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Foret-Bruno P, Shafran R, Stephenson T, Nugawela MD, Chan D, Ladhani S, McOwat K, Mensah A, Simmons R, Fox Smith L, D'oelsnitz A, Xu L, Dalrymple E, Heyman I, Ford T, Segal T, Chalder T, Rojas N, Pinto Pereira SM. Prevalence and co-occurrence of cognitive impairment in children and young people up to 12-months post infection with SARS-CoV-2 (Omicron variant). Brain Behav Immun 2024:S0889-1591(24)00389-1. [PMID: 38735404 DOI: 10.1016/j.bbi.2024.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 03/06/2024] [Accepted: 05/02/2024] [Indexed: 05/14/2024] Open
Abstract
BACKGROUND Cognitive impairment is often reported after SARS-CoV-2 infection, yet evidence gaps remain. We aimed to (i) report the prevalence and characteristics of children and young people (CYP) reporting "brain fog" (i.e., cognitive impairment) 12-months post PCR-proven SARS-CoV-2 infection and determine whether differences by infection status exist and (ii) explore the prevalence of CYP experiencing cognitive impairment over a 12-month period post-infection and investigate the relationship between cognitive impairment and poor mental health and well-being, mental fatigue and sleep problems. METHODS The Omicron CLoCk sub-study, set up in January 2022, collected data on first-time PCR-test-positive and PCR-proven reinfected CYP at time of testing and at 3-, 6- and 12-months post-testing. We describe the prevalence of cognitive impairment at 12-months, indicating when it was first reported. We characterise CYP experiencing cognitive impairment and use chi-squared tests to determine whether cognitive impairment prevalence varied by infection status. We explore the relationship between cognitive impairment and poor mental health and well-being, mental fatigue and trouble sleeping using validated scales. We examine associations at 3-, 6- and 12-months post-testing by infection status using Mann-Whitney U and chi-square tests. RESULTS At 12-months post-testing, 7.0 % (24/345) of first-positives and 7.5 % (27/360) of reinfected CYP experienced cognitive impairment with no difference between infection-status groups (p = 0.78). The majority of these CYP experienced cognitive impairment for the first time at either time of testing or 3-months post-test (no difference between the infection-status groups; p = 0.60). 70.8 % of first-positives experiencing cognitive impairment at 12-months, were 15-to-17-years-old as were 33.3 % of reinfected CYP experiencing cognitive impairment (p < 0.01). Consistently at all time points post-testing, CYP experiencing cognitive impairment were more likely to score higher on all Strengths and Difficulties Questionnaire subscales, higher on the Chalder Fatigue sub-scale for mental fatigue, lower on the Short Warwick-Edinburgh Mental Wellbeing Scale and report more trouble sleeping. CONCLUSIONS CYP have a fluctuating experience of cognitive impairment by 12-months post SARS-CoV-2-infection. Cognitive impairment is consistently correlated with poorer sleep, behavioural and emotional functioning over a 12-month period. Clinicians should be aware of cognitive impairment post-infection and its co-occurring nature with poorer sleep, behavioural and mental health symptoms.
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Affiliation(s)
- Paul Foret-Bruno
- Institut de Psychologie, Université Lumière Lyon 2, 18 Quai Claude Bernard 69365 LYON Cedex 07, France
| | - Roz Shafran
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, the United Kingdom of Great Britain and Northern Ireland.
