COPEDI-CAT: estrategia de calidad para la investigación en covid-19 pediátrica en Cataluña / COPEDI-CAT: estratègia de qualitat per a la recerca en covid-19 pediàtrica a Catalunya / COPEDI-CAT: quality strategy for pediatric covid-19 research in Cataloni

Fundamento. El estallido brusco de la pandemia de la covid-19suposo la necesidad de iniciar proyectos de investigación coordinados. La creación del grupo COPEDI-CAT (julio 2020; más de170 profesionales) para estudiar la covid-19 pediátrica en Cataluña es un buen ejemplo de ello.Objetivo. Dar a conocer los resultados del grupo COPEDI-CAT, paramostrar la viabilidad de una estrategia de investigación multidisciplinaria de calidad con amplia participación de la atención primaria (AP).Método. Recogida de la producción científica del grupo COPEDICAT, resultado del trabajo multidisciplinario a partir de una extensa base de datos. En el grupo se revisan los estudios en cursoy los datos recogidos, se proponen nuevos proyectos, se realizanintervenciones de profesionales expertos (locales y de otros ámbitos y países) y se genera un espacio de debate y seguimiento de lapandemia.Resultados. Se han respondido las principales cuestiones sobre clínica, transmisibilidad, gravedad y principales complicaciones dela covid-19 en pediatría (síndrome pediátrico inflamatorio multisistémico y covid-19 persistente). Esta investigación ha generadocomunicaciones en congresos nacionales e internacionales, publicaciones científicas de alto impacto, la guía clínica de recomendaciones para el manejo de la covid-19 persistente, modelos depredicción clínica, becas de investigación (beca Prandi y MaratóTV3) y la participación en el proyecto «Escoles Sentinella».Conclusiones. La pandemia de covid-19 ha representado una oportunidad única para realizar investigación multidisciplinaria de calidad en pediatría de AP. COPEDI-CAT puede ser un modelo parala investigación futura de las patologías que afectan a los niños y adolescentes de nuestro país.

Background. The sudden outbreak of the covid-19 pandemic resulted in a need to start coordinated research projects on the disease. The creation of the COPEDI-CAT group (July 2020; more than 170professionals) to study pediatric covid-19 in Catalonia representsa good example of this effort.Objective. To disseminate the results of the COPEDI-CAT group toshow the feasibility of a quality multidisciplinary research strategywith wide participation of primary care (PC).Method. Review of the scientific production of the COPEDI-CATgroup generated by a multidisciplinary team. The group reviewedongoing studies and collected data, proposed new projects, implemented interventions recommended by expert professionals (local,national, and international), and created a space for debate andmonitoring of the pandemic.Results. The main questions about the symptoms, transmissibility,severity, and main complications of covid-19 in pediatrics (multisystem inflammatory syndrome and long covid-19) have beenaddressed. This research has generated papers at national andinternational conferences, high-impact scientific publications,recommended clinical guidelines for the management of longcovid-19, clinical prediction models, research grants (Prandi andMarató TV3 scholarship) and the participation in the «Escoles Sentinella» project.Conclusions. The covid-19 pandemic has represented a unique opportunity to carry out quality multidisciplinary research in pediatrics at PC. COPEDI-CAT can be a model for future research ondiseases that affect children and adolescents in our country. (AU)

Fonament. L’esclat brusc de la pandèmia va comportar la necessitat d’iniciar projectes de recerca coordinats. La creació del grup COPEDI-CAT (juliol 2020; més de 170 professionals) per estudiar la covid-19 pediàtrica a Catalunya n’és un bon exemple. Objectiu. Donar a conèixer els resultats del grup COPEDICAT, per mostrar la viabilitat d’una estratègia d’investigació multidisciplinària de qualitat amb àmplia participació de l’atenció primària (AP). Mètode. Recollida de la producció científica del grup COPEDI-CAT, resultat del treball multidisciplinari a partir d’una extensa base de dades. Al grup es revisen els estudis en curs i les dades recollides, es proposen nous projectes, es fan intervencions de professionals experts (locals i d’altres àmbits i països) i es genera un espai de debat i seguiment de la pandèmia. Resultats. S’han respost les principals qüestions sobre clínica, transmissibilitat, gravetat i principals complicacions de la covid-19 pediàtrica (síndrome pediàtrica multisistèmica i covid-19 persistent). Aquesta recerca ha generat comunicacions a congressos nacionals i internacionals, publicacions científiques d’alt impacte, la guia clínica de recomanacions pel maneig de la covid-19 persistent, models de predicció clínica, beques d’investigació (beca Prandi i Marató TV3) i la participació al projecte «Escoles Sentinella». Conclusions. La pandèmia de covid-19 ha representat una oportunitat única per fer investigació multidisciplinària de qualitat en pediatria d’AP. COPEDI-CAT pot ser un model per a la recerca futura de les patologies que afecten els infants i adolescents del nostre país. (AU)

Schools as a Framework for COVID-19 Epidemiological Surveillance of Children in Catalonia, Spain: A Population-Based Study.

