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Buonsenso D, Camporesi A, Morello R, De Rose C, Fracasso M, Valentini P. Paediatric long COVID studies should focus on clinical evaluations that examine the impact on daily life not just self-reported symptoms. Acta Paediatr 2024; 113:778-780. [PMID: 38287466 DOI: 10.1111/apa.17129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/26/2023] [Accepted: 01/17/2024] [Indexed: 01/31/2024]
Affiliation(s)
- Danilo Buonsenso
- Department of Woman and Child Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Center for Global Health Research Studies, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Anna Camporesi
- Anesthesia and Intensive Care Unit, 'Vittore Buzzi' Children's Hospital, Milan, Italy
| | - Rosa Morello
- Department of Woman and Child Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Cristina De Rose
- Department of Woman and Child Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Matteo Fracasso
- Medicine and Surgery, Universityà Cattolica del Sacro Cuore, Roma, Italy
| | - Piero Valentini
- Department of Woman and Child Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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Piastra M, Picconi E, Genovese O, Ferrari V, Morena TC, Valentini P, De Pascale G, Antonelli M, Conti G. Complicated Falciparum Malarial ARDS Requiring Noninvasive Support. Pediatr Infect Dis J 2024; 43:e96-e99. [PMID: 38381957 DOI: 10.1097/inf.0000000000004189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
Severe plasmodium falciparum infection can induce respiratory distress and clinical ARDS in children, requiring intensive care admission and respiratory support. We present 3 cases of imported malarial acute respiratory distress syndrome requiring noninvasive ventilation in the pediatric intensive care unit, in the absence of any cerebral involvement. Radiological features and their relationship with severe hematological complications are also illustrated.
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Affiliation(s)
- Marco Piastra
- From the Pediatric ICU and Trauma Center, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
- Institute of Anesthesia and Intensive Care, Catholic University of the Sacred Heart, Rome, Italy
| | - Enzo Picconi
- From the Pediatric ICU and Trauma Center, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Orazio Genovese
- From the Pediatric ICU and Trauma Center, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Vittoria Ferrari
- Institute of Anesthesia and Intensive Care, Catholic University of the Sacred Heart, Rome, Italy
| | - Tony Christian Morena
- From the Pediatric ICU and Trauma Center, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Piero Valentini
- Pediatric Infectious Diseases, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Gennaro De Pascale
- Institute of Anesthesia and Intensive Care, Catholic University of the Sacred Heart, Rome, Italy
| | - Massimo Antonelli
- Institute of Anesthesia and Intensive Care, Catholic University of the Sacred Heart, Rome, Italy
| | - Giorgio Conti
- From the Pediatric ICU and Trauma Center, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
- Institute of Anesthesia and Intensive Care, Catholic University of the Sacred Heart, Rome, Italy
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Buonsenso D, Morello R, Mariani F, Mazzoli B, De Rose C, Lazzareschi I, Raffaelli F, Blandino R, Sanguinetti M, Valentini P. Utility of Rapid Nasopharyngeal Swab for Respiratory Pathogens in the Diagnosis of Viral Infections in Children Hospitalized with Fever: A Prospective Validation Study to Improve Antibiotic Use. Children (Basel) 2024; 11:225. [PMID: 38397338 PMCID: PMC10887280 DOI: 10.3390/children11020225] [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] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 01/31/2024] [Accepted: 02/07/2024] [Indexed: 02/25/2024]
Abstract
Introduction: Fever is among the most common reason for medical assessment and antibiotic prescription in practice. The aim of this study was to evaluate positive and negative predictive values of rapid nasopharyngeal swabs for respiratory pathogens to discriminate viral from bacterial infections. Methods: We prospectively tested children with signs and/or symptoms of infections (e.g., fever, cough, wheezing, suspected urinary tract infection) admitted to a paediatric department. Following discharge, clinical phenotypes were assigned defining a cohort of children having probable/certain viral infection, probable/certain bacterial infection, other inflammatory conditions or healthy controls. Results: In this study, 190 children were enrolled (50.5% females, median age 30.5 (8-86) months). In total, 102 patients (53.7%) were affected by respiratory viral infections, 16 (8.4%) by bacterial infections, 29 (15.3%) were healthy controls and 43 (22.6%) were affected by another pathological condition manifested with fever. In total, 84.3% of patients classified as viral infection tested positive for viruses, compared with 18.8% of patients with bacterial infection (p < 0.001), 18.6% of patients with other condition (p < 0.001) and 17.2% of control patients (p < 0.001). The positive predictive value of NPSs in the diagnosis of viral infection was 88.6% and the negative predictive value was 75.0%. Conclusion: Our findings suggest that rapid NPS tests for respiratory viruses are a useful tool to confirm viral infections in children with fever and improve antibiotic use.
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Affiliation(s)
- Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (R.M.); (F.M.); (C.D.R.); (I.L.); (P.V.)
- Centro di Salute Globale, Università Cattolica del Sacro Cuore, 00168 Roma, Italy
| | - Rosa Morello
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (R.M.); (F.M.); (C.D.R.); (I.L.); (P.V.)
| | - Francesco Mariani
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (R.M.); (F.M.); (C.D.R.); (I.L.); (P.V.)
| | - Bianca Mazzoli
- Department of Pediatrics, Catholic University of Rome, 00168 Rome, Italy; (B.M.); (R.B.)
| | - Cristina De Rose
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (R.M.); (F.M.); (C.D.R.); (I.L.); (P.V.)
| | - Ilaria Lazzareschi
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (R.M.); (F.M.); (C.D.R.); (I.L.); (P.V.)
| | - Francesca Raffaelli
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (F.R.); (M.S.)
| | - Rita Blandino
- Department of Pediatrics, Catholic University of Rome, 00168 Rome, Italy; (B.M.); (R.B.)
| | - Maurizio Sanguinetti
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (F.R.); (M.S.)
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Sezione di Microbiologia, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Piero Valentini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (R.M.); (F.M.); (C.D.R.); (I.L.); (P.V.)
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Buonsenso D, Ferro V, Viozzi F, Morello R, Proli F, Bersani G, Lazzareschi I, Santangelo R, Sanguinetti M, Fiori B, Zampino G, Valentini P. Changes in clinical, demographic, and outcome patterns of children hospitalized with non-SARS-CoV-2 viral low respiratory tract infections before and during the COVID pandemic in Rome, Italy. Pediatr Pulmonol 2024; 59:362-370. [PMID: 37937896 DOI: 10.1002/ppul.26755] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 10/24/2023] [Accepted: 11/01/2023] [Indexed: 11/09/2023]
Abstract
INTRODUCTION We performed this study aiming to evaluate changes in epidemiology, clinical presentation and outcomes of children hospitalized for viral lower respiratory tract infections (LRTI). METHODS We performed a retrospective study of children younger than 18 years of age hospitalized for LRTIs with a positive respiratory viral testing from 2018 to 2022. We compared need of pediatric intensive care unit (PICU), invasive ventilation, and other respiratory support, viral etiologies, clinical presentations, imaging, and laboratory results in the precovid (2018-2019) and covid (2020-2022) period. RESULTS A total of 523 were included in the analysis. In the pandemic period, the detection of influenza was 95% less likely to occur (odds ratio [OR]: 0.05; 95% confidence interval [95% CI]: 0.02-0.12; p < .001), likewise the detection of adenovirus was 77% less likely to occur (OR: 0.23; 95% CI: 0.10-0.51; p < .001). In the pandemic period, the number of codetections increased from 15.52% in 2018 to 57.25% in 2022, resulting in a significantly increasing trend (p < .001). The odds of transfer to PICU was more than five times greater during the pandemic period (OR: 5.31; 95% CI: 1.78-15.86; p = .003). CONCLUSIONS We found that the pattern of LRTI in children during COVID-19 pandemic significantly changed in terms of etiologies and increased severity.
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Affiliation(s)
- Danilo Buonsenso
- Department of Woman and Child Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Centro di Salute Globale, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Valentina Ferro
- Department of Emergency, Acceptance and General Pediatrics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Francesca Viozzi
- Medicine and Surgery, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Rosa Morello
- Department of Woman and Child Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Francesco Proli
- Department of Woman and Child Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giulia Bersani
- Department of Woman and Child Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Ilaria Lazzareschi
- Department of Woman and Child Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | - Maurizio Sanguinetti
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie-Sezione di Microbiologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Barbara Fiori
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giuseppe Zampino
- Department of Woman and Child Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Piero Valentini
- Department of Woman and Child Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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5
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Brackel CLH, Noij LCE, Vijverberg SJH, Legghe CL, Maitland-van der Zee AH, van Goudoever JB, Buonsenso D, Munblit D, Sigfrid L, McFarland S, Anmyr L, Ashkenazi-Hoffnung L, Bellinat APN, Dias NLS, Edwards A, Fashina T, Juraški RG, Gonçalves ALN, Hansted E, Herczeg V, Hertting O, Jankauskaite LN, Kaswandani N, Kevalas R, Krivácsy P, Lorenz M, Malone LA, McVoy M, Miller DW, Morrow AK, Nugawela MD, Oliveira CR, Oliveira PRS, Osmanov IM, Overmars IM, Paintsil E, Pinto Pereira SM, Prawira Y, Putri ND, Ramos RCF, Rasche M, Ryd-Rinder M, De Rose C, Samitova E, Jovanović TS, Say D, Scott JT, Shachar-Lavie I, Shafran R, Shmueli E, Snipaitiene A, Stephenson T, Ténai N, Tosif S, Turkalj M, Valentini P, Vasconcelos LRS, Villard L, Vilser D, Hashimoto S, Terheggen-Lagro SWJ. International Care programs for Pediatric Post-COVID Condition (Long COVID) and the way forward. Pediatr Res 2024:10.1038/s41390-023-03015-0. [PMID: 38287106 DOI: 10.1038/s41390-023-03015-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 11/16/2023] [Accepted: 12/15/2023] [Indexed: 01/31/2024]
Abstract
BACKGROUND Pediatric Post-COVID-Condition (PPCC) clinics treat children despite limited scientific substantiation. By exploring real-life management of children diagnosed with PPCC, the International Post-COVID-Condition in Children Collaboration (IP4C) aimed to provide guidance for future PPCC care. METHODS We performed a cross-sectional international, multicenter study on used PPCC definitions; the organization of PPCC care programs and patients characteristics. We compared aggregated data from PPCC cohorts and identified priorities to improve PPCC care. RESULTS Ten PPCC care programs and six COVID-19 follow-up research cohorts participated. Aggregated data from 584 PPCC patients was analyzed. The most common symptoms included fatigue (71%), headache (55%), concentration difficulties (53%), and brain fog (48%). Severe limitations in daily life were reported in 31% of patients. Most PPCC care programs organized in-person visits with multidisciplinary teams. Diagnostic testing for respiratory and cardiac morbidity was most frequently performed and seldom abnormal. Treatment was often limited to physical therapy and psychological support. CONCLUSIONS We found substantial heterogeneity in both the diagnostics and management of PPCC, possibly explained by scarce scientific evidence and lack of standardized care. We present a list of components which future guidelines should address, and outline priorities concerning PPCC care pathways, research and international collaboration. IMPACT Pediatric Post-COVID Condition (PPCC) Care programs have been initiated in many countries. Children with PPCC in different countries are affected by similar symptoms, limiting many to participate in daily life. There is substantial heterogeneity in diagnostic testing. Access to specific diagnostic tests is required to identify some long-term COVID-19 sequelae. Treatments provided were limited to physical therapy and psychological support. This study emphasizes the need for evidence-based diagnostics and treatment of PPCC. The International Post-COVID Collaboration for Children (IP4C) provides guidance for guideline development and introduces a framework of priorities for PPCC care and research, to improve PPCC outcomes.
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Affiliation(s)
- Caroline L H Brackel
- Department of Pediatric Pulmonology, Emma Children's Hospital, Amsterdam UMC, location University of Amsterdam, Amsterdam, the Netherlands.
- Department of Pediatrics, Tergooi MC, Hilversum, the Netherlands.
| | - Lieke C E Noij
- Department of Pediatric Pulmonology, Emma Children's Hospital, Amsterdam UMC, location University of Amsterdam, Amsterdam, the Netherlands
| | - Susanne J H Vijverberg
- Department of Pediatric Pulmonology, Emma Children's Hospital, Amsterdam UMC, location University of Amsterdam, Amsterdam, the Netherlands
- Department of Pulmonary Medicine, Amsterdam Institute for Infection and Immunology, Amsterdam UMC, location University of Amsterdam, Amsterdam, the Netherlands
| | - Camille L Legghe
- Department of Pediatric Pulmonology, Emma Children's Hospital, Amsterdam UMC, location University of Amsterdam, Amsterdam, the Netherlands
- Faculty of Pharmacy, University of Lille, Lille, France
| | - Anke H Maitland-van der Zee
- Department of Pediatric Pulmonology, Emma Children's Hospital, Amsterdam UMC, location University of Amsterdam, Amsterdam, the Netherlands
- Department of Pulmonary Medicine, Amsterdam Institute for Infection and Immunology, Amsterdam UMC, location University of Amsterdam, Amsterdam, the Netherlands
| | - Johannes B van Goudoever
- Department of Pediatrics, Emma Children's Hospital, Amsterdam UMC, location University of Amsterdam, Amsterdam, the Netherlands
| | - Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Daniel Munblit
- Care for Long Term Conditions Division, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
- Research and Clinical Center for Neuropsychiatry, Moscow, Russia
| | - Louise Sigfrid
- ISARIC Global Support Centre, Pandemic Science Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Sammie McFarland
- Long COVID Kids and Friends, Fletcher & Partners, Crown Chambers, Bridge Street, Salisbury, SP1 2LZ, UK
| | - Lena Anmyr
- Medical Unit Social Work, Function Allied Health Professionals, Karolinska University Hospital, Stockholm, Sweden
| | - Liat Ashkenazi-Hoffnung
- Department of Day Hospitalization, Schneider Children's Medical Center, Petach Tikva, Tel Aviv, Israel
| | - Ana P N Bellinat
- Pediatric Intensive Care Unit, Hospital Martagão Gesteira - Children's Hospital, Salvador, Brazil
| | - Nathália L S Dias
- Pediatric Intensive Care Unit, Hospital Martagão Gesteira - Children's Hospital, Salvador, Brazil
| | - Amy Edwards
- Department of Infectious Disease, Rainbow Babies and Children's Hospital, Cleveland, OH, USA
| | - Tomini Fashina
- Department of Global Health, Yale University School of Public Health, New Haven, CT, USA
| | - Romana Gjergja Juraški
- Department of Pediatric Neurology, Srebrnjak Children's Hospital, Srebrnjak, Zagreb, Croatia
- Medical School of Osijek, University of Osijek, Osijek, Zagreb, Croatia
| | | | - Edita Hansted
- Department of Pediatrics, Lithuanian University of Health Sciences Hospital KaunoKlinikos, Kaunas, Lithuania
| | - Vivien Herczeg
- Pediatric Center, MTA Center of Excellence, Semmelweis University, Bókay Unit, Budapest, Hungary
| | - Olof Hertting
- Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
| | - Lina N Jankauskaite
- Department of Pediatrics, Lithuanian University of Health Sciences Hospital KaunoKlinikos, Kaunas, Lithuania
| | - Nastiti Kaswandani
- Department of Child Health, Dr. Cipto Mangunkusumo General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Rimantas Kevalas
- Department of Pediatrics, Lithuanian University of Health Sciences Hospital KaunoKlinikos, Kaunas, Lithuania
| | - Péter Krivácsy
- Pediatric Center, MTA Center of Excellence, Semmelweis University, Bókay Unit, Budapest, Hungary
| | - Michael Lorenz
- Pediatric Pulmonology, Department of Paediatrics, Jena University Hospital, Friedrich-Schiller-University, Jena, Germany
| | - Laura A Malone
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Physical Medicine & Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Kennedy Krieger Institute, Baltimore, MD, USA
| | - Molly McVoy
- Department of Pediatric Psychiatry, Rainbow Babies and Children's Hospital, Cleveland, OH, USA
| | - David W Miller
- Department of Pediatric Integrative Medicine, Rainbow Babies and Children's Hospital, Cleveland, OH, USA
| | - Amanda K Morrow
- Department of Physical Medicine & Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Carlos R Oliveira
- Department of Pediatrics, Division of Infectious Diseases & Global Health, Yale University School of Medicine, New Haven, CT, USA
| | | | - Ismael M Osmanov
- ZA Bashlyaeva Children's Municipal Clinical Hospital, Moscow, Russia
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - Isabella M Overmars
- Department of Infection and Immunity, Murdoch Children's Research Institute, Royal Children's Hospital Melbourne, Melbourne, VIC, Australia
| | - Elijah Paintsil
- Department of Pediatrics, Division of Infectious Diseases & Global Health, Yale University School of Medicine, New Haven, CT, USA
| | | | - Yogi Prawira
- Department of Child Health, Dr. Cipto Mangunkusumo General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Nina Dwi Putri
- Department of Child Health, Dr. Cipto Mangunkusumo General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | | | - Marius Rasche
- Pediatric Pulmonology, Department of Paediatrics, Jena University Hospital, Friedrich-Schiller-University, Jena, Germany
| | - Malin Ryd-Rinder
- Pediatric Emergency Care, Astrid Lindgren Children Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Christina De Rose
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Elmira Samitova
- ZA Bashlyaeva Children's Municipal Clinical Hospital, Moscow, Russia
- Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | | | - Daniela Say
- Department of Infection and Immunity, Murdoch Children's Research Institute, Royal Children's Hospital Melbourne, Melbourne, VIC, Australia
| | - Janet T Scott
- Department of Infectious Disease, MRC-University of Glasgow Centre for Virus Research, Glasgow, United Kingdom
| | - Iris Shachar-Lavie
- Department of Psychological Medicine, Schneider Children's Medical Center, Petach Tikva, Israel
| | - Roz Shafran
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Einat Shmueli
- Pulmonary Institute, Schneider Children's Medical Center, Petach Tikva, Tel Aviv, Israel
| | - Ausra Snipaitiene
- Department of Pediatrics, Lithuanian University of Health Sciences Hospital KaunoKlinikos, Kaunas, Lithuania
| | - Terence Stephenson
- UCL Great Ormond Street Institute of Child Health, University College Hospital & Great Ormond Street Hospital, London, UK
| | - Nikolett Ténai
- Pediatric Center, MTA Center of Excellence, Semmelweis University, Bókay Unit, Budapest, Hungary
| | - Shidan Tosif
- Department of General Medicine, Murdoch Children's Research Institute, Royal Children's Hospital Melbourne, Melbourne, Australia
| | - Mirjana Turkalj
- Department of Pulmonology, Allergy and Immunology, Srebrnjak Children's Hospital, Zagreb, Croatia
- Medical School, Catholic University of Croatia, Zagreb, Croatia
| | - Piero Valentini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Luydson R S Vasconcelos
- Hospital Universitário Oswaldo Cruz, Recife, Pernambuco, Brazil
- Aggeu Magalhães Institute, Oswaldo Cruz Foundation, FIOCRUZ-PE, Recife, Brazil
| | - Li Villard
- Medical Unit Occupational Therapy and Physiotherapy, Function Allied Health Professionals, Karolinska University Hospital, Stockholm, Sweden
| | - Daniel Vilser
- Clinic for Pediatric and Adolescent Medicine Neuberg/Ingolstadt AMEOS Hospital Association, Neuberg, Germany
| | - Simone Hashimoto
- Department of Pediatric Pulmonology, Emma Children's Hospital, Amsterdam UMC, location University of Amsterdam, Amsterdam, the Netherlands
- Department of Pulmonary Medicine, Amsterdam Institute for Infection and Immunology, Amsterdam UMC, location University of Amsterdam, Amsterdam, the Netherlands
| | - Suzanne W J Terheggen-Lagro
- Department of Pediatric Pulmonology, Emma Children's Hospital, Amsterdam UMC, location University of Amsterdam, Amsterdam, the Netherlands
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Buonsenso D, Sodero G, Camporesi A, Pierucci UM, Raffaelli F, Proli F, Valentini P, Rendeli C. Predictors of Urinary Abnormalities in Children Hospitalised for Their First Urinary Tract Infection. Children (Basel) 2023; 11:55. [PMID: 38255368 PMCID: PMC10814763 DOI: 10.3390/children11010055] [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] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 12/12/2023] [Accepted: 12/18/2023] [Indexed: 01/24/2024]
Abstract
We aimed to investigate if children with their first UTI and a concomitant positive blood culture have a higher risk of abnormalities. We performed a retrospective study of children younger than 18 years of age with their first UTI. Multivariate logistic regression and receiver operating characteristic (ROC) curves were used to evaluate if positive blood cultures are associated with urinary abnormalities. After the screening process, we considered the enrolled 161 children with UTIs. The median age was three months, and 83 were females (43.2%). In multivariate analysis, age (p = 0.001, 95% CI 1.005-1.020), the presence of Pseudomonas aeruginosa or unusual germs in urine cultures (p = 0.002, 95% CI 2.18-30.36) and the positivity of blood cultures (p = 0.001, 95% CI 2.23-18.98) were significantly associated with urinary abnormalities. A model based on these parameters has an AUC of 0.7168 to predict urinary malformations (p = 0.0315). Conclusions include how greater age, a positive blood culture and the presence of Pseudomonas aeruginosa or unusual germs in urine culture in children hospitalised for their first episode of a UTI are factors associated with a significantly higher risk of urinary abnormalities. These data can guide the implementation of more personalized strategies to screen for urinary abnormalities that may be included in future guidelines.
