COVID-19 In Pediatric Population Research Articles

Risk of COVID-19 in pediatric population and the effects of COVID-19 vaccination: A retrospective cohort study

ObjectivePrior studies have demonstrated the adverse effects of upper respiratory infections on the pediatric population, such as increased risk for acute otitis media (AOM). Other studies have noted decreased otitis media complaints during the COVID-19 pandemic. This project aims to identify whether individuals who tested positive for COVID-19 at the Emergency Department (ED) visit had an increased risk of developing severe complications. Additionally, we will study whether vaccination helped decrease following COVID-19 complications. MethodsUtilizing the TriNetX database, we obtained de-identified electronic medical records for children under five and 6–10 years old from 2020–2023 in the United States. The study population was propensity-matched for gender, index age, and comorbidities. Complications within eight weeks of the ED visit were compared between COVID-19 vaccinated and unvaccinated children. Risk ratio was used to measure associations between our groups. A p-value less than or equal to 0.05 was considered significant. ResultsAfter propensity matching, a total of 211,138 children were identified. Within eight weeks after the ED visit, unvaccinated children <5 years old who tested negative for COVID-19 had a 30 % relative risk reduction for AOM, 52 % for sinusitis, 76 % for multisystem inflammatory system (MIS), 17 % for acute respiratory failure, and 37 % for septic shock when compared to those with a positive COVID-19 result (p ≤ 0.05). Unvaccinated 6–10 years old children who tested negative for COVID-19 had an 18 % risk reduction for AOM, 44 % reduction for sinusitis, 63 % reduction for MIS, and 42 % for acute respiratory failure (p ≤ 0.05) compared to those that tested positive for COVID-19. Vaccinated children with positive COVID-19 results have no significant risk of AOM or acute respiratory failure. Additionally, children 6–10 years old with positive COVID-19 results did not have a substantial risk of sinusitis. ConclusionCOVID-19′s effects require continued investigation in children. This study showed that there are some increased risks of severe complications following this viral infection.

Hepatitis –A late manifestation of COVID-19 in pediatric population?

Complete spectrum of covid 19 infection in children as well as its sequaele is still unknown to the world even after two years of ongoing pandemic. Many manifestations of covid 19 have been missed and are yet to be identified. In this study, we aim to hypothesize hepatitis as a probable late manifestation of COVID-19 infection in children. It was a descriptive retrospective study, in which we have included twenty patients who presented with hepatitis in the pediatric department of a secondary level care centre in Sagar from May to July 2021. And we investigated them further to find out the cause of Hepatitis. Among the 20 patients with HEPATITIS, 15 were tested for covid antibody levels, out of them 14 had raised level of SARS-CoV-2 antibody titre. Pediatricians should recognize that the clinical spectrum of COVID-19 in children can be wider than previously described, often with hepatitis as late manifestation of COVID-19 in children, apart from MIS-C.

COVID-19 У ДЕТЕЙ: ОБОБЩЕНИЕ МИРОВОГО ОПЫТА

The purpose of this bibliographical review is to provide an exceptional and up-to-date overview of COVID-19 infection in children describing its epidemiology, pathogenesis, clinical features and outcomes. The article provides a comprehensive analysis of publications by foreign and Russian authors on a new coronavirus infection (COVID-19) caused by SARS-CoV-2 in children. A complete clinical description of the course of COVID-19 in pediatric population is given: from asymptomatic virus carrying till the development of acute pneumonia, multi-inflammatory syndrome, multiple organ failure and death. Among the clinical manifestations there are described as follows: respiratory syndrome, gastrointestinal tract injury, manifestations in the central nervous system, lesions of the skin and mucous membranes and a complete characteristic of multi-inflammatory syndrome. The studied methods of development of COVID-19 are examined in pathogenesis. The issues of anti-tuberculosis vaccination, the impact of serum cholecalciferol level on the severity and outcomes of COVID-19 disease are highlighted. The latest publications on intrauterine infection of the fetus and the breast milk research for the presence of SARS-CoV-2 were analyzed.

