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Zambrano LD, Newhams MM, Simeone RM, Payne AB, Wu M, Orzel-Lockwood AO, Halasa NB, Calixte JM, Pannaraj PS, Mongkolrattanothai K, Boom JA, Sahni LC, Kamidani S, Chiotos K, Cameron MA, Maddux AB, Irby K, Schuster JE, Mack EH, Biggs A, Coates BM, Michelson KN, Bline KE, Nofziger RA, Crandall H, Hobbs CV, Gertz SJ, Heidemann SM, Bradford TT, Walker TC, Schwartz SP, Staat MA, Bhumbra SS, Hume JR, Kong M, Stockwell MS, Connors TJ, Cullimore ML, Flori HR, Levy ER, Cvijanovich NZ, Zinter MS, Maamari M, Bowens C, Zerr DM, Guzman-Cottrill JA, Gonzalez I, Campbell AP, Randolph AG. Durability of Original Monovalent mRNA Vaccine Effectiveness Against COVID-19 Omicron-Associated Hospitalization in Children and Adolescents - United States, 2021-2023. MMWR Morb Mortal Wkly Rep 2024; 73:330-338. [PMID: 38635481 PMCID: PMC11037436 DOI: 10.15585/mmwr.mm7315a2] [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] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Abstract
Pediatric COVID-19 vaccination is effective in preventing COVID-19-related hospitalization, but duration of protection of the original monovalent vaccine during SARS-CoV-2 Omicron predominance merits evaluation, particularly given low coverage with updated COVID-19 vaccines. During December 19, 2021-October 29, 2023, the Overcoming COVID-19 Network evaluated vaccine effectiveness (VE) of ≥2 original monovalent COVID-19 mRNA vaccine doses against COVID-19-related hospitalization and critical illness among U.S. children and adolescents aged 5-18 years, using a case-control design. Too few children and adolescents received bivalent or updated monovalent vaccines to separately evaluate their effectiveness. Most case-patients (persons with a positive SARS-CoV-2 test result) were unvaccinated, despite the high frequency of reported underlying conditions associated with severe COVID-19. VE of the original monovalent vaccine against COVID-19-related hospitalizations was 52% (95% CI = 33%-66%) when the most recent dose was administered <120 days before hospitalization and 19% (95% CI = 2%-32%) if the interval was 120-364 days. VE of the original monovalent vaccine against COVID-19-related hospitalization was 31% (95% CI = 18%-43%) if the last dose was received any time within the previous year. VE against critical COVID-19-related illness, defined as receipt of noninvasive or invasive mechanical ventilation, vasoactive infusions, extracorporeal membrane oxygenation, and illness resulting in death, was 57% (95% CI = 21%-76%) when the most recent dose was received <120 days before hospitalization, 25% (95% CI = -9% to 49%) if it was received 120-364 days before hospitalization, and 38% (95% CI = 15%-55%) if the last dose was received any time within the previous year. VE was similar after excluding children and adolescents with documented immunocompromising conditions. Because of the low frequency of children who received updated COVID-19 vaccines and waning effectiveness of original monovalent doses, these data support CDC recommendations that all children and adolescents receive updated COVID-19 vaccines to protect against severe COVID-19.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Overcoming COVID-19 Investigators
- Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, CDC; Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children’s Hospital, Boston, Massachusetts; Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee; Division of Infectious Diseases, Children’s Hospital Los Angeles, Los Angeles, California; Department of Pediatrics, University of California, San Diego, San Diego, California; Division of Pediatric Infectious Diseases, Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, California; Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children’s Hospital, Houston, Texas; The Center for Childhood Infections and Vaccines of Children’s Healthcare of Atlanta, Atlanta, Georgia; Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia; Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania; Division of Pediatric Hospital Medicine, UC San Diego-Rady Children’s Hospital, San Diego, California; Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine, Aurora, Colorado; Children’s Hospital Colorado, Aurora, Colorado; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock, Arkansas; Division of Pediatric Infectious Diseases, Department of Pediatrics, Children’s Mercy Kansas City, Kansas City, Missouri; Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston, South Carolina; Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Division of Critical Care Medicine, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois; Division of Pediatric Critical Care Medicine, Nationwide Children’s Hospital, Columbus, Ohio; Division of Critical Care Medicine, Department of Pediatrics, Akron Children’s Hospital, Akron, Ohio; Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City, Utah; Primary Children’s Hospital, Salt Lake City, Utah; Department of Pediatrics, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson, Mississippi; Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, New Jersey; Division of Pediatric Critical Care Medicine, Children’s Hospital of Michigan, Central Michigan University, Detroit, Michigan; Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center, New Orleans, Louisiana; Children’s Hospital of New Orleans, New Orleans, Louisiana; Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill, North Carolina; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana; Division of Pediatric Critical Care, University of Minnesota Masonic Children’s Hospital, Minneapolis, Minnesota; Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama; Division of Child and Adolescent Health, Department of Pediatrics, Vagelos College of Physicians and Surgeons, New York, New York; Department of Population and Family Health, Mailman School of Public Health Columbia University, New York, New York; New York-Presbyterian Morgan Stanley Children’s Hospital; New York, New York; Division of Critical Care and Hospital Medicine, Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York; Division of Pediatric Critical Care, Department of Pediatrics, Children's Nebraska, Omaha, Nebraska; Division of Pediatric Critical Care Medicine, Department of Pediatrics, C.S. Mott Children’s Hospital, Ann Arbor, Michigan; Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota; Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland, California; Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California San Francisco, San Francisco, California; Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center Dallas, Texas; Division of Pediatric Infectious Diseases, Department of Pediatrics, Seattle Children's Hospital, Seattle, Washington; Department of Pediatrics, Division of Infectious Diseases, Oregon Health & Science University, Portland, Oregon; Division of Pediatric Infectious Diseases, Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida; Department of Anaesthesia, Harvard Medical School, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
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Zambrano LD, Newhams MM, Simeone RM, Fleming-Dutra KE, Halasa N, Wu M, Orzel-Lockwood AO, Kamidani S, Pannaraj PS, Chiotos K, Cameron MA, Maddux AB, Schuster JE, Crandall H, Kong M, Nofziger RA, Staat MA, Bhumbra SS, Irby K, Boom JA, Sahni LC, Hume JR, Gertz SJ, Maamari M, Bowens C, Levy ER, Bradford TT, Walker TC, Schwartz SP, Mack EH, Guzman-Cottrill JA, Hobbs CV, Zinter MS, Cvijanovich NZ, Bline KE, Hymes SR, Campbell AP, Randolph AG. Characteristics and Clinical Outcomes of Vaccine-Eligible US Children Under-5 Years Hospitalized for Acute COVID-19 in a National Network. Pediatr Infect Dis J 2024; 43:242-249. [PMID: 38145397 DOI: 10.1097/inf.0000000000004225] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2023]
Abstract
BACKGROUND AND OBJECTIVES In June 2022, the mRNA COVID-19 vaccination was recommended for young children. We examined clinical characteristics and factors associated with vaccination status among vaccine-eligible young children hospitalized for acute COVID-19. METHODS We enrolled inpatients 8 months to <5 years of age with acute community-acquired COVID-19 across 28 US pediatric hospitals from September 20, 2022 to May 31, 2023. We assessed demographic and clinical factors, including the highest level of respiratory support, and vaccination status defined as unvaccinated, incomplete, or complete primary series [at least 2 (Moderna) or 3 (Pfizer-BioNTech) mRNA vaccine doses ≥14 days before hospitalization]. RESULTS Among 597 children, 174 (29.1%) patients were admitted to the intensive care unit and 75 (12.6%) had a life-threatening illness, including 51 (8.5%) requiring invasive mechanical ventilation. Children with underlying respiratory and neurologic/neuromuscular conditions more frequently received higher respiratory support. Only 4.5% of children hospitalized for COVID-19 (n = 27) had completed their primary COVID-19 vaccination series and 7.0% (n = 42) of children initiated but did not complete their primary series. Among 528 unvaccinated children, nearly half (n = 251) were previously healthy, 3 of them required extracorporeal membrane oxygenation for acute COVID-19 and 1 died. CONCLUSIONS Most young children hospitalized for acute COVID-19, including most children admitted to the intensive care unit and with life-threatening illness, had not initiated COVID-19 vaccination despite being eligible. Nearly half of these children had no underlying conditions. Of the small percentage of children who initiated a COVID-19 primary series, most had not completed it before hospitalization.
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Affiliation(s)
- Laura D Zambrano
- From the Coronavirus and Other Respiratory Viruses Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Margaret M Newhams
- Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - Regina M Simeone
- From the Coronavirus and Other Respiratory Viruses Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Katherine E Fleming-Dutra
- From the Coronavirus and Other Respiratory Viruses Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Natasha Halasa
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Michael Wu
- From the Coronavirus and Other Respiratory Viruses Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Amber O Orzel-Lockwood
- Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - Satoshi Kamidani
- The Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Pia S Pannaraj
- Division of Infectious Diseases, Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Children's Hospital Los Angeles, Los Angeles, California
| | - Kathleen Chiotos
- Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Melissa A Cameron
- Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego, California
| | - Aline B Maddux
- Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado
| | - Jennifer E Schuster
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri
| | - Hillary Crandall
- Division of Pediatric Critical Care, Department of Pediatrics, University of Utah and Primary Children's Hospital, Salt Lake City, Utah
| | - Michele Kong
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama
| | - Ryan A Nofziger
- Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron, Ohio
| | - Mary A Staat
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Samina S Bhumbra
- Department of Pediatrics, The Ryan White Center for Pediatric Infectious Disease and Global Health, Indiana University School of Medicine, Indianapolis, Indiana
| | - Katherine Irby
- Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock, Arkansas
| | - Julie A Boom
- Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston, Texas
| | - Leila C Sahni
- Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston, Texas
| | - Janet R Hume
- Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis, Minnesota
| | - Shira J Gertz
- Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, New Jersey
| | - Mia Maamari
- Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center Dallas, Texas
| | - Cindy Bowens
- Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center Dallas, Texas
| | - Emily R Levy
- Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota
| | - Tamara T Bradford
- Division of Cardiology, Department of Pediatrics, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans, Louisiana
| | - Tracie C Walker
- Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill, North Carolina
| | - Stephanie P Schwartz
- Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill, North Carolina
| | - Elizabeth H Mack
- Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Judith A Guzman-Cottrill
- Division of Infectious Diseases, Department of Pediatrics, Oregon Health and Science University, Portland, Oregon
| | - Charlotte V Hobbs
- Division of Infectious Diseases, Department of Pediatrics, and Department of Cell and Molecular Biology, Children's of Mississippi, University of Mississippi Medical Center, Jackson, Mississippi
| | - Matt S Zinter
- Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, Department of Pediatrics, University of California San Francisco, San Francisco, California
| | - Natalie Z Cvijanovich
- Division of Critical Care Medicine, UCSF Benioff Children's Hospital Oakland, California
| | - Katherine E Bline
- Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus, Ohio
| | - Saul R Hymes
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Bernard and Millie Duker Children's Hospital, Albany Med Health System, Albany, New York
| | - Angela P Campbell
- From the Coronavirus and Other Respiratory Viruses Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Adrienne G Randolph
- Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts
- Departments of Anaesthesia and Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
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3
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Simeone RM, Zambrano LD, Halasa NB, Fleming-Dutra KE, Newhams MM, Wu MJ, Orzel-Lockwood AO, Kamidani S, Pannaraj PS, Irby K, Maddux AB, Hobbs CV, Cameron MA, Boom JA, Sahni LC, Kong M, Nofziger RA, Schuster JE, Crandall H, Hume JR, Staat MA, Mack EH, Bradford TT, Heidemann SM, Levy ER, Gertz SJ, Bhumbra SS, Walker TC, Bline KE, Michelson KN, Zinter MS, Flori HR, Campbell AP, Randolph AG. Effectiveness of Maternal mRNA COVID-19 Vaccination During Pregnancy Against COVID-19-Associated Hospitalizations in Infants Aged <6 Months During SARS-CoV-2 Omicron Predominance - 20 States, March 9, 2022-May 31, 2023. MMWR Morb Mortal Wkly Rep 2023; 72:1057-1064. [PMID: 37874864 PMCID: PMC10545433 DOI: 10.15585/mmwr.mm7239a3] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2023]
Abstract
Infants aged <6 months are not eligible for COVID-19 vaccination. Vaccination during pregnancy has been associated with protection against infant COVID-19-related hospitalization. The Overcoming COVID-19 Network conducted a case-control study during March 9, 2022-May 31, 2023, to evaluate the effectiveness of maternal receipt of a COVID-19 vaccine dose (vaccine effectiveness [VE]) during pregnancy against COVID-19-related hospitalization in infants aged <6 months and a subset of infants aged <3 months. VE was calculated as (1 - adjusted odds ratio) x 100% among all infants aged <6 months and <3 months. Case-patients (infants hospitalized for COVID-19 outside of birth hospitalization and who had a positive SARS-CoV-2 test result) and control patients (infants hospitalized for COVID-19-like illness with a negative SARS-CoV-2 test result) were compared. Odds ratios were determined using multivariable logistic regression, comparing the odds of receipt of a maternal COVID-19 vaccine dose (completion of a 2-dose vaccination series or a third or higher dose) during pregnancy with maternal nonvaccination between case- and control patients. VE of maternal vaccination during pregnancy against COVID-19-related hospitalization was 35% (95% CI = 15%-51%) among infants aged <6 months and 54% (95% CI = 32%-68%) among infants aged <3 months. Intensive care unit admissions occurred in 23% of all case-patients, and invasive mechanical ventilation was more common among infants of unvaccinated (9%) compared with vaccinated mothers (1%) (p = 0.02). Maternal vaccination during pregnancy provides some protection against COVID-19-related hospitalizations among infants, particularly those aged <3 months. Expectant mothers should remain current with COVID-19 vaccination to protect themselves and their infants from hospitalization and severe outcomes associated with COVID-19.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Overcoming COVID-19 Investigators
- Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, CDC; Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital, Boston, Massachusetts; The Center for Childhood Infections and Vaccines of Children’s Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia; Division of Infectious Diseases, Children’s Hospital Los Angeles, Los Angeles, California; Department of Pediatrics, University of California, San Diego, San Diego, California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children’s Hospital, Little Rock, Arkansas; Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine, Aurora, Colorado; Children’s Hospital Colorado, Aurora, Colorado; Department of Pediatrics, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson, Mississippi; Division of Pediatric Hospital Medicine, University of California San Diego-Rady Children’s Hospital, San Diego, California; Immunization Project, Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas; Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama; Division of Critical Care Medicine, Department of Pediatrics, Akron Children’s Hospital, Akron, Ohio; Division of Pediatric Infectious Diseases, Department of Pediatrics, Children’s Mercy Kansas City, Kansas City, Missouri; Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City, Utah; Primary Children’s Hospital, Salt Lake City, Utah; Division of Pediatric Critical Care, University of Minnesota Masonic Children’s Hospital, Minneapolis, Minnesota; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio; Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston, South Carolina; Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center, New Orleans, Louisiana; Children’s Hospital of New Orleans, New Orleans, Louisiana; Division of Pediatric Critical Care Medicine, Children’s Hospital of Michigan, Central Michigan University, Detroit, Michigan; Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota; Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, New Jersey; Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana; Department of Pediatrics, University of North Carolina at Chapel Hill Children’s Hospital, Chapel Hill, North Carolina; Division of Pediatric Critical Care Medicine, Nationwide Children’s Hospital Columbus, Ohio; Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Division of Critical Care Medicine, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois; Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California San Francisco, San Francisco, California; Division of Pediatric Critical Care Medicine, Department of Pediatrics, C.S. Mott Children’s Hospital, Ann Arbor, Michigan; Department of Anaesthesia, Harvard Medical School, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
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4
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Bodansky A, Vazquez SE, Chou J, Novak T, Al-Musa A, Young C, Newhams M, Kucukak S, Zambrano LD, Mitchell A, Wang CY, Moffitt K, Halasa NB, Loftis LL, Schwartz SP, Walker TC, Mack EH, Fitzgerald JC, Gertz SJ, Rowan CM, Irby K, Sanders RC, Kong M, Schuster JE, Staat MA, Zinter MS, Cvijanovich NZ, Tarquinio KM, Coates BM, Flori HR, Dahmer MK, Crandall H, Cullimore ML, Levy ER, Chatani B, Nofziger R, Geha RS, DeRisi J, Campbell AP, Anderson M, Randolph AG. NFKB2 haploinsufficiency identified via screening for IFN-α2 autoantibodies in children and adolescents hospitalized with SARS-CoV-2-related complications. J Allergy Clin Immunol 2023; 151:926-930.e2. [PMID: 36509151 PMCID: PMC9733962 DOI: 10.1016/j.jaci.2022.11.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [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] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 11/21/2022] [Accepted: 11/29/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Autoantibodies against type I IFNs occur in approximately 10% of adults with life-threatening coronavirus disease 2019 (COVID-19). The frequency of anti-IFN autoantibodies in children with severe sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is unknown. OBJECTIVE We quantified anti-type I IFN autoantibodies in a multicenter cohort of children with severe COVID-19, multisystem inflammatory syndrome in children (MIS-C), and mild SARS-CoV-2 infections. METHODS Circulating anti-IFN-α2 antibodies were measured by a radioligand binding assay. Whole-exome sequencing, RNA sequencing, and functional studies of peripheral blood mononuclear cells were used to study any patients with levels of anti-IFN-α2 autoantibodies exceeding the assay's positive control. RESULTS Among 168 patients with severe COVID-19, 199 with MIS-C, and 45 with mild SARS-CoV-2 infections, only 1 had high levels of anti-IFN-α2 antibodies. Anti-IFN-α2 autoantibodies were not detected in patients treated with intravenous immunoglobulin before sample collection. Whole-exome sequencing identified a missense variant in the ankyrin domain of NFKB2, encoding the p100 subunit of nuclear factor kappa-light-chain enhancer of activated B cells, aka NF-κB, essential for noncanonical NF-κB signaling. The patient's peripheral blood mononuclear cells exhibited impaired cleavage of p100 characteristic of NFKB2 haploinsufficiency, an inborn error of immunity with a high prevalence of autoimmunity. CONCLUSIONS High levels of anti-IFN-α2 autoantibodies in children and adolescents with MIS-C, severe COVID-19, and mild SARS-CoV-2 infections are rare but can occur in patients with inborn errors of immunity.
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Affiliation(s)
- Aaron Bodansky
- Department of Pediatric Critical Care Medicine, University of California, San Francisco, Calif
| | - Sara E Vazquez
- Department of Biochemistry and Biophysics, University of California, San Francisco, Calif; Diabetes Center, School of Medicine, University of California, San Francisco, Calif
| | - Janet Chou
- Division of Immunology, Boston Children's Hospital, Harvard Medical School, Boston, Mass; Department of Pediatrics, Boston Children's Hospital and Harvard Medical School, Boston, Mass.
| | - Tanya Novak
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital and Harvard Medical School, Boston, Mass; Department of Anesthesia, Harvard Medical School, Boston, Mass
| | - Amer Al-Musa
- Division of Immunology, Boston Children's Hospital, Harvard Medical School, Boston, Mass
| | - Cameron Young
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital and Harvard Medical School, Boston, Mass
| | - Margaret Newhams
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital and Harvard Medical School, Boston, Mass
| | - Suden Kucukak
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital and Harvard Medical School, Boston, Mass
| | - Laura D Zambrano
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Ga
| | - Anthea Mitchell
- Department of Biochemistry and Biophysics, University of California, San Francisco, Calif; Chan Zuckerberg Biohub, San Francisco, Calif
| | | | - Kristin Moffitt
- Department of Pediatrics, Boston Children's Hospital and Harvard Medical School, Boston, Mass; Division of Infectious Diseases, Boston Children's Hospital, Boston, Mass
| | - Natasha B Halasa
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Vanderbilt University Medical Center, Nashville, Tenn
| | - Laura L Loftis
- Section of Critical Care Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, Tex
| | - Stephanie P Schwartz
- Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill, NC
| | - Tracie C Walker
- Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill, NC
| | - Elizabeth H Mack
- Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston, SC
| | - Julie C Fitzgerald
- Department of Anesthesiology and Critical Care, Division of Critical Care, The University of Pennsylvania Perelman School of Medicine, Philadelphia, Pa
| | - Shira J Gertz
- Department of Pediatrics, Division of Pediatric Critical Care, Cooperman Barnabas Medical Center, Livingston, NJ
| | - Courtney M Rowan
- Department of Pediatrics, Division of Pediatric Critical Care Medicine, Indiana University School of Medicine, Riley Hospital for Children, Indianapolis, Ind
| | - Katherine Irby
- Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock, Ark
| | - Ronald C Sanders
- Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock, Ark
| | - Michele Kong
- Department of Pediatrics, Division of Pediatric Critical Care Medicine, University of Alabama at Birmingham, Birmingham, Ala
| | - Jennifer E Schuster
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Children's Mercy Kansas City, Kansas City, Mo
| | - Mary A Staat
- Department of Pediatrics, Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Matt S Zinter
- Department of Pediatrics, Divisions of Critical Care and Bone Marrow Transplantation, University of California, San Francisco, Calif
| | - Natalie Z Cvijanovich
- Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland, Calif
| | - Keiko M Tarquinio
- Department of Pediatrics, Division of Critical Care Medicine, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Ga
| | - Bria M Coates
- Department of Pediatrics, Division of Critical Care Medicine, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill
| | - Heidi R Flori
- Department of Pediatrics, Division of Pediatric Critical Care Medicine, Mott Children's Hospital and University of Michigan, Ann Arbor, Mich
| | - Mary K Dahmer
- Department of Pediatrics, Division of Pediatric Critical Care Medicine, Mott Children's Hospital and University of Michigan, Ann Arbor, Mich
| | - Hillary Crandall
- Department of Pediatrics, Division of Pediatric Critical Care, Primary Children's Hospital and University of Utah, Salt Lake City, Utah
| | - Melissa L Cullimore
- Department of Pediatrics, University of Nebraska Medical Center, College of Medicine, Children's Hospital and Medical Center, Omaha, Neb
| | - Emily R Levy
- Department of Pediatric and Adolescent Medicine, Division of Pediatric Infectious Diseases, Division of Pediatric Critical Care Medicine, Mayo Clinic, Rochester, Minn
| | - Brandon Chatani
- Department of Pediatrics, Division of Pediatric Critical Care Medicine, Holtz Children's Hospital, University of Miami Miller School of Medicine, Miami, Fla
| | - Ryan Nofziger
- Department of Pediatrics, Division of Critical Care Medicine, Akron Children's Hospital, Akron, Ohio
| | - Raif S Geha
- Division of Immunology, Boston Children's Hospital, Harvard Medical School, Boston, Mass
| | - Joseph DeRisi
- Department of Biochemistry and Biophysics, University of California, San Francisco, Calif; Chan Zuckerberg Biohub, San Francisco, Calif
| | - Angela P Campbell
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Ga
| | - Mark Anderson
- Diabetes Center, School of Medicine, University of California, San Francisco, Calif
| | - Adrienne G Randolph
- Department of Pediatrics, Boston Children's Hospital and Harvard Medical School, Boston, Mass; Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital and Harvard Medical School, Boston, Mass; Department of Anesthesia, Harvard Medical School, Boston, Mass
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Moffitt KL, Nakamura MM, Young CC, Newhams MM, Halasa NB, Reed JN, Fitzgerald JC, Spinella PC, Soma VL, Walker TC, Loftis LL, Maddux AB, Kong M, Rowan CM, Hobbs CV, Schuster JE, Riggs BJ, McLaughlin GE, Michelson KN, Hall MW, Babbitt CJ, Cvijanovich NZ, Zinter MS, Maamari M, Schwarz AJ, Singh AR, Flori HR, Gertz SJ, Staat MA, Giuliano JS, Hymes SR, Clouser KN, McGuire J, Carroll CL, Thomas NJ, Levy ER, Randolph AG. Community-Onset Bacterial Coinfection in Children Critically Ill With Severe Acute Respiratory Syndrome Coronavirus 2 Infection. Open Forum Infect Dis 2023; 10:ofad122. [PMID: 36968962 PMCID: PMC10034750 DOI: 10.1093/ofid/ofad122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 03/02/2023] [Indexed: 03/09/2023] Open
Abstract
Background Community-onset bacterial coinfection in adults hospitalized with coronavirus disease 2019 (COVID-19) is reportedly uncommon, though empiric antibiotic use has been high. However, data regarding empiric antibiotic use and bacterial coinfection in children with critical illness from COVID-19 are scarce. Methods We evaluated children and adolescents aged <19 years admitted to a pediatric intensive care or high-acuity unit for COVID-19 between March and December 2020. Based on qualifying microbiology results from the first 3 days of admission, we adjudicated whether patients had community-onset bacterial coinfection. We compared demographic and clinical characteristics of those who did and did not (1) receive antibiotics and (2) have bacterial coinfection early in admission. Using Poisson regression models, we assessed factors associated with these outcomes. Results Of the 532 patients, 63.3% received empiric antibiotics, but only 7.1% had bacterial coinfection, and only 3.0% had respiratory bacterial coinfection. In multivariable analyses, empiric antibiotics were more likely to be prescribed for immunocompromised patients (adjusted relative risk [aRR], 1.34 [95% confidence interval {CI}, 1.01-1.79]), those requiring any respiratory support except mechanical ventilation (aRR, 1.41 [95% CI, 1.05-1.90]), or those requiring invasive mechanical ventilation (aRR, 1.83 [95% CI, 1.36-2.47]) (compared with no respiratory support). The presence of a pulmonary comorbidity other than asthma (aRR, 2.31 [95% CI, 1.15-4.62]) was associated with bacterial coinfection. Conclusions Community-onset bacterial coinfection in children with critical COVID-19 is infrequent, but empiric antibiotics are commonly prescribed. These findings inform antimicrobial use and support rapid de-escalation when evaluation shows coinfection is unlikely.
