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1. Extracorporeal Life Support Organization Registry International Report 2022: 100,000 Survivors

Author

Tonna, Joseph E., Boonstra, Philip S., MacLaren, Graeme, Paden, Matthew, Brodie, Daniel, Anders, Marc, Hoskote, Aparna, Ramanathan, Kollengode, Hyslop, Rob, Fanning, Jeffrey J., Rycus, Peter, Stead, Christine, Barrett, Nicholas A., Mueller, Thomas, Gómez, Rene D., Malhotra Kapoor, Poonam, Fraser, John F., Bartlett, Robert H., Alexander, Peta M.A., Barbaro, Ryan P., Abbasi, Adeel, Said Abdalmohsen, Ahmad, Abdelbary, Akram M., Abecasis, Francisco, Abel, Peter, Abu-Omar, Yasir, Adams, Douglas R, Manuel Africano, Juan, Aganga, Devon, Agati, Salvatore, Agerstrand, Cara, Aguillon, Mario V., Akers, Crystal S., Akhtarekhavari, Julia, Alazzam, Mohammad Izzat Salah, Albert, Martin, Alberti, Angela, Al-Fares, Abdulrahman A., Alfoudri, Huda, Allaert, Silvie, Allbert, Keesha N., Allen, Christopher T., Lescano Alva, Miguel Ángel, Alwardt, Cory M., Amigoni, Angela, Anandamurthy, Balaram, Anastasiadis, Kyriakos, Anders, Nicholas R., Anderson, Scott A., Anderson, Patricia L., Andrijević, Ana, Annoni, Alice, Anselmi, Michael, Anstey, James R., Antonini, Marta V., Antonitsis, Polychronis, Stein Araujo, Tays, Arcalas, Rhodney, Areinamo, Igor, Martin Arias, Anibal, Armijo-Garcia, Veronica, Aronsky, Vladimir, Arora, Lovkesh, Arora, Madhur, Leigh Aspenleiter, Marit, Atik, Fernando A., AugustGeorg Auzinger, Erin Colleen, Azzam, Ismail, Bacchetta, Matthew, Bak, Erica I., Balcells, Joan, Sánchez Ballesteros, Jesús, Banjac, Igor S., Barbaria, Jacqueline M., Barrigoto, Cleide L., Bass, Stephanie D., Batranović, Uroš, Bauer, Matthew H., Fernando Bautista, Diego, Beck, Robert M., Giraldo Bejarano, Estefania, Belohlavek, Jan, Bembea, Melania M., Benes, Jan, Benharash, Peyman, Benish, Lynne A., Bennett, Suzanne, Bento, Luís F.N., Bermudez, Christian A., Bertini, Pietro, Best, Derek, Bharat, Ankit, Bhutta, Omar J., Bizzell, Samantha J., Blakeman, Stephanie A., Blanco-Schweizer, Pablo, Blanton, Jessica K., Blood, Peggy S., Bohlmann, Allison S., Kyle Bohman, John, Bombino, Michela, Kathleen Bonadonna, Desiree, Bond, Ashley, Borgmann, Kristina M., Bourgoin, Pierre, Boville, Brian M., Boza, Raquel, Brady, Heather L., Brady, Alison, Braunlich, Jessica M., Bridges, Brian C., Brinkley, Karen K., Brookshire, Robert S., Brozzi Nicole Brueggemann, Nicolas A., Buckley, Dwight P., Jr., Buckley, Klayton, Budhani, Irfan B., Bukamal, Nazar, Burgos, Lucrecia M, Burša, Filip, Busby, Landon K., Buscher, Hergen, Butler, Menoly, Butt, Warwick W., Byrnes, Jonathan W., Calaritis, Christos, Caldwell, Lisa R., Calligaro, Gregory L., Campbell, Patrick T., Camporota, Luigi, Fernando Caneo, Luiz, Jovo Carapic, Vladimir, Carrasco-Carrasco, Cristina, Ivan Carrizo, Nestor, Carrow, Heidi, Carton, Edmund G., Casabella, Christian, Gomez Casal, Vanesa, Casey, Francis L., III, Castillo, Andres, Castleberry, Anthony W., Alexandros Cavayas, Yiorgos, Cerqua, Karey, Ming Chan, Kai Man ChanWai, Brian Chapman, Jason, Brahma Chari, Hari, Cheifetz, Omair ChaudharyIra M., Chen, Robin H.S, Chen, Weiting, Cheung, Eva W., Cheung, Anson, Chico, Juan I., Chiletti, Roberto, Jin Cho, Hwa, Cholette, Jill M., Christensen, Steffen, Chui, Betty S., Circelli, Alessandro, Clement, Katherine C., Cleuziou, Julie, Clouse, Brian, Cole, Gwendolen, Coles, Garrett M., Collins, Monika F., Collins, Monika F., Connelly, James, Conrad, Steven A., Cook, Marlene, Copeland, Hannah, Copus, Scott C., Cox, Charles S., Jr, Craig, Lynne K., Crain, Natasha, Cremonese, Ricardo V., Criswell, Emily A., Cross, Lisa M., Crowley, Moira A., Crowley, Jerome C., Cruz, Leonora, Cypel, Marcelo, Czarnik, Tomasz, Czuczwa, Miroslaw E., Sica da Rocha, Taís, Daddow, Samuel, Dali, Dante C., Dalton, Heidi J., Daly, Kathleen J.R., Damuth, Emily, Daniel, Dennis A., Daniel IV, John M., Daniel, Josiane M., Danis, Max D., Danko, Melissa E., Rodrigues Dantas, Joao Alberto, Daoust, Isabelle, Dauwe, Dieter F., Davidson, Mark, Davis, Joel C., Davis, Mitchell, D’Cunha, Jonathan, de Arruda Bravim, Bruno, de BoodeKim T. De La Cruz, Willem P., Gray DeAngelis, Kathryn, Debeuckelaere, Gerdy, Deitemyer, Matthew A., DellaVolpe, Jeffrey, Deneau, Jamie L., DeNino, Walter F., Denmark, Christopher G., Denney, Derek, DeValeria, Patrick A., Dewulf, Petra, Di Nardo, Matteo, DiBardino, Daniel J., DiMartino, Joseph, Dimopoulos, Stavros, Domico, Michele B., Dominy, Meaghan E., Donker, Dirk W., Dresbach, Till, Droogh, Joep M., Dunlap, Tiffany W., Dupon, Allsion, Durham, Lucian A., III, Durward, Andrew, Dvorak, Anna, Dyett, John F., Dziedzina, Carol L., Eaken, Carmen L., Eaton, Jonathan S., Eberle, Christopher J., Edwards, Linda, Efseviou, Christakis, Eigner, Juliann M., Ahmed Elhamrawi, Hazem, Elhazmi, Alyaa M., Elizondo, Tammy, Ellersick, Beverly L., Emling, Jonathan A., Ernst, Andreas, Pablo Escalante, Juan, Espinoza, Otoniel, Evey, Lee W., Fan, Eddy, Fang, Gary, Faulkner, Gail M., Fauman, Karen R, Ferguson, Niall, Ferreira, Benigno, Fiane, Arnt E., Andrade Fierro, Dario, Martha Filippi, María, Findeisen, Michael C., Finlay, Katie, Finlayson, Gordon, Fischer, Gwenyth A., Fischer, Courtney D., Fischer, William J., III, Fisher, Caleb M., Fitriasari, Reni, Fitzgerald, Jillian, Fix, Melissa