Long COVID-19 in children: an Italian cohort study

BackgroundLong COVID-19 syndrome is a complex of symptoms that occurs after the acute SARS-CoV-2 infection, in the absence of other possible diagnoses. Studies on Long COVID-19 in pediatric population are scanty and heterogeneous in design, inclusion criteria, outcomes, and follow-up time. The objective of the present study is to assess the prevalence of Long COVID-19 syndrome in a cohort of Italian pediatric primary care patients, observed for a period of time of 8 to 36 weeks from healing. Prevalence was also assessed in a cohort of pediatric patients hospitalized during acute infection.MethodsData concerning 629 primary care patients with previous acute SARS-CoV-2 infection were collected by a questionnaire filled in by Primary Care Pediatrician (PCP). The questionnaire was administrated to patients by 18 PCPs based in 8 different Italian regions from June to August 2021. Data concerning 60 hospitalized patients were also collected by consultation of clinical documents.ResultsCumulative incidence of Long COVID-19 resulted to be 24.3% in primary care patients and 58% in hospitalized patients. The most frequently reported symptoms were abnormal fatigue (7%), neurological (6.8%), and respiratory disorders (6%) for the primary care cohort. Hospitalized patients displayed more frequently psychological symptoms (36.7%), cardiac involvement (23.3%), and respiratory disorders (18.3%). No difference was observed in cumulative incidence in males and females in both cohorts. Previous diseases did not influence the probability to develop Long COVID-19. The prevalence of Long COVID-19 was 46.5% in children who were symptomatic during acute infection and 11.5% in asymptomatic ones. Children aged 0 to 5 years had a greater risk to develop respiratory symptoms, while adolescents (aged 11–16 years) had a greater risk to develop neurological and psychological Long COVID-19 symptoms.ConclusionsOur study demonstrates that Long COVID-19 is a reality in pediatric age and could involve even patients with mild or no acute symptoms. The results stress the importance of monitoring primary care pediatric patients after acute COVID-19 infection and the relevance of vaccination programs in pediatric population, also in order to avoid the consequences of Long COVID-19 syndrome.

Cutaneous manifestations of covid-19 in pediatric population: A web based comparative study between the perspectives of dermatologists and pediatricians

Objectives: To compare the perspectives of dermatologists and pediatricians regarding cutaneous manifestations of covid-19 in the pediatric age group. Material and methods: An online semi-structured English questionnaire was circulated among the doctors (snowball sampling). Items of the questionnaire with a content validity ratio ≥0.49 were retained. Content validity index (CVI) was estimated, and those with a CVI score of &gt;0.79, were accepted. Appropriate statistical tests were carried out for data analysis. Results: Among 305 responders, majority were dermatologists (n = 139; 45.57%) followed by pediatricians (n = 106; 34.75%) and other specialties (n = 60; 19.6%). Nearly 46.55% of all responders (n = 142) observed cutaneous manifestations among pediatric covid patients (40/139 dermatologists, 28.77%, and 94/106 pediatricians, 88.67%). Nearly 54.22% of pediatricians and 10% of dermatologists reported the infection to be moderate to severe. About 15% of dermatologists and 5.3% of pediatricians came across cutaneous manifestations as the sole manifestation. The commonest manifestation was urticarial (61.26%) followed by a morbilliform rash (52.81%). Multisystem inflammatory syndrome in covid (MISC) was observed almost exclusively by 63.82% of pediatricians. Vascular manifestations were seen by 11.97% responders (n = 17). Chilblains were reported by 4.5% of pediatricians. Nearly 78.04% of pediatricians and 35% of dermatologists observed mucosal manifestations. Conclusion: Pediatricians are more commonly observing cutaneous manifestations. MISC is exclusively reported by pediatricians, highlighting the fact that severe disease is usually not seen by dermatologists. Vascular manifestations are uncommon in the skin of color. Dermatologists encounter asymptomatic covid patients with cutaneous manifestation more often, reiterating the fact that children presenting with urticarial and morbilliform rashes should be tested for covid-19, considering the present scenario.

