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1. Impact of SARS-CoV-2 Infection on the Association Between Laboratory Tests and Severe Outcomes Among Hospitalized Children.

Author

Xie, Jianling, Kuppermann, Nathan, Florin, Todd, Tancredi, Daniel, Funk, Anna, Kim, Kelly, Salvadori, Marina, Yock-Corrales, Adriana, Shah, Nipam, Breslin, Kristen, Chaudhari, Pradip, Bergmann, Kelly, Ahmad, Fahd, Nebhrajani, Jasmine, Mintegi, Santiago, Gangoiti, Iker, Plint, Amy, Avva, Usha, Gardiner, Michael, Malley, Richard, Finkelstein, Yaron, Dalziel, Stuart, Bhatt, Maala, Kannikeswaran, Nirupama, Caperell, Kerry, Campos, Carmen, Sabhaney, Vikram, Chong, Shu-Ling, Lunoe, Maren, Rogers, Alexander, Becker, Sarah, Borland, Meredith, Sartori, Laura, Pavlicich, Viviana, Rino, Pedro, Morrison, Andrea, Neuman, Mark, Poonai, Naveen, Simon, Norma-Jean, Kam, April, Kwok, Maria, Morris, Claudia, Palumbo, Laura, Ambroggio, Lilliam, Navanandan, Nidhya, Eckerle, Michelle, Klassen, Terry, Payne, Daniel, Cherry, Jonathan, Waseem, Muhammad, Dixon, Andrew, Ferre, Isabel, and Freedman, Stephen

Subjects
C-reactive protein, COVID-19, SARS-CoV-2, child, lymphopenia, procalcitonin
Abstract

BACKGROUND: To assist clinicians with identifying children at risk of severe outcomes, we assessed the association between laboratory findings and severe outcomes among severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected children and determined if SARS-CoV-2 test result status modified the associations. METHODS: We conducted a cross-sectional analysis of participants tested for SARS-CoV-2 infection in 41 pediatric emergency departments in 10 countries. Participants were hospitalized, had laboratory testing performed, and completed 14-day follow-up. The primary objective was to assess the associations between laboratory findings and severe outcomes. The secondary objective was to determine if the SARS-CoV-2 test result modified the associations. RESULTS: We included 1817 participants; 522 (28.7%) SARS-CoV-2 test-positive and 1295 (71.3%) test-negative. Seventy-five (14.4%) test-positive and 174 (13.4%) test-negative children experienced severe outcomes. In regression analysis, we found that among SARS-CoV-2-positive children, procalcitonin ≥0.5 ng/mL (adjusted odds ratio [aOR], 9.14; 95% CI, 2.90-28.80), ferritin >500 ng/mL (aOR, 7.95; 95% CI, 1.89-33.44), D-dimer ≥1500 ng/mL (aOR, 4.57; 95% CI, 1.12-18.68), serum glucose ≥120 mg/dL (aOR, 2.01; 95% CI, 1.06-3.81), lymphocyte count

Published
2023

5. Household Transmission Dynamics of Asymptomatic SARS-CoV-2–Infected Children: A Multinational, Controlled Case-Ascertained Prospective Study

Author

Funk, Anna, primary, Florin, Todd A, additional, Kuppermann, Nathan, additional, Finkelstein, Yaron, additional, Kazakoff, Alissa, additional, Baldovsky, Michael, additional, Tancredi, Daniel J, additional, Breslin, Kristen, additional, Bergmann, Kelly R, additional, Gardiner, Michael, additional, Pruitt, Christopher M, additional, Liu, Deborah R, additional, Neuman, Mark I, additional, Wilkinson, Matthew, additional, Ambroggio, Lilliam, additional, Pang, Xiao-Li, additional, Cauchemez, Simon, additional, Malley, Richard, additional, Klassen, Terry P, additional, Lee, Bonita E, additional, Payne, Daniel C, additional, Mahmud, Salaheddin M, additional, and Freedman, Stephen B, additional

Published
2024
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9. Features Associated With Radiographic Pneumonia in Children with SARS-CoV-2