| | - Terence Stephenson
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, the United Kingdom of Great Britain and Northern Ireland
| | - Manjula D Nugawela
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, the United Kingdom of Great Britain and Northern Ireland
| | - Dennis Chan
- UCL Institute of Cognitive Neuroscience, Alexandra House, London, WC1N 3AZ, the United Kingdom of Great Britain and Northern Ireland
| | - Shamez Ladhani
- Immunisations and Vaccine Preventable Diseases, UK Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, the United Kingdom of Great Britain and Northern Ireland
| | - Kelsey McOwat
- Immunisations and Vaccine Preventable Diseases, UK Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, the United Kingdom of Great Britain and Northern Ireland
| | - Anna Mensah
- Immunisations and Vaccine Preventable Diseases, UK Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, the United Kingdom of Great Britain and Northern Ireland
| | - Ruth Simmons
- Immunisations and Vaccine Preventable Diseases, UK Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, the United Kingdom of Great Britain and Northern Ireland
| | - Lana Fox Smith
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, the United Kingdom of Great Britain and Northern Ireland
| | - Anaïs D'oelsnitz
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, the United Kingdom of Great Britain and Northern Ireland
| | - Laila Xu
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, the United Kingdom of Great Britain and Northern Ireland
| | - Emma Dalrymple
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, the United Kingdom of Great Britain and Northern Ireland
| | - Isobel Heyman
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, the United Kingdom of Great Britain and Northern Ireland
| | - Tamsin Ford
- Department of Psychiatry, University of Cambridge, Hershel Smith Building Cambridge Biomedical Campus, CB2 0SZ, the United Kingdom of Great Britain and Northern Ireland
| | - Terry Segal
- University College London Hospitals NHS Foundation Trust, London, NW1 2PG, the United Kingdom of Great Britain and Northern Ireland
| | - Trudie Chalder
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De'Crespigny Park, London, SE5 8AF, the United Kingdom of Great Britain and Northern Ireland
| | - Natalia Rojas
- Division of Surgery & Interventional Science, Faculty of Medical Sciences, University College London, WC1E 6BT, the United Kingdom of Great Britain and Northern Ireland
| | - Snehal M Pinto Pereira
- Division of Surgery & Interventional Science, Faculty of Medical Sciences, University College London, WC1E 6BT, the United Kingdom of Great Britain and Northern Ireland.
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Gutfreund MC, Kobayashi T, Callado GY, Pardo I, Hsieh MK, Lin V, Perencevich EN, Salinas JL, Edmond MB, Mendonça E, Rizzo LV, Marra AR. The effectiveness of the COVID-19 vaccines in the prevention of post-COVID conditions in children and adolescents: a systematic literature review and meta-analysis. Antimicrob Steward Healthc Epidemiol 2024; 4:e54. [PMID: 38655026 PMCID: PMC11036435 DOI: 10.1017/ash.2024.42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 02/29/2024] [Accepted: 03/01/2024] [Indexed: 04/26/2024]
Abstract
Objective We performed a systematic literature review and meta-analysis on the effectiveness of coronavirus disease 2019 (COVID-19) vaccination against post-COVID conditions (long COVID) in the pediatric population. Design Systematic literature review/meta-analysis. Methods We searched PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, Cochrane Central Register of Controlled Trials, Scopus, and Web of Science from December 1, 2019, to August 14, 2023, for studies evaluating the COVID-19 vaccine effectiveness against post-COVID conditions among vaccinated individuals < 21 years old who received at least 1 dose of COVID-19 vaccine. A post-COVID condition was defined as any symptom that was present 4 or more weeks after COVID-19 infection. We calculated the pooled diagnostic odds ratio (DOR) (95% CI) for post-COVID conditions between vaccinated and unvaccinated individuals. Results Eight studies with 23,995 individuals evaluated the effect of vaccination on post-COVID conditions, of which 5 observational studies were included in the meta-analysis. The prevalence of children who did not receive COVID-19 vaccines ranged from 65% to 97%. The pooled prevalence of post-COVID conditions was 21.3% among those unvaccinated and 20.3% among those vaccinated at least once. The pooled DOR for post-COVID conditions among individuals vaccinated with at least 1 dose and those vaccinated with 2 doses were 1.07 (95% CI, 0.77-1.49) and 0.82 (95% CI, 0.63-1.08), respectively. Conclusions A significant proportion of children and adolescents were unvaccinated, and the prevalence of post-COVID conditions was higher than reported in adults. While vaccination did not appear protective, conclusions were limited by the lack of randomized trials and selection bias inherent in observational studies.