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Affiliation(s)
- Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (F.P.); (P.V.); (C.R.)
- Centro di Salute Globale, Università Cattolica del Sacro Cuore, 00168 Roma, Italy
| | - Giorgio Sodero
- Institute of Pediatrics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
| | - Anna Camporesi
- Department of Pediatric Anesthesia and Intensive Care, Buzzi Children’s Hospital, 20154 Milan, Italy;
| | - Ugo Maria Pierucci
- Department of Pediatric Surgery, Buzzi Children’s Hospital, 20154 Milan, Italy;
| | - Francesca Raffaelli
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy;
| | - Francesco Proli
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (F.P.); (P.V.); (C.R.)
| | - Piero Valentini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (F.P.); (P.V.); (C.R.)
| | - Claudia Rendeli
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (F.P.); (P.V.); (C.R.)
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Cursi L, Lancella L, Mariani F, Martino L, Leccese B, Di Giuseppe M, Venuti F, Cristina R, Gentile L, Sali M, Delogu G, Valentini P, Buonsenso D. Monocyte-to-lymphocyte, neutrophil-to-lymphocyte and neutrophil-to-monocyte plus lymphocyte ratios in children with active tuberculosis: A multicentre study. Acta Paediatr 2023; 112:2418-2425. [PMID: 37540888 DOI: 10.1111/apa.16932] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 06/13/2023] [Revised: 07/19/2023] [Accepted: 07/20/2023] [Indexed: 08/06/2023]
Abstract
AIM Higher number of monocytes and neutrophils may correlate with active tuberculosis (TB) in children. However, the few paediatric studies available are limited by the small numbers of children with TB disease or infection included. METHODS We calculated the monocyte-to-lymphocyte-ratio (MLR), neutrophil-to-lymphocyte-ratio (NLR) and neutrophil-to-monocyte-plus-lymphocyte-ratio (NMLR) in children with active TB, latent TB infection (LTBI), other infectious and non-infectious conditions and healthy children evaluated in two referral centres in Rome. RESULTS Overall, 649 children were included (41.8% females, mean age of 5.74 years). MLR, NLR and NMLR values were always significantly higher in patients with TB compared with the other groups (p < 0.001). Considering the entire population with the outcome of TB diagnosis, NMLR, with a cut-off of 1.2, had a sensitivity of 63% and a specificity of 76% (AUC: 0.71 [0.64-0.78]); NLR, with a cut-off of 1.5, had a sensitivity of 61% and a specificity of 79% (AUC: 0.72 [0.65-0.79]); MLR, considering a cut-off of 0.2, was less sensitive (56%) but more specific (82%) with a similar AUC (0.72 [0.65-0.79]). CONCLUSION Our study provides further evidence that MLR, NLR and NMLR can serve as first level diagnostics to support the clinical suspicion of TB in children.
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Affiliation(s)
- Laura Cursi
- Infectious Disease Unit, Bambino Gesù Children's Hospital, Hospital University Pediatrics Clinical Area (APUO), IRCCS, Rome, Italy
| | - Laura Lancella
- Infectious Disease Unit, Bambino Gesù Children's Hospital, Hospital University Pediatrics Clinical Area (APUO), IRCCS, Rome, Italy
| | - Francesco Mariani
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Laura Martino
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Bianca Leccese
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Martina Di Giuseppe
- Infectious Disease Unit, Bambino Gesù Children's Hospital, Hospital University Pediatrics Clinical Area (APUO), IRCCS, Rome, Italy
| | - Francesco Venuti
- Infectious Disease Unit, Bambino Gesù Children's Hospital, Hospital University Pediatrics Clinical Area (APUO), IRCCS, Rome, Italy
| | - Russo Cristina
- Virology and Mycobacteria Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Leonarda Gentile
- Virology and Mycobacteria Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Michela Sali
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie-Sezione di Microbiologia, Università Cattolica del Sacro Cuore, Rome, Italy
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario "A. Gemelli", IRCCS, Rome, Italy
| | - Giovanni Delogu
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie-Sezione di Microbiologia, Università Cattolica del Sacro Cuore, Rome, Italy
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario "A. Gemelli", IRCCS, Rome, Italy
| | - Piero Valentini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Centro di Salute Globale, Università Cattolica del Sacro Cuore, Rome, Italy
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Buonsenso D, Camporesi A, Morello R, De Rose C, Fracasso M, Chieffo DPR, Valentini P. Social Stigma in Children with Long COVID. Children (Basel) 2023; 10:1518. [PMID: 37761479 PMCID: PMC10529184 DOI: 10.3390/children10091518] [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] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 09/03/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023]
Abstract
There is growing evidence that adults with Long COVID suffer from different sets of stigmata related to their condition. In children with Long COVID, this aspect has never been investigated. This study aims to investigate if children with Long COVID also experience stigma. METHODS Children with a previous SARS-CoV-2 infection evaluated at 3 month follow-ups in a pediatric post COVID unit were asked to fill in an online Long COVID Stigma Scale survey before they were assessed by a pediatrician. Doctors were unaware of children's responses when they performed a diagnosis of Long COVID or full recovery from previous infection, according to the World Health Organization definition of pediatric Long COVID. Responses to the Stigma scale were then compared in the two cohorts of children. RESULTS 224 patients responded to the questionnaire; 40 patients were diagnosed with Long COVID. Children with Long COVID significantly more frequently felt embarrassed about having Long COVID (p 0.035), felt embarrassed about having physical limitations (p < 0.001), felt they were valued less due to Long COVID (p 0.003), felt they were different from other peers due to Long COVID (p 0.033), felt significantly more frequently that people behaved differently towards them because they might be lying since the diagnosis of Long COVID (p 0.006), that they were less respected by others due to Long COVID (p 0.017), that other people thought that Long COVID is not a real disease (p 0.007), that other people thought that developing Long COVID is a sign of weakness (p 0.008), and that other people might judge them negatively due to their diagnosis of Long COVID (p < 0.001). CONCLUSIONS Children with Long COVID, similar to adults, are suffering from stigmata due to their condition,. These data may have implication and should be used by the public, policy makers, and healthcare professionals regarding pediatric Long COVID.
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Affiliation(s)
- Danilo Buonsenso
- Department of Woman and Child Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (R.M.); (C.D.R.); (P.V.)
- Center for Global Health Research Studies, Università Cattolica del Sacro Cuore, 00168 Roma, Italy
| | - Anna Camporesi
- Pediatric Anesthesia and Intensive Care Unit, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy;
| | - Rosa Morello
- Department of Woman and Child Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (R.M.); (C.D.R.); (P.V.)
| | - Cristina De Rose
- Department of Woman and Child Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (R.M.); (C.D.R.); (P.V.)
| | - Matteo Fracasso
- Medicine and Surgery, Universityà Cattolica del Sacro Cuore, 00168 Roma, Italy;
| | - Daniela Pia Rosaria Chieffo
- Clinical Psychology Unit, Fondazione Policlinico Universitario A Gemelli IRCCS, 00168 Rome, Italy;
- Department of Woman, Children and Public Health, Catholic University of Sacred Heart, 00168 Rome, Italy
| | - Piero Valentini
- Department of Woman and Child Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (R.M.); (C.D.R.); (P.V.)
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9
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Buonsenso D, Poretti G, Mariani F, Colonna AT, Costa S, Giordano L, Priolo F, Conti G, Tizio A, Rodolico D, Amorelli GM, Orazi L, Petrianni M, Ricci D, Lanzone A, Sanguinetti M, Cattani P, Raffaelli F, Sali M, Zampino G, Vento G, Valentini P. Acute and post-acute multidisciplinary outcomes of newborns born from mothers with SARS-CoV-2 infection during pregnancy or the perinatal period. Heliyon 2023; 9:e19206. [PMID: 37662770 PMCID: PMC10474402 DOI: 10.1016/j.heliyon.2023.e19206] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 08/10/2023] [Accepted: 08/16/2023] [Indexed: 09/05/2023] Open
Abstract
INTRODUCTION We performed a single-center, prospective, observational study of newborns born from mothers with microbiologically confirmed SARS-CoV-2 infection in pregnancy or at time of delivery to evaluate acute and mid-term multidisciplinary outcomes. METHODS Infants were offered a multidisciplinary follow-up consisting of nasopharyngeal Polymerase Chain Reaction test at birth and at 48-72 h of life, auxological and ophthalmological assessments, and serologic testing. RESULTS 791 women and their 791 children (52.3% males) were included. Most placentas (94.9%) had abnormal inflammatory findings. 171 (27.3%) and 36 (13.7%) children respectively had pathological TEOAEs in at least one ear and bilaterally, while only four of the 85 children that underwent ABR had pathological findings (4.7%). 64 children underwent fluorescein angiography, which resulted pathological only in 1 case (1.6%). Anti-SARS-CoV-2 IgGs were found in up to 60% of children tested at six months of age. Our findings showed no association between the maternal vaccination status or the presence of maternal symptoms during pregnancy and neonatal outcomes. CONCLUSIONS Our study shows that the large majority of newborns exposed to SARS-CoV-2 infection in utero or during the first hours of life have optimal outcomes. Our previous report of abnormal ophthalmologic findings was not confirmed on a larger cohort, while further studies are needed to better characterize audiological outcomes. Further prospective, case-controlled studies are still needed.
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Affiliation(s)
- Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
- Global Health Research Institute, Istituto di Igiene, Università Cattolica Del Sacro Cuore, Rome, Italy
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Sezione di Microbiologia, Università Cattolica Del Sacro Cuore, Rome, Italy
| | - Giulia Poretti
- Medicine and Surgery, Università Cattolica Del Sacro Cuore, 00168 Rome, Italy
| | - Francesco Mariani
- Pediatric Resident, Università Cattolica Del Sacro Cuore, 00168 Rome, Italy
| | | | - Simonetta Costa
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Lucia Giordano
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Francesca Priolo
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Guido Conti
- Institute of Otorhinolaryngology, Università Cattolica Del Sacro Cuore, Fondazione Policlinico “A Gemelli”, IRCCS, Rome, Italy
| | - Angelo Tizio
- Institute of Otorhinolaryngology, Università Cattolica Del Sacro Cuore, Fondazione Policlinico “A Gemelli”, IRCCS, Rome, Italy
| | - Daniela Rodolico
- Institute of Otorhinolaryngology, Università Cattolica Del Sacro Cuore, Fondazione Policlinico “A Gemelli”, IRCCS, Rome, Italy
| | - Giulia Maria Amorelli
- Department of Ophthalmology, Gemelli Foundation IRCSS, Catholic University of the Sacred Heart, Rome, Italy
- National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of Low Vision Patients, IAPB Italia Onlus- Fondazione Policlinico Agostino Gemelli IRCCS, Rome, Italy
| | - Lorenzo Orazi
- Department of Ophthalmology, Gemelli Foundation IRCSS, Catholic University of the Sacred Heart, Rome, Italy
| | - Maria Petrianni
- Department of Ophthalmology, Gemelli Foundation IRCSS, Catholic University of the Sacred Heart, Rome, Italy
| | - Daniela Ricci
- Department of Ophthalmology, Gemelli Foundation IRCSS, Catholic University of the Sacred Heart, Rome, Italy
| | - Antonio Lanzone
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Maurizio Sanguinetti
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Sezione di Microbiologia, Università Cattolica Del Sacro Cuore, Rome, Italy
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Paola Cattani
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Sezione di Microbiologia, Università Cattolica Del Sacro Cuore, Rome, Italy
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Francesca Raffaelli
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Michela Sali
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Sezione di Microbiologia, Università Cattolica Del Sacro Cuore, Rome, Italy
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Giuseppe Zampino
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Giovanni Vento
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Piero Valentini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
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Buonsenso D, Martino L, Morello R, Mariani F, Fearnley K, Valentini P. Viral persistence in children infected with SARS-CoV-2: current evidence and future research strategies. Lancet Microbe 2023; 4:e745-e756. [PMID: 37385286 PMCID: PMC10292824 DOI: 10.1016/s2666-5247(23)00115-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/30/2023] [Accepted: 04/04/2023] [Indexed: 07/01/2023]
Abstract
In this Personal View, we discuss current knowledge on SARS-CoV-2 RNA or antigen persistence in children infected with SARS-CoV-2. Based on the evidence that the virus can persist in adults, we have done a literature review and analysed studies that looked for SARS-CoV-2 RNA or antigens in children undergoing autopsy, biopsy, or surgery for either death from COVID-19 or multisystem inflammatory syndrome, or assessments for long COVID-19 or other conditions. Our analysis suggests that in children, independent from disease severity, SARS-CoV-2 can spread systemically and persist for weeks to months. We discuss what is known about the biological effects of viral persistence for other viral infections and highlight new scenarios for clinical, pharmacological, and basic research exploration. Such an approach will improve the understanding and management of post-viral syndromes.
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Affiliation(s)
- Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy; Centro di Salute Globale, Università Cattolica del Sacro Cuore, Rome, Italy.
| | - Laura Martino
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Rosa Morello
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Francesco Mariani
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | | | - Piero Valentini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
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11
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Mariani F, Gentili C, Pulcinelli V, Martino L, Valentini P, Buonsenso D. State of the Art of Invasive Group A Streptococcus Infection in Children: A Scoping Review of the Literature with a Focus on Predictors of Invasive Infection. Children (Basel) 2023; 10:1472. [PMID: 37761433 PMCID: PMC10528266 DOI: 10.3390/children10091472] [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] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 08/21/2023] [Accepted: 08/27/2023] [Indexed: 09/29/2023]
Abstract
Currently, it remains unclear why some children develop invasive group A Streptococcus (iGAS) and how to manage this condition. Therefore, to explore available works in the literature, we performed a scoping review aiming to analyze the current literature on clinical presentation of different illnesses outcomes of iGAS, with a specific focus on predictors of invasive infection, including an assessment of the prodromal stages of the disease and the possible presence of previous non-invasive GAS infections in children that later developed iGAS. METHODS We conducted a systematic search on PubMed and SCOPUS of all pediatric studies reporting iGAS cases, following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. For those studies in which multivariable analysis investigating iGAS risk factors was performed, a second review was performed and reported in detail. RESULTS A total of 209 studies were included. Five studies investigated risk factors for iGAS, the most relevant being varicella infection, chronic underlying illness, presence of the speC gene in GAS strains, acetaminophen and ibuprofen use, children nonwhite, living in low-income households, exposure to varicella at home, persistent high fever, having more than one other child in the home, and new use of NSAIDs. Although we observed a progressive increase in the number of papers published on this topic, no trials investigating the benefits of clindamycin or intravenous immunoglobulins were found and low-to-middle-income countries were found to be poorly represented in the current literature. CONCLUSIONS Our scoping review highlights important gaps regarding several aspects of iGAS in children, including prodromic presentation and optimal treatment strategies. There is also little representation of low-middle-income countries. The current literature does not allow the performance of systematic reviews or meta-analyses, but this work should inform healthcare professionals, policy makers, and funding agencies on which studies to prioritize on this topic.
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Affiliation(s)
- Francesco Mariani
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (F.M.); (C.G.); (V.P.); (L.M.); (P.V.)
| | - Carolina Gentili
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (F.M.); (C.G.); (V.P.); (L.M.); (P.V.)
| | - Valentina Pulcinelli
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (F.M.); (C.G.); (V.P.); (L.M.); (P.V.)
| | - Laura Martino
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (F.M.); (C.G.); (V.P.); (L.M.); (P.V.)
| | - Piero Valentini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (F.M.); (C.G.); (V.P.); (L.M.); (P.V.)
| | - Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (F.M.); (C.G.); (V.P.); (L.M.); (P.V.)
- Centro di Salute Globale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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12
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Buonsenso D, Giaimo M, Pata D, Rizzi A, Fiori B, Spanu T, Ruggiero A, Attinà G, Piastra M, Genovese O, Vento G, Costa S, Tiberi E, Sanguinetti M, Valentini P. Retrospective Study on Staphylococcus aureus Resistance Profile and Antibiotic Use in a Pediatric Population. Antibiotics (Basel) 2023; 12:1378. [PMID: 37760675 PMCID: PMC10525873 DOI: 10.3390/antibiotics12091378] [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: 07/05/2023] [Revised: 08/06/2023] [Accepted: 08/25/2023] [Indexed: 09/29/2023] Open
Abstract
The growing phenomenon of antibiotic resistance and the presence of limited data concerning the pediatric area prompted us to focus on Staphylococcus aureus infection in this study, its antibiotic resistance profile, and the therapeutic management of affected children. We conducted a retrospective study by collecting clinical data on infants and children with antibiogram-associated S. aureus infection. We enrolled 1210 patients with a mean age of 0.9 years. We analyzed the resistance patterns and found 61.5% resistance to oxacillin, 58.4% resistance to cephalosporins, 41.6% resistance to aminoglycosides, and 38.3% resistance to fluoroquinolones. Importantly, we found no resistance to glycopeptides, a key antibiotic for MRSA infections whose resistance is increasing worldwide. We also found that the main risk factors associated with antibiotic resistance are being aged between 0 and 28 days, the presence of devices, and comorbidities. Antibiotic resistance is a growing concern; knowing the resistance profiles makes it possible to better target the therapy; however, it is important to use antibiotics according to the principles of antibiotic stewardship to limit their spread.
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Affiliation(s)
- Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (M.G.); (D.P.); (A.R.); (G.A.); (G.V.); (S.C.); (E.T.); (P.V.)