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Affiliation(s)
- Kristin L Moffitt
- Division of Infectious Diseases, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| | - Mari M Nakamura
- Division of Infectious Diseases, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
- Antimicrobial Stewardship Program, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Cameron C Young
- Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Margaret M Newhams
- Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Natasha B Halasa
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - J Nelson Reed
- Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Julie C Fitzgerald
- Division of Critical Care, Department of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Philip C Spinella
- Division of Critical Care, Department of Pediatrics, Washington University School of Medicine in St Louis, St Louis, Missouri, USA
| | - Vijaya L Soma
- Division of Pediatric Infectious Diseases, Department of Pediatrics, New York University Grossman School of Medicine, Hassenfeld Children's Hospital, New York, New York, USA
| | - Tracie C Walker
- Department of Pediatrics, University of North Carolina at Chapel Hill Children’s Hospital, Chapel Hill, North Carolina, USA
| | - Laura L Loftis
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Aline B Maddux
- Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, Colorado, USA
| | - Michele Kong
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Courtney M Rowan
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Indiana University School of Medicine, Riley Hospital for Children, Indianapolis, Indiana, USA
| | - Charlotte V Hobbs
- Department of Pediatrics, Division of Disease, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Jennifer E Schuster
- Division of Pediatric Infectious Disease, Department of Pediatrics, Children’s Mercy Kansas City, Kansas City, Missouri, USA
| | - Becky J Riggs
- Division of Pediatric Anesthesiology and Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Gwenn E McLaughlin
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Kelly N Michelson
- Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Mark W Hall
- Division of Critical Care Medicine, Department of Pediatrics, Nationwide Children’s Hospital, Columbus, Ohio, USA
| | | | - Natalie Z Cvijanovich
- Division of Critical Care Medicine, University of California, San Francisco Benioff Children’s Hospital,Oakland, California, USA
| | - Matt S Zinter
- School of Medicine, Department of Pediatrics, Division of Critical Care Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Mia Maamari
- Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children’s Health Medical Center Dallas, Dallas, Texas, USA
| | - Adam J Schwarz
- Division of Critical Care Medicine, Children’s Hospital Orange County, Orange, California, USA
| | - Aalok R Singh
- Pediatric Critical Care Division, Maria Fareri Children’s Hospital at Westchester Medical Center and New York Medical College, Valhalla, New York, USA
| | - Heidi R Flori
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor, Michigan, USA
| | - Shira J Gertz
- Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, New Jersey, USA
| | - Mary A Staat
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
| | - John S Giuliano
- Department of Pediatrics, Division of Critical Care, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Saul R Hymes
- Division of Pediatric Infectious Diseases, Stony Brook Children's Hospital, Renaissance School of Medicine, Stony Brook, New York, USA
| | - Katharine N Clouser
- Department of Pediatrics, Hackensack Meridian School of Medicine, Hackensack, New Jersey, USA
| | - John McGuire
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Seattle Children’s Hospital and the University of Washington, Seattle, Washington, USA
| | | | - Neal J Thomas
- Department of Pediatrics, Penn State Hershey Children's Hospital, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Emily R Levy
- Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Adrienne G Randolph
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
- Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Anaesthesia, Harvard Medical School, Boston, Massachusetts, USA
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6
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LaRovere KL, Poussaint TY, Young CC, Newhams MM, Kucukak S, Irby K, Kong M, Schwartz SP, Walker TC, Bembea MM, Wellnitz K, Havlin KM, Cvijanovich NZ, Hall MW, Fitzgerald JC, Schuster JE, Hobbs CV, Halasa NB, Singh AR, Mack EH, Bradford TT, Gertz SJ, Schwarz AJ, Typpo KV, Loftis LL, Giuliano JS, Horwitz SM, Biagas KV, Clouser KN, Rowan CM, Maddux AB, Soma VL, Babbitt CJ, Aguiar CL, Kolmar AR, Heidemann SM, Harvey H, Zambrano LD, Campbell AP, Randolph AG. Changes in Distribution of Severe Neurologic Involvement in US Pediatric Inpatients With COVID-19 or Multisystem Inflammatory Syndrome in Children in 2021 vs 2020. JAMA Neurol 2023; 80:91-98. [PMID: 36342679 PMCID: PMC9641594 DOI: 10.1001/jamaneurol.2022.3881] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 09/02/2022] [Indexed: 11/09/2022]
Abstract
Importance In 2020 during the COVID-19 pandemic, neurologic involvement was common in children and adolescents hospitalized in the United States for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related complications. Objective To provide an update on the spectrum of SARS-CoV-2-related neurologic involvement among children and adolescents in 2021. Design, Setting, and Participants Case series investigation of patients reported to public health surveillance hospitalized with SARS-CoV-2-related illness between December 15, 2020, and December 31, 2021, in 55 US hospitals in 31 states with follow-up at hospital discharge. A total of 2253 patients were enrolled during the investigation period. Patients suspected of having multisystem inflammatory syndrome in children (MIS-C) who did not meet criteria (n = 85) were excluded. Patients (<21 years) with positive SARS-CoV-2 test results (reverse transcriptase-polymerase chain reaction and/or antibody) meeting criteria for MIS-C or acute COVID-19 were included in the analysis. Exposure SARS-CoV-2 infection. Main Outcomes and Measures Patients with neurologic involvement had acute neurologic signs, symptoms, or diseases on presentation or during hospitalization. Life-threatening neurologic involvement was adjudicated by experts based on clinical and/or neuroradiological features. Type and severity of neurologic involvement, laboratory and imaging data, vaccination status, and hospital discharge outcomes (death or survival with new neurologic deficits). Results Of 2168 patients included (58% male; median age, 10.3 years), 1435 (66%) met criteria for MIS-C, and 476 (22%) had documented neurologic involvement. Patients with neurologic involvement vs without were older (median age, 12 vs 10 years) and more frequently had underlying neurologic disorders (107 of 476 [22%] vs 240 of 1692 [14%]). Among those with neurologic involvement, 42 (9%) developed acute SARS-CoV-2-related life-threatening conditions, including central nervous system infection/demyelination (n = 23; 15 with possible/confirmed encephalitis, 6 meningitis, 1 transverse myelitis, 1 nonhemorrhagic leukoencephalopathy), stroke (n = 11), severe encephalopathy (n = 5), acute fulminant cerebral edema (n = 2), and Guillain-Barré syndrome (n = 1). Ten of 42 (24%) survived with new neurologic deficits at discharge and 8 (19%) died. Among patients with life-threatening neurologic conditions, 15 of 16 vaccine-eligible patients (94%) were unvaccinated. Conclusions and Relevance SARS-CoV-2-related neurologic involvement persisted in US children and adolescents hospitalized for COVID-19 or MIS-C in 2021 and was again mostly transient. Central nervous system infection/demyelination accounted for a higher proportion of life-threatening conditions, and most vaccine-eligible patients were unvaccinated. COVID-19 vaccination may prevent some SARS-CoV-2-related neurologic complications and merits further study.
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Affiliation(s)
- Kerri L. LaRovere
- Department of Neurology, Boston Children’s Hospital, Boston, Massachusetts
| | - Tina Y. Poussaint
- Department of Radiology, Boston Children’s Hospital, Boston, Massachusetts
| | - Cameron C. Young
- Division of Critical Care Medicine, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital, Boston, Massachusetts
| | - Margaret M. Newhams
- Division of Critical Care Medicine, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital, Boston, Massachusetts
| | - Suden Kucukak
- Division of Critical Care Medicine, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital, Boston, Massachusetts
| | - Katherine Irby
- Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock
| | - Michele Kong
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham
| | - Stephanie P. Schwartz
- Department of Pediatrics, University of North Carolina at Chapel Hill Children’s Hospital, Chapel Hill
| | - Tracie C. Walker
- Department of Pediatrics, University of North Carolina at Chapel Hill Children’s Hospital, Chapel Hill
| | - Melania M. Bembea
- Division of Pediatric Anesthesiology and Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Kari Wellnitz
- Division of Pediatric Critical Care, Stead Family Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City
| | - Kevin M. Havlin
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Louisville, Norton Children’s Hospital, Louisville, Kentucky
| | - Natalie Z. Cvijanovich
- Division of Critical Care Medicine, UCSF Benioff Children’s Hospital, Oakland, California
| | - Mark W. Hall
- Division of Critical Care Medicine, Department of Pediatrics, Nationwide Children’s Hospital, Columbus, Ohio
| | - Julie C. Fitzgerald
- Division of Critical Care, Department of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Jennifer E. Schuster
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Children’s Mercy Kansas City, Kansas City, Missouri
| | - Charlotte V. Hobbs
- Division of Infectious Diseases, Departments of Pediatrics and Microbiology, University of Mississippi Medical Center, Jackson
| | - Natasha B. Halasa
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Aalok R. Singh
- Pediatric Critical Care Division, Maria Fareri Children’s Hospital at Westchester Medical Center, New York Medical College, Valhalla
| | - Elizabeth H. Mack
- Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston
| | - Tamara T. Bradford
- Division of Cardiology, Department of Pediatrics, Louisiana State University Health Sciences Center, Children’s Hospital of New Orleans, New Orleans
| | - Shira J. Gertz
- Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, New Jersey
| | - Adam J. Schwarz
- Division of Critical Care Medicine, Children’s Health Orange County (CHOC), Orange, California
| | - Katri V. Typpo
- Department of Pediatrics and Banner Children’s at Diamond Children’s Medical Center, University of Arizona, Tucson
| | - Laura L. Loftis
- Section of Critical Care Medicine, Department of Pediatrics, Texas Children’s Hospital, Houston
| | - John S. Giuliano
- Division of Critical Care, Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut
| | - Steven M. Horwitz
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | - Katherine V. Biagas
- Department of Pediatrics, Stony Brook University Renaissance School of Medicine, Stony Brook, New York
| | - Katharine N. Clouser
- Department of Pediatrics, Joseph M. Sanzari Children’s Hospital at Hackensack University Medical Center, Hackensack, New Jersey
| | - Courtney M. Rowan
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Indiana University School of Medicine, Riley Hospital for Children, Indianapolis
| | - Aline B. Maddux
- Section of Critical Care Medicine, Department of Pediatrics, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora
| | - Vijaya L. Soma
- Division of Pediatric Infectious Diseases, Department of Pediatrics, New York University Grossman School of Medicine, New York
| | | | - Cassyanne L. Aguiar
- Division of Pediatric Rheumatology, Department of Pediatrics, Eastern Virginia Medical School, Children’s Hospital of The King’s Daughters, Norfolk
| | - Amanda R. Kolmar
- Division of Critical Care, Department of Pediatrics, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Sabrina M. Heidemann
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Central Michigan University, Detroit
| | - Helen Harvey
- Division of Pediatric Critical Care, Rady Children’s Hospital, San Diego, California
| | - Laura D. Zambrano
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Angela P. Campbell
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Adrienne G. Randolph
- Division of Critical Care Medicine, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital, Boston, Massachusetts
- Departments of Anaesthesia and Pediatrics, Harvard Medical School, Boston, Massachusetts
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7
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Sahni LC, Price AM, Olson SM, Newhams MM, Pannaraj PS, Maddux AB, Halasa NB, Bline KE, Cameron MA, Schwartz SP, Walker TC, Irby K, Chiotos K, Nofziger RA, Mack EH, Smallcomb L, Bradford TT, Kamidani S, Tarquinio KM, Cvijanovich NZ, Schuster JE, Bhumbra SS, Levy ER, Hobbs CV, Cullimore ML, Coates BM, Heidemann SM, Gertz SJ, Kong M, Flori HR, Staat MA, Zinter MS, Hume JR, Chatani BM, Gaspers MG, Maamari M, Randolph AG, Patel MM, Boom JA. Factors Associated With COVID-19 Non-vaccination in Adolescents Hospitalized Without COVID-19. J Pediatric Infect Dis Soc 2022; 12:29-35. [PMID: 36309873 PMCID: PMC9620352 DOI: 10.1093/jpids/piac113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 10/28/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Pfizer-BioNTech COVID-19 vaccine received emergency use authorization for persons ≥ 16 years in December 2020 and for adolescents 12-15 years in May 2021. Despite the clear benefits and favorable safety profile, vaccine uptake in adolescents has been suboptimal. We sought to assess factors associated with COVID-19 non-vaccination in adolescents 12-18 years of age. METHODS Between June 1, 2021 and April 29, 2022, we assessed factors associated with COVID-19 non-vaccination in hospitalized adolescents ages 12-18 years enrolled in the Overcoming COVID-19 vaccine effectiveness network. Demographic characteristics and clinical information were captured through parent interviews and/or electronic medical record abstraction; COVID-19 vaccination was assessed through documented sources. We assessed associations between receipt of the COVID-19 vaccine and demographic and clinical factors using univariate and multivariable logistic regression and estimated adjusted odds ratios (aOR) for each factor associated with non-vaccination. RESULTS Among 1665 hospitalized adolescents without COVID-19, 56% were unvaccinated. Unvaccinated adolescents were younger (median age 15.1 years vs. 15.4 years, p < .01) and resided in areas with higher social vulnerability index (SVI) scores (median 0.6 vs 0.5, p < .001) than vaccinated adolescents. Residence in the Midwest [aOR 2.60 (95% CI: 1.80, 3.79)] or South [aOR 2.49 (95% CI: 1.77, 3.54)] US census regions, rarely or never receiving influenza vaccine [aOR 5.31 (95% CI: 3.81, 7.47)], and rarely or never taking precautions against COVID-19 [aOR 3.17 (95% CI: 1.94, 5.31)] were associated with non-vaccination against COVID-19. CONCLUSIONS Efforts to increase COVID-19 vaccination of adolescents should focus on persons with geographic, socioeconomic, and medical risk factors associated with non-vaccination.
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Affiliation(s)
- Leila C Sahni
- Corresponding author: Leila C. Sahni, PhD, MPH. Texas Children's Hospital, 1102 Bates Ave Ste 1550, Houston, TX 77030. Telephone: (832) 824-2057;
| | - Ashley M Price
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Samantha M Olson
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Margaret M Newhams
- Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children’s Hospital, Boston, MA 02115, USA
| | - Pia S Pannaraj
- Division of Infectious Diseases, Children’s Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles, CA 90027, USA
| | - Aline B Maddux
- Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO 80045, USA
| | - Natasha B Halasa
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Katherine E Bline
- Division of Pediatric Critical Care Medicine, Nationwide Children’s Hospital Columbus, OH 43205, USA
| | - Melissa A Cameron
- Division of Pediatric Hospital Medicine, UC San Diego-Rady Children’s Hospital, San Diego, CA 92123, USA
| | - Stephanie P Schwartz
- Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill, NC 27514, USA
| | - Tracie C Walker
- Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill, NC 27514, USA
| | - Katherine Irby
- Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock, AR 72202, USA
| | - Kathleen Chiotos
- Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Ryan A Nofziger
- Division of Critical Care Medicine, Department of Pediatrics, Akron Children’s Hospital, Akron, OH 44308, USA
| | - Elizabeth H Mack
- Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Laura Smallcomb
- Department of Pediatrics, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Tamara T Bradford
- Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children’s Hospital of New Orleans, New Orleans, LA 70118, USA
| | - Satoshi Kamidani
- The Center for Childhood Infections and Vaccines of Children’s Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Keiko M Tarquinio
- Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA 30322, USA
| | - Natalie Z Cvijanovich
- Division of Critical Care Medicine, UCSF Benioff Children's Hospital Oakland, CA 94609, USA
| | - Jennifer E Schuster
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Children’s Mercy Kansas City, Kansas City, MO 64108, USA
| | - Samina S Bhumbra
- The Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Emily R Levy
- Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Charlotte V Hobbs
- Department of Pediatrics, Department of Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Melissa L Cullimore
- Division of Pediatric Critical Care, Department of Pediatrics, Children’s Hospital and Medical Center, Omaha, NE 68114, USA
| | - Bria M Coates
- Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL 60611, USA
| | - Sabrina M Heidemann
- Division of Pediatric Critical Care Medicine, Children’s Hospital of MI, Central Michigan University, Detroit, MI 48201, USA
| | - Shira J Gertz
- Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ 07039, USA
| | - Michele Kong
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Heidi R Flori
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children’s Hospital and University of Michigan, Ann Arbor, MI 48109, USA
| | - Mary A Staat
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 42559, USA
| | - Matt S Zinter
- Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California San Francisco, San Francisco, CA 94143, USA
| | - Janet R Hume
- Division of Pediatric Critical Care, University of Minnesota Masonic Children’s Hospital, Minneapolis, MN 55454, USA
| | - Brandon M Chatani
- Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth/Holtz Children's Hospital, Miami, FL 33136, USA
| | - Mary G Gaspers
- University of Arizona, Diamond Children’s Banner Children’s Medical Center, Tucson, AZ 85719, USA
| | - Mia Maamari
- Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center Dallas, TX 75235, USA
| | - Adrienne G Randolph
- Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children’s Hospital, Boston, MA 02115, USA,Departments of Anaesthesia and Pediatrics, Harvard Medical School, Boston, MA 02115, USA
| | - Manish M Patel
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Julie A Boom
- Alternate corresponding author: Julie A. Boom, MD, Texas Children's Hospital, 1102 Bates Ave Ste 1550, Houston, TX 77030. Telephone: (832) 822-3433;
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8
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Sigal GB, Novak T, Mathew A, Chou J, Zhang Y, Manjula N, Bathala P, Joe J, Padmanabhan N, Romero D, Allegri-Machado G, Joerger J, Loftis LL, Schwartz SP, Walker TC, Fitzgerald JC, Tarquinio KM, Zinter MS, Schuster JE, Halasa NB, Cullimore ML, Maddux AB, Staat MA, Irby K, Flori HR, Coates BM, Crandall H, Gertz SJ, Randolph AG, Pollock NR. Measurement of Severe Acute Respiratory Syndrome Coronavirus 2 Antigens in Plasma of Pediatric Patients With Acute Coronavirus Disease 2019 or Multisystem Inflammatory Syndrome in Children Using an Ultrasensitive and Quantitative Immunoassay. Clin Infect Dis 2022; 75:1351-1358. [PMID: 35213684 PMCID: PMC8903440 DOI: 10.1093/cid/ciac160] [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: 12/09/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antigens in blood has high sensitivity in adults with acute coronavirus disease 2019 (COVID-19), but sensitivity in pediatric patients is unclear. Recent data suggest that persistent SARS-CoV-2 spike antigenemia may contribute to multisystem inflammatory syndrome in children (MIS-C). We quantified SARS-CoV-2 nucleocapsid (N) and spike (S) antigens in blood of pediatric patients with either acute COVID-19 or MIS-C using ultrasensitive immunoassays (Meso Scale Discovery). METHODS Plasma was collected from inpatients (<21 years) enrolled across 15 hospitals in 15 US states. Acute COVID-19 patients (n = 36) had a range of disease severity and positive nasopharyngeal SARS-CoV-2 RT-PCR within 24 hours of blood collection. Patients with MIS-C (n = 53) met CDC criteria and tested positive for SARS-CoV-2 (RT-PCR or serology). Controls were patients pre-COVID-19 (n = 67) or within 24 hours of negative RT-PCR (n = 43). RESULTS Specificities of N and S assays were 95-97% and 100%, respectively. In acute COVID-19 patients, N/S plasma assays had 89%/64% sensitivity; sensitivities in patients with concurrent nasopharyngeal swab cycle threshold (Ct) ≤35 were 93%/63%. Antigen concentrations ranged from 1.28-3844 pg/mL (N) and 1.65-1071 pg/mL (S) and correlated with disease severity. In MIS-C, antigens were detected in 3/53 (5.7%) samples (3 N-positive: 1.7, 1.9, 121.1 pg/mL; 1 S-positive: 2.3 pg/mL); the patient with highest N had positive nasopharyngeal RT-PCR (Ct 22.3) concurrent with blood draw. CONCLUSIONS Ultrasensitive blood SARS-CoV-2 antigen measurement has high diagnostic yield in children with acute COVID-19. Antigens were undetectable in most MIS-C patients, suggesting that persistent antigenemia is not a common contributor to MIS-C pathogenesis.
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Affiliation(s)
| | - Tanya Novak
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital, and Department of Anesthesia, Harvard Medical School, Boston, Massachusetts, USA
| | - Anu Mathew
- Meso Scale Diagnostics, LLC, Rockville, Maryland, USA
| | - Janet Chou
- Department of Pediatrics, Boston Children’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Yubo Zhang
- Institutional Centers for Clinical and Translational Research, Boston Children’s Hospital, Boston, Massachusetts, USA
| | | | | | - Jessica Joe
- Meso Scale Diagnostics, LLC, Rockville, Maryland, USA
| | | | - Daniel Romero
- Meso Scale Diagnostics, LLC, Rockville, Maryland, USA
| | | | - Jill Joerger
- Department of Laboratory Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA
| | - Laura L Loftis
- Division of Critical Care Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Stephanie P Schwartz
- Department of Pediatrics, University of North Carolina at Chapel Hill Children’s Hospital, Chapel Hill, North Carolina, USA
| | - Tracie C Walker
- Department of Pediatrics, University of North Carolina at Chapel Hill Children’s Hospital, Chapel Hill, North Carolina, USA
| | - Julie C Fitzgerald
- Division of Critical Care, Department of Anesthesiology and Critical Care, The University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Keiko M Tarquinio
- Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children’s Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Matt S Zinter
- Divisions of Critical Care and Bone Marrow Transplantation, Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
| | - Jennifer E Schuster
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Children’s Mercy Kansas City, Kansas City, Missouri, USA
| | - Natasha B Halasa
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Melissa L Cullimore
- Department of Pediatrics, College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Aline B Maddux
- Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, Colorado, USA
| | - Mary A Staat
- Department of Pediatrics, University of Cincinnati, Division of Infectious Diseases, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
| | - Katherine Irby
- Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children’s Hospital, Little Rock, Arkansas, USA
| | - Heidi R Flori
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children’s Hospital and University of Michigan, Ann Arbor, Michigan, USA
| | - Bria M Coates
- Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois, USA
| | - Hillary Crandall
- Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA
| | - Shira J Gertz
- Division of Pediatric Critical Care, Department of Pediatrics, Saint Barnabas Medical Center, Livingston, New Jersey, USA
| | - Adrienne G Randolph
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital, and Department of Anesthesia, Harvard Medical School, Boston, Massachusetts, USA
| | - Nira R Pollock
- Department of Laboratory Medicine, Boston Children’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
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9
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Maddux AB, Berbert L, Young CC, Feldstein LR, Zambrano LD, Kucukak S, Newhams MM, Miller K, FitzGerald MM, He J, Halasa NB, Cvijanovich NZ, Loftis LL, Walker TC, Schwartz SP, Gertz SJ, Tarquinio KM, Fitzgerald JC, Kong M, Schuster JE, Mack EH, Hobbs CV, Rowan CM, Staat MA, Zinter MS, Irby K, Crandall H, Flori H, Cullimore ML, Nofziger RA, Shein SL, Gaspers MG, Hume JR, Levy ER, Chen SR, Patel MM, Tenforde MW, Weller E, Campbell AP, Randolph AG. Health Impairments in Children and Adolescents After Hospitalization for Acute COVID-19 or MIS-C. Pediatrics 2022; 150:e2022057798. [PMID: 35765138 PMCID: PMC10281852 DOI: 10.1542/peds.2022-057798] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [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] [Accepted: 06/13/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To evaluate risk factors for postdischarge sequelae in children and adolescents hospitalized for acute coronavirus disease 2019 (COVID-19) or multisystem inflammatory syndrome in children (MIS-C). METHODS Multicenter prospective cohort study conducted in 25 United States pediatric hospitals. Patients <21-years-old, hospitalized May 2020 to May 2021 for acute COVID-19 or MIS-C with follow-up 2 to 4 months after admission. We assessed readmissions, persistent symptoms or activity impairment, and new morbidities. Multivariable regression was used to calculate adjusted risk ratios (aRR) and 95% confidence intervals (CI). RESULTS Of 358 eligible patients, 2 to 4 month survey data were available for 119 of 155 (76.8%) with acute COVID-19 and 160 of 203 (78.8%) with MIS-C. Thirteen (11%) patients with acute COVID-19 and 12 (8%) with MIS-C had a readmission. Thirty-two (26.9%) patients with acute COVID-19 had persistent symptoms (22.7%) or activity impairment (14.3%) and 48 (30.0%) with MIS-C had persistent symptoms (20.0%) or activity impairment (21.3%). For patients with acute COVID-19, persistent symptoms (aRR, 1.29 [95% CI, 1.04-1.59]) and activity impairment (aRR, 1.37 [95% CI, 1.06-1.78]) were associated with more organ systems involved. Patients with MIS-C and pre-existing respiratory conditions more frequently had persistent symptoms (aRR, 3.09 [95% CI, 1.55-6.14]) and those with obesity more frequently had activity impairment (aRR, 2.52 [95% CI, 1.35-4.69]). New morbidities were infrequent (9% COVID-19, 1% MIS-C). CONCLUSIONS Over 1 in 4 children hospitalized with acute COVID-19 or MIS-C experienced persistent symptoms or activity impairment for at least 2 months. Patients with MIS-C and respiratory conditions or obesity are at higher risk of prolonged recovery.
