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Telma Lery Janssen EMEA therapeutic area lead for infectious diseases and vaccines at Johnson & Johnson, explains that the company's COVID-19 vaccine candidate (also known as Ad26.COV2.S, Ad26COVS1, VAC31518, JNJ-78436735, or Ad26-S.PP) is a monovalent, recombinant, inactivated/non-infective adenovirus vector (similar to a cold virus), which contains a transgene that codes for the coronavirus spike (S) protein. The vaccine technology, AdVac, is based on the development and production of adenovirus vectors (gene carriers). Adenovirus vectors (gene carriers) are genetically altered forms of an adenovirus and lack the DNA needed to replicate. Some of the main differences between a COVID-19 oral tablet vaccine from injectable COVID-19 vaccines, according to Tucker, include: * Immune responses are triggered in the mucosa and the serum with a COVID-19 oral tablet vaccine (based on preclinical and clinical testing), unlike the existing vaccines that are serum-only. * Ease of distribution and vaccination with a COVID-19 oral tablet vaccine, which eliminates the need for special accommodations to transport injectable vaccines that require cold chain infrastructure as well as the need for trained professionals to administer vaccines.
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"5 However, more recent findings, such as the presentation of joint swelling without EM in Black children, are the result of research efforts to identify differences among racial and ethnic groups in presentations of disease symptoms, with the aim of greater diagnostic accuracy and reduced health care disparities.4 Treatment of Lyme disease Although most resources, such as the CDC's website,1 published articles and sites,2,3 and the Red Book,5 recommend that pediatric, adolescent, and young adult patients with Lyme disease receive an antibiotic, such as doxycycline, amoxicillin, or cefuroxime (for penicillin-allergic patients), these publications differ in recommended dosage and duration of treatment. [...]PHCPs who are unfamiliar with antibiotic treatments for Lyme disease should consult with infectious disease specialists. Children who have evidence of Lyme carditis, Lyme arthritis, cranial neuritis, Lyme meningitis, or radiculoneuritis should immediately be referred to infectious disease and the appropriate pediatric specialists.2 Respiratory infections and health care inequities Although researchers have reported studies on racial and ethnic inequities among children related to respiratory diseases over the last 20 years, few randomized controlled trials have scientifically investigated the problem or have identified and rigorously investigated evidencebased interventions. The COVID-19 pandemic brought a new focus in pediatric health care on the inequities experienced by Black, Hispanic, American Indian or Alaska Native, and Pacific Islander children living in poverty, who regularly experience a disproportionate number of respirator y illnesses and infections.6 Several studies have shown increased hospitalization rates for Blac k and H ispan ic children who contracted COVID-19.6 One team of researchers studying children from birth to 4 years old reported a hospitalization rate of 55% for Black and Hispanic children.7 For years, PHCPs have observed and treated children for asthma in all health care settings. Bhavnani et al reported that Black children had a 7-fold higher rate of emergency department visits compared with White children in 2019, 1 year before the pandemic began.8 However, the difference decreased to a 2-fold increase for Black children compared with White children in 2020, when COVID-19 measures such as masking, social distancing, and school closures were in place.8 Researchers are continuing to investigate why Black and Hispanic children are more vulnerable to upper respiratory infections with viruses such as influenza, rhinovirus, and adenovirus.8 Summertime prevention of respiratory infections Talking about prevention strategies with families is the first step toward reducing asthma episodes and exacerbations.
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Objective To analyze the composition and epidemiological characteristics of respiratory pathogens in hospitalized patients with respiratory tract infections in Huairou district before and after the outbreak of corona virus disease 2019（COVID-19）. Methods Respiratory specimens were collected from hospitalized patients who met the case definition in Huairou district during the period of January 2018 and December 2021. The samples were tested for influenza virus, respiratory syncytial virus, adenovirus, parainfluenza virus, metapneumovirus, coronavirus, rhinovirus, bocavirus, enterovirus, mycoplasma pneumoniae, chlamydophila pneumoniae and other respiratory pathogens by using ABI 7500 real-time fluorescent quantitative PCR assay. Results From January 2018 to December 2021, a total of 1 148 samples were tested and the overall positive rate was 24. 65%（283cases）. The positive detection rate after the outbreak of COVID-19 in 2020-2021（79/522） was significantly lower than that before the outbreak of COVID-19 in 2018-2019（204/626）（15. 13% vs 32. 59%, χ~2=46. 683, P＜0. 01）. The positive rates in children aged 0-＜2 years and 2-＜5 years after the outbreak of COVID-19were 46. 15% and 45. 45% respectively, were significantly higher than those in other age groups （χ~2=73. 053,P＜0. 01）. Mycoplasma pneumoniae（12. 75%）, enterovirus（10. 29%） and adenovirus（10. 29%） were the top three pathogens before the outbreak, while, after the outbreak, the top three pathogens were syncytial virus（21. 52%）, parainfluenza（17. 72%） and rhinovirus（17. 72%）. In Huairou district, the detection rate of respiratory pathogens peaked in winter, there was also a small peak in summer. Conclusion After the outbreak of COVID-19, children under 5 years old are still the main population for respiratory infection control. The change of pathogen spectrum before and after the outbreak of covid-19 is helpful for clinician to recognize and diagnose the disease.
