ABSTRACT
INTRODUCTION: The SARS-CoV-2 pandemic remains a threat to public health. Soon after its outbreak, it became apparent that children are less severely affected. Indeed, opposing clinical manifestations between children and adults are observed for other infections. The SARS-CoV-2 outbreak provides the unique opportunity to study the underlying mechanisms. This protocol describes the methods of an observational study that aims to characterise age dependent differences in immune responses to primary respiratory infections using SARS-CoV-2 as a model virus and to assess age differences in clinical outcomes including lung function. METHODS AND ANALYSIS: The study aims to recruit at least 120 children and 60 adults that are infected with SARS-CoV-2 and collect specimen for a multiomics analysis, including single cell RNA sequencing of nasal epithelial cells and peripheral blood mononuclear cells, mass cytometry of whole blood samples and nasal cells, mass spectrometry-based serum and plasma proteomics, nasal epithelial cultures with functional in vitro analyses, SARS-CoV-2 antibody testing, sequencing of the viral genome and lung function testing. Data obtained from this multiomics approach are correlated with medical history and clinical data. Recruitment started in October 2020 and is ongoing. ETHICS AND DISSEMINATION: The study was reviewed and approved by the Ethics Committee of Charité - Universitätsmedizin Berlin (EA2/066/20). All collected specimens are stored in the central biobank of Charité - Universitätsmedizin Berlin and are made available to all participating researchers and on request. TRIAL REGISTRATION NUMBER: DRKS00025715, pre-results publication.
Subject(s)
COVID-19 , Adult , Child , Humans , SARS-CoV-2 , Leukocytes, Mononuclear , Specimen Handling , Nose , Observational Studies as TopicABSTRACT
This current consensus paper for long COVID complements the existing AWMF S1 guidelines for long COVID with a detailed overview on the various clinical aspects of long COVID in children and adolescents. Members of 19 different pediatric societies of the DGKJ convent and collaborating societies together provide expert-based recommendations for the clinical management of long COVID based on the currently available but limited academic evidence for long COVID in children and adolescents. It contains screening questions for long COVID and suggestions for a structured, standardized pediatric medical history and diagnostic evaluation for patients with suspected long COVID. A time and resource-saving questionnaire, which takes the clinical complexity of long COVID into account, is offered via the DGKJ and DGPI websites as well as additional questionnaires suggested for an advanced screening of specific neurocognitive and/or psychiatric symptoms including post-exertional malaise (PEM) and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). According to the individual medical history as well as clinical signs and symptoms a step by step diagnostic procedure and a multidisciplinary therapeutic approach are recommended.
ABSTRACT
Das vorliegende Konsensuspapier bietet in Ergänzung zur AWMF-S1-Leitlinie eine Übersicht über die verschiedenen klinischen Aspekte von Long COVID im Kindes- und Jugendalter. Es wurde von Vertreter:innen aus 19 Fachgesellschaften des DGKJ-Konvents und kooperierenden Fachgesellschaften erstellt und bietet Expertenempfehlungen für die Praxis auf Grundlage der bisherigen, noch geringen studienbasierten Evidenz zu Long COVID im Kindes- und Jugendalter. Es enthält Screeningfragen zu Long COVID sowie einen Vorschlag zur strukturierten, standardisierten pädiatrischen Anamnese und zur diagnostischen Evaluation bei V. a. Long COVID. Dazu werden ein zeit- und ressourcensparender Erfassungsbogen, der die Komplexität des Krankheitsbildes berücksichtigt, über die Internetseiten der DGKJ und DGPI zur Verfügung gestellt und weitere Fragebögen zur Abklärung von spezifischen neurokognitiven und/oder psychischen Störungen sowie post-exertioneller Malaise (PEM) und myalgischer Enzephalomyelitis/chronischem Fatigue-Syndrom (ME/CFS) benannt. Anhand der jeweiligen anamnestisch und klinisch ermittelten Hauptsymptome werden ein gestuftes, diagnostisches Vorgehen und eine multidisziplinäre Betreuung empfohlen. Zusatzmaterial online Die Online-Version dieses Beitrags (10.1007/s00112-021-01408-1) enthält weitere Tabellen mit Angaben zur erweiterten Diagnostik (Labor- und Funktionsdiagnostik, Bildgebung).
ABSTRACT
OBJECTIVE: COVID-19 patients may present mild symptoms. The identification of paucisymptomatic patients is paramount in order to interrupt the transmission chain of the virus. Olfactory loss could be one of those early symptoms which might help in the diagnosis of COVID-19 patients. In this study, we aim to develop and validate a fast, inexpensive, reliable and easy-to-perform olfactory test for the screening of suspected COVID-19 patients. STUDY DESIGN: Phase I was a case-control study and Phase II a transversal descriptive study. SUBJECTS AND METHODS: Olfaction was assessed with the ethyl alcohol threshold test and symptoms with visual analogue scales. The study was designed in two phases: In Phase I, we compared confirmed COVID-19 patients and healthy controls. In Phase II, patients with suspected COVID-19 infection referred for testing were studied. RESULTS: 275 participants were included in Phase I, 135 in Phase II. The ROC curve showed an AUC of 0.749 in Phase I, 0.737 in Phase II. The cutoff value which offered the highest amount of correctly classified patients was ≥ 2 (10% alcohol) for all age intervals. The odds ratio was 8.19 in Phase I, 6.56 in Phase II with a 75% sensitivity. When cases report normal sense of smell (VAS < 4), it misdiagnoses 57.89% of patients detected by the alcohol threshold test. CONCLUSION: The olfactory loss assessed with the alcohol threshold test has shown high sensitivity and odds ratio in both patients with confirmed COVID-19 illness and participants with suspected SARS-CoV-2 infection.