Risk factors for post-COVID-19 condition (Long Covid) in children: a prospective cohort study

EClinicalMedicine, Journal Year: 2023, Volume and Issue: 59, P. 101961 - 101961

Published: April 14, 2023

Language: Английский

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SARS-CoV-2 Reinfections and Long COVID in the Post-Omicron Phase of the Pandemic

International Journal of Molecular Sciences, Journal Year: 2023, Volume and Issue: 24(16), P. 12962 - 12962

Published: Aug. 19, 2023

We are reviewing the current state of knowledge on virological and immunological correlates long COVID, focusing recent evidence for possible association between increasing number SARS-CoV-2 reinfections parallel pandemic COVID. The severity largely depends initial episode; in turn, this is determined both by a combination genetic factors, particularly related to innate immune response, pathogenicity specific variant, especially its ability infect induce syncytia formation at lower respiratory tract. cumulative risk COVID as well various cardiac, pulmonary, or neurological complications increases proportionally infections, primarily elderly. Therefore, cases expected remain high future. Reinfections apparently increase likelihood but less so if they mild asymptomatic children adolescents. Strategies prevent urgently needed, among older adults who have higher burden comorbidities. Follow-up studies using an established case definition precise diagnostic criteria people with without reinfection may further elucidate contribution burden. Although accumulating supports vaccination, before after infection, preventive strategy reduce more robust comparative observational studies, including randomized trials, needed provide conclusive effectiveness vaccination preventing mitigating all age groups. Thankfully, answers not only prevention, also treatment options rates recovery from gradually starting emerge.

Language: Английский

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Long COVID in pediatrics—epidemiology, diagnosis, and management

European Journal of Pediatrics, Journal Year: 2024, Volume and Issue: 183(4), P. 1543 - 1553

Published: Jan. 27, 2024

Abstract This review summarizes current knowledge on post-acute sequelae of COVID-19 (PASC) and post-COVID-19 condition (PCC) in children adolescents. A literature was performed to synthesize information from clinical studies, expert opinions, guidelines. PASC also termed Long COVID — at any age comprise a plethora unspecific symptoms present later than 4 weeks after confirmed or probable infection with severe respiratory syndrome corona virus type 2 (SARS-CoV-2), without another medical explanation. PCC adolescents defined by the WHO as occurring within 3 months acute coronavirus disease 2019 (COVID-19), lasting least months, limiting daily activities. Pediatric mostly manifest mild courses majority cases remit few months. However, can last for more 1 year may result significant disability. Frequent include fatigue, exertion intolerance, anxiety. Some patients postural tachycardia (PoTS), small number fulfill criteria myalgic encephalomyelitis/chronic fatigue (ME/CFS). To date, no diagnostic marker has been established, differential diagnostics remains challenging. Therapeutic approaches appropriate self-management well palliation non-pharmaceutical pharmaceutical strategies. Conclusion : pediatrics heterogenous severity duration. stepped, interdisciplinary, individualized approach is essential management. Current health care structures have be adapted, research extended meet psychosocial needs young people similar conditions. What Known: • Post-acute (COVID-19) lead activity limitation reduced quality life. belongs large group syndromes (PAIS). Specific biomarkers causal treatment options are not yet available. New: In February 2023, case definition post provided World Health Organization (WHO), indicating duration Interdisciplinary collaborations necessary established worldwide offer harmonized, multimodal diagnosis management PASC/PCC

Language: Английский

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COVID-19 Vaccination and Odds of Post–COVID-19 Condition Symptoms in Children Aged 5 to 17 Years

JAMA Network Open, Journal Year: 2025, Volume and Issue: 8(2), P. e2459672 - e2459672

Published: Feb. 24, 2025

Importance An estimated 1% to 3% of children with SARS-CoV-2 infection will develop post–COVID-19 condition (PCC). Objective To evaluate the odds PCC among COVID-19 vaccination prior compared unvaccinated children. Design, Setting, and Participants In this case-control study, were enrolled in a multisite longitudinal pediatric cohort from July 27, 2021, September 1, 2022, followed up through May 2023. Analysis used case (PCC reported)–control (no reported) design included aged 5 17 years whose first real time–polymerase chain reaction (RT-PCR)–confirmed occurred during study period, who vaccine age-eligible at time infection, completed survey least 60 days after infection. From December 31, 2023, had weekly testing surveyed regarding (≥1 new or ongoing symptom lasting ≥1 month infection). Exposures mRNA status was exposure interest; participants categorized as vaccinated (≥2-dose series ≥14 before infection) unvaccinated. Vaccination verified cards registry and/or medical records when available. Main Outcome Measures outcomes estimates symptoms. Multivariate logistic regression performed estimate Results A total 622 included, 28 (5%) 594 (95%) control participants. Median (IQR) age 10.0 (7.0-11.9) for 10.3 (7.8-12.7) ( P = .37). Approximately half both groups reported female sex (13 [46%] 287 [48%]). Overall, 57% (16 children) 77% (458 .05). After adjusting demographic characteristics, number acute symptoms, baseline health, associated decreased 1 more (adjusted ratio [aOR], 0.43; 95% CI, 0.19-0.98) 2 symptoms (aOR, 0.27; 0.10-0.69). Conclusions Relevance reduced The aORs correspond an 73% likelihood respectively, vs These findings suggest benefits beyond those protection against may encourage increased uptake.