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As of 8 July 2022, the World Health Organization (WHO) have reported 1010 probable cases of acute hepatitis of unknown aetiology in children worldwide, including approximately 250 cases in the United Kingdom (UK). Clinical presentations have often been severe, with liver transplantation a frequent clinical outcome. Human adenovirus F41 (HAdV-F41) has been detected in most children with acute hepatitis, but its role in the pathogenesis of this infection has yet to be established. Wastewater-based epidemiology (WBE) has become a well-established tool for monitoring the community spread of SARS-CoV-2, as well as other pathogens and chemicals. In this study, we adopted a WBE approach to monitoring levels of HAdV-F40/41 in wastewater before and during an acute hepatitis outbreak in Northern Ireland. We report increasing detection of HAdV-F40/41 in wastewater, concomitant with increasing numbers of clinical cases. Amplicon whole genome sequencing further classified the wastewater-derived HAdV as belonging to the F41 genotype which in turn was homologous to clinically derived sequences. We propose that WBE has the potential to inform community surveillance of HAdV-F41 and can further contribute to the ongoing global discussion supporting HAdV-F41 involvement in acute hepatitis cases. © 2022 The Authors
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Lazăr Mihaela1 iCantacuzino National Military Medical Institute for Research and Development, Bucharest, Romania 2Carol Davila University of Medicine and Pharmacy, Bucharest, Romania Objectives: Upper respiratory infections are among the most common diseases. 4 type B. respiratory syncytial virus (RSV) were identified in 71 samples. enterovirus in 2 samples and parainfluenza type 1. adenovirus and rhinovirus were detected in 1 sample each. 428 samples of necroptic fragments tested positive for SARS-CoV-2. Real-time PCR assays allow the identification of multiple pathogens in a single reaction to detect the types of viruses that cause viral respiratory infections. identifying new strains/variants that play a key role in triggering outbreaks.
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La literatura más reciente indica que la enfermedad renal crónica constituye la comorbilidad con mayor riesgo de desarrollar enfermedad grave por SARS-CoV-2, coronavirus 2019 (COVID-19). Muchas sociedades científicas se han posicionado a favor de la vacunación de los pacientes con enfermedad renal crónica como prioritaria, debido a esta alta vulnerabilidad. En España, la quinta actualización de la Estrategia de vacunación frente a COVID-19 del Consejo Interterritorial de Salud, incluyó a los pacientes con ERC dentro del grupo 7 (personas con condiciones de muy alto riesgo). A lo largo del artículo se describen los tipos de vacunas según mecanismo de acción, las vacunas actualmente aprobadas por la Agencia Europea del Medicamento (EMA) y todo lo relacionado con el proceso de vacunación (preparación, administración y seguimiento), además de los aspectos a tener en cuenta en los pacientes con enfermedad renal crónica.Alternate : The most recent evidence indicates that chronic kidney disease is the comorbidity with the highest risk of developing severe disease due to SARS-CoV-2, coronavirus 2019 (COVID-19). Many scientific societies have advocated for vaccination of patients with chronic kidney disease as a priority, due to this high vulnerability. In Spain, the fifth update of the COVID-19 vaccination strategy published by the Interterritorial Health Council included CKD patients in group 7 (people with very high-risk conditions). This manuscript describes the types of vaccines according to mechanism of action, the vaccines currently approved by the European Medicines Agency (EMA) and information related to the vaccination process (preparation, administration and follow-up), as well as aspects to be taken into account in patients with CKD.
