Intensive Care Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Maya C André
- Division of Respiratory and Critical Care Medicine, University of Basel Children's Hospital, Basel, Switzerland.,Department of Pediatric Hematology and Oncology, University Children's Hospital, Eberhard Karls University, Tuebingen, Germany
| | - Barbara Brotschi
- Department of Pediatric and Neonatal Intensive Care, University Children's Hospital Zurich, Zurich, Switzerland.,Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
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17
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Nathan N, Prevost B, Lambert S, Schnuriger A, Corvol H. Severe Acute Respiratory Syndrome Coronavirus 2 Variant Delta Infects All 6 Siblings but Spares Comirnaty (BNT162b2, BioNTech/Pfizer)-Vaccinated Parents. J Infect Dis 2021; 224:1984-1986. [PMID: 34409999 PMCID: PMC8499735 DOI: 10.1093/infdis/jiab410] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 08/18/2021] [Indexed: 01/31/2023] Open
Affiliation(s)
- Nadia Nathan
- Paediatric Pulmonology Department and Reference Centre for Rare Lung Disease RespiRare, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Blandine Prevost
- Paediatric Pulmonology Department and Reference Centre for Rare Lung Disease RespiRare, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Sidonie Lambert
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Paris, France.,Virology Department, Trousseau and Saint Antoine Hospitals, AP-HP, Paris, France
| | - Aurélie Schnuriger
- Virology Department, Trousseau and Saint Antoine Hospitals, AP-HP, Paris, France.,Sorbonne Université, Centre de Recherche Saint-Antoine (CRSA), Paris, France
| | - Harriet Corvol
- Paediatric Pulmonology Department and Reference Centre for Rare Lung Disease RespiRare, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.,Sorbonne Université, Centre de Recherche Saint-Antoine (CRSA), Paris, France
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18
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Acute myeloid leukemia complicated by post COVID-19 multi-system inflammatory syndrome-children. PEDIATRIC HEMATOLOGY ONCOLOGY JOURNAL 2021. [PMCID: PMC8689414 DOI: 10.1016/j.phoj.2021.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Corona Virus disease 2019 (COVID-19) pandemic has presented a huge challenge to the health care system in terms of magnitude of cases and to pediatric oncology units with varied clinical presentations. Acute myeloid leukemia(AML) is a rare heterogenous cancer of childhood with an induction mortality around 15% in our country due to neutropenic sepsis. Multisystem inflammatory syndrome in children(MIS-C) is an hyperinflammatory syndrome seen 4–6 weeks after COVID-19 infection. COVID infection in some of these children would have gone unnoticed. Here we report a two year eight months old boy diagnosed with AML on induction chemotherapy developed post COVID MIS-C.
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19
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Soleimani G, Akbarirad F, Shafighi Shahri E, Sajjadi SM. Demographic, clinical, and paraclinical characteristics of COVID-19 pediatric cases in southeast Iran. Antimicrob Resist Infect Control 2021; 10:165. [PMID: 34838145 PMCID: PMC8626734 DOI: 10.1186/s13756-021-01020-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 10/04/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Even though children seem to be less vulnerable to the Coronavirus disease 2019 (COVID-19) infection, still a diverse range of clinical presentations and symptoms have been reported in children. Few studies assessed the clinical presentations of COVID-19 among Iranian children. We aimed to evaluate the clinical and paraclinical characteristics of COVID-19 infected children. METHODS All COVID-19 suspected and confirmed children were referred to the Ali-ibn-Abitaleb Hospital, Zahedan, Iran. Patients were included in this longitudinal study. Patients were evaluated at admission and during hospitalization. Patients with some of the main COVID symptoms with positive PCR test were defined as confirmed cases. Clinical, imaging and laboratory results were collected for all patients. RESULTS A total of 62 patients participated in this study. The male:female ratio was 1:1.03. There was a significant difference in fatigue prevalence between age groups (P = 0.002). There was no significant difference between groups in terms of fever duration (P = 0.624) and maximum temperature (P = 0.629). There was a significant difference between PCR positive and negative patients in terms of neurologic signs (P = 0.003), Intensive care unit admission (P = 0.001), white blood cell (P = 0.047). CONCLUSIONS Even though our population was small, most of the findings matched other studies conducted on pediatric cases in Iran or other countries. It was also found that some clinical features such as pneumonia, cough, diarrhea, and tachycardia at admission time were statistically different among age groups.