K., Fleming, Sarah B., Flynn, Brigid C., Forst, Beth A., Fortuna, Philip P., Foti, Giuseppe, Fox, Matthew P., Franco, Thais O., David Freeland, C., Fried, Justin A., Friedman, Matthew L., Furlanetto, Beatriz, Fux, Thomas, Gaião, Sérgio, Gale, Michael J., Garcia, Joann Kathleen G., Garcia-Montilla, Romel, Gardner, Eric R., Garg, Meena, Garrison, Lawrence L., Gavrilovic, Srdjan M., Gawda, Ryszard, Geer, Laura W., Gelandt, Elton A., Gelvin, Michael G., Genovese, Bradley M., George, Jeffrey A., George, Timothy J, George, Sangley, Ghimire, Anup, Giani, Marco, Gill, Baljit S., Glikes, Erin, Golecki, Michael, Gongora, Enrique, Govener, Sara, Graf, Amanda, Grasselli, Giacomo, Gray, Brian W., Greenlee, Joseph A., III, Gregoric, Igor D., Gregory, Melinda, Grins, Edgars, Volker Groesdonk, Heinrich, Group, Kimberly F., Guarracino, Fabio, Joy Guidi-Solloway, Alexandra, Gunn, Tyler M., Guru, Pramod K, Haddle, John C., Haft, Jonathan W., Haisz, Emma, Hall, Julie L., Hall, Cameron, Hamaguchi, Jun, Hammond, Terese C., Han, Peggy K., Hardison, Daphne C., Harischandra, Dickwelle T., Hart, Shaun M., Harting, Matthew T., Hartley, Louise, Harvey, Chris J., Hasan, Zubair, Fawzy Hassan, Ibrahim, Hastings, Jennifer R., Hatcher, Renee’, Hatton, Kevin W., Haught, Christopher K., Awori Hayanga, Jeremiah, Peter Haydon, Timothy, Healy, Aaron H., Heard, Micheal L., Heather, Beth M., Hendrix, Rik H.J., Hennig, Felix, Hermens, Greet HermansJeannine A.J., Hernandez, Deborah A., Hernandez-Montfort, Jaime, Herrera, Guillermo, Hickman, Keri, Hittel, Ashley, Hobbs, Crystal, Hoffman, Jordan R.H., Hollinger, Laura E., Homishak, Michael, Horigoshi, Nelson K., Hoshino, Kota, Huang, Shu-Chien, Huenges, Katharina, Hussey, Alexander D., Hyslop, Robert W., Ihle, Rayan E., Ingemansson, Ola, Ivulich, Daniel, Jackson, Amanda L., Garcia Jacques, Rogelio, Jain, Harsh, Jakobs, Sharon M., Jan, Robert, Janowiak, Lisa M., Jara, Claire B., Jarden, Angela M., Jarzembowski, Jamie L., Jaudon, Andrew, Kishore Jayanthi, Venkata Krishna, Jennings, Joseph A., Jeong, Inseok, Meza Jiménez, Rafael, Jimenez-Rodriguez, Gian M., Joachim, Sabrina, Joelsons, Daniel, Johnson, Caroline A., Johnson, Andrea L., Jones, Jeffry H., Joseph, Mark, Joseph, Sunimol, Joshi, Raja, Joyce, Christopher J., Seung Jung, Jae, Carone Junior, José, Kallas, Harry J., KamerkarPilje Kang, Asavari, Kar, Biswajit, Karapanagiotidis, Georgios T., Kattan, Javier, Kaufman, David A., Kawauchi, Akira, Keene, Sarah D., Keller, Norma M., Keller, Roberta, Kelley, Emily W., Kelley, Kellie, Kelly-Geyer, Janet F., Kenderessy, Peter, Kenny, Laura E., Keshavjee, Shaf, Kessel, D., Kessler, Heather, Keuler, Suzanne, Khicha, Sanjay, Wan Kim, Do, Kim, Richard Y., Maxwell Kime, Aaron, Kincade, Robert C., Kipfmueller, Florian, Kirk, Douglas A., Klein, Liviu, Knapp, Randall S., Knapp, Randall S., Kneyber, Martin C.J., Knowles, Andrea L., Koch, Jillian M., Koepke, Stephanie, Kogelmann, Klaus M., Elzo Kraemer, Carlos, Krauklis, Amanda, Krumroy, Samantha L., Kumar, Madhan, Kumar, Arun, Kumpf, Matthias E, Kyle, Kimberly, Laffin, Anna, Kees Lagrand, Wim, Lahiji, Parshawn A., Keung Lai, Peter Chi, Ka Lai, Cally Ho, Danielle Laird, Amanda, Landsberg, Michelle LaMarreDavid M., Lanmueller, Pia, Oude Lansink-Hartgring, Annemieke, Beth Larson, Sharon, Laufenberg, De’Ann M., Lavana, Jayshree, Layne, Tracie L., John Lazar, Michael, Ledoux, Matthew R., Lee, Raymond C., Leek, Thomas M., Lequier, Laurance, Lesbekov, Timur, Leslie, Robert, Anne Leung, Kit Hung, Lillie, Jon, Phang Lim, Yeong, Lim, Sang-Hyun, Lin, Ling, Lindsey, Thomas, Ho Ling, Steven Kin, Lingle, Kaitlyn J., Lipes, Jed, Liu, Songqiao, Llevadias, Judit, Lomas, Erin A., Longenecker, Robert D., Lorusso, Roberto, Ann Low, Tracy, Steven Lubinsky, Anthony, Lucas, Matthias LubnowMark T., Lucchini, Alberto, Luze, Lisa E., Lynch, William R., Manoj, M.C., Maas, Jacinta J., MacNamara, Vanessa, Madden, Jesse L., Maimone, Justin, Malhotra, Rajiv, Malone, Matthew P., Mangukia, Chirantan, Manzur-Sandoval, Daniel, Maráczi, Veronika, Marinaro, Jonathan L., Marinucci, Christina R., Marshall, Tammy, Martin, Mark, Marwali, Eva M., Maslach-Hubbard, Anna, Matijašević, Jovan, Mattke, Adrian, Mattucci, Joseph, Maul, Timothy M., Maybauer, Marc O., Mayette, Michael, Mayville, Joni R., McAllister, Catherine, McBride, Martha W., Scott McCaul, David, McClelland, Samantha L.S., Gregory McCloskey, Colin, McGregor, Randy, McKamie, Wesley A., McKee, Andrew D., McMahon, Chelsea M., McMullin, Kaye, McNicol, Jane, McNulty, John P., McRae, Thomas, Meade, Maureen E., Meersseman, Philippe, Mekeirele, Michael, Ito Mendes, Elisa, Menon, Anuradha P., Meyer, Jason P., Meyers, Jourdan E., Meyns, Bart, Mignone, John L., Miller, Brittany D., Miller, Malcolm G.A., Miller, Deborah, Mintak, Renee, Minter, Sarah M., Reis Miranda, Dinis, Mirza, Farrukh, Mishkin, Joseph D., Modelewski, Paul, Mohan, Rajeev C., Hui Mok, Yee, Money, Dustin, Monteagudo, Julie, Moores, Russell R., Jr., Moran, Patrick, Morelock, Shawn, Moreno, Marsha R., Blanco Morillo, Juan, Morrison, Tracy, Morton, John M., Morton, Brenda, Moscatelli, Andrea, Mosier, Jarrod M., Muellenbach, Ralf M., Mueller, Andreas, Mueller, Dale, Musca, Steven C., Nagpal, Dave, Najaf, Tasnim, Narasimhan, Mangala, Nater, Melissa, Natividad, Zynthia, Nedeljkov, Djordje, Nelson, Bryan