Author

Florin, Todd A, primary, Freedman, Stephen B, additional, Xie, Jianling, additional, Funk, Anna L, additional, Tancredi, Daniel J, additional, Kim, Kelly, additional, Neuman, Mark I, additional, Yock-Corrales, Adriana, additional, Bergmann, Kelly R, additional, Breslin, Kristen A, additional, Finkelstein, Yaron, additional, Ahmad, Fahd A, additional, Avva, Usha R, additional, Lunoe, Maren M, additional, Chaudhari, Pradip P, additional, Shah, Nipam P, additional, Plint, Amy C, additional, Sabhaney, Vikram J, additional, Sethuraman, Usha, additional, Gardiner, Michael A, additional, Sartori, Laura F, additional, Wright, Bruce, additional, Navanandan, Nidhya, additional, Mintegi, Santiago, additional, Gangoiti, Iker, additional, Borland, Meredith L, additional, Chong, Shu-Ling, additional, Kwok, Maria Y, additional, Eckerle, Michelle, additional, Poonai, Naveen, additional, Romero, Carlos Miguel Angelats, additional, Waseem, Muhammad, additional, Nebhrajani, Jasmine R, additional, Bhatt, Maala, additional, Caperell, Kerry, additional, Campos, Carmen, additional, Becker, Sarah M, additional, Morris, Claudia R, additional, Rogers, Alexander J, additional, Kam, April J, additional, Pavlicich, Viviana, additional, Palumbo, Laura, additional, Dalziel, Stuart R, additional, Morrison, Andrea K, additional, Rino, Pedro B, additional, Cherry, Jonathan C, additional, Salvadori, Marina I, additional, Ambroggio, Lilliam, additional, Klassen, Terry P, additional, Payne, Daniel C, additional, Malley, Richard, additional, Simon, Norma-Jean, additional, and Kuppermann, Nathan, additional

Published
2024
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21. Characteristics and Clinical Outcomes of Children and Adolescents Aged <18 Years Hospitalized with COVID-19 — Six Hospitals, United States, July–August 2021

Author

Wanga, Valentine, Gerdes, Megan E., Shi, Dallas S., Choudhary, Rewa, Dulski, Theresa M., Hsu, Sophia, Idubor, Osatohamwen I., Webber, Bryant J., Wendel, Arthur M., Agathis, Nickolas T., Anderson, Kristi, Boyles, Tricia, Chiu, Sophia K., Click, Eleanor S., Da Silva, Juliana, Dupont, Hannah, Evans, Mary, Gold, Jeremy A.W., Haston, Julia, Logan, Pamela, Maloney, Susan A., Martinez, Marisol, Natarajan, Pavithra, Spicer, Kevin B., Swancutt, Mark, Stevens, Valerie A., Brown, Jessica, Chandra, Gyan, Light, Megan, Barr, Frederick E., Snowden, Jessica, Kociolek, Larry K., McHugh, Matthew, Wessel, David, Simpson, Joelle N., Gorman, Kathleen C., Breslin, Kristen A., DeBiasi, Roberta L., Thompson, Aaron, Kline, Mark W., Bloom, Julie A., Singh, Ila R., Dowlin, Michael, Wietecha, Mark, Schweitzer, Beth, Morris, Sapna Bamrah, Koumans, Emily H., Ko, Jean Y., Kimball, Anne A., and Siegel, David A.

Subjects
Male, Pediatric Obesity, COVID-19 Vaccines, Health (social science), Adolescent, Coinfection, Epidemiology, Health, Toxicology and Mutagenesis, Vaccination, COVID-19, Infant, General Medicine, Hospitals, United States, Hospitalization, Treatment Outcome, Health Information Management, Child, Preschool, Humans, Female, Full Report, Child
Abstract