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What can we expect from mRNA vaccines going forward? A brief history of mRNA vaccines Experiments showing that mRNA could be introduced into cells to generate an immune response against the encoded protein date to the 1990s, although technical challenges including the biological instability of mRNA and the induction of undesirable inflammatory responses by unmodified nucleic acid hampered development of this technology into clinical application.3,4 Advances including chemical modifications to the nucleo-side constituents of the mRNA polymer and the use of a lipid outer coating for delivery of the mRNA formed the basis for this technology to enter human studies.5,6 These changes led to increased production of the target protein after inoculation with fewer inflammatory adverse effects (AEs), while retaining induction of an immune response.7-9 These technologic advances were the basis for the COVID-19 mRNA vaccines in widespread use today. The sequence of events that leads to induction of effective immunity includes the following: O Creation of a nucleic acid sequence that results in production of the protein or a part of the protein against which a specific immune response is desired (immunogen) O Delivery of that sequence into the cell to engage the cellular machinery for producing the immunogen O Induction of inflammatory pathways to stimulate adaptive immunity leading to antibodies and T cells that respond to the immunogen Immune protein sensors that initiate inflammation are present in all cell types. A killed virus vaccine platform is the basis for Sinopharm and Coro-naVac vaccines developed in China and the BBV152 vaccine made in In-dia.15 Vaccines based on this plat form have been given to billions of individuals worldwide.16 Manufacture of these vaccines early in the pandemic required the ability to grow infectious viruses in a controlled setting, which unlike manufacture of mRNA vaccines carries nonzero transmission risk. Because these vaccines do not produce proteins in the immunized individual, they tend to be better at inducing antibody-based protection than cellular responses.
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Human adenoviruses (HAdVs) are important tools for vector development for applications such as immunization, oncolytic therapy, or gene therapy. However, their potential is limited by preexisting immunity against HAdV; therefore, it is important for future vector design to identify HAdV types of low seroprevalence. To provide such data, we performed an analysis of both binding and neutralizing antibodies in sera from three student cohorts. Among these young adults, we found the highest levels of binding antibodies against HAdV-C1, -D33, -A31, -B35, -C5, -D26, -E4, and -B7. The highest levels of neutralizing antibodies were detected against HAdV-C2, -B3, -C1, -F41, -G52, -C5, -A31, -E4, and -C6. While binding and neutralizing antibody levels were not different in males and females or in samples collected before and after the cold season, we found significantly lower levels of binding antibodies in sera collected 20 months after the beginning of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, indicating a waning of HAdV-specific antibody responses on that time scale. Our data indicate that mainly HAdV types of species A, B, and D show low seroprevalence with regard to both binding and neutralizing antibodies and may represent good candidates for further characterization and future development as novel vector systems. IMPORTANCE Vectors based on human adenoviruses (HAdVs) are important for the development of novel immunizations, oncolytic therapies, and gene therapies. The use of HAdV-based vaccines against Ebola virus, the rapid adaptation of the vector technology for vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and their very good efficacy have shown the great potential of HAdV-based vaccines. Preexisting immunity against HAdV-based vectors can limit their efficacy significantly; therefore, it is highly desirable to identify HAdV types with low seroprevalence. The identification of new suitable HAdV types for vector development will broaden the repertoire and contribute to future epidemic preparedness.
