Evidence of lung perfusion defects and ongoing inflammation in an adolescent with post-acute sequelae of SARS-CoV-2 infection

Buonsenso, Danilo; Giuda, Daniela Di; Sigfrid, Louise; Pizzuto, Daniele Antonio; Sante, Gabriele Di; Rose, Cristina De; Lazzareschi, Ilaria; Sali, Michela; Baldi, Fabiana; Chieffo, Daniela Pia Rosaria; Munblit, Daniel; Valentini, Piero

doi:10.1016/s2352-4642(21)00196-6

Cited by 97 publications

(100 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In particular, COVID-19 sequelae could be linked with the mast cell activation syndrome and the Th-2 biased immunological response in children with allergic diseases [ 5 ]. Importantly, these findings are in line with a recent case report describing an adolescent with persisting symptoms with first documentation of ongoing immune dysfunction and lung perfusion defects after mild COVID-19 [ 14 ].…”

Section: Long Covid In Childrensupporting

confidence: 89%

Long COVID: to investigate immunological mechanisms and sex/gender related aspects as fundamental steps for tailored therapy

Ortona

Malorni

2021

Eur Respir J

View full text Add to dashboard Cite

Around a quarter of people who have had COVID-19 experience symptoms that continue for at least a month but one in ten are still unwell after 12 weeks. This very debilitating condition has been defined by patient groups as “Long COVID” elsewhere called post-COVID, whereas the patients are frequently called COVID-19 long-haulers [1]. Long COVID has a serious impact on patient ability to go back to work or school, to have a social life and may have significant economic consequences for patients, their families and for society. The condition is characterized by long-term sequelae and can involve a range of about 200 different and overlapping symptoms such as persistent fatigue, chest and muscle pain, headache, shortness of breath, anosmia, muscle weakness, fever, cognitive dysfunction (brain fog), tachycardia, intestinal disorders and skin manifestations. It can affect anyone but women appear to be twice as likely to develop Long COVID as men, but only until around age 60, when the risk level becomes similar [2–4]. Long COVID has also been described in paediatric age [5]. An Italian study reported that at least one symptom persisted 4 months after COVID-19 infection [6] whereas an Australian analysis suggested that only 8% of children had ongoing symptoms 3–6 months after mild SARS-Cov-2 infection [7]. No gender difference was observed in the prevalence of Long-COVID in this population [5].

show abstract

Section: Long Covid In Childrensupporting

confidence: 89%

Long COVID: to investigate immunological mechanisms and sex/gender related aspects as fundamental steps for tailored therapy

Ortona

Malorni

2021

Eur Respir J

View full text Add to dashboard Cite

show abstract

“…As can be highlighted in Table 5 , an increase in D-dimers was associated not only with an increased risk of PICU hospitalization, but also with an increased risk of the need for mechanical ventilation or of developing cardiovascular complications or distant sequelae. This observation is also interesting considering the increasing evidence of long COVID-19 (or Post-Acute Sequelae of SARS-CoV-2, PASC) in children [ 26 , 27 ], since adult studies have documented those endothelial abnormalities and microembolisms can play a role in the pathology of PASC, and a recent pediatric study also confirmed the presence of lung perfusion defects months after acute infection [ 28 ].…”

Section: Discussionmentioning

confidence: 88%

Association between Coagulation Profile and Clinical Outcome in Children with SARS-CoV-2 Infection or MIS-C: A Multicenter Cross-Sectional Study

et al. 2022

Self Cite

View full text Add to dashboard Cite

Limited data on the coagulation profile in children affected by the SARS-CoV-2 infection are available. We aimed to evaluate the role of d-dimers as predictors of poor outcomes in a pediatric population affected by the SARS-CoV-2 infection or multisystem inflammatory syndrome (MIS-C). We performed a retrospective cross-sectional multicenter study. Data from four different centers were collected. Laboratory tests, when performed, were collected at the time of diagnosis, and 24, 48, 72, 96, 120 and beyond 120 h from diagnosis; blood counts with formula, an international normalized ratio (INR), activated partial thromboplastin time (aPTT), D-dimers and fibrinogen values were collected. Data regarding clinical history, management and outcome of the patients were also collected. Three hundred sixteen patients with a median age of 3.93 years (IQR 0.62–10.7) diagnosed with COVID-19 or MIS-C were enrolled. Fifty-eight patients (18.3%) showed a severe clinical outcome, 13 (4.1%) developed sequelae and 3 (0.9%) died. The univariate analysis showed that age, high D-dimer values, hyperfibrinogenemia, INR and aPTT elongation, and low platelet count were associated with an increased risk of pediatric intensive care unit (PICU) admission (p < 0.01). Three multivariate logistic regressions showed that a d-dimer level increase was associated with a higher risk of PICU admission. This study shows that D-dimer values play an important role in predicting the more severe spectrum of the SARS-CoV-2 infection, and was higher also in those that developed sequelae, including long COVID-19.

show abstract

“…According to our data, the most common post-acute COVID-19 clinical features were noted in children from 10 to 18 years. In conclusion, future studies assessing organ damage will be needed to better understand and characterise Long COVID in children [11]. This study has several limitations.…”

Section: To the Editormentioning

confidence: 88%

Clinical features of pediatric post-acute COVID-19: a descriptive retrospective follow-up study

et al. 2021

View full text Add to dashboard Cite

To date, information on COVID-19 long-term post-recovery sequelae in children and adolescents remains scarce. A retrospective descriptive cohort study was performed by collecting data on 92 patients (age ≤ 18 years). All were evaluated during a face-to-face visit following a specially designed post-COVID-19 symptom assessment protocol at the following stage: 1–3 months after COVID-19 onset. Among the 92 children, 45 (49%) were completely free of any COVID-19-related symptoms, while 47 (51%) reported persistence of at least one symptom, in particular tiredness, loss of taste and/or smell and headaches. The most common post-acute COVID-19 clinical features were noted in children aged between 10 and 18 years. A detailed multidisciplinary follow-up of patients with COVID-19 seems relevant, whatever the severity of the symptoms.

show abstract

Evidence of lung perfusion defects and ongoing inflammation in an adolescent with post-acute sequelae of SARS-CoV-2 infection

Cited by 97 publications

References 14 publications

Long COVID: to investigate immunological mechanisms and sex/gender related aspects as fundamental steps for tailored therapy

Long COVID: to investigate immunological mechanisms and sex/gender related aspects as fundamental steps for tailored therapy

Association between Coagulation Profile and Clinical Outcome in Children with SARS-CoV-2 Infection or MIS-C: A Multicenter Cross-Sectional Study

Clinical features of pediatric post-acute COVID-19: a descriptive retrospective follow-up study

Contact Info

Product

Resources

About