- Global Health Center, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Martina Giaimo
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (M.G.); (D.P.); (A.R.); (G.A.); (G.V.); (S.C.); (E.T.); (P.V.)
| | - Davide Pata
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (M.G.); (D.P.); (A.R.); (G.A.); (G.V.); (S.C.); (E.T.); (P.V.)
| | - Alessia Rizzi
- Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
| | - Barbara Fiori
- Department of Laboratory Sciences and Infectious Disease, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (B.F.); (T.S.); (M.S.)
| | - Teresa Spanu
- Department of Laboratory Sciences and Infectious Disease, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (B.F.); (T.S.); (M.S.)
| | - Antonio Ruggiero
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (M.G.); (D.P.); (A.R.); (G.A.); (G.V.); (S.C.); (E.T.); (P.V.)
| | - Giorgio Attinà
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (M.G.); (D.P.); (A.R.); (G.A.); (G.V.); (S.C.); (E.T.); (P.V.)
| | - Marco Piastra
- Department of Emergency, Anesthesiological and Resuscitation Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (M.P.); (O.G.)
| | - Orazio Genovese
- Department of Emergency, Anesthesiological and Resuscitation Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (M.P.); (O.G.)
| | - Giovanni Vento
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (M.G.); (D.P.); (A.R.); (G.A.); (G.V.); (S.C.); (E.T.); (P.V.)
| | - Simonetta Costa
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (M.G.); (D.P.); (A.R.); (G.A.); (G.V.); (S.C.); (E.T.); (P.V.)
| | - Eloisa Tiberi
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (M.G.); (D.P.); (A.R.); (G.A.); (G.V.); (S.C.); (E.T.); (P.V.)
| | - Maurizio Sanguinetti
- Department of Laboratory Sciences and Infectious Disease, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (B.F.); (T.S.); (M.S.)
| | - Piero Valentini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (M.G.); (D.P.); (A.R.); (G.A.); (G.V.); (S.C.); (E.T.); (P.V.)
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13
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Proli F, Margiotta G, Ferretti S, Drosi A, Valentini P, Buonsenso D, Onesimo R, Giorgio V, Guerriero C, Zampino G, Lazzareschi I. Acrodermatitis enteropathica during parenteral nutrition: a pediatric case report. Acta Biomed 2023; 94:e2023180. [PMID: 37486600 DOI: 10.23750/abm.v94is1.14489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 05/02/2023] [Indexed: 07/25/2023]
Abstract
Background and aim Acrodermatitis enteropathica is a rare disorder characterized by the triad composed by dermatitis, alopecia and diarrhoea. Its acquired form can be caused by inadequate zinc intake, malabsorptive processes, excessive renal or intestinal loss. A rare cause of acquired zinc deficiency is iatrogenic nutritional deficiency due to parenteral nutrition. The diagnosis can be really difficult because the early clinical signs are non-specific and patient's eventual comorbidities can often mask symptoms. Methods: A 5-years-old child affected by several comorbidities, consequent to C. Koseri meningo-encephalitis occurred in the neonatal period, was admitted to Pediatric ward for acute pancreatitis and had been fed via total parenteral nutrition for one month. Symptoms started approximately 15 days after the start of a standardized parenteral nutrition mixture. The child presented with diarrhoea, alopecia and erythematous bullous skin lesions, distributed predominantly in acral and periorificial sites and not responsive to topical treatments. Zinc serum dosage were very low (10 µg/dL, with normal values 68-107 µg/dL). Clinical improvement was very fast after oral zinc supplementation (5mg/daily), with a rapid regularisation in the intestinal habits and re-epithelialization of the skin lesions. Results and Conclusions: Trace elements are an essential component of parenteral nutrition. The supplementation of trace elements is an important part of the parenteral nutrition prescription. Even few days of zinc shortage, especially in frail patients, may cause a severe dermatitis that can be easily prevented. Despite its rarity, acrodermatitis enteropathica should be strongly considered in the differential diagnosis of skin lesions for these patients.
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Affiliation(s)
| | - Gaia Margiotta
- a:1:{s:5:"en_US";s:135:"Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy.";}.
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Pata D, Buonsenso D, Turriziani-Colonna A, Salerno G, Scarlato L, Colussi L, Ulloa-Gutierrez R, Valentini P. Role of Valganciclovir in Children with Congenital CMV Infection: A Review of the Literature. Children (Basel) 2023; 10:1246. [PMID: 37508743 PMCID: PMC10378502 DOI: 10.3390/children10071246] [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] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 07/15/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND Cytomegalovirus (CMV) is the most common agent of congenital infection in humans. It is a main cause of neurodevelopmental delay and sensorineural hearing loss in infancy. Since the 2000s, a number of studies have used Valganciclovir as a therapy for children with congenital CMV infection. METHODS In order to evaluate the efficacy of Valganciclovir in preventing clinical sequelae and its possible side effects, we performed a review of the published literature. This search was completed via PubMed for manuscripts published from January 2007 to December 2021, combining the MeSH words "Valganciclovir", "Congenital", and "Cytomegalovirus". RESULTS A total of 27 articles were included (12 retrospective studies, 4 prospective studies, 1 randomized controlled trial, and 10 case reports). The clinical features were similar to those already described in the literature. The therapeutic protocols used were very different between the various studies included and neonatal antiviral treatments were only moderately effective. The therapy proved to be well-tolerated. CONCLUSIONS The quality of the included studies and the sample size were limited due to the rarity of the disease. The use of different therapeutic protocols in terms of starting dates, doses, and durations made it impossible to compare and correctly evaluate the efficacy of the treatments. Randomized controlled trials are needed to establish the correct effective dose with the fewest side effects and the most efficient duration of therapy.
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Affiliation(s)
- Davide Pata
- Global Health Research Institute, Istituto di Igiene, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Danilo Buonsenso
- Global Health Research Institute, Istituto di Igiene, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli, 00168 Rome, Italy
| | - Arianna Turriziani-Colonna
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli, 00168 Rome, Italy
| | - Gilda Salerno
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli, 00168 Rome, Italy
| | - Lucia Scarlato
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli, 00168 Rome, Italy
| | - Lara Colussi
- Medicine and Surgery, Università Cattolica del Sacro Cuore, 20123 Rome, Italy
| | - Rolando Ulloa-Gutierrez
- Servicio de Infectologia Pediatrica, Hospital Nacional de Niños "Dr. Carlos Sáenz Herrera", Centro de Ciencias Médicas, Caja Costarricense de Seguro Social (CCSS), San José P.O. Box 1654-1000, Costa Rica
- Instituto de Investigación en Ciencias Médicas UCIMED (IICIMED), San José 10108, Costa Rica
- Cátedra de Pediatría, Facultad de Medicina, Universidad de Ciencias Médicas (UCIMED), San José 10108, Costa Rica
| | - Piero Valentini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli, 00168 Rome, Italy
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Camporesi A, Morello R, Pierucci UM, Proli F, Lazzareschi I, Bersani G, Valentini P, Roland D, Buonsenso D. 2021/22 and 2022/23 Post-Pandemic Bronchiolitis Seasons in Two Major Italian Cities: A Prospective Study. Children (Basel) 2023; 10:1081. [PMID: 37371312 DOI: 10.3390/children10061081] [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] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 06/14/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023]
Abstract
Objectives: Bronchiolitis remains a major cause of morbidity and mortality in children under 24 months. During the first year of the pandemic, non-pharmacological interventions resulted in a significant reduction of bronchiolitis cases. Early in 2021, a rebound of bronchiolitis was reported with a description of out-of-season outbreaks. In this study, we prospectively evaluated the impact of bronchiolitis in two Italian University centers located in different geographical areas, aiming to compare two post-pandemic bronchiolitis seasons (2021/22 and 2022/23) in terms of severity, outcomes, microbiology and temporal distribution. Methods: This was a bicentric prospective observational cohort study. All consecutive children under 24 months of age assessed in the participating institutions during the specified seasons and receiving a clinical diagnosis of bronchiolitis were included. Results: A total of 900 patients were enrolled. Patients in the second season were globally younger and had comorbidities less often. Temporal distribution changed between the two seasons. Of the patients, 56% were tested for RSV; 60% of these was positive. Patients with RSV were globally younger (3.5 months vs. 4.9, p < 0.001), more often had a need for any kind of respiratory and fluid support and more often needed ward or PICU admission. At the end of the ED visit, 430 patients were discharged home, 372 (41.3%) were admitted to an inpatient ward and 46 (5.1%) to a pediatric intensive care unit. Conclusions: The 2022/23 post-COVID bronchiolitis was mostly similar to that of 2021/22, and was in line with pre-pandemic expectations.
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Affiliation(s)
- Anna Camporesi
- Department of Pediatric Anesthesia and Intensive Care, Children's Hospital "Vittore Buzzi", Via Ludovico Castelvetro 32, 20154 Milano, Italy
| | - Rosa Morello
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Ugo Maria Pierucci
- Department of Pediatric Surgery, Children's Hospital "Vittore Buzzi", 20154 Milano, Italy
| | - Francesco Proli
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Ilaria Lazzareschi
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Giulia Bersani
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Piero Valentini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Damian Roland
- Paediatric Emergency Medicine Leicester Academic (PEMLA) Group, Leicester Hospital, Leicester LE1 5WW, UK
- Social Science APPlied to Healthcare Improvement Research, SAPPHIRE Group, Health Sciences, Leicester University, Leicester LE1 7RH, UK
| | - Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Center for Global Health Research Studies, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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Cocciolillo F, Chieffo DPR, Giordano A, Arcangeli V, Lazzareschi I, Morello R, Zampino G, Valentini P, Buonsenso D. Case report: Post-COVID new-onset neurocognitive decline with bilateral mesial-temporal hypometabolism in two previously healthy sisters. Front Pediatr 2023; 11:1165072. [PMID: 37303754 PMCID: PMC10251436 DOI: 10.3389/fped.2023.1165072] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 04/17/2023] [Indexed: 06/13/2023] Open
Abstract
Background Long coronavirus disease (COVID) is increasingly recognized in adults and children; however, it is still poorly characterized from a clinical and diagnostic perspective, particularly in the younger populations. Case presentation We described the story of two sisters-with high social and academic performance before their severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection-who reported severe neurocognitive problems, initially classified as psychologic pandemic distress and eventually found to have significant brain hypometabolism. Conclusions We provided a detailed clinical presentation of neurocognitive symptoms in two sisters with long COVID associated with brain hypometabolism documented in both sisters. We believe that the evidence of objective findings in these children further supports the hypothesis that organic events cause persisting symptoms in a cohort of children after SARS-CoV-2 infection. Such findings highlight the importance of discovering diagnostics and therapeutics.
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Affiliation(s)
- Fabrizio Cocciolillo
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, UOC di Medicina Nucleare, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Daniela Pia Rosaria Chieffo
- Clinical Psychology Unit, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
- Department of Woman, Children and Public Health, Catholic University of Sacred Heart, Rome, Italy
| | - Alessandro Giordano
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, UOC di Medicina Nucleare, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Sezione di Medicina Nucleare, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Valentina Arcangeli
- Clinical Psychology Unit, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Ilaria Lazzareschi
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Rosa Morello
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giuseppe Zampino
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Piero Valentini
- Sezione di Medicina Nucleare, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Centro di Salute Globale, Università Cattolica del Sacro Cuore, Roma, Italy
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Buonsenso D, Valentini P, Mariani F, Di Noi S, Mazza S, Palucci I, Sanguinetti M, Sali M. Comparison between Nasopharyngeal and Saliva Samples for the Detection of Respiratory Viruses in Children with Acute Lower Respiratory Tract Infections: A Pilot Study. Children (Basel) 2023; 10:children10050899. [PMID: 37238447 DOI: 10.3390/children10050899] [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] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 05/15/2023] [Accepted: 05/17/2023] [Indexed: 05/28/2023]
Abstract
PURPOSE During the COVID-19 pandemic, the use of salivary swabs (SS) to detect the SARS-CoV-2 virus has been implemented and widely studied in adults and children. However, the role of SS in detecting other common respiratory viruses in children is poorly investigated. METHODS Children younger than 18 years of age admitted with respiratory signs and symptoms underwent both nasopharyngeal and SS procedures. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of SS were calculated, considering the nasopharyngeal swab result as the gold standard. RESULTS A total of 83 patients (44 females, 53%) underwent both nasopharyngeal and SS procedures. Overall, the sensitivity of SS was 49.4%. Sensitivity according to different respiratory viruses ranged from 0% to 71.43%, while the specificity ranged from 96% to 100%. Negative predictive value ranged from 68.06% to 98.8%, while positive predictive value ranged from 0 to 100%. SS sensitivity in patients younger than 12 months of age was 39.47%, while in patients older than or equal to 12 months of age it was 57.78%. Patients with negative SS had a significantly lower median age (8.5 months (15.25) vs. 23 months (34), p = 0.001) and a significantly lower quantity of median saliva collected for salivary analysis (0 μL (213) vs. 300 μL (100), p < 0.001). CONCLUSIONS SS has a relatively low sensitivity in detecting common respiratory viruses in children with LRTI, with a lower probability in younger children (and in particular those younger than 6 months of age) or those from whom we have collected lesser amounts of saliva. New strategies to improve saliva collection are needed for testing on a larger study population.
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Affiliation(s)
- Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, 00168 Rome, Italy
- Global Health Research Institute, Istituto di Igiene, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Piero Valentini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, 00168 Rome, Italy
| | - Francesco Mariani
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, 00168 Rome, Italy
| | - Silvia Di Noi
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, 00168 Rome, Italy
| | - Sofia Mazza
- Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Ivana Palucci
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Sezione di Microbiologia, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A Gemelli IRCCS, 00168 Rome, Italy
| | - Maurizio Sanguinetti
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Sezione di Microbiologia, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A Gemelli IRCCS, 00168 Rome, Italy
| | - Michela Sali
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Sezione di Microbiologia, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A Gemelli IRCCS, 00168 Rome, Italy
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Buonsenso D, Morello R, Mariani F, De Rose C, Cortese R, Vetrugno L, Valentini P. Role of Lung Ultrasound in the Follow-Up of Children with Previous SARS-CoV-2 Infection: A Case-Control Assessment of Children with Long COVID or Fully Recovered. J Clin Med 2023; 12:jcm12093342. [PMID: 37176782 PMCID: PMC10179159 DOI: 10.3390/jcm12093342] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 04/28/2023] [Accepted: 05/04/2023] [Indexed: 05/15/2023] Open
Abstract
Lung ultrasound (LUS) can detect lower respiratory tract involvement in children with acute SARS-CoV-2 infection. However, its role in follow-up assessments is still unclear. To describe LUS findings in children after SARS-CoV-2 infection, we conducted a prospective study in a population of pediatric patients referred to the post-COVID unit in a tertiary center during the study period from February 2021 to May 2022. Children were classified as recovered from acute infection or with persisting symptoms. LUS was performed in all children and a LUS score (ranging from 0 to 36 points) was calculated according to the Italian Academy of Thoracic Ultrasound. Six hundred forty-seven children (304 females, 47%) were enrolled. The median follow-up evaluation was two months. The median age was 7.9 (IQR: 6) years. At the follow-up evaluation, 251 patients (38.8%) had persistent symptoms, of whom 104 (16.1%) had at least one respiratory symptom. The median LUS level was 2 (IQR: 4). LUS findings and LUS scores did not differ in children with Long COVID compared to the group of children fully recovered from the initial infection. In conclusion, after SARS-CoV-2 infection, LUS was mostly normal or showed minimal artifacts in all groups of children.
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Affiliation(s)
- Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy
- Global Health Center, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Rosa Morello
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy
| | - Francesco Mariani
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy
| | - Cristina De Rose
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy
| | - Rossella Cortese
- School of Medicine, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Luigi Vetrugno
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, 66100 Chieti, Italy
| | - Piero Valentini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy
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Morello R, Mariani F, Mastrantoni L, De Rose C, Zampino G, Munblit D, Sigfrid L, Valentini P, Buonsenso D. Risk factors for post-COVID-19 condition (Long Covid) in children: a prospective cohort study. EClinicalMedicine 2023; 59:101961. [PMID: 37073325 PMCID: PMC10101848 DOI: 10.1016/j.eclinm.2023.101961] [Citation(s) in RCA: 30] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/22/2023] [Accepted: 03/23/2023] [Indexed: 04/20/2023] Open
Abstract
Background Adults and children can develop post-Covid-19 condition (PCC) (also referred to as Long Covid). However, existing evidence is scarce, partly due to a lack of a standardised case definition, short follow up duration, and heterogenous study designs, resulting in wide variation of reported outcomes. The primary aim of this study was to characterise risk factors for PCC and longitudinal rates of recovery in a cohort of children and young people using a standardised protocol. Methods We performed a prospective "disease-based" cohort study between 01/02/2020 to 31/10/2022 including children aged 0-18 years old, with a previous diagnosis of Covid-19. Children with microbiologically confirmed SARS-CoV-2 infection, were invited for an in-clinic follow-up assessment at a paediatric post-covid clinic in Rome, Italy, at serial intervals (3-, 6-, 12- and 18-months post-onset). PCC was defined as persistence of otherwise unexplained symptoms for at least three months after initial infection. The statistical association between categorical variables was obtained by Chi-squared tests or Fisher's exact tests. Multivariable logistic regressions are presented using odds ratios (OR) and 95% confidence interval (CI). Survival analysis was conducted using the Kaplan-Meier method. Findings 1243 children were included, median age: 7.5 (4-10.3) years old; 575 (46.3%) were females. Of these, 23% (294/1243) were diagnosed with PCC at three months post-onset. Among the study population, 143 patients remained symptomatic at six months, 38 at 12 months, and 15 at 18 months follow up evaluation. The following risk factors were associated with PCC: >10 years of age (OR 1.23; 95% CI 1.18-1.28), comorbidities (OR 1.68; 95% CI 1.14-2.50), and hospitalisation during the acute phase (OR 4.80; 95%CI 1.91-12.1). Using multivariable logistic regression, compared to the Omicron variant, all other variants were significantly associated with PCC at 3 and 6 months. At least one dose of vaccine was associated with a reduced, but not statistically significant risk of developing PCC. Interpretation In our study, acute-phase hospitalisation, pre-existing comorbidity, being infected with pre-Omicron variants and older age were associated with a higher risk of developing PCC. Most children recovered over time, but one-in-twenty of those with PCC at three months reported persistent symptoms 18 months post-Sars-CoV-2 infection. Omicron infection was associated with shorter recovery times. We did not find a strong protective effect of vaccination on PCC development. Although our cohort cannot be translated to all Italian children with PCC as more nationwide studies are needed, our findings highlight the need of new strategies to prevent and treat pediatric PCC are needed. Funding This study has been funded by Pfizer non-competitive grant, granted to DB (# 65925795).
