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SARS-CoV-2 proteins

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    Adolescent and Young Adult Stress and Coping During COVID-19 MESHD: The Utility of a Pediatric Emergency Department Screener

    Authors: Alan L Nager; Ji-Ting Janet Yau

    doi:10.21203/rs.3.rs-245776/v1 Date: 2021-02-16 Source: ResearchSquare

    Background: COVID-19 MESHD altered lives, especially adolescents and young adults who lost their emotional and social support systems and may be suffering. Objective: In response to the Coronavirus pandemic, a questionnaire was created and administered to Pediatric Emergency Department (PED) patients in order to identify psychosocial stress MESHD and coping abilities. Methods: A 12-question (yes/no) Quality Improvement (QI) paper-based questionnaire was administered by PED providers to assess psychosocial stress MESHD and coping among patients 12 years and greater who presented to the PED at a tertiary Children’s Hospital, March - September 2020. Questions were asked/recorded to determine rates of distress and provide social work intervention, if needed. Analysis-Chi-squared, Fisher’s exact, and Mann-Whitney U tests. Results: Among 1261 PED MESHD patients who participated in the study, the mean age was 15.4 years (SD=2.4), (58% female, 41.5% male, 0.6% missing data). We identified 611 patients (48.5%) who admitted to feeling scared about contracting the disease, 876 patients (69.5%) who were concerned about the health of their families, and 229 patients (18.2%) who screened positive for food MESHD insecurity. In addition, 596 patients (47.3%) felt anxiety MESHD, 333 patients (26.4%) felt depressed MESHD and 13 patients (1%) admitted to having suicidal ideation because of COVID-19 MESHD. The majority of patients, 1165 (92.4%), felt supported during the pandemic. Social work was consulted for 235 (18.6%) of patients participating. Conclusions: While patients typically present to PEDs for a somatic complaint, screening their psychosocial MESHD and emotional states may reveal underlying mental health concerns that require intervention and at times, assistance from social workers.

    SARS-CoV-2 Seroepidemiology in Children and Adolescents

    Authors: Rebecca E Levorson; Erica Christian; Brett Hunter; Jasdeep Sayal; Jiayang Sun; Scott A Bruce; Stephanie Garofalo; Matthew Southerland; Svetlana Ho; Shira Levy; Christopher Defillipi; Lilian Peake; Frederick C Place; Suchitra K Hourigan

    doi:10.1101/2021.01.28.21250466 Date: 2021-01-31 Source: medRxiv

    Background: Pediatric SARS-CoV-2 data remain limited and seropositivity rates in children were reported as <1% early in the pandemic. Seroepidemiologic evaluation of SARS-CoV-2 in children in a major metropolitan region of the United States was performed.Methods: Children and adolescents [≤] 19 years were enrolled in a cross-sectional, observational study of SARS-CoV-2 seroprevalence from July-October 2020 in Northern Virginia, United States. Demographic, health, and COVID-19 MESHD exposure information was collected, and blood was analyzed for SARS-CoV-2 spike PROTEIN protein total antibody. Risk factors associated with SARS-CoV-2 seropositivity were analyzed. Orthogonal antibody testing was performed, and samples were evaluated for responses to different antigens. Results: In 1038 children, the anti-SARS-CoV-2 total antibody positivity rate was 8.5%. After multivariate logistic regression, significant risk factors included Hispanic ethnicity, public or absent insurance, a history of COVID-19 MESHD symptoms, exposure to person with COVID-19 MESHD, a household member positive for SARS-CoV-2 and multi-family or apartment dwelling without a private entrance. 66% of seropositive children had no symptoms of COVID-19 MESHD. Orthogonal antibody testing with a receptor binding domain specific antigen revealed a high concordance of 80.5%. Children also demonstrated a robust immune response to the nucleocapsid antigen. Conclusions: A much higher burden of SARS-CoV-2 infection MESHD, as determined by seropositivity, was found in children than previously reported. This was also higher compared to adults in the same region at a similar time. Contrary to prior reports, we determined children shoulder a significant burden of COVID-19 MESHD infection. The role of pediatric infection MESHD and transmission must be considered in COVID-19 MESHD mitigation strategies including vaccination.

    Clinico-laboratory profile, intensive care needs, treatment details, and outcome of Pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS): A systematic review and Meta-analysis.