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Affiliation(s)
- Gholamreza Soleimani
- Department of Pediatrics, School of Medicine, Children and Adolescents Health Research Center, Ali-Ibn-Abitaleb Hospital, Zahedan, Iran
| | - Fatemeh Akbarirad
- Department of Pediatrics, Ali-ebne-Abitaleb Hospital, Zehedan University of Medical Sciences, Zahedan, Iran
| | - Elham Shafighi Shahri
- Department of Pediatrics, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Seyyed Masoud Sajjadi
- Department of Cardiovascular Disease, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
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20
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Ebrahimpour L, Marashi M, Zamanian H, Abedi M. Computed tomography findings in 3,557 COVID-19 infected children: a systematic review. Quant Imaging Med Surg 2021; 11:4644-4660. [PMID: 34737930 DOI: 10.21037/qims-20-1410] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 07/07/2021] [Indexed: 01/08/2023]
Abstract
Background Although it was assumed in the early stages of the coronavirus disease 2019 (COVID-19) outbreak that the novel coronavirus infection was uncommon among children, the number of infected children has since been increasing significantly. Real-time polymerase chain reaction (RT-PCR) is the gold standard modality for the diagnosis of COVID-19 infection. In adults, chest CT is performed as an adjunct for identifying suspected COVID-19 cases along with patients' management and follow-up. However, CT findings in COVID-19 children studies have shown a diverse incidence of abnormal CT and finding patterns that made CT scan necessity to have remained controversial. The aim of the present review was to comprehensively determine the imaging findings of chest CT scans of confirmed COVID-19-infected pediatric patients through a systematic review of the available published studies. Methods A systematic literature search was performed in the PubMed, Embase, Scopus, and Web of Science core collection databases (four databases including SSCI, SCIE, AHCI, and ESCI) to find original articles containing chest CT findings in children with COVID-19 through May 7, 2021. This review included 81 articles published in English that in total included 3,557 pediatric patients. Results This review included 81 articles published in English that in total included 3,557 pediatric patients. Among the total confirmed coronavirus-infected cases (via RT-PCR test), two-thirds had abnormal chest CT findings; among these patients, 549 (37.8%) had bilateral lung involvement, and 475 (32.7%) had unilateral disease. Regarding the types of lung lesions, ground glass opacities were observed in 794 (54.7%) of patients, and consolidation was observed in 10.2%; moreover, halo sign, discrete pulmonary nodules, interstitial abnormalities or reticulations, and vascular thickening shadows were reported in 7.4%, 2.6%, 9.7% and 1.7% of the patients, respectively. Discussion This review revealed that chest CT scan manifestations in majority of COVID-19 positive children are mild, so regarding the risk of radiation exposure, it is reasonable to confine CT scan to individual cases that its benefits outweigh the risks.
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Affiliation(s)
- Laleh Ebrahimpour
- Department of Radiology, Bahar Hospital, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Mahdis Marashi
- Department of Radiology, Shahid Mohammadi Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Hadi Zamanian
- School of Health, Qom University of Medical Sciences, Qom, Iran
| | - Mahboubeh Abedi
- Radiology Department, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran
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21
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Neale H, Hawryluk EB. COVID-19 Pediatric Dermatology. Dermatol Clin 2021; 39:505-519. [PMID: 34556241 PMCID: PMC8165089 DOI: 10.1016/j.det.2021.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Holly Neale
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA; University of Massachusetts Medical School, Worcester, MA, USA
| | - Elena B Hawryluk
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Boston Children's Hospital, Boston, MA, USA.