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Affiliation(s)
- Maria Celidonio Gutfreund
- Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Takaaki Kobayashi
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Gustavo Yano Callado
- Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Isabele Pardo
- Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Mariana Kim Hsieh
- Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Vivian Lin
- Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Eli N. Perencevich
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA
- Center for Access & Delivery Research & Evaluation (CADRE), Iowa City Veterans Affairs Health Care System, Iowa City, IA, USA
| | - Jorge L. Salinas
- Division of Infectious Diseases & Geographic Medicine, Stanford University, Stanford, CA, USA
| | - Michael B. Edmond
- Department of Medicine, West Virginia University School of Medicine, Morgantown, WV, USA
| | - Eneida Mendonça
- Department of Biomedical Informatics, University of Cincinnati, Cincinnati, OH, USA
- Division of Biomedical Informatics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Luiz Vicente Rizzo
- Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Alexandre R. Marra
- Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA
- Center for Access & Delivery Research & Evaluation (CADRE), Iowa City Veterans Affairs Health Care System, Iowa City, IA, USA
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Iversen A, Blomberg B, Haug K, Kittang B, Özgümüs T, Cox RJ, Langeland N. Symptom trajectories of post-COVID sequelae in patients with acute Delta or Omicron infection in Bergen, Norway. Front Public Health 2024; 12:1320059. [PMID: 38504678 PMCID: PMC10948556 DOI: 10.3389/fpubh.2024.1320059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 02/22/2024] [Indexed: 03/21/2024] Open
Abstract
Introduction A substantial proportion of the over 700 million COVID-19 cases world-wide experience long-term symptoms. The objectives of this study were to compare symptom trajectories and risk factors for post-COVID-19 condition after Delta and Omicron infection. Methods This study consecutively recruited patients with SARS-CoV-2 infection from November 2021 to March 2022. We recorded demographics, comorbidities, vaccination status, sick leave, and 18 symptoms during acute infection and after 4 months. The primary outcome measures were symptoms during acute infection and after 4 months. Secondary outcome measures were work and school absenteeism. Results We followed a cohort of 1,374 non-hospitalized COVID-19 patients in Bergen, Norway, at three time points. The median age was 39.8 years and 11% were children <16 years. Common acute upper respiratory symptoms waned during follow-up. Fatigue remained common from acute infection (40%) until after 4 months (37%). Four months post-infection, patients reported increased frequencies of dyspnea (from 15% during acute illness to 25% at 4 months, p < 0.001), cognitive symptoms (from 9 to 32%, p < 0.001) and depression (from 1 to 17%, p < 0.001). Patients infected with Omicron reported less dyspnea (22% versus 27%, p = 0.046) and smell/taste problems (5% versus 19%, p < 0.001) at 4 months follow-up than those with Delta infection. Comorbidities and female sex were risk factors for persistent dyspnea and cognitive symptoms. Ten percent reported sick leave after acute illness, and vaccination reduced the risk of absenteeism (adjusted risk ratio: 0.36, 95% confidence interval: 0.15, 0.72, p = 0.008). Conclusion At 4 months, home-isolated patients infected with Omicron reported overall comparable symptom burden, but less dyspnea and smell/taste problems than Delta infected patients. Several acute symptoms waned during follow-up. It is worrying that dyspnea, neurocognitive symptoms, and particularly depression, increased significantly during the first 4 months after acute infection. Previous vaccination was protective against prolonged sick leave.
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Affiliation(s)
- Arild Iversen
- Chief Municipal Doctor’s Office, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Bjørn Blomberg
- Department of Clinical Science, University of Bergen, Bergen, Norway
- National Centre for Tropical Infectious Diseases, Department of Medicine, Haukeland University Hospital, Bergen, Norway
| | - Kjell Haug
- Chief Municipal Doctor’s Office, Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Bård Kittang
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Medicine, Haraldsplass Deaconess Hospital, Bergen, Norway
- Department of Nursing Home Medicine, Bergen Municipality, Bergen, Norway
| | - Türküler Özgümüs
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Rebecca Jane Cox
- Influenza Centre, Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Microbiology, Haukeland University Hospital, Bergen, Norway
| | - Nina Langeland
- Department of Clinical Science, University of Bergen, Bergen, Norway
- National Centre for Tropical Infectious Diseases, Department of Medicine, Haukeland University Hospital, Bergen, Norway
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Rayner DG, Wang E, Su C, Patel OD, Aleluya S, Giglia A, Zhu E, Siddique M. Risk factors for long COVID in children and adolescents: a systematic review and meta-analysis. World J Pediatr 2024; 20:133-142. [PMID: 38055113 DOI: 10.1007/s12519-023-00765-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 09/26/2023] [Indexed: 12/07/2023]
Abstract
BACKGROUND The long-term sequelae of COVID-19 in children and adolescents remain poorly understood and characterized. This systematic review and meta-analysis sought to summarize the risk factors for long COVID in the pediatric population. METHODS We searched six databases from January 2020 to May 2023 for observational studies reporting on risk factors for long COVID or persistent symptoms those were present 12 or more weeks post-infection using multivariable regression analyses. Trial registries, reference lists of included studies, and preprint servers were hand-searched for relevant studies. Random-effects meta-analyses were conducted to pool odds ratios for each risk factor. Individual study risk of bias was rated using QUIPS, and the GRADE framework was used to assess the certainty of evidence for each unique factor. RESULTS Sixteen observational studies (N = 46,262) were included, and 19 risk factors were amenable to meta-analysis. With moderate certainty in the evidence, age (per 2-year increase), allergic rhinitis, obesity, previous respiratory diseases, hospitalization, severe acute COVID-19, and symptomatic acute COVID-19 are probably associated with an increased risk of long COVID. Female sex, asthma, comorbidity, and heart diseases may be associated with an increased risk of long COVID, and Asian and Black races may be associated with a decreased risk of long COVID. We did not observe any credible subgroup effects for any risk factor. CONCLUSIONS The current body of literature presents several compelling risk factors for the development of long COVID in the pediatric population. Further research is necessary to elucidate the pathophysiology of long COVID.