Objective: We describe and analyze the childhood (<18 years) COVID-19 incidence in Catalonia, Spain, during the first 36 weeks of the 2020-2021 school-year and to compare it with the incidence in adults. Methods: Data on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) tests were obtained from the Catalan Agency for Quality and Health Assessment. Overall, 7,203,663 SARS-CoV-2 tests were performed, of which 491,819 were positive (6.8%). We collected epidemiological data including age-group incidence, diagnostic effort, and positivity rate per 100,000 population to analyze the relative results for these epidemiological characteristics. Results: Despite a great diagnostic effort among children, with a difference of 1,154 tests per 100,000 population in relation to adults, the relative incidence of SARS-CoV-2 for <18 years was slightly lower than for the general population, and it increased with the age of the children. Additionally, positivity of SARS-CoV-2 in children (5.7%) was lower than in adults (7.2%), especially outside vacation periods, when children were attending school (4.9%). Conclusions: A great diagnostic effort, including mass screening and systematic whole-group contact tracing when a positive was detected in the class group, was associated with childhood SARS-CoV-2 incidence and lower positivity rate in the 2020-2021 school year. Schools have been a key tool in epidemiological surveillance rather than being drivers of SARS-CoV-2 incidence in Catalonia, Spain.

Household Severe Acute Respiratory Syndrome Coronavirus 2 Transmission and Children: A Network Prospective Study.

BACKGROUND: The role of children in household transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains unclear. We describe the epidemiological and clinical characteristics of children with coronavirus disease 2019 (COVID-19) in Catalonia, Spain, and investigate the household transmission dynamics. METHODS: A prospective, observational, multicenter study was performed during summer and school periods (1 July 2020-31 October 2020) to analyze epidemiological and clinical features and viral household transmission dynamics in COVID-19 patients aged <16 years. A pediatric index case was established when a child was the first individual infected. Secondary cases were defined when another household member tested positive for SARS-CoV-2 before the child. The secondary attack rate (SAR) was calculated, and logistic regression was used to assess associations between transmission risk factors and SARS-CoV-2 infection. RESULTS: The study included 1040 COVID-19 patients. Almost half (47.2%) were asymptomatic, 10.8% had comorbidities, and 2.6% required hospitalization. No deaths were reported. Viral transmission was common among household members (62.3%). More than 70% (756/1040) of pediatric cases were secondary to an adult, whereas 7.7% (80/1040) were index cases. The SAR was significantly lower in households with COVID-19 pediatric index cases during the school period relative to summer (P = .02) and compared to adults (P = .006). No individual or environmental risk factors associated with the SAR. CONCLUSIONS: Children are unlikely to cause household COVID-19 clusters or be major drivers of the pandemic, even if attending school. Interventions aimed at children are expected to have a small impact on reducing SARS-CoV-2 transmission.

Symptom-Based Predictive Model of COVID-19 Disease in Children.

BACKGROUND: Testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is neither always accessible nor easy to perform in children. We aimed to propose a machine learning model to assess the need for a SARS-CoV-2 test in children (<16 years old), depending on their clinical symptoms. METHODS: Epidemiological and clinical data were obtained from the REDCap® registry. Overall, 4434 SARS-CoV-2 tests were performed in symptomatic children between 1 November 2020 and 31 March 2021, 784 were positive (17.68%). We pre-processed the data to be suitable for a machine learning (ML) algorithm, balancing the positive-negative rate and preparing subsets of data by age. We trained several models and chose those with the best performance for each subset. RESULTS: The use of ML demonstrated an AUROC of 0.65 to predict a COVID-19 diagnosis in children. The absence of high-grade fever was the major predictor of COVID-19 in younger children, whereas loss of taste or smell was the most determinant symptom in older children. CONCLUSIONS: Although the accuracy of the models was lower than expected, they can be used to provide a diagnosis when epidemiological data on the risk of exposure to COVID-19 is unknown.

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