D., Newman, Sally F., Newton, Debra E., Neyman, Jonathan L., George Ng, Wing Yiu, Nicholson, Meghan C., Nicolaas, Christine, Nix, Charlie, Nkwantabisa, Raymond, Nolan, Shirley, Norese, Mariano, Norton, Bridget M., Norton, Bridget M., O’Brien, Serena G., O’Callaghan, Maura, Oishi, Peter, O’Leary, Tony D., Olia, Salim E., O’Meara, Carlisle, Oppel, Emily E., Arias Ortiz, Julian, Oza, Pranay L., Ozment, Caroline P., Pacific, Marjorie, Pálizas, Fernando, Palmer, David, Paoletti, Luca, Pardo, Diego H., Paredes, Pablo, Patel, Thomas PasgaardMrunal G., Patel, Sandeep M., Patel, Vijay S., Patel, Brijesh V., PatelDrisya Paul, Sameer, Pawale, Amit A., Pearson, Nicole M., Renee Pearson, Crystal, Peek, Giles J., Pellecchia, Crescens M., Pellegrino, Vincent, Peperstraete, Harlinde, Perkins, Rebecca L., Perkins, Brandon, Peterec, Steven, Peterman, Claire, Phillips, Cooper W., Piekutowski, Richard R., Pilan, María L., Luisa Pilan, Maria, Mark Pincus, Jason, Pino, Melissa, Plambeck, Robert W., Plisco, Michael S., Plumley, Donald A., Plunkett, Mark D., Poffo, Robinson, Poh, Pei-Fen, Polito, Angelo, Pollema, Travis L, Pozzi, Matteo, Pozzi, Matteo, Pranikoff, Thomas, Prekker, Matthew E., Prossen, Erik F., Puligandla, Pramod S., Puslecki, Mateusz, Raheel Qureshi, Muhammad, Emilia Rabanal, Lily, Abdulhamid Rabie, Ahmed, Rackley, Craig R., Radovancevic, Rajko, Raes, Matthias, Allen Raff, Lauren Desiree, Rahban, Youssef, Raimer, Patricia L., Rajbanshi, Bijoy G., Ramanan, Raj, Rambaud, Jerome, Ramírez-Arce, Jorge A., Simões Ramos, Ana Carolina, Rao, Suresh G., Rector, Raymond, Redfors, Bengt, Regmi, Ashim, Alejandro Rey, Jose, Miguel Ribeiro, Joao, Richards, Chelsea E, Joan Richardson, C., Riddle, Christy C., Riera, Jordi, Ripardo, Marina, Rivas, Fernando M., Roan, Ronald M., Robertson, Elizabeth, Robinson, Megan, Röder, Daniel, Rodrigus, Inez E.R., Paul Roeleveld, Peter, Romano, Jennifer C., Rona, Roberto, Ann Rosenberg, Carol, Rosenow, Felix, Rowe, Robert J., Rower, Katy E., Rudolph, Kristina L., Fernando Rueda, Luis, Ruf, Bettina, Russell, Hyde M., Russell, Nichole, Ryan, Kathleen, Saberi, Asif A., Said, Ahmed S., Sailor, Caitlin, Sakal, Angela, Lujan Salas, Gisela, Salazar, Leonardo, Saleem, Kashif, Samoukovic, Gordan, Sanchez, Pablo G., Marie Santiago, Lian, Sargin, Murat, Miguel Sassine, Assad, Satou, Nancy L., Saunders, Paul C., Schachinger, Scott, Schaible, Thomas, Schellongowski, Peter, Schlager, Gerald W., Schmid, Christof, Schmitt, Joachim, Schnell, LeeAndra, Schnur, Janos, Schroeder, Lukas, Schubach, Scott, Schuetz, Michael T., Schwartz, Gary S., Schwarz, Patricia, Scriven, Nicole M., Seabrook, Ruth B., Seefeldt, Cassandra, Seelhammer, Troy G., Segura-Matute, Susana, Sen, Ayan, Adrian Seoane, Leonardo, Shaffer, Jamie, Shafi, Bilal M., Shambley, Shannon, Shankar, Shyam, Shapland, Amanda, Sharng, Yih, Shavelle, David, Sheldrake, Jayne, Mohan Shetty, Rajesh, Shiber, Joseph R., Shimzu, Naoki, Lou Short, Billie, Sichting, Kay A., Sidehamer, Keith E., Siebenaler, Teka, Silvestry, Scott C., Sinclair, Jennifer T, Sinclair, Andrew, Singh, Aalok R., Singh, Gurmeet, Skinner, Sean C., Smart, Alexandra, Smith, Reanna M., Smith, Adam, Smith, Karen, Sommer-Candelario, Sherri, Song, Seunghwan, Sorensen, Gro, Sousa, Eduardo, Sower, Christopher T., Spadea, Nicholas V, Spangle, April, Speicher, David G., Spieth, Peter M., Srivastava, Ankur, Srivastava, Neeraj, Stahl, Mark, Stallkamp, Eric D., Jr, Stanley, Vanessa J., Starr, Joanne P., Staudinger, Thomas, Stevens, Berkeley E., Stevens, Kimberly, Stocker, Christian, Strickland, Richard, Suarez, Erik E., Kumar Subramanian, Rakesh, Sudakevych, Serhii, Summerall, Charlene, Sundararajan, Santosh, Susupaus, Attapoom, Suzuki, Hiroyuki, Sweberg, Todd, Sydzyik, Troy, Anh Ta, Tuan, Tagliari, Luciana, Tanaka, Hiroyuki, Tanski, Christopher T., Tasset, Mark, Taylor, Donna M., Teman, Nicholas R., Ramesh Thangaraj, Paul, Thiagarajan, Ravi R., Thiruchelvam, Timothy, Thomas, James A., Thomas, Owain D., Thompson, Shaun L., Thomson, David A., Thukaram, Roopa, Todd, Mark L., Toeg, Hadi, Torres, Silvio F., Trautner, Simon, Trombino, Terry, Tuazon, Divina M., Tuel, Julie, Tukacs, Monika, Turner, April N., Tyree, Melissa M., Uchiyama, Prashant Vaijyanath, Makoto, van den Brule, Judith M.D., van Dyck, Marlice A., van Gijlswijk, Mascha, Van Meurs, Krisa P., VanDyck, Tyler J., Vardi, Amir, Vega, Alejandra, Ventetuolo, Corey E., Vera, Magdalena, Vercaemst, Leen, Vets, Philippe, Viamonte, Heather, Vidlund, Mårten, Vitali, Sally H., Vlaa, Alexander P.J., Vuylsteke, Alain, Loon Wan, Kah, Watkins, Reuben, Watson, Pia, Weast, Travis A., Weaver, Karen E., Welkovics, Norbert, Wellner, Heidi L., Wells, Jason C., Welter, Karen, Westpheling, Amber G., Whalen, Lesta D.S., Whebell, Stephen, Wiersema, Ubbo, Wiisanen, Matthew E., Eugene Wilcox, Bradley, Wille, Keith, Jan Will, Ellyne, Wilson, Brock J., Win, April M., Winearls, James R., Wise, Linda J., Witter, Tobias, Ruby Wong, Hoi Mei, Worku, Berhane, Wright, Tina M, Wu, James K., Yalon, Larissa A., Yantosh, Garrett, Yaranov, Dmitry M., Yee, Pat, Yi, Cassia, Yost, Christian C., Young, John, Younger, Katrina, Zaborowski, Steven, Zachmann, Brenda, Zainab, Asma, Zanai, Rosanna, Zhao, Ju, Zhou, Chengbin, and Zinger, Marcia

