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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

7. 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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17. 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

18. Updated Diagnosis Grouping System for Pediatric Emergency Department Visits.

Author

Fant, Colleen, Marin, Jennifer R., Ramgopal, Sriram, Simon, Norma-Jean E., Richards, Rachel, Olsen, Cody S., Alessandrini, Evaline A., Alpern, Elizabeth R., Babcock, Lynn, Bajaj, Lalit, Brousseau, David, Campos, Diego A., Chamberlain, James M., Cook, Larry, Deakyne Davies, Sara J., Elsholz, Cara, Gorelick, Marc H., Grundmeier, Robert W., Mahajan, Prashant, and Shihabuddin, Bashar

Published
2023
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21. 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

22. 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

29. Validation of the Pediatric Sequential Organ Failure Assessment Score and Evaluation of Third International Consensus Definitions for Sepsis and Septic Shock Definitions in the Pediatric Emergency Department.

Author

Balamuth, Fran, Scott, Halden F., Weiss, Scott L., Webb, Michael, Chamberlain, James M., Bajaj, Lalit, Depinet, Holly, Grundmeier, Robert W., Campos, Diego, Deakyne Davies, Sara J., Simon, Norma Jean, Cook, Lawrence J., and Alpern, Elizabeth R.

Published
2022
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40. Urban versus rural setting as a predictor of injury type and severity among pediatric pedestrians: using a database derived from state-wide crash data and hospital discharge data in Illinois.

Author

Fant, Colleen, Koopmans, Joy, Simon, Norma-Jean E., Lorenz, Doug, Rychlik, Karen, and Sheehan, Karen

Subjects
SOFT tissue injuries, HOSPITAL admission & discharge, BRAIN injuries, PEDESTRIANS, MOTORCYCLING injuries, DEMOGRAPHIC characteristics
Abstract

We obtained and linked data from the Illinois Department of Transportation and the Illinois Hospital Discharge Data System 2008 − 2015. We evaluated differences in demographic characteristics, injury severity and type among cases and examined associations among injury type, severity, and crash location. There were 11,303 injured pedestrians under 19 years of age and 46% matched to hospital data. Demographic characteristics were similar to unlinked cases. Among linked cases, fractures, traumatic brain injury, open wound or amputation, and internal organ injuries occurred more often in rural areas (p < 0.001), as were more severe injuries (p < 0.001). Mild injury and soft tissue injuries occurred more often in urban areas (p < 0.001). These data can inform targeted interventions for injury reduction. Preliminary investigations found that more severe injuries and specific injury types are more likely to occur in rural versus urban settings. Our combined database approach may be extended to other databases. [ABSTRACT FROM AUTHOR]

Published
2021
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42. Academic engagement in public and political discourse:Proceedings of the Michigan Meeting, May 2015

Author

Hoffman, Andrew J., Ashworth, Kirsti, Dwelle, Chase, Goldberg, Peter, Henderson, Andrew, Merlin, Louis, Muzyrya, Yulia, Simon, Norma-Jean, Taylor, Veronica, Weisheit, Corinne, Wilson, Sarah, Hoffman, Andrew J., Ashworth, Kirsti, Dwelle, Chase, Goldberg, Peter, Henderson, Andrew, Merlin, Louis, Muzyrya, Yulia, Simon, Norma-Jean, Taylor, Veronica, Weisheit, Corinne, and Wilson, Sarah

Published
2015

47. Risk behaviours for HIV infection among travelling Mexican migrants: The Mexico–US border as a contextual risk factor.

Author

Zhang, Xiao, Martinez-Donate, Ana P., Simon, Norma-Jean E., Hovell, Melbourne F., Rangel, Maria Gudelia, Magis-Rodriguez, Carlos, and Sipan, Carol L.