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Affiliation(s)
- Aline B Maddux
- Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado
| | - Laura Berbert
- Biostatistics and Research Design Center, Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, Boston, Massachusetts
| | - Cameron C Young
- Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - Leora R Feldstein
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Laura D Zambrano
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Suden Kucukak
- Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - Margaret M Newhams
- Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - Kristen Miller
- Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado
| | - Madyson M FitzGerald
- Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - Jie He
- Biostatistics and Research Design Center, Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, Boston, Massachusetts
| | - Natasha B Halasa
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Natalie Z Cvijanovich
- Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland, California
| | - Laura L Loftis
- Section of Critical Care Medicine, Department of Pediatrics, Texas Children's Hospital, Houston, Texas
| | - Tracie C Walker
- Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill, North Carolina
| | - Stephanie P Schwartz
- Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill, North Carolina
| | - Shira J Gertz
- Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, New Jersey
| | - Keiko M Tarquinio
- Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Julie C Fitzgerald
- Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Michele Kong
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama
| | - Jennifer E Schuster
- Division of Pediatric Infectious Disease, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri
| | - Elizabeth H Mack
- Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Charlotte V Hobbs
- Department of Pediatrics, Department of Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson, Mississippi
| | - Courtney M Rowan
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Indiana University School of Medicine, Riley Hospital for Children, Indianapolis, Indiana
| | - Mary A Staat
- Department of Pediatrics, University of Cincinnati, Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Matt S Zinter
- Department of Pediatrics, Division of Critical Care, University of California San Francisco, San Francisco, California
| | - Katherine Irby
- Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock, Arkansas
| | - Hillary Crandall
- Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City, Utah
| | - Heidi Flori
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor, Michigan
| | - Melissa L Cullimore
- Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, Nebraska
| | - Ryan A Nofziger
- Division of Critical Care Medicine, Akron Children's Hospital, Akron, Ohio
| | - Steven L Shein
- Division of Pediatric Critical Care Medicine, Rainbow Babies and Children's Hospital, Cleveland, Ohio
| | - Mary Glas Gaspers
- University of Arizona, Diamond Children's Banner Children's Medical Center, Tucson, Arizona
| | - Janet R Hume
- Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis, Minnesota
| | - Emily R Levy
- Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado
| | - Sabrina R Chen
- Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - Manish M Patel
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Mark W Tenforde
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Edie Weller
- Biostatistics and Research Design Center, Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, Boston, Massachusetts
- Departments of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Angela P Campbell
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Adrienne G Randolph
- Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts
- Departments of Pediatrics, Harvard Medical School, Boston, Massachusetts
- Department of Anaesthesia, Harvard Medical School, Boston, Massachusetts
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10
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Zambrano LD, Newhams MM, Olson SM, Halasa NB, Price AM, Orzel AO, Young CC, Boom JA, Sahni LC, Maddux AB, Bline KE, Kamidani S, Tarquinio KM, Chiotos K, Schuster JE, Cullimore ML, Heidemann SM, Hobbs CV, Nofziger RA, Pannaraj PS, Cameron MA, Walker TC, Schwartz SP, Michelson KN, Coates BM, Flori HR, Mack EH, Smallcomb L, Gertz SJ, Bhumbra SS, Bradford TT, Levy ER, Kong M, Irby K, Cvijanovich NZ, Zinter MS, Bowens C, Crandall H, Hume JR, Patel MM, Campbell AP, Randolph AG. BNT162b2 mRNA Vaccination Against Coronavirus Disease 2019 is Associated With a Decreased Likelihood of Multisystem Inflammatory Syndrome in Children Aged 5-18 Years-United States, July 2021 - April 2022. Clin Infect Dis 2022; 76:e90-e100. [PMID: 35924406 PMCID: PMC9384630 DOI: 10.1093/cid/ciac637] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 07/21/2022] [Accepted: 08/01/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Multisystem inflammatory syndrome in children (MIS-C), linked to antecedent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, is associated with considerable morbidity. Prevention of SARS-CoV-2 infection or coronavirus disease 2019 (COVID-19) by vaccination might also decrease MIS-C likelihood. METHODS In a multicenter, case-control, public health investigation of children ages 5-18 years hospitalized from 1 July 2021 to 7 April 2022, we compared the odds of being fully vaccinated (2 doses of BNT162b2 vaccine ≥28 days before hospital admission) between MIS-C case-patients and hospital-based controls who tested negative for SARS-CoV-2. These associations were examined by age group, timing of vaccination, and periods of Delta and Omicron variant predominance using multivariable logistic regression. RESULTS We compared 304 MIS-C case-patients (280 [92%] unvaccinated) with 502 controls (346 [69%] unvaccinated). MIS-C was associated with decreased likelihood of vaccination (adjusted OR [aOR]: .16; 95% CI: .10-.26), including among children ages 5-11 years (aOR: .22; 95% CI: .10-.52), ages 12-18 years (aOR: .10; 95% CI: .05-.19), and during the Delta (aOR: .06; 95% CI: .02-.15) and Omicron (aOR: .22; 95% CI: .11-.42) variant-predominant periods. This association persisted beyond 120 days after the second dose (aOR: .08; 95% CI: .03-.22) in 12-18-year-olds. Among all MIS-C case-patients, 187 (62%) required intensive care unit admission and 280 (92%) vaccine-eligible case-patients were unvaccinated. CONCLUSIONS Vaccination with 2 doses of BNT162b2 is associated with reduced likelihood of MIS-C in children ages 5-18 years. Most vaccine-eligible hospitalized patients with MIS-C were unvaccinated.
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Affiliation(s)
- Laura D Zambrano
- Corresponding author: Laura D. Zambrano U.S. Centers for Disease Control and Prevention 1600 Clifton Rd NE MS H24-5 Atlanta, GA 30329 USA
| | | | | | - Natasha B Halasa
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | | | - Amber O Orzel
- Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA
| | - Cameron C Young
- Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA
| | - Julie A Boom
- Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children’s Hospital, Houston, Texas, USA
| | - Leila C Sahni
- Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children’s Hospital, Houston, Texas, USA
| | - Aline B Maddux
- Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado, USA
| | - Katherine E Bline
- Division of Pediatric Critical Care Medicine, Nationwide Children’s Hospital Columbus, Ohio, USA
| | - Satoshi Kamidani
- The Center for Childhood Infections and Vaccines of Children’s Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Keiko M Tarquinio
- Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children’s Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Kathleen Chiotos
- Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Jennifer E Schuster
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Children’s Mercy Kansas City, Kansas City, Missouri, USA
| | - Melissa L Cullimore
- Division of Pediatric Critical Care, Department of Pediatrics, Children’s Hospital and Medical Center, Omaha, Nebraska, USA
| | - Sabrina M Heidemann
- Division of Pediatric Critical Care Medicine, Children’s Hospital of Michigan, Central Michigan University, Detroit, Michigan, USA
| | - Charlotte V Hobbs
- Department of Pediatrics, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Ryan A Nofziger
- Division of Critical Care Medicine, Department of Pediatrics, Akron Children’s Hospital, Akron, Ohio, USA
| | - Pia S Pannaraj
- Division of Infectious Diseases, Children’s Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles, California, USA
| | - Melissa A Cameron
- Division of Pediatric Hospital Medicine, UC San Diego-Rady Children’s Hospital, San Diego, California, USA
| | - Tracie C Walker
- Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill, North Carolina, USA
| | - Stephanie P Schwartz
- Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill, North Carolina, USA
| | - Kelly N Michelson
- Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Bria M Coates
- Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Heidi R Flori
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children’s Hospital and University of Michigan, Ann Arbor, Michigan, USA
| | - Elizabeth H Mack
- Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Laura Smallcomb
- Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Shira J Gertz
- Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, New Jersey, USA
| | - Samina S Bhumbra
- The Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Tamara T Bradford
- Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children’s Hospital of New Orleans, New Orleans, Louisiana, USA
| | - Emily R Levy
- Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Michele Kong
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Katherine Irby
- Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock, Arkansas, USA
| | - Natalie Z Cvijanovich
- Division of Critical Care Medicine, UCSF Benioff Children's Hospital Oakland, California, USA
| | - Matt S Zinter
- Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California San Francisco, San Francisco, California, USA
| | - Cindy Bowens
- Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center Dallas, Texas, USA
| | - Hillary Crandall
- Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA
| | - Janet R Hume
- Division of Pediatric Critical Care, University of Minnesota Masonic Children’s Hospital, Minneapolis, Minnesota, USA
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11
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Halasa NB, Olson SM, Staat MA, Newhams MM, Price AM, Pannaraj PS, Boom JA, Sahni LC, Chiotos K, Cameron MA, Bline KE, Hobbs CV, Maddux AB, Coates BM, Michelson KN, Heidemann SM, Irby K, Nofziger RA, Mack EH, Smallcomb L, Schwartz SP, Walker TC, Gertz SJ, Schuster JE, Kamidani S, Tarquinio KM, Bhumbra SS, Maamari M, Hume JR, Crandall H, Levy ER, Zinter MS, Bradford TT, Flori HR, Cullimore ML, Kong M, Cvijanovich NZ, Gilboa SM, Polen KN, Campbell AP, Randolph AG, Patel MM. Maternal Vaccination and Risk of Hospitalization for Covid-19 among Infants. N Engl J Med 2022; 387:109-119. [PMID: 35731908 PMCID: PMC9342588 DOI: 10.1056/nejmoa2204399] [Citation(s) in RCA: 105] [Impact Index Per Article: 52.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Infants younger than 6 months of age are at high risk for complications of coronavirus disease 2019 (Covid-19) and are not eligible for vaccination. Transplacental transfer of antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) after maternal Covid-19 vaccination may confer protection against Covid-19 in infants. METHODS We used a case-control test-negative design to assess the effectiveness of maternal vaccination during pregnancy against hospitalization for Covid-19 among infants younger than 6 months of age. Between July 1, 2021, and March 8, 2022, we enrolled infants hospitalized for Covid-19 (case infants) and infants hospitalized without Covid-19 (control infants) at 30 hospitals in 22 states. We estimated vaccine effectiveness by comparing the odds of full maternal vaccination (two doses of mRNA vaccine) among case infants and control infants during circulation of the B.1.617.2 (delta) variant (July 1, 2021, to December 18, 2021) and the B.1.1.259 (omicron) variant (December 19, 2021, to March 8, 2022). RESULTS A total of 537 case infants (181 of whom had been admitted to a hospital during the delta period and 356 during the omicron period; median age, 2 months) and 512 control infants were enrolled and included in the analyses; 16% of the case infants and 29% of the control infants had been born to mothers who had been fully vaccinated against Covid-19 during pregnancy. Among the case infants, 113 (21%) received intensive care (64 [12%] received mechanical ventilation or vasoactive infusions). Two case infants died from Covid-19; neither infant's mother had been vaccinated during pregnancy. The effectiveness of maternal vaccination against hospitalization for Covid-19 among infants was 52% (95% confidence interval [CI], 33 to 65) overall, 80% (95% CI, 60 to 90) during the delta period, and 38% (95% CI, 8 to 58) during the omicron period. Effectiveness was 69% (95% CI, 50 to 80) when maternal vaccination occurred after 20 weeks of pregnancy and 38% (95% CI, 3 to 60) during the first 20 weeks of pregnancy. CONCLUSIONS Maternal vaccination with two doses of mRNA vaccine was associated with a reduced risk of hospitalization for Covid-19, including for critical illness, among infants younger than 6 months of age. (Funded by the Centers for Disease Control and Prevention.).
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Affiliation(s)
- Natasha B Halasa
- From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., S.M.G., K.N.P., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital, Columbus (K.E.B.), and the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.) - all in Ohio; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Infectious Diseases, Children's Hospital Los Angeles, and the Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.), and the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.) - all in California; the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.); the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Department of Pediatrics, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine, and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M.C., K.N.M.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine (E.H.M.), and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (S.P.S., T.C.W.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri (J.E.S.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.), and the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.) - both in Minnesota; the Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City (H.C.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.)
| | - Samantha M Olson
- From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., S.M.G., K.N.P., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital, Columbus (K.E.B.), and the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.) - all in Ohio; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Infectious Diseases, Children's Hospital Los Angeles, and the Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.), and the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.) - all in California; the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.); the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Department of Pediatrics, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine, and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M.C., K.N.M.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine (E.H.M.), and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (S.P.S., T.C.W.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri (J.E.S.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.), and the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.) - both in Minnesota; the Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City (H.C.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.)
| | - Mary A Staat
- From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., S.M.G., K.N.P., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital, Columbus (K.E.B.), and the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.) - all in Ohio; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Infectious Diseases, Children's Hospital Los Angeles, and the Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.), and the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.) - all in California; the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.); the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Department of Pediatrics, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine, and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M.C., K.N.M.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine (E.H.M.), and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (S.P.S., T.C.W.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri (J.E.S.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.), and the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.) - both in Minnesota; the Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City (H.C.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.)
| | - Margaret M Newhams
- From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., S.M.G., K.N.P., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital, Columbus (K.E.B.), and the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.) - all in Ohio; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Infectious Diseases, Children's Hospital Los Angeles, and the Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.), and the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.) - all in California; the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.); the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Department of Pediatrics, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine, and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M.C., K.N.M.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine (E.H.M.), and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (S.P.S., T.C.W.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri (J.E.S.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.), and the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.) - both in Minnesota; the Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City (H.C.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.)
| | - Ashley M Price
- From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., S.M.G., K.N.P., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital, Columbus (K.E.B.), and the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.) - all in Ohio; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Infectious Diseases, Children's Hospital Los Angeles, and the Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.), and the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.) - all in California; the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.); the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Department of Pediatrics, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine, and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M.C., K.N.M.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine (E.H.M.), and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (S.P.S., T.C.W.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri (J.E.S.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.), and the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.) - both in Minnesota; the Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City (H.C.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.)
| | - Pia S Pannaraj
- From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., S.M.G., K.N.P., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital, Columbus (K.E.B.), and the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.) - all in Ohio; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Infectious Diseases, Children's Hospital Los Angeles, and the Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.), and the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.) - all in California; the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.); the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Department of Pediatrics, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine, and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M.C., K.N.M.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine (E.H.M.), and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (S.P.S., T.C.W.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri (J.E.S.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.), and the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.) - both in Minnesota; the Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City (H.C.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.)
| | - Julie A Boom
- From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., S.M.G., K.N.P., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital, Columbus (K.E.B.), and the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.) - all in Ohio; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Infectious Diseases, Children's Hospital Los Angeles, and the Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.), and the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.) - all in California; the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.); the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Department of Pediatrics, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine, and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M.C., K.N.M.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine (E.H.M.), and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (S.P.S., T.C.W.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri (J.E.S.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.), and the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.) - both in Minnesota; the Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City (H.C.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.)
| | - Leila C Sahni
- From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., S.M.G., K.N.P., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital, Columbus (K.E.B.), and the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.) - all in Ohio; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Infectious Diseases, Children's Hospital Los Angeles, and the Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.), and the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.) - all in California; the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.); the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Department of Pediatrics, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine, and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M.C., K.N.M.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine (E.H.M.), and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (S.P.S., T.C.W.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri (J.E.S.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.), and the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.) - both in Minnesota; the Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City (H.C.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.)
| | - Kathleen Chiotos
- From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., S.M.G., K.N.P., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital, Columbus (K.E.B.), and the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.) - all in Ohio; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Infectious Diseases, Children's Hospital Los Angeles, and the Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.), and the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.) - all in California; the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.); the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Department of Pediatrics, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine, and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M.C., K.N.M.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine (E.H.M.), and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (S.P.S., T.C.W.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri (J.E.S.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.), and the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.) - both in Minnesota; the Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City (H.C.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.)
| | - Melissa A Cameron
- From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., S.M.G., K.N.P., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital, Columbus (K.E.B.), and the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.) - all in Ohio; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Infectious Diseases, Children's Hospital Los Angeles, and the Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.), and the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.) - all in California; the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.); the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Department of Pediatrics, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine, and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M.C., K.N.M.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine (E.H.M.), and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (S.P.S., T.C.W.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri (J.E.S.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.), and the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.) - both in Minnesota; the Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City (H.C.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.)
| | - Katherine E Bline
- From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., S.M.G., K.N.P., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital, Columbus (K.E.B.), and the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.) - all in Ohio; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Infectious Diseases, Children's Hospital Los Angeles, and the Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.), and the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.) - all in California; the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.); the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Department of Pediatrics, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine, and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M.C., K.N.M.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine (E.H.M.), and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (S.P.S., T.C.W.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri (J.E.S.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.), and the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.) - both in Minnesota; the Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City (H.C.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.)
| | - Charlotte V Hobbs
- From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., S.M.G., K.N.P., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital, Columbus (K.E.B.), and the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.) - all in Ohio; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Infectious Diseases, Children's Hospital Los Angeles, and the Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.), and the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.) - all in California; the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.); the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Department of Pediatrics, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine, and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M.C., K.N.M.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine (E.H.M.), and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (S.P.S., T.C.W.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri (J.E.S.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.), and the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.) - both in Minnesota; the Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City (H.C.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.)
| | - Aline B Maddux
- From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., S.M.G., K.N.P., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital, Columbus (K.E.B.), and the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.) - all in Ohio; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Infectious Diseases, Children's Hospital Los Angeles, and the Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.), and the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.) - all in California; the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.); the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Department of Pediatrics, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine, and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M.C., K.N.M.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine (E.H.M.), and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (S.P.S., T.C.W.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri (J.E.S.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.), and the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.) - both in Minnesota; the Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City (H.C.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.)
| | - Bria M Coates
- From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., S.M.G., K.N.P., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital, Columbus (K.E.B.), and the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.) - all in Ohio; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Infectious Diseases, Children's Hospital Los Angeles, and the Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.), and the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.) - all in California; the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.); the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Department of Pediatrics, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine, and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M.C., K.N.M.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine (E.H.M.), and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (S.P.S., T.C.W.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri (J.E.S.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.), and the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.) - both in Minnesota; the Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City (H.C.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.)
| | - Kelly N Michelson
- From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., S.M.G., K.N.P., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital, Columbus (K.E.B.), and the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.) - all in Ohio; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Infectious Diseases, Children's Hospital Los Angeles, and the Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.), and the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.) - all in California; the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.); the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Department of Pediatrics, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine, and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M.C., K.N.M.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine (E.H.M.), and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (S.P.S., T.C.W.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri (J.E.S.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.), and the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.) - both in Minnesota; the Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City (H.C.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.)
| | - Sabrina M Heidemann
- From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., S.M.G., K.N.P., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital, Columbus (K.E.B.), and the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.) - all in Ohio; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Infectious Diseases, Children's Hospital Los Angeles, and the Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.), and the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.) - all in California; the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.); the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Department of Pediatrics, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine, and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M.C., K.N.M.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine (E.H.M.), and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (S.P.S., T.C.W.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri (J.E.S.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.), and the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.) - both in Minnesota; the Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City (H.C.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.)
| | - Katherine Irby
- From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., S.M.G., K.N.P., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital, Columbus (K.E.B.), and the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.) - all in Ohio; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Infectious Diseases, Children's Hospital Los Angeles, and the Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.), and the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.) - all in California; the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.); the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Department of Pediatrics, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine, and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M.C., K.N.M.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine (E.H.M.), and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (S.P.S., T.C.W.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri (J.E.S.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.), and the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.) - both in Minnesota; the Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City (H.C.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.)
| | - Ryan A Nofziger
- From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., S.M.G., K.N.P., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital, Columbus (K.E.B.), and the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.) - all in Ohio; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Infectious Diseases, Children's Hospital Los Angeles, and the Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.), and the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.) - all in California; the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.); the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Department of Pediatrics, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine, and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M.C., K.N.M.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine (E.H.M.), and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (S.P.S., T.C.W.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri (J.E.S.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.), and the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.) - both in Minnesota; the Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City (H.C.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.)
| | - Elizabeth H Mack
- From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., S.M.G., K.N.P., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital, Columbus (K.E.B.), and the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.) - all in Ohio; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Infectious Diseases, Children's Hospital Los Angeles, and the Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.), and the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.) - all in California; the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.); the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Department of Pediatrics, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine, and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M.C., K.N.M.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine (E.H.M.), and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (S.P.S., T.C.W.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri (J.E.S.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.), and the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.) - both in Minnesota; the Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City (H.C.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.)
| | - Laura Smallcomb
- From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., S.M.G., K.N.P., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital, Columbus (K.E.B.), and the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.) - all in Ohio; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Infectious Diseases, Children's Hospital Los Angeles, and the Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.), and the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.) - all in California; the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.); the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Department of Pediatrics, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine, and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M.C., K.N.M.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine (E.H.M.), and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (S.P.S., T.C.W.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri (J.E.S.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.), and the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.) - both in Minnesota; the Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City (H.C.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.)
| | - Stephanie P Schwartz
- From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., S.M.G., K.N.P., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital, Columbus (K.E.B.), and the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.) - all in Ohio; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Infectious Diseases, Children's Hospital Los Angeles, and the Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.), and the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.) - all in California; the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.); the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Department of Pediatrics, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine, and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M.C., K.N.M.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine (E.H.M.), and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (S.P.S., T.C.W.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri (J.E.S.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.), and the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.) - both in Minnesota; the Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City (H.C.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.)
| | - Tracie C Walker
- From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., S.M.G., K.N.P., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital, Columbus (K.E.B.), and the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.) - all in Ohio; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Infectious Diseases, Children's Hospital Los Angeles, and the Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.), and the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.) - all in California; the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.); the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Department of Pediatrics, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine, and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M.C., K.N.M.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine (E.H.M.), and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (S.P.S., T.C.W.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri (J.E.S.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.), and the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.) - both in Minnesota; the Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City (H.C.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.)
| | - Shira J Gertz
- From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., S.M.G., K.N.P., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital, Columbus (K.E.B.), and the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.) - all in Ohio; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Infectious Diseases, Children's Hospital Los Angeles, and the Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.), and the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.) - all in California; the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.); the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Department of Pediatrics, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine, and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M.C., K.N.M.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine (E.H.M.), and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (S.P.S., T.C.W.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri (J.E.S.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.), and the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.) - both in Minnesota; the Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City (H.C.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.)
| | - Jennifer E Schuster
- From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., S.M.G., K.N.P., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital, Columbus (K.E.B.), and the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.) - all in Ohio; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Infectious Diseases, Children's Hospital Los Angeles, and the Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.), and the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.) - all in California; the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.); the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Department of Pediatrics, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine, and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M.C., K.N.M.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine (E.H.M.), and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (S.P.S., T.C.W.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri (J.E.S.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.), and the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.) - both in Minnesota; the Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City (H.C.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.)