Published
2024
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2. A genetically modulated Toll-like-receptor-tolerant phenotype in peripheral blood cells of children with multisystem inflammatory syndrome

Author

Khan, Rehan, primary, Ji, Weizhen, additional, Guzman-Rivera, Jeisac, additional, Madhvi, Abhilasha, additional, Andrews, Tracy, additional, Richlin, Benjamin, additional, Suarez, Christian, additional, Gaur, Sunanda, additional, Cuddy, William, additional, Singh, Aalok R., additional, Bukulmez, Hulya, additional, Kaelber, David, additional, Kimura, Yukiko, additional, Ganapathi, Usha, additional, Michailidis, Ioannis E., additional, Ukey, Rahul, additional, Moroso-Fela, Sandra, additional, Kuster, John K., additional, Casseus, Myriam, additional, Roy, Jason, additional, Kleinman, Lawrence C., additional, Horton, Daniel B., additional, Lakhani, Saquib A., additional, and Gennaro, Maria Laura, additional

Published
2024
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3. Data-driven clustering identifies features distinguishing multisystem inflammatory syndrome from acute COVID-19 in children and adolescents

Author

Geva, Alon, Patel, Manish M., Newhams, Margaret M., Young, Cameron C., Son, Mary Beth F., Kong, Michele, Maddux, Aline B., Hall, Mark W., Riggs, Becky J., Singh, Aalok R., Giuliano, John S., Hobbs, Charlotte V., Loftis, Laura L., McLaughlin, Gwenn E., Schwartz, Stephanie P., Schuster, Jennifer E., Babbitt, Christopher J., Halasa, Natasha B., Gertz, Shira J., Doymaz, Sule, Hume, Janet R., Bradford, Tamara T., Irby, Katherine, Carroll, Christopher L., McGuire, John K., Tarquinio, Keiko M., Rowan, Courtney M., Mack, Elizabeth H., Cvijanovich, Natalie Z., Fitzgerald, Julie C., Spinella, Philip C., Staat, Mary A., Clouser, Katharine N., Soma, Vijaya L., Dapul, Heda, Maamari, Mia, Bowens, Cindy, Havlin, Kevin M., Mourani, Peter M., Heidemann, Sabrina M., Horwitz, Steven M., Feldstein, Leora R., Tenforde, Mark W., Newburger, Jane W., Mandl, Kenneth D., and Randolph, Adrienne G.

Published
2021
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5. Community-onset bacterial coinfection in children critically ill with SARS-CoV-2 infection

Author

Moffitt, Kristin L, primary, Nakamura, Mari M, additional, Young, Cameron C, additional, Newhams, Margaret M, additional, Halasa, Natasha B, additional, Reed, J Nelson, additional, Fitzgerald, Julie C, additional, Spinella, Philip C, additional, Soma, Vijaya L, additional, Walker, Tracie C, additional, Loftis, Laura L, additional, Maddux, Aline B, additional, Kong, Michele, additional, Rowan, Courtney M, additional, Hobbs, Charlotte V, additional, Schuster, Jennifer E, additional, Riggs, Becky J, additional, McLaughlin, Gwenn E, additional, Michelson, Kelly N, additional, Hall, Mark W, additional, Babbitt, Christopher J, additional, Cvijanovich, Natalie Z, additional, Zinter, Matt S, additional, Maamari, Mia, additional, Schwarz, Adam J, additional, Singh, Aalok R, additional, Flori, Heidi R, additional, Gertz, Shira J, additional, Staat, Mary A, additional, Giuliano, John S, additional, Hymes, Saul R, additional, Clouser, Katharine N, additional, McGuire, John, additional, Carroll, Christopher L, additional, Thomas, Neal J, additional, Levy, Emily R, additional, and Randolph, Adrienne G, additional

Published
2023
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7. Variation in Early Anakinra Use and Short‐Term Outcomes in Multisystem Inflammatory Syndrome in Children.

Author

Chang, Joyce C., Young, Cameron C., Muscal, Eyal, Sexson Tejtel, Sara K., Newhams, Margaret M., Kucukak, Suden, Crandall, Hillary, Maddux, Aline B., Rowan, Courtney M., Halasa, Natasha B., Harvey, Helen A., Hobbs, Charlotte V., Hall, Mark W., Kong, Michele, Aguiar, Cassyanne L., Schuster, Jennifer E., Fitzgerald, Julie C., Singh, Aalok R., Wellnitz, Kari, and Nofziger, Ryan A.

Subjects
THERAPEUTIC use of cytokines, VASOCONSTRICTORS, C-reactive protein, GLUCOCORTICOIDS, RELATIVE medical risk, MULTISYSTEM inflammatory syndrome, CONFIDENCE intervals, RETROSPECTIVE studies, IMMUNOMODULATORS, MEDICAL care, TREATMENT effectiveness, INTRAVENOUS immunoglobulins, CARDIOVASCULAR system, LONGITUDINAL method, CHILDREN
Abstract

Objective: Evidence regarding effectiveness of interleukin‐1 receptor antagonism in multisystem inflammatory syndrome in children (MIS‐C) is lacking. We characterized variation in initial treatment with anakinra and evaluated cardiovascular outcomes associated with adding anakinra to standard initial therapy. Methods: We conducted a retrospective cohort study of MIS‐C cases in a US surveillance registry from November 2020 to December 2021. Day 0 was the first calendar day of immunomodulatory treatment. Factors associated with initial anakinra use (days 0–1) were identified. We compared cases in patients ages 2–20 years receiving intravenous immunoglobulin (IVIG) and glucocorticoids versus anakinra plus IVIG and/or glucocorticoids on days 0–1, using inverse probability weighting to balance disease severity. Primary outcomes were vasopressor requirement on day 3 and impaired left ventricular ejection fraction on days 3–4. The secondary outcome was 50% reduction in C‐reactive protein on day 3. Results: Among 1,516 MIS‐C cases at 44 sites, 193 (13%) patients received anakinra alone or with other immunomodulators as initial treatment (range 0–74% by site). Site accounted for 59% of residual variance in anakinra use. After balancing disease severity, initial treatment with anakinra plus IVIG and/or glucocorticoids (n = 121) versus IVIG plus glucocorticoids (n = 389) was not associated with significant differences in vasopressor requirement (25.6% versus 20.1%, respectively; risk ratio [RR] 1.27 [95% confidence interval (95% CI) 0.88–1.84]), ventricular dysfunction (33.7% versus 25.7%, respectively; RR 1.31 [95% CI 0.98–1.75]), or C‐reactive protein reduction. Conclusion: We identified substantial variation in initial anakinra use in a real‐world population of children with MIS‐C, but no average short‐term improvement in cardiovascular outcomes associated with early addition of anakinra to IVIG and/or glucocorticoids compared to IVIG and glucocorticoids alone. [ABSTRACT FROM AUTHOR]

Published
2023
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8. Extracorporeal Membrane Oxygenation Characteristics and Outcomes in Children and Adolescents With COVID-19 or Multisystem Inflammatory Syndrome Admitted to U.S. ICUs.