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Affiliation(s)
- Rosa Morello
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Francesco Mariani
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Luca Mastrantoni
- Medical Oncology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Cristina De Rose
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giuseppe Zampino
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Daniel Munblit
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, I.M. Sechenov First Moscow State Medical University, Sechenov University, Moscow, Russia
- Care for Long Term Conditions Division, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, United Kingdom
| | - Louise Sigfrid
- ISARIC Global Support Centre, GloPID-R Research and Policy Team, Pandemic Sciences Institute, University of Oxford, Oxford, UK
| | - Piero Valentini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Centro di Salute Globale, Università Cattolica del Sacro Cuore, Roma, Italy
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Pizzuto DA, Buonsenso D, Morello R, De Rose C, Valentini P, Fragano A, Baldi F, Di Giuda D. Lung perfusion assessment in children with long-COVID: A pilot study. Pediatr Pulmonol 2023. [PMID: 37097045 DOI: 10.1002/ppul.26432] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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: 12/01/2022] [Revised: 04/09/2023] [Accepted: 04/16/2023] [Indexed: 04/26/2023]
Abstract
BACKGROUND There is increasing evidence that chronic endotheliopathy can play a role in patients with Post-Covid Condition (PCC, or Long Covid) by affecting peripheral vascularization. This pilot study aimed at assessing lung perfusion in children with Long-COVID with 99m Tc-MAA SPECT/CT. MATERIALS AND METHODS lung 99m Tc-MAA SPECT/CT was performed in children with Long-COVID and a pathological cardiopulmonary exercise testing (CPET). Intravenous injections were performed on patients in the supine position immediately before the planar scan according to the EANM guidelines for lung scintigraphy in children, followed by lung SPECT/CT acquisition. Reconstructed studies were visually analyzed. RESULTS Clinical and biochemical data were collected during acute infection and follow-up in 14 children (6 females, mean age: 12.6 years) fulfilling Long-COVID diagnostic criteria and complaining of chronic fatigue and postexertional malaise after mild efforts, documented by CPET. Imaging results were compared with clinical scenarios during acute infection and follow-up. Six out of 14 (42.8%) children showed perfusion defects on 99m Tc-MAA SPECT/CT scan, without morphological alterations on coregistered CT. CONCLUSIONS This pilot investigation confirmed previous data suggesting that a small subgroup of children can develop lung perfusion defects after severe acute respiratory syndrome coronavirus 2 infection. Larger cohort studies are needed to confirm these preliminary results, providing also a better understanding of which children may deserve this test and how to manage those with lung perfusion defects.
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Affiliation(s)
- Daniele Antonio Pizzuto
- Department of Radiology, Radiotherapy and Hematology, Nuclear Medicine Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
- GlobalHealth Research Institute, Istituto di Igiene, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Rosa Morello
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Cristina De Rose
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Piero Valentini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - A Fragano
- Department of Radiology, Radiotherapy and Hematology, Nuclear Medicine Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Fabiana Baldi
- Division of Respiratory Medicine, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Daniela Di Giuda
- Department of Radiology, Radiotherapy and Hematology, Nuclear Medicine Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
- University Department of Radiological Sciences and Hematology, Section of Nuclear Medicine, Uniiversità Cattolica del Sacro Cuore, Rome, Italy
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Mariani F, Morello R, Traini DO, La Rocca A, De Rose C, Valentini P, Buonsenso D. Risk Factors for Persistent Anosmia and Dysgeusia in Children with SARS-CoV-2 Infection: A Retrospective Study. Children (Basel) 2023; 10:children10030597. [PMID: 36980155 PMCID: PMC10047825 DOI: 10.3390/children10030597] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 03/05/2023] [Accepted: 03/20/2023] [Indexed: 03/30/2023]
Abstract
BACKGROUND Olfactory and gustative dysfunctions are two of the most common post-acute sequelae of SARS-CoV-2 infection in children, which can have a negative impact on the routines of children and families. As several children have had COVID-19 since the Omicron variant, it is important to investigate if this increase in infections is reflected in higher olfactory/taste disfunctions. The primary aim of this study was to characterize the presence of olfactory/gustative problems in a cohort of children, its evolution, and its association with risk factors such as COVID-19 variant, hospitalization, presence of olfactory/gustative dysfunction during the acute phase, and vaccination. METHODS This was a retrospective analysis of children with microbiologically confirmed SARS-CoV-2 infection evaluated in person at a referral pediatric post-COVID-19 clinic in Rome, Italy. We included children younger than 19 years old, evaluated from the beginning of the pandemic up to October 2022. At specific timepoints, we investigated the presence of olfactory/taste disfunctions and evaluated them according to the SARS-CoV-2 variants circulating at the time of infection. RESULTS A total of 1250 children (650 females; 52.0%) with a mean age of 6.77 (±4.12) years were included in the study. At 3, 6, 12, and 18 months, 12 (9.6%), 7 (5.6%), 2 (1.6%), and 1 (0.8%) of the children reported anosmia and dysgeusia post-COVID-19 infection, respectively. The presence of anosmia and dysgeusia during the acute phase of infection and being infected with a pre-Omicron variant were found to be significant risk factors for persistent olfactory and gustatory dysfunction during all follow-up periods. CONCLUSIONS anosmia and dysgeusia symptoms tended to decrease gradually over time, but not all children recovered quickly.
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Affiliation(s)
- Francesco Mariani
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Rosa Morello
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | | | - Anna La Rocca
- Medicine and Surgery, Catholic University of Rome, 00168 Rome, Italy
| | - Cristina De Rose
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Piero Valentini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Centro di Salute Globale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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Buonsenso D, Morello R, Mariani F, De Rose C, Mastrantoni L, Zampino G, Valentini P. Risk of Long Covid in children infected with Omicron or pre-Omicron SARS-CoV-2 variants. Acta Paediatr 2023; 112:1284-1286. [PMID: 36938946 DOI: 10.1111/apa.16764] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 02/28/2023] [Accepted: 03/17/2023] [Indexed: 03/21/2023]
Affiliation(s)
- Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Centro di Salute Globale, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Rosa Morello
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Francesco Mariani
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Cristina De Rose
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Luca Mastrantoni
- Medical Oncology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giuseppe Zampino
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Piero Valentini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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Buonsenso D, Mariani F, Morello R, Cammarota G, De Rose C, Valentini P, Camporesi A, Vetrugno L. Ultrasound Imaging for Diaphragm Function in a Population of Healthy Infants: A Short Observational Report. Diagnostics (Basel) 2023; 13:diagnostics13061095. [PMID: 36980403 PMCID: PMC10047558 DOI: 10.3390/diagnostics13061095] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 03/07/2023] [Accepted: 03/10/2023] [Indexed: 03/16/2023] Open
Abstract
Introduction: Diaphragm ultrasound is increasingly used in adults, and more recently in pediatric practice. However, normal diaphragm parameters in healthy infants are unknown. This was a prospective observational pilot study aiming to define the normal diaphragm ultrasound characteristics in healthy infants during the first 6 months of life. Methods: We recruited healthy neonates at 7 to 15 days of life, who were followed until the sixth month of life, undergoing five assessments in different time points. The measurements included diaphragm thickness at end expiration (TEE) and at end inspiration (TEI). The thickening fraction (TF) was calculated as (TEI-TEE)/TEE and expressed as a percentage, and as (TEI-TEE)/TEI. Results: A total of 37 toddlers, 16 of which were females (43.2%), were enrolled. Thirty-four children (91.9%) were of Caucasian ethnicity and the median gestational age was 38.4 (35.7–40) weeks. Normal TEE, TEI, and TF have been provided for each time point. Conclusion: We provided new insight regarding data about thickness and thickening function in healthy children to be used for future physiologic and pathologic pediatric studies.
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Affiliation(s)
- Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
- Centro di Salute Globale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Correspondence: ; Tel.: +39-0630154390
| | - Francesco Mariani
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Rosa Morello
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Gianmaria Cammarota
- Department of Anaesthesia and Intensive Care Medicine, University of Perugia, 06100 Perugia, Italy
| | - Cristina De Rose
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Piero Valentini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Anna Camporesi
- Department of Pediatric Anesthesia and Intensive Care, Children’s Hospital “Vittore Buzzi”, 20154 Milan, Italy
| | - Luigi Vetrugno
- Department of Anesthesia, “SS Annunziata” Hospital, Via dei Vestini, 66100 Chieti, Italy
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, 66100 Chieti, Italy
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Buonsenso D, Delogu G, del Carmen Pereyra Boza M, De Maio F, Palucci I, Martino L, Pata D, Sanguinetti M, Valentini P, Sali M. Commercially available CD4 + and CD8 + IFN-γ release assays combined with an HBHA-induced IGRA improve the characterization of the tuberculosis spectrum and monitoring of treatment in children. Eur J Pediatr 2023; 182:2155-2167. [PMID: 36847873 PMCID: PMC9969014 DOI: 10.1007/s00431-023-04844-1] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 10/25/2022] [Accepted: 01/23/2023] [Indexed: 03/01/2023]
Abstract
Commercially available Interferon-γ release assays (IGRAs), including the last-generation QuantiFERON TB-Plus (QFT-Plus), are effective in aiding the diagnosis of tuberculosis (TB) infection but cannot distinguish latent TB subjects from active TB patients. The aim of this study was to prospectively evaluate the performance of an HBHA-based IGRA, combined with commercially available IGRAs, to assess their usefulness as a prognostic biomarkers and aid in the monitoring of TB treatment in children. Following clinical, microbiological, and radiological assessment, children younger than 18 years of age classified as either LTBI or active TB were tested at baseline and during treatment by the QuantiFERON TB-Plus (QFT) assay and an aliquot of whole-blood was stimulated with HBHA. Among the 655 children evaluated, 559 (85.3%) were classified as "Non TB", 44 patients (6.7%) with active TB, and 52 (7.9%) with LTBI. The median HBHA-IGRA IFN-gamma responses were able to discriminate active TB from LTBI (0.13 IU/ml vs 1.995, (p < 0,0001), those with asymptomatic TB from those with symptomatic TB (1.01 IU/ml vs 0.115 IU/ml, p 0.017), or more severe TB (p 0.022), and significantly raised during successful TB treatment (p < 0.0001). Conversely, CD4 + and CD8 + responses were similar in all groups of patients, although active TB patients had higher CD4 + responses and LTBI higher CD8 + responses. Conclusion: HBHA-based IGRA, combined with CD4 + and CD8 + responses assessed by commercially available IGRAs, is a useful support in the characterization of the TB spectrum in children and monitoring of TB-therapy. What is Known: • Current immune diagnostics are not able to discriminate active and latent Ttuberculosis, including the recently approved QFT-PLUS.. • New immunological assays with prognostic value are highly needed. What is New: • HBHA-based IGRA, combined with CD4+ and CD8+ responses assessed by commercially available IGRAs, is a useful support for the differentiation of active and latent TB in children.. • HBHA-based IGRA, combined with CD4+ and CD8+ responses assessed by commercially available IGRAs, is a useful support in the monitoring of TBtherapy in children..
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Affiliation(s)
- Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
- Global Health Research Institute, Istituto di Igiene, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giovanni Delogu
- Dipartimento di Scienze di Laboratorio e infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Dipartimento di Scienze biotecnologiche di base, cliniche intensivologiche e perioperatorie – Sezione di Microbiologia, Università Cattolica del S. Cuore, Milan, Italy
| | - Maria del Carmen Pereyra Boza
- Dipartimento di Scienze di Laboratorio e infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Flavio De Maio
- Dipartimento di Scienze di Laboratorio e infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Ivana Palucci
- Dipartimento di Scienze di Laboratorio e infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Dipartimento di Scienze biotecnologiche di base, cliniche intensivologiche e perioperatorie – Sezione di Microbiologia, Università Cattolica del S. Cuore, Milan, Italy
| | - Laura Martino
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Davide Pata
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Maurizio Sanguinetti
- Dipartimento di Scienze di Laboratorio e infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Dipartimento di Scienze biotecnologiche di base, cliniche intensivologiche e perioperatorie – Sezione di Microbiologia, Università Cattolica del S. Cuore, Milan, Italy
| | - Piero Valentini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
- Global Health Research Institute, Istituto di Igiene, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Michela Sali
- Dipartimento di Scienze di Laboratorio e infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Dipartimento di Scienze biotecnologiche di base, cliniche intensivologiche e perioperatorie – Sezione di Microbiologia, Università Cattolica del S. Cuore, Milan, Italy
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Benfield T, Rämet M, Valentini P, Seppä I, Dagan R, Richmond P, Mercer S, Churchill C, Lupinacci R, McFetridge R, Park J, Wittke F, Banniettis N, Musey L, Bickham K, Kaminski J. Safety, tolerability, and immunogenicity of V114 pneumococcal vaccine compared with PCV13 in a 2+1 regimen in healthy infants: A phase III study (PNEU-PED-EU-2). Vaccine 2023; 41:2456-2465. [PMID: 36841723 DOI: 10.1016/j.vaccine.2023.02.041] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 11/08/2022] [Revised: 02/10/2023] [Accepted: 02/13/2023] [Indexed: 02/26/2023]
Abstract
BACKGROUND This phase III study evaluated safety, tolerability, and immunogenicity of V114 (15-valent pneumococcal conjugate vaccine) in healthy infants. V114 contains all 13 serotypes in PCV13 and additional serotypes 22F and 33F. METHODS Healthy infants were randomized to two primary doses and one toddler dose (2+1 regimen) of V114 or PCV13 at 3, 5, and 12 months of age; diphtheria, tetanus, pertussis (DTaP), inactivated poliovirus (IPV), Haemophilus influenzae type b (Hib), hepatitis B (HepB) vaccine was administered concomitantly. Adverse events (AEs) were collected on Days 1-14 following each vaccination. Serotype-specific anti-pneumococcal immunoglobulin G (IgG) was measured 30 days post-primary series, immediately prior to toddler dose, and 30 days post-toddler dose. Primary objectives included non-inferiority of V114 to PCV13 for 13 shared serotypes and superiority of V114 to PCV13 for serotypes 22F and 33F. RESULTS 1191 healthy infants were randomized to V114 (n = 595) or PCV13 (n = 596). Proportions of participants with solicited AEs and serious AEs were comparable between groups. V114 met non-inferiority criteria for 13 shared serotypes, based on difference in proportions with serotype-specific IgG ≥0.35 μg/mL (lower bound of two-sided 95% confidence interval [CI] >-10.0) and IgG geometric mean concentration (GMC) ratios (lower bound of two-sided 95% CI >0.5) at 30 days post-toddler dose. V114 met superiority criteria for serotypes 22F and 33F, based on response rates (lower bound of two-sided 95% CI >10.0) and IgG GMC ratios (lower bound of two-sided 95% CI >2.0) at 30 days post-toddler dose. Antibody responses to DTaP-IPV-Hib-HepB met non-inferiority criteria, based on antigen-specific response rates. CONCLUSION A two-dose primary series plus toddler dose of V114 was well-tolerated in healthy infants. Compared with PCV13, V114 provided non-inferior immune responses to 13 shared serotypes and superior immune responses to additional serotypes 22F and 33F.
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Affiliation(s)
- Thomas Benfield
- Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark
| | - Mika Rämet
- Faculty of Medicine and Health Technology, Tampere University, and FVR - Finnish Vaccine Research, Tampere, Finland
| | - Piero Valentini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Ilkka Seppä
- Vaccine Research Center, Tampere University, Tampere, Finland
| | - Ron Dagan
- The Shraga Segal Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences of the Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Peter Richmond
- School of Medicine, University of Western Australia, Perth, Australia
| | | | | | | | | | - Jun Park
- Merck & Co., Inc., Rahway, NJ, USA
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26
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Sodero G, Mariani F, Proli F, Lazzareschi I, Bersani G, Delogu AB, De Rosa G, Zampino G, Valentini P, Buonsenso D. Admissions for acute cardiac inflammatory events or chest pain before and after the severe acute respiratory syndrome coronavirus 2 was in circulation. Acta Paediatr 2023; 112:1038-1040. [PMID: 36795000 DOI: 10.1111/apa.16712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/23/2023] [Accepted: 02/14/2023] [Indexed: 02/17/2023]
Affiliation(s)
- Giorgio Sodero
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Francesco Mariani
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Francesco Proli
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Ilaria Lazzareschi
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giulia Bersani
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Angelica Bibiana Delogu
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Gabriella De Rosa
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giuseppe Zampino
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Piero Valentini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Centro di Salute Globale, Università Cattolica del Sacro Cuore, Rome, Italy
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27
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Morello R, Bocchi B, Mariani F, Bononi A, Giuli C, Bonfiglio N, Valentini P, Lazzareschi I, Rendeli C, Palmacci O, Buonsenso D. Assessment for late developmental hip dysplasia in a cohort of infants with risk factors and normal hip ultrasound. Front Pediatr 2023; 11:1140349. [PMID: 37025287 PMCID: PMC10070681 DOI: 10.3389/fped.2023.1140349] [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: 01/08/2023] [Accepted: 02/21/2023] [Indexed: 04/08/2023] Open
Abstract
Background Developmental dysplasia of the hip (DDH) is a known orthopedic pathology of newborns that, if not diagnosed and treated, can lead to debilitating long-term consequences. Ultrasound has proven to be an effective method for the early diagnosis of this condition. Recently, reports of late DDH in populations at risk (breech presentation) and after negative ultrasound examination have emerged in the literature. Aim The objective of the study was to assess the possible appearance of late DDH in Italian children with risk factors but negative ultrasound screening. Materials and methods We selected patients with risk factors for DDH and a negative hip ultrasound from the medical records of children referred to the Hip Ultrasound Clinic (Rome, Italy) from January 2018 to November 2021. To identify possible cases of late DDH, from February 2022 to July 2022, all patients who met the inclusion criteria were submitted to orthopedic follow-up clinical evaluation. In the case of a pathological objective examination, radiography was performed. Results Fifty-five patients (52.7% female, 52.7% with breech presentation, and 41.8% with a positive family history) met the inclusion criteria. The median age of gait onset was 13 months. The median age of orthopedic follow-up examination was 45 months. Only three patients (5.5%) had a pathological examination, but no x-ray were pathological. Conclusion Our study has not documented cases of late DDH. Considering the small study population and the only clinical follow-up, further studies are needed to clarify the possible late development of this condition.
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Affiliation(s)
- Rosa Morello
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Beatrice Bocchi
- Department of Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Department of Orthopedics, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Francesco Mariani
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Alice Bononi
- Department of Woman and Child Health and Public Health, Medical School, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Cristina Giuli
- Department of Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Department of Orthopedics, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Nadia Bonfiglio
- Department of Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Department of Orthopedics, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Piero Valentini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Ilaria Lazzareschi
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Claudia Rendeli
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Osvaldo Palmacci
- Department of Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Centro di Salute Globale, Università Cattolica del Sacro Cuore, Roma, Italy
- Correspondence: Danilo Buonsenso
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Di Gennaro L, Valentini P, Sorrentino S, Ferretti MA, De Candia E, Basso M, Lancellotti S, De Cristofaro R, De Rose C, Mariani F, Morello R, Lazzareschi I, Sigfrid L, Munblit D, Buonsenso D. Extended coagulation profile of children with Long Covid: a prospective study. Sci Rep 2022; 12:18392. [PMID: 36319840 PMCID: PMC9626616 DOI: 10.1038/s41598-022-23168-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 10/26/2022] [Indexed: 11/18/2022] Open
Abstract
Emerging data suggests that endotheliopathy changes can be associated with post covid condition (PCC) in adults. Research on the matter in children is lacking. We analyzed an extended coagulation profile including biomarkers of endothelial damage in children with PCC and compared it with a control group of children that fully recovered post- SARS-CoV-2 infection. A case-control study enrolling children below 18 years of age with previous microbiologically confirmed SARS-CoV-2 infection in a pediatric post-covid unit in Italy ≥ 8 weeks after the initial infection. Samples were taken at 8 and 12 weeks after the SARS-CoV-2 diagnosis and analyzed for coagulation profiling (fibrinogen, prothrombin time, international normalized ratio, activated partial thromboplastin time, d-dimers, factor VIII coagulant activity, plasma von Willebrand factor (VWF) antigen and VWF ristocetin cofactor (RC)). We compared coagulation profiles in samples from children identified with PCC (at least one, or three or more symptoms, which could not be explained by an alternative diagnosis, at the 8- and 12-week follow-up assessment using the pediatric Long Covid International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) survey. Seventy-five children were enrolled, 49.3% were females, the median age was 10.2 (IQR 4.9) years. Forty-six (61%) of the children had at least one persisting symptom at the eight weeks post-onset, (PCC8); 39/75 (52%) had persistent symptoms for more than 12 weeks (PCC12) and 15/75(32%) had at least three persisting symptoms (PCC ≥ 3) at 12 weeks. Children with PCC presented more frequently with abnormal D-Dimer levels above the reference range compared to children that had fully recovered at the 8-12 weeks (39.1% vs. 17.2%, p = 0.04), and 12 week follow up or more (41% vs. 17.2%, p = 0.05), and in children with three or more symptoms at 12 weeks follow up compared to those that had recovered (64.3% vs. 22.2%, p = 0.002). For the other coagulation profiles, there were abnormal values detected for VWF, FVIII, RC and Fibrinogen but no significant differences between children with PCC compared to controls. Although the majority of children in our cohort showed coagulation profile within or close to normal ranges, we found that a higher proportion of children with PCC, and specifically those with a more severe spectrum characterized with three or more persisting symptoms, had abnormal D-dimer levels compared to other children that fully recovered from an acute SARS-CoV-2 infection.