During June 2021, the highly transmissible

Published
2021

25. Factors Associated With Severe Illness in Patients Aged &lt;21 Years Hospitalized for COVID-19

Author

Choudhary, Rewa, primary, Webber, Bryant J., additional, Womack, Lindsay S., additional, Dupont, Hannah K., additional, Chiu, Sophia K., additional, Wanga, Valentine, additional, Gerdes, Megan E., additional, Hsu, Sophia, additional, Shi, Dallas S., additional, Dulski, Theresa M., additional, Idubor, Osatohamwen I., additional, Wendel, Arthur M., additional, Agathis, Nickolas T., additional, Anderson, Kristi, additional, Boyles, Tricia, additional, Click, Eleanor S., additional, Da Silva, Juliana, additional, Evans, Mary E., additional, Gold, Jeremy A.W., additional, Haston, Julia C., additional, Logan, Pamela, additional, Maloney, Susan A., additional, Martinez, Marisol, additional, Natarajan, Pavithra, additional, Spicer, Kevin B., additional, Swancutt, Mark, additional, Stevens, Valerie A., additional, Rogers-Brown, Jessica, additional, Chandra, Gyan, additional, Light, Megan, additional, Barr, Frederick E., additional, Snowden, Jessica, additional, Kociolek, Larry K., additional, McHugh, Matthew, additional, Wessel, David L., additional, Simpson, Joelle N., additional, Gorman, Kathleen C., additional, Breslin, Kristen A., additional, DeBiasi, Roberta L., additional, Thompson, Aaron, additional, Kline, Mark W., additional, Boom, Julie A., additional, Singh, Ila R., additional, Dowlin, Michael, additional, Wietecha, Mark, additional, Schweitzer, Beth, additional, Morris, Sapna Bamrah, additional, Koumans, Emilia H., additional, Ko, Jean Y., additional, Siegel, David A., additional, and Kimball, Anne A., additional

Published
2022
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26. Post–COVID-19 Conditions Among Children 90 Days After SARS-CoV-2 Infection

Author

Pediatría, Pediatria, Funk, Anna L., Kuppermann, Nathan, Florin, Todd A., Tancredi, Daniel J., Xie, Jianling, Kim, Kelly, Finkelstein, Yaron, Neuman, Mark I., Salvadori, Marina I., Yock-Corrales, Adriana, Breslin, Kristen A., Ambroggio, Lilliam, Chaudhari, Pradip P., Bergmann, Kelly R., Gardiner, Michael A., Nebhrajani, Jasmine R., Campos, Carmen, Ahmad, Fahd A., Sartori, Laura F., Navanandan, Nidhya, Kannikeswaran, Nirupama, Caperell, Kerry, Morris, Claudia R., Mintegi Raso, Santiago, Gangoiti, Iker, Sabhaney, Vikram J., Plint, Amy C., Klassen, Terry P., Avva, Usha R., Shah, Nipam P., Dixon, Andrew C., Lunoe, Maren M., Becker, Sarah M., Rogers, Alexander J., Pavlicich, Viviana, Dalziel, Stuart R., Payne, Daniel C., Malley, Richard, Borland, Meredith L., Morrison, Andrea K., Bhatt, Maala, Rino, Pedro B., Beneyto Ferre, Isabel, Eckerle, Michelle, Kam, April J., Chong, Shu-Ling, Palumbo, Laura, Kwok, Maria Y., Cherry, Jonathan C., Poonai, Naveen, Waseem, MD; Norma-Jean Simon, MPH, Waseem, Muhammad, Simon, Norma-Jean, Freedman, Stephen B., Pediatric Emergency Research Network–COVID-19 Study Team, Pediatría, Pediatria, Funk, Anna L., Kuppermann, Nathan, Florin, Todd A., Tancredi, Daniel J., Xie, Jianling, Kim, Kelly, Finkelstein, Yaron, Neuman, Mark I., Salvadori, Marina I., Yock-Corrales, Adriana, Breslin, Kristen A., Ambroggio, Lilliam, Chaudhari, Pradip P., Bergmann, Kelly R., Gardiner, Michael A., Nebhrajani, Jasmine R., Campos, Carmen, Ahmad, Fahd A., Sartori, Laura F., Navanandan, Nidhya, Kannikeswaran, Nirupama, Caperell, Kerry, Morris, Claudia R., Mintegi Raso, Santiago, Gangoiti, Iker, Sabhaney, Vikram J., Plint, Amy C., Klassen, Terry P., Avva, Usha R., Shah, Nipam P., Dixon, Andrew C., Lunoe, Maren M., Becker, Sarah M., Rogers, Alexander J., Pavlicich, Viviana, Dalziel, Stuart R., Payne, Daniel C., Malley, Richard, Borland, Meredith L., Morrison, Andrea K., Bhatt, Maala, Rino, Pedro B., Beneyto Ferre, Isabel, Eckerle, Michelle, Kam, April J., Chong, Shu-Ling, Palumbo, Laura, Kwok, Maria Y., Cherry, Jonathan C., Poonai, Naveen, Waseem, MD; Norma-Jean Simon, MPH, Waseem, Muhammad, Simon, Norma-Jean, Freedman, Stephen B., and Pediatric Emergency Research Network–COVID-19 Study Team