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Adenovirus Infections, Human , Adenoviruses, Human , COVID-19 , Male , Young Adult , Female , Humans , Adenoviruses, Human/genetics , Antibodies, Neutralizing , SARS-CoV-2 , Pandemics , Prevalence , Seroepidemiologic Studies , COVID-19/epidemiology , StudentsABSTRACT
Introduction: Polyethylene glycol (PEG) is one of the ingredients in the Pfizer/BioNTech COVID 19 vaccine (mRNA vaccine) and has been known to cause hypersensitivity [1-3]. Polysorbate is an ingredient in the Johnson vaccine (adenovirus vaccine) which may crossreact with PEG. Objective: We report a case of cross-reactivity between Pfizer/ BioNTech and Johnsson vaccines. Methods: This observation was notified in the pharmacovigilance center of Sfax, Tunisia (faculty of medicine of Sfax). The study of drug imputability was carried out according to the WHO method. Results: We report the case of a 32-year-old Tunisian woman with a history of atopy and intolerance to non-steroidal anti-inflammatory drugs (NSAIDs) but no history of SARS-CoV-2 infection. On August 15, 2021 (at 08:30), she developed sweating, vomiting and dizziness immediately after receiving the initial dose of Johnson COVID-19 vaccine. Her blood pressure became lower (less than 90/60 mmHg). She had to stay at the vaccination centre for one hour, and the clinical signs improved spontaneously after one hour. In the evening of the same day, the patient presented a febrile maculopapular eruption in the abdomen, trunk, and face. The rash resolved spontaneously over a week. The patient was referred to the pharma-covigilance center of Sfax (Tunisia). The messenger RNA vaccine was advocated for the second vaccine. On December 2021, she was received the second dose of the Pfizer/BioNTech COVID 19 vaccine (mRNA vaccine). Six hours later, she experienced a pruritic maculopapular rash on the abdomen, trunk, neck, and face. These clinical signs improved spontaneously after two days. the diagnosis of cross-allergy between these two vaccines was retained for this patient Conclusion: To our knowledge, this is the first cross-allergy between mRNA and adenovirus COVID-19 vaccines notified in Tunisian population. Healthcare professionals should be aware that hypersen-sitivity can occur with COVID-19 vaccines containing macrogols/ PEGs and those containing polysorbates. Its recognition may be challenging and often require skin testing. Per CDC guidance, con-sultation with an allergist-pharmacologist should be considered to help determine if the patient can safely receive vaccination [4].
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Unfortunately, the data used did not include patients on direct oral anticoagulants, which have largely replaced warfarin in the treatment of atrial fibrillation, meaning the conclusion that LAAO may be of most benefit to those with a high bleeding risk and low stroke risk is very much up for debate (Ann Intern Med doi:10.7326/M21-4653). What is the sensitivity and clinical value of a low home oxygen saturation reading when over 20% of participants in all study arms reported hypoxaemia, yet so few required hospital admission? (N Engl J Med doi:10.1056/NEJMoa2201662). [...]a linked editorial calls for more caution: no evidence has been seen of hepatocellular adenoviral infection on histological examinations in these cases: might the virus activity be an immunological response leading to acute hepatitis, or could adenovirus even be an “innocent bystander?” Better epidemiological data and registries of clinical studies are needed, it argues (NEJM doi:10.1056/NEJMoa2206704;10.1056/NEJMoa2206294).
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In early 2022, physicians in the UK raised alarm over an apparent surge in cases of unexplained severe acute hepatitis in children. By late June, the UK reported 258 cases, 12 of which required liver transplants, up from about 20 in a normal year. As of mid-July, 35 countries reported more than 1000 probable cases, including 22 deaths, with most of those cases occurring in Europe. Canada reported 23 as of mid-August, two of which required liver transplants. An expert told CMAJ that's roughly the number you would expect to see given the size of Canada's population. It's not unusual for the causes of severe liver inflammation in children to be unknown--by some estimates, up to half of such cases are unexplained. And it's still unclear whether the numbers reported globally reflect a true uptick in unexplained cases rather than increased attention to the issue.
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Both studies, published as preprints, ruled out the likelihood of recent or prior SARS-CoV-2 infection as a direct cause for the acute hepatitis.1 (Full story doi:10.1136/bmj.o1876) Vitamin D Supplements “don’t reduce fractures in healthy elderly” Vitamin D supplementation did not result in a significantly lower risk of fractures than placebo in generally healthy middle aged and older adults who were not recruited on the basis of vitamin D deficiency, low bone mass, or osteoporosis, in a study reported in the New England Journal of Medicine.1 The 25 871 participants were followed for five years, and the researchers found no difference in the number of fractures in people taking vitamin D and those taking placebo. [...]of ambulance workers see deaths linked to delays A third of ambulance workers have been involved in cases where a patient’s death was linked to delays in receiving treatment, a poll by the GMB union found. Eye care guidance NICE rapid recommendation on eye condition treatment In final draft guidance the National Institute for Health and Care Excellence recommended brolucizumab (also known as Beovu and manufactured by Novartis) as an option for treating visual impairment due to diabetic macular oedema in adults, the main cause in the UK of sight loss in people with diabetes.
