Severe respiratory viral infections in children with history of asymptomatic or mild COVID‐19

Rai, Nooralam; Cornett, Joseph A.; Zachariah, Philip; Quittell, Lynne M.; Lovinsky‐Desir, Stephanie

doi:10.1002/ppul.25752

Cited by 3 publications

(1 citation statement)

References 32 publications

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“…There is evidence that adults and children with established type 1 and type 2 diabetes mellitus, particularly those with Black race, have a higher incidence of diabetic ketoacidosis during COVID-19 illness [6][7][8]. There is mixed evidence in asthma with multiple studies reporting worsening asthma symptoms and rates of hospitalization during COVID-19 illness [9][10][11][12][13] while other studies report a protective or neutral effect [14][15][16][17][18]. Obesity predisposes children to increased severity of COVID-19 and is a risk factor for critical illness in adolescents with COVID-19 [19,20].…”

Section: Introductionmentioning

confidence: 99%

Healthcare utilization following SARS-CoV-2 infection in children and adolescents with chronic conditions: An EHR-based Cohort Study from the RECOVER Program

Pajor

Lorman

Razzaghi

et al. 2022

Preprint

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Background Chronic medical conditions are a risk factor for moderate or severe COVID-19 in children, but little is known about post-acute sequelae of SARS-CoV-2 infection (PASC) in children with chronic medical conditions (CMCs). To understand whether SARS-CoV-2 infection led to potential exacerbation of underlying chronic disease in children, we explored whether children with CMCs had increased healthcare utilization in the post-acute (28 days after infection) period compared to children with CMCs without SARS-CoV-2 infection. Methods We conducted a retrospective, matched-cohort study using electronic health record data collected from 8 pediatric health care systems participating in the PEDSnet network. We included children <21 years of age with a wide array of chronic conditions, defined by the presence of diagnostic codes, who were diagnosed with COVID-19 between March 1, 2020 and February 28, 2022. Cohort entry was defined by presence of a positive SARS-CoV-2 PCR test (polymerase chain reaction or antigen) or diagnostic codes for COVID-19, PASC or MIS-C. A comparison cohort of patients testing negative or without these conditions was matched using a stratified propensity score model and exact matching on age group, race/ethnicity, institution, test location, and month of cohort entry. A negative binomial model was used to examine our primary outcome: composite and setting-specific (inpatient, outpatient, ED) utilization rate ratios between the positive and comparison cohorts. Secondary outcomes included time to first utilization in the post-acute period, and utilization stratified by severity at cohort entry. Results We identified 748,692 patients with at least one chronic condition, 78,744 of whom met inclusion criteria for the COVID-19 cohort. 96% of patients from the positive cohort were matched. Cohorts were well-balanced for chronic condition clusters, total number of conditions, time since first diagnosis, baseline utilization, cohort entry period, age, sex, race/ethnicity and test location. We found that among children with chronic medical conditions, those with COVID-19 had higher healthcare utilization than those with no recorded COVID-19 diagnosis or positive test, with utilization rate ratio of 1.21 (95% CI: 1.18-1.24). The utilization was highest for inpatient care with utilization rate ratio of 2.03 (95% CI: 1.85-2.23) but the utilization was increased across all settings. Hazard ratios estimated in time-to-first-utilization analysis mirrored these results. Patients with severe or moderate acute COVID-19 illness had greater increases in utilization in all settings than those with mild or asymptomatic disease. Conclusions We found that care utilization in all settings was increased following COVID-19 in children with chronic medical conditions in the post-acute period, particularly in the inpatient setting. Increased utilization was correlated with more severe COVID-19. Additional research is needed to better understand the reasons for higher care utilization by studying condition-specific outcomes in children with chronic disease.

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Section: Introductionmentioning

confidence: 99%

Healthcare utilization following SARS-CoV-2 infection in children and adolescents with chronic conditions: An EHR-based Cohort Study from the RECOVER Program

Pajor

Lorman

Razzaghi

et al. 2022

Preprint

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Severe respiratory viral infections in children with history of asymptomatic or mild COVID‐19

Rai

Cornett

Zachariah

et al. 2021

Pediatric Pulmonology

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Importance The spectrum of complications of COVID‐19 in children, including the effect of COVID‐19 on later viral infection, is not known. Objective To examine the features of children hospitalized for respiratory illness with history of prior COVID‐19. Design Retrospective observational case series at a single pediatric quaternary medical center in New York City. Data were obtained from review of medical records. Participants Children with prior mild or asymptomatic COVID‐19 and no known risk factors for severe respiratory disease, who were hospitalized at our center for acute respiratory illness from October 2020 to May 2021, were reviewed. Main Outcomes and Measures Co‐morbidities, history of prior COVID‐19 symptoms, respiratory viral panel findings, acuity of illness, degree of respiratory decompensation based on support and interventions required, duration of hospitalization, and overall clinical course were assessed from the medical record. Results This study included 5 patients (median age, 4 years; age range: 0.8–9 years; 4 [80%] male). All had positive COVID‐19 serology, 1 (20%) had mild symptoms, while the others had no symptoms of prior Sars‐CoV‐2 infection, 3 (60%) had asthma, and the remaining had no co‐morbidities. All were admitted between April and May 2021. Two were re‐admitted for respiratory symptoms in the subsequent 3 months. Conclusions and Relevance This case series describes a possible association between severe lower respiratory tract infection and prior mild COVID‐19 in children. Larger cohort studies describing the respiratory effects of prior COVID‐19 in children are needed.

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SARS-CoV-2 Is Not Special, but the Pandemic Is: The Ecology, Evolution, Policy, and Future of the Deadliest Pandemic in Living Memory

Brinkworth

Rusen

2022

Annu. Rev. Anthropol.

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The COVID-19 pandemic is extraordinary, but many ordinary events have contributed to its becoming and persistence. Here, we argue that the emergence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, which has radically altered day-to-day life for people across the globe, was an inevitability of contemporary human ecology, presaged by spillovers past. We show the ways in which the emergence of this virus reiterates other infectious disease crises, from its origin via habitat encroachment and animal use by humans to its evolution of troublesome features, and we spotlight a long-running crisis of inequitable infectious disease incidence and death. We conclude by describing aspects of SARS-CoV-2 and the COVID-19 pandemic that present opportunities for disease control: spaces for intervention in infection and recovery that reduce transmission and impact. There are no more “before times”; therefore, we encourage embracing a future using old mitigation tactics and government support for ongoing disease control. Expected final online publication date for the Annual Review of Anthropology Volume 51 is October 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

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Severe respiratory viral infections in children with history of asymptomatic or mild COVID‐19

Cited by 3 publications

References 32 publications

Healthcare utilization following SARS-CoV-2 infection in children and adolescents with chronic conditions: An EHR-based Cohort Study from the RECOVER Program

Healthcare utilization following SARS-CoV-2 infection in children and adolescents with chronic conditions: An EHR-based Cohort Study from the RECOVER Program

Severe respiratory viral infections in children with history of asymptomatic or mild COVID‐19

SARS-CoV-2 Is Not Special, but the Pandemic Is: The Ecology, Evolution, Policy, and Future of the Deadliest Pandemic in Living Memory

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