Author

Bembea, Melania M., Loftis, Laura L., Thiagarajan, Ravi R., Young, Cameron C., McCadden, Timothy P., Newhams, Margaret M., Kucukak, Suden, Mack, Elizabeth H., Fitzgerald, Julie C., Rowan, Courtney M., Maddux, Aline B., Kolmar, Amanda R., Irby, Katherine, Heidemann, Sabrina, Schwartz, Stephanie P., Kong, Michele, Crandall, Hillary, Havlin, Kevin M., Singh, Aalok R., and Schuster, Jennifer E.

Published
2023
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9. Changes in Distribution of Severe Neurologic Involvement in US Pediatric Inpatients With COVID-19 or Multisystem Inflammatory Syndrome in Children in 2021 vs 2020.

Author

LaRovere, Kerri L., Poussaint, Tina Y., Young, Cameron C., Newhams, Margaret M., Kucukak, Suden, Irby, Katherine, Kong, Michele, Schwartz, Stephanie P., Walker, Tracie C., Bembea, Melania M., Wellnitz, Kari, Havlin, Kevin M., Cvijanovich, Natalie Z., Hall, Mark W., Fitzgerald, Julie C., Schuster, Jennifer E., Hobbs, Charlotte V., Halasa, Natasha B., Singh, Aalok R., and Mack, Elizabeth H.

Published
2023
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10. Investigating Health Disparities Associated With Multisystem Inflammatory Syndrome in Children After SARS-CoV-2 Infection.

Author

Zambrano, Laura D., Ly, Kathleen N., Link-Gelles, Ruth, Newhams, Margaret M., Akande, Manzilat, Wu, Michael J., Feldstein, Leora R., Tarquinio, Keiko M., Sahni, Leila C., Riggs, Becky J., Singh, Aalok R., Fitzgerald, Julie C., Schuster, Jennifer E., Giuliano Jr, John S., Englund, Janet A., Hume, Janet R., Hall, Mark W., Osborne, Christina M., Doymaz, Sule, and Rowan, Courtney M.

Published
2022
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11. Multisystem Inflammatory Syndrome in Children — Initial Therapy and Outcomes

Author

Son, Mary Beth F., primary, Murray, Nancy, additional, Friedman, Kevin, additional, Young, Cameron C., additional, Newhams, Margaret M., additional, Feldstein, Leora R., additional, Loftis, Laura L., additional, Tarquinio, Keiko M., additional, Singh, Aalok R., additional, Heidemann, Sabrina M., additional, Soma, Vijaya L., additional, Riggs, Becky J., additional, Fitzgerald, Julie C., additional, Kong, Michele, additional, Doymaz, Sule, additional, Giuliano, John S., additional, Keenaghan, Michael A., additional, Hume, Janet R., additional, Hobbs, Charlotte V., additional, Schuster, Jennifer E., additional, Clouser, Katharine N., additional, Hall, Mark W., additional, Smith, Lincoln S., additional, Horwitz, Steven M., additional, Schwartz, Stephanie P., additional, Irby, Katherine, additional, Bradford, Tamara T., additional, Maddux, Aline B., additional, Babbitt, Christopher J., additional, Rowan, Courtney M., additional, McLaughlin, Gwenn E., additional, Yager, Phoebe H., additional, Maamari, Mia, additional, Mack, Elizabeth H., additional, Carroll, Christopher L., additional, Montgomery, Vicki L., additional, Halasa, Natasha B., additional, Cvijanovich, Natalie Z., additional, Coates, Bria M., additional, Rose, Charles E., additional, Newburger, Jane W., additional, Patel, Manish M., additional, and Randolph, Adrienne G., additional

Published
2021
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12. Frequency, Characteristics and Complications of COVID-19 in Hospitalized Infants.

Author

Hobbs, Charlotte V., Woodworth, Kate, Young, Cameron C., Jackson, Ashley M., Newhams, Margaret M., Dapul, Heda, Maamari, Mia, Hall, Mark W., Maddux, Aline B., Singh, Aalok R., Schuster, Jennifer E., Rowan, Courtney M. r, Fitzgerald, Julie C., Irby, Katherine, Kong, Michele, Mack, Elizabeth H. MS, Staat, Mary A., Cvijanovich, Natalie Z., Bembea, Melania M., and Coates, Bria M.

Published
2022
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13. Identification of a host protein essential for assembly of immature HIV-1 capsids

Author

Zimmerman, Concepcion, Klein, Kevin C., Kiser, Patti K., Singh, Aalok R., Firestein, Bonnie L., Riba, Shannyn C., and Lingappa, Jaisri R.

Subjects
HIV (Viruses) -- Genetic aspects -- Research, Electron microscopy -- Usage -- Research, Viral proteins -- Identification and classification -- Genetic aspects -- Research -- Usage, Environmental issues, Science and technology, Zoology and wildlife conservation, Identification and classification, Usage, Research, Genetic aspects
Abstract

Author(s): Concepcion Zimmerman [1]; Kevin C. Klein [2]; Patti K. Kiser [2]; Aalok R. Singh [1]; Bonnie L. Firestein [3]; Shannyn C. Riba [2]; Jaisri R. Lingappa (corresponding author) [2, [...]

