COVID 19 infection: Pediatric perspectives

Adeyinka, Adebayo; Bailey, Keneisha; Pierre, Louisdon; Kondamudi, Noah P.

doi:10.1002/emp2.12375

Cited by 43 publications

(49 citation statements)

References 45 publications

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“…Oxygen therapy was administered in 21/26 subjects. Twenty patients were hospitalized in the pediatric intensive care unit (PICU); the median PICU stay was three days (2,4). Ventilator support was required in 11 cases, including continuous positive airway pressure in 10 patients and high flow nasal cannula in one case (median days of ventilation, 3 (2.0-4.5).…”

Section: Patient Characteristicsmentioning

confidence: 99%

“…Children have been found to be less affected by Coronavirus disease (COVID-19) than adults; in most pediatric cases, SARS CoV-2 is asymptomatic or only causes mild symptoms [1][2][3][4]. However, a limited number of reports describe a severe multisystem inflammatory syndrome in children (MIS-C), developing 1-2 months after acute SARS-CoV-2 infection [5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

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Non-thyroidal illness syndrome and SARS-CoV-2-associated multisystem inflammatory syndrome in children

Calcaterra

Biganzoli

Dilillo

et al. 2021

J Endocrinol Invest

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Purpose COVID-19 disease may result in a severe multisystem inflammatory syndrome in children (MIS-C), which in turn may alter thyroid function (TF). We assessed TF in MIS-C, evaluating its impact on disease severity. Methods We retrospectively considered children admitted with MIS-C to a single pediatric hospital in Milan (November 2019–January 2021). Non-thyroidal illness syndrome (NTIS) was defined as any abnormality in TF tests (FT3, FT4, TSH) in the presence of critical illness and absence of a pre-existing hormonal abnormality. We devised a disease severity score by combining severity scores for each organ involved. Glucose and lipid profiles were also considered. A principal component analysis (PCA) was performed, to characterize the mutual association patterns between TF and disease severity. Results Of 26 (19 M/7F) patients, median age 10.7 (IQR 5.8–13.3) years, 23 (88.4%) presented with NTIS. A low FT3 level was noted in 15/23 (65.3%), while the other subjects had varying combinations of hormone abnormalities (8/23, 34.7%). Mutually correlated variables related to organ damage and inflammation were represented in the first dimension (PC1) of the PCA. FT3, FT4 and total cholesterol were positively correlated and characterized the second axis (PC2). The third axis (PC3) was characterized by the association of triglycerides, TyG index and HDL cholesterol. TF appeared to be related to lipemic and peripheral insulin resistance profiles. A possible association between catabolic components and severity score was also noted. Conclusions A low FT3 level is common among MIS-C. TF may be useful to define the impact of MIS-C on children’s health and help delineate long term follow-up management and prognosis.

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Section: Patient Characteristicsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Non-thyroidal illness syndrome and SARS-CoV-2-associated multisystem inflammatory syndrome in children

Calcaterra

Biganzoli

Dilillo

et al. 2021

J Endocrinol Invest

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“…In general, people with an impaired immune function, like the elderly, experience the most severe symptoms of COVID-19. Newborn infants also have an impaired immune function due to the lack of a fully developed immune system; therefore, they may be seriously affected by SARS-CoV-2, although usually mildly (Adeyinka et al, 2021;Barrero-Castillero et al, 2020;De Rose et al, 2020;Kim et al, 2020;Raschetti et al, 2020;Shah & Saugstad, 2020). Human milk is considered to be the main source of passive and active immunity for newborns and infants, as it contains a large array of bioactive factors, including antibodies, oligosaccharides, nucleic acids, and cytokines, that help enrich an infant's immune system (Mosca & Giannì, 2017).…”

Section: Introductionmentioning

confidence: 99%

Antibodies Against SARS-CoV-2 in Human Milk: Milk Conversion Rates in the Netherlands

et al. 2021

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Background It has been demonstrated that human milk from mothers who have been infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) contains antibodies against the virus, which could play an important role in protecting the recipient infant against coronavirus disease 2019 (COVID-19). Seroconversion is measured frequently around the world, but the milk conversion rate is unknown. Research Aims To determine (1) the prevalence and (2) the dynamics of immunoglobulin A (IgA) antibodies against SARS-CoV-2 in human milk amongst lactating mothers in the Netherlands. Methods In this large prospective cohort study, lactating mothers ( N = 2312) were included between October 12, 2020 and February 24, 2021. Enzyme-linked immunosorbent assay was used to determine levels of IgA antibodies in human milk and immunoglobulin G (IgG) antibodies in serum against the ectodomain of the SARS-CoV-2 spike protein. Results A total of 691 (30.6%) participants had SARS-CoV-2 specific antibodies in human milk and/or serum. Of these participants, 524 (23.1%) had IgA antibodies against SARS-CoV-2 in human milk, and 356 (15.7%) had IgG antibodies against SARS-CoV-2 in serum. A total of 199 (8.8%) participants had antibodies in both human milk and serum. SARS-CoV-2 specific IgA antibodies in human milk remain present at least 10 months after a polymerase chain reaction confirmed infection. Conclusion The prevalence of IgA antibodies against SARS-CoV-2 in human milk was 23.1% in our cohort. This high prevalence of antibodies in human milk might lead to passive immunity in many breastfed infants and may serve as protection against COVID-19.

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“…During the pandemic children have been less affected than adults and SARS-CoV-2 was in most cases asymptomatic or with mild symptoms [3][4][5]. However, the development of a severe multisystem inflammatory syndrome in children (MIS-C) related to SARS-CoV-2 infection has been reported [6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Impaired Glucose-Insulin Metabolism in Multisystem Inflammatory Syndrome Related to SARS-CoV-2 in Children

et al. 2021

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An interaction between metabolic glucose impairment and coronavirus disease 2019 is reported. The development of a severe multisystem inflammatory syndrome in children (MIS-C) related to SARS-CoV-2 infection has been described. We evaluated the impact of MIS-C on glycemic patterns in pediatric patients. A group of 30 children and adolescents affected by MIS-C were considered; all patients were normal weight. Clinical and biochemical assessments, including surrogate markers of insulin resistance (IR) such as homeostasis model analysis-IR (HOMA-IR) and triglyceride–glucose (TyG) indexes, were recorded. Patients were also invited to undergo an intermittently scanned continuous glucose monitoring (isCGM). HOMA-IR index was calculated in 18 patients (60%), of which 17 (94%) revealed a pathological value. TyG index was computed for all patients and pathological values were detected in all cases. In 15 patients, isCGM data were recorded on average for 9 days (±3 days). Overall, average glucose was 105 mg/dL (±16 mg/dL) and average time spent in the 70–180 mg/dL range (TIR) was 93.76%, with nearly 10% of glucose readings in the 141–180 mg/dL range; glycemic fluctuations over the hyperglycemic threshold were detected in four patients. Regular glucose monitoring may be useful to prevent metabolic imbalance and obtain a better outcome.

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COVID 19 infection: Pediatric perspectives

Cited by 43 publications

References 45 publications

Non-thyroidal illness syndrome and SARS-CoV-2-associated multisystem inflammatory syndrome in children

Non-thyroidal illness syndrome and SARS-CoV-2-associated multisystem inflammatory syndrome in children

Antibodies Against SARS-CoV-2 in Human Milk: Milk Conversion Rates in the Netherlands

Impaired Glucose-Insulin Metabolism in Multisystem Inflammatory Syndrome Related to SARS-CoV-2 in Children

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