Abstract

IMPORTANCE Little is known about the risk factors for, and the risk of, developing post-COVID-19 conditions (PCCs) among children. OBJECTIVES To estimate the proportion of SARS-CoV-2-positive children with PCCs 90 days after a positive test result, to compare this proportion with SARS-CoV-2-negative children, and to assess factors associated with PCCs. DESIGN, SETTING, AND PARTICIPANTS This prospective cohort study, conducted in 36 emergency departments (EDs) in 8 countries between March 7, 2020, and January 20, 2021, included 1884 SARS-CoV-2-positive children who completed 90-day follow-up; 1686 of these children were frequency matched by hospitalization status, country, and recruitment date with 1701 SARS-CoV-2-negative controls. EXPOSURE SARS-CoV-2 detected via nucleic acid testing. MAIN OUTCOMES AND MEASURES Post-COVID-19 conditions, defined as any persistent, new, or recurrent health problems reported in the 90-day follow-up survey. RESULTS Of 8642 enrolled children, 2368 (27.4%) were SARS-CoV-2 positive, among whom 2365 (99.9%) had index ED visit disposition data available; among the 1884 children (79.7%) who completed follow-up, the median age was 3 years (IQR, 0-10 years) and 994 (52.8%) were boys. A total of 110 SARS-CoV-2-positive children (5.8%; 95% CI, 4.8%-7.0%) reported PCCs, including 44 of 447 children (9.8%; 95% CI, 7.4%-13.0%) hospitalized during the acute illness and 66 of 1437 children (4.6%; 95% CI, 3.6%-5.8%) not hospitalized during the acute illness (difference. 5.3%; 95% CI, 2.5%-8.5%). Among SARS-CoV-2-positive children, the most common symptom was fatigue or weakness (21 [1.1%]). Characteristics associated with reporting at least 1 PCC at 90 days included being hospitalized 48 hours or more compared with no hospitalization (adjusted odds ratio [aOR], 2.67 [95% CI, 1.63-4.38]); having 4 or more symptoms reported at the index ED visit compared with 1 to 3 symptoms (4-6 symptoms: aOR, 2.35 [95% CI, 1.28-4.31]; >= 7 symptoms: aOR, 4.59 [95% CI

Published
2022

27. Post–COVID-19 Conditions Among Children 90 Days After SARS-CoV-2 Infection

Author

Funk, Anna L., Kuppermann, Nathan, Florin, Todd A., Tancredi, Daniel J., Xie, Jianling, Kim, Kelly, Finkelstein, Yaron, Neuman, Mark I., Salvadori, Marina I., Yock-Corrales, Adriana, Breslin, Kristen A., Ambroggio, Lilliam, Chaudhari, Pradip P., Bergmann, Kelly R., Gardiner, Michael A., Nebhrajani, Jasmine R., Campos, Carmen, Ahmad, Fahd A., Sartori, Laura F., Navanandan, Nidhya, Kannikeswaran, Nirupama, Caperell, Kerry, Morris, Claudia R., Mintegi Raso, Santiago, Gangoiti, Iker, Sabhaney, Vikram J., Plint, Amy C., Klassen, Terry P., Avva, Usha R., Shah, Nipam P., Dixon, Andrew C., Lunoe, Maren M., Becker, Sarah M., Rogers, Alexander J., Pavlicich, Viviana, Dalziel, Stuart R., Payne, Daniel C., Malley, Richard, Borland, Meredith L., Morrison, Andrea K., Bhatt, Maala, Rino, Pedro B., Beneyto Ferre, Isabel, Eckerle, Michelle, Kam, April J., Chong, Shu-Ling, Palumbo, Laura, Kwok, Maria Y., Cherry, Jonathan C., Poonai, Naveen, Waseem, MD, Norma-Jean Simon, MPH, Waseem, Muhammad, Simon, Norma-Jean, Freedman, Stephen B., and Pediatric Emergency Research Network–COVID-19 Study Team