    Authors: Vijai Williams; Nabaneea Dash; Renu Suthar; Vichithra Mohandoss; Nishant Jaiswal; TK Kavitha; Karthi Nallasamy; Suresh Kumar Angurana

    doi:10.1101/2020.10.21.20217034 Date: 2020-10-25 Source: medRxiv

    Objectives: To synthesize the current data on clinico-laboratory features, intensive care needs, treatment, and outcome of Pediatric inflammatory multisystem syndrome MESHD temporally associated with SARS-CoV-2 (PIMS-TS) or multisystem inflammatory syndrome MESHD in children (MIS-C). Data Sources: Articles published in PubMed, Web of Science, Scopus, Google Scholar, and WHO COVID-19 MESHD research database, CDC database, and Cochrane COVID-19 MESHD study register between 1st December 2019 to 10th July 2020. Study Selection: Observational studies involving patients [≤]21 years with PIMS-TS or MIS-C, that reported the clinico-laboratory features, intensive care needs, treatment, and outcome. Data Extraction: The search identified 422 citations and finally 18 studies with 833 participants were included and pooled estimate was calculated for parameters of interest utilising random effect model. Data Synthesis: The median age was 9 (8-11) years. Fever MESHD, gastrointestinal symptoms MESHD, rash MESHD, conjunctival injection, and respiratory symptoms MESHD were common clinical features. Majority had positive SARS-CoV-2 antibody test and only 1/3rd had RT-PCR positive. The commonest laboratory abnormalities were elevated CRP, D-dimer, procalcitonin, BNP HGNC, fibrinogen HGNC, ferritin, troponin, and IL-6 HGNC; and lymphopenia MESHD, hypoalbuminemia MESHD, and thrombocytopenia MESHD. The cardiovascular complications included shock (65%), myocardial dysfunction MESHD (61%), myocarditis MESHD (65%), and coronary artery abnormalities MESHD (39%). Three-fourth children required admission in PICU for mechanical ventilation (25%) and vasoactive drugs (61%). The common treatment provided was IVIG (82%), steroids (54%), antiplatelet drugs (64%), and anticoagulation (51%). The mortality was low (n=13). Conclusion: Fever MESHD, gastrointestinal MESHD and mucocutaneous symptoms, cardiac dysfunction MESHD, shock, and hyperinflammation are common manifestations of PIMS-TS or MIS-C. The short-term outcome is good with supportive intensive care and immunomodulatory treatment.

    Pediatric Inflammatory Multisystem Syndrome (PIMS) Did Occur in Poland during Months with Low COVID-19 MESHD Prevalence. Preliminary Results of a Nationwide Register.

    Authors: Magdalena Okarska-Napierała; Kamila Ludwikowska; Leszek Szenborn; Natalia Dudek; Anna Mania; Piotr Buda; Janusz Książyk; Katarzyna Mazur-Malewska; Magdalena Figlerowicz; Maciej Szczukocki; Beata Kucińska; Bożena Werner; Lidia Stopyra; Agnieszka Czech; Elżbieta Berdej-Szczot; Aneta Gawlik; Paulina Opalińska; Artur Mazur; Danuta Januszkiewicz-Lewandowska; Cezary Niszczota; Teresa Jackowska; Jacek Wysocki; Paweł Tracewski; Jacek Kusa; Paulina Potocka; Artur Sulik; Katarzyna Ziora; Helena Krakowczyk; Aleksandra Wodniak; Janusz Zaryczański; Alicja Żakiewicz-Cepak; Elżbieta Jarocka-Cyrta; Agnieszka Koczwara; Anna Prusek-Dudkiewicz; Ewa Zbucka-Jachowska; Sabina Langer-Wójcik; Elżbieta Kołodziej; Ernest Kuchar

