ABSTRACT
Background: The aim of this study was to describe the prevalence of persistent symptoms of COVID in hospitalized pediatric population one year after admission compared to a control group. Method(s): Prospective observational study conducted in 2 hospitals. We included patients aged 0-18 years hospitalized for acute COVID-19 more than a year ago and controls, matched by age and sex, hospitalized for causes other than COVID-19, and who had never COVID-19 at recruitment or during the follow-up. Families were contacted and a standardized survey was conducted. Persistent COVID/disease was defined as the presence of symptoms with onset in the first 3 months after COVID-19 and with persistence for more than 2 months. Result(s): 50 cases and 46 controls were analyzed, 58.3% male, 36% <5 years. Families were interviewed a median of 1.89 years (interquartile range;1.25-2.07) after hospitalization. The definition of persistent COVID-19/disease was met in 34% of cases vs. 37% of controls (p=0.767). Symptoms persisted >=11 months in 24% (12/50) of cases vs. 13% (6/46) of controls (p=0.182), with no differences by age group. The most frequent symptoms at 1 year in cases were fatigue (8%), headache (6%), poor appetite (6%), abdominal pain (6%) and variations in heart rate (6%). In controls, persistent symptoms were mostly abdominal pain (6%) and poor appetite (6%). The number of readmissions was 11/50 (22%) and 6/46 (13%) (p=0.267), respectively. On emotional/behavioral items, 16/50 (32%) of cases reported that their emotional state was worse or much worse than before admission, compared to 16/46 (34.7%). No risk factors associated with the development of persistent symptoms were found, except the length of hospital admission (p=0.043). Conclusion(s): In this study, the prevalence of persistent symptoms was not different in patients with and without COVID-19. 1-year persistence was higher in COVID-19 cases but did not reach significance. Persistence correlated with length of hospitalization.
ABSTRACT
Background: SARS-CoV2 infection severity during pregnancy and posible consequences for exposed newborns information is still unknown. The objective of this study is to analyse clinical and epidemiological characteristics of a SARS-CoV2 infected women during pregnancy and their newborns cohort. Methods: Multicentric observational study from the Spanish GENEO-COVID cohort (participating in RECLIP). Infected pregnant women and their newborns born from 15 March to 31 July with a 15 days follow up were included. Data regarding epidemiological, clinical, virological and immunological characteristics of the patients was collected. Results: Globally, 105 pregnant women with a median age of 34 (IQR: 29-37) years old and 107 newborns were included in the study. Median gestational age at diagnosis was 36.9 (IQR-33.4-39.2) weeks, and 6.7% os women were diagnosed in the second trimester. More than 34% of the women presented at least one comorbidity and almost 65% of women had COVID19 symptoms and 43% of them were treated for the infection. Overall, 30.8% had COVID-19 pneumonia and 4.8% were admitted to the intensive care unit (ICU) needing invasive mechanical ventilation. The rate of positive RT-PCR at delivery was 61.9%. There was a 36.2% rate of caesarean sections, associated with pneumonia during pregnancy OR:4.2 (95% CI 1.5,12.0) and lower gestational age at delivery OR:0.7 (95% CI: 0.6,0.9). Regarding newborns, 46.7% were male, 66.4% breastfed, with median Apgar 1' of 9 and Apgar 5' of 10. Almost 6% were small for gestational age and 16.8% needed admission to the neonatal ICU. Oxygen was needed by 12.1% and surfactant by 5.6% newborns. Prematurity rate was 20.6%, associated with pneumonia during gestation OR:7.0 (95% CI: 2.3,22.8) and with a positive RT-PCR at delivery OR:6.5 (95% CI: 1.8,31.8). No associations were found with age, comorbidities or blood group. No vertical transmission was reported but one newborn was horizontally infected. Two newborns died, one due to prematurity causes and another of unexpected sudden death during early skin-to-skin contact after delivery. Conclusion: Even there is no vertical transmission reported in this cohort, we found a case of horizontal transmission. SARS-CoV2 infection could produce COVID19 pneumonia during pregnancy, that increases caesarean sections and prematurity rates worsening exposed newborns prognosis. (Figure Presented).