OP0219 HIGH INCIDENCE OF MIS-C AND OTHER AUTOIMMUNE DISEASES AFTER SARS-COV-2 INFECTION COMPARED TO COVID-19 VACCINATION IN PEDIATRIC POPULATION FROM SOUTH CENTRAL EUROPE

BackgroundIn contrast to adults, children are less likely to develop serious disease upon infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) but are at increased risk for inflammatory and autoimmune diseases linked to the virus (1). The reported incidence of multisystem inflammatory syndrome in children (MIS-C) varied from 0.2 to 11.4/100,000 persons under 21 years (2,3). It is yet unknown whether MIS-C can recur after SARS-CoV-2 reinfection or COVID-19 vaccination.ObjectivesTo estimate the incidence and describe the spectrum of inflammatory and autoimmune diseases linked to SARS-CoV-2 infection and coronavirus (COVID-19) vaccination in pediatric patients from two neighbouring South Central European countries and regions, Slovenia and Friuli Venezia Giulia (FVG), Italy.MethodsWe performed a multi-centre prospective cohort study of all children and adolescents (under 18 years) newly diagnosed with MIS-C or other inflammatory/autoimmune diseases linked to SARS-CoV-2 infection, who were admitted to the pediatric tertiary care hospitals in Slovenia or FVG, Italy during the period from January 1, 2020, to December 31, 2021. These hospitals serve a combined population of 587,053 children and adolescents. Only patients who had positive anti-SARS-CoV-2 antibodies and/or positive SARS-CoV-2 PCR test within 3 months prior to disease onset were considered for estimating the disease incidence. We obtained the number of patients with serious adverse events (SAE) after COVID-19 vaccination and the number of patients with severe COVID-19 in the same population. This study was conducted as a part of the EU interregional Italy-Slovenia project CATTEDRA (Cross border cooperation for innovative diagnosis of rare diseases in paediatrics).Results192 children and adolescents were diagnosed with inflammatory and autoimmune diseases linked to SARS-CoV-2 (Figure 1). Median age at diagnosis was 11.9 years (IQR 7.6 -14.7). All included patients were White. Incidence of MIS-C was one in 921 children and adolescents after SARS-CoV-2 infection and one in 5870 of all children and adolescents. Cumulative incidence of MIS-C since the start of the pandemic was 17/100,000 children and adolescents. Until December 31, 2021, 92,139 children and adolescents (15.7 %) received at least one dose of COVID-19 vaccine. Three patients presented with inflammatory/autoimmune disease after COVID-19 vaccination, including 2 patients with MIS-C and one patient with myositis. All 3 had evidence of recent SARS-CoV-2 infection in form of positive anti-N SARS-CoV-2 antibodies. In the same period, 15 children and adolescents were hospitalised with severe COVID-19. Seven patients from our cohort were vaccinated against COVID-19 median 8 months after MIS-C and further 6 patients had a SARS-CoV-2 reinfection 3-14 months after MIS-C. None of them experienced SAE or recurrence of MIS-C.Figure 1.Inflammatory and autoimmune diseases linked to SARS-CoV-2 and severe COVID-19 in pediatric population in Slovenia and FVG, ItalyCOVID-19=coronavirus disease, FVG=Friuli Venezia Giulia region in Italy, MIS-C=multisystem inflammatory syndrome in children, SARS-CoV-2=severe acute respiratory syndrome coronavirus 2ConclusionMIS-C was the most common manifestation and its incidence in this predominantly white population was higher than previously reported. Based on our limited experience, MIS-C does not seem to recur after SARS-CoV-2 reinfection or COVID-19 vaccination, however long-term data are lacking. Autoimmune diseases were much more common after SARS-CoV-2 infection than after COVID-19 vaccination. Hospitalisations due to MIS-C were seven times as frequent as hospitalisations due to severe COVID-19 in children.

