Seguridad de las actividades extraescolares en tiempos de pandemia por SARS-CoV-2. Estudio prospectivo en población pediátrica / Safety of extracurricular activities in times of pandemic by SARS-CoV-2. Prospective study in paediatric population

Introducción: la epidemia de la enfermedad por coronavirus 2019 ha obligado a implementar diferentes medidas para mitigar el impacto de un aumento inevitable de casos de COVID-19, como fue el cierre de los colegios. A su reapertura, dado que la actividad deportiva en la infancia y adolescencia es clave para su óptimo desarrollo, nos planteamos: ¿son seguras las actividades extraescolares deportivas en tiempos de COVID? Material y métodos: estudio observacional descriptivo longitudinal. Se siguió a 717 escolares deportistas y monitores de una asociación deportiva municipal que participaron en alguna de las actividades deportivas ofrecidas durante el periodo de septiembre a diciembre del año 2020. Ante un caso positivo, se contactó con la familia, cumplimentando la hoja de recogida de datos y realizando seguimiento de los menores. Resultados: de los 679 escolares deportistas y 38 adultos monitores estudiados, únicamente se registró un caso de infección por virus SARS-CoV-2. El caso fue un jugador de baloncesto de 13 años por un contacto familiar, la sintomatología fue leve y tanto él como su grupo de convivencia estable mantuvieron 10 días de cuarentena sin aparición de nuevos casos positivos. Conclusiones: nuestros resultados indican que si la práctica deportiva se realiza en grupos controlados, en medios optimizados y respetando las normas sanitarias, pueden ser espacios seguros para nuestra población pediátrica, con una baja tasa de transmisión del virus SARS-CoV-2. No hemos observado ningún brote en nuestra muestra habiendo implantado las medidas preventivas oportunas y siendo los niños excelentes cumplidores de las mismas. No obstante, es importante disponer de un registro preciso del alumnado existente para el rastreo de contactos e incidir tanto en las medidas generales de prevención como en las específicas para actividades deportivas para minimizar los riesgos (AU)

Introduction: the coronavirus disease 2019 pandemic has compelled the implementation of various measures to mitigate the impact of an inevitable increase in COVID-19 cases, such as the closure of schools. Upon their reopening, given that physical activity in childhood and adolescence is crucial for optimal development, we considered whether extracurricular athletic activities are safe in the COVID age. Material and methods: we conducted a longitudinal, observational and descriptive study. We followed up 717 students and instructors from a municipal sports organization that participated in sports activities offered between September and December 2020. When a positive case was identified, the staff contacted the family, filling in the data collection form and monitoring the students. Results: there was only 1 detected case SARS-CoV-2 infection among the 679 students and 38 adult instructors included in the study. It occurred in an adolescent aged 13 years that played basketball and acquired the infection from a family member and developed mild symptoms; both the boy and the peers in his consistent contact group were quarantined for 10 days without identification of additional cases. Discussion: our results suggests that if athletic activities are carried out in controlled groups in optimised environments and adhering to health standards, sports facilities can be safe spaces for the paediatric population with a low SARS-CoV-2 transmission rate. We did not identify any outbreaks in the sample, having implemented the appropriate preventive measures and verified strict adherence by the students. Nevertheless, it is important to keep accurate records of current students for contact tracing and to guide the implementation of preventive measures, both general and specific to particular sports activities, with the aim of minimising risk (AU)

Fecal Calprotectin and Eosinophil-Derived Neurotoxin in Children with Non-IgE-Mediated Cow's Milk Protein Allergy.

Our aim is to assess the efficacy of fecal calprotectin (fCP) and fecal eosinophil-derived neurotoxin (fEDN) as diagnostic markers of cow's milk protein allergy (CMPA) and for monitoring the infants' response to a non-IgE mediated cow's milk protein (CMP)-free diet. We prospectively recruited infants aged 0 to 9 months. Stool samples were taken from 30 infants with CMPA, 19 with mild functional gastrointestinal disorders, 28 healthy infants, and 28 children who presented mild infections. Despite the fact that levels of fCP and fEDN in CMPA infants were higher than in healthy infants at month 0, differences for both parameters did not reach statistical significance (p-value 0.119 and 0.506). After 1 month of an elimination diet, no statistically significant differences in fCP with basal levels were found (p-values 0.184) in the CMPA group. We found a high variability in the fCP and fEDN levels of young infants, and discrepancies in individual behavior of these markers after a CMP-free diet was started. It seems that neither fCP nor fEDN levels are helpful to discriminate between healthy infants and those with signs or symptoms related to non-IgE-mediated CMPA. Additionally, it is debatable if on an individual basis, fCP or fEDN levels could be used for clinical follow-up and dietary compliance monitoring. However, prospective studies with larger populations are needed to draw robust conclusions.

Urolithins in Human Breast Milk after Walnut Intake and Kinetics of Gordonibacter Colonization in Newly Born: The Role of Mothers' Urolithin Metabotypes.