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22
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Corvol H, Alimi A, Prevost B, Schnuriger A, Le Pointe HD, Rambaud J, Tabone MD. Atypical severe organizing pneumonia following COVID-19 in an immunocompromised teenager. Clin Infect Dis 2021; 74:938-939. [PMID: 34309637 DOI: 10.1093/cid/ciab657] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
- Harriet Corvol
- Pediatric Pulmonology Department, Trousseau Hospital, AP-HP, Sorbonne Université, Paris, France
| | - Aurelia Alimi
- Pediatric Hematology Department, Trousseau Hospital, AP-HP, Sorbonne Université, Paris, France
| | - Blandine Prevost
- Pediatric Pulmonology Department, Trousseau Hospital, AP-HP, Sorbonne Université, Paris, France
| | - Aurélie Schnuriger
- Virology Department, Trousseau Hospital, AP-HP, Sorbonne Université, Paris, France
| | | | - Jérome Rambaud
- Pediatric Intensive care Unit, Trousseau Hospital, AP-HP, Sorbonne Université, Paris, France
| | - Marie-Dominique Tabone
- Pediatric Hematology Department, Trousseau Hospital, AP-HP, Sorbonne Université, Paris, France
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23
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Campos RK, Camargos VN, Azar SR, Haines CA, Eyzaguirre EJ, Rossi SL. SARS-CoV-2 Infects Hamster Testes. Microorganisms 2021; 9:1318. [PMID: 34204370 PMCID: PMC8235703 DOI: 10.3390/microorganisms9061318] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 06/08/2021] [Accepted: 06/14/2021] [Indexed: 01/03/2023] Open
Abstract
The COVID-19 pandemic continues to affect millions of people worldwide. Although SARS-CoV-2 is a respiratory virus, there is growing concern that the disease could cause damage and pathology outside the lungs, including in the genital tract. Studies suggest that SARS-CoV-2 infection can damage the testes and reduce testosterone levels, but the underlying mechanisms are unknown and evidence of virus replication in testicular cells is lacking. We infected golden Syrian hamsters intranasally, a model for mild human COVID-19, and detected viral RNA in testes samples without histopathological changes up to one month post-infection. Using an ex vivo infection model, we detected SARS-CoV-2 replication in hamster testicular cells. Taken together, our data raise the possibility that testes damage observed in severe cases of COVID-19 could be partly explained by direct SARS-CoV-2 infection of the testicular cells.
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Affiliation(s)
- Rafael K. Campos
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX 77555, USA; (R.K.C.); (C.A.H.)
| | - Vidyleison N. Camargos
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555-0609, USA; (V.N.C.); (S.R.A.); (E.J.E.)
| | - Sasha R. Azar
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555-0609, USA; (V.N.C.); (S.R.A.); (E.J.E.)
| | - Clint A. Haines
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX 77555, USA; (R.K.C.); (C.A.H.)
| | - Eduardo J. Eyzaguirre
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555-0609, USA; (V.N.C.); (S.R.A.); (E.J.E.)
| | - Shannan L. Rossi
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX 77555, USA; (R.K.C.); (C.A.H.)
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555-0609, USA; (V.N.C.); (S.R.A.); (E.J.E.)
- Institute for Human Infection and Immunity, University of Texas Medical Branch, Galveston, TX 77555, USA
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24
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Asseri AA, Alzaydani I, Al-Jarie A, Albishri A, Alsabaani A, Almaghrabi MK, Ali AS. Clinical Characteristics and Laboratory Abnormalities of Hospitalized and Critically Ill Children with Coronavirus Disease 2019: A Retrospective Study from Saudi Arabia. Int J Gen Med 2021; 14:1949-1958. [PMID: 34040426 PMCID: PMC8141390 DOI: 10.2147/ijgm.s311831] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 04/30/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND COVID-19 was reported in several studies characterized by milder clinical course, benign disease, and peculiar epidemiologic patterns among pediatric patients compared to adults' disease. However, other studies indicated that critical cases also exist and are associated with preexisting cardiopulmonary comorbidities and concurrent multisystem inflammatory syndrome in children. METHODS The study period was six months, May-October 2020. Data on demographics, clinical manifestations, laboratory abnormalities were extracted from the patients' hospital records. During the study period, 644 pediatric patients attended the hospital. They were all screened for SARS-CoV-2 using RT-PCR. Only the confirmed positive patients were included in the subsequent study analysis. They were hospitalized either in the general pediatric wards (GPW) or pediatric intensive care unit (PICU). RESULTS Out of the total patients screened, 79 (12.3%) children were confirmed to have COVID-19 infection. All the confirmed COVID-19 patients were either admitted to the general pediatric wards (58; 73.4%) or PICU (21; 26.6%). The admission diagnoses for these children were acute gastroenteritis (22.85%), acute pneumonia (19%), clinical sepsis (17.7%), and multisystem inflammatory syndrome in children (10.1%). A significantly higher percentage of the PICU admitted patients showed shortness of breath (SOB) (P= 0.016). Respiratory insufficiencies, prematurity, and congenital heart diseases are the most reported comorbid conditions among the admitted children. The oxygen saturation was significantly lower among PICU patients than those in GPW (P=0.001). The total hospital stays differ significantly between the two groups, which were ten days for the PICU group compared to 4.5 days for the GPW group with a statistical significance noted (P= 0.001). CONCLUSION Despite the observable variations in the clinical and laboratory findings among the hospitalized pediatric COVID-19 patients, no serious consequences among all patients were observed. The history of SOB and the initial oxygen saturation level were significantly associated with PICU admissions.