Subjects
COVID-19, outcomes
Abstract

IMPORTANCE Little is known about the risk factors for, and the risk of, developing post-COVID-19 conditions (PCCs) among children. OBJECTIVES To estimate the proportion of SARS-CoV-2-positive children with PCCs 90 days after a positive test result, to compare this proportion with SARS-CoV-2-negative children, and to assess factors associated with PCCs. DESIGN, SETTING, AND PARTICIPANTS This prospective cohort study, conducted in 36 emergency departments (EDs) in 8 countries between March 7, 2020, and January 20, 2021, included 1884 SARS-CoV-2-positive children who completed 90-day follow-up; 1686 of these children were frequency matched by hospitalization status, country, and recruitment date with 1701 SARS-CoV-2-negative controls. EXPOSURE SARS-CoV-2 detected via nucleic acid testing. MAIN OUTCOMES AND MEASURES Post-COVID-19 conditions, defined as any persistent, new, or recurrent health problems reported in the 90-day follow-up survey. RESULTS Of 8642 enrolled children, 2368 (27.4%) were SARS-CoV-2 positive, among whom 2365 (99.9%) had index ED visit disposition data available; among the 1884 children (79.7%) who completed follow-up, the median age was 3 years (IQR, 0-10 years) and 994 (52.8%) were boys. A total of 110 SARS-CoV-2-positive children (5.8%; 95% CI, 4.8%-7.0%) reported PCCs, including 44 of 447 children (9.8%; 95% CI, 7.4%-13.0%) hospitalized during the acute illness and 66 of 1437 children (4.6%; 95% CI, 3.6%-5.8%) not hospitalized during the acute illness (difference. 5.3%; 95% CI, 2.5%-8.5%). Among SARS-CoV-2-positive children, the most common symptom was fatigue or weakness (21 [1.1%]). Characteristics associated with reporting at least 1 PCC at 90 days included being hospitalized 48 hours or more compared with no hospitalization (adjusted odds ratio [aOR], 2.67 [95% CI, 1.63-4.38]); having 4 or more symptoms reported at the index ED visit compared with 1 to 3 symptoms (4-6 symptoms: aOR, 2.35 [95% CI, 1.28-4.31]; >= 7 symptoms: aOR, 4.59 [95% CI, 2.50 8.44]); and being 14 years of age or older compared with younger than 1 year (aOR, 2.67 [95% CI, 1.43-4.99]). SARS-CoV-2-positive children were more likely to report PCCs at 90 days compared with those who tested negative, both among those who were not hospitalized (55 of 1295 [4.2%; 95% CI, 3.2%-5.5%] vs 35 of 1321[2.7%; 95% CI, 1.9%-3.7%]; difference, 1.6% [95% CI, 0.2%-3.0%]) and those who were hospitalized (40 of 391[10.2%; 95% CI, 7.4%-13.7%] vs 19 of 380 [5.0%; 95% CI, 3.0%-7.7%]; difference, 5.2% [95% CI, 1.5%-9.1%]). In addition, SARS-CoV-2 positivity was associated with reporting PCCs 90 days after the index ED visit (aOR, 1.63 [95% CI, 1.14-2.35]), specifically systemic health problems (eg, fatigue, weakness, fever; aOR, 2.44 [95% CI, 1.19-5.00]). CONCLUSIONS AND RELEVANCE In this cohort study, SARS-CoV-2 infection was associated with reporting PCCs at 90 days in children. Guidance and follow-up are particularly necessary for hospitalized children who have numerous acute symptoms and are older. This studywas supported by grants from the Canadian Institutes of Health Research (operating grant: COVID-19-clinical management); the Alberta Health Services-University of Calgary-Clinical Research Fund; the Alberta Children's Hospital Research Institute; the COVID-19 Research Accelerator Funding Track (CRAFT) Program at the University of California, Davis; and the Cincinnati Children's Hospital Medical Center Division of Emergency Medicine Small Grants Program. Dr Funk is supported by the University of Calgary Eyes-High PostDoctoral Research Fund. Dr Freedman is supported by the Alberta Children's Hospital Foundation Professorship in Child Health andWellness.