Language: Английский

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Autonomic cardiac function in children and adolescents with long COVID: a case-controlled study

European Journal of Pediatrics, Journal Year: 2024, Volume and Issue: 183(5), P. 2375 - 2382

Published: March 6, 2024

Although the mechanisms underlying pathophysiology of long COVID condition are still debated, there is growing evidence that autonomic dysfunction may play a role in long-term complications or persisting symptoms observed significant proportion patients after SARS-CoV-2 infection. However, studies focused on have primarily been conducted adults, while function has not yet investigated pediatric subjects. In this study, for first time, we assessed whether with present abnormalities cardiac function. Fifty-six (mean age 10.3 ± 3.8 y) and 27 age-, sex-, body surface area-matched healthy controls 10.4 4.5y) underwent standard 12-lead electrocardiography (ECG) 24-h ECG Holter monitoring. Autonomic was by time-domain frequency-domain heart rate variability parameters. A comprehensive echocardiographic study also obtained two-dimensional echocardiography tissue Doppler imaging. Data analysis showed had changes HRV variables compared to controls: significantly lower r-MSSD (root mean square successive RR interval differences, 47.4 16.9 versus 60.4 29.1, p = 0.02), higher values VLF (very low frequency, 2077.8 1023.3 494.3 1015.5 ms, 0.000), LF (low 1340.3 635.6 354.6 816.8 HF (high 895.7 575.8 278.9 616.7 0.000). No differences were between two groups both systolic diastolic parameters echocardiography. Conclusion: These findings suggest an imbalance toward relative predominance parasympathetic tone, as already reported adult COVID. Further needed clarify clinical significance demonstrate its pathophysiological mechanism COVID, paving way effective therapeutic preventive strategies. What Known: • Long Covid children described globally, but mostly collecting temporal evolution symptoms. New: Cardiac tone children, adults.

Language: Английский

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Post‑COVID syndrome in children compared with adults (Review)

World Academy of Sciences Journal, Journal Year: 2025, Volume and Issue: 7(2)

Published: Jan. 15, 2025

Post‑COVID‑19 syndrome (or long‑COVID) was recognized as a clinical entity early in the spring of 2020, when it documented that non‑negligible number patients with COVID‑19 continued to exhibit symptoms several weeks following severe acute respiratory coronavirus 2 (SARS‑CoV‑2) infection. Although beginning pandemic considered almost all SARS‑CoV‑2 infections children and adolescents were either asymptomatic or mildly symptomatic, duly noted may also experience prolonged therefore manifest post‑COVID syndrome. It subsequently involve multiple organs systems persist, majority cases, for months; however, some cases persisted even 1 year follow‑up. There is evidence indicate are at an increased risk developing anxiety, depression loss appetite, while overall impact on developmental psychological domain well‑being remains largely unknown. The present review discusses current state knowledge compares adults. Issues pathogenesis, prognosis, role vaccination implications future research discussed.

Language: Английский

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Association of COVID-19 with respiratory syncytial virus (RSV) infections in children aged 0–5 years in the USA in 2022: a multicentre retrospective cohort study

Family Medicine and Community Health, Journal Year: 2023, Volume and Issue: 11(4), P. e002456 - e002456

Published: Oct. 1, 2023

Objective To investigate whether COVID-19 infection was associated with increased risk for incident respiratory syncytial virus (RSV) infections and diseases among young children that might have contributed to the 2022 surge of severe paediatric RSV cases in USA. Design This is a retrospective population-based cohort study. Five outcomes were examined, including overall infection, positive lab test-confirmed clinically diagnosed diseases, RSV-associated bronchiolitis unspecified bronchiolitis. Risk ratio (RR) 95% CI occurred during 2021 seasons calculated by comparing propensity-score matched cohorts. Setting Nationwide multicentre database electronic health records (EHRs) 61.4 million patients USA 1.7 0–5 years age, which accessed through TriNetX Analytics provides web-based secure access patient EHR data from hospitals, primary care specialty treatment providers. Participants The study population consisted 228 940 no prior who had medical encounters October 2022. Findings replicated separate 370 919 July 2021–August non-overlapping time period. Results For (average age 2.4 years, 46.8% girls, 61% white, 16% black), – December 6.40% higher than 4.30% without (RR 1.40, 1.27 1.55); aged 0 1 year, 7.90% those 5.64% 1.21 1.62). 2.2 46% 57% 20% 4.85% 3.68% 1.32, 1.12 1.56); 7.30% year 4.98% 1.47, 1.18 1.82). Conclusion significantly Similar findings 2021. Our suggest large buildup COVID-19-infected potential long-term adverse effects on immune system.