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Affiliation(s)
- Leonardo Di Gennaro
- Department of Diagnostic Imaging, Radiotherapy, Oncology and Haematology, Hemorrhagic and Thrombotic Diseases Center, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Piero Valentini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Silvia Sorrentino
- Department of Diagnostic Imaging, Radiotherapy, Oncology and Haematology, Hemorrhagic and Thrombotic Diseases Center, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Maria Antonietta Ferretti
- Department of Diagnostic Imaging, Radiotherapy, Oncology and Haematology, Hemorrhagic and Thrombotic Diseases Center, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Erica De Candia
- Department of Diagnostic Imaging, Radiotherapy, Oncology and Haematology, Hemorrhagic and Thrombotic Diseases Center, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Istituto di Ematologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Maria Basso
- Department of Diagnostic Imaging, Radiotherapy, Oncology and Haematology, Hemorrhagic and Thrombotic Diseases Center, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Stefano Lancellotti
- Department of Diagnostic Imaging, Radiotherapy, Oncology and Haematology, Hemorrhagic and Thrombotic Diseases Center, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Raimondo De Cristofaro
- Department of Diagnostic Imaging, Radiotherapy, Oncology and Haematology, Hemorrhagic and Thrombotic Diseases Center, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Istituto di Ematologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Cristina De Rose
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Francesco Mariani
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Rosa Morello
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Ilaria Lazzareschi
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Louise Sigfrid
- Nuffield Department of Medicine, International Severe Acute Respiratory and Emerging Infection Consortium Global Support Centre, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| | - Daniel Munblit
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University, Moscow, Russia
- Inflammation, Repair and Development Section, Faculty of Medicine, National Heart and Lung Institute, Imperial College London, London, W2 1PG, UK
| | - Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
- Centro di Salute Globale, Università Cattolica del Sacro Cuore, Rome, Italy.
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Wulf Hanson S, Abbafati C, Aerts JG, Al-Aly Z, Ashbaugh C, Ballouz T, Blyuss O, Bobkova P, Bonsel G, Borzakova S, Buonsenso D, Butnaru D, Carter A, Chu H, De Rose C, Diab MM, Ekbom E, El Tantawi M, Fomin V, Frithiof R, Gamirova A, Glybochko PV, Haagsma JA, Haghjooy Javanmard S, Hamilton EB, Harris G, Heijenbrok-Kal MH, Helbok R, Hellemons ME, Hillus D, Huijts SM, Hultström M, Jassat W, Kurth F, Larsson IM, Lipcsey M, Liu C, Loflin CD, Malinovschi A, Mao W, Mazankova L, McCulloch D, Menges D, Mohammadifard N, Munblit D, Nekliudov NA, Ogbuoji O, Osmanov IM, Peñalvo JL, Petersen MS, Puhan MA, Rahman M, Rass V, Reinig N, Ribbers GM, Ricchiuto A, Rubertsson S, Samitova E, Sarrafzadegan N, Shikhaleva A, Simpson KE, Sinatti D, Soriano JB, Spiridonova E, Steinbeis F, Svistunov AA, Valentini P, van de Water BJ, van den Berg-Emons R, Wallin E, Witzenrath M, Wu Y, Xu H, Zoller T, Adolph C, Albright J, Amlag JO, Aravkin AY, Bang-Jensen BL, Bisignano C, Castellano R, Castro E, Chakrabarti S, Collins JK, Dai X, Daoud F, Dapper C, Deen A, Duncan BB, Erickson M, Ewald SB, Ferrari AJ, Flaxman AD, Fullman N, Gamkrelidze A, Giles JR, Guo G, Hay SI, He J, Helak M, Hulland EN, Kereselidze M, Krohn KJ, Lazzar-Atwood A, Lindstrom A, Lozano R, Malta DC, Månsson J, Mantilla Herrera AM, Mokdad AH, Monasta L, Nomura S, Pasovic M, Pigott DM, Reiner RC, Reinke G, Ribeiro ALP, Santomauro DF, Sholokhov A, Spurlock EE, Walcott R, Walker A, Wiysonge CS, Zheng P, Bettger JP, Murray CJL, Vos T. Estimated Global Proportions of Individuals With Persistent Fatigue, Cognitive, and Respiratory Symptom Clusters Following Symptomatic COVID-19 in 2020 and 2021. JAMA 2022; 328:1604-1615. [PMID: 36215063 PMCID: PMC9552043 DOI: 10.1001/jama.2022.18931] [Citation(s) in RCA: 262] [Impact Index Per Article: 131.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 09/25/2022] [Indexed: 01/14/2023]
Abstract
Importance Some individuals experience persistent symptoms after initial symptomatic SARS-CoV-2 infection (often referred to as Long COVID). Objective To estimate the proportion of males and females with COVID-19, younger or older than 20 years of age, who had Long COVID symptoms in 2020 and 2021 and their Long COVID symptom duration. Design, Setting, and Participants Bayesian meta-regression and pooling of 54 studies and 2 medical record databases with data for 1.2 million individuals (from 22 countries) who had symptomatic SARS-CoV-2 infection. Of the 54 studies, 44 were published and 10 were collaborating cohorts (conducted in Austria, the Faroe Islands, Germany, Iran, Italy, the Netherlands, Russia, Sweden, Switzerland, and the US). The participant data were derived from the 44 published studies (10 501 hospitalized individuals and 42 891 nonhospitalized individuals), the 10 collaborating cohort studies (10 526 and 1906), and the 2 US electronic medical record databases (250 928 and 846 046). Data collection spanned March 2020 to January 2022. Exposures Symptomatic SARS-CoV-2 infection. Main Outcomes and Measures Proportion of individuals with at least 1 of the 3 self-reported Long COVID symptom clusters (persistent fatigue with bodily pain or mood swings; cognitive problems; or ongoing respiratory problems) 3 months after SARS-CoV-2 infection in 2020 and 2021, estimated separately for hospitalized and nonhospitalized individuals aged 20 years or older by sex and for both sexes of nonhospitalized individuals younger than 20 years of age. Results A total of 1.2 million individuals who had symptomatic SARS-CoV-2 infection were included (mean age, 4-66 years; males, 26%-88%). In the modeled estimates, 6.2% (95% uncertainty interval [UI], 2.4%-13.3%) of individuals who had symptomatic SARS-CoV-2 infection experienced at least 1 of the 3 Long COVID symptom clusters in 2020 and 2021, including 3.2% (95% UI, 0.6%-10.0%) for persistent fatigue with bodily pain or mood swings, 3.7% (95% UI, 0.9%-9.6%) for ongoing respiratory problems, and 2.2% (95% UI, 0.3%-7.6%) for cognitive problems after adjusting for health status before COVID-19, comprising an estimated 51.0% (95% UI, 16.9%-92.4%), 60.4% (95% UI, 18.9%-89.1%), and 35.4% (95% UI, 9.4%-75.1%), respectively, of Long COVID cases. The Long COVID symptom clusters were more common in women aged 20 years or older (10.6% [95% UI, 4.3%-22.2%]) 3 months after symptomatic SARS-CoV-2 infection than in men aged 20 years or older (5.4% [95% UI, 2.2%-11.7%]). Both sexes younger than 20 years of age were estimated to be affected in 2.8% (95% UI, 0.9%-7.0%) of symptomatic SARS-CoV-2 infections. The estimated mean Long COVID symptom cluster duration was 9.0 months (95% UI, 7.0-12.0 months) among hospitalized individuals and 4.0 months (95% UI, 3.6-4.6 months) among nonhospitalized individuals. Among individuals with Long COVID symptoms 3 months after symptomatic SARS-CoV-2 infection, an estimated 15.1% (95% UI, 10.3%-21.1%) continued to experience symptoms at 12 months. Conclusions and Relevance This study presents modeled estimates of the proportion of individuals with at least 1 of 3 self-reported Long COVID symptom clusters (persistent fatigue with bodily pain or mood swings; cognitive problems; or ongoing respiratory problems) 3 months after symptomatic SARS-CoV-2 infection.
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Affiliation(s)
- Sarah Wulf Hanson
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Cristiana Abbafati
- Department of Juridical and Economic Studies, La Sapienza University, Rome, Italy
| | - Joachim G Aerts
- Department of Pulmonary Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Ziyad Al-Aly
- John T. Milliken Department of Internal Medicine, Washington University in St Louis, St Louis, Missouri
- Clinical Epidemiology Center, US Department of Veterans Affairs, St Louis, Missouri
| | - Charlie Ashbaugh
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Tala Ballouz
- Epidemiology, Biostatistics, and Prevention Institute, University of Zürich, Zurich, Switzerland
| | - Oleg Blyuss
- Wolfson Institute of Population Health, Queen Mary University of London, London, England
- Department of Pediatrics and Pediatric Infectious Diseases, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Polina Bobkova
- Clinical Medicine (Pediatric Profile), I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Gouke Bonsel
- EuroQol Research Foundation, Rotterdam, the Netherlands
| | - Svetlana Borzakova
- Pirogov Russian National Research Medical University, Moscow
- Research Institute for Healthcare Organization and Medical Management, Moscow Healthcare Department, Moscow, Russia
| | - Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Agostino Gemelli University Polyclinic IRCCS, Rome, Italy
- Global Health Research Institute, Catholic University of Sacred Heart, Rome, Italy
| | - Denis Butnaru
- I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Austin Carter
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Helen Chu
- Department of Medicine, University of Washington, Seattle
| | - Cristina De Rose
- Department of Woman and Child Health and Public Health, Agostino Gemelli University Polyclinic IRCCS, Rome, Italy
| | - Mohamed Mustafa Diab
- Center for Policy Impact in Global Health, Duke University, Durham, North Carolina
- Department of Surgery, Duke University, Durham, North Carolina
| | - Emil Ekbom
- Uppsala University Hospital, Uppsala, Sweden
| | - Maha El Tantawi
- Pediatric Dentistry and Dental Public Health Department, Alexandria University, Alexandria, Egypt
| | - Victor Fomin
- Rector's Office, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Robert Frithiof
- Department of Surgical Sciences, Anesthesiology, and Intensive Care Medicine, Uppsala University, Uppsala, Sweden
| | - Aysylu Gamirova
- Clinical Medicine (General Medicine Profile), I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Petr V Glybochko
- Administration Department, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Juanita A Haagsma
- Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Shaghayegh Haghjooy Javanmard
- Applied Physiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Erin B Hamilton
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | - Majanka H Heijenbrok-Kal
- Department of Rehabilitation Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
- Neurorehabilitation, Rijndam Rehabilitation, Rotterdam, the Netherlands
| | - Raimund Helbok
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Merel E Hellemons
- Department of Pulmonary Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - David Hillus
- Department of Infectious Diseases and Respiratory Medicine, Charité Medical University Berlin, Berlin, Germany
| | - Susanne M Huijts
- Department of Respiratory Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Michael Hultström
- Department of Surgical Sciences, Anesthesiology, and Intensive Care Medicine, Uppsala University, Uppsala, Sweden
- Department of Medical Cell Biology, Uppsala University, Uppsala, Sweden
| | - Waasila Jassat
- Department of Public Health Surveillance and Response, National Institute for Communicable Diseases, Johannesburg, South Africa
| | - Florian Kurth
- Department of Infectious Diseases and Respiratory Medicine, Charité University Medical Center Berlin, Berlin, Germany
- Department of Clinical Research and Tropical Medicine, Bernhard-Nocht Institute of Tropical Medicine, Hamburg, Germany
| | - Ing-Marie Larsson
- Department of Surgical Sciences, Anesthesiology, and Intensive Care Medicine, Uppsala University, Uppsala, Sweden
| | - Miklós Lipcsey
- Department of Surgical Sciences, Anesthesiology, and Intensive Care Medicine, Uppsala University, Uppsala, Sweden
| | - Chelsea Liu
- Department of Epidemiology, Harvard University, Boston, Massachusetts
| | | | | | - Wenhui Mao
- Center for Policy Impact in Global Health, Duke University, Durham, North Carolina
- Duke Global Health Institute, Duke University, Durham, North Carolina
| | - Lyudmila Mazankova
- Russian Medical Academy of Continuous Professional Education, Ministry of Healthcare of the Russian Federation, Moscow
| | | | - Dominik Menges
- Epidemiology, Biostatistics, and Prevention Institute, University of Zürich, Zurich, Switzerland
| | - Noushin Mohammadifard
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Daniel Munblit
- Department of Pediatrics and Pediatric Infectious Diseases, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
- National Heart and Lung Institute, Imperial College London, London, England
| | - Nikita A Nekliudov
- Clinical Medicine (General Medicine Profile), I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Osondu Ogbuoji
- Duke Global Health Institute, Duke University, Durham, North Carolina
| | - Ismail M Osmanov
- Pirogov Russian National Research Medical University, Moscow
- ZA Bashlyaeva Children's Municipal Clinical Hospital, Moscow, Russia
| | - José L Peñalvo
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
| | - Maria Skaalum Petersen
- Department of Occupational Medicine and Public Health, Faroese Hospital System, Torshavn, Faroe Islands
- Centre of Health Science, University of Faroe Islands, Torshavn
| | - Milo A Puhan
- Epidemiology, Biostatistics, and Prevention Institute, University of Zürich, Zurich, Switzerland
- Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland
| | - Mujibur Rahman
- Department of Internal Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Verena Rass
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Nickolas Reinig
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Gerard M Ribbers
- Department of Rehabilitation Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Antonia Ricchiuto
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Sten Rubertsson
- Department of Surgical Sciences, Anesthesiology, and Intensive Care Medicine, Uppsala University, Uppsala, Sweden
- Department of Surgical Sciences, Hedenstierna Laboratory, Uppsala University, Uppsala, Sweden
| | - Elmira Samitova
- Russian Medical Academy of Continuous Professional Education, Ministry of Healthcare of the Russian Federation, Moscow
- ZA Bashlyaeva Children's Municipal Clinical Hospital, Moscow, Russia
| | - Nizal Sarrafzadegan
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Anastasia Shikhaleva
- Clinical Medicine (Pediatric Profile), I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Kyle E Simpson
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Dario Sinatti
- Department of Woman and Child Health and Public Health, Agostino Gemelli University Polyclinic IRCCS, Rome, Italy
| | - Joan B Soriano
- Hospital Universitario de La Princesa, Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Respiratorias (Center for Biomedical Research in Respiratory Diseases Network), Madrid, Spain
| | - Ekaterina Spiridonova
- Clinical Medicine (General Medicine Profile), I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Fridolin Steinbeis
- Department of Infectious Diseases and Respiratory Medicine, Charité Medical University Berlin, Berlin, Germany
| | - Andrey A Svistunov
- Administration Department, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Piero Valentini
- Department of Woman and Child Health and Public Health, Agostino Gemelli University Polyclinic IRCCS, Rome, Italy
| | - Brittney J van de Water
- Department of Global Health and Social Medicine, Harvard University, Boston, Massachusetts
- Nursing and Midwifery Department, Seed Global Health, Boston, Massachusetts
| | - Rita van den Berg-Emons
- Department of Rehabilitation Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Ewa Wallin
- Department of Surgical Sciences, Anesthesiology, and Intensive Care Medicine, Uppsala University, Uppsala, Sweden
| | - Martin Witzenrath
- Department of Infectious Diseases and Respiratory Medicine, Charité University Medical Center Berlin, Berlin, Germany
- German Center for Lung Research, Berlin
| | - Yifan Wu
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Hanzhang Xu
- Department of Family Medicine and Community Health, Duke University, Durham, North Carolina
| | - Thomas Zoller
- Department of Infectious Diseases and Respiratory Medicine, Charité Medical University Berlin, Berlin, Germany
| | - Christopher Adolph
- Department of Political Science, University of Washington, Seattle
- Center for Statistics and the Social Sciences, University of Washington, Seattle
| | - James Albright
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Joanne O Amlag
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Aleksandr Y Aravkin
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Applied Mathematics, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Bree L Bang-Jensen
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Catherine Bisignano
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Rachel Castellano
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Emma Castro
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Suman Chakrabarti
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Global Health, University of Washington, Seattle
| | - James K Collins
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Xiaochen Dai
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Farah Daoud
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Carolyn Dapper
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Amanda Deen
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Bruce B Duncan
- Postgraduate Program in Epidemiology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Megan Erickson
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Samuel B Ewald
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Alize J Ferrari
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- School of Public Health, University of Queensland, Brisbane, Australia
| | - Abraham D Flaxman
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Nancy Fullman
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | | | - John R Giles
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Gaorui Guo
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Jiawei He
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Monika Helak
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Erin N Hulland
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Global Health, University of Washington, Seattle
| | - Maia Kereselidze
- National Center for Disease Control and Public Health, Tbilisi, Georgia
| | - Kris J Krohn
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Alice Lazzar-Atwood
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Akiaja Lindstrom
- School of Public Health, University of Queensland, Brisbane, Australia
- School of Public Health, Queensland Centre for Mental Health Research, Wacol, Australia
| | - Rafael Lozano
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Deborah Carvalho Malta
- Department of Maternal and Child Nursing and Public Health, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Johan Månsson
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Ana M Mantilla Herrera
- School of Public Health, University of Queensland, Brisbane, Australia
- West Moreton Hospital Health Services, Queensland Centre for Mental Health Research, Wacol, Australia
| | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Lorenzo Monasta
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
| | - Shuhei Nomura
- Department of Health Policy and Management, Keio University, Tokyo, Japan
- Department of Global Health Policy, University of Tokyo, Tokyo, Japan
| | - Maja Pasovic
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - David M Pigott
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Robert C Reiner
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Grace Reinke
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Antonio Luiz P Ribeiro
- Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
- Centre of Telehealth, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Damian Francesco Santomauro
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- School of Public Health, University of Queensland, Brisbane, Australia
- Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Wacol, Australia
| | - Aleksei Sholokhov
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Emma Elizabeth Spurlock
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Social and Behavioral Sciences, School of Public Health, Yale University, New Haven, Connecticut
| | - Rebecca Walcott
- Evans School of Public Policy and Governance, University of Washington, Seattle
| | - Ally Walker
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Charles Shey Wiysonge
- Cochrane South Africa, South African Medical Research Council, Cape Town
- HIV and Other Infectious Diseases Research Unit, South African Medical Research Council, Durban
| | - Peng Zheng
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Janet Prvu Bettger
- Department of Orthopedic Surgery, Duke University, Durham, North Carolina
| | - Christopher J L Murray
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Theo Vos
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
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Buonsenso D, Morello R, Ferro V, Musolino AM, De Rose C, Inchingolo R, Valentini P. Are Lung Ultrasound Features More Severe in Children Diagnosed with Bronchiolitis after the COVID-19 Lockdown Period? J Clin Med 2022; 11:5294. [PMID: 36142940 PMCID: PMC9500987 DOI: 10.3390/jcm11185294] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 07/25/2022] [Revised: 08/18/2022] [Accepted: 09/05/2022] [Indexed: 11/16/2022] Open
Abstract
The non-pharmacological measures implemented during the SARS-CoV-2 pandemic disrupted the usual bronchiolitis seasonality. Some authors have speculated that, after the lock down period, there would be an increase in the number and severity of respiratory infections due to the re-introduction of respiratory viruses. We collected clinical, microbiological and lung ultrasound data using the classification of the Italian Society of Thoracic Ultrasound (ADET) in children with bronchiolitis during the pandemic compared to the pre-pandemic period, with the aim of assessing whether the epidemic of bronchiolitis during the pandemic was characterized by a more severe lung involvement documented by lung ultrasound. We enrolled 108 children with bronchiolitis (52 pre-pandemic and 56 COVID-19 period), with a median age of 1.74 months (interquartile range, IQR 1-3.68) and 39.8% were females. Rhinovirus detection and high-flow nasal cannula usage were both increased during the COVID-19 period, although overall need of hospitalization and pediatric intensive care unit admissions did not change during the two periods. Lung ultrasound scores were similar in the two cohorts evaluated. Conclusions: our study suggests that, despite changes in microbiology and treatments performed, lung ultrasound severity scores were similar, suggesting that that bronchiolitis during the pandemic period was no more severe than pre-pandemic period, despite children diagnosed during the pandemic had a higher, but it was not statistically significant, probably, due to small sample size, probability of being admitted.