| | - Satoshi Kamidani
- From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., S.M.G., K.N.P., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital, Columbus (K.E.B.), and the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.) - all in Ohio; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Infectious Diseases, Children's Hospital Los Angeles, and the Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.), and the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.) - all in California; the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.); the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Department of Pediatrics, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine, and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M.C., K.N.M.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine (E.H.M.), and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (S.P.S., T.C.W.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri (J.E.S.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.), and the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.) - both in Minnesota; the Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City (H.C.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.)
| | - Keiko M Tarquinio
- From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., S.M.G., K.N.P., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital, Columbus (K.E.B.), and the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.) - all in Ohio; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Infectious Diseases, Children's Hospital Los Angeles, and the Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.), and the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.) - all in California; the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.); the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Department of Pediatrics, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine, and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M.C., K.N.M.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine (E.H.M.), and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (S.P.S., T.C.W.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri (J.E.S.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.), and the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.) - both in Minnesota; the Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City (H.C.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.)
| | - Samina S Bhumbra
- From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., S.M.G., K.N.P., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital, Columbus (K.E.B.), and the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.) - all in Ohio; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Infectious Diseases, Children's Hospital Los Angeles, and the Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.), and the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.) - all in California; the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.); the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Department of Pediatrics, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine, and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M.C., K.N.M.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine (E.H.M.), and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (S.P.S., T.C.W.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri (J.E.S.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.), and the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.) - both in Minnesota; the Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City (H.C.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.)
| | - Mia Maamari
- From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., S.M.G., K.N.P., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital, Columbus (K.E.B.), and the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.) - all in Ohio; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Infectious Diseases, Children's Hospital Los Angeles, and the Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.), and the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.) - all in California; the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.); the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Department of Pediatrics, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine, and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M.C., K.N.M.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine (E.H.M.), and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (S.P.S., T.C.W.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri (J.E.S.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.), and the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.) - both in Minnesota; the Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City (H.C.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.)
| | - Janet R Hume
- From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., S.M.G., K.N.P., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital, Columbus (K.E.B.), and the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.) - all in Ohio; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Infectious Diseases, Children's Hospital Los Angeles, and the Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.), and the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.) - all in California; the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.); the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Department of Pediatrics, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine, and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M.C., K.N.M.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine (E.H.M.), and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (S.P.S., T.C.W.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri (J.E.S.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.), and the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.) - both in Minnesota; the Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City (H.C.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.)
| | - Hillary Crandall
- From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., S.M.G., K.N.P., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital, Columbus (K.E.B.), and the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.) - all in Ohio; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Infectious Diseases, Children's Hospital Los Angeles, and the Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.), and the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.) - all in California; the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.); the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Department of Pediatrics, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine, and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M.C., K.N.M.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine (E.H.M.), and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (S.P.S., T.C.W.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri (J.E.S.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.), and the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.) - both in Minnesota; the Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City (H.C.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.)
| | - Emily R Levy
- From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., S.M.G., K.N.P., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital, Columbus (K.E.B.), and the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.) - all in Ohio; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Infectious Diseases, Children's Hospital Los Angeles, and the Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.), and the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.) - all in California; the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.); the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Department of Pediatrics, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine, and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M.C., K.N.M.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine (E.H.M.), and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (S.P.S., T.C.W.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri (J.E.S.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.), and the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.) - both in Minnesota; the Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City (H.C.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.)
| | - Matt S Zinter
- From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., S.M.G., K.N.P., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital, Columbus (K.E.B.), and the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.) - all in Ohio; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Infectious Diseases, Children's Hospital Los Angeles, and the Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.), and the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.) - all in California; the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.); the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Department of Pediatrics, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine, and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M.C., K.N.M.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine (E.H.M.), and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (S.P.S., T.C.W.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri (J.E.S.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.), and the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.) - both in Minnesota; the Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City (H.C.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.)
| | - Tamara T Bradford
- From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., S.M.G., K.N.P., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital, Columbus (K.E.B.), and the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.) - all in Ohio; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Infectious Diseases, Children's Hospital Los Angeles, and the Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.), and the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.) - all in California; the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.); the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Department of Pediatrics, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine, and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M.C., K.N.M.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine (E.H.M.), and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (S.P.S., T.C.W.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri (J.E.S.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.), and the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.) - both in Minnesota; the Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City (H.C.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.)
| | - Heidi R Flori
- From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., S.M.G., K.N.P., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital, Columbus (K.E.B.), and the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.) - all in Ohio; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Infectious Diseases, Children's Hospital Los Angeles, and the Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.), and the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.) - all in California; the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.); the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Department of Pediatrics, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine, and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M.C., K.N.M.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine (E.H.M.), and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (S.P.S., T.C.W.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri (J.E.S.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.), and the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.) - both in Minnesota; the Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City (H.C.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.)
| | - Melissa L Cullimore
- From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., S.M.G., K.N.P., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital, Columbus (K.E.B.), and the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.) - all in Ohio; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Infectious Diseases, Children's Hospital Los Angeles, and the Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.), and the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.) - all in California; the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.); the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Department of Pediatrics, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine, and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M.C., K.N.M.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine (E.H.M.), and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (S.P.S., T.C.W.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri (J.E.S.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.), and the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.) - both in Minnesota; the Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City (H.C.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.)
| | - Michele Kong
- From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., S.M.G., K.N.P., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital, Columbus (K.E.B.), and the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.) - all in Ohio; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Infectious Diseases, Children's Hospital Los Angeles, and the Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.), and the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.) - all in California; the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.); the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Department of Pediatrics, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine, and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M.C., K.N.M.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine (E.H.M.), and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (S.P.S., T.C.W.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri (J.E.S.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.), and the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.) - both in Minnesota; the Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City (H.C.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.)
| | - Natalie Z Cvijanovich
- From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., S.M.G., K.N.P., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital, Columbus (K.E.B.), and the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.) - all in Ohio; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Infectious Diseases, Children's Hospital Los Angeles, and the Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.), and the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.) - all in California; the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.); the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Department of Pediatrics, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine, and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M.C., K.N.M.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine (E.H.M.), and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (S.P.S., T.C.W.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri (J.E.S.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.), and the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.) - both in Minnesota; the Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City (H.C.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.)
| | - Suzanne M Gilboa
- From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., S.M.G., K.N.P., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital, Columbus (K.E.B.), and the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.) - all in Ohio; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Infectious Diseases, Children's Hospital Los Angeles, and the Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.), and the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.) - all in California; the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.); the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Department of Pediatrics, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine, and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M.C., K.N.M.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine (E.H.M.), and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (S.P.S., T.C.W.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri (J.E.S.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.), and the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.) - both in Minnesota; the Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City (H.C.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.)
| | - Kara N Polen
- From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., S.M.G., K.N.P., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital, Columbus (K.E.B.), and the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.) - all in Ohio; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Infectious Diseases, Children's Hospital Los Angeles, and the Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.), and the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.) - all in California; the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.); the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Department of Pediatrics, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine, and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M.C., K.N.M.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine (E.H.M.), and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (S.P.S., T.C.W.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri (J.E.S.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.), and the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.) - both in Minnesota; the Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City (H.C.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.)
| | - Angela P Campbell
- From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., S.M.G., K.N.P., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital, Columbus (K.E.B.), and the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.) - all in Ohio; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Infectious Diseases, Children's Hospital Los Angeles, and the Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.), and the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.) - all in California; the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.); the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Department of Pediatrics, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine, and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M.C., K.N.M.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine (E.H.M.), and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (S.P.S., T.C.W.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri (J.E.S.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.), and the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.) - both in Minnesota; the Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City (H.C.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.)
| | - Adrienne G Randolph
- From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., S.M.G., K.N.P., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital, Columbus (K.E.B.), and the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.) - all in Ohio; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Infectious Diseases, Children's Hospital Los Angeles, and the Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.), and the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.) - all in California; the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.); the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Department of Pediatrics, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine, and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M.C., K.N.M.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine (E.H.M.), and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (S.P.S., T.C.W.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri (J.E.S.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.), and the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.) - both in Minnesota; the Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City (H.C.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.)
| | - Manish M Patel
- From the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., S.M.G., K.N.P., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital, Columbus (K.E.B.), and the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.) - all in Ohio; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Infectious Diseases, Children's Hospital Los Angeles, and the Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.), and the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.) - all in California; the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.); the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Department of Pediatrics, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine, and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M.C., K.N.M.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine (E.H.M.), and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (S.P.S., T.C.W.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri (J.E.S.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.), and the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.) - both in Minnesota; the Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City (H.C.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.)
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Schuster JE, Halasa NB, Nakamura M, Levy ER, Fitzgerald JC, Young CC, Newhams MM, Bourgeois F, Staat MA, Hobbs CV, Dapul H, Feldstein LR, Jackson AM, Mack EH, Walker TC, Maddux AB, Spinella PC, Loftis LL, Kong M, Rowan CM, Bembea MM, McLaughlin GE, Hall MW, Babbitt CJ, Maamari M, Zinter MS, Cvijanovich NZ, Michelson KN, Gertz SJ, Carroll CL, Thomas NJ, Giuliano JS, Singh AR, Hymes SR, Schwarz AJ, McGuire JK, Nofziger RA, Flori HR, Clouser KN, Wellnitz K, Cullimore ML, Hume JR, Patel M, Randolph AG. A Description of COVID-19-Directed Therapy in Children Admitted to US Intensive Care Units 2020. J Pediatric Infect Dis Soc 2022; 11:191-198. [PMID: 35022779 PMCID: PMC8807297 DOI: 10.1093/jpids/piab123] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 11/17/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND It is unclear how acute coronavirus disease 2019 (COVID-19)-directed therapies are used in children with life-threatening COVID-19 in US hospitals. We described characteristics of children hospitalized in the intensive care unit or step-down unit (ICU/SDU) who received COVID-19-directed therapies and the specific therapies administered. METHODS Between March 15, 2020 and December 27, 2020, children <18 years of age in the ICU/SDU with acute COVID-19 at 48 pediatric hospitals in the United States were identified. Demographics, laboratory values, and clinical course were compared in children who did and did not receive COVID-19-directed therapies. Trends in COVID-19-directed therapies over time were evaluated. RESULTS Of 424 children in the ICU/SDU, 235 (55%) received COVID-19-directed therapies. Children who received COVID-19-directed therapies were older than those who did not receive COVID-19-directed therapies (13.3 [5.6-16.2] vs 9.8 [0.65-15.9] years), more had underlying medical conditions (188 [80%] vs 104 [55%]; difference = 25% [95% CI: 16% to 34%]), more received respiratory support (206 [88%] vs 71 [38%]; difference = 50% [95% CI: 34% to 56%]), and more died (8 [3.4%] vs 0). Of the 235 children receiving COVID-19-directed therapies, 172 (73%) received systemic steroids and 150 (64%) received remdesivir, with rising remdesivir use over the study period (14% in March/April to 57% November/December). CONCLUSION Despite the lack of pediatric data evaluating treatments for COVID-19 in critically ill children, more than half of children requiring intensive or high acuity care received COVID-19-directed therapies.
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Affiliation(s)
- Jennifer E Schuster
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Children’s Mercy Kansas City, Kansas City, Missouri, USA
| | - Natasha B Halasa
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Mari Nakamura
- Division of Pediatric Infectious Diseases, Department of Pediatrics and Antimicrobial Stewardship Program, Boston Children’s Hospital, Boston, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| | - Emily R Levy
- Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Julie C Fitzgerald
- Division of Critical Care, Department of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Cameron C Young
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA
| | - Margaret M Newhams
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA
| | - Florence Bourgeois
- Pediatric Therapeutics and Regulatory Science Initiative, Computational Health Informatics Program, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Mary A Staat
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
| | - Charlotte V Hobbs
- Division of Disease, Departments of Pediatrics and Microbiology, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Heda Dapul
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, New York University Grossman School of Medicine and Hassenfeld Children’s Hospital, New York, New York, USA
| | - Leora R Feldstein
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Ashley M Jackson
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Elizabeth H Mack
- Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Tracie C Walker
- Department of Pediatrics, Division of Critical Care, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Aline B Maddux
- Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, Colorado, USA
| | - Philip C Spinella
- Division of Critical Care, Department of Pediatrics, Washington University School of Medicine in St Louis, St. Louis, Missouri, USA
| | - Laura L Loftis
- Section of Critical Care Medicine, Department of Pediatrics, Texas Children’s Hospital, Houston, Texas, USA
| | - Michele Kong
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Courtney M Rowan
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Indiana University School of Medicine, Riley Hospital for Children, Indianapolis, Indiana, USA
| | - Melania M Bembea
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Gwenn E McLaughlin
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Mark W Hall
- Division of Critical Care Medicine, Department of Pediatrics, Nationwide Children’s Hospital, Columbus, Ohio, USA
| | - Christopher J Babbitt
- Division of Pediatric Critical Care, Department of Pediatrics, Miller Children’s and Women’s Hospital of Long Beach, Long Beach, California, USA
| | - Mia Maamari
- Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children’s Health Medical Center, Dallas, Texas, USA
| | - Matt S Zinter
- Department of Pediatrics, Division of Critical Care, University of California San Francisco, San Francisco, California, USA
| | - Natalie Z Cvijanovich
- Division of Critical Care Medicine, UCSF Benioff Children’s Hospital Oakland, Oakland, California, USA
| | - Kelly N Michelson
- Division of Pediatric Critical Care Medicine, Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Shira J Gertz
- Division of Pediatric Critical Care, Department of Pediatrics, Saint Barnabas Medical Center, Livingston, New Jersey, USA
| | - Christopher L Carroll
- Division of Critical Care, Connecticut Children’s Medical Center, Hartford, Connecticut, USA
| | - Neal J Thomas
- Department of Pediatrics, Penn State Hershey Children’s Hospital, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - John S Giuliano
- Department of Pediatrics, Division of Critical Care, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Aalok R Singh
- Pediatric Critical Care Division, Maria Fareri Children’s Hospital at Westchester Medical Center and New York Medical College, Valhalla, New York, USA
| | - Saul R Hymes
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Stony Brook Children’s Hospital, Stony Brook, New York, USA
| | - Adam J Schwarz
- Division of Critical Care Medicine, CHOC Children’s Hospital, Orange, California, USA
| | - John K McGuire
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Seattle Children’s Hospital and the University of Washington, Seattle, Washington, USA
| | - Ryan A Nofziger
- Division of Critical Care Medicine, Akron Children’s Hospital, Akron, Ohio, USA
| | - Heidi R Flori
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children’s Hospital and University of Michigan, Ann Arbor, Michigan, USA
| | - Katharine N Clouser
- Department of Pediatrics, Hackensack Meridian School of Medicine, Hackensack, New Jersey, USA
| | - Kari Wellnitz
- Division of Pediatric Critical Care, Stead Family Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Melissa L Cullimore
- Division of Pediatric Critical Care, Department of Pediatrics, Children’s Hospital and Medical Center, Omaha, Nebraska, USA
| | - Janet R Hume
- Division of Pediatric Critical Care, University of Minnesota Masonic Children’s Hospital, Minneapolis, Minnesota, USA
| | - Manish Patel
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Adrienne G Randolph
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA
- Departments of Anesthesia and Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
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Price AM, Olson SM, Newhams MM, Halasa NB, Boom JA, Sahni LC, Pannaraj PS, Irby K, Bline KE, Maddux AB, Nofziger RA, Cameron MA, Walker TC, Schwartz SP, Mack EH, Smallcomb L, Schuster JE, Hobbs CV, Kamidani S, Tarquinio KM, Bradford TT, Levy ER, Chiotos K, Bhumbra SS, Cvijanovich NZ, Heidemann SM, Cullimore ML, Gertz SJ, Coates BM, Staat MA, Zinter MS, Kong M, Chatani BM, Hume JR, Typpo KV, Maamari M, Flori HR, Tenforde MW, Zambrano LD, Campbell AP, Patel MM, Randolph AG. BNT162b2 Protection against the Omicron Variant in Children and Adolescents. N Engl J Med 2022; 386:1899-1909. [PMID: 35353976 PMCID: PMC9006785 DOI: 10.1056/nejmoa2202826] [Citation(s) in RCA: 142] [Impact Index Per Article: 71.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) B.1.1.529 (omicron) variant, which led to increased U.S. hospitalizations for coronavirus disease 2019 (Covid-19), generated concern about immune evasion and the duration of protection from vaccines in children and adolescents. METHODS Using a case-control, test-negative design, we assessed vaccine effectiveness against laboratory-confirmed Covid-19 leading to hospitalization and against critical Covid-19 (i.e., leading to receipt of life support or to death). From July 1, 2021, to February 17, 2022, we enrolled case patients with Covid-19 and controls without Covid-19 at 31 hospitals in 23 states. We estimated vaccine effectiveness by comparing the odds of antecedent full vaccination (two doses of BNT162b2 messenger RNA vaccine) at least 14 days before illness among case patients and controls, according to time since vaccination for patients 12 to 18 years of age and in periods coinciding with circulation of B.1.617.2 (delta) (July 1, 2021, to December 18, 2021) and omicron (December 19, 2021, to February 17, 2022) among patients 5 to 11 and 12 to 18 years of age. RESULTS We enrolled 1185 case patients (1043 [88%] of whom were unvaccinated, 291 [25%] of whom received life support, and 14 of whom died) and 1627 controls. During the delta-predominant period, vaccine effectiveness against hospitalization for Covid-19 among adolescents 12 to 18 years of age was 93% (95% confidence interval [CI], 89 to 95) 2 to 22 weeks after vaccination and was 92% (95% CI, 80 to 97) at 23 to 44 weeks. Among adolescents 12 to 18 years of age (median interval since vaccination, 162 days) during the omicron-predominant period, vaccine effectiveness was 40% (95% CI, 9 to 60) against hospitalization for Covid-19, 79% (95% CI, 51 to 91) against critical Covid-19, and 20% (95% CI, -25 to 49) against noncritical Covid-19. During the omicron period, vaccine effectiveness against hospitalization among children 5 to 11 years of age was 68% (95% CI, 42 to 82; median interval since vaccination, 34 days). CONCLUSIONS BNT162b2 vaccination reduced the risk of omicron-associated hospitalization by two thirds among children 5 to 11 years of age. Although two doses provided lower protection against omicron-associated hospitalization than against delta-associated hospitalization among adolescents 12 to 18 years of age, vaccination prevented critical illness caused by either variant. (Funded by the Centers for Disease Control and Prevention.).
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Affiliation(s)
- Ashley M Price
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (A.M.P., S.M.O., M.W.T., L.D.Z., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus (K.E.B.), the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.) - all in Ohio; the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Division of Pediatric Critical Care Medicine (E.H.M.) and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Departments of Pediatrics and Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M. Coates); the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth Holtz Children's Hospital, Miami (B.M. Chatani); and the Department of Pediatrics and Banner Children's at Diamond Children's Medical Center, University of Arizona, Tucson (K.V.T.)
| | - Samantha M Olson
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (A.M.P., S.M.O., M.W.T., L.D.Z., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus (K.E.B.), the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.) - all in Ohio; the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Division of Pediatric Critical Care Medicine (E.H.M.) and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Departments of Pediatrics and Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M. Coates); the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth Holtz Children's Hospital, Miami (B.M. Chatani); and the Department of Pediatrics and Banner Children's at Diamond Children's Medical Center, University of Arizona, Tucson (K.V.T.)
| | - Margaret M Newhams
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (A.M.P., S.M.O., M.W.T., L.D.Z., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus (K.E.B.), the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.) - all in Ohio; the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Division of Pediatric Critical Care Medicine (E.H.M.) and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Departments of Pediatrics and Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M. Coates); the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth Holtz Children's Hospital, Miami (B.M. Chatani); and the Department of Pediatrics and Banner Children's at Diamond Children's Medical Center, University of Arizona, Tucson (K.V.T.)
| | - Natasha B Halasa
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (A.M.P., S.M.O., M.W.T., L.D.Z., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus (K.E.B.), the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.) - all in Ohio; the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Division of Pediatric Critical Care Medicine (E.H.M.) and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Departments of Pediatrics and Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M. Coates); the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth Holtz Children's Hospital, Miami (B.M. Chatani); and the Department of Pediatrics and Banner Children's at Diamond Children's Medical Center, University of Arizona, Tucson (K.V.T.)
| | - Julie A Boom
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (A.M.P., S.M.O., M.W.T., L.D.Z., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus (K.E.B.), the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.) - all in Ohio; the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Division of Pediatric Critical Care Medicine (E.H.M.) and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Departments of Pediatrics and Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M. Coates); the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth Holtz Children's Hospital, Miami (B.M. Chatani); and the Department of Pediatrics and Banner Children's at Diamond Children's Medical Center, University of Arizona, Tucson (K.V.T.)
| | - Leila C Sahni
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (A.M.P., S.M.O., M.W.T., L.D.Z., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus (K.E.B.), the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.) - all in Ohio; the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Division of Pediatric Critical Care Medicine (E.H.M.) and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Departments of Pediatrics and Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M. Coates); the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth Holtz Children's Hospital, Miami (B.M. Chatani); and the Department of Pediatrics and Banner Children's at Diamond Children's Medical Center, University of Arizona, Tucson (K.V.T.)
| | - Pia S Pannaraj
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (A.M.P., S.M.O., M.W.T., L.D.Z., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus (K.E.B.), the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.) - all in Ohio; the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Division of Pediatric Critical Care Medicine (E.H.M.) and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Departments of Pediatrics and Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M. Coates); the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth Holtz Children's Hospital, Miami (B.M. Chatani); and the Department of Pediatrics and Banner Children's at Diamond Children's Medical Center, University of Arizona, Tucson (K.V.T.)
| | - Katherine Irby
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (A.M.P., S.M.O., M.W.T., L.D.Z., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus (K.E.B.), the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.) - all in Ohio; the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Division of Pediatric Critical Care Medicine (E.H.M.) and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Departments of Pediatrics and Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M. Coates); the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth Holtz Children's Hospital, Miami (B.M. Chatani); and the Department of Pediatrics and Banner Children's at Diamond Children's Medical Center, University of Arizona, Tucson (K.V.T.)
| | - Katherine E Bline
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (A.M.P., S.M.O., M.W.T., L.D.Z., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus (K.E.B.), the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.) - all in Ohio; the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Division of Pediatric Critical Care Medicine (E.H.M.) and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Departments of Pediatrics and Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M. Coates); the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth Holtz Children's Hospital, Miami (B.M. Chatani); and the Department of Pediatrics and Banner Children's at Diamond Children's Medical Center, University of Arizona, Tucson (K.V.T.)
| | - Aline B Maddux
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (A.M.P., S.M.O., M.W.T., L.D.Z., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus (K.E.B.), the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.) - all in Ohio; the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Division of Pediatric Critical Care Medicine (E.H.M.) and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Departments of Pediatrics and Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M. Coates); the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth Holtz Children's Hospital, Miami (B.M. Chatani); and the Department of Pediatrics and Banner Children's at Diamond Children's Medical Center, University of Arizona, Tucson (K.V.T.)
| | - Ryan A Nofziger
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (A.M.P., S.M.O., M.W.T., L.D.Z., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus (K.E.B.), the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.) - all in Ohio; the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Division of Pediatric Critical Care Medicine (E.H.M.) and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Departments of Pediatrics and Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M. Coates); the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth Holtz Children's Hospital, Miami (B.M. Chatani); and the Department of Pediatrics and Banner Children's at Diamond Children's Medical Center, University of Arizona, Tucson (K.V.T.)
| | - Melissa A Cameron
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (A.M.P., S.M.O., M.W.T., L.D.Z., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus (K.E.B.), the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.) - all in Ohio; the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Division of Pediatric Critical Care Medicine (E.H.M.) and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Departments of Pediatrics and Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M. Coates); the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth Holtz Children's Hospital, Miami (B.M. Chatani); and the Department of Pediatrics and Banner Children's at Diamond Children's Medical Center, University of Arizona, Tucson (K.V.T.)
| | - Tracie C Walker
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (A.M.P., S.M.O., M.W.T., L.D.Z., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus (K.E.B.), the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.) - all in Ohio; the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Division of Pediatric Critical Care Medicine (E.H.M.) and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Departments of Pediatrics and Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M. Coates); the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth Holtz Children's Hospital, Miami (B.M. Chatani); and the Department of Pediatrics and Banner Children's at Diamond Children's Medical Center, University of Arizona, Tucson (K.V.T.)