Language: Английский

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Time trend and seasonality in medically attended respiratory syncytial virus (RSV) infections in US children aged 0–5 years, January 2010–January 2023

Family Medicine and Community Health, Journal Year: 2023, Volume and Issue: 11(4), P. e002453 - e002453

Published: Oct. 1, 2023

Objective The long-term time trend and seasonality variations of first-time medically attended respiratory syncytial virus (RSV) infections among young children are unknown. We aim to examine the RSV in USA from January 2010 through 2023. Design This is a population-based cohort study using electronic health records (EHRs). Monthly incidence rate infection (cases per 10 000 person-days). A time-series regression model was used predict trends seasonality. Setting Multicenter nationwide TriNetX Network USA. Participants population comprised aged 0–5 years who had medical visits during period Results data included 29 013 937 for 0 – 5 (46.5% girls 53.5% boys) From 2019, monthly followed consistent seasonal pattern. Seasonal patterns were significantly disrupted COVID-19 pandemic. In 2020, variation disappeared with peak 20 cases 1 person-days, decrease 97.4% expected (rate ratio or RR: 0.026, 95% CI 0.017 0.040). 2021, returned but started 4 months earlier, lasted 9 months, peaked August at 753 9.6% (RR: 0.90, 0.82 0.99). 2022, pattern similar prepandemic reached historically high 2182 person-days November, an increase 143% 2.43, 2.25 2.63). EHR-based those RSV-associated hospitalisations Centers Disease Control Prevention (CDC) survey-based surveillance system. Conclusion findings show pandemic surge paediatric that required attention 2022. Our demonstrates potential EHRs as cost-effective alternative real-time pathogen syndromic unexpected disease including infection.

Language: Английский

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Long COVID in Children, Adults, and Vulnerable Populations: A Comprehensive Overview for an Integrated Approach

Diseases, Journal Year: 2024, Volume and Issue: 12(5), P. 95 - 95

Published: May 6, 2024

Long COVID affects both children and adults, including subjects who experienced severe, mild, or even asymptomatic SARS-CoV-2 infection. We have provided a comprehensive overview of the incidence, clinical characteristics, risk factors, outcomes persistent COVID-19 symptoms in encompassing vulnerable populations, such as pregnant women oncological patients. Our objective is to emphasize critical significance adopting an integrated approach for early detection appropriate management long COVID. The incidence severity can significant impact on quality life patients course disease case pre-existing pathologies. Particularly, fragile patients, presence PASC related significantly worse survival, independent from vulnerabilities treatment. It important try achieve recognition management. Various mechanisms are implicated, resulting wide range presentations. Understanding specific factors involved crucial tailoring effective interventions support strategies. Management approaches involve biopsychosocial assessments treatment comorbidities, autonomic dysfunction, well multidisciplinary rehabilitation. overall one gradual improvement, with recovery observed majority, though not all, As research long-COVID continues evolve, ongoing studies likely shed more light intricate relationship between chronic diseases, status, cardiovascular psychiatric disorders, effects This information could guide healthcare providers, researchers, policymakers developing targeted interventions.

Language: Английский

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Lung perfusion assessment in children with long‐COVID: A pilot study

Pediatric Pulmonology, Journal Year: 2023, Volume and Issue: 58(7), P. 2059 - 2067

Published: April 25, 2023

Abstract Background There is increasing evidence that chronic endotheliopathy can play a role in patients with Post‐Covid Condition (PCC, or Long Covid) by affecting peripheral vascularization. This pilot study aimed at assessing lung perfusion children Long‐COVID 99m Tc‐MAA SPECT/CT. Materials and Methods SPECT/CT was performed pathological cardiopulmonary exercise testing (CPET). Intravenous injections were on the supine position immediately before planar scan according to EANM guidelines for scintigraphy children, followed acquisition. Reconstructed studies visually analyzed. Results Clinical biochemical data collected during acute infection follow‐up 14 (6 females, mean age: 12.6 years) fulfilling diagnostic criteria complaining of fatigue postexertional malaise after mild efforts, documented CPET. Imaging results compared clinical scenarios follow‐up. Six out (42.8%) showed defects scan, without morphological alterations coregistered CT. Conclusions investigation confirmed previous suggesting small subgroup develop severe respiratory syndrome coronavirus 2 infection. Larger cohort are needed confirm these preliminary results, providing also better understanding which may deserve this test how manage those defects.

Language: Английский

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