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Affiliation(s)
- Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Centro di Salute Globale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Rosa Morello
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Valentina Ferro
- Dipartimento di Emergenza e Accettazione, Ospedale Pediatrico Bambino Gesù, 00165 Rome, Italy
| | - Anna Maria Musolino
- Dipartimento di Emergenza e Accettazione, Ospedale Pediatrico Bambino Gesù, 00165 Rome, Italy
| | - Cristina De Rose
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Riccardo Inchingolo
- Dipartimento Scienze Mediche e Chirurgiche, UOC Pneumologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Piero Valentini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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Buonsenso D, Gualano MR, Rossi MF, Valz Gris A, Sisti LG, Borrelli I, Santoro PE, Tumminello A, Gentili C, Malorni W, Valentini P, Ricciardi W, Moscato U. Post-Acute COVID-19 Sequelae in a Working Population at One Year Follow-Up: A Wide Range of Impacts from an Italian Sample. Int J Environ Res Public Health 2022; 19:11093. [PMID: 36078808 PMCID: PMC9518581 DOI: 10.3390/ijerph191711093] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/26/2022] [Accepted: 09/02/2022] [Indexed: 06/15/2023]
Abstract
Long COVID-19 is a term used to describe the symptomatic sequelae that develop after suffering from COVID-19. Very few studies have investigated the impact of COVID-19 sequelae on employment status. The aim of this research was to characterise sequelae of COVID-19 in a population of workers who tested positive for COVID-19, with a follow-up within one year of the acute illness, and to analyse the possible association between this and changes in the workers' occupational status. In this retrospective cohort study, a questionnaire was administered to 155 workers; descriptive, univariate (chi-square tests), and multivariate (logistic regression model) analyses were carried out. The mean age was 46.48 years (SD ± 7.302); 76 participants were males (49.7%), and 33 participants reported being current smokers (21.3%). Overall, 19.0% of patients reported not feeling fully recovered at follow-up, and 13.7% reported a change in their job status after COVID-19. A change in occupational status was associated with being a smoker (OR 4.106, CI [1.406-11.990], p = 0.010); hospital stay was associated with age > 46 years in a statistically significant way (p = 0.025) and with not feeling fully recovered at follow-up (p = 0.003). A persistent worsening in anxiety was more common in women (p = 0.028). This study identifies smoking as a risk factor for workers not able to resume their job; furthermore, occupational physicians should monitor mental health more closely after COVID-19, particularly in female workers.
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Affiliation(s)
- Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy
- Center for Global Health Research and Studies, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Maria Rosaria Gualano
- Center for Global Health Research and Studies, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
- Department of Public Health Sciences and Paediatrics, University of Torino, 10124 Torino, Italy
- Leadership in Medicine Research Center, Università Cattolica del Sacro Cuore, 20123 Rome, Italy
| | - Maria Francesca Rossi
- Department of Health Science and Public Health, Section of Occupational Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Angelica Valz Gris
- Department of Health Science and Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Leuconoe Grazia Sisti
- Institute of Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- National Institute for Health, Migration and Poverty, 00153 Rome, Italy
| | - Ivan Borrelli
- Department of Health Science and Public Health, Section of Occupational Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Paolo Emilio Santoro
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy
- Department of Health Science and Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Antonio Tumminello
- Department of Health Science and Public Health, Section of Occupational Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Carolina Gentili
- Medical School, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Walter Malorni
- Center for Global Health Research and Studies, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Piero Valentini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy
| | - Walter Ricciardi
- Center for Global Health Research and Studies, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
- Leadership in Medicine Research Center, Università Cattolica del Sacro Cuore, 20123 Rome, Italy
- Department of Health Science and Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Umberto Moscato
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy
- Center for Global Health Research and Studies, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
- Department of Health Science and Public Health, Section of Occupational Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
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Costa S, Priolo F, Fattore S, Tedesco M, Rubortone SA, Giordano L, Chioma R, Neri Md C, Lanzone A, Buonsenso D, Valentini P, Vento G. Rooming-In Practice During the Pandemic: Results From a Retrospective Cohort Study. J Hum Lact 2022; 38:443-451. [PMID: 35272513 DOI: 10.1177/08903344221081840] [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] [Indexed: 11/17/2022]
Abstract
BACKGROUND The Coronavirus disease 2019 (COVID-19) pandemic emerged in December 2019 and spread rapidly worldwide. So far, evidence regarding the breastfeeding and rooming-in management of mothers with COVID-19 and their newborn infants is scarce. RESEARCH AIMS 1) To assess the rate of exclusive breastfeeding at discharge among mothers with COVID-19 and their newborn infants managed either using a rooming-in or a separation regimen; and 2) to evaluate different neonatal outcomes, including the need for re-hospitalization related to COVID-19 among newborn infants in the two groups. METHOD We conducted a retrospective two-group comparative observational study. The sample was participants with COVID-19 and their newborn infants (N = 155 dyads) between March 1, 2020, and April 30, 2021. Two time periods were outlined resulting from the two different clinical practices of mother-infant separation and rooming-in. RESULTS Within the sample, 145 (93.5%) were asymptomatic. All neonates had documented Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) test results, and six tested positive by reverse transcriptase polymerase chain reaction within 48 hr of life. The rate of exclusive breastfeeding was significantly higher (p < .0001) within the rooming-in group. Length of hospital stay was significantly lower (p = .001) within the rooming-in group. CONCLUSIONS Protected rooming-in practice has proven to be safe and effective in supporting breastfeeding: None of the infants enrolled were hospitalized due to COVID-19 infection and the rate of exclusive breastfeeding at discharge was increased compared to those infants separated from their mothers.
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Affiliation(s)
- Simonetta Costa
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesca Priolo
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | | | - Serena Antonia Rubortone
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Lucia Giordano
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | - Caterina Neri Md
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Antonio Lanzone
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
| | - Danilo Buonsenso
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Global Health Research Institute, Istituto di Igiene, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Piero Valentini
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy.,Global Health Research Institute, Istituto di Igiene, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giovanni Vento
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
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33
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Cocciolillo F, Di Giuda D, Morello R, De Rose C, Valentini P, Buonsenso D. Orbito-Frontal Cortex Hypometabolism in Children With Post-COVID Condition (Long COVID): A Preliminary Experience. Pediatr Infect Dis J 2022; 41:663-665. [PMID: 35839175 PMCID: PMC9281418 DOI: 10.1097/inf.0000000000003578] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [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] [Accepted: 04/18/2022] [Indexed: 01/18/2023]
Abstract
We describe 3 children with new-onset neurocognitive problems after coronavirus disease 2019 (COVID-19), that showed, at the brain [18F]-fluorodeoxyglucose positron emission tomography/computed tomography, hypometabolism in the left orbito-frontal region. The voxel-wise analysis confirmed a cluster of hypometabolic voxels in this region with a peak at -18/46/-4mm (179 voxels, T-Score 8.1). These findings may explain neurocognitive symptoms that some children develop after COVID-19 and require further investigations.
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Affiliation(s)
- Fabrizio Cocciolillo
- From the Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, UOC di Medicina Nucleare, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Daniela Di Giuda
- From the Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, UOC di Medicina Nucleare, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Istituto di Medicina Nucleare, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Rosa Morello
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy and
| | - Cristina De Rose
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy and
| | - Piero Valentini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy and
| | - Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy and
- Global Health Research Institute, Istituto di Igiene, Università Cattolica del Sacro Cuore, Roma, Italy
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Bucci A, Ippoliti L, Valentini P, Fontanella S. Clustering spatio-temporal series of confirmed COVID-19 deaths in Europe. Spat Stat 2022; 49:100543. [PMID: 34631400 PMCID: PMC8493647 DOI: 10.1016/j.spasta.2021.100543] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 09/22/2021] [Accepted: 09/23/2021] [Indexed: 06/13/2023]
Abstract
The impact of the COVID-19 pandemic varied significantly across different countries, with important consequences in the definition of control and response strategies. In this work, to investigate the heterogeneity of this crisis, we analyse the spatial patterns of deaths attributed to COVID-19 in several European countries. To this end, we propose a Bayesian nonparametric approach, based on mixture of Gaussian processes coupled with Dirichlet process, to group the COVID-19 mortality curves. The model provides a flexible framework for the analysis of time series data, allowing the inclusion in the clustering procedure of different features of the series, such as spatial correlations, time varying parameters and measurement errors. We evaluate the proposed methodology on the death counts recorded at NUTS-2 regional level for several European countries in the period from March 2020 to February 2021.
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Affiliation(s)
- A Bucci
- Department of Economics, University G. d'Annunzio, Chieti-Pescara, Italy
| | - L Ippoliti
- Department of Economics, University G. d'Annunzio, Chieti-Pescara, Italy
| | - P Valentini
- Department of Economics, University G. d'Annunzio, Chieti-Pescara, Italy
| | - S Fontanella
- National Heart and Lung Institute, Imperial College London, UK
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35
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Buonsenso D, De Rose C, Morello R, Lazzareschi I, Valentini P. Aspiration pneumonia in children with neurological disorders: a new indication for lung ultrasound? A case series. J Ultrasound 2022; 25:325-331. [PMID: 32757145 PMCID: PMC9148346 DOI: 10.1007/s40477-020-00520-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 07/28/2020] [Indexed: 12/27/2022] Open
Abstract
Aspiration pneumonia is a common cause of morbidity and mortality in both adults and children that, however, is difficult to accurately diagnose. In current literature, there are no reports or clinical research study focused on the possible use of lung ultrasound (LUS) in the diagnosis and follow-up of aspiration pneumonia in children. In this case series, we describe clinical, laboratory, radiological results as well as detailed lung ultrasound findings of three children with severe disability and diagnosed with aspiration pneumonia. In these three cases, albeit at different times, LUS played an important role in both the initial diagnostic process and follow-up.
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Affiliation(s)
- Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario "A. Gemelli", IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - Cristina De Rose
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario "A. Gemelli", IRCCS, Rome, Italy.
| | - Rosa Morello
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario "A. Gemelli", IRCCS, Rome, Italy
| | - Ilaria Lazzareschi
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario "A. Gemelli", IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - Piero Valentini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario "A. Gemelli", IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
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36
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Wulf Hanson S, Abbafati C, Aerts JG, Al-Aly Z, Ashbaugh C, Ballouz T, Blyuss O, Bobkova P, Bonsel G, Borzakova S, Buonsenso D, Butnaru D, Carter A, Chu H, De Rose C, Diab MM, Ekbom E, El Tantawi M, Fomin V, Frithiof R, Gamirova A, Glybochko PV, Haagsma JA, Javanmard SH, Hamilton EB, Harris G, Heijenbrok-Kal MH, Helbok R, Hellemons ME, Hillus D, Huijts SM, Hultström M, Jassat W, Kurth F, Larsson IM, Lipcsey M, Liu C, Loflin CD, Malinovschi A, Mao W, Mazankova L, McCulloch D, Menges D, Mohammadifard N, Munblit D, Nekliudov NA, Ogbuoji O, Osmanov IM, Peñalvo JL, Petersen MS, Puhan MA, Rahman M, Rass V, Reinig N, Ribbers GM, Ricchiuto A, Rubertsson S, Samitova E, Sarrafzadegan N, Shikhaleva A, Simpson KE, Sinatti D, Soriano JB, Spiridonova E, Steinbeis F, Svistunov AA, Valentini P, van de Water BJ, van den Berg-Emons R, Wallin E, Witzenrath M, Wu Y, Xu H, Zoller T, Adolph C, Albright J, Amlag JO, Aravkin AY, Bang-Jensen BL, Bisignano C, Castellano R, Castro E, Chakrabarti S, Collins JK, Dai X, Daoud F, Dapper C, Deen A, Duncan BB, Erickson M, Ewald SB, Ferrari AJ, Flaxman AD, Fullman N, Gamkrelidze A, Giles JR, Guo G, Hay SI, He J, Helak M, Hulland EN, Kereselidze M, Krohn KJ, Lazzar-Atwood A, Lindstrom A, Lozano R, Magistro B, Malta DC, Månsson J, Mantilla Herrera AM, Mokdad AH, Monasta L, Nomura S, Pasovic M, Pigott DM, Reiner RC, Reinke G, Ribeiro ALP, Santomauro DF, Sholokhov A, Spurlock EE, Walcott R, Walker A, Wiysonge CS, Zheng P, Bettger JP, Murray CJ, Vos T. A global systematic analysis of the occurrence, severity, and recovery pattern of long COVID in 2020 and 2021. medRxiv 2022. [PMID: 35664995 PMCID: PMC9164454 DOI: 10.1101/2022.05.26.22275532] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Importance: While much of the attention on the COVID-19 pandemic was directed at the daily counts of cases and those with serious disease overwhelming health services, increasingly, reports have appeared of people who experience debilitating symptoms after the initial infection. This is popularly known as long COVID. Objective: To estimate by country and territory of the number of patients affected by long COVID in 2020 and 2021, the severity of their symptoms and expected pattern of recovery Design: We jointly analyzed ten ongoing cohort studies in ten countries for the occurrence of three major symptom clusters of long COVID among representative COVID cases. The defining symptoms of the three clusters (fatigue, cognitive problems, and shortness of breath) are explicitly mentioned in the WHO clinical case definition. For incidence of long COVID, we adopted the minimum duration after infection of three months from the WHO case definition. We pooled data from the contributing studies, two large medical record databases in the United States, and findings from 44 published studies using a Bayesian meta-regression tool. We separately estimated occurrence and pattern of recovery in patients with milder acute infections and those hospitalized. We estimated the incidence and prevalence of long COVID globally and by country in 2020 and 2021 as well as the severity-weighted prevalence using disability weights from the Global Burden of Disease study. Results: Analyses are based on detailed information for 1906 community infections and 10526 hospitalized patients from the ten collaborating cohorts, three of which included children. We added published data on 37262 community infections and 9540 hospitalized patients as well as ICD-coded medical record data concerning 1.3 million infections. Globally, in 2020 and 2021, 144.7 million (95% uncertainty interval [UI] 54.8–312.9) people suffered from any of the three symptom clusters of long COVID. This corresponds to 3.69% (1.38–7.96) of all infections. The fatigue, respiratory, and cognitive clusters occurred in 51.0% (16.9–92.4), 60.4% (18.9–89.1), and 35.4% (9.4–75.1) of long COVID cases, respectively. Those with milder acute COVID-19 cases had a quicker estimated recovery (median duration 3.99 months [IQR 3.84–4.20]) than those admitted for the acute infection (median duration 8.84 months [IQR 8.10–9.78]). At twelve months, 15.1% (10.3–21.1) continued to experience long COVID symptoms. Conclusions and relevance: The occurrence of debilitating ongoing symptoms of COVID-19 is common. Knowing how many people are affected, and for how long, is important to plan for rehabilitative services and support to return to social activities, places of learning, and the workplace when symptoms start to wane.
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37
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Costa S, Giordano L, Bottoni A, Tiberi E, Fattore S, Pastorino R, Simone ND, Lanzone A, Buonsenso D, Valentini P, Cattani P, Santangelo R, Sanguinetti M, Scambia G, Vento G. Vertical Transmission of SARS-CoV-2 during Pregnancy: A Prospective Italian Cohort Study. Am J Perinatol 2022. [PMID: 35263767 DOI: 10.1055/a-1792-4535] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The extent of vertical transmission (VT) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from mothers their fetuses or neonates is still uncertain. We aimed to determine the incidence of VT. STUDY DESIGN In this prospective cohort study. All mother diagnosed with SARS-CoV-2 infection at the time of delivery or up to 1 week prior and their neonates, managed in a tertiary referral hospital for pregnancy complicated by coronavirus disease 2019 (COVID-19) in Rome, from April 2 to December 22, 2020, were included. Maternal infection was defined as nasopharyngeal swab test results positive for SARS-CoV-2 reverse transcription-polymerase chain reaction (RT-PCR). Biological samples were collected before, at, and after delivery to test positivity for SARS-CoV-2 RT-PCR and anti-SARS-CoV-2-specific antibodies. RESULTS The cohort included 95 women and 96 neonates with documented SARS-CoV-2 test results. Four neonates (4.2%) tested positive. The incidence of VT, according to the guidance criteria for diagnosing perinatal SARS-CoV-2 infection, was 5.2%. Neonatal symptoms were due to prematurity or fetal distress: symptomatic infants had lower median (min-max) gestational age, 38.1 (29.3-40.6) versus 39.3 (33.9-41.9) weeks (p = 0.036), and 1-minute and 5-minute Apgar scores, 9 (3-9) versus 9 (7-10) (p = 0.036) and 10 (6-10) versus 10 (8-10) (p = 0.012), respectively, than asymptomatic infants and needed more frequent assistance in the delivery room (22.2 vs 2.5%; p = 0.008). Only six (7.1%) neonates had anti-SARS-CoV-2-specific antibodies, despite the ongoing maternal infection. CONCLUSION The incidence of VT is low as is the detection of specific anti-SARS-CoV-2 antibodies in cord blood when infection is contracted late in pregnancy. This would suggest poor protection of infants against horizontal transmission of the virus. KEY POINTS · VT of SARS-CoV-2 from pregnant mothers to fetuses or neonates can be possible.. · In this prospective cohort study, the incidence of VT is found to be 5.2%.. · VT is low but exists..