Subjects
DIAGNOSIS of HIV infections, HIV prevention, HIV infection risk factors, CHI-squared test, CONFIDENCE intervals, FISHER exact test, HEALTH behavior, HEALTH services accessibility, MEDICAL screening, NOMADS, PROBABILITY theory, SEX work, PUBLIC health, QUESTIONNAIRES, RESEARCH funding, RISK-taking behavior, HUMAN sexuality, SEX distribution, SOCIAL norms, T-test (Statistics), LOGISTIC regression analysis, CROSS-sectional method, DATA analysis software, DESCRIPTIVE statistics, ODDS ratio
Abstract

The Mexico–US border region is a transit point in the trajectory of Mexican migrants travelling to and from the USA and a final destination for domestic migrants from other regions in Mexico. This region also represents a high-risk environment that may increase risk for HIV among migrants and the communities they connect. We conducted a cross-sectional, population-based survey, in Tijuana, Mexico, and compared Mexican migrants with a recent stay on the Mexico–US border region (Border,n = 553) with migrants arriving at the border from Mexican sending communities (Northbound,n = 1077). After controlling for demographics and migration history, border migrants were more likely to perceive their risk for HIV infection as high in this region and regard this area as a liberal place for sexual behaviours compared to Northbound migrants reporting on their perceptions of the sending communities (p < .05). Male border migrants were more likely to engage in sex, and have unprotected sex, with female sex workers during their recent stay on the border compared to other contexts (rate ratio = 3.0 and 6.6, respectively,p < .05). Binational and intensified interventions targeting Mexican migrants should be deployed in the Mexican border region to address migration related HIV transmission in Mexico and the USA. [ABSTRACT FROM PUBLISHER]

Published
2017
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49. Healthcare access among circular and undocumented Mexican migrants: results from a pilot survey on the Mexico-US border

Author

Martínez-Donate, Ana P., Zhang, Xiao, Rangel Gomez, M. Gudelia, Hovell, Melbourne F., Simon, Norma-Jean, Amuedo-Dorantes, Catalina, Sipan, Carol, and Guendelman, Sylvia

Abstract

Temporary and unauthorised migrants may face unique obstacles to access healthcare services in the USA. This study estimated levels of healthcare access among Mexican migrants returning to Mexico from the USA and factors associated with access to healthcare, with emphasis on the role of modifiable, enabling factors. We conducted a pilot probability healthcare survey of migrants in the border city of Tijuana, Mexico (N = 186). Approximately 42% of migrants reported having used healthcare services in the USA during the past year. Only 38% had a usual source of care and approximately 11% went without needed medical care in the USA. About 71% of migrants did not have health insurance in the USA. Lack of health insurance and transportation limitations were significantly related to various access indicators. These results have implications for future policies and programmes aimed to address modifiable healthcare access barriers faced by these vulnerable and underserved segments of the Mexican migrant population.

Published
2014
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50. Post-COVID-19 Conditions Among Children 90 Days After SARS-CoV-2 Infection.

Author

Funk AL, Kuppermann N, Florin TA, Tancredi DJ, Xie J, Kim K, Finkelstein Y, Neuman MI, Salvadori MI, Yock-Corrales A, Breslin KA, Ambroggio L, Chaudhari PP, Bergmann KR, Gardiner MA, Nebhrajani JR, Campos C, Ahmad FA, Sartori LF, Navanandan N, Kannikeswaran N, Caperell K, Morris CR, Mintegi S, Gangoiti I, Sabhaney VJ, Plint AC, Klassen TP, Avva UR, Shah NP, Dixon AC, Lunoe MM, Becker SM, Rogers AJ, Pavlicich V, Dalziel SR, Payne DC, Malley R, Borland ML, Morrison AK, Bhatt M, Rino PB, Beneyto Ferre I, Eckerle M, Kam AJ, Chong SL, Palumbo L, Kwok MY, Cherry JC, Poonai N, Waseem M, Simon NJ, and Freedman SB

Subjects
Acute Disease, Child, Child, Preschool, Cohort Studies, Fatigue, Female, Humans, Infant, Infant, Newborn, Male, Prospective Studies, SARS-CoV-2, COVID-19 epidemiology
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.

Published
2022
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