Published
2002
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14. Multisystem Inflammatory Syndrome in U.S. Children and Adolescents

Author

Feldstein, Leora R., primary, Rose, Erica B., additional, Horwitz, Steven M., additional, Collins, Jennifer P., additional, Newhams, Margaret M., additional, Son, Mary Beth F., additional, Newburger, Jane W., additional, Kleinman, Lawrence C., additional, Heidemann, Sabrina M., additional, Martin, Amarilis A., additional, Singh, Aalok R., additional, Li, Simon, additional, Tarquinio, Keiko M., additional, Jaggi, Preeti, additional, Oster, Matthew E., additional, Zackai, Sheemon P., additional, Gillen, Jennifer, additional, Ratner, Adam J., additional, Walsh, Rowan F., additional, Fitzgerald, Julie C., additional, Keenaghan, Michael A., additional, Alharash, Hussam, additional, Doymaz, Sule, additional, Clouser, Katharine N., additional, Giuliano, John S., additional, Gupta, Anjali, additional, Parker, Robert M., additional, Maddux, Aline B., additional, Havalad, Vinod, additional, Ramsingh, Stacy, additional, Bukulmez, Hulya, additional, Bradford, Tamara T., additional, Smith, Lincoln S., additional, Tenforde, Mark W., additional, Carroll, Christopher L., additional, Riggs, Becky J., additional, Gertz, Shira J., additional, Daube, Ariel, additional, Lansell, Amanda, additional, Coronado Munoz, Alvaro, additional, Hobbs, Charlotte V., additional, Marohn, Kimberly L., additional, Halasa, Natasha B., additional, Patel, Manish M., additional, and Randolph, Adrienne G., additional

Published
2020
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15. A Description of COVID-19-Directed Therapy in Children Admitted to US Intensive Care Units 2020

Author

Schuster, Jennifer E, Halasa, Natasha B, Nakamura, Mari, Levy, Emily R, Fitzgerald, Julie C, Young, Cameron C, Newhams, Margaret M, Bourgeois, Florence, Staat, Mary A, Hobbs, Charlotte V, Dapul, Heda, Feldstein, Leora R, Jackson, Ashley M, Mack, Elizabeth H, Walker, Tracie C, Maddux, Aline B, Spinella, Philip C, Loftis, Laura L, Kong, Michele, Rowan, Courtney M, Bembea, Melania M, McLaughlin, Gwenn E, Hall, Mark W, Babbitt, Christopher J, Maamari, Mia, Zinter, Matt S, Cvijanovich, Natalie Z, Michelson, Kelly N, Gertz, Shira J, Carroll, Christopher L, Thomas, Neal J, Giuliano, John S, Singh, Aalok R, Hymes, Saul R, Schwarz, Adam J, McGuire, John K, Nofziger, Ryan A, Flori, Heidi R, Clouser, Katharine N, Wellnitz, Kari, Cullimore, Melissa L, Hume, Janet R, Patel, Manish, and Randolph, Adrienne G

Abstract

No therapies for acute coronavirus disease 2019 (COVID-19) have been tested in children to establish effectiveness. Despite this, across 48 hospitals, 235/424 children (55%) admitted to the intensive care or step-down unit with COVID-19 received directed therapies. Systemic steroids and remdesivir were most commonly administered, with use rising from March 2020 to December 2020.

Published
2022
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16. Neurologic Involvement in Children and Adolescents Hospitalized in the United States for COVID-19 or Multisystem Inflammatory Syndrome.

Author

LaRovere, Kerri L., Riggs, Becky J., Poussaint, Tina Y., Young, Cameron C., Newhams, Margaret M., Maamari, Mia, Walker, Tracie C., Singh, Aalok R., Dapul, Heda, Hobbs, Charlotte V., McLaughlin, Gwenn E., Son, Mary Beth F., Maddux, Aline B., Clouser, Katharine N., Rowan, Courtney M., McGuire, John K., Fitzgerald, Julie C., Gertz, Shira J., Shein, Steven L., and Munoz, Alvaro Coronado

Published
2021
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18. Characteristics and Outcomes of US Children and Adolescents With Multisystem Inflammatory Syndrome in Children (MIS-C) Compared With Severe Acute COVID-19.

Author

Feldstein, Leora R., Tenforde, Mark W., Friedman, Kevin G., Newhams, Margaret, Rose, Erica Billig, Dapul, Heda, Soma, Vijaya L., Maddux, Aline B., Mourani, Peter M., Bowens, Cindy, Maamari, Mia, Hall, Mark W., Riggs, Becky J., Giuliano, John S., Singh, Aalok R., Li, Simon, Kong, Michele, Schuster, Jennifer E., McLaughlin, Gwenn E., and Schwartz, Stephanie P.

Subjects
COVID-19, INFLAMMATION, AMERICAN children, TEENAGERS, PUBLIC health, MULTISYSTEM inflammatory syndrome in children
Abstract

Importance: Refinement of criteria for multisystem inflammatory syndrome in children (MIS-C) may inform efforts to improve health outcomes.Objective: To compare clinical characteristics and outcomes of children and adolescents with MIS-C vs those with severe coronavirus disease 2019 (COVID-19).Setting, Design, and Participants: Case series of 1116 patients aged younger than 21 years hospitalized between March 15 and October 31, 2020, at 66 US hospitals in 31 states. Final date of follow-up was January 5, 2021. Patients with MIS-C had fever, inflammation, multisystem involvement, and positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcriptase-polymerase chain reaction (RT-PCR) or antibody test results or recent exposure with no alternate diagnosis. Patients with COVID-19 had positive RT-PCR test results and severe organ system involvement.Exposure: SARS-CoV-2.Main Outcomes and Measures: Presenting symptoms, organ system complications, laboratory biomarkers, interventions, and clinical outcomes. Multivariable regression was used to compute adjusted risk ratios (aRRs) of factors associated with MIS-C vs COVID-19.Results: Of 1116 patients (median age, 9.7 years; 45% female), 539 (48%) were diagnosed with MIS-C and 577 (52%) with COVID-19. Compared with patients with COVID-19, patients with MIS-C were more likely to be 6 to 12 years old (40.8% vs 19.4%; absolute risk difference [RD], 21.4% [95% CI, 16.1%-26.7%]; aRR, 1.51 [95% CI, 1.33-1.72] vs 0-5 years) and non-Hispanic Black (32.3% vs 21.5%; RD, 10.8% [95% CI, 5.6%-16.0%]; aRR, 1.43 [95% CI, 1.17-1.76] vs White). Compared with patients with COVID-19, patients with MIS-C were more likely to have cardiorespiratory involvement (56.0% vs 8.8%; RD, 47.2% [95% CI, 42.4%-52.0%]; aRR, 2.99 [95% CI, 2.55-3.50] vs respiratory involvement), cardiovascular without respiratory involvement (10.6% vs 2.9%; RD, 7.7% [95% CI, 4.7%-10.6%]; aRR, 2.49 [95% CI, 2.05-3.02] vs respiratory involvement), and mucocutaneous without cardiorespiratory involvement (7.1% vs 2.3%; RD, 4.8% [95% CI, 2.3%-7.3%]; aRR, 2.29 [95% CI, 1.84-2.85] vs respiratory involvement). Patients with MIS-C had higher neutrophil to lymphocyte ratio (median, 6.4 vs 2.7, P < .001), higher C-reactive protein level (median, 152 mg/L vs 33 mg/L; P < .001), and lower platelet count (<150 ×103 cells/μL [212/523 {41%} vs 84/486 {17%}, P < .001]). A total of 398 patients (73.8%) with MIS-C and 253 (43.8%) with COVID-19 were admitted to the intensive care unit, and 10 (1.9%) with MIS-C and 8 (1.4%) with COVID-19 died during hospitalization. Among patients with MIS-C with reduced left ventricular systolic function (172/503, 34.2%) and coronary artery aneurysm (57/424, 13.4%), an estimated 91.0% (95% CI, 86.0%-94.7%) and 79.1% (95% CI, 67.1%-89.1%), respectively, normalized within 30 days.Conclusions and Relevance: This case series of patients with MIS-C and with COVID-19 identified patterns of clinical presentation and organ system involvement. These patterns may help differentiate between MIS-C and COVID-19. [ABSTRACT FROM AUTHOR]

