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Choe YJ, Choi EH, Choi JW, Eun BW, Eun LY, Kim YJ, Kim YH, Kim YA, Kim YK, Kwak JH, Lee H, Park JD, Jung YH, Gwack J, Lee S. Change in Severity and Clinical Manifestation of MIS-C Over SARS-CoV-2 Variant Outbreaks in Korea. J Korean Med Sci 2023; 38:e225. [PMID: 37527908 PMCID: PMC10396435 DOI: 10.3346/jkms.2023.38.e225] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 03/29/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND There is difference in the incidence of multi-system inflammatory syndrome in children (MIS-C) in patients with different variants of severe acute respiratory syndrome coronavirus 2, however, little is known about the epidemiology in Asian countries. We investigated and compared the epidemiology of the MIS-C during omicron-dominant period with that of previous periods in South Korea. METHODS We obtained clinical, epidemiological and laboratory data on MIS-C cases from national MIS-C surveillance in South Korea. We defined pre-delta period as January 2020-May 2021; delta period as June 2021-December 2021; and omicron period as January 2022-April 2022. We describe the clinical characteristics and outcomes of MIS-C patients by period. RESULTS A total of 91 cases were assessed to be MIS-C cases. Number of MIS-C cases have increased from six cases during pre-delta period to 66 cases during omicron period, while the incidence rate (the number of MIS-C cases per 100,000 cases of reported coronavirus disease 2019) has decreased from 38.5 cases per 100,000 (95% confidence interval [CI], 14.1-83.9) during pre-delta period to 1.6 cases per 100,000 (95% CI, 1.2-2.0) during omicron periods. During pre-delta period, 66.7% and 100% had hypotension and gastrointestinal involvement, respectively; while during omicron period, 12.1% and 6.1% had such clinical manifestations. Fifty percent of pre-delta MIS-C patients were taken intensive care unit (ICU) cares, while 10.6% of patients during omicron periods were in ICUs. CONCLUSION Omicron period were associated with less severe clinical manifestation compared to pre-delta and delta periods. Although incidence rate of MIS-C was lower for the omicron period than pre-delta and delta periods, number of patients reported with MIS-C may pose a substantial clinical burden.
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Affiliation(s)
- Young June Choe
- Department of Pediatrics, Korea University Anam Hospital, Seoul, Korea
| | - Eun Hwa Choi
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.
| | - Jong Woon Choi
- Department of Pediatrics, Bundang Jesaeng General Hospital, Seongnam, Korea
| | - Byung Wook Eun
- Department of Pediatrics, Nowon Eulji University Hospital, Seoul, Korea
| | - Lucy Youngmin Eun
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Yae-Jean Kim
- Department of Pediatrics, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yeo Hyang Kim
- Department of Pediatrics, School of Medicine Kyungpook National University, Daegu, Korea
| | - Young A Kim
- Department of Pediatrics, Pusan National University School of Medicine, Yangsan, Korea
| | - Yun-Kyung Kim
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Ji Hee Kwak
- Department of Pediatrics, Sungkyunkwan University School of Medicine, Seoul, Korea
- Department of Pediatrics, Kangbuk Samsung Hospital, Seoul, Korea
| | - Hyukmin Lee
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - June Dong Park
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Yeon Haw Jung
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jin Gwack
- Director General for Public Health Emergency Preparedness, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Sangwon Lee
- Director General for Public Health Emergency Preparedness, Korea Disease Control and Prevention Agency, Cheongju, Korea
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Gorgels KMF, van Alphen LB, van der Veer BMJW, Hackert VH, Hensels AYJ, Heijer CDJD, Dingemans J, Savelkoul PHM, Hoebe CJPA. Increased transmissibility of SARS-CoV-2 alpha variant (B.1.1.7) in children: three large primary school outbreaks revealed by whole genome sequencing in the Netherlands. BMC Infect Dis 2022; 22:713. [PMID: 36038845 PMCID: PMC9421630 DOI: 10.1186/s12879-022-07623-9] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 06/07/2022] [Indexed: 11/18/2022] Open
Abstract