Published
2022

28. Outcomes of SARS-CoV-2–Positive Youths Tested in Emergency Departments

Author

Funk, Anna L., Florin, Todd A., Kuppermann, Nathan, Tancredi, Daniel J., Xie, Jianling, Kim, Kelly, Neuman, Mark I., Ambroggio, Lilliam, Plint, Amy C., Mintegi, Santiago, Klassen, Terry P., Salvadori, Marina I., Malley, Richard, Payne, Daniel C., Simon, Norma-Jean, Yock-Corrales, Adriana, Nebhrajani, Jasmine R., Chaudhari, Pradip P., Breslin, Kristen A., Finkelstein, Yaron, Campos, Carmen, Bergmann, Kelly R., Bhatt, Maala, Ahmad, Fahd A., Gardiner, Michael A., Avva, Usha R., Shah, Nipam P., Sartori, Laura F., Sabhaney, Vikram J., Caperell, Kerry, Navanandan, Nidhya, Borland, Meredith L., Morris, Claudia R., Gangoiti, Iker, Pavlicich, Viviana, Kannikeswaran, Nirupama, Lunoe, Maren M., Rino, Pedro B., Kam, April J., Cherry, Jonathan C., Rogers, Alexander J., Chong, Shu-Ling, Palumbo, Laura, Angelats, Carlos M., Morrison, Andrea K., Kwok, Maria Y., Becker, Sarah M., Dixon, Andrew C., Poonai, Naveen, Eckerle, Michelle, Wassem, Muhammad, Dalziel, Stuart R., and Freedman, Stephen B.

Subjects
Male, Adolescent, SARS-CoV-2, Research, Infant, Newborn, COVID-19, Infant, Pediatrics, Severity of Illness Index, Hospitalization, Online Only, COVID-19 Testing, Risk Factors, Child, Preschool, Odds Ratio, Humans, Female, Prospective Studies, Child, Emergency Service, Hospital, Original Investigation, Follow-Up Studies
Abstract

Key Points Question What proportion of SARS-CoV-2–positive youths tested in emergency departments (ED) experience severe outcomes (ie, intensive interventions, severe organ impairment, or death) within 14 days? Findings Among 3221 SARS-CoV-2–positive youths enrolled in a global prospective cohort study with outcome data, 3.3% had severe outcomes within 14 days. Across a subgroup of 2510 SARS-CoV-2–positive youths discharged home after testing, 0.5% had severe outcomes during the 2-week follow-up period. Meaning The findings of this study suggest that risk factors such as age, underlying chronic illness, and symptom duration may be useful for clinicians to consider when evaluating pediatric patients with SARS-CoV-2 infection., This cohort study investigates the prevalence of severe outcomes among youths aged 17 years or younger within 14 days of testing positive for SARS-CoV-2 in emergency departments in 8 countries., Importance Severe outcomes among youths with SARS-CoV-2 infections are poorly characterized. Objective To estimate the proportion of children with severe outcomes within 14 days of testing positive for SARS-CoV-2 in an emergency department (ED). Design, Setting, and Participants This prospective cohort study with 14-day follow-up enrolled participants between March 2020 and June 2021. Participants were youths aged younger than 18 years who were tested for SARS-CoV-2 infection at one of 41 EDs across 10 countries including Argentina, Australia, Canada, Costa Rica, Italy, New Zealand, Paraguay, Singapore, Spain, and the United States. Statistical analysis was performed from September to October 2021. Exposures Acute SARS-CoV-2 infection was determined by nucleic acid (eg, polymerase chain reaction) testing. Main Outcomes and Measures Severe outcomes, a composite measure defined as intensive interventions during hospitalization (eg, inotropic support, positive pressure ventilation), diagnoses indicating severe organ impairment, or death. Results Among 3222 enrolled youths who tested positive for SARS-CoV-2 infection, 3221 (>99.9%) had index visit outcome data available, 2007 (62.3%) were from the United States, 1694 (52.6%) were male, and 484 (15.0%) had a self-reported chronic illness; the median (IQR) age was 3 (0-10) years. After 14 days of follow-up, 735 children (22.8% [95% CI, 21.4%-24.3%]) were hospitalized, 107 (3.3% [95% CI, 2.7%-4.0%]) had severe outcomes, and 4 children (0.12% [95% CI, 0.03%-0.32%]) died. Characteristics associated with severe outcomes included being aged 5 to 18 years (age 5 to