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Affiliation(s)
- Daniel G Rayner
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4K1, Canada.
| | - Elaine Wang
- Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4K1, Canada
| | - Cloris Su
- Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4K1, Canada
| | - Om D Patel
- Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4K1, Canada
| | - Stephanie Aleluya
- Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4K1, Canada
| | - Alessandra Giglia
- Faculty of Science, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4K1, Canada
| | - Evelyn Zhu
- Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4K1, Canada
| | - Maha Siddique
- Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4K1, Canada
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Minotti C, McKenzie C, Dewandel I, Bekker C, Sturniolo G, Doni D, Giaquinto C, Van Der Zalm MM, Donà D. How does post COVID differ from other post-viral conditions in childhood and adolescence (0-20 years old)? A systematic review. EClinicalMedicine 2024; 68:102436. [PMID: 38333536 PMCID: PMC10850405 DOI: 10.1016/j.eclinm.2024.102436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 01/03/2024] [Accepted: 01/10/2024] [Indexed: 02/10/2024] Open
Abstract
Background Post Coronavirus disease (COVID) and other post-viral infection syndromes present an overlap of pathogenesis, onset, progression, and symptom profile. We aimed to systematically describe studies on post-viral conditions and determine the entity of post COVID compared to other post-viral conditions in children. Methods We conducted a systematic search of the Embase, MEDLINE, Cochrane Library, and GoogleScholar databases (January 1946-3 November 2023), according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. The main outcomes were differences in condition duration, symptom type, and development of chronic symptoms. This systematic review was registered on PROSPERO (CRD42023401789). Findings 35/5051 studies were included, with 42,934 children, adolescents and young adults (0-20 years old) overall. Twenty-eight studies focused on post COVID symptoms, followed by five papers on Respiratory Syncytial Virus (RSV) and Rhinovirus, one study on Epstein-Barr Virus (EBV), and one on gastrointestinal viruses. Studies on post COVID mainly reported data on older children/adolescents, describing long-lasting symptoms, including fatigue, neurologic, cardiorespiratory, musculoskeletal, mental health, and gastrointestinal symptoms. The maximum described symptoms duration was eighteen months, with an average follow-up of seven months. The development of chronic symptoms was reported by 30 studies (93.8%) for 10,473/28,474 patients (36.8%). Recovery was achieved in 18,001/28,474 cases (63.2%). The study on EBV reported persistent fatigue in adolescents for a similar duration (6 months, 46% chronic). Studies on RSV and Rhinovirus were mainly done in children under three years, with development of recurrent wheezing (up to 3 years). Interpretation Post-viral fatigue was a shared feature between post COVID and post EBV conditions. A better understanding of post COVID as a unique condition, sharing features with other post-viral syndromes, is needed. The healthcare burden and socio-economic consequences for children and their families warrant further investigation and development of appropriate healthcare management plans. The foremost requirement is the establishment of consistent and shareable definitions, as well as a consensus on outcomes, to effectively evaluate follow-up and quantify the burden of different viral infections. Funding EU Horizon, EDCTP, NIH.