Background Variant of concern (VOC) SARS-CoV-2 alpha variant (B.1.1.7) was the dominant strain in the Netherlands between March 2021–June 2021. We describe three primary school outbreaks due to the alpha variant using whole genome sequencing with evidence of large-scale transmission among children, teachers and their household contacts. Method All outbreaks described were investigated by the South Limburg Public Health Service, the Netherlands. A case was defined as an individual with a real-time polymerase chain reaction test or antigen test positive for SARS-CoV-2. Whole genome sequencing was performed on random samples from at least one child and one teacher of each affected class. Results Peak attack rates in classes were 53%, 33% and 39%, respectively. Specific genotypes were identified for each school across a majority of affected classes. Attack rates were high among staff members, likely to promote staff-to-children transmission. Cases in some classes were limited to children, indicating child-to-child transmission. At 39%, the secondary attack rate (SAR) in household contacts of infected children was remarkably high, similar to SAR in household contacts of staff members (42%). SAR of household contacts of asymptomatic children was only 9%. Conclusion Our findings suggest increased transmissibility of the alpha variant in children compared to preceding non-VOC variants, consistent with a substantial rise in the incidence of cases observed in primary schools and children aged 5–12 since the alpha variant became dominant in March 2021. Lack of mandatory masking, insufficient ventilation and lack of physical distancing also probably contributed to the school outbreaks. The rise of the delta variant (B.1.617.2) since July 2021 which is estimated to be 55% more transmissible than the alpha variant, provides additional urgency to adequate infection prevention in school settings. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07623-9.
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Affiliation(s)
- Koen M F Gorgels
- Department of Sexual Health, Infectious Diseases and Environmental Health, South Limburg Public Health Service, PO Box 33, 6400 AA, Heerlen, The Netherlands.
| | - Lieke B van Alphen
- Department of Medical Microbiology, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre (MUMC+), P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands
| | - Brian M J W van der Veer
- Department of Medical Microbiology, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre (MUMC+), P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands
| | - Volker H Hackert
- Department of Sexual Health, Infectious Diseases and Environmental Health, South Limburg Public Health Service, PO Box 33, 6400 AA, Heerlen, The Netherlands.,Department of Medical Microbiology, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre (MUMC+), P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands.,Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - Audrey Y J Hensels
- Department of Sexual Health, Infectious Diseases and Environmental Health, South Limburg Public Health Service, PO Box 33, 6400 AA, Heerlen, The Netherlands
| | - Casper D J den Heijer
- Department of Sexual Health, Infectious Diseases and Environmental Health, South Limburg Public Health Service, PO Box 33, 6400 AA, Heerlen, The Netherlands.,Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - Jozef Dingemans
- Department of Medical Microbiology, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre (MUMC+), P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands
| | - Paul H M Savelkoul
- Department of Medical Microbiology, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre (MUMC+), P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands
| | - Christian J P A Hoebe
- Department of Sexual Health, Infectious Diseases and Environmental Health, South Limburg Public Health Service, PO Box 33, 6400 AA, Heerlen, The Netherlands.,Department of Medical Microbiology, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre (MUMC+), P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands.,Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
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Crawford D, Van Cleve S, McCarthy AM, Kimm V, Nielsen AK, Lee J. Exploring the Effects of the COVID-19 Pandemic on the Children and Families Cared for by Pediatric-Focused Advanced Practice Registered Nurses. J Pediatr Health Care 2022; 36:321-329. [PMID: 35153108 PMCID: PMC8784574 DOI: 10.1016/j.pedhc.2022.01.003] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 01/17/2022] [Accepted: 01/18/2022] [Indexed: 11/23/2022]
Abstract
INTRODUCTION The coronavirus disease 2019 (COVID-19) pandemic has significantly affected children and families. The study purpose was to better understand the perceptions of pediatric-focused advanced practice registered nurses (P-APRNs) on the impact of COVID-19 on patients and practice. METHOD A 25-item electronic survey including Likert scales, multiple choice , and open-ended questions was sent by e-mail to electronic mailing list of the National Association of Pediatric Nurse Practitioners. RESULTS Responses (N = 109) reflect the magnitude of challenges affecting child physical health, mental health, parental stress, and social determinants of health. P-APRNs expect greater refusal of the COVID-19 vaccine compared with other vaccines. Telehealth use continues at an increased rate and greater resources are needed to support clinical practice. DISCUSSION The COVID-19 pandemic has transformed the lives of children, families, and P-APRN practice. These findings reflect challenges and opportunities moving forward. P-APRNs are well-prepared to lead change to support better and more equitable outcomes for all.
