ABSTRACT
Background Available data on aerosol emisions in children and adolescents during spontaneous breathing are limited. Our aim was to gain insight into the role of children in the spread of SARS-CoV-2 and whether aerosol measurements in children can be used to help detect so-called superspreaders - infected individuals with extremely high numbers of exhaled aerosol particles. Methods In this prospective study, the aerosol concentration of SARS-CoV-2 PCR-positive and SARS-CoV-2 PCR-negative children and adolescents (2-17 years) was investigated. All subjects were asked about their current health status and medical history. The exhaled aerosol particle counts of PCR-negative and PCR-positive subjects were measured using the Resp-Aer-Meter (Palas GmbH, Karlsruhe, Germany) and compared using linear regresion. The study was registered in the German Register of Clinical Studies (DRKS), DRKS00028539. Results A total of 250 children and adolescents were included in the study, 105 of whom were SARS-CoV-2 positive and 145 of whom were SARS-CoV-2 negative. The median age acros both groups was nine years (IQR 7-11). A total of 124 (49.6%) participants were female, and 126 (50.4%) participants were male. A total of 81.9% of the SARS-CoV-2-positive group had symptoms of viral infection. The median particle count of all individuals was 79.55 p/l (IQR 44.55-141.15). There was a tendency for older children to exhale more particles (1-5 years: 79.54 p/l;6-11 years: 77.96 p/l;12-17 years: 98.63 p/l). SARS-CoV-2 PCR status was not a bivariate predictor (t=.82, p=.415) for the exhaled aerosol particle count;however, the SARS-CoV-2 status was shown to be a significant predictor in a multiple regresion model together with age, body mas index (BMI), covid vaccination, and past SARS-CoV-2 infection (t=.2.81 p=.005). Covid vaccination status was a highly significant predictor of exhaled aerosol particles (p <.001).Conclusion During SARS-CoV-2 infection, children and adolescents do not have elevated aerosol levels. In addition, no superspreaders were found. Children and adolescents are not the main driver of the SARS-CoV-2 pandemic. .
ABSTRACT
The German Society of Pneumology initiated 2021 the AWMF S1 guideline Long COVID/Post-COVID. In a broad interdisciplinary approach, this S1 guideline was designed based on the current state of knowledge.The clinical recommendations describe current Long COVID/Post-COVID symptoms, diagnostic approaches, and therapies.In addition to the general and consensus introduction, a subject-specific approach was taken to summarize the current state of knowledge.The guideline has an explicit practical claim and will be developed and adapted by the author team based on the current increase in knowledge.
Subject(s)
COVID-19 , Post-Acute COVID-19 Syndrome , HumansABSTRACT
Objectives: The aim of this ongoing longitudinal study is to examine the effects of elexacaftor/tezacaftor/ivacaftor (ELX/TEZ/IVA) on aspects of physical fitness (PF, strength endurance, explosive power, coordination under time pressure, coordination for the precision aspect, trunk flexibility, peak workload, habitual physical activity (HPA, steps/day, intensity), and zscores of FEV1 and BMI in children with cystic fibrosis (CF)). All children have been receiving ELX/TEZ/IVA for 19.2 ± 10.4 (11–33) months. Methods: Six children with CF agreed to participate (3f/3 m) mean age 13 ± 4yrs (9–17 yrs), FEV1 z-score − 1.017 ± 1.817 (-3.2–0.8). PFwas assessed using 5 test items at baseline and 4.51 ± 0.98 years later;strength endurance (PU push-ups, SU sit-ups), explosive power (SLJ standing long jump), coordination under time pressure (JSS jumping side to side), coordination for the precision aspect (BB balancing backward on beams), and trunk flexibility (FB, forward bend). Cycle-ergometry (Godfrey-protocol) was used to determine Wpeak. Lung function was measured by spirometry. Results: Significant improvements were seen in test items representing strength endurance (PU, SU) and coordination under time pressure (JSS) (p < .05). Although HPA expressed as steps/day remained the same, thetime of moderate to vigorous intensity of HPA decreases significantly (p < .05). A slight, not significant, improvement of BMI Z-score was observed (p > .05). No or small changes could be observed for the parameter FEV1 z-score, Wpeak, PF, SLJ, BB and FB (p > 0.05). Conclusion: ELX/TEZ/IVA therapy seems to be a facilitator to increase some aspects of PF. The decrease in intensity of HPA is possibly an effect of the COVID-19 Pandemic that has already been described in healthy and asthmatic children. In this ongoing study, we assume that clearer effects will be shown with a greater number of children included. However, ELX/ TEZ/IVA enhanced muscle strength endurance in children with CF.
ABSTRACT
The current state of knowledge points to the COVID-19 pandemic as likely having fewer fatal somatic consequences than expected. However, the repercussions for the mental health of children and adolescents are alarmingly on the rise. These findings are even more alerting because they affect a system that was already heavily burdened before the pandemic. Moreover, efforts must be targeted on the as yet unclear consequences for the overall psychological, social, and emotional development of these age groups, since, for example, common learning spaces with peers were lacking over long periods or were accessible only to a limited extent. Regarding children and adolescents themselves, the immediate reference system of parents and family is also relevant for identifying potential protective and risk factors. Overall, both the studies included in this current special issue as well as further studies point to the necessity to expand prevention and early intervention, and to improve access to the healthcare system for affected children, adolescents, and families.