Factors Associated With Severe Illness in Patients Aged &amp;lt;21 Years Hospitalized for COVID-19

Choudhary, Rewa; Webber, Bryant J.; Womack, Lindsay S.; Dupont, Hannah; Chiu, Sophia; Wanga, Valentine; Gerdes, Megan E.; Hsu, Sophia; Shi, Dallas S.; Dulski, Theresa M.; Idubor, Osatohamwen I.; Wendel, Arthur M.; Agathis, Nickolas T.; Anderson, Kristi; Boyles, Tricia; Click, Eleanor S.; Silva, Juliana da; Evans, Mary; Gold, Jeremy A W; Haston, Julia C.; Logan, Pamela; Maloney, Susan A.; Martínez, Marisol; Natarajan, Pavithra; Spicer, Kevin B.; Swancutt, Mark A.; Stevens, Valerie A.; Rogers-Brown, Jessica; Chandra, Gyan; Light, Megan; Barr, Frederick E.; Snowden, Jessica; Kociolek, Larry K.; McHugh, Matthew D.; Wessel, David; Simpson, Joelle; Gorman, Kathleen; Breslin, Kristen; DeBiasi, Roberta L.; Thompson, Aaron; Kline, Mark W.; Boom, Julie A.; Singh, Ila R.; Dowlin, Michael; Wietecha, Mark; Schweitzer, Beth; Morris, Sapna Bamrah; Koumans, Emilia H.; Ko, Jean Y.; Siegel, David A.; Kimball, Anne

doi:10.1542/hpeds.2022-006613

Cited by 13 publications

(20 citation statements)

References 31 publications

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“…obesity is associated with a severe course of Covid-19 in children, a condition with also was present in our case [17]. There is a growing body of evidence, that immune-related aspects might determine the development of severe causes.…”

Section: Accepted Manuscriptsupporting

confidence: 74%

“… 16 As in adults, obesity is associated with a severe course of COVID-19 in children, a condition with also was present in our case. 17 There is a growing body of evidence, that immune-related aspects might determine the development of severe causes. Therefore, immunomodulatory and anti-inflammatory therapies are recommended, especially in the early phase of COVID-19 disease.…”

Section: Discussionmentioning

confidence: 99%

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Treatment of Acquired von Willebrand Disease due to Extracorporeal Membrane Oxygenation in a Pediatric COVID-19 Patient with Vonicog Alfa: A Case Report and Literature Review

Heubner

Trautmann

Tiebel

et al. 2023

TH Open

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Acquired von Willebrand syndrome (aVWD) is frequently observed in patients with the need for extracorporeal membrane oxygenation (ECMO). aVWD can be treated by plasma-derived concentrates containing FVIII and/or VWF and recombinant vWF concentrate as well as adjuvant therapies such as tranexamic acid and desmopressin. However, all of these therapeutic options possibly cause thromboembolism. Therefore, the optimal treatment remains uncertain. This report presents a case of a 16 year old patient suffering from severe acute respiratory distress syndrome due to COVID-19 with the need of ECMO support. Our patient developed aVWD under ECMO-therapy characterized by loss of high-molecular-weight multimers (HMWM) and severe bleeding symptoms following endoscopic papillotomy due to sclerosing cholangitis. At the same time standard laboratory parameters showed hypercoagulability with increased fibrinogen level and platelet count. The patient was successfully treated with recombinant vWF concentrate (rvWF; vonicog alfa; Veyvondi®) combined with topic tranexamic acid application and cortisone therapy. AvWD is characterized by ultra-large multimers and absence of FVIII. Patient could be successfully weaned from ECMO-support after 72 days. Multimer analysis one week after ECMO-decannulation showed an adequate reappearance of HMWM.

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Section: Accepted Manuscriptsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Treatment of Acquired von Willebrand Disease due to Extracorporeal Membrane Oxygenation in a Pediatric COVID-19 Patient with Vonicog Alfa: A Case Report and Literature Review

Heubner

Trautmann

Tiebel

et al. 2023

TH Open

View full text Add to dashboard Cite

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“…In a study by Choudhary et al [ 72 ] on COVID-19-related pediatric hospitalizations, including 759 COVID-19 positive patients, an age-related trend was noted for RSV co-infection (42 (23.9%), 26 (21.3%), 4 (2.8%), and 3 (1.1%), in infants, children aged 1–4 years, 5–11 years, and 12–17 years, respectively). The authors also noted the co-infection with RSV to be one of the factors associated with severe illness (prevalence ratio of 3.64, 1.96, 2.2, and 2.48, in infants, children aged 1–4 years, 5–11 years, and 12–17 years, respectively).…”