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Affiliation(s)
- Daniel Crawford
- Daniel Crawford, Associate Professor (Clinical) & Director, Pediatric Primary Care Nurse Practitioner Program, The University of Iowa College of Nursing, Iowa City, IA.
| | - Susan Van Cleve
- Susan Van Cleve, Clinical Professor, The University of Iowa College of Nursing, Iowa City, IA
| | - Ann Marie McCarthy
- Ann Marie McCarthy, Professor, The University of Iowa College of Nursing, Iowa City, IA
| | - Vanessa Kimm
- Vanessa Kimm, Assistant Professor (Clinical), Pediatric Nurse Practitioner Program, The University of Iowa College of Nursing, Iowa City, IA
| | - Anne K Nielsen
- Anne K. Nielsen, Pediatric Nurse Practitioner, General Pediatrics/Child Protection Program, The University of Iowa Stead Family Children's Hospital, Iowa City, IA
| | - Jihye Lee
- Jihye Lee, PhD Student, The University of Iowa College of Nursing, Iowa City, IA
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Rudan I, Adeloye D, Katikireddi V, Murray J, Simpson C, Shah SA, Robertson C, Sheikh A. The COVID-19 pandemic in children and young people during 2020-2021: A complex discussion on vaccination. J Glob Health 2021; 11:01011. [PMID: 35047183 PMCID: PMC8763337 DOI: 10.7189/jogh.11.01011] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Igor Rudan
- Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Davies Adeloye
- Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, UK
| | | | - Josie Murray
- COVID-19 Surveillance Lead, Public Health Scotland, Fife, UK
| | - Colin Simpson
- School of Health, Wellington Faculty of Health, Victoria University of Wellington, New Zealand
- Usher Institute, The University of Edinburgh, Edinburgh, UK
| | | | - Chris Robertson
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK and Public Health Scotland, Glasgow, UK
| | - Aziz Sheikh
- Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - EAVE II collaboration
- Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, UK
- MRC/CSO Social & Public Health Sciences Unit, Glasgow, UK
- COVID-19 Surveillance Lead, Public Health Scotland, Fife, UK
- School of Health, Wellington Faculty of Health, Victoria University of Wellington, New Zealand
- Usher Institute, The University of Edinburgh, Edinburgh, UK
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK and Public Health Scotland, Glasgow, UK
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Saied AA, Metwally AA, Dhama K. Our children are at risk of COVID-19- associated rhino-orbito-cerebral mucormycosis (ROCM). Ann Med Surg (Lond) 2021; 72:103058. [PMID: 34804523 PMCID: PMC8592640 DOI: 10.1016/j.amsu.2021.103058] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 11/03/2021] [Accepted: 11/09/2021] [Indexed: 01/10/2023] Open
Affiliation(s)
- AbdulRahman A Saied
- Department of Food Establishments Licensing (Aswan Branch), National Food Safety Authority (NFSA), Aswan, 81511, Egypt.,Touristic Activities and Interior Offices Sector (Aswan Office), Ministry of Tourism and Antiquities, Aswan, 81511, Egypt
| | - Asmaa A Metwally
- Department of Surgery, Anesthesiology, and Radiology, Faculty of Veterinary Medicine, Aswan University, Aswan, 81511, Egypt
| | - Kuldeep Dhama
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, India
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