Published
2022

31. Identifying pediatric patients with multisystem inflammatory syndrome in children presenting to a pediatric emergency department

Author

Kline, Jaclyn N., primary, Isbey, Sarah C., additional, McCollum, Nichole L., additional, Falk, Michael J., additional, Gutierrez, Camilo E., additional, Guse, Sabrina E., additional, Harahsheh, Ashraf S., additional, Brown, Kathleen M., additional, Chamberlain, James M., additional, and Breslin, Kristen A., additional

Published
2022
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35. Factors Associated With Severe Illness in Patients Aged <21 Years Hospitalized for COVID-19

Author

Choudhary, Rewa, Webber, Bryant J., Womack, Lindsay S., Dupont, Hannah K., Chiu, Sophia K., Wanga, Valentine, Gerdes, Megan E., Hsu, Sophia, Shi, Dallas S., Dulski, Theresa M., Idubor, Osatohamwen I., Wendel, Arthur M., Agathis, Nickolas T., Anderson, Kristi, Boyles, Tricia, Click, Eleanor S., Da Silva, Juliana, Evans, Mary E., Gold, Jeremy A.W., Haston, Julia C., Logan, Pamela, Maloney, Susan A., Martinez, Marisol, Natarajan, Pavithra, Spicer, Kevin B., Swancutt, Mark, Stevens, Valerie A., Rogers-Brown, Jessica, Chandra, Gyan, Light, Megan, Barr, Frederick E., Snowden, Jessica, Kociolek, Larry K., McHugh, Matthew, Wessel, David L., Simpson, Joelle N., Gorman, Kathleen C., Breslin, Kristen A., DeBiasi, Roberta L., Thompson, Aaron, Kline, Mark W., Boom, Julie A., Singh, Ila R., Dowlin, Michael, Wietecha, Mark, Schweitzer, Beth, Morris, Sapna Bamrah, Koumans, Emilia H., Ko, Jean Y., Siegel, David A., and Kimball, Anne A.

Abstract

To describe coronavirus disease 2019 (COVID-19)–related pediatric hospitalizations during a period of B.1.617.2 (Δ) variant predominance and to determine age-specific factors associated with severe illness.We abstracted data from medical charts to conduct a cross-sectional study of patients aged <21 years hospitalized at 6 United States children’s hospitals from July to August 2021 for COVID-19 or with an incidental positive severe acute respiratory syndrome coronavirus 2 test. Among patients with COVID-19, we assessed factors associated with severe illness by calculating age-stratified prevalence ratios (PR). We defined severe illness as receiving high-flow nasal cannula, positive airway pressure, or invasive mechanical ventilation.Of 947 hospitalized patients, 759 (80.1%) had COVID-19, of whom 287 (37.8%) had severe illness. Factors associated with severe illness included coinfection with respiratory syncytial virus (RSV) (PR 3.64) and bacteria (PR 1.88) in infants; RSV coinfection in patients aged 1 to 4 years (PR 1.96); and obesity in patients aged 5 to 11 (PR 2.20) and 12 to 17 years (PR 2.48). Having ≥2 underlying medical conditions was associated with severe illness in patients aged <1 (PR 1.82), 5 to 11 (PR 3.72), and 12 to 17 years (PR 3.19).Among patients hospitalized for COVID-19, factors associated with severe illness included RSV coinfection in those aged <5 years, obesity in those aged 5 to 17 years, and other underlying conditions for all age groups <18 years. These findings can inform pediatric practice, risk communication, and prevention strategies, including vaccination against COVID-19.

