Thyroid stimulating hormone levels in children before and during the coronavirus disease‐19 pandemic

Coronavirus disease-2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may have a direct effect on several endocrine glands, including the thyroid. 1 SARS-CoV-2 enters cells using the angiotensin-converting enzyme-2 (ACE-2) receptor, expressed by the thyroid. 2 Prior literature reported low levels of triiodothyronine (TT3) and thyroid stimulating hormone (TSH) in adult patients with COVID-19. 3 However, levels of TSH in children during the pandemic are unknown. Wang et al., evaluated thyroid function in 96 hospitalized adults with COVID-19 3;levels of TSH were significantly lower than those of healthy controls. 3 Levels of TSH increased gradually within 2 months after hospitalization. 3 Similarly, Chen et al. reported TSH levels lower than the normal range in 28 of 50 (56%) adult patients with COVID-19. 5 It is unknown what caused the observed pattern and/or how significant it was. TSH levels may also differ according to ethnicity and race;discrepancies may exist between Asian, White, Black, and Hispanics. [...]this finding may only reflect one specific community representation, and may not apply to non-White children.

Factors impacting vaccine hesitancy toward Coronavirus disease-19 (COVID-19) vaccination in Brooklyn, New York.

The Coronavirus disease-2019 (COVID-19) pandemic led to the development of several candidate vaccines. However, current research suggests that the potential of successful vaccines is tempered by vaccine skepticism or hesitancy. If vaccine efficacy is 80%, then the herd immunity required from vaccination is about 75-90%. The aim of the current study was to study factors impacting COVID-19 vaccine hesitancy in a representative sample of adults (age≥18 years) in a COVID-19 hotspotAbbreviations: COVID-19: coronavirus disease-19.

Severe Acute Respiratory Syndrome Coronavirus 2 Clinical Syndromes and Predictors of Disease Severity in Hospitalized Children and Youth.

OBJECTIVE: To characterize the demographic and clinical features of pediatric severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) syndromes and identify admission variables predictive of disease severity. STUDY DESIGN: We conducted a multicenter, retrospective, and prospective study of pediatric patients hospitalized with acute SARS-CoV-2 infections and multisystem inflammatory syndrome in children (MIS-C) at 8 sites in New York, New Jersey, and Connecticut. RESULTS: We identified 281 hospitalized patients with SARS-CoV-2 infections and divided them into 3 groups based on clinical features. Overall, 143 (51%) had respiratory disease, 69 (25%) had MIS-C, and 69 (25%) had other manifestations including gastrointestinal illness or fever. Patients with MIS-C were more likely to identify as non-Hispanic black compared with patients with respiratory disease (35% vs 18%, P = .02). Seven patients (2%) died and 114 (41%) were admitted to the intensive care unit. In multivariable analyses, obesity (OR 3.39, 95% CI 1.26-9.10, P = .02) and hypoxia on admission (OR 4.01; 95% CI 1.14-14.15; P = .03) were predictive of severe respiratory disease. Lower absolute lymphocyte count (OR 8.33 per unit decrease in 109 cells/L, 95% CI 2.32-33.33, P = .001) and greater C-reactive protein (OR 1.06 per unit increase in mg/dL, 95% CI 1.01-1.12, P = .017) were predictive of severe MIS-C. Race/ethnicity or socioeconomic status were not predictive of disease severity. CONCLUSIONS: We identified variables at the time of hospitalization that may help predict the development of severe SARS-CoV-2 disease manifestations in children and youth. These variables may have implications for future prognostic tools that inform hospital admission and clinical management.