The maternal-infant transmission of several urolithins through breast milk and the gut colonization of infants by the urolithin-producing bacterium Gordonibacter during their first year of life were explored. Two trials (proof-of-concept study: n = 11; validation study: n = 30) were conducted, where breastfeeding mothers consumed walnuts as a dietary source of urolithin precursors. An analytical method was developed and validated to characterize the urolithin profile in breast milk. Total urolithins ranged from 8.5 to 176.9 nM, while they were not detected in breast milk of three mothers. The mothers' urolithin metabotypes governed the urolithin profile in breast milk, which might have biological significance on infants. A specific quantitative polymerase chain reaction method allowed monitoring the gut colonization of infants by Gordonibacter during their first year of life, and neither breastfeeding nor vaginal delivery was essential for this. The pattern of Gordonibacter establishment in babies was conditioned by their mother's urolithin metabotype, probably because of mother-baby close contact.

Fecal calprotectin in healthy children aged 4-16 years.

Reference values of fecal calprotectin (fCP) have not been convincingly established in children. We aimed to investigate fCP concentrations in a larger population of healthy children aged 4-16 years to analyze more in depth the behavior of fCP in this age range and to determine if cut-off levels could be conclusively recommended. A prospective study was conducted to investigate fCP concentrations of healthy children aged 4-16 years. In 212 healthy children, the median and 95th percentile for fCP were 18.8 mg/kg and 104.5 mg/kg, respectively. We found a statistically significant association between the 95th percentile of fCP concentrations and age (p < 0.001). We propose a nomogram to facilitate the interpretation of fCP results in children aged 4-16 years. Further studies are required to validate the proposed values in clinical practice.

Urolithin Metabotypes can Anticipate the Different Restoration of the Gut Microbiota and Anthropometric Profiles during the First Year Postpartum.

The metabolism of dietary polyphenols ellagitannins by the gut-microbiota allows the human stratification in urolithin metabotypes depending on the final urolithins produced. Metabotype-A only produces urolithin-A, metabotype-B yields urolithin-B and isourolithin-A in addition to urolithin-A, and metabotype 0 does not produce urolithins. Metabotype-A has been suggested to be 'protective', and metabotype-B dysbiotic-prone to cardiometabolic impairments. We analyzed the gut-microbiome of 40 healthy women and determined their metabotypes and enterotypes, and their associations with anthropometric and gut-microbial changes after 3 weeks, 4, 6, and 12 months postpartum. Metabotype-A was predominant in mothers who lost weight (≥2 kg) (75%) versus metabotype-B (54%). After delivery, the microbiota of metabotype-A mothers changed, unlike metabotype-B, which barely changed over 1 year. The metabotype-A discriminating bacteria correlated to the decrease of the women's waist while some metabotype-B bacteria were inversely associated with a reduction of body mass index (BMI), waist, and waist-to-hip ratio. Metabotype-B was associated with a more robust and less modulating microbial and anthropometric profiles versus metabotype-A, in which these profiles were normalized through the 1-year follow-up postpartum. Consequently, urolithin metabotypes assessment could be a tool to anticipate the predisposition of women to normalize their anthropometric values and gut-microbiota, significantly altered during pregnancy and after childbirth.

Fecal Calprotectin and Eosinophil-derived Neurotoxin in Healthy Children Between 0 and 12 Years.

OBJECTIVES: In young children, the use of fecal calprotectin (fCP) as a biomarker is limited because reference values have not been widely accepted up to now. Moreover, reference values for fecal eosinophil-derived neurotoxin (fEDN) in children have not been established. The aim of the present study was to investigate fCP and fEDN levels in young healthy children to establish reference values. METHODS: Stool samples were obtained from healthy children ages 0 to 12 years. fCP and fEDN levels were analyzed using the EliA Calprotectin 2 assay (Phadia AB) and a novel research assay (on the ImmunoCAP platform), respectively. RESULTS: In the 174 included children (87 boys), 95th Percentile values ranged from 1519 mg/kg at 0 months to 54.4 mg/kg at 144 months for fCP and from 9.9 mg/kg at 0 months to 0.2 mg/kg at 144 months for fEDN. There was a statistically significant association between age and fCP concentrations (P < 0.001) and age and fEDN concentrations (P < 0.001). We also found a statistically significant association between fEDN and fCP concentrations (rho = 0.52, P < 0.001). According to our results, we provide a nomogram and we suggest 3 different age groups for evaluation of fCP and fEDN concentrations, the 95th percentile being respectively 910.3 and 7.4 mg/kg for 0-12 months, 285.9 and 2.9 mg/kg for >1 to 4 years, and 54.4 and 0.2 mg/kg for >4 to 12 years. DISCUSSION: By using an improved analytical method, we have confirmed that young healthy children have higher fCP concentrations than healthy adults. We, for the first time, report reference values for fEDN concentrations in a pediatric population. The proposed nomograms and reference values for fCP and fEDN are aimed at facilitating the applicability of biomarkers for both neutrophil- and eosinophil-mediated intestinal inflammation in children in clinical practice.