| | - Stephanie P Schwartz
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (A.M.P., S.M.O., M.W.T., L.D.Z., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus (K.E.B.), the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.) - all in Ohio; the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Division of Pediatric Critical Care Medicine (E.H.M.) and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Departments of Pediatrics and Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M. Coates); the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth Holtz Children's Hospital, Miami (B.M. Chatani); and the Department of Pediatrics and Banner Children's at Diamond Children's Medical Center, University of Arizona, Tucson (K.V.T.)
| | - Elizabeth H Mack
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (A.M.P., S.M.O., M.W.T., L.D.Z., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus (K.E.B.), the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.) - all in Ohio; the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Division of Pediatric Critical Care Medicine (E.H.M.) and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Departments of Pediatrics and Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M. Coates); the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth Holtz Children's Hospital, Miami (B.M. Chatani); and the Department of Pediatrics and Banner Children's at Diamond Children's Medical Center, University of Arizona, Tucson (K.V.T.)
| | - Laura Smallcomb
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (A.M.P., S.M.O., M.W.T., L.D.Z., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus (K.E.B.), the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.) - all in Ohio; the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Division of Pediatric Critical Care Medicine (E.H.M.) and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Departments of Pediatrics and Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M. Coates); the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth Holtz Children's Hospital, Miami (B.M. Chatani); and the Department of Pediatrics and Banner Children's at Diamond Children's Medical Center, University of Arizona, Tucson (K.V.T.)
| | - Jennifer E Schuster
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (A.M.P., S.M.O., M.W.T., L.D.Z., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus (K.E.B.), the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.) - all in Ohio; the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Division of Pediatric Critical Care Medicine (E.H.M.) and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Departments of Pediatrics and Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M. Coates); the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth Holtz Children's Hospital, Miami (B.M. Chatani); and the Department of Pediatrics and Banner Children's at Diamond Children's Medical Center, University of Arizona, Tucson (K.V.T.)
| | - Charlotte V Hobbs
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (A.M.P., S.M.O., M.W.T., L.D.Z., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus (K.E.B.), the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.) - all in Ohio; the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Division of Pediatric Critical Care Medicine (E.H.M.) and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Departments of Pediatrics and Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M. Coates); the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth Holtz Children's Hospital, Miami (B.M. Chatani); and the Department of Pediatrics and Banner Children's at Diamond Children's Medical Center, University of Arizona, Tucson (K.V.T.)
| | - Satoshi Kamidani
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (A.M.P., S.M.O., M.W.T., L.D.Z., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus (K.E.B.), the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.) - all in Ohio; the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Division of Pediatric Critical Care Medicine (E.H.M.) and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Departments of Pediatrics and Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M. Coates); the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth Holtz Children's Hospital, Miami (B.M. Chatani); and the Department of Pediatrics and Banner Children's at Diamond Children's Medical Center, University of Arizona, Tucson (K.V.T.)
| | - Keiko M Tarquinio
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (A.M.P., S.M.O., M.W.T., L.D.Z., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus (K.E.B.), the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.) - all in Ohio; the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Division of Pediatric Critical Care Medicine (E.H.M.) and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Departments of Pediatrics and Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M. Coates); the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth Holtz Children's Hospital, Miami (B.M. Chatani); and the Department of Pediatrics and Banner Children's at Diamond Children's Medical Center, University of Arizona, Tucson (K.V.T.)
| | - Tamara T Bradford
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (A.M.P., S.M.O., M.W.T., L.D.Z., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus (K.E.B.), the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.) - all in Ohio; the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Division of Pediatric Critical Care Medicine (E.H.M.) and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Departments of Pediatrics and Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M. Coates); the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth Holtz Children's Hospital, Miami (B.M. Chatani); and the Department of Pediatrics and Banner Children's at Diamond Children's Medical Center, University of Arizona, Tucson (K.V.T.)
| | - Emily R Levy
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (A.M.P., S.M.O., M.W.T., L.D.Z., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus (K.E.B.), the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.) - all in Ohio; the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Division of Pediatric Critical Care Medicine (E.H.M.) and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Departments of Pediatrics and Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M. Coates); the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth Holtz Children's Hospital, Miami (B.M. Chatani); and the Department of Pediatrics and Banner Children's at Diamond Children's Medical Center, University of Arizona, Tucson (K.V.T.)
| | - Kathleen Chiotos
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (A.M.P., S.M.O., M.W.T., L.D.Z., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus (K.E.B.), the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.) - all in Ohio; the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Division of Pediatric Critical Care Medicine (E.H.M.) and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Departments of Pediatrics and Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M. Coates); the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth Holtz Children's Hospital, Miami (B.M. Chatani); and the Department of Pediatrics and Banner Children's at Diamond Children's Medical Center, University of Arizona, Tucson (K.V.T.)
| | - Samina S Bhumbra
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (A.M.P., S.M.O., M.W.T., L.D.Z., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus (K.E.B.), the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.) - all in Ohio; the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Division of Pediatric Critical Care Medicine (E.H.M.) and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Departments of Pediatrics and Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M. Coates); the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth Holtz Children's Hospital, Miami (B.M. Chatani); and the Department of Pediatrics and Banner Children's at Diamond Children's Medical Center, University of Arizona, Tucson (K.V.T.)
| | - Natalie Z Cvijanovich
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (A.M.P., S.M.O., M.W.T., L.D.Z., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus (K.E.B.), the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.) - all in Ohio; the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Division of Pediatric Critical Care Medicine (E.H.M.) and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Departments of Pediatrics and Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M. Coates); the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth Holtz Children's Hospital, Miami (B.M. Chatani); and the Department of Pediatrics and Banner Children's at Diamond Children's Medical Center, University of Arizona, Tucson (K.V.T.)
| | - Sabrina M Heidemann
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (A.M.P., S.M.O., M.W.T., L.D.Z., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus (K.E.B.), the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.) - all in Ohio; the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Division of Pediatric Critical Care Medicine (E.H.M.) and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Departments of Pediatrics and Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M. Coates); the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth Holtz Children's Hospital, Miami (B.M. Chatani); and the Department of Pediatrics and Banner Children's at Diamond Children's Medical Center, University of Arizona, Tucson (K.V.T.)
| | - Melissa L Cullimore
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (A.M.P., S.M.O., M.W.T., L.D.Z., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus (K.E.B.), the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.) - all in Ohio; the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Division of Pediatric Critical Care Medicine (E.H.M.) and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Departments of Pediatrics and Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M. Coates); the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth Holtz Children's Hospital, Miami (B.M. Chatani); and the Department of Pediatrics and Banner Children's at Diamond Children's Medical Center, University of Arizona, Tucson (K.V.T.)
| | - Shira J Gertz
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (A.M.P., S.M.O., M.W.T., L.D.Z., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus (K.E.B.), the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.) - all in Ohio; the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Division of Pediatric Critical Care Medicine (E.H.M.) and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Departments of Pediatrics and Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M. Coates); the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth Holtz Children's Hospital, Miami (B.M. Chatani); and the Department of Pediatrics and Banner Children's at Diamond Children's Medical Center, University of Arizona, Tucson (K.V.T.)
| | - Bria M Coates
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (A.M.P., S.M.O., M.W.T., L.D.Z., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus (K.E.B.), the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.) - all in Ohio; the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Division of Pediatric Critical Care Medicine (E.H.M.) and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Departments of Pediatrics and Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M. Coates); the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth Holtz Children's Hospital, Miami (B.M. Chatani); and the Department of Pediatrics and Banner Children's at Diamond Children's Medical Center, University of Arizona, Tucson (K.V.T.)
| | - Mary A Staat
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (A.M.P., S.M.O., M.W.T., L.D.Z., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus (K.E.B.), the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.) - all in Ohio; the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Division of Pediatric Critical Care Medicine (E.H.M.) and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Departments of Pediatrics and Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M. Coates); the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth Holtz Children's Hospital, Miami (B.M. Chatani); and the Department of Pediatrics and Banner Children's at Diamond Children's Medical Center, University of Arizona, Tucson (K.V.T.)
| | - Matt S Zinter
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (A.M.P., S.M.O., M.W.T., L.D.Z., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus (K.E.B.), the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.) - all in Ohio; the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Division of Pediatric Critical Care Medicine (E.H.M.) and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Departments of Pediatrics and Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M. Coates); the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth Holtz Children's Hospital, Miami (B.M. Chatani); and the Department of Pediatrics and Banner Children's at Diamond Children's Medical Center, University of Arizona, Tucson (K.V.T.)
| | - Michele Kong
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (A.M.P., S.M.O., M.W.T., L.D.Z., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus (K.E.B.), the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.) - all in Ohio; the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Division of Pediatric Critical Care Medicine (E.H.M.) and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Departments of Pediatrics and Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M. Coates); the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth Holtz Children's Hospital, Miami (B.M. Chatani); and the Department of Pediatrics and Banner Children's at Diamond Children's Medical Center, University of Arizona, Tucson (K.V.T.)
| | - Brandon M Chatani
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (A.M.P., S.M.O., M.W.T., L.D.Z., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus (K.E.B.), the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.) - all in Ohio; the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Division of Pediatric Critical Care Medicine (E.H.M.) and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Departments of Pediatrics and Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M. Coates); the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth Holtz Children's Hospital, Miami (B.M. Chatani); and the Department of Pediatrics and Banner Children's at Diamond Children's Medical Center, University of Arizona, Tucson (K.V.T.)
| | - Janet R Hume
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (A.M.P., S.M.O., M.W.T., L.D.Z., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus (K.E.B.), the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.) - all in Ohio; the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Division of Pediatric Critical Care Medicine (E.H.M.) and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Departments of Pediatrics and Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M. Coates); the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth Holtz Children's Hospital, Miami (B.M. Chatani); and the Department of Pediatrics and Banner Children's at Diamond Children's Medical Center, University of Arizona, Tucson (K.V.T.)
| | - Katri V Typpo
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (A.M.P., S.M.O., M.W.T., L.D.Z., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus (K.E.B.), the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.) - all in Ohio; the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Division of Pediatric Critical Care Medicine (E.H.M.) and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Departments of Pediatrics and Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M. Coates); the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth Holtz Children's Hospital, Miami (B.M. Chatani); and the Department of Pediatrics and Banner Children's at Diamond Children's Medical Center, University of Arizona, Tucson (K.V.T.)
| | - Mia Maamari
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (A.M.P., S.M.O., M.W.T., L.D.Z., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus (K.E.B.), the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.) - all in Ohio; the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Division of Pediatric Critical Care Medicine (E.H.M.) and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Departments of Pediatrics and Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M. Coates); the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth Holtz Children's Hospital, Miami (B.M. Chatani); and the Department of Pediatrics and Banner Children's at Diamond Children's Medical Center, University of Arizona, Tucson (K.V.T.)
| | - Heidi R Flori
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (A.M.P., S.M.O., M.W.T., L.D.Z., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus (K.E.B.), the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.) - all in Ohio; the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Division of Pediatric Critical Care Medicine (E.H.M.) and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Departments of Pediatrics and Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M. Coates); the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth Holtz Children's Hospital, Miami (B.M. Chatani); and the Department of Pediatrics and Banner Children's at Diamond Children's Medical Center, University of Arizona, Tucson (K.V.T.)
| | - Mark W Tenforde
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (A.M.P., S.M.O., M.W.T., L.D.Z., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus (K.E.B.), the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.) - all in Ohio; the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Division of Pediatric Critical Care Medicine (E.H.M.) and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Departments of Pediatrics and Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M. Coates); the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth Holtz Children's Hospital, Miami (B.M. Chatani); and the Department of Pediatrics and Banner Children's at Diamond Children's Medical Center, University of Arizona, Tucson (K.V.T.)
| | - Laura D Zambrano
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (A.M.P., S.M.O., M.W.T., L.D.Z., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus (K.E.B.), the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.) - all in Ohio; the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Division of Pediatric Critical Care Medicine (E.H.M.) and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Departments of Pediatrics and Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M. Coates); the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth Holtz Children's Hospital, Miami (B.M. Chatani); and the Department of Pediatrics and Banner Children's at Diamond Children's Medical Center, University of Arizona, Tucson (K.V.T.)
| | - Angela P Campbell
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (A.M.P., S.M.O., M.W.T., L.D.Z., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus (K.E.B.), the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.) - all in Ohio; the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Division of Pediatric Critical Care Medicine (E.H.M.) and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Departments of Pediatrics and Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M. Coates); the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth Holtz Children's Hospital, Miami (B.M. Chatani); and the Department of Pediatrics and Banner Children's at Diamond Children's Medical Center, University of Arizona, Tucson (K.V.T.)
| | - Manish M Patel
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (A.M.P., S.M.O., M.W.T., L.D.Z., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus (K.E.B.), the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.) - all in Ohio; the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Division of Pediatric Critical Care Medicine (E.H.M.) and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Departments of Pediatrics and Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M. Coates); the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth Holtz Children's Hospital, Miami (B.M. Chatani); and the Department of Pediatrics and Banner Children's at Diamond Children's Medical Center, University of Arizona, Tucson (K.V.T.)
| | - Adrienne G Randolph
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (A.M.P., S.M.O., M.W.T., L.D.Z., A.P.C., M.M.P.), the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.), and the Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta (K.M.T.) - all in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital, Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus (K.E.B.), the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.) - all in Ohio; the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Division of Pediatric Critical Care Medicine (E.H.M.) and the Department of Pediatrics (L.S.), Medical University of South Carolina, Charleston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Departments of Pediatrics and Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); the Division of Pediatric Critical Care Medicine, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ (S.J.G.); the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (B.M. Coates); the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth Holtz Children's Hospital, Miami (B.M. Chatani); and the Department of Pediatrics and Banner Children's at Diamond Children's Medical Center, University of Arizona, Tucson (K.V.T.)
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Hobbs CV, Woodworth K, Young CC, Jackson AM, Newhams MM, Dapul H, Maamari M, Hall MW, Maddux AB, Singh AR, Schuster JE, Rowan CM, Fitzgerald JC, Irby K, Kong M, Mack EH, Staat MA, Cvijanovich NZ, Bembea MM, Coates BM, Halasa NB, Walker TC, McLaughlin GE, Babbitt CJ, Nofziger RA, Loftis LL, Bradford TT, Campbell AP, Patel MM, Randolph AG. Frequency, Characteristics and Complications of COVID-19 in Hospitalized Infants. Pediatr Infect Dis J 2022; 41:e81-e86. [PMID: 34955519 PMCID: PMC8828316 DOI: 10.1097/inf.0000000000003435] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/29/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Previous studies of severe acute respiratory syndrome coronavirus 2 infection in infants have incompletely characterized factors associated with severe illness or focused on infants born to mothers with coronavirus disease 2019 (COVID-19). Here we highlight demographics, clinical characteristics and laboratory values that differ between infants with and without severe acute COVID-19. METHODS Active surveillance was performed by the Overcoming COVID-19 network to identify children and adolescents with severe acute respiratory syndrome coronavirus 2-related illness hospitalized at 62 sites in 31 states from March 15 to December 27, 2020. We analyzed patients >7 days to <1 year old hospitalized with symptomatic acute COVID-19. RESULTS We report 232 infants >7 days to <1 year of age hospitalized with acute symptomatic COVID-19 from 37 US hospitals in our cohort from March 15 to December 27, 2020. Among 630 cases of severe COVID-19 in patients >7 days to <18 years old, 128 (20.3%) were infants. In infants with severe illness from the entire study period, the median age was 2 months, 66% were from racial and ethnic minority groups, 66% were previously healthy, 73% had respiratory complications, 13% received mechanical ventilation and <1% died. CONCLUSIONS Infants accounted for over a fifth of children <18 years of age hospitalized for severe acute COVID-19, commonly manifesting with respiratory symptoms and complications. Although most infants hospitalized with COVID-19 did not suffer significant complications, longer term outcomes remain unclear. Notably, 75% of infants with severe disease were <6 months of age in this cohort study period, which predated maternal COVID-19 vaccination, underscoring the importance of maternal vaccination for COVID-19 in protecting the mother and infant.
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Affiliation(s)
- Charlotte V. Hobbs
- From the Department of Pediatrics, Division of Disease, Microbiology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Kate Woodworth
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Cameron C. Young
- Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children’s Hospital, Boston, Massachusetts
| | - Ashley M. Jackson
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Margaret M. Newhams
- Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children’s Hospital, Boston, Massachusetts
| | - Heda Dapul
- Department of Pediatrics, Division of Infectious Diseases, New York University Grossman School of Medicine and Hassenfeld Children’s Hospital, New York, New York
| | - Mia Maamari
- Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children’s Medical Center Dallas, Texas
| | - Mark W. Hall
- Division of Critical Care Medicine, Department of Pediatrics, Nationwide Children’s Hospital, Columbus, OH
| | - Aline B. Maddux
- Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, Colorado
| | - Aalok R. Singh
- Pediatric Critical Care Division, Maria Fareri Children’s Hospital at Westchester Medical Center and New York Medical College, Valhalla, New York
| | - Jennifer E. Schuster
- Division of Pediatric Infectious Disease, Department of Pediatrics, Children’s Mercy Kansas City, Kansas City, Missouri
| | - Courtney M. Rowan
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Indiana University School of Medicine, Riley Hospital for Children, Indianapolis, Indiana
| | - Julie C. Fitzgerald
- Division of Critical Care, Department of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Katherine Irby
- Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children’s Hospital, Little Rock, Arkansas
| | - Michele Kong
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama
| | - Elizabeth H. Mack
- Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Mary A. Staat
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Natalie Z. Cvijanovich
- Division of Critical Care Medicine, UCSF Benioff Children’s Hospital Oakland, California
| | - Melania M. Bembea
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Bria M. Coates
- Division of Pediatric Critical Care Medicine, Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Natasha B. Halasa
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Tracie C. Walker
- Department of Pediatrics, Division of Critical Care, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Gwenn E. McLaughlin
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida
| | - Christopher J. Babbitt
- Division of Pediatric Critical Care, Department of Pediatrics, Miller Children’s and Women’s Hospital of Long Beach, Long Beach, California
| | - Ryan A. Nofziger
- Division of Critical Care Medicine, Akron Children’s Hospital, Akron, Ohio
| | - Laura L. Loftis
- Section of Critical Care Medicine, Department of Pediatrics, Texas Children’s Hospital, Houston, Texas
| | - Tamara T. Bradford
- Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children’s Hospital of New Orleans, New Orleans, Louisiana
| | - Angela P. Campbell
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Manish M. Patel
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Adrienne G. Randolph
- Department of Pediatrics, Division of Infectious Diseases, New York University Grossman School of Medicine and Hassenfeld Children’s Hospital, New York, New York
- Department of Anaesthesia
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
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15
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Fink EL, Robertson CL, Wainwright MS, Roa JD, Lovett ME, Stulce C, Yacoub M, Potera RM, Zivick E, Holloway A, Nagpal A, Wellnitz K, Czech T, Even KM, Brunow de Carvalho W, Rodriguez IS, Schwartz SP, Walker TC, Campos-Miño S, Dervan LA, Geneslaw AS, Sewell TB, Pryce P, Silver WG, Lin JE, Vargas WS, Topjian A, Alcamo AM, McGuire JL, Domínguez Rojas JA, Muñoz JT, Hong SJ, Muller WJ, Doerfler M, Williams CN, Drury K, Bhagat D, Nelson A, Price D, Dapul H, Santos L, Kahoud R, Francoeur C, Appavu B, Guilliams KP, Agner SC, Walson KH, Rasmussen L, Janas A, Ferrazzano P, Farias-Moeller R, Snooks KC, Chang CCH, Yun J, Schober ME. Prevalence and Risk Factors of Neurologic Manifestations in Hospitalized Children Diagnosed with Acute SARS-CoV-2 or MIS-C. Pediatr Neurol 2022; 128:33-44. [PMID: 35066369 PMCID: PMC8713420 DOI: 10.1016/j.pediatrneurol.2021.12.010] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/20/2021] [Accepted: 12/21/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Our objective was to characterize the frequency, early impact, and risk factors for neurological manifestations in hospitalized children with acute severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection or multisystem inflammatory syndrome in children (MIS-C). METHODS Multicenter, cross-sectional study of neurological manifestations in children aged <18 years hospitalized with positive SARS-CoV-2 test or clinical diagnosis of a SARS-CoV-2-related condition between January 2020 and April 2021. Multivariable logistic regression to identify risk factors for neurological manifestations was performed. RESULTS Of 1493 children, 1278 (86%) were diagnosed with acute SARS-CoV-2 and 215 (14%) with MIS-C. Overall, 44% of the cohort (40% acute SARS-CoV-2 and 66% MIS-C) had at least one neurological manifestation. The most common neurological findings in children with acute SARS-CoV-2 and MIS-C diagnosis were headache (16% and 47%) and acute encephalopathy (15% and 22%), both P < 0.05. Children with neurological manifestations were more likely to require intensive care unit (ICU) care (51% vs 22%), P < 0.001. In multivariable logistic regression, children with neurological manifestations were older (odds ratio [OR] 1.1 and 95% confidence interval [CI] 1.07 to 1.13) and more likely to have MIS-C versus acute SARS-CoV-2 (OR 2.16, 95% CI 1.45 to 3.24), pre-existing neurological and metabolic conditions (OR 3.48, 95% CI 2.37 to 5.15; and OR 1.65, 95% CI 1.04 to 2.66, respectively), and pharyngeal (OR 1.74, 95% CI 1.16 to 2.64) or abdominal pain (OR 1.43, 95% CI 1.03 to 2.00); all P < 0.05. CONCLUSIONS In this multicenter study, 44% of children hospitalized with SARS-CoV-2-related conditions experienced neurological manifestations, which were associated with ICU admission and pre-existing neurological condition. Posthospital assessment for, and support of, functional impairment and neuroprotective strategies are vitally needed.
