Differences in children and adolescents with SARS-CoV-2 infection: a cohort study in a Brazilian tertiary referral hospital

Marques, Heloísa Helena de Sousa; Pereira, Maria Fernanda Bádue; Santos, Angélica Carreira dos; Fink, Thais T.; Paula, Camila Sanson Yoshino de; Litvinov, Nadia; Schvartsman, Cláudio; Delgado, Artur Figueiredo; Gibelli, Maria Augusta Bento Cicaroni; Carvalho, Werther Brunow de; Filho, Vicente Odone; Tannuri, Uenis; Carneiro‐Sampaio, Magda; Grisi, Sandra; Duarte, Alberto José da Silva; Antonângelo, Leila; Francisco, Rossana Pucineli Vieira; Okay, Thelma Suely; Batisttella, Linamara Rizzo; Carvalho, Carlos Roberto Ribeiro de; Brentani, Alexandra; Silva, Clóvis A.; Eisencraft, Adriana Pasmanik; Rossi, Alfio; Fante, Alice Lima; Corá, Aline Pivetta; Reis, Amelia Gorete A de Costa; Ferrer, Ana Paula Scoleze; Andrade, Anarella Penha Meirelles de; Watanabe, Andréia; Gonçalves, Angelina Maria Freire; Waetge, Aurora Rosaria Pagliara; Silva, Camila Altenfelder; Ceneviva, Carina; Lazari, Carolina dos Santos; Abellan, Deipara Monteiro; Santos, Emanuella Barros dos; Sabino, Éster Cerdeira; Bianchini, Fabíola Roberta Marim; Alcantara, Flávio Ferraz de Paes; Ramos, Gabriel F.; Leal, Gabriela Nunes; Rodriguez, Isadora Souza; Pinho, João Renato Rebello; Carneiro, J.D.A.; Paz, José Albino da; Ferreira, Juliana Carvalho; Ferranti, Juliana Ferreira; Ferreira, Juliana de Oliveira Achili; Framil, Juliana Valéria de Souza; Silva, Katia Regina da; Kanunfre, Kelly Aparecida; Bastos, Karina Lucio de Medeiros; Galleti, Karine Vusberg; Cristófani, Lílian Maria; Suzuki, Lisa; Campos, Lúcia Maria Arruda; Perondi, Maria Beatriz de Moliterno; Diniz, Maria de Fátima Rodrigues; Fonseca, Maria Fernanda Mota; Cordon, Mariana Nutti de Almeida; Pissolato, Mariana; Peres, Marina Silva; Garanito, Marlene Pereira; Imamura, Marta; Dorna, Mayra de Barros; Luglio, Michele; Rocha, Mussya Cisotto; Aikawa, Nádia E.; Degaspare, Natália Viu; Sakita, Neusa Keico; Udsen, Nicole Lee; Scudeller, Paula Gobi; Gaiolla, Paula V.; Severini, Rafael da Silva Giannasi; Rodrigues, Regina Maria; Toma, Ricardo Katsuya; Paula, Ricardo Iunis Citrangulo de; Palmeira, Patrícia; Forsait, Silvana; Farhat, Sylvia Costa Lima; Sakano, Tânia Miyuki Shimoda; Koch, Vera H.; Cobello, Vilson

doi:10.6061/clinics/2021/e3488

Cited by 6 publications

(5 citation statements)

References 40 publications

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“…Recruitment dates ranged from 1 January 2020 to 24 September 2021 but were primarily based in 2020. There were 26 cohort studies (5, 9-33), 10 cross-sectional studies (34)(35)(36)(37)(38)(39)(40)(41)(42)(43), seven chart reviews (44-50), three case-control studies (51-53) and one case series (54).…”

Section: Resultsmentioning

confidence: 99%

“…Recruitment dates ranged from 1 January 2020 to 24 September 2021 but were primarily based in 2020. There were 26 cohort studies (5, 9–33), 10 cross-sectional studies (34–43), seven chart reviews (44–50), three case-control studies (51–53) and one case series (54). Details on the characteristics of the included cohort studies are presented in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

“…As per our inclusion criteria, the studies had no geographical limitations. Twenty studies were conducted in the United States (US) (5, 11, 15, 17–23, 27, 31, 35, 36, 39, 47, 48, 50, 53, 54), two in Brazil (34, 49), and one in Canada (10). In addition, five studies took place in Europe, of which one in France (9), one in Switzerland (30), one in Spain (33), one in Poland (32) and one across 25 European countries (16).…”

