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Preprint | medRxiv | ID: ppmedrxiv-21250375


There is increasing evidence that adult patients diagnosed with acute COVID-19 suffer from Long COVID initially described in Italy. To date, data on Long COVID in children are lacking. We assessed persistent symptoms in pediatric patients previously diagnosed with COVID-19. More than a half reported at least one persisting symptom even after 120 days since COVID-19, with 42.6% being impaired by these symptoms during daily activities. Symptoms like fatigue, muscle and joint pain, headache, insomnia, respiratory problems and palpitations were particularly frequent, as also described in adults. The evidence that COVID-19 can have long-term impact children as well, including those with asymptomatic/paucisymptomatic COVID-19, highlight the need for pediatricians, mental health experts and policy makers of implementing measures to reduce impact of the pandemic on childs health.

Preprint | medRxiv | ID: ppmedrxiv-20225359


BackgroundHealth conditions and immune dysfunction associated with trisomy 21 (Down syndrome, DS) may impact the clinical course of COVID-19 once infected by SARS-CoV-2. MethodsThe T21RS COVID-19 Initiative launched an international survey for clinicians or caregivers/family members on patients with COVID-19 and DS (N=1046). De-identified survey data collected between April and October 2020 were analysed and compared with the UK ISARIC4C survey of hospitalized COVID-19 patients with and without DS. COVID-19 patients with DS from the ISARIC4C survey (ISARIC4C DS cases=100) were matched to a random set of patients without DS (ISARIC4C controls=400) and hospitalized DS cases in the T21RS survey (T21RS DS cases=100) based on age, gender, and ethnicity. FindingThe mean age in the T21RS survey was 29 years (SD=18), 73% lived with their family. Similar to the general population, the most frequent signs and symptoms of COVID-19 were fever, cough, and shortness of breath. Pain and nausea were reported less frequently (p<0.01), whereas altered consciousness/confusion were reported more frequently (p<0.01). Risk factors for hospitalization and mortality were similar to the general population (age, male gender, diabetes, obesity, dementia) with the addition of congenital heart defects as a risk factor for hospitalization. Mortality rates showed a rapid increase from age 40 and were higher than for controls (T21RS DS versus controls: risk ratio (RR)=3.5 (95%-CI=2.6;4.4), ISARIC4C DS versus controls: RR=2.9 (95%-CI=2.1;3.8)) even after adjusting for known risk factors for COVID-19 mortality. InterpretationLeading signs/symptoms of COVID-19 and risk factors for severe disease course are similar to the general population. However, individuals with DS present significantly higher rates of mortality, especially from age 40. FundingDown Syndrome Affiliates in Action, Down Syndrome Medical Interest Group-USA, GiGis Playhouse, Jerome Lejeune Foundation, LuMind IDSC Foundation, Matthews Foundation, National Down Syndrome Society, National Task Group on Intellectual Disabilities and Dementia Practices.

Preprint | medRxiv | ID: ppmedrxiv-20169912


Wheather children are easily susceptible to SARS-CoV-2 infection is still a debated question and a currently a hot topic, particularly in view of important decisions on school opening. For this reason, we decide to describe preliminary data showing the prevalence of anti-SARS-CoV-2 IgG in children with known household exposure to SARS-CoV-2. Our report shows that household transmission of SARS-CoV-2 is high in both adults and children, with similar rates of SARS-CoV-2 IgG in all age groups, including the younger children. A total of 44 out of 80 household contacts (55%) of index patients had anti SARS-CoV-2 IgG. In particular, 16 (59,26%) adult partners had IgG antibodies compared with 28 (52,83%) of pediatric contacts (P > 0.05). Among the pediatric population, children [≥] 5 years of age had similar probability of having SARS-CoV-2 IgG (21/39, 53.8%) compared with those < 5 years (7/14, 50%) (P > 0.05). Adult partners and children also had a probability of having SARS-CoV-2 IgG. Interestingly, 35.7% of children and 33.3% of adults with SARS-CoV-2 IgG were previously diagnosed as COVID-19 cases. Since this evidence of high rate of IgG in children exposed to SARS-CoV-2 has public health implication, with this comment we highlight the need of establishing appropriate guidelines for school opening and other social activities related to childhood.