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Affiliation(s)
- Ali Alsuheel Asseri
- Department of Child Health, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Ibrahim Alzaydani
- Department of Pediatrics, Abha Maternity and Children Hospital, Abha, Saudi Arabia
| | - Ahmed Al-Jarie
- Department of Pediatrics, Abha Maternity and Children Hospital, Abha, Saudi Arabia
| | - Ahmed Albishri
- Department of Pediatrics, Khamis Military Hospital, Ministry of Defense, Khamis Mushait, Saudi Arabia
| | - Abdullah Alsabaani
- Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Mohammed Khamash Almaghrabi
- Department of Microbiology and Clinical Parasitology, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Abdelwahid Saeed Ali
- Department of Microbiology and Clinical Parasitology, College of Medicine, King Khalid University, Abha, Saudi Arabia
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25
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Zhao Y, Yin L, Patel J, Tang L, Huang Y. The inflammatory markers of multisystem inflammatory syndrome in children (MIS-C) and adolescents associated with COVID-19: A meta-analysis. J Med Virol 2021; 93:4358-4369. [PMID: 33739452 PMCID: PMC8250955 DOI: 10.1002/jmv.26951] [Citation(s) in RCA: 70] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 03/09/2021] [Accepted: 03/17/2021] [Indexed: 12/17/2022]
Abstract
To conduct a systematic review and meta‐analysis to characterize inflammatory markers in comparisons of multisystem inflammatory syndrome in children (MIS‐C) versus severe/non‐severe COVID‐19, severe MIS‐C versus non‐severe MIS‐C, and among age groups of MIS‐C. Nine databases were searched for studies on inflammatory markers of MIS‐C. After quality checks, data were pooled using a fixed or random effects model. Inflammatory markers included white blood cell count (WBC) or leukocytes, absolute lymphocyte count (ALC), absolute neutrophil count (ANC), platelet count (PLT), C‐reactive protein (CRP), procalcitonin (PCT), ferritin, D‐dimer, lactate dehydrogenase (LDH), fibrinogen, and erythrocyte sedimentation rate (ESR) for comparisons by severity and age. Twenty‐one studies with 1735 participants yielded 787 MIS‐C patients. Compared to non‐severe COVID‐19 patients, MIS‐C patients had lower ALC and higher ANC, CRP, and D‐dimer levels. Compared to severe COVID‐19 patients, MIS‐C patients had lower LDH and PLT counts and higher ESR levels. Severe MIS‐C patients had higher levels of WBC, ANC, CRP, D‐dimer, and ferritin than non‐severe MIS‐C patients. For MIS‐C, younger children (0–5 years) had lower CRP and ferritin levels than middle‐aged/older children/adolescents. Measurement of inflammatory markers might assist clinicians in accurate evaluation and diagnosis of MIS‐C and the associated disorders. To conduct a comprehensive characterization of the inflammatory markers of MIS‐C during the COVID‐19 pandemic. This meta‐analysis summarized the available data and demonstrated significant implications by characterizing the laboratory inflammatory markers of MIS‐C that has widely emerged as a major complication among children with COVID‐19. The results indicated that inflammatory markers, including WBC, ALC, ANC, PLT, CRP, PCT, ferritin, D‐dimer, LDH, fibrinogen, and ESR, were different while comparing MIS‐C versus severe/non‐severe COVID‐19, severe MIS‐C versus non‐severe MIS‐C, and age groups of MIS‐C.