Published
2021
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22. Incidence of Multisystem Inflammatory Syndrome in Children Among US Persons Infected With SARS-CoV-2

Author

Payne, Amanda B., Gilani, Zunera, Godfred-Cato, Shana, Belay, Ermias D., Feldstein, Leora R., Patel, Manish M., Randolph, Adrienne G., Newhams, Margaret, Thomas, Deepam, Magleby, Reed, Hsu, Katherine, Burns, Meagan, Dufort, Elizabeth, Maxted, Angie, Pietrowski, Michael, Longenberger, Allison, Bidol, Sally, Henderson, Justin, Sosa, Lynn, Edmundson, Alexandra, Tobin-D’Angelo, Melissa, Edison, Laura, Heidemann, Sabrina, Singh, Aalok R., Giuliano, John S., Kleinman, Lawrence C., Tarquinio, Keiko M., Walsh, Rowan F., Fitzgerald, Julie C., Clouser, Katharine N., Gertz, Shira J., Carroll, Ryan W., Carroll, Christopher L., Hoots, Brooke E., Reed, Carrie, Dahlgren, F. Scott, Oster, Matthew E., Pierce, Timmy J., Curns, Aaron T., Langley, Gayle E., Campbell, Angela P., Balachandran, Neha, Murray, Thomas S., Burkholder, Cole, Brancard, Troy, Lifshitz, Jenna, Leach, Dylan, Charpie, Ian, Tice, Cory, Coffin, Susan E., Perella, Dana, Jones, Kaitlin, Marohn, Kimberly L., Yager, Phoebe H., Fernandes, Neil D., Flori, Heidi R., Koncicki, Monica L., Walker, Karen S., Di Pentima, Maria Cecilia, Li, Simon, Horwitz, Steven M., Gaur, Sunanda, Coffey, Dennis C., Harwayne-Gidansky, Ilana, Hymes, Saul R., Thomas, Neal J., Ackerman, Kate G., and Cholette, Jill M.

Abstract

IMPORTANCE: Multisystem inflammatory syndrome in children (MIS-C) is associated with recent or current SARS-CoV-2 infection. Information on MIS-C incidence is limited. OBJECTIVE: To estimate population-based MIS-C incidence per 1?000?000 person-months and to estimate MIS-C incidence per 1?000?000 SARS-CoV-2 infections in persons younger than 21 years. DESIGN, SETTING, AND PARTICIPANTS: This cohort study used enhanced surveillance data to identify persons with MIS-C during April to June 2020, in 7 jurisdictions reporting to both the Centers for Disease Control and Prevention national surveillance and to Overcoming COVID-19, a multicenter MIS-C study. Denominators for population-based estimates were derived from census estimates; denominators for incidence per 1?000?000 SARS-CoV-2 infections were estimated by applying published age- and month-specific multipliers accounting for underdetection of reported COVID-19 case counts. Jurisdictions included Connecticut, Georgia, Massachusetts, Michigan, New Jersey, New York (excluding New York City), and Pennsylvania. Data analyses were conducted from August to December 2020. EXPOSURES: Race/ethnicity, sex, and age group (ie, =5, 6-10, 11-15, and 16-20 years). MAIN OUTCOMES AND MEASURES: Overall and stratum-specific adjusted estimated MIS-C incidence per 1?000?000 person-months and per 1?000?000 SARS-CoV-2 infections. RESULTS: In the 7 jurisdictions examined, 248 persons with MIS-C were reported (median [interquartile range] age, 8 [4-13] years; 133 [53.6%] male; 96 persons [38.7%] were Hispanic or Latino; 75 persons [30.2%] were Black). The incidence of MIS-C per 1?000?000 person-months was 5.1 (95% CI, 4.5-5.8) persons. Compared with White persons, incidence per 1?000?000 person-months was higher among Black persons (adjusted incidence rate ratio [aIRR], 9.26 [95% CI, 6.15-13.93]), Hispanic or Latino persons (aIRR, 8.92 [95% CI, 6.00-13.26]), and Asian or Pacific Islander (aIRR, 2.94 [95% CI, 1.49-5.82]) persons. MIS-C incidence per 1?000?000 SARS-CoV-2 infections was 316 (95% CI, 278-357) persons and was higher among Black (aIRR, 5.62 [95% CI, 3.68-8.60]), Hispanic or Latino (aIRR, 4.26 [95% CI, 2.85-6.38]), and Asian or Pacific Islander persons (aIRR, 2.88 [95% CI, 1.42-5.83]) compared with White persons. For both analyses, incidence was highest among children aged 5 years or younger (4.9 [95% CI, 3.7-6.6] children per 1?000?000 person-months) and children aged 6 to 10 years (6.3 [95% CI, 4.8-8.3] children per 1?000?000 person-months). CONCLUSIONS AND RELEVANCE: In this cohort study, MIS-C was a rare complication associated with SARS-CoV-2 infection. Estimates for population-based incidence and incidence among persons with infection were higher among Black, Hispanic or Latino, and Asian or Pacific Islander persons. Further study is needed to understand variability by race/ethnicity and age group.

Published
2021
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23. Pre-existing Immunocompromising Conditions and Outcomes of Acute COVID-19 Patients Admitted for Pediatric Intensive Care.

Author

Rowan CM, LaBere B, Young CC, Zambrano LD, Newhams MM, Kucukak S, McNamara ER, Mack EH, Fitzgerald JC, Irby K, Maddux AB, Schuster JE, Kong M, Dapul H, Schwartz SP, Bembea MM, Loftis LL, Kolmar AR, Babbitt CJ, Nofziger RA, Hall MW, Gertz SJ, Cvijanovich NZ, Zinter MS, Halasa NB, Bradford TT, McLaughlin GE, Singh AR, Hobbs CV, Wellnitz K, Staat MA, Coates BM, Crandall HR, Maamari M, Havlin KM, Schwarz AJ, Carroll CL, Levy ER, Moffitt KL, Campbell AP, Randolph AG, and Chou J

Subjects
Humans, Child, Male, Female, Adolescent, Child, Preschool, Infant, Hospitalization statistics & numerical data, United States epidemiology, Hospital Mortality, COVID-19 mortality, COVID-19 epidemiology, COVID-19 therapy, Immunocompromised Host, Intensive Care Units, Pediatric statistics & numerical data, SARS-CoV-2
Abstract