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Affiliation(s)
- Chiara Minotti
- Department of Women's and Children's Health, University of Padua, Italy
- PhD Program in Clinical Research, University Children's Hospital Basel, University of Basel, Switzerland
| | - Carla McKenzie
- Desmond Tutu TB Centre, Department of Pediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Isabelle Dewandel
- Desmond Tutu TB Centre, Department of Pediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Carien Bekker
- Desmond Tutu TB Centre, Department of Pediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Giulia Sturniolo
- Department of Women's and Children's Health, University of Padua, Italy
| | - Denis Doni
- Department of Women's and Children's Health, University of Padua, Italy
| | - Carlo Giaquinto
- Department of Women's and Children's Health, University of Padua, Italy
| | - Marieke M. Van Der Zalm
- Desmond Tutu TB Centre, Department of Pediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Daniele Donà
- Department of Women's and Children's Health, University of Padua, Italy
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Körner RW, Bansemir OY, Franke R, Sturm J, Dafsari HS. Atopy and Elevation of IgE, IgG3, and IgG4 May Be Risk Factors for Post COVID-19 Condition in Children and Adolescents. Children (Basel) 2023; 10:1598. [PMID: 37892261 PMCID: PMC10605545 DOI: 10.3390/children10101598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 09/04/2023] [Accepted: 09/12/2023] [Indexed: 10/29/2023]
Abstract
SARS-CoV-2 infection causes transient cardiorespiratory and neurological disorders, and severe acute illness is rare among children. Post COVID-19 condition (PCC) may cause profound, persistent phenotypes with increasing prevalence. Its manifestation and risk factors remain elusive. In this monocentric study, we hypothesized that atopy, the tendency to produce an exaggerated immunoglobulin E (IgE) immune response, is a risk factor for the manifestation of pediatric PCC. We present a patient cohort (n = 28) from an early pandemic period (2021-2022) with comprehensive evaluations of phenotypes, pulmonary function, and molecular investigations. PCC predominantly affected adolescents and presented with fatigue, dyspnea, and post-exertional malaise. Sensitizations to aeroallergens were found in 93% of cases. We observed elevated IgE levels (mean 174.2 kU/L, reference < 100 kU/L) regardless of disease severity. Concurrent Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) was found in 29% of patients that also faced challenges in school attendance. ME/CFS manifestation was significantly associated with elevated immunoglobulin G subclasses IgG3 (p < 0.05) and IgG4 (p < 0.05). A total of 57% of patients showed self-limiting disease courses with mean recovery at 12.7 months (range 5-25 months), 29% at 19.2 months (range 12-30 months), and the rest demonstrated overall improvement. These findings offer additional insights into immune dysregulation as a risk factor for pediatric PCC.
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Affiliation(s)
- Robert Walter Körner
- Department of Pediatrics, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
| | - Ole Yannick Bansemir
- Department of Pediatrics, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
| | - Rosa Franke
- Department of Pediatrics, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
| | - Julius Sturm
- Department of Pediatrics, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
| | - Hormos Salimi Dafsari
- Department of Pediatrics, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
- Center for Rare Diseases, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
- Max-Planck-Institute for Biology of Ageing, 50931 Cologne, Germany
- Cologne Excellence Cluster on Cellular Stress Responses in Aging Associated Diseases (CECAD), University of Cologne, 50931 Cologne, Germany
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Su L, Chen S, Chen H, Fang Y, Peng W, Zhou X, Luo J, Liang X, Zhang K, Wang Z. Associations between COVID-19 Vaccination Status and Self-Reported SARS-CoV-2 Infection among 8538 Children Aged 3-17 Years during a Massive COVID-19 Outbreak after China Changed Its Zero-COVID-19 Policy: A Cross-Sectional Survey. Vaccines (Basel) 2023; 11:1401. [PMID: 37766079 PMCID: PMC10535453 DOI: 10.3390/vaccines11091401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/07/2023] [Accepted: 08/11/2023] [Indexed: 09/29/2023] Open
Abstract
This study aimed to investigate the associations between COVID-19 vaccination status and self-reported SARS-CoV-2 infection among children and adolescents aged 3-17 years during a massive COVID-19 outbreak after China changed its zero COVID policy. A cross-sectional online survey was conducted between 1 and 9 March 2023. Participants were the parents of children studying in kindergartens, primary schools, or secondary schools in Shenzhen. Convenient sampling was used. All kindergartens, primary schools, and secondary schools in the Longhua District of Shenzhen invited the parents of children and adolescents attending the schools. Interested parents completed an online survey. Multivariate logistic regression was fitted. Among 8538 participants, 40.9% self-reported that their children had SARS-CoV-2 infection after 7 December 2022, where 92.9% of them received two doses of the COVID-19 vaccines, and 74.6% received their second dose for more than six months. In multivariate analysis, children who received their second dose of the COVID-19 vaccination for no more than three months had a lower SARS-CoV-2 infection rate compared to unvaccinated children (<1 month: AOR: 0.17, 95% CI: 0.07, 0.44; 1-3 months: AOR: 0.54, 95% CI: 0.41, 0.75). The duration of protection conferred by the primary COVID-19 vaccination series was relatively short among children. A booster dose should be considered for children.