Section: Rsv and Covid-19 Co-infectionmentioning

confidence: 99%

Impact of COVID-19 on the Changing Patterns of Respiratory Syncytial Virus Infections

Garg

Shekhar

Sheikh

et al. 2022

Infectious Disease Reports

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Seasonal epidemics of respiratory syncytial virus (RSV) is one of the leading causes of hospitalization and mortality among children. Preventive measures implemented to reduce the spread of SARS-CoV-2, including facemasks, stay-at-home orders, closure of schools and local-national borders, and hand hygiene, may have also prevented the transmission of RSV and influenza. However, with the easing of COVID-19 imposed restrictions, many regions are noticing a delayed RSV outbreak. Some of these regions have also noted an increase in severity of these delayed RSV outbreaks partly due to a lack of protective immunity in the community following a lack of exposure from the previous season. Lessons learned from the COVID-19 pandemic can be implemented for controlling RSV outbreaks, including: (1) measures to reduce the spread, (2) effective vaccine development, and (3) genomic surveillance tools and computational modeling to predict the timing and severity of RSV outbreaks. These measures can help reduce the severity and prepare the health care system to deal with future RSV outbreaks by appropriate and timely allocation of health care resources.

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“…Similar to findings in adults and limited pediatric studies, our results confirm that clinical illness was more severe during the Delta period compared with the wild-type period, as evidenced by higher rates of ICU admission and an increased proportion of children who required respiratory support. 8,[15][16][17] Length of stay was relatively short overall (2-3 days) and was shortest during the Omicron period, which could reflect decreasing severity of illness during this variant period and/or improvements in the management of symptomatic COVID-19 infection in children. 5,6,9,18 While not specifically examined in our study, SARS-CoV-2 infection commonly presented as upper airway inflammation (croup) during the Omicron period, which may have contributed to the shorter length of stay in this period.…”

Section: Discussionmentioning

confidence: 99%

Changing Characteristics of Children With COVID-19 in Colorado Admitted During Different Variant Periods

Jelic¹,

Silveira²,

Lang³

et al. 2023

Pediatric Infectious Disease Journal

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Background: Data are lacking on the impact of different severe acute respiratory syndrome coronavirus 2 variants in children and on pediatric vaccine effectiveness. We examined differences among children requiring hospital admission associated with coronavirus disease 2019 (COVID-19) during wild type, Delta and Omicron variant periods and calculated vaccine effectiveness at preventing symptomatic hospitalization during the Delta and Omicron variant periods. Methods: We conducted a retrospective review of children younger than 21 years of age hospitalized with symptomatic COVID-19. Characteristics were compared between variant periods using Kruskal–Wallis or generalized Fisher exact tests. We estimated vaccine effectiveness in preventing symptomatic hospitalization. Results: We included 115 children admitted during the wild type period, 194 during Delta and 226 during the Omicron periods. Median age (years) decreased (12.2 wild type, 5.9 Delta, 1.3 Omicron periods, P < 0.0001) over time. Children were less likely to have a comorbid condition, including diabetes or obesity, and had shorter admissions during Omicron compared with the wild type and Delta periods. Intensive care unit admissions and respiratory support requirements were highest during the Delta period (P = 0.05). Among children ≥12 years, adjusted vaccine effectiveness at preventing symptomatic hospitalization was 86% during Delta and 45% during Omicron periods. Conclusion(s): Children hospitalized with COVID-19 during later variant periods were younger and less likely to have comorbidities. Children admitted during the Delta variant period required more intensive care and respiratory support compared to other variant periods. Vaccination was less effective at preventing symptomatic hospital admission during the Omicron period compared to the Delta period.

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Factors Associated With Severe Illness in Patients Aged <21 Years Hospitalized for COVID-19

Cited by 13 publications

References 31 publications

Treatment of Acquired von Willebrand Disease due to Extracorporeal Membrane Oxygenation in a Pediatric COVID-19 Patient with Vonicog Alfa: A Case Report and Literature Review

Treatment of Acquired von Willebrand Disease due to Extracorporeal Membrane Oxygenation in a Pediatric COVID-19 Patient with Vonicog Alfa: A Case Report and Literature Review

Impact of COVID-19 on the Changing Patterns of Respiratory Syncytial Virus Infections

Changing Characteristics of Children With COVID-19 in Colorado Admitted During Different Variant Periods

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