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Loop-mediated isothermal amplification (LAMP) is an alternative to PCR that is faster and requires fewer resources. Here, we describe two LAMP assays for the detection of human adenoviruses in the feces of children with acute intestinal infections. We designed Ñolorimetric LAMP (c-LAMP) and real-time LAMP (f-LAMP) with fluorescent probes to detect the DNA of the adenovirus F human adenovirus 40/41 (hAdV40/41) hexon gene. The detection limit of both developed methods was 103 copies/mL, which is comparable to the sensitivity of PCR. The specificities of both c-LAMP and f-LAMP were high, with no false-positive results for clinical samples that do not contain adenovirus F, when testing other viruses and microorganisms. Comparative tests of PCR and LAMP on clinical samples from patients with acute gastroenteritis were carried out. For all samples with a PCR threshold cycle (CT) of up to 36, the PCR and LAMP results completely coincided; however, at low viral loads, the diagnostic sensitivity of LAMP, especially c-LAMP with colorimetric detection, was inferior to that of PCR. The combination of LAMP with modern methods of nucleic acid extraction, both in manual and automatic modes, can reduce the time for a complete study, including extraction of nucleic acid material and amplification, to 60 min. IMPORTANCE In April 2022, several cases of acute hepatitis of unknown origin were reported in children from 12 countries. In many cases, enteric adenovirus or SARS-CoV-2 and adenovirus coinfection were detected. It is known that human adenoviruses can cause different infections of varying severity, from asymptomatic to severe cases with lethal outcomes. There is a need to increase the diagnostic capabilities of clinical laboratories to identify such an underestimated pathogen as adenovirus. Although PCR remains the gold standard for pathogen detection, this method requires specialized equipment and has a long turnaround time to process samples. Previously, LAMP assays for the detection of human adenovirus have been based on measuring the turbidity, the fluorescence of intercalated dyes, or electrophoretic separation. Herein, we present LAMP-based assays with colorimetric or fluorescent detection and perform a detailed assessment of their sensitivity, specificity, and diagnostic performance.
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Adenoviridae Infections , Adenoviruses, Human , COVID-19 , Nucleic Acids , Adenoviridae Infections/diagnosis , Adenoviruses, Human/genetics , Child , Feces , Humans , Molecular Diagnostic Techniques/methods , Nucleic Acid Amplification Techniques , SARS-CoV-2 , Sensitivity and SpecificityABSTRACT
Vaccines have played a critical role in controlling disease outbreaks, hence the proliferation of the development and testing of multiple vaccine candidates during the COVID-19 pandemic. Randomised trials are gold standards for evaluating the safety and efficacy of pharmaceutical interventions such as COVID-19 vaccines. However, contextual differences may attenuate effects of COVID-19 vaccines. Thus, the need to conduct COVID-19 vaccine trials in all settings, including in Africa. We conducted a crosssectional analysis of planned, ongoing, and completed COVID-19 vaccine trials in Africa. We searched the South African National Clinical Trials Register, Pan African Clinical Trials Registry, and International Clinical Trials Registry Platform (ICTRP) on 12 January and 30 April 2022: and complemented this with a search of ClinicalTrials.gov on 17 May 2022. We screened the search output and included randomised trials with at least one recruitment site in Africa. We identified only 108 eligible trials: 90 (83%) evaluating candidate COVID-19 vaccines, 11 (10%) assessing if existing vaccines could prevent SARS-CoV-2 infection, and 7 (7%) evaluating interventions for improving COVID-19 vaccination coverage. South Africa had the highest number of trials at 58 (54%). Beyond South Africa, countries with more than 10 trial sites include Kenya, Ghana, Egypt, Uganda, and Zimbabwe. Among the trials, 14 (13%) do not have principal investigators based in Africa, 39 (30%) are funded by industry, and 91 (84%) are funded by institutions based outside the host country. COVID-19 vaccine trials with recruitment sites in Africa represented only 7% of the 1453 COVID-19 vaccine trials in the ICTRP The paucity of COVID-19 vaccine trials conducted on the African continent is a cause for concern. This has implications for the role that Africa may play in future pandemics.
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As of 10 May 2022, at least 450 cases of pediatric patients with acute hepatitis of unknown cause have been reported worldwide. Human adenoviruses (HAdVs) have been detected in at least 74 cases, including the F type HAdV41 in 18 cases, which indicates that adenoviruses may be associated with this mysterious childhood hepatitis, although other infectious agents or environmental factors cannot be excluded. In this review, we provide a brief introduction of the basic features of HAdVs and describe diseases caused by different HAdVs in humans, aiming to help understand the biology and potential risk of HAdVs and cope with the outbreak of acute child hepatitis.