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Affiliation(s)
- Simonetta Costa
- Department of Woman and Child Health and Public Health, Catholic University of Sacred Heart, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Lucia Giordano
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Anthea Bottoni
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Eloisa Tiberi
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Simona Fattore
- Department of Woman and Child Health and Public Health, Catholic University of Sacred Heart, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Roberta Pastorino
- Department of Woman and Child Health and Public Health, Catholic University of Sacred Heart, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Nicoletta Di Simone
- Department of Biomedical Sciences, Humanitas University, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Antonio Lanzone
- Department of Woman and Child Health and Public Health, Catholic University of Sacred Heart, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Piero Valentini
- Department of Woman and Child Health and Public Health, Catholic University of Sacred Heart, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Paola Cattani
- Department of Woman and Child Health and Public Health, Catholic University of Sacred Heart, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Rosaria Santangelo
- Department of Laboratory and Infectivology Science, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of Sacred Heart, Rome, Italy
| | - Maurizio Sanguinetti
- Department of Laboratory and Infectivology Science, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of Sacred Heart, Rome, Italy
| | - Giovanni Scambia
- Department of Woman and Child Health and Public Health, Catholic University of Sacred Heart, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giovanni Vento
- Department of Woman and Child Health and Public Health, Catholic University of Sacred Heart, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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Curatola A, Ferretti S, Gatto A, Valentini P, Giugno G, Della Marca G, Brunetti V, Lazzareschi I. The Effects of COVID-19 Pandemic on Italian School-Aged Children: Sleep-Related Difficulties and Trauma Reactions. J Child Neurol 2022; 37:8830738221096194. [PMID: 35535411 PMCID: PMC9096002 DOI: 10.1177/08830738221096194] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/10/2022] [Accepted: 04/04/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE The COVID-19 pandemic has affected the mental and physical health of the world population. This study aims to investigate incidence of sleep-related difficulties and post-traumatic stress disorder in the school-aged children after 1 year of the pandemic. METHODS A sample of Italian children (6-12 years) was queried about their sleep behaviors after 1 year of the pandemic, answering the Children's Sleep Habits Questionnaire (CSHQ). We also evaluated trauma symptoms with the Children's Impact of Event Scale (CRIES-8). RESULTS Among 205 participants, 184 (89.8%) presented sleep-related difficulties. Out of all, 99 (48.3%) had a high risk to develop post-traumatic stress disorder. Ninety-five (51.6%) children with sleep-related difficulties also presented an abnormal CRIES-8 total score. A correlation was found between the CSHQ total score and the CRIES-8 total score (r = 0.354, P < .01). CONCLUSIONS The sleep-related difficulties occurring during COVID-19 outbreak may compound to increase the risk to develop post-traumatic stress disorder among Italian children.
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Affiliation(s)
- Antonietta Curatola
- Department of Pediatrics, Fondazione
Policlinico Universitario “Agostino Gemelli,” IRCCS,
Università
Cattolica del Sacro Cuore, Rome,
Italy
| | - Serena Ferretti
- Department of Pediatrics, Fondazione
Policlinico Universitario “Agostino Gemelli,” IRCCS,
Università
Cattolica del Sacro Cuore, Rome,
Italy
| | - Antonio Gatto
- Department of Pediatrics, Fondazione
Policlinico Universitario “Agostino Gemelli,” IRCCS,
Università
Cattolica del Sacro Cuore, Rome,
Italy
| | - Piero Valentini
- Department of Pediatrics, Fondazione
Policlinico Universitario “Agostino Gemelli,” IRCCS,
Università
Cattolica del Sacro Cuore, Rome,
Italy
| | - Giulia Giugno
- Department of Pediatrics, Fondazione
Policlinico Universitario “Agostino Gemelli,” IRCCS,
Università
Cattolica del Sacro Cuore, Rome,
Italy
| | - Giacomo Della Marca
- Institute of Neurology, Fondazione
Policlinico Universitario “Agostino Gemelli,” IRCCS,
Università
Cattolica del Sacro Cuore, Rome,
Italy
| | - Valerio Brunetti
- Institute of Neurology, Fondazione
Policlinico Universitario “Agostino Gemelli,” IRCCS,
Università
Cattolica del Sacro Cuore, Rome,
Italy
| | - Ilaria Lazzareschi
- Department of Pediatrics, Fondazione
Policlinico Universitario “Agostino Gemelli,” IRCCS,
Università
Cattolica del Sacro Cuore, Rome,
Italy
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39
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Di Sante G, Buonsenso D, De Rose C, Tredicine M, Palucci I, De Maio F, Camponeschi C, Bonadia N, Biasucci D, Pata D, Chiaretti A, Valentini P, Ria F, Sanguinetti M, Sali M. Immunopathology of SARS-CoV-2 Infection: A Focus on T Regulatory and B Cell Responses in Children Compared with Adults. Children (Basel) 2022; 9:children9050681. [PMID: 35626859 PMCID: PMC9139466 DOI: 10.3390/children9050681] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/29/2022] [Accepted: 05/03/2022] [Indexed: 12/24/2022]
Abstract
While the clinical impact of COVID-19 on adults has been massive, the majority of children develop pauci-symptomatic or even asymptomatic infection and only a minority of the latter develop a fatal outcome. The reasons of such differences are not yet established. We examined cytokines in sera and Th and B cell subpopulations in peripheral blood mononuclear cells (PBMC) from 40 children (<18 years old), evaluating the impact of COVID-19 infection during the pandemic’s first waves. We correlated our results with clinical symptoms and compared them to samples obtained from 16 infected adults and 7 healthy controls. While IL6 levels were lower in SARS-CoV-2+ children as compared to adult patients, the expression of other pro-inflammatory cytokines such as IFNγ and TNFα directly correlated with early age infection and symptoms. Th and B cell subsets were modified during pediatric infection differently with respect to adult patients and controls and within the pediatric group based on age. Low levels of IgD− CD27+ memory B cells correlated with absent/mild symptoms. On the contrary, high levels of FoxP3+/CD25high T-Regs associated with a moderate−severe clinical course in the childhood. These T and B cells subsets did not associate with severity in infected adults, with children showing a predominant expansion of immature B lymphocytes and natural regulatory T cells. This study shows differences in immunopathology of SARS-CoV-2 infection in children compared with adults. Moreover, these data could provide information that can drive vaccination endpoints for children.
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Affiliation(s)
- Gabriele Di Sante
- Dipartimento di Medicina e Chirurgia Traslazionale, Sezione di Patologia Generale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (G.D.S.); (M.T.); (C.C.); (F.R.)
- Dipartimento di Medicina Traslazionale, Sezione di Anatomia Umana, Clinica e Forense, Università degli studi di Perugia, 06123 Perugia, Italy
| | - Danilo Buonsenso
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (I.P.); (F.D.M.); (M.S.); (M.S.)
- Dipartimento della Salute della Donna e del Bambino e di Sanità, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (C.D.R.); (D.P.); (A.C.); (P.V.)
- Global Health Research Center, Università Cattolica del Sacro Cuore, 00168 Roma, Italy
- Correspondence: ; Tel./Fax: +39-063-015-4390
| | - Cristina De Rose
- Dipartimento della Salute della Donna e del Bambino e di Sanità, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (C.D.R.); (D.P.); (A.C.); (P.V.)
| | - Maria Tredicine
- Dipartimento di Medicina e Chirurgia Traslazionale, Sezione di Patologia Generale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (G.D.S.); (M.T.); (C.C.); (F.R.)
| | - Ivana Palucci
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (I.P.); (F.D.M.); (M.S.); (M.S.)
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie—Sezione di Microbiologia, Università Cattolica del S. Cuore, 00168 Rome, Italy
| | - Flavio De Maio
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (I.P.); (F.D.M.); (M.S.); (M.S.)
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie—Sezione di Microbiologia, Università Cattolica del S. Cuore, 00168 Rome, Italy
| | - Chiara Camponeschi
- Dipartimento di Medicina e Chirurgia Traslazionale, Sezione di Patologia Generale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (G.D.S.); (M.T.); (C.C.); (F.R.)
| | - Nicola Bonadia
- Dipartimento di Medicina di Emergenza, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy;
| | - Daniele Biasucci
- Dipartimento di Anestesia e Terapia Intensiva, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy;
| | - Davide Pata
- Dipartimento della Salute della Donna e del Bambino e di Sanità, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (C.D.R.); (D.P.); (A.C.); (P.V.)
| | - Antonio Chiaretti
- Dipartimento della Salute della Donna e del Bambino e di Sanità, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (C.D.R.); (D.P.); (A.C.); (P.V.)
| | - Piero Valentini
- Dipartimento della Salute della Donna e del Bambino e di Sanità, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (C.D.R.); (D.P.); (A.C.); (P.V.)
| | - Francesco Ria
- Dipartimento di Medicina e Chirurgia Traslazionale, Sezione di Patologia Generale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (G.D.S.); (M.T.); (C.C.); (F.R.)
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (I.P.); (F.D.M.); (M.S.); (M.S.)
| | - Maurizio Sanguinetti
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (I.P.); (F.D.M.); (M.S.); (M.S.)
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie—Sezione di Microbiologia, Università Cattolica del S. Cuore, 00168 Rome, Italy
| | - Michela Sali
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (I.P.); (F.D.M.); (M.S.); (M.S.)
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie—Sezione di Microbiologia, Università Cattolica del S. Cuore, 00168 Rome, Italy
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Buonsenso D, Valentini P, Macchi M, Folino F, Pensabene C, Patria MF, Agostoni C, Castaldi S, Lecce M, Giannì ML, Marchisio P, Milani GP. Caregivers' Attitudes Toward COVID-19 Vaccination in Children and Adolescents With a History of SARS-CoV-2 Infection. Front Pediatr 2022; 10:867968. [PMID: 35463893 PMCID: PMC9021633 DOI: 10.3389/fped.2022.867968] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 03/03/2022] [Indexed: 12/28/2022] Open
Abstract
Background Limited data are available on the attitudes of caregivers toward COVID-19 vaccination in children and adolescents with a history of SARS-CoV-2 infection or Long Covid symptoms. The aim of this study was to investigate the vaccine hesitancy among caregivers of children and adolescents with a documented history of SARS-CoV-2 infection and to explore the possible associations between COVID-19 manifestations and the acceptance of the vaccine. Methods Caregivers of children or adolescents with a microbiologically confirmed diagnosis of SARS-CoV-2 infection evaluated in two University Hospitals were interviewed. Results We were able to contact 132 caregivers and 9 declined to participate. 68 caregivers (56%) were in favor of COVID-19 vaccination for their child. In the multiple logistic regression, child's age (OR 1.17, 95%CI 1.06-1.28) and hospitalization due to COVID-19 (OR 3.25, 95%CI 1.06-9.95) were positively associated with being in favor of COVID-19 vaccination. On the contrary, the occurrence of child's Long Covid was associated with a higher likelihood of being against the vaccination (OR 0.28, 95%CI 0.10-0.80). Conclusions This preliminary study shows that only about half of the interviewed parents of children and adolescents with a previous SARS-CoV-2 infection are willing to vaccinate them to prevent a repeated COVID-19 infection. These findings might help healthcare workers to provide tailored information to caregivers of children with a previous SARS-CoV-2 infection.
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Affiliation(s)
- Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario “A. Gemelli”, Rome, Italy
- Center for Global Health Research and Studies, Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Piero Valentini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario “A. Gemelli”, Rome, Italy
- Center for Global Health Research and Studies, Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Marina Macchi
- Department of Clinical Science and Community Health, University of Milan, Milan, Italy
| | - Francesco Folino
- Department of Clinical Science and Community Health, University of Milan, Milan, Italy
| | - Carola Pensabene
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Unit, Milan, Italy
| | | | - Carlo Agostoni
- Department of Clinical Science and Community Health, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Unit, Milan, Italy
| | - Silvana Castaldi
- Department of Biomedical Sciences for Health, Postgraduate School of Public Health, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Maurizio Lecce
- Department of Biomedical Sciences for Health, Postgraduate School of Public Health, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Maria Lorella Giannì
- Department of Clinical Science and Community Health, University of Milan, Milan, Italy
- Neonatal Intensive Care Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paola Marchisio
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Unit, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Gregorio P. Milani
- Department of Clinical Science and Community Health, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Unit, Milan, Italy
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Buonsenso D, Salerno G, Sodero G, Mariani F, Pisapia L, Gelormini C, Di Nardo M, Valentini P, Scoppettuolo G, Biasucci DG. Catheter salvage strategies in children with central venous catheter related or associated bloodstream infections: a systematic review and meta-analysis. J Hosp Infect 2022; 125:1-20. [PMID: 35390396 DOI: 10.1016/j.jhin.2022.03.010] [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: 01/16/2022] [Revised: 03/25/2022] [Accepted: 03/26/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Optimal management of Central Venous Catheter related, or associated, bloodstream infections (CRBSI or CLABSI) in children is not established. OBJECTIVE To evaluate successful of catheter salvage strategies in pediatric patients. METHODS Studies retrieved from medical databases and article reference lists. Data were collected relating to clinical outcomes of 2 treatments: systemic antibiotics alone or in association with antimicrobial lock therapy (ALT). 95% CIs and OR were calculated from a mixed logistic effects model. Heterogeneity was summarized using I2 statistics. Publication bias was investigated by Egger's regression test and funnel plots. RESULTS From 345 identified publications, 19 met inclusion criteria (total of 914 attempted salvage strategies. To achieve successful catheter salvage, in CRBSI the addition of ALT was superior to systemic antibiotics alone (OR -0.40, 95%CI -1.41 - 0.62): 77% (95%CI 69-85, I2=42.5%, p=0.12) and 68% of success (95%CI 59-77, I2=0, p<0.05), respectively. CRBSI recurrence was less common in studies that used ALT compared with systemic antibiotics alone: 5% (95%CI 0-13, I2=59.7%; p=0.03) and 18% of recurrence (95%CI, 9-28, I2=0, p< 0.05), respectively. Recurrences were low with both antibiotic-locks and ethanol-lock. No clear benefits of ALT addition compared to systemic antibiotic only was found in CLABSI (OR -0.81, 95% CI -0.80 - 2.43). CONCLUSIONS The addition of an antimicrobial lock solution to systemic antibiotic may be beneficial for successful catheter salvage in pediatric patients with CRBSI, depending on etiology, whilst no statistically significant difference between systemic antibiotic with or without addition of an antimicrobial lock solution was found regarding CLABSI.
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Affiliation(s)
- Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy; Global Health Research Institute, Istituto di Igiene, Università Cattolica del Sacro Cuore, Rome, Italy.
| | - Gilda Salerno
- Institute of Pediatrics, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giorgio Sodero
- Institute of Pediatrics, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesco Mariani
- Institute of Pediatrics, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Luca Pisapia
- Department of Emergency, Intensive Care Medicine and Anesthesiology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Camilla Gelormini
- Department of Emergency, Intensive Care Medicine and Anesthesiology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Matteo Di Nardo
- Pediatric Intensive Care Unit, Children's Hospital Bambino Gesù, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Piero Valentini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
| | - Giancarlo Scoppettuolo
- Department of Infectious Diseases, Fondazione Policlinico Universitario "A.Gemelli" IRCCS, Rome, Italy
| | - Daniele Guerino Biasucci
- Department of Emergency, Intensive Care Medicine and Anesthesiology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
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Buonsenso D, Bianchi F, Scoppettuolo G, Frassanito P, Massimi L, Caldarelli M, Salvatelli N, Ferro V, Valentini P, Tamburrini G. Cerebrospinal Fluid Shunt Infections in Children: Do Hematologic and Cerebrospinal Fluid White Cells Examinations Correlate With the Type of Infection? Pediatr Infect Dis J 2022; 41:324-329. [PMID: 34654790 PMCID: PMC10863656 DOI: 10.1097/inf.0000000000003374] [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] [Accepted: 09/05/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Cerebrospinal fluid (CSF) shunt infections in children represent an increasing problem in clinical practice. However, comprehensive clinical, laboratory and microbiologic data are scarce in pediatric age. METHODS We conducted a 10-year retrospective study to (1) analyze clinical, laboratory and microbiologic parameters associated with infections in children; (2) analyze results according to the type of catheter (medicated or not), type of infection (first or relapses), type of hydrocephalus (acquired and congenital), presence or not of bacteriemia; (3) describe antibiotic susceptibilities and their evolution during the study period. RESULTS Eighty-seven children with shunt infection and 61 children with mechanical shunt malfunction were enrolled. Fever, vomit, leukocytosis and elevated C-reactive protein were more frequent in the infected group (P < 0.001), while neurologic symptoms developed more frequently in the noninfected group (10.3% vs. 27.87%; P = 0.006). Local signs of inflammation and abdomen distension were similarly reported in the 2 groups. Children with medicated shunts had lower cell count in the CSF (12/mm3) compared with those with nonmedicated shunts (380/mm3; P < 0.0001). Gram-negative bacteria were more common in the not-medicated catheters (90.91% vs. 50% of cultures; P = 0.04). Gram-negative bacteria were identified in 50.67% of CSF cultures, Gram-positive bacteria in 53.33% and fungi were observed in 5.33%. Sixteen children (18.4%) had also a positive blood culture. Enterococci isolation was associated with relapsed infections (37.50% vs. 15.25%; P = 0.05). CONCLUSIONS Our study shows that the diagnosis and management of children with shunt infections are challenging. Prospective studies with a comprehensive approach focusing on patient, medical, microbiologic and surgical risk factors for first infection are urgently needed.
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Affiliation(s)
- Danilo Buonsenso
- From the Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore
- Center for Global Health Research and Studies, Università Cattolica del Sacro Cuore
| | - Federico Bianchi
- Pediatric Neurosurgery, Institute of Neurosurgery, Catholic University Medical School
| | - Giancarlo Scoppettuolo
- Department of Infectious Diseases, Fondazione Policlinico Universitario “A. Gemelli” IRCCS
| | - Paolo Frassanito
- Pediatric Neurosurgery, Institute of Neurosurgery, Catholic University Medical School
| | - Luca Massimi
- Pediatric Neurosurgery, Institute of Neurosurgery, Catholic University Medical School
| | - Massimo Caldarelli
- Pediatric Neurosurgery, Institute of Neurosurgery, Catholic University Medical School
| | - Niccolò Salvatelli
- From the Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS
| | - Valentina Ferro
- Emergency Department, Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - Piero Valentini
- From the Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS
- Center for Global Health Research and Studies, Università Cattolica del Sacro Cuore
| | - Gianpiero Tamburrini
- Pediatric Neurosurgery, Institute of Neurosurgery, Catholic University Medical School
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Camporesi A, Morello R, Ferro V, Pierantoni L, Rocca A, Lanari M, Trobia GL, Sciacca T, Bellinvia AG, De Ferrari A, Valentini P, Roland D, Buonsenso D. Epidemiology, Microbiology and Severity of Bronchiolitis in the First Post-Lockdown Cold Season in Three Different Geographical Areas in Italy: A Prospective, Observational Study. Children (Basel) 2022; 9:children9040491. [PMID: 35455535 PMCID: PMC9024462 DOI: 10.3390/children9040491] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 03/19/2022] [Accepted: 03/21/2022] [Indexed: 11/16/2022]
Abstract
The aim of this study was to understand the epidemiology, disease severity, and microbiology of bronchiolitis in Italy during the 2021–2022 cold season, outside of lockdowns. Before COVID-19, the usual bronchiolitis season in Italy would begin in November and end in April, peaking in February. We performed a prospective observational study in four referral pediatric centers located in different geographical areas in Italy (two in the north, one in the center and one in the south). From 1 July 2021 to 31 January 2022, we collected all new clinical diagnoses of bronchiolitis in children younger than two years of age recording demographic, clinical and microbiological data. A total of 657 children with a clinical diagnosis of bronchiolitis were enrolled; 56% children were admitted and 5.9% required PICU admission. The first cases were detected during the summer, peaking in November 2021 and declining into December 2021 with only a few cases detected in January 2022. RSV was the commonest etiological agent, while SARS-CoV-2 was rarely detected and only since the end of December 2021. Disease severity was similar in children with RSV vs. non-RSV bronchiolitis, and in those with a single infectious agent detected compared with children with co-infections. The 2021–2022 bronchiolitis season in Italy started and peaked earlier than the usual pre-pandemic seasons, but had a shorter duration. Importantly, the current bronchiolitis season was not more severe when data were compared with Italian published data, and SARS-CoV-2 was rarely a cause of bronchiolitis in children younger than 24 months of age.
