COVID-19 severity and vaccine breakthrough infections in idiopathic inflammatory myopathies, other systemic autoimmune and inflammatory diseases, and healthy controls: a multicenter cross-sectional study from the COVID-19 Vaccination in Autoimmune Diseases (COVAD) survey

OBJECTIVES

We aimed to compare the spectrum and severity of COVID-19 and vaccine breakthrough infections (BIs) among patients with IIMs, other systemic autoimmune and inflammatory diseases (SAIDs), and healthy controls (HCs).

METHODS

This is a cross-sectional study with data from the COVAD study, a self-reported online global survey that collected demographics, COVID-19 history, and vaccination details from April to September 2021. Adult patients with at least one COVID-19 vaccine dose were included. BIs were defined as infections occurring > 2 weeks after any dose of vaccine. Characteristics associated with BI were analyzed with a multivariate regression analysis.

RESULTS

Among 10,900 respondents [42 (30-55) years, 74%-females, 45%-Caucasians] HCs were (47%), SAIDs (42%) and IIMs (11%). Patients with IIMs reported fewer COVID-19 cases before vaccination (6.2%-IIM vs 10.5%-SAIDs vs 14.6%-HC; OR = 0.6, 95% CI 0.4-0.8, and OR = 0.3, 95% CI 0.2-0.5, respectively). BIs were uncommon (1.4%-IIM; 1.9%-SAIDs; 3.2%-HC) and occurred in 17 IIM patients, 13 of whom were on immunosuppressants, and 3(18%) required hospitalization. All-cause hospitalization was higher in patients with IIM compared to HCs [23 (30%) vs 59 (8%), OR = 2.5, 95% CI 1.2-5.1 before vaccination, and 3 (18%) vs 9 (5%), OR = 2.6, 95% CI 1.3-5.3 in BI]. In a multivariate regression analysis, age 30-60 years was associated with a lower odds of BI (OR = 0.7, 95% CI 0.5-1.0), while the use of immunosuppressants had a higher odds of BI (OR = 1.6, 95% CI 1.1-2.7).

CONCLUSIONS

Patients with IIMs reported fewer COVID-19 cases than HCs and other SAIDs, but had higher odds of all-cause hospitalization from COVID-19 than HCs. BIs were associated with the use of immunosuppressants and were uncommon in IIMs.

Impacts of COVID-19 on children and adolescents: A systematic review analyzing its psychiatric effects

OBJECTIVE

To summarize the most relevant data from a systematic review on the impact of COVID-19 on children and adolescents, particularly analyzing its psychiatric effects.

METHODS

This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines and included experimental studies (randomized-individually or pooled-and non-randomized controlled trials), observational studies with a group for internal comparison (cohort studies-prospective and retrospective-and case-control) and qualitative studies in the period from 2021 to 2022.

RESULTS

The search identified 325 articles; we removed 125 duplicates. We selected 200 manuscripts, chosen by title and selected abstracts. We excluded 50 records after screening titles and abstracts, as they did not meet the inclusion criteria. We retrieved 150 records selected for a full reading. We excluded 90 text articles and we selected 25 records for the (n) final. Limitations: Due to the short period of data collection, from 2021 to 2022, there is a possibility of lack of relevant studies related to the mental health care of children and adolescents. In addition, there is the possibility of publication bias, such as only significant findings being published.

CONCLUSION

The impact of COVID-19 on the mental health of children and adolescents is of great concern to child and youth psychiatry. Situations such as fear, anxiety, panic, depression, sleep and appetite disorders, as well as impairment in social interactions caused by psychic stress, are punctual markers of pain and psychic suffering, which have increasing impacts on the mental health panorama of children and adolescents globally, particularly in vulnerable and socially at-risk populations.

Children are in need of humanitarian aid in Afghanistan

Almost 60% of Afghans forced to flee their homes in 2021 because of the Taliban advance are children. They are starving. It is estimated that approximately one million will suffer from severe, life-threatening malnutrition by the end of 2021. Many have been separated from their families by the chaos that has ensued in Afghanistan after Taliban took power, and hundreds of them were driven out of the country unaccompanied. How must these children have been when they suddenly found themselves without their relatives during the chaotic crisis, or when they boarded an evacuation flight? It is vital to identify them quickly. Too many children witnessed scenes that no child should see. Children and teenagers are dealing with anxiety and fear and desperately need help and mental health care. This is the sad reality facing Afghan children, regardless of ongoing political developments and changes in government.

Children are in need of humanitarian aid in Afghanistan

Almost 60% of Afghans forced to flee their homes in 2021 because of the Taliban advance are children. They are starving. It is estimated that approximately one million will suffer from severe, life-threatening malnutrition by the end of 2021. Many have been separated from their families by the chaos that has ensued in Afghanistan after Taliban took power, and hundreds of them were driven out of the country unaccompanied. How must these children have been when they suddenly found themselves without their relatives during the chaotic crisis, or when they boarded an evacuation flight? It is vital to identify them quickly. Too many children witnessed scenes that no child should see. Children and teenagers are dealing with anxiety and fear and desperately need help and mental health care. This is the sad reality facing Afghan children, regardless of ongoing political developments and changes in government.