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Affiliation(s)
- Ericka L Fink
- Division of Pediatric Critical Care Medicine, Department of Critical Care Medicine, Pittsburgh, Pennsylvania; Safar Center for Resuscitation Research, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania.
| | - Courtney L Robertson
- Departments of Anesthesiology and Critical Care Medicine, and Pediatrics of The Johns Hopkins University SOM, Baltimore, Maryland
| | - Mark S Wainwright
- Division of Pediatric Neurology, University of Washington, Seattle Children's Hospital, Seattle, Washington
| | - Juan D Roa
- Department of Pediatrics, Universidad Nacional de Colombia and Fundación Universitaria de Ciencias de la Salud, Bogotá, Colombia
| | - Marlina E Lovett
- Division of Critical Care Medicine, Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio
| | - Casey Stulce
- Department of Pediatrics, University of Chicago, Chicago, Illinois
| | - Mais Yacoub
- Division of Critical Care, Department of Pediatrics, UMC Children's Hospital, Las Vegas, Nevada
| | - Renee M Potera
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Elizabeth Zivick
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina
| | - Adrian Holloway
- Division of Critical Care, Department of Pediatrics, University of Maryland Medical Center, Baltimore, Maryland
| | - Ashish Nagpal
- Department of Pediatrics, Section of Critical Care Medicine, Oklahoma Children's Hospital at OU health, Oklahoma University College of Medicine, Oklahoma City, Oklahoma
| | - Kari Wellnitz
- Division of Pediatric Critical Care, Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Theresa Czech
- Division of Pediatric Neurology, Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Katelyn M Even
- Division of Pediatric Critical Care Medicine, Penn State College of Medicine, Hershey, Pennsylvania
| | | | | | - Stephanie P Schwartz
- Department of Pediatrics, University of North Carolina at Chapel Hill Hospitals, Chapel Hill, North Carolina
| | - Tracie C Walker
- Department of Pediatrics, University of North Carolina at Chapel Hill Hospitals, Chapel Hill, North Carolina
| | | | - Leslie A Dervan
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington
| | - Andrew S Geneslaw
- Division of Pediatric Critical Care and Hospital Medicine, Department of Pediatrics, Columbia University Irving Medical Center, New York, New York
| | - Taylor B Sewell
- Division of Pediatric Critical Care and Hospital Medicine, Department of Pediatrics, Columbia University Irving Medical Center, New York, New York
| | - Patrice Pryce
- Division of Pediatric Critical Care and Hospital Medicine, Department of Pediatrics, Columbia University Irving Medical Center, Morgan Stanley Children's Hospital New York-Presbyterian Hospital, New York, New York
| | - Wendy G Silver
- Division of Child Neurology, Department of Neurology, Columbia University Irving Medical Center, New York, New York
| | - Jieru Egeria Lin
- Division of Child Neurology, Department of Neurology, Columbia University Irving Medical Center, New York, New York
| | - Wendy S Vargas
- Division of Child Neurology, Department of Neurology, Columbia University Irving Medical Center, New York, New York
| | - Alexis Topjian
- Division of Critical Care Medicine at The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Departments of Anesthesiology and Critical Care Medicine and Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Alicia M Alcamo
- Division of Critical Care Medicine at The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Departments of Anesthesiology and Critical Care Medicine and Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Jennifer L McGuire
- Division of Neurology at The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Departments of Neurology and Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jesus Angel Domínguez Rojas
- Division of Pediatric Critical Care, Department of Pediatrics, Hospital de Emergencia Villa El Salvador, Lima, Peru
| | - Jaime Tasayco Muñoz
- Division of Pediatric Critical Care, Department of Pediatrics, Hospital de Emergencia Villa El Salvador, Lima, Peru
| | - Sue J Hong
- Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago and Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - William J Muller
- Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago and Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Matthew Doerfler
- Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago and Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Cydni N Williams
- Division of Pediatric Critical Care, Department of Pediatrics Pediatric Critical Care and Neurotrauma Recovery Program Portland, Oregon Health & Science University, Oregon
| | - Kurt Drury
- Division of Pediatric Critical Care, Department of Pediatrics, Oregon Health & Science University, Portland, Oregon
| | - Dhristie Bhagat
- Department of Neurology, NYU Langone Health, New York, New York
| | - Aaron Nelson
- Department of Neurology, NYU Langone Health, New York, New York
| | - Dana Price
- Department of Neurology, NYU Langone Health, New York, New York
| | - Heda Dapul
- Division of Pediatric Critical Care, Department of Pediatrics, Hassenfeld Children's Hospital at NYU Langone Health, New York, New York
| | - Laura Santos
- Division of Pediatric Critical Care, Department of Pediatrics, Hassenfeld Children's Hospital at NYU Langone Health, New York, New York
| | - Robert Kahoud
- Division of Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota
| | - Conall Francoeur
- Department of Pediatrics, CHU de Québec - Université Laval Research Center, Quebec City, Quebec, Canada
| | - Brian Appavu
- Division of Neurology, Barrow Neurological Institute at Phoenix Children's Hospital, University of Arizona, College of Medicine, Phoenix, Arizona
| | - Kristin P Guilliams
- Departments of Neurology, Pediatrics, and Radiology, Washington University in St. Louis, St. Louis, Missouri
| | - Shannon C Agner
- Departments of Neurology, Pediatrics, and Radiology, Washington University in St. Louis, St. Louis, Missouri
| | - Karen H Walson
- Department of Pediatric Critical Care Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Lindsey Rasmussen
- Pediatric Critical Care Medicine, Lucile Packard Children's Hospital, Stanford University, Stanford, California
| | - Anna Janas
- Pediatric Critical Care Medicine, Lucile Packard Children's Hospital, Stanford University, Stanford, California
| | - Peter Ferrazzano
- Department of Pediatrics, University of Wisconsin, Madison, Wisconsin
| | - Raquel Farias-Moeller
- Division Child Neurology, Department of Neurology, Medical College of Wisconsin, Children's Wisconsin, Milwaukee, Wisconsin
| | - Kellie C Snooks
- Department of Pediatrics, Medical College of Wisconsin, Children's Wisconsin, Milwaukee, Wisconsin
| | - Chung-Chou H Chang
- Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - James Yun
- Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Michelle E Schober
- Division of Critical Care of the University of Utah, Department of Pediatrics, Salt Lake City, Utah
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16
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Olson SM, Newhams MM, Halasa NB, Price AM, Boom JA, Sahni LC, Pannaraj PS, Irby K, Walker TC, Schwartz SP, Maddux AB, Mack EH, Bradford TT, Schuster JE, Nofziger RA, Cameron MA, Chiotos K, Cullimore ML, Gertz SJ, Levy ER, Kong M, Cvijanovich NZ, Staat MA, Kamidani S, Chatani BM, Bhumbra SS, Bline KE, Gaspers MG, Hobbs CV, Heidemann SM, Maamari M, Flori HR, Hume JR, Zinter MS, Michelson KN, Zambrano LD, Campbell AP, Patel MM, Randolph AG. Effectiveness of BNT162b2 Vaccine against Critical Covid-19 in Adolescents. N Engl J Med 2022; 386:713-723. [PMID: 35021004 PMCID: PMC8781318 DOI: 10.1056/nejmoa2117995] [Citation(s) in RCA: 113] [Impact Index Per Article: 56.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND The increasing incidence of pediatric hospitalizations associated with coronavirus disease 2019 (Covid-19) caused by the B.1.617.2 (delta) variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the United States has offered an opportunity to assess the real-world effectiveness of the BNT162b2 messenger RNA vaccine in adolescents between 12 and 18 years of age. METHODS We used a case-control, test-negative design to assess vaccine effectiveness against Covid-19 resulting in hospitalization, admission to an intensive care unit (ICU), the use of life-supporting interventions (mechanical ventilation, vasopressors, and extracorporeal membrane oxygenation), or death. Between July 1 and October 25, 2021, we screened admission logs for eligible case patients with laboratory-confirmed Covid-19 at 31 hospitals in 23 states. We estimated vaccine effectiveness by comparing the odds of antecedent full vaccination (two doses of BNT162b2) in case patients as compared with two hospital-based control groups: patients who had Covid-19-like symptoms but negative results on testing for SARS-CoV-2 (test-negative) and patients who did not have Covid-19-like symptoms (syndrome-negative). RESULTS A total of 445 case patients and 777 controls were enrolled. Overall, 17 case patients (4%) and 282 controls (36%) had been fully vaccinated. Of the case patients, 180 (40%) were admitted to the ICU, and 127 (29%) required life support; only 2 patients in the ICU had been fully vaccinated. The overall effectiveness of the BNT162b2 vaccine against hospitalization for Covid-19 was 94% (95% confidence interval [CI], 90 to 96); the effectiveness was 95% (95% CI, 91 to 97) among test-negative controls and 94% (95% CI, 89 to 96) among syndrome-negative controls. The effectiveness was 98% against ICU admission and 98% against Covid-19 resulting in the receipt of life support. All 7 deaths occurred in patients who were unvaccinated. CONCLUSIONS Among hospitalized adolescent patients, two doses of the BNT162b2 vaccine were highly effective against Covid-19-related hospitalization and ICU admission or the receipt of life support. (Funded by the Centers for Disease Control and Prevention.).
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Affiliation(s)
- Samantha M Olson
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., L.D.Z., A.P.C., M.M.P.), and the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.) - both in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center Dallas, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston (E.H.M.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), and the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus, Columbus (K.E.B.) - all in Ohio; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Saint Barnabas Medical Center, Livingston, NJ (S.J.G.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.), the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth/Holtz Children's Hospital, Miami (B.M.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); University of Arizona, Diamond Children's Banner Children's Medical Center, Tucson (M.G.G.); the Department of Pediatrics, Department of Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); and the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (K.N.M.)
| | - Margaret M Newhams
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., L.D.Z., A.P.C., M.M.P.), and the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.) - both in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center Dallas, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston (E.H.M.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), and the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus, Columbus (K.E.B.) - all in Ohio; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Saint Barnabas Medical Center, Livingston, NJ (S.J.G.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.), the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth/Holtz Children's Hospital, Miami (B.M.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); University of Arizona, Diamond Children's Banner Children's Medical Center, Tucson (M.G.G.); the Department of Pediatrics, Department of Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); and the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (K.N.M.)
| | - Natasha B Halasa
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., L.D.Z., A.P.C., M.M.P.), and the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.) - both in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center Dallas, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston (E.H.M.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), and the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus, Columbus (K.E.B.) - all in Ohio; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Saint Barnabas Medical Center, Livingston, NJ (S.J.G.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.), the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth/Holtz Children's Hospital, Miami (B.M.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); University of Arizona, Diamond Children's Banner Children's Medical Center, Tucson (M.G.G.); the Department of Pediatrics, Department of Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); and the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (K.N.M.)
| | - Ashley M Price
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., L.D.Z., A.P.C., M.M.P.), and the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.) - both in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center Dallas, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston (E.H.M.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), and the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus, Columbus (K.E.B.) - all in Ohio; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Saint Barnabas Medical Center, Livingston, NJ (S.J.G.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.), the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth/Holtz Children's Hospital, Miami (B.M.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); University of Arizona, Diamond Children's Banner Children's Medical Center, Tucson (M.G.G.); the Department of Pediatrics, Department of Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); and the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (K.N.M.)
| | - Julie A Boom
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., L.D.Z., A.P.C., M.M.P.), and the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.) - both in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center Dallas, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston (E.H.M.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), and the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus, Columbus (K.E.B.) - all in Ohio; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Saint Barnabas Medical Center, Livingston, NJ (S.J.G.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.), the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth/Holtz Children's Hospital, Miami (B.M.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); University of Arizona, Diamond Children's Banner Children's Medical Center, Tucson (M.G.G.); the Department of Pediatrics, Department of Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); and the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (K.N.M.)
| | - Leila C Sahni
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., L.D.Z., A.P.C., M.M.P.), and the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.) - both in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center Dallas, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston (E.H.M.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), and the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus, Columbus (K.E.B.) - all in Ohio; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Saint Barnabas Medical Center, Livingston, NJ (S.J.G.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.), the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth/Holtz Children's Hospital, Miami (B.M.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); University of Arizona, Diamond Children's Banner Children's Medical Center, Tucson (M.G.G.); the Department of Pediatrics, Department of Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); and the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (K.N.M.)
| | - Pia S Pannaraj
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., L.D.Z., A.P.C., M.M.P.), and the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.) - both in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center Dallas, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston (E.H.M.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), and the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus, Columbus (K.E.B.) - all in Ohio; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Saint Barnabas Medical Center, Livingston, NJ (S.J.G.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.), the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth/Holtz Children's Hospital, Miami (B.M.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); University of Arizona, Diamond Children's Banner Children's Medical Center, Tucson (M.G.G.); the Department of Pediatrics, Department of Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); and the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (K.N.M.)
| | - Katherine Irby
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., L.D.Z., A.P.C., M.M.P.), and the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.) - both in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center Dallas, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston (E.H.M.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), and the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus, Columbus (K.E.B.) - all in Ohio; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Saint Barnabas Medical Center, Livingston, NJ (S.J.G.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.), the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth/Holtz Children's Hospital, Miami (B.M.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); University of Arizona, Diamond Children's Banner Children's Medical Center, Tucson (M.G.G.); the Department of Pediatrics, Department of Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); and the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (K.N.M.)
| | - Tracie C Walker
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., L.D.Z., A.P.C., M.M.P.), and the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.) - both in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center Dallas, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston (E.H.M.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), and the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus, Columbus (K.E.B.) - all in Ohio; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Saint Barnabas Medical Center, Livingston, NJ (S.J.G.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.), the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth/Holtz Children's Hospital, Miami (B.M.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); University of Arizona, Diamond Children's Banner Children's Medical Center, Tucson (M.G.G.); the Department of Pediatrics, Department of Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); and the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (K.N.M.)
| | - Stephanie P Schwartz
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., L.D.Z., A.P.C., M.M.P.), and the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.) - both in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center Dallas, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston (E.H.M.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), and the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus, Columbus (K.E.B.) - all in Ohio; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Saint Barnabas Medical Center, Livingston, NJ (S.J.G.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.), the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth/Holtz Children's Hospital, Miami (B.M.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); University of Arizona, Diamond Children's Banner Children's Medical Center, Tucson (M.G.G.); the Department of Pediatrics, Department of Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); and the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (K.N.M.)
| | - Aline B Maddux
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., L.D.Z., A.P.C., M.M.P.), and the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.) - both in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center Dallas, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston (E.H.M.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), and the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus, Columbus (K.E.B.) - all in Ohio; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Saint Barnabas Medical Center, Livingston, NJ (S.J.G.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.), the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth/Holtz Children's Hospital, Miami (B.M.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); University of Arizona, Diamond Children's Banner Children's Medical Center, Tucson (M.G.G.); the Department of Pediatrics, Department of Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); and the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (K.N.M.)
| | - Elizabeth H Mack
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., L.D.Z., A.P.C., M.M.P.), and the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.) - both in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center Dallas, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston (E.H.M.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), and the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus, Columbus (K.E.B.) - all in Ohio; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Saint Barnabas Medical Center, Livingston, NJ (S.J.G.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.), the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth/Holtz Children's Hospital, Miami (B.M.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); University of Arizona, Diamond Children's Banner Children's Medical Center, Tucson (M.G.G.); the Department of Pediatrics, Department of Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); and the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (K.N.M.)
| | - Tamara T Bradford
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., L.D.Z., A.P.C., M.M.P.), and the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.) - both in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center Dallas, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston (E.H.M.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), and the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus, Columbus (K.E.B.) - all in Ohio; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Saint Barnabas Medical Center, Livingston, NJ (S.J.G.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.), the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth/Holtz Children's Hospital, Miami (B.M.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); University of Arizona, Diamond Children's Banner Children's Medical Center, Tucson (M.G.G.); the Department of Pediatrics, Department of Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); and the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (K.N.M.)
| | - Jennifer E Schuster
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., L.D.Z., A.P.C., M.M.P.), and the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.) - both in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center Dallas, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston (E.H.M.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), and the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus, Columbus (K.E.B.) - all in Ohio; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Saint Barnabas Medical Center, Livingston, NJ (S.J.G.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.), the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth/Holtz Children's Hospital, Miami (B.M.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); University of Arizona, Diamond Children's Banner Children's Medical Center, Tucson (M.G.G.); the Department of Pediatrics, Department of Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); and the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (K.N.M.)
| | - Ryan A Nofziger
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., L.D.Z., A.P.C., M.M.P.), and the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.) - both in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center Dallas, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston (E.H.M.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), and the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus, Columbus (K.E.B.) - all in Ohio; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Saint Barnabas Medical Center, Livingston, NJ (S.J.G.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.), the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth/Holtz Children's Hospital, Miami (B.M.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); University of Arizona, Diamond Children's Banner Children's Medical Center, Tucson (M.G.G.); the Department of Pediatrics, Department of Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); and the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (K.N.M.)
| | - Melissa A Cameron
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., L.D.Z., A.P.C., M.M.P.), and the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.) - both in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center Dallas, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston (E.H.M.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), and the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus, Columbus (K.E.B.) - all in Ohio; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Saint Barnabas Medical Center, Livingston, NJ (S.J.G.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.), the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth/Holtz Children's Hospital, Miami (B.M.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); University of Arizona, Diamond Children's Banner Children's Medical Center, Tucson (M.G.G.); the Department of Pediatrics, Department of Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); and the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (K.N.M.)
| | - Kathleen Chiotos
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., L.D.Z., A.P.C., M.M.P.), and the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.) - both in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center Dallas, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston (E.H.M.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), and the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus, Columbus (K.E.B.) - all in Ohio; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Saint Barnabas Medical Center, Livingston, NJ (S.J.G.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.), the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth/Holtz Children's Hospital, Miami (B.M.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); University of Arizona, Diamond Children's Banner Children's Medical Center, Tucson (M.G.G.); the Department of Pediatrics, Department of Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); and the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (K.N.M.)
| | - Melissa L Cullimore
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., L.D.Z., A.P.C., M.M.P.), and the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.) - both in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center Dallas, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston (E.H.M.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), and the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus, Columbus (K.E.B.) - all in Ohio; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Saint Barnabas Medical Center, Livingston, NJ (S.J.G.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.), the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth/Holtz Children's Hospital, Miami (B.M.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); University of Arizona, Diamond Children's Banner Children's Medical Center, Tucson (M.G.G.); the Department of Pediatrics, Department of Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); and the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (K.N.M.)
| | - Shira J Gertz
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., L.D.Z., A.P.C., M.M.P.), and the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.) - both in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center Dallas, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston (E.H.M.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), and the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus, Columbus (K.E.B.) - all in Ohio; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Saint Barnabas Medical Center, Livingston, NJ (S.J.G.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.), the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth/Holtz Children's Hospital, Miami (B.M.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); University of Arizona, Diamond Children's Banner Children's Medical Center, Tucson (M.G.G.); the Department of Pediatrics, Department of Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); and the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (K.N.M.)
| | - Emily R Levy
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., L.D.Z., A.P.C., M.M.P.), and the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.) - both in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center Dallas, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston (E.H.M.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), and the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus, Columbus (K.E.B.) - all in Ohio; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Saint Barnabas Medical Center, Livingston, NJ (S.J.G.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.), the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth/Holtz Children's Hospital, Miami (B.M.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); University of Arizona, Diamond Children's Banner Children's Medical Center, Tucson (M.G.G.); the Department of Pediatrics, Department of Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); and the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (K.N.M.)
| | - Michele Kong
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., L.D.Z., A.P.C., M.M.P.), and the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.) - both in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center Dallas, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston (E.H.M.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), and the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus, Columbus (K.E.B.) - all in Ohio; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Saint Barnabas Medical Center, Livingston, NJ (S.J.G.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.), the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth/Holtz Children's Hospital, Miami (B.M.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); University of Arizona, Diamond Children's Banner Children's Medical Center, Tucson (M.G.G.); the Department of Pediatrics, Department of Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); and the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (K.N.M.)
| | - Natalie Z Cvijanovich
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., L.D.Z., A.P.C., M.M.P.), and the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.) - both in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center Dallas, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston (E.H.M.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), and the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus, Columbus (K.E.B.) - all in Ohio; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Saint Barnabas Medical Center, Livingston, NJ (S.J.G.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.), the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth/Holtz Children's Hospital, Miami (B.M.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); University of Arizona, Diamond Children's Banner Children's Medical Center, Tucson (M.G.G.); the Department of Pediatrics, Department of Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); and the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (K.N.M.)
| | - Mary A Staat
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., L.D.Z., A.P.C., M.M.P.), and the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.) - both in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center Dallas, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston (E.H.M.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), and the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus, Columbus (K.E.B.) - all in Ohio; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Saint Barnabas Medical Center, Livingston, NJ (S.J.G.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.), the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth/Holtz Children's Hospital, Miami (B.M.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); University of Arizona, Diamond Children's Banner Children's Medical Center, Tucson (M.G.G.); the Department of Pediatrics, Department of Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); and the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (K.N.M.)
| | - Satoshi Kamidani
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., L.D.Z., A.P.C., M.M.P.), and the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.) - both in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center Dallas, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston (E.H.M.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), and the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus, Columbus (K.E.B.) - all in Ohio; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Saint Barnabas Medical Center, Livingston, NJ (S.J.G.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.), the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth/Holtz Children's Hospital, Miami (B.M.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); University of Arizona, Diamond Children's Banner Children's Medical Center, Tucson (M.G.G.); the Department of Pediatrics, Department of Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); and the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (K.N.M.)
| | - Brandon M Chatani
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., L.D.Z., A.P.C., M.M.P.), and the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.) - both in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center Dallas, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston (E.H.M.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), and the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus, Columbus (K.E.B.) - all in Ohio; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Saint Barnabas Medical Center, Livingston, NJ (S.J.G.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.), the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth/Holtz Children's Hospital, Miami (B.M.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); University of Arizona, Diamond Children's Banner Children's Medical Center, Tucson (M.G.G.); the Department of Pediatrics, Department of Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); and the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (K.N.M.)
| | - Samina S Bhumbra
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., L.D.Z., A.P.C., M.M.P.), and the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.) - both in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center Dallas, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston (E.H.M.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), and the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus, Columbus (K.E.B.) - all in Ohio; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Saint Barnabas Medical Center, Livingston, NJ (S.J.G.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.), the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth/Holtz Children's Hospital, Miami (B.M.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); University of Arizona, Diamond Children's Banner Children's Medical Center, Tucson (M.G.G.); the Department of Pediatrics, Department of Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); and the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (K.N.M.)
| | - Katherine E Bline
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., L.D.Z., A.P.C., M.M.P.), and the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.) - both in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center Dallas, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston (E.H.M.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), and the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus, Columbus (K.E.B.) - all in Ohio; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Saint Barnabas Medical Center, Livingston, NJ (S.J.G.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.), the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth/Holtz Children's Hospital, Miami (B.M.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); University of Arizona, Diamond Children's Banner Children's Medical Center, Tucson (M.G.G.); the Department of Pediatrics, Department of Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); and the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (K.N.M.)
| | - Mary G Gaspers
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., L.D.Z., A.P.C., M.M.P.), and the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.) - both in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center Dallas, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston (E.H.M.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), and the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus, Columbus (K.E.B.) - all in Ohio; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Saint Barnabas Medical Center, Livingston, NJ (S.J.G.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.), the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth/Holtz Children's Hospital, Miami (B.M.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); University of Arizona, Diamond Children's Banner Children's Medical Center, Tucson (M.G.G.); the Department of Pediatrics, Department of Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); and the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (K.N.M.)
| | - Charlotte V Hobbs
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., L.D.Z., A.P.C., M.M.P.), and the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.) - both in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center Dallas, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston (E.H.M.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), and the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus, Columbus (K.E.B.) - all in Ohio; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Saint Barnabas Medical Center, Livingston, NJ (S.J.G.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.), the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth/Holtz Children's Hospital, Miami (B.M.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); University of Arizona, Diamond Children's Banner Children's Medical Center, Tucson (M.G.G.); the Department of Pediatrics, Department of Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); and the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (K.N.M.)
| | - Sabrina M Heidemann
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., L.D.Z., A.P.C., M.M.P.), and the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.) - both in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center Dallas, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston (E.H.M.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), and the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus, Columbus (K.E.B.) - all in Ohio; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Saint Barnabas Medical Center, Livingston, NJ (S.J.G.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.), the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth/Holtz Children's Hospital, Miami (B.M.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); University of Arizona, Diamond Children's Banner Children's Medical Center, Tucson (M.G.G.); the Department of Pediatrics, Department of Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); and the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (K.N.M.)
| | - Mia Maamari
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., L.D.Z., A.P.C., M.M.P.), and the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.) - both in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center Dallas, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston (E.H.M.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), and the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus, Columbus (K.E.B.) - all in Ohio; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Saint Barnabas Medical Center, Livingston, NJ (S.J.G.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.), the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth/Holtz Children's Hospital, Miami (B.M.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); University of Arizona, Diamond Children's Banner Children's Medical Center, Tucson (M.G.G.); the Department of Pediatrics, Department of Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); and the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (K.N.M.)
| | - Heidi R Flori
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., L.D.Z., A.P.C., M.M.P.), and the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.) - both in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center Dallas, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston (E.H.M.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), and the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus, Columbus (K.E.B.) - all in Ohio; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Saint Barnabas Medical Center, Livingston, NJ (S.J.G.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.), the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth/Holtz Children's Hospital, Miami (B.M.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); University of Arizona, Diamond Children's Banner Children's Medical Center, Tucson (M.G.G.); the Department of Pediatrics, Department of Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); and the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (K.N.M.)
| | - Janet R Hume
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., L.D.Z., A.P.C., M.M.P.), and the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.) - both in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center Dallas, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston (E.H.M.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), and the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus, Columbus (K.E.B.) - all in Ohio; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Saint Barnabas Medical Center, Livingston, NJ (S.J.G.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.), the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth/Holtz Children's Hospital, Miami (B.M.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); University of Arizona, Diamond Children's Banner Children's Medical Center, Tucson (M.G.G.); the Department of Pediatrics, Department of Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); and the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (K.N.M.)
| | - Matt S Zinter
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., L.D.Z., A.P.C., M.M.P.), and the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.) - both in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center Dallas, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston (E.H.M.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), and the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus, Columbus (K.E.B.) - all in Ohio; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Saint Barnabas Medical Center, Livingston, NJ (S.J.G.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.), the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth/Holtz Children's Hospital, Miami (B.M.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); University of Arizona, Diamond Children's Banner Children's Medical Center, Tucson (M.G.G.); the Department of Pediatrics, Department of Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); and the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (K.N.M.)
| | - Kelly N Michelson
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., L.D.Z., A.P.C., M.M.P.), and the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.) - both in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center Dallas, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston (E.H.M.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), and the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus, Columbus (K.E.B.) - all in Ohio; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Saint Barnabas Medical Center, Livingston, NJ (S.J.G.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.), the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth/Holtz Children's Hospital, Miami (B.M.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); University of Arizona, Diamond Children's Banner Children's Medical Center, Tucson (M.G.G.); the Department of Pediatrics, Department of Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); and the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (K.N.M.)
| | - Laura D Zambrano
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., L.D.Z., A.P.C., M.M.P.), and the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.) - both in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center Dallas, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston (E.H.M.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), and the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus, Columbus (K.E.B.) - all in Ohio; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Saint Barnabas Medical Center, Livingston, NJ (S.J.G.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.), the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth/Holtz Children's Hospital, Miami (B.M.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); University of Arizona, Diamond Children's Banner Children's Medical Center, Tucson (M.G.G.); the Department of Pediatrics, Department of Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); and the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (K.N.M.)
| | - Angela P Campbell
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., L.D.Z., A.P.C., M.M.P.), and the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.) - both in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center Dallas, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston (E.H.M.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), and the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus, Columbus (K.E.B.) - all in Ohio; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Saint Barnabas Medical Center, Livingston, NJ (S.J.G.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.), the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth/Holtz Children's Hospital, Miami (B.M.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); University of Arizona, Diamond Children's Banner Children's Medical Center, Tucson (M.G.G.); the Department of Pediatrics, Department of Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); and the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (K.N.M.)
| | - Manish M Patel
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., L.D.Z., A.P.C., M.M.P.), and the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.) - both in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center Dallas, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston (E.H.M.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), and the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus, Columbus (K.E.B.) - all in Ohio; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Saint Barnabas Medical Center, Livingston, NJ (S.J.G.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.), the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth/Holtz Children's Hospital, Miami (B.M.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); University of Arizona, Diamond Children's Banner Children's Medical Center, Tucson (M.G.G.); the Department of Pediatrics, Department of Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); and the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (K.N.M.)
| | - Adrienne G Randolph
- From the Covid-19 Response Team, Centers for Disease Control and Prevention (S.M.O., A.M.P., L.D.Z., A.P.C., M.M.P.), and the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine (S.K.) - both in Atlanta; the Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital (M.M.N., A.G.R.), and the Departments of Anaesthesia and Pediatrics, Harvard Medical School (A.G.R.) - both in Boston; the Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville (N.B.H.); the Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children's Hospital, Houston (J.A.B., L.C.S.), and the Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center Dallas, Dallas (M.M.); the Division of Infectious Diseases, Children's Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles (P.S.P.), the Division of Pediatric Hospital Medicine, UC San Diego-Rady Children's Hospital, San Diego (M.A.C.), the Division of Critical Care Medicine, UCSF Benioff Children's Hospital Oakland (N.Z.C.), and the Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California, San Francisco, San Francisco (M.S.Z.) - all in California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock (K.I.); the Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill (T.C.W., S.P.S.); the Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (A.B.M.); the Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston (E.H.M.); the Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans (T.T.B.); the Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO (J.E.S.); the Division of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron (R.A.N.), the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati (M.A.S.), and the Division of Pediatric Critical Care Medicine, Nationwide Children's Hospital Columbus, Columbus (K.E.B.) - all in Ohio; the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Philadelphia (K.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NE (M.L.C.); the Division of Pediatric Critical Care, Department of Pediatrics, Saint Barnabas Medical Center, Livingston, NJ (S.J.G.); the Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester (E.R.L.), and the Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis (J.R.H.) - both in Minnesota; the Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham (M.K.), the Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth/Holtz Children's Hospital, Miami (B.M.C.); the Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis (S.S.B.); University of Arizona, Diamond Children's Banner Children's Medical Center, Tucson (M.G.G.); the Department of Pediatrics, Department of Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson (C.V.H.); the Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University, Detroit (S.M.H.), and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor (H.R.F.); and the Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago (K.N.M.)