Section: Resultsmentioning

confidence: 99%

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Prognostic factors for mortality, ICU, MIS-C and hospital admission due to SARS-CoV-2 in paediatric patients: A systematic review and meta-analysis

Vardavas,

Nikitara,

Mathioudakis

et al. 2024

Preprint

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BackgroundThere is a paucity of data on the factors associated with severe COVID-19 disease, especially in children. This systematic review and meta-analysis aim to identify the risk factors for acute adverse outcomes of COVID-19 within paediatric populations, using the recruitment setting as a proxy of initial disease severity.MethodsA systematic review and meta-analysis were performed representing published evidence from the start of the pandemic up to 14 February 2022. Our primary outcome was the identification of risk factors for adverse outcomes, stratified by recruitment setting (community, hospital). No geographical restrictions were imposed. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology was used to evaluate the certainty in the body of evidence for each meta-analysis. In anticipation of significant clinical and methodological heterogeneity in the meta-analyses, we fitted logistic regression models with random effects.FindingsOur review identified 47 studies involving 94,210 paediatric cases of COVID-19. Infants up to 3 months were more likely to be hospitalised than older children. Gender and ethnicity were not associated with an increased likelihood of adverse outcomes among children within the community setting. Concerning comorbidities, having at least one pre-existing disease increased the odds of hospitalisation. Concerning BMI, underweight children and severely obese were noted to have an increased likelihood of hospital admission. The presence of metabolic disorders and children with underlying cardiovascular diseases, respiratory disorders, neuromuscular disorders and neurologic conditions were also more likely to be hospitalised. Concerning underlying comorbidities, paediatric hospitalised patients with congenital/genetic disease, those obese, with malignancy, cardiovascular diseases and respiratory disease were associated with higher odds of being admitted to ICU or ventilated.InterpretationOur findings suggest that age, male, gender, and paediatric comorbidities increased the likelihood of hospital and ICU admission. Obesity, malignancy, and respiratory and cardiovascular disorders were among the most important risk factors for hospital and ICU admission among children with COVID-19. The extent to which these factors were linked to actual severity or where the application of cautious preventive care is an area in which further research is needed.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Prognostic factors for mortality, ICU, MIS-C and hospital admission due to SARS-CoV-2 in paediatric patients: A systematic review and meta-analysis

Vardavas,

Nikitara,

Mathioudakis

et al. 2024

Preprint

View full text Add to dashboard Cite

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“…Upon completion of the database and case validation, the possibility of accessing the institutional database above was widely advertised in successive calls open to HC-FMUSP-based research groups. Thus far, the database has been used in 17 published studies, attracting several research groups (36,(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53) (see Supplementary Table S3). The hospitalization database is currently being used for a few additional analyses, and it will continue to be accessible for new studies proposed in the near future.…”

Section: Institutional Database Of Hospitalizations Due To Covid-19mentioning

confidence: 99%

Data-driven, cross-disciplinary collaboration: lessons learned at the largest academic health center in Latin America during the COVID-19 pandemic

Ritto,

de Araujo,

de Carvalho

et al. 2024

Front. Public Health

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IntroductionThe COVID-19 pandemic has prompted global research efforts to reduce infection impact, highlighting the potential of cross-disciplinary collaboration to enhance research quality and efficiency.MethodsAt the FMUSP-HC academic health system, we implemented innovative flow management routines for collecting, organizing and analyzing demographic data, COVID-related data and biological materials from over 4,500 patients with confirmed SARS-CoV-2 infection hospitalized from 2020 to 2022. This strategy was mainly planned in three areas: organizing a database with data from the hospitalizations; setting-up a multidisciplinary taskforce to conduct follow-up assessments after discharge; and organizing a biobank. Additionally, a COVID-19 curated collection was created within the institutional digital library of academic papers to map the research output.ResultsOver the course of the experience, the possible benefits and challenges of this type of research support approach were identified and discussed, leading to a set of recommended strategies to enhance collaboration within the research institution. Demographic and clinical data from COVID-19 hospitalizations were compiled in a database including adults and a minority of children and adolescents with laboratory confirmed COVID-19, covering 2020–2022, with approximately 350 fields per patient. To date, this database has been used in 16 published studies. Additionally, we assessed 700 adults 6 to 11 months after hospitalization through comprehensive, multidisciplinary in-person evaluations; this database, comprising around 2000 fields per subject, was used in 15 publications. Furthermore, thousands of blood samples collected during the acute phase and follow-up assessments remain stored for future investigations. To date, more than 3,700 aliquots have been used in ongoing research investigating various aspects of COVID-19. Lastly, the mapping of the overall research output revealed that between 2020 and 2022 our academic system produced 1,394 scientific articles on COVID-19.DiscussionResearch is a crucial component of an effective epidemic response, and the preparation process should include a well-defined plan for organizing and sharing resources. The initiatives described in the present paper were successful in our aim to foster large-scale research in our institution. Although a single model may not be appropriate for all contexts, cross-disciplinary collaboration and open data sharing should make health research systems more efficient to generate the best evidence.