Published
2022
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42. Detection of TNT in water using an evanescent wave fiber-optic biosensor

Author

Shriver-Lake, Lisa C., Breslin, Kristen A., Charles, Paul T., Conrad, David W., Golden, Joel P., and Ligler, Frances S.

Subjects
Explosives -- Research, Water -- Composition, Optoelectronic devices -- Research, Biosensors -- Research, Chemistry
Abstract

A general health hazard from explosive toxicity exists due to poor storage facilities for explosives and from contamination of soil and water with byproducts of explosive manufacture. To provide an effective method for monitoring water contamination, the Naval Research Laboratory's fiber-optic biosensor was adapted for the detection of small molecules such as explosives. A competitive immunoassay was developed for the detection of the most widely used explosive, trinitrotoluene (TNT). Trinitrobenzenesulfonic acid (TNB), an analog of TNT, was labeled with a fluorophore and used as the analyte competitor. A solution containing 7.5 ng/mL sulfoindocyanine 5-ethylenediamine-labeled TNB (Cy5-EDA-TNB) was exposed to an antibody-coated optical fiber, generating a specific signal above background that corresponds to the 100% or reference signal. Inhibition of the 100% signal was proportional to the TNT concentration in the sample. Detection sensitivities of 10 ng/mL TNT (8 ppb) in buffer were achieved. Tests on river, harbor, and bilge water samples spiked with TNT showed results similar to tests on laboratory (buffer matrix) samples. To determine possible interferences, several structural analogs of TNT were tested.

Published
1995

45. Domestic Safety Screening in a PED: Positive Screen Demographics

Author

Jarvis, Lenore, primary, Brown, Kathleen, additional, Neway, Beemnet, additional, Badolato, Gia, additional, Breslin, Kristen, additional, Sheys, Karen, additional, Goyal, Monika, additional, Jackson, Allison, additional, Pettinichi, Jeanne, additional, Tapia, Jaclyn, additional, and Chamberlain, James, additional

Published
2019
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50. Impact of Transcervical Ultrasound for the Diagnosis of Pediatric Peritonsillar Abscesses on Emergency Department Performance Measures.

Author

Zhao, Xian, Delaney, Marc, Breslin, Kristen, Chamberlain, James M., Rubio, Eva I., Reilly, Brian K., and Cohen, Joanna S.

Subjects
HOSPITAL emergency services, PEDIATRIC emergency services, ABSCESSES, RATE of return, MULTIDETECTOR computed tomography, COMPUTED tomography, TRANSVAGINAL ultrasonography
Abstract

Objectives: To evaluate the impact of transcervical ultrasound (US) as the initial imaging study for suspected peritonsillar abscesses (PTAs) on pediatric emergency department (ED) throughput measures. Methods: A retrospective cohort study of patients evaluated for suspected PTAs between January 2009 and April 2017 was conducted. We compared the ED length of stay (LOS) before and after implementation of transcervical US to diagnose a PTA. The balancing measure was the rate of return visits within 2 weeks. Results: There were 387 eligible patients over the study period. A total of 101 patients were evaluated for PTAs with computed tomography and 286 with US. The mean LOS was significantly less for patients who had US (347 minutes; 95% confidence interval [CI], 330, 364 minutes) compared to computed tomography (426 minutes; 95% CI, 392, 459 minutes), with an absolute difference of 79 minutes (95% CI, 44, 113 minutes). Patients who were evaluated with US did not have an increased rate of return visits (5.9% versus 8.0%; P =.66). Conclusions: The introduction of transcervical US was associated with a decrease of greater than 1 hour in the ED LOS for patients with suspected PTAs. Given the better radiation profile of US and no increase in the rate of return visits after its implementation, we propose the adoption of a transcervical US‐first approach for the diagnosis of PTAs in pediatrics. [ABSTRACT FROM AUTHOR]

Published
2020
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