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17
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Halasa NB, Olson SM, Staat MA, Newhams MM, Price AM, Boom JA, Sahni LC, Cameron MA, Pannaraj PS, Bline KE, Bhumbra SS, Bradford TT, Chiotos K, Coates BM, Cullimore ML, Cvijanovich NZ, Flori HR, Gertz SJ, Heidemann SM, Hobbs CV, Hume JR, Irby K, Kamidani S, Kong M, Levy ER, Mack EH, Maddux AB, Michelson KN, Nofziger RA, Schuster JE, Schwartz SP, Smallcomb L, Tarquinio KM, Walker TC, Zinter MS, Gilboa SM, Polen KN, Campbell AP, Randolph AG, Patel MM. Effectiveness of Maternal Vaccination with mRNA COVID-19 Vaccine During Pregnancy Against COVID-19-Associated Hospitalization in Infants Aged <6 Months - 17 States, July 2021-January 2022. MMWR Morb Mortal Wkly Rep 2022; 71:264-270. [PMID: 35176002 PMCID: PMC8853480 DOI: 10.15585/mmwr.mm7107e3] [Citation(s) in RCA: 123] [Impact Index Per Article: 61.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
COVID-19 vaccination is recommended for persons who are pregnant, breastfeeding, trying to get pregnant now, or who might become pregnant in the future, to protect them from COVID-19.§ Infants are at risk for life-threatening complications from COVID-19, including acute respiratory failure (1). Evidence from other vaccine-preventable diseases suggests that maternal immunization can provide protection to infants, especially during the high-risk first 6 months of life, through passive transplacental antibody transfer (2). Recent studies of COVID-19 vaccination during pregnancy suggest the possibility of transplacental transfer of SARS-CoV-2-specific antibodies that might provide protection to infants (3-5); however, no epidemiologic evidence currently exists for the protective benefits of maternal immunization during pregnancy against COVID-19 in infants. The Overcoming COVID-19 network conducted a test-negative, case-control study at 20 pediatric hospitals in 17 states during July 1, 2021-January 17, 2022, to assess effectiveness of maternal completion of a 2-dose primary mRNA COVID-19 vaccination series during pregnancy against COVID-19 hospitalization in infants. Among 379 hospitalized infants aged <6 months (176 with COVID-19 [case-infants] and 203 without COVID-19 [control-infants]), the median age was 2 months, 21% had at least one underlying medical condition, and 22% of case- and control-infants were born premature (<37 weeks gestation). Effectiveness of maternal vaccination during pregnancy against COVID-19 hospitalization in infants aged <6 months was 61% (95% CI = 31%-78%). Completion of a 2-dose mRNA COVID-19 vaccination series during pregnancy might help prevent COVID-19 hospitalization among infants aged <6 months.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Overcoming COVID-19 Investigators
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee; CDC COVID-19 Emergency Response Team; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio; Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children’s Hospital, Boston, Massachusetts; Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children’s Hospital, Houston, Texas; Division of Pediatric Hospital Medicine, UC San Diego-Rady Children’s Hospital, San Diego, California; Division of Infectious Diseases, Children’s Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles, California; Division of Pediatric Critical Care Medicine, Nationwide Children’s Hospital, Columbus, Ohio; The Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana; Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children’s Hospital of New Orleans, New Orleans, Louisiana; Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania; Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois; Division of Pediatric Critical Care, Department of Pediatrics, Children’s Hospital and Medical Center, Omaha, Nebraska; Division of Critical Care Medicine, UCSF Benioff Children’s Hospital Oakland, California; Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children’s Hospital and University of Michigan, Ann Arbor, Michigan; Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, New Jersey; Division of Pediatric Critical Care Medicine, Children’s Hospital of Michigan, Central Michigan University, Detroit, Michigan; Department of Pediatrics, Department of Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson, Mississippi; Division of Pediatric Critical Care, University of Minnesota Masonic Children’s Hospital, Minneapolis, Minnesota; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children’s Hospital, Little Rock, Arkansas; The Center for Childhood Infections and Vaccines of Children’s Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine; Atlanta, Georgia; Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama; Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota; Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston, South Carolina; Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, Colorado; Division of Critical Care Medicine, Department of Pediatrics, Akron Children’s Hospital, Akron, Ohio; Division of Pediatric Infectious Diseases, Department of Pediatrics, Children’s Mercy Kansas City, Kansas City, Missouri; Department of Pediatrics, University of North Carolina at Chapel Hill Children’s Hospital, Chapel Hill, North Carolina; Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina; Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children’s Healthcare of Atlanta, Atlanta, Georgia; Department of Pediatrics, Divisions of Critical Care Medicine and Allergy, Immunology, and Bone Marrow Transplant, University of California San Francisco, San Francisco, California; Departments of Anaesthesia and Pediatrics, Harvard Medical School, Boston, Massachusetts
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18
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Zambrano LD, Newhams MM, Olson SM, Halasa NB, Price AM, Boom JA, Sahni LC, Kamidani S, Tarquinio KM, Maddux AB, Heidemann SM, Bhumbra SS, Bline KE, Nofziger RA, Hobbs CV, Bradford TT, Cvijanovich NZ, Irby K, Mack EH, Cullimore ML, Pannaraj PS, Kong M, Walker TC, Gertz SJ, Michelson KN, Cameron MA, Chiotos K, Maamari M, Schuster JE, Orzel AO, Patel MM, Campbell AP, Randolph AG. Effectiveness of BNT162b2 (Pfizer-BioNTech) mRNA Vaccination Against Multisystem Inflammatory Syndrome in Children Among Persons Aged 12-18 Years - United States, July-December 2021. MMWR Morb Mortal Wkly Rep 2022; 71:52-58. [PMID: 35025852 PMCID: PMC8757620 DOI: 10.15585/mmwr.mm7102e1] [Citation(s) in RCA: 174] [Impact Index Per Article: 87.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Multisystem inflammatory syndrome in children (MIS-C) is a severe postinfectious hyperinflammatory condition, which generally occurs 2-6 weeks after a typically mild or asymptomatic infection with SARS-CoV-2, the virus that causes COVID-19 (1-3). In the United States, the BNT162b2 (Pfizer-BioNTech) COVID-19 vaccine is currently authorized for use in children and adolescents aged 5-15 years under an Emergency Use Authorization and is fully licensed by the Food and Drug Administration for persons aged ≥16 years (4). Prelicensure randomized trials in persons aged ≥5 years documented high vaccine efficacy and immunogenicity (5),§ and real-world studies in persons aged 12-18 years demonstrated high vaccine effectiveness (VE) against severe COVID-19 (6). Recent evidence suggests that COVID-19 vaccination is associated with lower MIS-C incidence among adolescents (7); however, VE of the 2-dose Pfizer-BioNTech regimen against MIS-C has not been evaluated. The effectiveness of 2 doses of Pfizer-BioNTech vaccine received ≥28 days before hospital admission in preventing MIS-C was assessed using a test-negative case-control design¶ among hospitalized patients aged 12-18 years at 24 pediatric hospitals in 20 states** during July 1-December 9, 2021, the period when most MIS-C patients could be temporally linked to SARS-CoV-2 B.1.617.2 (Delta) variant predominance. Patients with MIS-C (case-patients) and two groups of hospitalized controls matched to case-patients were evaluated: test-negative controls had at least one COVID-19-like symptom and negative SARS-CoV-2 reverse transcription-polymerase chain reaction (RT-PCR) or antigen-based assay results, and syndrome-negative controls were hospitalized patients without COVID-19-like illness. Among 102 MIS-C case-patients and 181 hospitalized controls, estimated effectiveness of 2 doses of Pfizer-BioNTech vaccine against MIS-C was 91% (95% CI = 78%-97%). All 38 MIS-C patients requiring life support were unvaccinated. Receipt of 2 doses of the Pfizer-BioNTech vaccine is associated with a high level of protection against MIS-C in persons aged 12-18 years, highlighting the importance of vaccination among all eligible children.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Overcoming COVID-19 Investigators
- CDC COVID-19 Response Team; Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children’s Hospital, Boston, Massachusetts; Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children’s Hospital, Houston, Texas; The Center for Childhood Infections and Vaccines of Children’s Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia; Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia; Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado; Department of Pediatrics, Children’s Hospital of Michigan, Central Michigan University, Detroit, Michigan; The Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana; Division of Pediatric Critical Care Medicine, Nationwide Children’s Hospital Columbus, Ohio; Division of Critical Care Medicine, Department of Pediatrics, Akron Children’s Hospital, Akron, Ohio; Department of Pediatrics, Department of Microbiology, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson, Mississippi; Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children’s Hospital of New Orleans, New Orleans, Louisiana; Division of Critical Care Medicine, UCSF Benioff Children's Hospital Oakland, Oakland, California; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock, Arkansas; Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston, South Carolina; Division of Pediatric Critical Care, Department of Pediatrics, Children’s Hospital and Medical Center, Omaha, Nebraska; Division of Infectious Diseases, Children’s Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles, California; Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama; Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill, North Carolina; Division of Pediatric Critical Care, Department of Pediatrics, Saint Barnabas Medical Center, Livingston, New Jersey; Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois; Division of Pediatric Hospital Medicine, UC San Diego-Rady Children’s Hospital, San Diego, California; Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Pediatrics, Division of Critical Care Medicine, University of Texas Southwestern, Children's Medical Center Dallas, Dallas, Texas; Division of Pediatric Infectious Diseases, Department of Pediatrics, Children’s Mercy Kansas City, Kansas City, Missouri; Departments of Anesthesia and Pediatrics, Harvard Medical School, Boston, Massachusetts
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19
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Sigal GB, Novak T, Mathew A, Chou J, Zhang Y, Manjula N, Bathala P, Joe J, Padmanabhan N, Romero D, Allegri-Machado G, Joerger J, Loftis LL, Schwartz SP, Walker TC, Fitzgerald JC, Tarquinio KM, Zinter MS, Schuster JE, Halasa NB, Cullimore ML, Maddux AB, Staat MA, Irby K, Flori HR, Coates BM, Crandall H, Gertz SJ, Randolph AG, Pollock NR. Measurement of SARS-CoV-2 antigens in plasma of pediatric patients with acute COVID-19 or MIS-C using an ultrasensitive and quantitative immunoassay. medRxiv 2021:2021.12.08.21267502. [PMID: 34909787 PMCID: PMC8669854 DOI: 10.1101/2021.12.08.21267502] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Detection of SARS-CoV-2 antigens in blood has high sensitivity in adults with acute COVID-19, but sensitivity in pediatric patients is unclear. Recent data suggest that persistent SARS-CoV-2 spike antigenemia may contribute to multisystem inflammatory syndrome in children (MIS-C). We quantified SARS-CoV-2 nucleocapsid (N) and spike (S) antigens in blood of pediatric patients with either acute COVID-19 or MIS-C using ultrasensitive immunoassays (Meso Scale Discovery). METHODS Plasma was collected from inpatients (<21 years) enrolled across 15 hospitals in 15 US states. Acute COVID-19 patients (n=36) had a range of disease severity and positive nasopharyngeal SARS-CoV-2 RT-PCR within 24 hours of blood collection. Patients with MIS-C (n=53) met CDC criteria and tested positive for SARS-CoV-2 (RT-PCR or serology). Controls were patients pre-COVID-19 (n=67) or within 24h of negative RT-PCR (n=43). RESULTS Specificities of N and S assays were 95-97% and 100%, respectively. In acute COVID-19 patients, N/S plasma assays had 89%/64% sensitivity, respectively; sensitivity in patients with concurrent nasopharyngeal swab cycle threshold (Ct) ≤ 35 were 93%/63%. Antigen concentrations ranged from 1.28-3,844 pg/mL (N) and 1.65-1,071 pg/mL (S) and correlated with disease severity. In MIS-C, antigens were detected in 3/53 (5.7%) samples (3 N-positive: 1.7, 1.9, 121.1 pg/mL; 1 S-positive: 2.3 pg/mL); the patient with highest N had positive nasopharyngeal RT-PCR (Ct 22.3) concurrent with blood draw. CONCLUSIONS Ultrasensitive blood SARS-CoV-2 antigen measurement has high diagnostic yield in children with acute COVID-19. Antigens were undetectable in most MIS-C patients, suggesting that persistent antigenemia is not a common contributor to MIS-C pathogenesis. KEY POINTS In a U.S. pediatric cohort tested with ultrasensitive immunoassays, SARS-CoV-2 nucleocapsid antigens were detectable in most patients with acute COVID-19, and spike antigens were commonly detectable. Both antigens were undetectable in almost all MIS-C patients.
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Affiliation(s)
| | - Tanya Novak
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital and Department of Anesthesia, Harvard Medical School, Boston, MA, USA
| | - Anu Mathew
- Meso Scale Diagnostics, LLC., Rockville, MD, USA
| | - Janet Chou
- Department of Pediatrics, Boston Children’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Yubo Zhang
- Institutional Centers for Clinical and Translational Research, Boston Children’s Hospital, Boston, MA, USA
| | | | | | - Jessica Joe
- Meso Scale Diagnostics, LLC., Rockville, MD, USA
| | | | | | | | - Jill Joerger
- Department of Laboratory Medicine, Boston Children’s Hospital, Boston, MA USA
| | - Laura L. Loftis
- Division of Critical Care Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Stephanie P. Schwartz
- Department of Pediatrics, University of North Carolina at Chapel Hill Children’s Hospital, Chapel Hill, NC, USA
| | - Tracie C. Walker
- Department of Pediatrics, University of North Carolina at Chapel Hill Children’s Hospital, Chapel Hill, NC, USA
| | - Julie C. Fitzgerald
- Division of Critical Care, Department of Anesthesiology and Critical Care, The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Keiko M. Tarquinio
- Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children’s Healthcare of Atlanta, Atlanta, GA, USA
| | - Matt S. Zinter
- Department of Pediatrics, Divisions of Critical Care and Bone Marrow Transplantation, University of California, San Francisco, San Francisco, CA, USA
| | - Jennifer E. Schuster
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Children’s Mercy Kansas City, Kansas City MO, USA
| | - Natasha B. Halasa
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Melissa L. Cullimore
- Department of Pediatrics, College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Aline B. Maddux
- Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, CO, USA
| | - Mary A. Staat
- Department of Pediatrics, University of Cincinnati, Division of Infectious Diseases, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Katherine Irby
- Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children’s Hospital, Little Rock, AR, USA
| | - Heidi R. Flori
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children’s Hospital and University of Michigan, Ann Arbor, MI, USA
| | - Bria M. Coates
- Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA
| | - Hillary Crandall
- Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City, UT, USA
| | - Shira J. Gertz
- Division of Pediatric Critical Care, Department of Pediatrics, Saint Barnabas Medical Center, Livingston, NJ, USA
| | - Adrienne G. Randolph
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital and Department of Anesthesia, Harvard Medical School, Boston, MA, USA
| | - Nira R. Pollock
- Department of Laboratory Medicine, Boston Children’s Hospital and Harvard Medical School, Boston, MA, USA
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20
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Olson SM, Newhams MM, Halasa NB, Price AM, Boom JA, Sahni LC, Irby K, Walker TC, Schwartz SP, Pannaraj PS, Maddux AB, Bradford TT, Nofziger RA, Boutselis BJ, Cullimore ML, Mack EH, Schuster JE, Gertz SJ, Cvijanovich NZ, Kong M, Cameron MA, Staat MA, Levy ER, Chatani BM, Chiotos K, Zambrano LD, Campbell AP, Patel MM, Randolph AG. Effectiveness of Pfizer-BioNTech mRNA Vaccination Against COVID-19 Hospitalization Among Persons Aged 12-18 Years - United States, June-September 2021. MMWR Morb Mortal Wkly Rep 2021; 70:1483-1488. [PMID: 34673751 PMCID: PMC9361838 DOI: 10.15585/mmwr.mm7042e1] [Citation(s) in RCA: 73] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Pfizer-BioNTech COVID-19 vaccine is authorized for use in children and adolescents aged 12-15 years and is licensed by the Food and Drug Administration (FDA) for persons aged ≥16 (1). A randomized placebo-controlled trial demonstrated an efficacy of 100% (95% confidence interval [CI] = 75.3%-100%) in preventing outpatient COVID-19 in persons aged 12-15 years (2); however, data among adolescents on vaccine effectiveness (VE) against COVID-19 in real-world settings are limited, especially among hospitalized patients. In early September 2021, U.S. pediatric COVID-19 hospitalizations reached the highest level during the pandemic (3,4). In a test-negative, case-control study at 19 pediatric hospitals in 16 states during June 1-September 30, 2021, the effectiveness of 2 doses of Pfizer-BioNTech vaccine against COVID-19 hospitalization was assessed among children and adolescents aged 12-18 years. Among 464 hospitalized persons aged 12-18 years (179 case-patients and 285 controls), the median age was 15 years, 72% had at least one underlying condition, including obesity, and 68% attended in-person school. Effectiveness of 2 doses of Pfizer-BioNTech vaccine against COVID-19 hospitalization was 93% (95% CI = 83%-97%), during the period when B.1.617.2 (Delta) was the predominant variant. This evaluation demonstrated that 2 doses of Pfizer-BioNTech vaccine are highly effective at preventing COVID-19 hospitalization among persons aged 12-18 years and reinforces the importance of vaccination to protect U.S. youths against severe COVID-19.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Overcoming COVID-19 Investigators
- CDC COVID-19 Response Team; Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children’s Hospital, Boston, Massachusetts; Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Pediatrics, Baylor College of Medicine, Immunization Project, Texas Children’s Hospital, Houston, Texas; Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock, Arkansas; Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill, North Carolina; Division of Infectious Diseases, Children’s Hospital Los Angeles and Departments of Pediatrics and Molecular Microbiology and Immunology, University of Southern California, Los Angeles, California; Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado; Department of Pediatrics, Division of Cardiology, Louisiana State University Health Sciences Center and Children’s Hospital of New Orleans, New Orleans, Louisiana; Division of Critical Care Medicine, Department of Pediatrics, Akron Children’s Hospital, Akron, Ohio; Division of Pediatric Critical Care, Department of Pediatrics, Children’s Hospital and Medical Center, Omaha, Nebraska; Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston, South Carolina; Division of Pediatric Infectious Diseases, Department of Pediatrics, Children’s Mercy Kansas City, Kansas City, Missouri; Division of Pediatric Critical Care, Department of Pediatrics, Saint Barnabas Medical Center, Livingston, New Jersey; Division of Critical Care Medicine, University of California, San Francisco Benioff Children's Hospital Oakland, Oakland, California; Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama; Division of Pediatric Hospital Medicine, University of California San Diego-Rady Children’s Hospital, San Diego, California; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota; Division of Pediatric Infectious Diseases, Department of Pediatrics, UHealth/Holtz Children's Hospital, Miami, Florida; Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania; Departments of Anesthesia and Pediatrics, Harvard Medical School, Boston, Massachusetts
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21
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LaRovere KL, Riggs BJ, Poussaint TY, Young CC, Newhams MM, Maamari M, Walker TC, Singh AR, Dapul H, Hobbs CV, McLaughlin GE, Son MBF, Maddux AB, Clouser KN, Rowan CM, McGuire JK, Fitzgerald JC, Gertz SJ, Shein SL, Munoz AC, Thomas NJ, Irby K, Levy ER, Staat MA, Tenforde MW, Feldstein LR, Halasa NB, Giuliano JS, Hall MW, Kong M, Carroll CL, Schuster JE, Doymaz S, Loftis LL, Tarquinio KM, Babbitt CJ, Nofziger RA, Kleinman LC, Keenaghan MA, Cvijanovich NZ, Spinella PC, Hume JR, Wellnitz K, Mack EH, Michelson KN, Flori HR, Patel MM, Randolph AG. Neurologic Involvement in Children and Adolescents Hospitalized in the United States for COVID-19 or Multisystem Inflammatory Syndrome. JAMA Neurol 2021; 78:536-547. [PMID: 33666649 DOI: 10.1001/jamaneurol.2021.0504] [Citation(s) in RCA: 240] [Impact Index Per Article: 80.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Importance Coronavirus disease 2019 (COVID-19) affects the nervous system in adult patients. The spectrum of neurologic involvement in children and adolescents is unclear. Objective To understand the range and severity of neurologic involvement among children and adolescents associated with COVID-19. Setting, Design, and Participants Case series of patients (age <21 years) hospitalized between March 15, 2020, and December 15, 2020, with positive severe acute respiratory syndrome coronavirus 2 test result (reverse transcriptase-polymerase chain reaction and/or antibody) at 61 US hospitals in the Overcoming COVID-19 public health registry, including 616 (36%) meeting criteria for multisystem inflammatory syndrome in children. Patients with neurologic involvement had acute neurologic signs, symptoms, or diseases on presentation or during hospitalization. Life-threatening involvement was adjudicated by experts based on clinical and/or neuroradiologic features. Exposures Severe acute respiratory syndrome coronavirus 2. Main Outcomes and Measures Type and severity of neurologic involvement, laboratory and imaging data, and outcomes (death or survival with new neurologic deficits) at hospital discharge. Results Of 1695 patients (909 [54%] male; median [interquartile range] age, 9.1 [2.4-15.3] years), 365 (22%) from 52 sites had documented neurologic involvement. Patients with neurologic involvement were more likely to have underlying neurologic disorders (81 of 365 [22%]) compared with those without (113 of 1330 [8%]), but a similar number were previously healthy (195 [53%] vs 723 [54%]) and met criteria for multisystem inflammatory syndrome in children (126 [35%] vs 490 [37%]). Among those with neurologic involvement, 322 (88%) had transient symptoms and survived, and 43 (12%) developed life-threatening conditions clinically adjudicated to be associated with COVID-19, including severe encephalopathy (n = 15; 5 with splenial lesions), stroke (n = 12), central nervous system infection/demyelination (n = 8), Guillain-Barré syndrome/variants (n = 4), and acute fulminant cerebral edema (n = 4). Compared with those without life-threatening conditions (n = 322), those with life-threatening neurologic conditions had higher neutrophil-to-lymphocyte ratios (median, 12.2 vs 4.4) and higher reported frequency of D-dimer greater than 3 μg/mL fibrinogen equivalent units (21 [49%] vs 72 [22%]). Of 43 patients who developed COVID-19-related life-threatening neurologic involvement, 17 survivors (40%) had new neurologic deficits at hospital discharge, and 11 patients (26%) died. Conclusions and Relevance In this study, many children and adolescents hospitalized for COVID-19 or multisystem inflammatory syndrome in children had neurologic involvement, mostly transient symptoms. A range of life-threatening and fatal neurologic conditions associated with COVID-19 infrequently occurred. Effects on long-term neurodevelopmental outcomes are unknown.