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Affiliation(s)
- Yan Zhao
- Department of Pediatrics, People's Hospital of Chongqing Banan District, Chongqing, China
| | - Lijuan Yin
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing, China.,Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Chongqing, China.,Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,Children's Hospital of Chongqing Medical University, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China
| | - Jenil Patel
- Department of Epidemiology, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, Texas, USA.,Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Lei Tang
- Department of Pediatrics, People's Hospital of Chongqing Banan District, Chongqing, China
| | - Ying Huang
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing, China
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26
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Ma H, Lim XC, Yu Q, Li Y, Li Y, Jia W. Ratios between circulating myeloid cells and lymphocytes are associated with mortality in severe COVID-19 patients. Open Med (Wars) 2021. [DOI: 10.1515/med-2021-0237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Abstract
Recent studies indicate that host immune responses are dysregulated with either myeloid cell compartment or lymphocyte composition being disturbed in COVID-19. This study aimed to assess the impact of SARS-CoV-2 viral infection on the composition of circulating immune cells in severe COVID-19 patients. In this retrospective single-center cohort, 71 out of 87 COVID-19 patients admitted to the intense care unit for oxygen treatment were included in this study. Demographics, clinical features, comorbidities, and laboratory findings were collected on admission. Out of the 71 patients, 5 died from COVID-19. Compared with survived patients, deceased patients showed higher blood cell counts of neutrophils and monocytes but lower cell counts of lymphocytes. Intriguingly, the neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and basophil-to-lymphocyte ratio (BLR) were markedly higher in deceased patients compared to survived patients. Furthermore, the lymphocyte counts were negatively correlated with D-dimer levels, while the ratios between myeloid cells and lymphocyte (NLR, MLR, and BLR) were positively correlated with D-dimer levels. Our findings revealed that the ratios between myeloid cells and lymphocytes were highly correlated with coagulation status and patient mortality in severe COVID-19.
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Affiliation(s)
- Hui Ma
- Department of Respiratory and Critical Care Medicine, Tianjin Chest Hospital , Tianjin , China
| | - Xiong Chang Lim
- Yong Loo Lin School of Medicine, National University of Singapore , Singapore , Singapore
| | - Qihong Yu
- Department of Respiratory and Critical Care Medicine, Tianjin Chest Hospital , Tianjin , China
| | - Yi Li
- Department of Respiratory and Critical Care Medicine, Tianjin Chest Hospital , Tianjin , China
| | - Yuechuan Li
- Department of Respiratory and Critical Care Medicine, Tianjin Chest Hospital , Tianjin , China
| | - Wei Jia
- Department of Respiratory and Critical Care Medicine, Tianjin Chest Hospital , No. 261, Taierzhuangnan Road, Jinnan District , Tianjin , 300222 , China
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27
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Corvol H, de Miranda S, Lemonnier L, Kemgang A, Reynaud Gaubert M, Chiron R, Dalphin ML, Durieu I, Dubus JC, Houdouin V, Prevotat A, Ramel S, Revillion M, Weiss L, Guillot L, Boelle PY, Burgel PR. First Wave of COVID-19 in French Patients with Cystic Fibrosis. J Clin Med 2020; 9:E3624. [PMID: 33182847 PMCID: PMC7697588 DOI: 10.3390/jcm9113624] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 10/27/2020] [Accepted: 11/09/2020] [Indexed: 12/13/2022] Open
Abstract
