Will children reveal their secret? The coronavirus dilemma

Cristiani, Luca; Mancino, Enrica; Matera, Luigi; Nenna, Raffaella; Pierangeli, Alessandra; Scagnolari, Carolina; Midulla, Fabio

doi:10.1183/13993003.00749-2020

Cited by 190 publications

(211 citation statements)

References 35 publications

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“…Currently, there is no evidence to suggest that up-regulation of ACE2 is associated with increased COVID-19 susceptibility or severity. In fact, estrogens appear to up-regulate ACE2 while children and younger adults have higher ACE2 levels as compared to older people, which could explain the milder COVID-19 in women and younger people and suggest a protective effect [53,54]. Moreover, the contradictory findings about smoking in the literature, with studies published before the COVID-19 pandemic reporting that smoking and nicotine down-regulate ACE2 [3,4] and other studies published during the pandemic reporting that they up-regulate ACE2 [5][6][7], do not allow for solid conclusions regarding the effects of nicotine or smoking on ACE2.…”

Section: Discussionmentioning

confidence: 99%

Systematic review of the prevalence of current smoking among hospitalized COVID-19 patients in China: could nicotine be a therapeutic option?

2020

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The effects of smoking on Corona Virus Disease 2019 are currently unknown. The purpose of this study was to systematically examine the prevalence of current smoking among hospitalized patients with COVID-19 in China, considering the high-population smoking prevalence in China (26.6%). A systematic review of the literature (PubMed) was performed on April 1. Thirteen studies examining the clinical characteristics of hospitalized COVID-19 patients in China and presenting data on the smoking status were found. The pooled prevalence of current smoking from all studies was calculated by random-effect meta-analysis. To address the possibility that some smokers had quit shortly before hospitalization and were classified as former smokers on admission to the hospital, we performed a secondary analysis in which all former smokers were classified as current smokers. A total of 5960 patients were included in the studies identified. The current smoking prevalence ranged from 1.4% (95% CI 0.0-3.4%) to 12.6% (95% CI 10.6-14.6%). An unusually low prevalence of current smoking was observed from the pooled analysis (6.5%, 95% CI 4.9-8.2%) as compared to population smoking prevalence in China. The secondary analysis, classifying former smokers as current smokers, found a pooled estimate of 7.3% (95% CI 5.7-8.9%). In conclusion, an unexpectedly low prevalence of current smoking was observed among patients with COVID-19 in China, which was approximately 1/4th the population smoking prevalence. Although the generalized advice to quit smoking as a measure to reduce health risk remains valid, the findings, together with the well-established immunomodulatory effects of nicotine, suggest that pharmaceutical nicotine should be considered as a potential treatment option in COVID-19.

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Section: Discussionmentioning

confidence: 99%

Systematic review of the prevalence of current smoking among hospitalized COVID-19 patients in China: could nicotine be a therapeutic option?

2020

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“…More so, the parameters that govern these epidemic models tend to reflect physiological rates of how the disease expresses itself in individuals, as well as effects that are moderated by demic characteristics. Examples are age structure in the population, which impacts both asymptomatic cases 11,26 and severity of disease 8 . Identification of asymptomatic cases has been problematic since testing protocols tended to require symptoms, or contacts with known infected people.…”

Section: Discussionmentioning

confidence: 99%

Lies, Gosh Darn Lies, and Not Enough Good Statistics: Why Epidemic Model Parameter Estimation Fails

Platt

Parida

Zalloua

2020

Preprint

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An opportunity exists in exploring epidemic modeling as a novel way to determine physiological and demic parameters for genetic association studies on a population/environmental (quasi) epidemiological study level. First, the spread of SARS-COV-2 has produced population specific lineages; second, epidemic spread model parameters are tied directly to these physiological and demic rates (e. g. incubation time, recovery time, transmission rate); and third, these parameters may serve as novel phenotypes to associate with region-specific genetic mutations as well as demic characteristics (e. g. age structure, cultural observance of personal space, crowdedness). Therefore, we sought to understand whether the parameters of epidemic models could be determined from the trajectory of infections, recovery, and hospitalizations prior to peak, and also to evaluate the quality and comparability of data between jurisdictions reporting their statistics necessary for the analysis of model parameters across populations. We found that, analytically, the pre-peak growth of an epidemic is limited by a subset of the model variates, and that the rate limiting variables are dominated by the expanding eigenmode of their equations. The variates quickly converge to the ratio of eigenvector components of the positive growth rate, which determines the doubling time. There are 9 parameters and 4 independent components in the eigenmode, leaving 5 undetermined parameters. Those parameters can be strikingly population dependent, and can have significant impact on estimates of hospital loads downstream. Without a sound framework, measurements of infection rates and other parameters are highly corrupted by uneven testing rates to uneven counting and reporting of relevant values. From the standpoint of phenotype parameters, this means that structured experiments must be performed to estimate these parameters in order to perform genetic association studies, or to construct viable models that accurately predict critical quantities such as hospitalization loads.

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“…The search identified 700 unique titles from which 66 full text manuscripts were pulled ( Figure 1) leading to 9 included case series with data on 4251 children from 4 countries (Table 3) [7][8][9][10][11][12][13][14][15][16][17][18] none of which were included in Table 2.…”

Section: Medical Literature Searchmentioning

confidence: 99%

COVID-19 Infection in Children: Estimating Pediatric Morbidity and Mortality

Forbes¹,

Mehta²,

Kumar³

et al. 2020

Preprint

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BACKGROUND: Estimates of pediatric morbidity and mortality from COVID-19 are vital for planning optimal use of human and material resources throughout this pandemic. METHODS:Government websites from countries with minimum 1000 cases in adults and children on April 13, 2020 were searched to find the number of cases confirmed in children, the age range, and the number leading to hospitalization, intensive care unit (ICU) admission or death. A systematic literature search was performed April 13, 2020 to find additional data from cases series. RESULTS:Data on pediatric cases were available from government websites for 23 of the 70 countries with minimum 1000 cases by April 13, 2020. Of 424 978 cases in these 23 countries, 8113 (1.9%) occurred in children. Nine publications provided data from 4251 cases in 4 additional countries. Combining data from the websites and the publications, 330 of 2361 cases required admission (14%). The ICU admission rate was 2.2 % of confirmed cases (44 of 2031) and 7.2% of admitted children (23 of 318). Death was reported for 15 cases. CONCLUSION:Children accounted for 1.9% of confirmed cases. The true incidence of pediatric infection and disease will only be known once testing is expanded to individuals with less severe or no symptoms. Admission rates vary from 0.3 to 10% of confirmed cases (presumably varying with the threshold for testing) with about 7% of admitted children requiring ICU care. Death is rare in middle and high income countries.

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Will children reveal their secret? The coronavirus dilemma

Cited by 190 publications

References 35 publications

Systematic review of the prevalence of current smoking among hospitalized COVID-19 patients in China: could nicotine be a therapeutic option?

Systematic review of the prevalence of current smoking among hospitalized COVID-19 patients in China: could nicotine be a therapeutic option?

Lies, Gosh Darn Lies, and Not Enough Good Statistics: Why Epidemic Model Parameter Estimation Fails

COVID-19 Infection in Children: Estimating Pediatric Morbidity and Mortality

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