Long-Term Outcomes of Pediatric Infections: From Traditional Infectious Diseases to Long Covid

Buonsenso, Danilo; Gennaro, Leonardo Di; Rose, Cristina De; Morello, Rosa; D’Ilario, Federico; Zampino, Giuseppe; Piazza, Michele; Boner, Attilio; Iraci, Cecilia; O’Connell, Sarah; Cohen, Valentina B; Esposito, Susanna; Munblit, Daniel; Joseph, Reena; Sigfrid, Louise; Valentini, Piero

doi:10.2217/fmb-2022-0031

Cited by 70 publications

(105 citation statements)

References 134 publications

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“…The long-term effects of SARS-CoV-2 infection in children are little understood [ 91 ]. To date, the majority of investigations have focused on adult populations.…”

Section: Discussionmentioning

confidence: 99%

“…However, a subset of children appear to recover from their initial COVID-19 infection but have signs and symptoms and may be diagnosed with long-COVID [ 92 ]. Severe acute infection might be related with chronic symptoms; however, symptoms might be also related with chronic inflammation, autoimmunity, chronic endotheliopathy, microthrombosis, or viral persistence [ 91 ]. Microbiota composition changes might also play a role in long-COVID.…”

Section: Discussionmentioning

confidence: 99%

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Intestinal microbiota composition of children with infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and multisystem inflammatory syndrome (MIS-C)

et al. 2022

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Microbiota composition may play a role in the development, prognosis, or post-infection of COVID-19. There are studies evaluating the microbiota composition at the time of diagnosis and during the course of COVID-19, especially in adults, while studies in children are limited and no study available in children with multisystem inflammatory syndrome in children (MIS-C). This study was planned to compare intestinal microbiota composition in children diagnosed with MIS-C and acute COVID-19 infection with healthy children. In this prospective multicenter study, 25 children diagnosed with MIS-C, 20 with COVID-19 infection, and 19 healthy children were included. Intestinal microbiota composition was evaluated by 16 s rRNA gene sequencing. We observed changes of diversity, richness, and composition of intestinal microbiota in MIS-C cases compared to COVID-19 cases and in the healthy controls. The Shannon index was higher in the MIS-C group than the healthy controls ( p < 0.01). At phylum level, in the MIS-C group, a significantly higher relative abundance of Bacteroidetes and lower abundance of Firmicutes was found compared to the control group. Intestinal microbiota composition changed in MIS-C cases compared to COVID-19 and healthy controls, and Faecalibacterium prausnitzii decreased; Bacteroides uniformis , Bacteroides plebeius , Clostridium ramosum , Eubacterium dolichum , Eggerthella lenta , Bacillus thermoamylovorans , Prevotella tannerae , and Bacteroides coprophilus were dominant in children with MIS-C. At species level, we observed decreased Faecalibacterium prausnitzii , and increased Eubacterium dolichum , Eggerthella lenta , and Bacillus thermoamylovorans in children with MIS-C and increased Bifidobacterium adolescentis and Dorea formicigenerasus in the COVID-19 group. Our study is the first to evaluate the microbiota composition in MIS-C cases. There is a substantial change in the composition of the gut microbiota: (1) reduction of F. prausnitzii in children with MIS-C and COVID-19; (2) an increase of Eggerthella lenta which is related with autoimmunity; and (3) the predominance of E. dolichum is associated with metabolic dysfunctions and obesity in children with MIS-C. Conclusions : Alterations of the intestinal microbiota might be part of pathogenesis of predisposing factor for MIS-C. It would be beneficial to conduct more extensive studies on the cause-effect relationship of these changes in microbiota composition and their effects on long-term prognosis. What is Known: • Mi...

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“…The long-term effects of SARS-CoV-2 infection in children are little understood [ 91 ]. To date, the majority of investigations have focused on adult populations.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Intestinal microbiota composition of children with infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and multisystem inflammatory syndrome (MIS-C)

et al. 2022

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“…For this reason, it seems implicit that the task of pediatricians, as well as of the general practitioner, is essentially to prevent, but also to evaluate the possibility of attenuating the symptoms with the use of the biologically plausible elements summarized in Table 1 [138]. A multi-disciplinary management is necessary, and the possible use of different nutraceuticals and essential elements, already suggested for COVID-19 patients [21][22][23][24] and in children with different inflammatory disease, seems reasonable [135,139,140].…”

Section: Future Perspectivesmentioning

confidence: 99%

Long COVID-19 in Children: From the Pathogenesis to the Biologically Plausible Roots of the Syndrome

et al. 2022

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Long Coronavirus disease-19 (COVID-19) refers to the persistence of symptoms related to the infection with severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). This condition is described as persistent and can manifest in various combinations of signs and symptoms, such as fatigue, headache, dyspnea, depression, cognitive impairment, and altered perception of smells and tastes. Long COVID-19 may be due to long-term damage to different organs—such as lung, brain, kidney, and heart—caused by persisting viral-induced inflammation, immune dysregulation, autoimmunity, diffuse endothelial damage, and micro thrombosis. In this review, we discuss the potential and biologically plausible role of some vitamins, essential elements, and functional foods based on the hypothesis that an individual’s dietary status may play an important adjunctive role in protective immunity against COVID-19 and possibly against its long-term consequences.

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“…Divergent PASC phenotypes also complicate investigation of PASC epidemiology and pathophysiology ( 11 , 12 , 14 ). Recent surveys of large population groups post–acute COVID-19 that include pre-pandemic comparator groups and involvement of more than one organ system suggest a PASC incidence of approximately 14% in adults ( 15 ) and approximately 21% in children and adolescents ( 16 ). In contrast, studies reporting much higher incidence rates often lack objective findings documented by quantitative assays ( 16 , 17 ).…”

Section: Introductionmentioning

confidence: 99%

Long COVID endotheliopathy: hypothesized mechanisms and potential therapeutic approaches

Ahamed¹,

Laurence²

2022

Journal of Clinical Investigation

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SARS-CoV-2–infected individuals may suffer a multi–organ system disorder known as “long COVID” or post-acute sequelae of SARS-CoV-2 infection (PASC). There are no standard treatments, the pathophysiology is unknown, and incidence varies by clinical phenotype. Acute COVID-19 correlates with biomarkers of systemic inflammation, hypercoagulability, and comorbidities that are less prominent in PASC. Macrovessel thrombosis, a hallmark of acute COVID-19, is less frequent in PASC. Female sex at birth is associated with reduced risk for acute COVID-19 progression, but with increased risk of PASC. Persistent microvascular endotheliopathy associated with cryptic SARS-CoV-2 tissue reservoirs has been implicated in PASC pathology. Autoantibodies, localized inflammation, and reactivation of latent pathogens may also be involved, potentially leading to microvascular thrombosis, as documented in multiple PASC tissues. Diagnostic assays illuminating possible therapeutic targets are discussed.

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Long-Term Outcomes of Pediatric Infections: From Traditional Infectious Diseases to Long Covid

Cited by 70 publications

References 134 publications

Intestinal microbiota composition of children with infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and multisystem inflammatory syndrome (MIS-C)

Intestinal microbiota composition of children with infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and multisystem inflammatory syndrome (MIS-C)

Long COVID-19 in Children: From the Pathogenesis to the Biologically Plausible Roots of the Syndrome

Long COVID endotheliopathy: hypothesized mechanisms and potential therapeutic approaches

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