Viral infections are known to lead to serious respiratory complications in cystic fibrosis (CF) patients. Hypothesizing that CF patients were a population at high risk for severe respiratory complications from SARS-CoV-2 infection, we conducted a national study to describe the clinical expression of COVID-19 in French CF patients. This prospective observational study involves all 47 French CF centers caring for approximately 7500 CF patients. Between March 1st and June 30th 2020, 31 patients were diagnosed with COVID-19: 19 had positive SARS-CoV-2 RT-PCR in nasopharyngeal swabs; 1 had negative RT-PCR but typical COVID-19 signs on a CT scan; and 11 had positive SARS-CoV-2 serology. Fifteen were males, median (range) age was 31 (9-60) years, and 12 patients were living with a lung transplant. The majority of the patients had CF-related diabetes (n = 19, 61.3%), and a mild lung disease (n = 19, 65%, with percent-predicted forced expiratory volume in 1 s (ppFEV1) > 70). Three (10%) patients remained asymptomatic. For the 28 (90%) patients who displayed symptoms, most common symptoms at admission were fever (n = 22, 78.6%), fatigue (n = 14, 50%), and increased cough (n = 14, 50%). Nineteen were hospitalized (including 11 out of the 12 post-lung transplant patients), seven required oxygen therapy, and four (3 post-lung transplant patients) were admitted to an Intensive Care Unit (ICU). Ten developed complications (including acute respiratory distress syndrome in two post-lung transplant patients), but all recovered and were discharged home without noticeable short-term sequelae. Overall, French CF patients were rarely diagnosed with COVID-19. Further research should establish whether they were not infected or remained asymptomatic upon infection. In diagnosed cases, the short-term evolution was favorable with rare acute respiratory distress syndrome and no death. Post-lung transplant patients had more severe outcomes and should be monitored more closely.
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Affiliation(s)
- Harriet Corvol
- Pediatric Pulmonology Department and Pediatric CF Center, Assistance Publique Hôpitaux de Paris (APHP) Hôpital Trousseau, 75012 Paris, France
- Centre de Recherche Saint‑Antoine (CRSA), INSERM UMR_S938, Sorbonne Université, 75012 Paris, France; (A.K.); (L.G.)
| | - Sandra de Miranda
- Pulmonology Department and CF Center, Hôpital Foch, 92151 Suresnes, France;
| | | | - Astrid Kemgang
- Centre de Recherche Saint‑Antoine (CRSA), INSERM UMR_S938, Sorbonne Université, 75012 Paris, France; (A.K.); (L.G.)
| | - Martine Reynaud Gaubert
- Pulmonology Department and CF Adult Center, Hôpital Nord, Assistance Publique Hôpitaux de Marseille (APHM), 13915 Marseille, France;
- Aix-Marseille Université, Institut de Recherche pour le Développement (IRD), IHU Méditerranée Infection, MEPHI, 13005 Marseille, France
| | - Raphael Chiron
- CF Center, Hôpital Arnaud de Villeneuve, CHU de Montpellier, 34295 Montpellier, France;
| | - Marie-Laure Dalphin
- Pediatric CF Center, Hôpital Jean-Minjoz, CHU de Besançon, 25030 Besançon, France;
| | - Isabelle Durieu
- Internal Medicine Department and Adult CF Center, Hospices Civils de Lyon, EA 7425 HESPER, Université de Lyon, 69495 Lyon, France;
| | - Jean-Christophe Dubus
- Pediatric Pulmonology Department and Pediatric CF Center, APHM, 13385 Marseille, France;
| | | | - Anne Prevotat
- Adult CF Center, Hôpital Calmette and University Lille, 59037 Lille, France;
| | - Sophie Ramel
- Pediatric and Adult CF Center, 29680 Roscoff, France;
| | - Marine Revillion
- Pediatric CF Center, Hôpital Jeanne de Flandres, CHU Lille, 59037 Lille, France;
| | - Laurence Weiss
- Pediatric CF Center, Hôpitaux Universitaires de Strasbourg, 67098 Strasbourg, France;
| | - Loic Guillot
- Centre de Recherche Saint‑Antoine (CRSA), INSERM UMR_S938, Sorbonne Université, 75012 Paris, France; (A.K.); (L.G.)
| | - Pierre-Yves Boelle
- Institut Pierre Louis d’Epidémiologie et de Santé Publique, INSERM, APHP, Sorbonne Université, 75012 Paris, France;
| | - Pierre-Régis Burgel
- Respiratory Medicine and National Reference CF Center, AP-HP Hôpital Cochin, 75014 Paris, France;
- Institut Cochin, Inserm U-1016, Université de Paris, 75014 Paris, France
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