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Prolonged positive polymerase chain reaction (PCR) results, irrespective of the transmission risk, can lead to prolonged restrictions on daily activities and infection precaution interventions. Studies evaluating the duration of PCR positivity for multiple pathogens in a single patient cohort are scarce. This study aimed to evaluate and compare the durations of PCR positivity for multiple respiratory viruses among children and adolescents. This retrospective study was conducted between April 2018 and March 2024 using a multiplex PCR respiratory panel for symptomatic children and adolescents who had at least two tests within 90 days of study period, with the first PCR test positive. The rate and likelihood of persistent PCR positivity were evaluated for multiple respiratory viruses. For 1325 positive results, repeat tests were conducted within 90 days. The persistent PCR positivity rate at repeat testing decreased over time (60.6%, Days 1–15 and 21.7%, Days 76–90, after the first test). In multivariate logistic regression analysis, an increased likelihood of persistent PCR positivity was observed for rhinovirus/enterovirus and adenovirus, whereas decreased likelihood of persistent positivity was seen in influenza and seasonal coronaviruses, compared with parainfluenza viruses. Persistent PCR positivity is common for multiple respiratory viruses in symptomatic children. [ABSTRACT FROM AUTHOR]

The authors respond to comments on a study which analyzed the risk and benefits of mRNA COVID-19 vaccines, including quality-adjusted life years, for the omicron variant by age, sex and presence of comorbidity. They agree on the importance of long-term follow-up studies of adverse events following immunization. They clarify that the study findings do not imply the zero efficiency of mRNA vaccines and that adverse events including death were considered in the analysis of vaccine effectiveness.

The development of the mutant omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the coronavirus disease 2019 (COVID-19) pandemic raised the importance of reevaluating the risk and benefit of COVID-19 vaccines. With a decision tree model, we calculated the benefit-risk ratio and the benefit-risk difference of receiving monovalent messenger RNA (mRNA) COVID-19 vaccine (primary 2 doses, a third dose, and a fourth dose) in the 4–5 months after vaccination using quality-adjusted life years. The analysis was stratified by age, sex, and the presence of comorbidity. Evidence from peer-reviewed publications and gray literature was reviewed on September 16, 2022, to inform the study. Benefit-risk ratios for receipt of the BNT162b2 vaccine (Pfizer-BioNTech) ranged from 6.8 for males aged 12–17 years without comorbidity for the primary doses to 221.3 for females aged ≥65 years with comorbidity for the third dose. The benefit-risk ratios for receipt of the mRNA-1273 vaccine (Moderna) ranged from 7.2 for males aged 18–29 years without comorbidity for the primary doses to 101.4 for females aged ≥65 years with comorbidity for the third dose. In all scenarios of the one-way sensitivity analysis, the benefit-risk ratios were more than 1, irrespective of age, sex, comorbidity status, and type of vaccine, for both primary and booster doses. The benefits of mRNA COVID-19 vaccines in protecting against the omicron variant outweigh the risks, irrespective of age, sex, and comorbidity. [ABSTRACT FROM AUTHOR]

Congenital cytomegalovirus infection is the most common congenital infection. Using a decision tree model, cost‐effectiveness of maternal screening with subsequent prenatal valacyclovir treatment and newborn screening with neonatal valganciclovir treatment was evaluated. The incremental cost‐effectiveness ratio (ICER) was calculated for (1) universal maternal antibody screening with prenatal valacyclovir treatment compared to targeted newborn screening, and (2) universal newborn screening with postnatal valganciclovir treatment compared to targeted newborn screening. We performed a one‐way sensitivity analysis. Compared to targeted newborn screening, the ICERs for universal newborn screening and maternal screening were 2 966 296 Japanese Yen (JPY) (21 188 USD) and 1 026 984 JPY (7336 USD), respectively. In all scenarios in the one‐way sensitivity analysis, the ICERs of the maternal screening and the universal newborn screening strategies were less than three gross domestic product per capita compared with the targeted newborn screening strategy. Both maternal and universal newborn screening strategies may be cost‐effective than a targeted newborn screening program. The potential utility of the maternal screening with valacyclovir treatment strategy, while potentially cost effective in regions with lower baseline seroprevalence rates, requires further study as the modeling was based on limited evidence. [ABSTRACT FROM AUTHOR]

Emerging evidence has shown that the risk of developing COVID-19 in SOT recipients following non-lung transplantation from SARS-CoV-2 positive donors appears to be low in adults, with the transmission of SARS-CoV-2 from positive donors having only been reported in lung transplant recipients. Conclusions regarding the broad use of organs from SARS-CoV-2-positive donors remain limited, and a careful case-by-case evaluation of the donor and recipient with individualized risk stratification is still needed in the pediatric population. Abbreviations COVID-19 coronavirus disease 2019 C t cycle threshold OPTN Organ Procurement and Transplantation Network PCR polymerase chain reaction SARS-CoV-2 severe acute respiratory syndrome coronavirus 2 SOT solid organ transplantation COVID-19 has had an undeniable impact on the transplant population, including with regards to organ allocation. [Extracted from the article]

The etiology of Kawasaki disease (KD) has not yet been completely elucidated. We evaluated the temporal association between respiratory pathogens and KD incidence and the association between respiratory pathogens and treatment responsiveness in patients with KD. This retrospective study was conducted to compare the number of symptomatic children with pathogens detected using multiplex PCR tests with the number of KD cases. Logistic analysis was performed to assess whether the presence of at least one respiratory virus was associated with immunoglobulin non-responsiveness in patients with KD. A statistically significant temporal association was found between the number of KD patients and the number of patients with a positive respiratory pathogen (Pearson correlation coefficient +0.595; p=0.003). The adjusted odds ratio of respiratory pathogen detection for immunoglobulin responsiveness was 1.24 (95% confidence interval 0.38-4.11) (p=0.721). Our study demonstrated a temporal association between the total number of respiratory infections and KD., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper, (Copyright © 2025 Elsevier Inc. All rights reserved.)

While COVID-19 vaccines are generally very safe, the risks of myocarditis and pericarditis has been established following mRNA vaccines, with the highest risk in young males. Most systematic reviews and meta-analyses of the risk of myocarditis or pericarditis have included passive surveillance data, which is subject to reporting errors. Accurate measures of age-, sex-, vaccine dose-, and vaccine type-specific risks are crucial for assessment of the benefits and risks of the vaccination. A systematic review and meta-analysis of the risks of myocarditis and pericarditis attributable COVID-19 vaccines was conducted stratified by age groups, sex, vaccine type, and vaccine dose. Five electronic databases and grey literature sources were searched on November 21, 2023.Studies that compared a COVID-19 vaccinated group with an unvaccinated group or time period (e.g., self-controlled) were included. Passive surveillance data were excluded. Meta-analyses were conducted using random-effects models. We identified 4,030 records and included 17 studies. Compared with unvaccinated groups or unvaccinated time periods, the highest attributable risk of myocarditis/pericarditis was observed after their 2nd dose in males aged 12-17 years (10.18 per 100,000 doses (95% confidence interval [CI] 0.50-19.87)) to BNT162b2 and in males aged 18-24 years (AR 20.02 per 100,000 doses (95% CI 10.47-29.57)) for mRNA-1273. The stratified results based on active surveillance data provide the most accurate available estimates of the risks of myocarditis and pericarditis attributable to specific COVID-19 vaccinations for specific populations., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)