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“…PCC or "long COVID-19" manifestations is generally defined when any symptoms continued after 12 weeks of acute SARS-CoV-2 infection onset and cannot be justified by other conditions (5)(6)(7)(8). The prevalence of PCC in pediatric populations ranges from 0.31% to 30% (1,9,10) and studies rarely included populations of children and adolescents with chronic preexisting conditions (3,5).…”

Section: Introductionmentioning

confidence: 99%

Health-related quality of life and functionality in primary caregiver of surviving pediatric COVID-19

Martins

Gonçalves

Imamura

et al. 2023

Front. Public Health

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ObjectivesTo prospectively assess health-related quality of life (HRQoL), global functionality, and disability in primary caregivers of surviving children and adolescents after COVID-19.MethodsA longitudinal observational study was carried out on primary caregivers of surviving pediatric post-COVID-19 patients (n = 51) and subjects without COVID-19 (n = 60). EuroQol five-dimension five-level questionnaire (EQ-5D-5L) and 12-question WHO Disability Assessment Schedule 2.0 (WHODAS 2.0) were answered for both groups. The univariate regression analysis was carried out using SPSS (v 20) and significance was established at 5%.ResultsThe median duration between COVID-19 diagnosis in children and adolescents and longitudinal follow-up visits was 4.4 months (0.8–10.7). The median age of children and adolescents caregivers with laboratory-confirmed COVID-19 was similar to primary caregivers of subjects without laboratory-confirmed COVID-19 [43.2 (31.6–60.9) vs. 41.5 (21.6–54.8) years, p = 0.08], as well as similar female sex (p = 1.00), level of schooling (p = 0.11), social assistance program (p = 0.28), family income/month U$ (p = 0.25) and the number of household’s members in the residence (p = 0.68). The frequency of slight to extreme problems (level ≥ 2) of the pain/discomfort domain according to EQ-5D-5L score was significantly higher in the former group [74% vs. 52.5%, p = 0.03, OR = 2.57 (1.14–5.96)]. The frequency of disability according to WHODAS 2.0 total score was similar to those without disability and unknown (p = 0.79); however, with a very high disability in both groups (72.5% and 78.3%). Further analysis of primary caregivers of children and adolescents with post-COVID-19 condition (PCC) [n = 12/51 (23%)] compared to those without PCC [n = 39/51(77%)] revealed no differences between demographic data, EQ-5D-5L and WHODAS 2.0 scores in both groups (p > 0.05).ConclusionWe longitudinally demonstrated that pain/discomfort were predominantly reported in approximately 75% of primary caregiver of COVID-19 patients, with high disability in approximately three-quarters of both caregiver groups. These data emphasized the prospective and systematic caregiver burden evaluation relevance of pediatric COVID-19.

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Differences in children and adolescents with SARS-CoV-2 infection: a cohort study in a Brazilian tertiary referral hospital

Cited by 6 publications

References 40 publications

Prognostic factors for mortality, ICU, MIS-C and hospital admission due to SARS-CoV-2 in paediatric patients: A systematic review and meta-analysis

Prognostic factors for mortality, ICU, MIS-C and hospital admission due to SARS-CoV-2 in paediatric patients: A systematic review and meta-analysis

Data-driven, cross-disciplinary collaboration: lessons learned at the largest academic health center in Latin America during the COVID-19 pandemic

Health-related quality of life and functionality in primary caregiver of surviving pediatric COVID-19

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