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1.
J Pediatr ; 2022 Aug 09.
Article in English | MEDLINE | ID: covidwho-1977556

ABSTRACT

The objective of this single-center cohort study was to characterize frequency, clinical characteristics, and molecular epidemiology of pediatric SARS-CoV-2 infection after vaccination. Between 5/15/2021 and 1/1/2022, 171 children experienced SARS-CoV-2 infection post-vaccination, 146 (86%) following Omicron variant predominance. Outcomes were generally mild and comparable before and after Omicron predominance.

2.
J Pediatric Infect Dis Soc ; 2022 Aug 04.
Article in English | MEDLINE | ID: covidwho-1973207

ABSTRACT

BACKGROUND: Recent COVID-19 surges are attributed to emergence of more transmissible SARS-CoV-2 variants of concern (VOCs). The relative severity of VOCs in children is unknown. METHODS: We performed a single-center retrospective cohort study of children ≤18 years old diagnosed with COVID-19 from October 2020-February 2022 and whose SARS-CoV-2 isolate underwent Illumina sequencing. We measured the frequency of five markers of COVID-19 severity. Logistic regression models were fitted to estimate the odds of each severity marker with each VOC. RESULTS: Among 714 children, 471 (66.0%) were infected with a VOC: 96 (13.4%) alpha, 38 (5.3%) gamma, 119 (16.7%) delta, and 215 (30.1%) omicron. High-risk medical conditions and increasing age were independently associated with COVID-19 severity. After adjusting for age, race, ethnicity, high-risk medical conditions, and COVID-19 community incidence, neither alpha, delta, nor omicron was associated with severe COVID-19. Gamma was independently associated with hospitalization (OR 6.7, 95% CI 2.0-22.1); pharmacologic treatment (OR 5.7, 95% CI 1.2-26.8); respiratory support (OR 11.9, 95% CI 2.7-62.4); and severe disease per the WHO Clinical Progression Scale (OR 11.7, 95% CI 2.1-90.5). Upon subgroup analyses, omicron was independently associated with ICU admission and severe disease per the WHO Clinical Progression Scale in children without SARS-CoV-2 immunization or prior COVID-19 infection. CONCLUSIONS: Compared to non-VOC COVID-19, the gamma VOC was independently associated with increased COVID-19 severity, as was omicron in children without SARS-CoV-2 immunization or prior COVID-19 infection. SARS-CoV-2 vaccination and prior COVID-19 prevented severe outcomes during the omicron surge.

3.
Infect Control Hosp Epidemiol ; : 1-5, 2021 Oct 01.
Article in English | MEDLINE | ID: covidwho-1447267

ABSTRACT

OBJECTIVE: To identify the impact of universal masking on COVID-19 incidence and putative SARS-CoV-2 transmissions events among children's hospital healthcare workers (HCWs). DESIGN: Quasi-experimental study. SETTING: Single academic free-standing children's hospital. METHODS: We performed whole-genome sequencing of SARS-CoV-2- PCR-positive samples collected from HCWs 3 weeks before and 6 weeks after implementing a universal masking policy. Phylogenetic analyses were performed to identify clusters of clonally related SARS-CoV-2 indicative of putative transmission events. We measured COVID-19 incidence, SARS-CoV-2 test positivity rates, and frequency of putative transmission events before and after the masking policy was implemented. RESULTS: HCW COVID-19 incidence and test positivity declined from 14.3 to 4.3 cases per week, and from 18.4% to 9.0%, respectively. Putative transmission events were only identified prior to universal masking. CONCLUSIONS: A universal masking policy was associated with reductions in HCW COVID-19 infections and occupational acquisition of SARS-CoV-2.

5.
J Cardiovasc Magn Reson ; 23(1): 86, 2021 07 01.
Article in English | MEDLINE | ID: covidwho-1292072

ABSTRACT

BACKGROUND: Cardiac evaluations, including cardiovascular magnetic resonance (CMR) imaging and biomarker results, are needed in children during mid-term recovery after infection with SARS-CoV-2. The incidence of CMR abnormalities 1-3 months after recovery is over 50% in older adults and has ranged between 1 and 15% in college athletes. Abnormal cardiac biomarkers are common in adults, even during recovery. METHODS: We performed CMR imaging in a prospectively-recruited pediatric cohort recovered from COVID-19 and multisystem inflammatory syndrome in children (MIS-C). We obtained CMR data and serum biomarkers. We compared these results to age-matched control patients, imaged prior to the SARS-CoV-2 pandemic. RESULTS: CMR was performed in 17 children (13.9 years, all ≤ 18 years) and 29 age-matched control patients without SARS-CoV-2 infection. Cases were recruited with symptomatic COVID-19 (11/17, 65%) or MIS-C (6/17, 35%) and studied an average of 2 months after diagnosis. All COVID-19 patients had been symptomatic with fever (73%), vomiting/diarrhea (64%), or breathing difficulty (55%) during infection. Left ventricular and right ventricular ejection fractions were indistinguishable between cases and controls (p = 0.66 and 0.70, respectively). Mean native global T1, global T2 values and segmental T2 maximum values were also not statistically different from control patients (p ≥ 0.06 for each). NT-proBNP and troponin levels were normal in all children. CONCLUSIONS: Children prospectively recruited following SARS-CoV-2 infection had normal CMR and cardiac biomarker evaluations during mid-term recovery. Trial Registration Not applicable.


Subject(s)
COVID-19/complications , Heart/diagnostic imaging , Heart/physiology , Magnetic Resonance Imaging/methods , Systemic Inflammatory Response Syndrome/complications , Adolescent , Biomarkers/blood , COVID-19/blood , Child , Female , Humans , Male , Prospective Studies , SARS-CoV-2 , Systemic Inflammatory Response Syndrome/blood
7.
J Pediatric Infect Dis Soc ; 9(5): 617-619, 2020 Nov 10.
Article in English | MEDLINE | ID: covidwho-919281

ABSTRACT

Asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) carriage among hospitalized children and risk of transmission to healthcare workers (HCWs) was evaluated by point prevalence survey. We estimated 1-2% prevalence of SARS-CoV-2 among children without coronavirus disease 2019 symptoms. There was no secondary transmission among HCWs exposed to these patients.


Subject(s)
Asymptomatic Infections/epidemiology , Betacoronavirus/isolation & purification , Coronavirus Infections/epidemiology , Infectious Disease Transmission, Patient-to-Professional/statistics & numerical data , Personnel, Hospital , Pneumonia, Viral/epidemiology , COVID-19 , Child , Child, Hospitalized , Child, Preschool , Coronavirus Infections/transmission , Female , Hospitals, Pediatric , Humans , Infant , Length of Stay , Male , Pandemics , Pneumonia, Viral/transmission , Prevalence , SARS-CoV-2
8.
J Pediatr ; 228: 294-296, 2021 01.
Article in English | MEDLINE | ID: covidwho-845393

ABSTRACT

We present 4 pediatric patients with trisomy 21 (T21) and associated comorbidities who developed coronavirus disease 2019 requiring hospitalization. A review of the literature revealed that comorbidities associated with T21 may predispose patients to severe disease. Children with T21 should be considered high risk and monitored carefully if infected with severe acute respiratory syndrome coronavirus 2.


Subject(s)
COVID-19/complications , COVID-19/epidemiology , Comorbidity , Disease Susceptibility , Down Syndrome/complications , Down Syndrome/epidemiology , Adolescent , Hospitalization , Humans , Infant , Male , Risk Factors , SARS-CoV-2
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