Child with post COVID MISC presenting with atypical Kawasaki like features in a rural medical college

COVID-19 in pediatric population is often milder but a segment of cases tend to worsen out and present with pediatric multi system inflammatory syndrome. Here we present a 3 year-old female child presenting with acute febrile illness, generalized rashes with loose stools. On examination child was in fluid refractory shock requiring vasoactives, oxygen by non-rebreather mask, antibiotics and other supportive. Investigations revealed neutrophilic leukocytosis, with normal absolute lymphocyte count, thrombocytopenia and elevated inflammatory markers with negative COVID real time-polymerase chain reaction (RT PCR) and positive COVID immunoglobulin G (IgG) antibody, suggesting a post COVID-19 sequelae. Children presenting with multisystem inflammatory syndrome in children (MIS-C) most often have a silent course of acute COVID infection. Lymphopenia and thrombocytosis are not always associated with MIS-C. COVID antibody with inflammatory markers like C-reactive protein (CRP), D-dimer plays an important role in the management and during follow up. More pediatric studies are needed regarding the role of aspirin in MIS-C with Kawasaki disease overlap, choice of anticoagulant in a thrombocytopenic child and any markers which could predict the development of MIS-C during acute COVID infection.

COVID-19 in Children and Neonates: A Comprehensive Review Article

Context: Novel coronavirus (COVID-19) has become a new public health crisis, posing a great threat to the people all around the world. We aimed to review the articles on COVID-19 in pediatric population to help physicians and other healthcare workers understand the importance of detecting silent disease carriers in this age group and stop further transmission to other healthy individuals and manage symptomatic patients based on the latest recommendations. Methods: We searched databases including PubMed, Scopus, Google Scholar, and Medline and reviewed 70 articles from December 2019 to mid-July 2020. Relevant articles about COVID-19 in children were included. Results: According to the latest reports, 1% - 5% of infected patients were under 19 years old. Death in this age group was rare but it can occur in children with severe disease. The overall course of disease -mainly pulmonary involvement- of the infected children tend to be milder than adults. This may be related to both host factors and exposure. The lab tests and computed tomography (CT) scan findings are nonspecific and milder compared to those in older ages. The cornerstone of COVID-19 management in pediatric group is supportive care. Of note, there is not any approved specific drug for treatment of children affected by COVID-19. Conclusions: COVID-19 disease characteristics in children are not yet fully established, which poses a significant problem for pediatric medical specialists. It should be considered that most children are asymptomatic or have mild symptoms. Critical cases, although uncommon, can occur especially in children with underlying diseases.

Multisystem inflammatory syndrome associated to COVID-19 in pediatric population.

The new SARS-CoV-2 coronavirus appears to be less aggressive in the pediatric population in comparison to the adult population. Yet, most recently, as the number of diagnosed pediatric patients with COVID-19 has increased, clinicians have observed the development of a multisystemic inflammatory response syndrome that is potentially associated with COVID-19 in the pediatric population. Our objective was to retrieve and synthesize the reports that have described the multisystemic inflammatory response syndrome potentially associated with COVID-19 in the pediatric population. We conducted a narrative review of scientific literature reported in PubMed from January 1st to June 30th, 2020, with the terms multisystem inflammatory syndrome, Kawasaki, children, COVID-19. This new syndrome has been associated with greater difficulty in treating children with COVID-19 and some deaths have been observed as a result. On the other hand, innate pediatric immunity, primarily driven by IgM, and the rapid immune response to generate germ-center dependent and non-dependent memory B cells as it has been hypothesized for other authors could largely explain the behavior and incidence of the new SARS-CoV-2 infection in the pediatric population.