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Affiliation(s)
- Lixian Su
- Department of Child Healthcare, Shenzhen Futian District Maternity & Child Healthcare Hospital, Shenzhen 518016, China
| | - Siyu Chen
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Hongbiao Chen
- Longhua District Centre for Disease Control and Prevention, Shenzhen 518109, China
| | - Yuan Fang
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong, China
| | - Weijun Peng
- Longhua District Centre for Disease Control and Prevention, Shenzhen 518109, China
| | - Xiaofeng Zhou
- Longhua District Centre for Disease Control and Prevention, Shenzhen 518109, China
| | - Jingwei Luo
- Longhua District Centre for Disease Control and Prevention, Shenzhen 518109, China
| | - Xue Liang
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Kechun Zhang
- Longhua District Centre for Disease Control and Prevention, Shenzhen 518109, China
| | - Zixin Wang
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
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Sluiter-Post JGC, Fourie E, Wildenbeest JG, van Lelyveld SFL, Bruijning-Verhagen PCJL, van Houten MA. Long term sequelae after SARS-CoV-2 infection in children: a household study. Virol J 2023; 20:137. [PMID: 37380990 DOI: 10.1186/s12985-023-02094-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 06/07/2023] [Indexed: 06/30/2023] Open
Abstract
BACKGROUND In children persistent symptoms after SARS-CoV-2 infection have been reported, however, duration and characteristics of symptoms in previously healthy children remain unclear. Therefore this study aimed to evaluate persisting symptoms in children at 6 and 12 months after a SARS-CoV-2 infection. METHODS In this prospective cohort study households with a confirmed SARS-CoV-2 positive outbreak were matched 1:1 to household controls from SARS-CoV-2 negative outbreaks. These households completed questionnaires at 6 and 12 months on the presence and severity of SARS-CoV-2 related symptoms, general well-being/functioning, cognition, persisting symptoms and quality of life. FINDINGS None of the children who had a SARS-CoV-2 infection during the study reported persistent symptoms at 6 and 12 months after infection, whereas almost 8% of the children with a negative RT-PCR test during the study reported symptoms such as coughing and mild fever, however, no significant differences were found. In addition, for all other outcomes, no differences were observed between the two groups. TAKE HOME MESSAGE Post-acute sequelae of mild SARS-CoV-2 infections appears to be uncommon in previously healthy children.
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Affiliation(s)
| | - Elandri Fourie
- Spaarne Gasthuis Academy, Hoofddorp and Haarlem, The Netherlands
| | - Joanne G Wildenbeest
- Department of Paediatric Infectious Diseases and Immunology, Wilhelmina Children's Hospital University Medical Center Utrecht, Utrecht, The Netherlands
| | - Steven F L van Lelyveld
- Spaarne Gasthuis Academy, Hoofddorp and Haarlem, The Netherlands
- Department of Internal Medicine, Spaarne Gasthuis, Hoofddorp and Haarlem, The Netherlands
| | - Patricia C J L Bruijning-Verhagen
- Department of Epidemiology, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Marianne A van Houten
- Spaarne Gasthuis Academy, Hoofddorp and Haarlem, The Netherlands.
- Department of Paediatrics, Spaarne Gasthuis, Hoofddorp and Haarlem, Spaarnepoort 1, 2134 TM, Hoofddorp, The Netherlands.
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