    id:10.20944/preprints202009.0435.v1 Date: 2020-09-18 Source: Preprints.org

    Pediatric inflammatory multisystem syndrome MESHD ( PIMS MESHD) is a new entity in children, likely associated with previous coronavirus disease MESHD 19 ( COVID-19 MESHD). Most of reports about PIMS MESHD come from countries particularly hit by the COVID-19 pandemic MESHD. Our aim was to investigate the nature of inflammatory syndromes in Poland (a country with low COVID-19 MESHD prevalence) and to perceive the emergence of PIMS MESHD in our country. On May 25th, we have launched a nationwide survey of inflammatory syndromes in children for retrospective (since 4th March 2020) and prospective data collection. Up to 28th July, 39 reported children met inclusion criteria. We stratified them according to age (<5 and ≥ 5 years old) and COVID-19 MESHD status. The majority of children had clinical and laboratory features of Kawasaki disease MESHD, probably non-associated with COVID-19 MESHD. However, children ≥5 years of age had PIMS MESHD characteristics, and 9 children had COVID-19 MESHD confirmation. This is the first to our knowledge report of PIMS MESHD register from the country with low COVID-19 MESHD prevalence, and it proves that PIMS MESHD may emerge in any area involved in the COVID-19 pandemic MESHD. In a context of limited COVID-19 MESHD testing availability, other risk factors of PIMS MESHD, e.g. older age should be considered in the differential diagnosis of inflammatory syndromes in children.

    Multisystem inflammatory syndrome in children related to COVID-19 MESHD: A systematic review

    Authors: Levi Hoste; Ruben Van Paemel; Filomeen Haerynck

    doi:10.1101/2020.08.17.20173641 Date: 2020-08-18 Source: medRxiv

    Importance. In April 2020, multiple reports of an association between a hyperinflammatory, Kawasaki-like condition and SARS-CoV-2 were published and termed as pediatric inflammatory multisystem syndrome MESHD ( PIMS MESHD) or multisystem inflammatory syndrome MESHD ( MIS MESHD MIS HGNC). A thorough characterization of this syndrome (demographics, presentation, diagnosis, and outcome) is currently lacking. Objective. We aimed to perform a systematic review of published cases of this novel multisystem inflammatory syndrome MESHD in children associated with COVID-19 MESHD. Evidence review. A literature search of Pubmed, Embase, BioRxiv, MedRxiv and COVID-19 MESHD specific research repositories (Cochrane COVID-19 MESHD Study Register and the World Health Organization (WHO) COVID-19 MESHD Global Research Database) was conducted from December 30th, 2019 to June 30th, 2020. Publications describing inflammatory syndromes associated with COVID-19 MESHD were included. Of 333 unique publications, 229 records were excluded based on title and abstract. After screening the full text, 40 observational studies and case reports were included, comprising 687 cases (published between May 9th, 2020 and June 30th, 2020). Findings. In contrast to classic Kawasaki disease MESHD, epidemiological enrichment for adolescents (median age 9 [6.0-12.3]) and ethnic minorities (35.8% black and 24.5% Hispanic/Latino) was observed. There was a male predominance (59.1%). Apart from obesity MESHD (24.4%), pre-existing conditions were infrequent. The majority suffered from gastrointestinal (87.2%) and cardiocirculatory (79.2%) manifestations. Respiratory symptoms (51.2%) were less frequent. Over half of patients (56.3%) presented with hemodynamic shock, and critical care interventions were often necessary (inotropics (56.5%), mechanical ventilation (22.9%), non-invasive ventilation (30.6%), extracorporal membrane oxygenation (ECMO;4.5%)). Anti-SARS-CoV-2 IgG and RT-PCR were positive in respectively 69.4% and 36.7%. Eleven deaths MESHD were reported (1.6%). The RCPCH case definition proved to be most comprehensive comprising all single cases. In contrast, WHO and CDC MIS MESHD MIS HGNC definitions are more stringent, with the CDC case definition often missing severe cases requiring intensive care (n = 33 out of 95 cases). Conclusions and Relevance. This novel pediatric multisystem hyperinflammatory condition MESHD, associated with COVID-19 MESHD, is characterized by a severe and heterogeneous disease spectrum. Despite frequent intensive care interventions, mortality rate was low and short-term outcome favorable. Long-term follow-up of possible chronic complications and additional clinical research, to elucidate the underlying immunological pathogenesis and possible genetic predisposition is crucial.