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Affiliation(s)
- Kerri L LaRovere
- Department of Neurology, Boston Children's Hospital, Boston, Massachusetts
| | - Becky J Riggs
- Division of Pediatric Anesthesiology and Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Tina Y Poussaint
- Department of Radiology, Boston Children's Hospital, Boston, Massachusetts
| | - Cameron C Young
- Division of Critical Care Medicine, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - Margaret M Newhams
- Division of Critical Care Medicine, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - Mia Maamari
- Division of Critical Care Medicine, Department of Pediatrics, University of Texas Southwestern, Children's Health Medical Center Dallas
| | - Tracie C Walker
- Department of Pediatrics, University of North Carolina at Chapel Hill Children's Hospital, Chapel Hill
| | - Aalok R Singh
- Pediatric Critical Care Division, Maria Fareri Children's Hospital at Westchester Medical Center and New York Medical College, Valhalla
| | - Heda Dapul
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, New York University Grossman School of Medicine, New York
| | - Charlotte V Hobbs
- Division of Infectious Diseases, Department of Pediatrics, Department of Microbiology, University of Mississippi Medical Center, Jackson
| | - Gwenn E McLaughlin
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida
| | - Mary Beth F Son
- Division of Immunology, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts
| | - Aline B Maddux
- Section of Critical Care Medicine, Department of Pediatrics, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora
| | - Katharine N Clouser
- Department of Pediatrics, Joseph M. Sanzari Children's Hospital at Hackensack University Medical Center, Hackensack, New Jersey
| | - Courtney M Rowan
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Indiana University School of Medicine, Riley Hospital for Children, Indianapolis
| | - John K McGuire
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Washington, Seattle
| | - Julie C Fitzgerald
- Division of Critical Care, Department of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Shira J Gertz
- Division of Pediatric Critical Care, Department of Pediatrics, Saint Barnabas Medical Center, Livingston, New Jersey
| | - Steven L Shein
- Division of Pediatric Critical Care Medicine, Rainbow Babies and Children's Hospital, Cleveland, Ohio
| | - Alvaro Coronado Munoz
- Pediatric Critical Care Division, Department of Pediatrics, University of Texas Health Science Center at Houston, Houston
| | - Neal J Thomas
- Department of Pediatrics, Penn State Hershey Children's Hospital, Pennsylvania State University College of Medicine, Hershey
| | - Katherine Irby
- Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock
| | - Emily R Levy
- Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota
| | - Mary A Staat
- Department of Pediatrics, University of Cincinnati, Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Mark W Tenforde
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia.,Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Leora R Feldstein
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia.,Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Natasha B Halasa
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - John S Giuliano
- Division of Critical Care, Yale University School of Medicine, New Haven, Connecticut
| | - Mark W Hall
- Division of Critical Care Medicine, Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio
| | - Michele Kong
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham
| | | | - Jennifer E Schuster
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri
| | - Sule Doymaz
- Division of Pediatric Critical Care, Department of Pediatrics, State University of New York Downstate Health Sciences University, Brooklyn
| | - Laura L Loftis
- Section of Critical Care Medicine, Department of Pediatrics, Texas Children's Hospital, Houston
| | - Keiko M Tarquinio
- Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | | | - Ryan A Nofziger
- Division of Critical Care Medicine, Akron Children's Hospital, Akron, Ohio
| | - Lawrence C Kleinman
- Division of Population Health, Quality, and Implementation Sciences (PopQuIS), Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | - Michael A Keenaghan
- Pediatric Critical Care, New York City Health and Hospitals, Kings County Hospital, Brooklyn, New York
| | - Natalie Z Cvijanovich
- Division of Critical Care Medicine, University of California, San Francisco, Benioff Children's Hospital, Oakland
| | - Philip C Spinella
- Division of Critical Care, Department of Pediatrics, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Janet R Hume
- Division of Pediatric Critical Care, University of Minnesota Masonic Children's Hospital, Minneapolis
| | - Kari Wellnitz
- Division of Pediatric Critical Care, Stead Family Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Elizabeth H Mack
- Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston
| | - Kelly N Michelson
- Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Heidi R Flori
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children's Hospital and University of Michigan, Ann Arbor
| | - Manish M Patel
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia.,Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Adrienne G Randolph
- Division of Critical Care Medicine, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts.,Departments of Anaesthesia and Pediatrics, Harvard Medical School, Boston, Massachusetts
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22
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Feldstein LR, Tenforde MW, Friedman KG, Newhams M, Rose EB, Dapul H, Soma VL, Maddux AB, Mourani PM, Bowens C, Maamari M, Hall MW, Riggs BJ, Giuliano JS, Singh AR, Li S, Kong M, Schuster JE, McLaughlin GE, Schwartz SP, Walker TC, Loftis LL, Hobbs CV, Halasa NB, Doymaz S, Babbitt CJ, Hume JR, Gertz SJ, Irby K, Clouser KN, Cvijanovich NZ, Bradford TT, Smith LS, Heidemann SM, Zackai SP, Wellnitz K, Nofziger RA, Horwitz SM, Carroll RW, Rowan CM, Tarquinio KM, Mack EH, Fitzgerald JC, Coates BM, Jackson AM, Young CC, Son MBF, Patel MM, Newburger JW, Randolph AG. Characteristics and Outcomes of US Children and Adolescents With Multisystem Inflammatory Syndrome in Children (MIS-C) Compared With Severe Acute COVID-19. JAMA 2021; 325:1074-1087. [PMID: 33625505 PMCID: PMC7905703 DOI: 10.1001/jama.2021.2091] [Citation(s) in RCA: 526] [Impact Index Per Article: 175.3] [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] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Refinement of criteria for multisystem inflammatory syndrome in children (MIS-C) may inform efforts to improve health outcomes. OBJECTIVE To compare clinical characteristics and outcomes of children and adolescents with MIS-C vs those with severe coronavirus disease 2019 (COVID-19). SETTING, DESIGN, AND PARTICIPANTS Case series of 1116 patients aged younger than 21 years hospitalized between March 15 and October 31, 2020, at 66 US hospitals in 31 states. Final date of follow-up was January 5, 2021. Patients with MIS-C had fever, inflammation, multisystem involvement, and positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcriptase-polymerase chain reaction (RT-PCR) or antibody test results or recent exposure with no alternate diagnosis. Patients with COVID-19 had positive RT-PCR test results and severe organ system involvement. EXPOSURE SARS-CoV-2. MAIN OUTCOMES AND MEASURES Presenting symptoms, organ system complications, laboratory biomarkers, interventions, and clinical outcomes. Multivariable regression was used to compute adjusted risk ratios (aRRs) of factors associated with MIS-C vs COVID-19. RESULTS Of 1116 patients (median age, 9.7 years; 45% female), 539 (48%) were diagnosed with MIS-C and 577 (52%) with COVID-19. Compared with patients with COVID-19, patients with MIS-C were more likely to be 6 to 12 years old (40.8% vs 19.4%; absolute risk difference [RD], 21.4% [95% CI, 16.1%-26.7%]; aRR, 1.51 [95% CI, 1.33-1.72] vs 0-5 years) and non-Hispanic Black (32.3% vs 21.5%; RD, 10.8% [95% CI, 5.6%-16.0%]; aRR, 1.43 [95% CI, 1.17-1.76] vs White). Compared with patients with COVID-19, patients with MIS-C were more likely to have cardiorespiratory involvement (56.0% vs 8.8%; RD, 47.2% [95% CI, 42.4%-52.0%]; aRR, 2.99 [95% CI, 2.55-3.50] vs respiratory involvement), cardiovascular without respiratory involvement (10.6% vs 2.9%; RD, 7.7% [95% CI, 4.7%-10.6%]; aRR, 2.49 [95% CI, 2.05-3.02] vs respiratory involvement), and mucocutaneous without cardiorespiratory involvement (7.1% vs 2.3%; RD, 4.8% [95% CI, 2.3%-7.3%]; aRR, 2.29 [95% CI, 1.84-2.85] vs respiratory involvement). Patients with MIS-C had higher neutrophil to lymphocyte ratio (median, 6.4 vs 2.7, P < .001), higher C-reactive protein level (median, 152 mg/L vs 33 mg/L; P < .001), and lower platelet count (<150 ×103 cells/μL [212/523 {41%} vs 84/486 {17%}, P < .001]). A total of 398 patients (73.8%) with MIS-C and 253 (43.8%) with COVID-19 were admitted to the intensive care unit, and 10 (1.9%) with MIS-C and 8 (1.4%) with COVID-19 died during hospitalization. Among patients with MIS-C with reduced left ventricular systolic function (172/503, 34.2%) and coronary artery aneurysm (57/424, 13.4%), an estimated 91.0% (95% CI, 86.0%-94.7%) and 79.1% (95% CI, 67.1%-89.1%), respectively, normalized within 30 days. CONCLUSIONS AND RELEVANCE This case series of patients with MIS-C and with COVID-19 identified patterns of clinical presentation and organ system involvement. These patterns may help differentiate between MIS-C and COVID-19.
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Affiliation(s)
- Leora R. Feldstein
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
- Public Health Service Commissioned Corps, Rockville, Maryland
| | - Mark W. Tenforde
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kevin G. Friedman
- Department of Cardiology, Boston Children’s Hospital, Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Margaret Newhams
- Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children’s Hospital, Boston, Massachusetts
| | - Erica Billig Rose
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
- Public Health Service Commissioned Corps, Rockville, Maryland
| | - Heda Dapul
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, New York University Grossman School of Medicine, New York
| | - Vijaya L. Soma
- Division of Pediatric Infectious Diseases, Department of Pediatrics, New York University Grossman School of Medicine, New York
| | - Aline B. Maddux
- Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora
| | - Peter M. Mourani
- Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora
| | - Cindy Bowens
- Division of Critical Care Medicine, Department of Pediatrics, University of Texas Southwestern, Children’s Medical Center Dallas, Dallas
| | - Mia Maamari
- Division of Critical Care Medicine, Department of Pediatrics, University of Texas Southwestern, Children’s Medical Center Dallas, Dallas
| | - Mark W. Hall
- Division of Critical Care Medicine, Department of Pediatrics, Nationwide Children’s Hospital, Columbus, Ohio
| | - Becky J. Riggs
- Department of Anesthesiology and Critical Care Medicine, Division of Pediatric Anesthesiology & Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - John S. Giuliano
- Division of Critical Care, Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut
| | - Aalok R. Singh
- Pediatric Critical Care Division, Maria Fareri Children’s Hospital at Westchester Medical Center and New York Medical College, Valhalla
| | - Simon Li
- Department of Pediatrics, Division of Pediatric Critical Care, Bristol-Myers Squibb Children’s Hospital, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey
| | - Michele Kong
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham
| | - Jennifer E. Schuster
- Division of Pediatric Infectious Disease, Department of Pediatrics, Children’s Mercy Kansas City, Kansas City, Missouri
| | - Gwenn E. McLaughlin
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida
| | - Stephanie P. Schwartz
- Department of Pediatrics, University of North Carolina at Chapel Hill Children’s Hospital
| | - Tracie C. Walker
- Department of Pediatrics, University of North Carolina at Chapel Hill Children’s Hospital
| | - Laura L. Loftis
- Section of Critical Care Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Charlotte V. Hobbs
- Division of Infectious Diseases, Department of Pediatrics, Department of Microbiology, University of Mississippi Medical Center, Jackson
| | - Natasha B. Halasa
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Sule Doymaz
- Division of Pediatric Critical Care, Department of Pediatrics, SUNY Downstate Health Sciences University, Brooklyn, New York
| | - Christopher J. Babbitt
- Division of Pediatric Critical Care, Miller Children’s and Women’s Hospital of Long Beach, Long Beach, California
| | - Janet R. Hume
- Division of Pediatric Critical Care, University of Minnesota Masonic Children’s Hospital, Minneapolis
| | - Shira J. Gertz
- Division of Pediatric Critical Care, Department of Pediatrics, Saint Barnabas Medical Center, Livingston, New Jersey
| | - Katherine Irby
- Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children’s Hospital, Little Rock
| | - Katharine N. Clouser
- Division of Hospital Medicine, Department of Pediatrics, Hackensack University Medical Center, Hackensack, New Jersey
| | - Natalie Z. Cvijanovich
- Division of Critical Care Medicine, UCSF Benioff Children’s Hospital Oakland, Oakland, California
| | - Tamara T. Bradford
- Division of Cardiology, Department of Pediatrics, Louisiana State University Health Sciences Center and Children’s Hospital of New Orleans, New Orleans
| | - Lincoln S. Smith
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Washington, Seattle
| | - Sabrina M. Heidemann
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Central Michigan University, Detroit
| | - Sheemon P. Zackai
- Pediatric Critical Care Medicine, Department of Pediatrics, Icahn School of Medicine at the Mount Sinai Kravis Children’s Hospital, New York, New York
| | - Kari Wellnitz
- Division of Pediatric Critical Care, Stead Family Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City
| | - Ryan A. Nofziger
- Division of Critical Care Medicine, Department of Pediatrics, Akron Children’s Hospital, Akron, Ohio
| | - Steven M. Horwitz
- Department of Pediatrics, Division of Critical Care, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | - Ryan W. Carroll
- Division of Pediatric Critical Care Medicine, MassGeneral Hospital for Children, Harvard Medical School, Boston, Massachusetts
| | - Courtney M. Rowan
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Indiana University School of Medicine, Riley Hospital for Children, Indianapolis
| | - Keiko M. Tarquinio
- Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children’s Healthcare of Atlanta, Atlanta, Georgia
| | - Elizabeth H. Mack
- Division of Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston
| | - Julie C. Fitzgerald
- Division of Critical Care, Department of Anesthesiology and Critical Care, The University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Bria M. Coates
- Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois
| | - Ashley M. Jackson
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Cameron C. Young
- Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children’s Hospital, Boston, Massachusetts
| | - Mary Beth F. Son
- Division of Immunology, Boston Children’s Hospital, Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Manish M. Patel
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia
- Public Health Service Commissioned Corps, Rockville, Maryland
| | - Jane W. Newburger
- Department of Cardiology, Boston Children’s Hospital, Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Adrienne G. Randolph
- Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children’s Hospital, Boston, Massachusetts
- Departments of Anesthesia and Pediatrics, Harvard Medical School, Boston, Massachusetts
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23
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Schwartz SP, Walker TC, Kihlstrom M, Isani M, Smith MM, Smith RL, McLean SE, Clement KC, Phillips MR. Extracorporeal Membrane Oxygenation for COVID-19-Associated Multisystem Inflammatory Syndrome in a 5-year-old. Am Surg 2020; 88:174-176. [PMID: 33372818 PMCID: PMC7780062 DOI: 10.1177/0003134820983198] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2) is
associated with multisystem inflammatory syndrome in children (MIS-C) that
ranges from mild symptoms to cardiopulmonary collapse. A 5-year-old girl
presented with shock and a rapid decline in left ventricular function requiring
intubation. SARS-CoV-2 was diagnosed by viral Polymerase Chain Reaction (PCR),
and she received remdesivir and COVID-19 convalescent plasma. Initial
echocardiogram (ECHO) demonstrated low normal left ventricular function and mild
left anterior descending coronary artery dilation. She remained hypotensive,
despite high-dose epinephrine and norepinephrine infusions as well as
stress-dose hydrocortisone. Admission SARS-CoV-2 IgG assay was positive, meeting
the criteria for MIS-C. An ECHO 9 hours after admission demonstrated a severe
decline in left ventricular function. Due to severe cardiogenic shock, she was
cannulated for venoarterial extracorporeal support (ECMO). During her ECMO
course, she was treated with remdesivir, intravenous methylprednisolone,
intravenous immunoglobulin, and anakinra. She was decannulated on ECMO day 7,
extubated the following day, and discharged home 2 weeks later without
respiratory or cardiac support. The use of ECMO for cardiopulmonary support for
pediatric patients with MIS-C is feasible and should be considered early as part
of the treatment algorithm for patients with severe cardiopulmonary
dysfunction.
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Affiliation(s)
- Stephanie P Schwartz
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of North Carolina, Chapel Hill, NC, USA
| | - Tracie C Walker
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of North Carolina, Chapel Hill, NC, USA
| | - Margaret Kihlstrom
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of North Carolina, Chapel Hill, NC, USA
| | - Mubina Isani
- Division of Pediatric Surgery, Department of Surgery, University of North Carolina, Chapel Hill, NC, USA
| | - Melissa M Smith
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of North Carolina, Chapel Hill, NC, USA
| | - Rebecca L Smith
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of North Carolina, Chapel Hill, NC, USA
| | - Sean E McLean
- Division of Pediatric Surgery, Department of Surgery, University of North Carolina, Chapel Hill, NC, USA
| | - Katherine C Clement
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of North Carolina, Chapel Hill, NC, USA
| | - Michael R Phillips
- Division of Pediatric Surgery, Department of Surgery, University of North Carolina, Chapel Hill, NC, USA
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24
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Abstract
Survivors of critical illness often experience multiple morbidities that start in the intensive care unit and impact their quality of life after discharge. Reduced physical function, cognitive decline, feeding disorders, and psychological stress are just a few of the potential complications. Many of these morbidities can lead to a reduced quality of life and lifelong impediments. Early mobilization, an intervention that is intended to maintain or restore musculoskeletal strength in the critically ill, has the potential to also yield positive psychological and cognitive benefits. In adults, early mobilization has been shown to be safe, decrease the incidence of delirium, and decrease length of stay. Early mobilization of the pediatric critically ill patient is still a novel topic with a growing body of research. This article will review the current literature on early mobilization of the pediatric critically ill patient.
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Affiliation(s)
- Tracie C Walker
- Department of Anesthesiology & Critical Care Medicine, Johns Hopkins University School of Medicine, Charlotte R. Bloomberg Children's Center, Baltimore, MD, USA
| | - Sapna R Kudchadkar
- Department of Anesthesiology & Critical Care Medicine, Johns Hopkins University School of Medicine, Charlotte R. Bloomberg Children's Center, Baltimore, MD, USA.,Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Physical Medicine & Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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25
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Walker TC, Renno MS, Parra DA, Guthrie SO. Neonatal ventricular fibrillation and an elusive ALCAPA: things are not always as they seem. BMJ Case Rep 2016; 2016:bcr-2015-214239. [PMID: 27033289 DOI: 10.1136/bcr-2015-214239] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
An anomalous left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital cardiac condition that typically presents with poor feeding and failure to thrive from progressive myocardial ischaemia. Previous reports of ALCAPA presenting with ventricular fibrillation (VF) have suggested a causative relationship. In this case, we present a neonate with VF without apparent cause after an extensive evaluation. Following implantable cardioverter-defibrillator placement for presumed idiopathic VF, at which time she also underwent surgical ligation of a patent ductus arteriosus (PDA), the neonate developed haemodynamic instability that ultimately was found to be due to ALCAPA. Numerous echocardiograms had missed the ALCAPA in the setting of mildly elevated pulmonary artery pressure. We discuss the limitations of current ultrasound technology in diagnosing ALCAPA in the setting of pulmonary hypertension and explain why the relationship between this patient's diagnosis of ALCAPA and her episode of VF is not clearly causative.
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Affiliation(s)
- Tracie C Walker
- Mildred Stahlman Division of Neonatology, Vanderbilt University, Nashville, Tennessee, USA
| | - Markus S Renno
- Thomas P Graham Jr Division of Pediatric Cardiology, Vanderbilt University, Nashville, Tennessee, USA
| | - David A Parra
- Thomas P Graham Jr Division of Pediatric Cardiology, Vanderbilt University, Nashville, Tennessee, USA
| | - Scott O Guthrie
- Mildred Stahlman Division of Neonatology, Vanderbilt University, Nashville, Tennessee, USA Department of Neonatology, Ayers Children's Medical Center, Jackson, Tennessee, USA
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Walker TC, Fidelman ML, Watlington CO, Biber TU. Insulin decreases apical cell membrane resistance in cultured kidney cells (A6). Biochem Biophys Res Commun 1984; 124:614-8. [PMID: 6388578 DOI: 10.1016/0006-291x(84)91598-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Intracellular potentials measured across the apical and basolateral cell membranes of cultured renal A6 cells were -53.5 +/- 1.5 and -48.7 +/- 1.3 mV, respectively, (19 measurements) and did not significantly change after insulin treatment. Analysis based on an equivalent circuit indicates that the resistances of the apical cell membrane and of the transcellular pathway decrease after insulin treatment to 36 +/- 6 and 42 +/- 6% of the control value respectively (7 measurements). Thus, the decrease in transcellular resistance which accompanies an increase in transcellular Na transport after insulin treatment appears to be connected with a commensurate decrease in apical cell membrane resistance.
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Abstract
The effect of changes in Cl concentration in the external and/or serosal bath on Cl transport across short-circuited frog skin was studied by measurements of transepithelial Cl influx (J13Cl) and efflux (J31Cl), short-circuit current, transepithelial potential, and conductance (Gm). J14Cl as well as J31Cl were found to have a saturating component and a component which is apparently linear with Cl concentration. The linear component of J31Cl appears only upon addition of Cl to external medium, and about 3/4 of this component does not contribute to Gm. The saturating component of J31Cl is only 5% of total J31Cl with 115mM Cl in the serosal medium. Replacement of 115 mM Cl- in external medium by SO4=, NO3-, HCO3- or I- results in 87-97% reduction of J31Cl, whereas replacement with Br- has no effect. As external Cl concentration is raised in steps from 2 to 115 mM, J13Cl and J31Cl increase by the same amount but J13Cl is persistently 0.15 mueg/cm2hr larger than J31Cl. These results indicate that at least 3/4 of linear components of J13Cl and J31Cl proceed via an exchange diffusion mechanism which seems to be located at the outer cell border. The saturating component of J13Cl is involved in active Cl transport in an inward direction, and there is evidence suggesting that Cl uptake across outer cell border, which proceeds against an electrochemical gradient, is electroneutral but not directly linked to Na.
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Biber TU, Walker TC, Mullen TL. Influence of extracellular Cl concentration on Cl transport across isolated skin of Rana pipiens. J Membr Biol 1980; 54:191-202. [PMID: 6967117 DOI: 10.1007/bf01870235] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The effect of changes in Cl concentration in the external and/or serosal bath on Cl transport across short-circuited frog skin was studied by measurements of transepithelial Cl influx (JCl13) and efflux (JCl31), short-circuit current, transepithelial potential, and conductance (Gm). JCl13 as well as JCl31 were found to have a saturating component and a component which is apparently linear with Cl concentration. The linear component of JCl31 appears only upon addition of Cl to external medium, and about 3/4 of this component does not contribute to Gm. The saturating component of JCl31 is only 5% of total JCl31 with 115 mM Cl in the serosal medium. Replacement of 115 mM Cl- in external medium by SO4=, NO3-, HCO-3 or I- results in 87-97% reduction of JCl31, whereas replacement with Br- has no effect. As external Cl concentration is raised in steps from 2 to 115 mM, JCl13 and JCl31 increase by the same amount but JCl13 is persistently 0.15 mu eq/cm2hr larger than JCl31. These results indicate that at least 3/4 of linear components of JCl13 and JCl31 proceed via an exchange diffusion mechanism which seems to be located at the outer cell border. The saturating component of JCl13 is involved in active Cl transport in an inward direction, and there is evidence suggesting that Cl uptake across outer cell border, which proceeds against an electrochemical gradient, is electroneutral but not directly linked to Na.
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