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The aim is determining the impact of non-pharmaceutical measures (NPIs) against SARS-CoV-2 in the incidence and prevalence of gastrointestinal viruses (GV) in children. Demographic, analytical, and clinical data of children from which samples were received at the Hospital Universitario La Paz (Madrid, Spain) and that had a gastrointestinal infection with a positive sample through multiplex-PCR for GV were collected. The time periods included were prepandemic (P1): March 14, 2019 to March 14, 2020 and pandemic (P2): March 15, 2020 to March 15, 2021. The global prevalence, relative incidence (RI, per 1,000 admissions) and absolute incidence (AI, per 100,000 population) of GV were compared for both time periods. The prevalence of GV versus SARS-CoV-2 was determined for P2. Seven-hundred and 50 out of 2,547 children analyzed in P1 and 106 out of 1,368 in P2 were positive by PCR for GV (46.3% decrease in P2). Prevalence and RI of GV declined in P2, except for the RI of rotavirus. Adenovirus showed the largest decreased of prevalence and RI (100%), followed by sapovirus. Astrovirus reduction was less pronounced (3.1% versus 0.4%). Norovirus was the most frequent virus in both time periods and its prevalence and RI also decreased in P2 (15.2% versus 4.7% and 3.40 versus 1.74, respectively). Rotavirus had the smallest decrease in prevalence (2.6% versus 2.5%), and its RI increased during P2 from 0.7 to 0.93. After removing the rotavirus vaccine strains from the analysis, the prevalence and RI decreased during P2 (2.1% to 0.7% and 0.5 to 0.3, respectively). The AI decreased during P2 in all GV, and the prevalence of SARS-CoV-2 and GV was inversely proportional over time. Prevalence and incidence of GV have decreased during the pandemic, probably due to the implementation of NPIs against this virus and the reduction of health care attention to infections other than COVID-19. The differences in the decrease of prevalence and incidence for each virus may be explained by differences in the transmission and the resistance in the environment. Prevalence and RI of rotavirus might be biased since the PCR used detects both the infecting and the vaccine strains. IMPORTANCE Our original article contains an analysis of the impact of the measures applied against SARS-CoV-2 on the prevalence and incidence of GV in children. The small number of studies published to date that analyze the impact of these measures individually on each of the GV makes our study of great interest at this time.
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COVID-19 , Communicable Diseases , Gastroenteritis , Gastrointestinal Diseases , Rotavirus , Viruses , COVID-19/epidemiology , Child , Communicable Diseases/epidemiology , Feces , Gastrointestinal Diseases/epidemiology , Humans , Incidence , Infant , Pandemics , Prevalence , Retrospective Studies , SARS-CoV-2/geneticsABSTRACT
Myocarditis is an inflammatory disease of the myocardium that is troublesome to diagnose and manage, especially in children. Since the introduction of endomyocardial biopsy (EMB), new diagnostic tools have provided useful data. Especially when enhanced with immunohistochemistry and polymerase chain reaction (PCR) studies, EMB remains the gold standard for the diagnosis. Notably, cardiac magnetic resonance (MRI) is a non-invasive tool that can confirm the diagnosis and has a particular usefulness during the follow-up. The causes of myocarditis are heterogeneous (mostly viral in children). The course and outcome of the illness in the pediatric population represent a complex interaction between etiologic agents and the immune system, which is still not fully understood. The clinical presentation and course of myocarditis vary widely from paucisymptomatic illness to acute heart failure refractory to therapy, arrhythmias, angina-like presentation and sudden cardiac death. In this setting, cardiac biomarkers (i.e., troponins and BNP), although unspecific, can be used to support the diagnosis. Finally, the efficacy of therapeutic strategies is controversial and not confirmed by clinical trials. In this review, we summarized the milestones in diagnosis and provided an overview of the therapeutic options for myocarditis in children.