    Clinical Characteristics of 10 Children With a Pediatric Inflammatory Multisystem Syndrome Associated with COVID-19 MESHD In Iran

    Authors: Leila Shahbaznejad; Mohammad Reza Navaifar; Ali Abbaskhanian; Fatemeh Hosseinzadeh; Golnar Rahimzadeh; Mohammad Sadegh Rezai

    doi:10.21203/rs.3.rs-51157/v3 Date: 2020-07-30 Source: ResearchSquare

    Background: Although symptoms and signs of COVID-19 MESHD ( Coronavirus disease 2019 MESHD) in children are milder than adults, there are reports of more severe cases which were defined as pediatric inflammatory multisystem syndrome MESHD ( PIMS MESHD). The purpose of this report was to describe the possible association between COVID-19 MESHD and PIMS in children.  Methods: From 28 March to 24 June 2020, 10 febrile children were admitted with COVID-19 MESHD infection showing characteristics of PIMS in Buali tertiary hospital of Sari, in Mazandaran province, northern Iran. Demographic and clinical characteristics, laboratory and imaging findings, and therapeutic modalities were recorded and analyzed. Results: The mean age of the patients was 5.37±3.9 years (13 months to 12 years). Six of them were boys. Kawasaki disease MESHD, myocarditis MESHD, toxic shock syndrome MESHD, appendicitis MESHD, sepsis MESHD, urosepsis, prolonged febrile seizure MESHD, acute hemorrhagic edema MESHD of infancy, and COVID-19 MESHD-related pneumonia MESHD were their first presentation. All of them had increased C-reactive protein HGNC levels, and most of them had elevated erythrocyte sedimentation rate, lymphopenia, anemia MESHD, and hypoalbuminemia MESHD. Three of them had thrombocytopenia MESHD(PLT<106). Six of them were serologically or polymerase chain reaction positive for COVID-19 MESHD, and 4 of them were diagnosed as COVID-19 MESHD just by chest computed tomography scan. Most of the patients improved without a residual sequel, except one who died with multiorgan failure MESHD and another case was discharged with a giant coronary aneurysm MESHD.Conclusion: Children with COVID-19 MESHD may present symptoms similar to Kawasaki disease MESHD and inflammatory syndromes. PIMS should be considered in children with fever MESHD, rash MESHD, seizure MESHD, cough, tachypnea MESHD, and gastrointestinal symptoms such as vomiting MESHD, diarrhea MESHD, and abdominal pain MESHD.

    A Saudi G6PD HGNC Deficient Girl Died with Pediatric Multisystem Inflammatory Syndrome- COVID-19 MESHD

    Authors: Maryam Ali Al-Aamri; Fatimah Tawfiq Al-Khars; Sami Jawad Alkhwaitem; Abdulaziz Khalifah AlHassan; Ali Mohammed Al Aithan; Fatima Hameed Alkhalifa; Sameer Yaseen Al-Abdi

    doi:10.1101/2020.07.08.20137497 Date: 2020-07-10 Source: medRxiv

    Reports on pediatric multisystem inflammatory syndrome MESHD ( PMIS MESHD) temporally related to coronavirus disease 2019 MESHD ( COVID-19 MESHD) are increasing. African and Afro-Caribbean children constituted about 47% of the cases in these reports. Despite the fact that glucose-6-phosphatase dehydrogenase ( G6PD HGNC) deficiency is common among this population, the G6PD HGNC status of these cases has not been reported in these reports. We reported the first case of PMIS related to COVID-19 MESHD from Saudi Arabia. This case was a Saudi G6PD HGNC deficient girl who died with PMIS related to COVID-19 MESHD. G6PD HGNC deficiency induces redox imbalance and exaggerates the inflammatory response; thus, it might contribute to the development or the grave outcome of our case. We urgently need to assess the association between G6PD HGNC deficiency and COVID-19 MESHD in a large study as the G6PD HGNC deficiency may be a useful predictor for the progression of the COVID-19 MESHD.

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

    Authors: Michelle Barton Forbes; Kayur Mehta; Kriti Kumar; Jielin Lu; Nicole Le Saux; Margaret Sampson; Joan Robinson

    doi:10.1101/2020.05.05.20091751 Date: 2020-05-08 Source: medRxiv

    BACKGROUND: Estimates of pediatric morbidity and mortality from COVID-19 MESHD 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 MESHD. 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 MESHD was reported for 15 cases. CONCLUSION: Children accounted for 1.9% of confirmed cases. The true incidence of pediatric infection MESHD 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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SARS-CoV-2 Proteins


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