Mild SARS-CoV-2 Infections and Neutralizing Antibody Titers

PURPOSE OF THE STUDY: To examine the production and persistence of neutralizing antibodies against SARS-CoV-2 in a cohort of family clusters with history of coronavirus disease 2019 (COVID-19). STUDY POPULATION: The study enrolled 57 Italian families over a 6-month period (March 1–September 4, 2020) who met the inclusion criteria, which required that the families had a child or children of pediatric age (<15 years old) and had at least 1 immediate family member with a history of COVID-19. METHODS: Families were enrolled 4 to 8 weeks after the end of isolation or hospitalization. They underwent clinical evaluation, and blood samples were collected from confirmed COVID-19 cases. Confirmed cases were defined as having a history of positive polymerase chain reaction (PCR) testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) or having a positive serologic test (chemiluminescence immunoassay or plaque reduction neutralizing test). Data regarding the date of infection, severity of illness, and age at the time of illness were retrospectively collected. RESULTS: During this study, 57 family clusters were evaluated. Of these, 209 recruited subjects underwent serological assessment. In total, 152 confirmed COVID-19 cases were identified, with 70 children or older siblings and 82 parents making up these confirmed cases. The median age for the group of children and older siblings was 8 years old, and the median age for the parent cohort was 42 years old. Neutralizing antibodies persisted up to 7 to 8 months from infection with only a modest decline over time. Neutralizing antibodies inversely correlated with age with children <6 years old (particularly toddlers <3 years old) showing the highest levels. Mildly affected children (<6 years old) showed increasing levels of neutralizing antibodies over the study time (236 days from time of infection). CONCLUSIONS: This study provides a longitudinal evaluation of neutralizing antibody production and duration in asymptomatic and mildly symptomatic patients from familial clusters. Of the participants in this study, younger children developed higher levels of neutralizing antibody compared with older siblings or adults.

Social media and its impact on health care.

OBJECTIVE: Social media has fundamentally changed how the world shares and receives information. This review offers a perspective for the practicing clinician regarding how patients are being influenced by their online interactions and considerations for proactively discussing medical decision making with patients. DATA SOURCES: Literature search of PubMed database and online published market research data surrounding social media use. STUDY SELECTIONS: Peer-reviewed studies, Pew research data, and editorials in the English language were selected and reviewed. RESULTS: There has been a substantial increase in the breadth and depth of literature surrounding the use of social media by patients and medical professionals. Increased focus on how it contributes to medical decision making and patient-clinician interactions has occurred in recent years. The coronavirus disease 2019 pandemic has highlighted the various sources of misinformation and disinformation and how they impact care on many levels. Best practices have been established to assist medical professionals in developing an online presence to combat misinformation or address individual patients. CONCLUSION: There is growing understanding and recognition of the myriad of ways in which social media is impacting health care. Health care professionals from all backgrounds need to increase their understanding of these complex interactions to best assist patients with their medical decision making.

Managing Food Allergy in Schools During the COVID-19 Pandemic.

In the wake of the COVID-19 pandemic and massive disruptions to daily life in the spring of 2020, in May 2020, the Centers for Disease Control (CDC) released guidance recommendations for schools regarding how to have students attend while adhering to principles of how to reduce the risk of contracting SARS-CoV-2. As part of physical distancing measures, the CDC is recommending that schools who traditionally have had students eat in a cafeteria or common large space instead have children eat their lunch or other meals in the classroom at already physically distanced desks. This has sparked concern for the safety of food-allergic children attending school, and some question of how the new CDC recommendations can coexist with recommendations in the 2013 CDC Voluntary Guidelines on Managing Food Allergy in Schools as well as accommodations that students may be afforded through disability law that may have previously prohibited eating in the classroom. This expert consensus explores the issues related to evidence-based management of food allergy at school, the issues of managing the health of children attending school that are acutely posed by the constraints of an infectious pandemic, and how to harmonize these needs so that all children can attend school with minimal risk from both an infectious and allergic standpoint.