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OBJECTIVES/GOALS: To compare rates and types of neurological symptoms in children hospitalized with seizures and respiratory infections, including SARS-CoV-2, influenza, and endemic coronaviruses. METHODS/STUDY POPULATION: Retrospective cohort study of children between 0-21 years of age admitted to a single pediatric free-standing quaternary referral center from January 1, 2014 to June 1, 2021 for seizures who had positive respiratory infection PCR for SARS-CoV-2, other coronaviruses (Coronavirus NL63 and Coronavirus OC34), influenza (A and B), adenovirus, Mycoplasma pneumoniae, and parainfluenza 3 or 4 infections. Patient characteristics including age, race, sex, ethnicity, hospital length of stay, intensive care unit admission, intubation, chest x-ray, and MRI results were included. The primary outcomes were rates of neurological diagnoses and mortality. RESULTS/ANTICIPATED RESULTS: A total of 883 children were included: 68 SARS-CoV-2, 232 influenza, and 187 with other coronaviruses (OC), 214 adenovirus, 20 M. pneumoniae, 121 parainfluenza 3, and 41 parainfluenza 4. Mortality rates were 0% M pneumoniae to 4.9% in parainfluenza 4, with 2.9% in SARS-CoV-2. Encephalopathy was noted in 5-15.6% and strokes were seen in all infections except for coronavirus OC43 and M. pneumoniae, with 4.9% in parainfluenza 4 and 5.9% in SARS-CoV-2. The most common brain MRI abnormality was diffusion restriction. Differences between SARS-CoV-2 and OC were observed in stroke (5.9% vs. 0.5%, p-value=0.019), ICU admission (50% vs. 69%, p-value=0.008), and intubation (19.1% vs. 34.8%, p-value=0.021, respectively). However, the rates of neurological symptoms were similar between SARS-CoV-2 and influenza. DISCUSSION/SIGNIFICANCE: We found higher rates of stroke, but lower rates of ICU admission and intubation in SARS-CoV-2 versus OC. Strokes were observed in many infections. Rates of neurological symptoms were similar in SARS-CoV-2 versus influenza patients. Vigilance should be undertaken in treatment of children presenting with all respiratory illnesses.
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Coronavirus disease immunization;Adverse events following immunization;Active surveillance INTRODUCTION The coronavirus disease (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused widespread impact on health, including higher rate of mortality among older adults and those with pre-existing health conditions and, various preventive measures such as social distancing, covering nose and mouth with mask are taken across the world to prevent spread of pandemic. In response, rapid global efforts to develop and test vaccines against SARS-CoV-2 have led to an unprecedented number of candidate vaccines starting clinical trials during 2020. MATERIALS AND METHODS The study was carried out at our tertiary care teaching hospital after obtaining written permission from the Institutional Ethics Committee with a number of CUSMC/IEC(HR)/ RP-02/2021/Approval-RP-02/1578. [...]section comprised socio-demographic data i.e., age, gender, education qualification.
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PurposeThe COVID‐19 pandemic has substantially changed hygiene habits and measures to reduce the transmission of viruses through the respiratory route. The purpose is to analyse the influence of these measures on the incidence of adenovirus eye infections during the first phase of the COVID‐19 pandemic in Spain.MethodsRetrospective study by consecutive sampling of patients who attended the Ophthalmology Emergency Department of our hospital between March 19 and April 30, 2019 and 2020. Quantitative variables were analysed using Student's t‐test for independent data and the difference in the proportion of patients diagnosed with viral conjunctivitis was measured using the chi‐square test (IBM spss 20).ResultsAll medical records of patients in the 2020 group were reviewed and no evidence of COVID infection was found in the 10 days following their visit to the hospital. We found no significant differences in age or sex. In the 2019 period, a total of 1139 patients were seen, of which 162 (14.2%) had a clinical diagnosis of adenovirus conjunctivitis vs. 977 (85.8%) had other diagnoses. In 2020, there were 280 patients seen in the same time period, with 19 (6.8%) diagnosed with conjunctivitis compared to 261 with other diagnoses (93.2%).We found a significant decrease in the incidence of cases of adenovirus conjunctivitis in 2020 compared to 2019 (p = 0.001). The 17.90% of patients (29) returned to the emergency department after a diagnosis of viral conjunctivitis in 2019, while only one of the patients seen in 2020 returned.ConclusionsThe use of face masks as well as hand and surface hygiene measures, especially in the healthcare setting, clearly reduce the incidence of adenovirus eye infections. Although the sample collected during 2020 covers the first period of confinement in Spain, our impression is that the trend of decreasing cases of adenovirus conjunctivitis cases is sustained over time.ReferencesRomano MR, et al. Facing COVID‐19 in Ophthalmology Department. Curr Eye Res. 2020;45(6):653–658.Hoeferlin C, Review of Clinical and Operative Recommendations for Ophthalmology Practices During the COVID‐19 Pandemic. SN Compr Clin Med. 2021;1–6.Güemes‐Villahoz N, et al. Conjunctivitis in COVID‐19 patients: frequency and clinical presentation. Graefes Arch Clin Exp Ophthalmol. 2020.