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Affiliation(s)
- Anna Camporesi
- Anesthesia and Intensive Care Unit, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (A.C.); (A.D.F.)
| | - Rosa Morello
- Department of Woman and Child Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (R.M.); (P.V.)
| | - Valentina Ferro
- Department of Pediatric Emergency, Bambin Gesù Children’s Hospital IRCCS, 00168 Rome, Italy;
| | - Luca Pierantoni
- Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (L.P.); (A.R.); (M.L.)
| | - Alessandro Rocca
- Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (L.P.); (A.R.); (M.L.)
| | - Marcello Lanari
- Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (L.P.); (A.R.); (M.L.)
| | - Gian Luca Trobia
- Pediatric and Pediatric Emergency Room Unit, Cannizzaro Emergency Hospital-Catania, 95126 Catania, Italy; (G.L.T.); (T.S.); (A.G.B.)
| | - Tiziana Sciacca
- Pediatric and Pediatric Emergency Room Unit, Cannizzaro Emergency Hospital-Catania, 95126 Catania, Italy; (G.L.T.); (T.S.); (A.G.B.)
| | - Agata Giuseppina Bellinvia
- Pediatric and Pediatric Emergency Room Unit, Cannizzaro Emergency Hospital-Catania, 95126 Catania, Italy; (G.L.T.); (T.S.); (A.G.B.)
| | - Alessandra De Ferrari
- Anesthesia and Intensive Care Unit, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (A.C.); (A.D.F.)
| | - Piero Valentini
- Department of Woman and Child Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (R.M.); (P.V.)
| | - Damian Roland
- Paediatric Emergency Medicine Leicester Academic (PEMLA) Group, Leicester Hospital, Leicester LE1 5WW, UK;
- Social science APPlied to Healthcare Improvement REsearch, SAPPHIRE Group, Health Sciences, Leicester University, Leicester LE1 7RH, UK
| | - Danilo Buonsenso
- Department of Woman and Child Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (R.M.); (P.V.)
- Center for Global Health Research Studies, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Correspondence: ; Tel.: +39-06-30154390
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Buonsenso D, Pata D, Turriziani Colonna A, Ferrari V, Salerno G, Valentini P. Vitamin D and tuberculosis in children: a role in the prevention or treatment of the disease? Monaldi Arch Chest Dis 2022; 92. [PMID: 35352542 DOI: 10.4081/monaldi.2022.2112] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 03/24/2022] [Indexed: 11/23/2022] Open
Abstract
Despite the growing number of published studies, the role of vitamin D in the prevention or treatment of tuberculosis remains unclear. In this review we analyze current scientific literature to provide evidence about the relationship between vitamin D and TB, with a special focus on the pediatric population. While in vitro studies have shown relevant antimycobacterial immune-stimulatory and immunosuppressive effects of vitamin D, this has not panned out in vivo with active TB. On the contrary, there is some evidence that this tool could work as prevention - both against TB infection as well as progression from latent to active infection. However, only a few studies have evaluated this correlation in children. The potential link between tuberculosis and vitamin D levels is promising. If effective, vitamin D supplementation of at-risk populations would be an affordable public health intervention, particularly in light of the worldwide increase in identified TB cases and drug-resistance. Vitamin D might represent a new, affordable, safe and easy to access drug for the prevention and treatment of TB. For stronger evidence, considering the features of infection (relative low incidence of reactivation of latent infection in immunocompetent patients) we need clinical trials with large numbers of participants conducted in endemic regions with a prolonged follow-up time.
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Affiliation(s)
- Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario "Agostino Gemelli", Rome.
| | - Davide Pata
- Institute of Pediatrics, Catholic University of Sacred Heart, Rome.
| | | | - Vittoria Ferrari
- Institute of Pediatrics, Catholic University of Sacred Heart, Rome.
| | - Gilda Salerno
- Institute of Pediatrics, Catholic University of Sacred Heart, Rome.
| | - Piero Valentini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario "Agostino Gemelli", Rome; Institute of Pediatrics, Catholic University of Sacred Heart, Rome.
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Buonsenso D, Gennaro LD, Rose CD, Morello R, D'Ilario F, Zampino G, Piazza M, Boner AL, Iraci C, O'Connell S, Cohen VB, Esposito S, Munblit D, Reena J, Sigfrid L, Valentini P. Long-term outcomes of pediatric infections: from traditional infectious diseases to long covid. Future Microbiol 2022; 17:551-571. [PMID: 35264003 PMCID: PMC8910780 DOI: 10.2217/fmb-2022-0031] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [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] [Indexed: 02/07/2023] Open
Abstract
There is limited evidence available on the long-term impact of SARS-CoV-2 infection in children. In this article, the authors analyze the recent evidence on pediatric long covid and lessons learnt from a pediatric post-covid unit in Rome, Italy. To gain a better understanding of the concerns raised by parents and physicians in relation to the potential long-term consequences of this novel infection, it is important to recognize that long-term effect of a post-infectious disease is not a new phenomenon. The authors analyze the recent evidence on pediatric long covid and lessons learnt from a pediatric post-covid unit in Rome, Italy. Also, we analyze the long-term effects of other infectious diseases. An analysis of the recent evidence on pediatric long covid and lessons learnt from a pediatric post-covid unit in Rome, Italy.
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Affiliation(s)
- Danilo Buonsenso
- Department of Woman & Child Health & Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy.,Center for Global Health Research & Studies, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Leonardo Di Gennaro
- Department of Diagnostic Imaging, Hemorrhagic & Thrombotic Diseases Center, Oncological Radiotherapy, & Hematology, Foundation 'A Gemelli' IRCCS University Hospital, Rome, Italy
| | - Cristina De Rose
- Department of Woman & Child Health & Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Rosa Morello
- Department of Woman & Child Health & Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Federico D'Ilario
- Department of Woman & Child Health & Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Giuseppe Zampino
- Department of Woman & Child Health & Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Michele Piazza
- Pediatric Section, Department of Surgery, Dentistry, pediatrics, & Gynaecology, University of Verona, Verona, Italy
| | - Attilio L Boner
- Pediatric Section, Department of Surgery, Dentistry, pediatrics, & Gynaecology, University of Verona, Verona, Italy
| | | | | | - Valentina B Cohen
- Patient author, member of the CAC Community Advisory Council of Solve ME/CFS Initiative, Pietro Barilla Children's Hospital, Department of Medicine & Surgery, University of Parma, Via Gramsci 14, Parma, 43126, Italy
| | - Susanna Esposito
- Pietro Barilla Children's Hospital, Department of Medicine & Surgery, University of Parma, Via Gramsci 14, Parma, 43126, Italy
| | - Daniel Munblit
- Department of pediatrics & pediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
| | - Joseph Reena
- MSc Immunology, Imperial College London, London, UK
| | - Louise Sigfrid
- ISARIC Global Support Centre, Centre for Tropical Medicine & Global Health, University of Oxford, Oxford, UK
| | - Piero Valentini
- Department of Woman & Child Health & Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
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De Maio F, Buonsenso D, Bianco DM, Giaimo M, Fosso B, Monzo FR, Sali M, Posteraro B, Valentini P, Sanguinetti M. Comparative Fecal Microbiota Analysis of Infants With Acute Bronchiolitis Caused or Not Caused by Respiratory Syncytial Virus. Front Cell Infect Microbiol 2022; 12:815715. [PMID: 35330643 PMCID: PMC8940166 DOI: 10.3389/fcimb.2022.815715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 02/07/2022] [Indexed: 12/11/2022] Open
Abstract
Bronchiolitis due to respiratory syncytial virus (RSV) or non-RSV agents is a health-menacing lower respiratory tract (LRT) disease of infants. Whereas RSV causes more severe disease than other viral agents may, genus-dominant fecal microbiota profiles have been identified in US hospitalized infants with bronchiolitis. We investigated the fecal microbiota composition of infants admitted to an Italian hospital with acute RSV (25/37 [67.6%]; group I) or non-RSV (12/37 [32.4%]; group II) bronchiolitis, and the relationship of fecal microbiota characteristics with the clinical characteristics of infants. Group I and group II infants differed significantly (24/25 [96.0%] versus 5/12 [41.7%]; P = 0.001) regarding 90% oxygen saturation (SpO2), which is an increased respiratory effort hallmark. Accordingly, impaired feeding in infants from group I was significantly more frequent than in infants from group II (19/25 [76.0%] versus 4/12 [33.3%]; P = 0.04). Conversely, the median (IQR) length of stay was not significantly different between the two groups (seven [3–14] for group I versus five [5–10] for group II; P = 0.11). The 16S ribosomal RNA V3–V4 region amplification of infants’ fecal samples resulted in 299 annotated amplicon sequence variants. Based on alpha- and beta-diversity microbiota downstream analyses, group I and group II infants had similar bacterial communities in their samples. Additionally, comparing infants having <90% SpO2 (n = 29) with infants having ≥90% SpO2 (n = 8) showed that well-known dominant genera (Bacteroides, Bifidobacterium, Escherichia/Shigella, and Enterobacter/Veillonella) were differently, but not significantly (P = 0.44, P = 0.71, P = 0.98, and P = 0.41, respectively) abundant between the two subgroups. Overall, we showed that, regardless of RSV or non-RSV bronchiolitis etiology, no fecal microbiota-composing bacteria could be associated with the severity of acute bronchiolitis in infants. Larger and longitudinally conducted studies will be necessary to confirm these findings.
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Affiliation(s)
- Flavio De Maio
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Danilo Buonsenso
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Delia Mercedes Bianco
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Martina Giaimo
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Bruno Fosso
- Istituto di Biomembrane, Bioenergetica e Biotecnologie Molecolari (IBIOM), Consiglio Nazionale delle Ricerche, Bari, Italy
| | - Francesca Romana Monzo
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Michela Sali
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Brunella Posteraro
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Piero Valentini
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Maurizio Sanguinetti
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy
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De Rose C, Miceli Sopo S, Valentini P, Morello R, Biasucci D, Buonsenso D. Potential Application of Lung Ultrasound in Children with Severe Uncontrolled Asthma: Preliminary Hypothesis Based on a Case Series. Medicines 2022; 9:medicines9020011. [PMID: 35200755 PMCID: PMC8877587 DOI: 10.3390/medicines9020011] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 01/26/2022] [Accepted: 01/27/2022] [Indexed: 11/16/2022]
Abstract
In recent years, lung ultrasound (LUS) has been increasingly used for the diagnosis of respiratory diseases in both adult and pediatric patients. However, asthma is a field in which the use of LUS is not yet well defined, or is in development. In the following case series, we describe clinical, laboratory, and radiological results, as well as detailed lung ultrasound findings of six children with asthma: some of them with acute asthma attack and with inadequately controlled allergic asthma or childhood asthma; others with acute asthma and allergic or infantile asthma adequately controlled by preventive therapy. Finally, we describe the clinical, laboratory, and imaging parameters of a child with severe allergic asthma in the absence of exacerbation. In these cases, albeit at different times, LUS played an important role in both the initial diagnostic process and follow-up. It also showed different ultrasound features depending on the severity of the individual asthma based on the type of asthmatic phenotype and control of it.
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Affiliation(s)
- Cristina De Rose
- Department of Woman and Child Health and Public Health, Policlinic Gemelli Universitary Foundation IRCCS, Catholic University of Sacre Hearth, 00168 Rome, Italy; (S.M.S.); (P.V.); (R.M.); (D.B.)
- Correspondence: ; Tel.: +32-7661-4543 or +39-06-3015-4390; Fax: +39-06-338-3211
| | - Stefano Miceli Sopo
- Department of Woman and Child Health and Public Health, Policlinic Gemelli Universitary Foundation IRCCS, Catholic University of Sacre Hearth, 00168 Rome, Italy; (S.M.S.); (P.V.); (R.M.); (D.B.)
| | - Piero Valentini
- Department of Woman and Child Health and Public Health, Policlinic Gemelli Universitary Foundation IRCCS, Catholic University of Sacre Hearth, 00168 Rome, Italy; (S.M.S.); (P.V.); (R.M.); (D.B.)
| | - Rosa Morello
- Department of Woman and Child Health and Public Health, Policlinic Gemelli Universitary Foundation IRCCS, Catholic University of Sacre Hearth, 00168 Rome, Italy; (S.M.S.); (P.V.); (R.M.); (D.B.)
| | - Daniele Biasucci
- Department of Anesthesia and Intensive Care, Fondazione Policlinico Universitario “A. Gemelli”, 00168 Rome, Italy;
| | - Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Policlinic Gemelli Universitary Foundation IRCCS, Catholic University of Sacre Hearth, 00168 Rome, Italy; (S.M.S.); (P.V.); (R.M.); (D.B.)
- Department of Basic Biotechnological Sciences, Intensive and Perioperative Clinics, Catholic University of Sacre Hearth, 00168 Rome, Italy
- Global Health Research Institute, Institute of Hygiene, Catholic University of Sacre Hearth, 00168 Rome, Italy
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48
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Buonsenso D, De Rose C, Ferro V, Morello R, Musolino A, Valentini P. Lung ultrasound to detect cardiopulmonary interactions in acutely ill children. Pediatr Pulmonol 2022; 57:483-497. [PMID: 34761881 DOI: 10.1002/ppul.25755] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 06/23/2021] [Revised: 09/28/2021] [Accepted: 10/28/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE AND DESIGN Our prospective observational study is the first study that evaluates the lung ultrasound (LUS) findings of cardiopulmonary interactions in acutely ill children with elevated pro-brain natriuretic peptide (BNP) levels, with the aim of establishing the specific LUS pattern in this category of patients without primary lung diseases. METHODOLOGY We prospectively analyzed epidemiological, clinical, laboratory, instrumental, and lung ultrasound parameters in acutely ill children aged 1 month to 18 years admitted to the Department of Pediatrics between March 2020 to August 2020. Among the acutely ill patients evaluated, only patients with pro-BNP > 300 pg/ml and who underwent LUS before the start of any treatment were included. They were stratified into three subcategories based on the diagnosis (A) cardiac disease, (B) systemic inflammatory disease/sepsis without functional and/or organic alterations of the myocardium, and (C) systemic inflammatory disease/sepsis and cardiac disease, and were classified into two groups based on the level of pro-BNP. We also enrolled patients belonging to two other categories (patients with primary infectious lung disease and completely healthy patients) analyzing their epidemiological, clinical, laboratory, instrumental parameters, and lung ultrasound findings and comparing them with those of acutely ill children. RESULTS AND CONCLUSION We found that LUS findings in these acutely ill children are different from the ultrasound pattern of other categories of children and in particular (1) children with acute lower respiratory tract infections and (2) healthy infants. The finding in a child of a sonographic interstitial syndrome with multiple, bright, long, separate, and nonconfluent B-lines/long vertical artifacts deriving from a normal and regular pleural line, in the absence of subpleural consolidations, is strongly predictive of cardiogenic pulmonary edema or pulmonary congestion in the course of systemic inflammatory disease/sepsis.
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Affiliation(s)
- Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy.,Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy.,Global Health Research Institute, Istituto di Igiene, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Cristina De Rose
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
| | - Valentina Ferro
- Department of Pediatric Emergency Medicine, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Rosa Morello
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
| | - Annamaria Musolino
- Department of Pediatric Emergency Medicine, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Piero Valentini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
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49
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Musolino AM, Tomà P, De Rose C, Pitaro E, Boccuzzi E, De Santis R, Morello R, Supino MC, Villani A, Valentini P, Buonsenso D. Ten Years of Pediatric Lung Ultrasound: A Narrative Review. Front Physiol 2022; 12:721951. [PMID: 35069230 PMCID: PMC8770918 DOI: 10.3389/fphys.2021.721951] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [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: 06/07/2021] [Accepted: 11/17/2021] [Indexed: 12/04/2022] Open
Abstract
Lung diseases are the most common conditions in newborns, infants, and children and are also the primary cause of death in children younger than 5 years old. Traditionally, the lung was not thought to be a target for an ultrasound due to its inability to penetrate the gas-filled anatomical structures. With the deepening of knowledge on ultrasound in recent years, it is now known that the affected lung produces ultrasound artifacts resulting from the abnormal tissue/gas/tissue interface when ultrasound sound waves penetrate lung tissue. Over the years, the application of lung ultrasound (LUS) has changed and its main indications in the pediatric population have expanded. This review analyzed the studies on lung ultrasound in pediatrics, published from 2010 to 2020, with the aim of highlighting the usefulness of LUS in pediatrics. It also described the normal and abnormal appearances of the pediatric lung on ultrasound as well as the benefits, limitations, and possible future challenges of this modality.
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Affiliation(s)
- Anna Maria Musolino
- Pediatric Emergency Unit, Department of Emergency and General Pediatrics, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Paolo Tomà
- Department of Imaging, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Cristina De Rose
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Eugenio Pitaro
- Pediatric Emergency Unit, Department of Emergency and General Pediatrics, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Elena Boccuzzi
- Pediatric Emergency Unit, Department of Emergency and General Pediatrics, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Rita De Santis
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Rosa Morello
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Maria Chiara Supino
- Pediatric Emergency Unit, Department of Emergency and General Pediatrics, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Alberto Villani
- General Pediatric and Infectious Disease Unit, Internal Care Department, Bambino Gesù Children’s Hospital, Rome, Italy
| | - Piero Valentini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy
- Global Health Research Institute, Istituto di Igiene, Università Cattolica del Sacro Cuore, Rome, Italy
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50
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Buonsenso D, Malorni W, Turriziani Colonna A, Morini S, Sbarbati M, Solipaca A, Di Mauro A, Carducci B, Lanzone A, Moscato U, Costa S, Vento G, Valentini P. Psychological Impact of the COVID-19 Pandemic on Pregnant Women. Front Pediatr 2022; 10:790518. [PMID: 35498808 PMCID: PMC9039297 DOI: 10.3389/fped.2022.790518] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 02/24/2022] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE The aim of this study is to assess the impact of the COVID-19 pandemic on mental health, type of delivery, and neonatal feeding of pregnant women with or without SARS-CoV-2 infection during gestation. STUDY DESIGN The study was conducted online, and anonymous survey was distributed to mothers that delivered during the COVID-19 pandemic. RESULTS The survey was completed by 286 women, and 64 women (22.4%) had COVID-19 during pregnancy. Women that had SARS-CoV-2 infection during pregnancy or at time of delivery had a significantly higher probability of being separated from the newborn (p < 0.0001) and a significantly lower probability of breastfeeding (p < 0.0001). The Edinburg Postnatal Depression Scale, to assess if mothers had symptoms of postnatal depression, showed that items suggestive of postnatal depression were relatively frequent in the whole cohort. However, women with SARS-CoV-2 infection during pregnancy reported higher probability of responses suggestive of postnatal depression in eight out of 10 items, with statistically significant differences in three items. CONCLUSION The COVID-19 pandemic affected the type of delivery and breastfeeding of pregnant women, particularly when they had SARS-CoV-2 infection. This, in turn, had an impact on the psychological status of the interviewed mothers, aspects that could benefit of special support.
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Affiliation(s)
- Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy.,Global Health Research Institute, Istituto di Igiene, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Walter Malorni
- Global Health Research Institute, Istituto di Igiene, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Arianna Turriziani Colonna
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Sofia Morini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Martina Sbarbati
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Alessandro Solipaca
- National Observatory on Health in the Italian Regions, Istituto di Igiene, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Antonio Di Mauro
- Pediatric Primary Care, National Pediatric Healthcare System, Margherita di Savoia, Italy
| | - Brigida Carducci
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Antonio Lanzone
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Umberto Moscato
- Global Health Research Institute, Istituto di Igiene, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Simonetta Costa
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giovanni Vento
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Piero Valentini
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy.,Global Health Research Institute, Istituto di Igiene, Università Cattolica del Sacro Cuore, Rome, Italy
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