Background: We aimed to determine if pre-existing immunocompromising conditions (ICCs) were associated with the presentation or outcome of patients with acute coronavirus disease 2019 (COVID-19) admitted for pediatric intensive care., Methods: Fifty-five hospitals in 30 US states reported cases through the Overcoming COVID-19 public health surveillance registry. Patients <21 years admitted 12 March 2020-30 December 2021 to the pediatric intensive care unit (PICU) or high-acuity unit for acute COVID-19 were included., Results: Of 1274 patients, 105 (8.2%) had an ICC, including 33 (31.4%) hematologic malignancies, 24 (22.9%) primary immunodeficiencies and disorders of hematopoietic cells, 19 (18.1%) nonmalignant organ failure with solid-organ transplantation, 16 (15.2%) solid tumors, and 13 (12.4%) autoimmune disorders. Patients with ICCs were older, had more underlying renal conditions, and had lower white blood cell and platelet counts than those without ICCs, but had similar clinical disease severity upon admission. In-hospital mortality from COVID-19 was higher (11.4% vs 4.6%, P = .005) and hospitalization was longer (P = .01) in patients with ICCs. New major morbidities upon discharge were not different between those with and without ICC (10.5% vs 13.9%, P = .40). In patients with ICCs, bacterial coinfection was more common in those with life-threatening COVID-19., Conclusions: In this national case series of patients <21 years of age with acute COVID-19 admitted for intensive care, existence of a prior ICCs were associated with worse clinical outcomes. Reassuringly, most patients with ICCs hospitalized in the PICU for severe acute COVID-19 survived and were discharged home without new severe morbidities., Competing Interests: Potential conflicts of interest. B. M. C. reports grants from NHLBI, American Lung Association, Doris Duke Foundation/Walder Foundation, and American Thoracic Society; payment for expert testimony from Tripplett Woolf Garretson; and participation on a multidisciplinary team for Sobi. N. B. H. reports grants from Sanofi, Quidel, and Merck. C. V. H. reports royalties, consulting fees, for Reviewer for Up To Date and Dynamed clinical databases; payment for presentations from Biofire; and expert consultation for the AstraZeneca FluMist Board. A. G. R. reports licenses as a Section Editor for Pediatric Critical Care Medicine, UpToDate, Inc; consulting fees from ThermoFisher, Inotrem; honoraria from a Grand Rounds presentation at St. Jude; support for meetings and/or travel from International Sepsis Forum, Institut Merieux, ThermoFisher; participation on an advisory board for the NIH Grace Study, REMAP-CAP, NIH-PREVENT-VILI; a medical advisory board member for Families Fighting Flu; chair member for International Sepsis Forum; and received reagents from Illumina, Inc. M. K. reports support for meetings and/or travel from the National Institute of Health (NIH) and a role on an advisory board for KultureCity. H. D. reports honoraria from Delex Pharma International, Inc. N. Z. C. reports grants from Cincinnati Children's Hospital Medical Center. J. C. F. reports grants from the National Institute of Diabetes and Digestive and Kidney Diseases (K23DK119463 and P50DK114786), and Pennsylvania CURE Grant. M. W. H. reports licenses from Kiadis, sub-board service for the American Board of Pediatrics, participation on a Data and Safety Monitoring Board (DSMB) for Abbvie, and receipt of drugs from Partner Therapeutics and Sobi. J. C. reports receipt of equipment from Illumina. B. L. reports receipt of an Immune Deficiency Foundation Research Grant. G. E. M. reports payment for expert testimony from Orlando Health, Bush Ross, Hall, Schiefflin & Smith, PA, Poole Brooks and Plumlee, PA, Hilltop Specialty Insurance, Smith, Hulsey, and Busey, PA. J. E. S. reports grants from the Food and Drug Administration (FDA), consulting fees from the Association for Professionals in Infection Control and Epidemiology (APIC), payment for presentations from the American Academy of Pediatrics, and participation on an advisory board for the American Association of Medical Colleges. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed., (© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Published
2024
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24. A genetically modulated Toll-like-receptor-tolerant phenotype in peripheral blood cells of children with multisystem inflammatory syndrome.

Author

Khan R, Ji W, Guzman-Rivera J, Madhvi A, Andrews T, Richlin B, Suarez C, Gaur S, Cuddy W, Singh AR, Bukulmez H, Kaelber D, Kimura Y, Ganapathi U, Michailidis IE, Ukey R, Moroso-Fela S, Kuster JK, Casseus M, Roy J, Kleinman LC, Horton DB, Lakhani SA, and Gennaro ML

Abstract

Dysregulated innate immune responses contribute to multisystem inflammatory syndrome in children (MIS-C), characterized by gastrointestinal, mucocutaneous, and/or cardiovascular injury occurring weeks after SARS-CoV-2 exposure. To investigate innate immune functions in MIS-C, we stimulated ex vivo peripheral blood cells from MIS-C patients with agonists of Toll-like receptors (TLR), key innate immune response initiators. We found severely dampened cytokine responses and elevated gene expression of negative regulators of TLR signaling. Increased plasma levels of zonulin, a gut leakage marker, were also detected. These effects were also observed in children enrolled months after MIS-C recovery. Moreover, cells from MIS-C children carrying rare genetic variants of lysosomal trafficking regulator ( LYST ) were less refractory to TLR stimulation and exhibited lysosomal and mitochondrial abnormalities with altered energy metabolism. Our results strongly suggest that MIS-C hyperinflammation and/or excessive or prolonged stimulation with gut-originated TLR ligands drive immune cells to a lasting refractory state. TLR hyporesponsiveness is likely beneficial, as suggested by excess lymphopenia among rare LYST variant carriers. Our findings point to cellular mechanisms underlying TLR hyporesponsiveness; identify genetic determinants that may explain the MIS-C clinical spectrum; suggest potential associations between innate refractory states and long COVID; and highlight the need to monitor long-term consequences of MIS-C.

Published
2024
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25. Community-Onset Bacterial Coinfection in Children Critically Ill With Severe Acute Respiratory Syndrome Coronavirus 2 Infection.

Author

Moffitt KL, Nakamura MM, Young CC, Newhams MM, Halasa NB, Reed JN, Fitzgerald JC, Spinella PC, Soma VL, Walker TC, Loftis LL, Maddux AB, Kong M, Rowan CM, Hobbs CV, Schuster JE, Riggs BJ, McLaughlin GE, Michelson KN, Hall MW, Babbitt CJ, Cvijanovich NZ, Zinter MS, Maamari M, Schwarz AJ, Singh AR, Flori HR, Gertz SJ, Staat MA, Giuliano JS Jr, Hymes SR, Clouser KN, McGuire J, Carroll CL, Thomas NJ, Levy ER, and Randolph AG

Abstract

Background: Community-onset bacterial coinfection in adults hospitalized with coronavirus disease 2019 (COVID-19) is reportedly uncommon, though empiric antibiotic use has been high. However, data regarding empiric antibiotic use and bacterial coinfection in children with critical illness from COVID-19 are scarce., Methods: We evaluated children and adolescents aged <19 years admitted to a pediatric intensive care or high-acuity unit for COVID-19 between March and December 2020. Based on qualifying microbiology results from the first 3 days of admission, we adjudicated whether patients had community-onset bacterial coinfection. We compared demographic and clinical characteristics of those who did and did not (1) receive antibiotics and (2) have bacterial coinfection early in admission. Using Poisson regression models, we assessed factors associated with these outcomes., Results: Of the 532 patients, 63.3% received empiric antibiotics, but only 7.1% had bacterial coinfection, and only 3.0% had respiratory bacterial coinfection. In multivariable analyses, empiric antibiotics were more likely to be prescribed for immunocompromised patients (adjusted relative risk [aRR], 1.34 [95% confidence interval {CI}, 1.01-1.79]), those requiring any respiratory support except mechanical ventilation (aRR, 1.41 [95% CI, 1.05-1.90]), or those requiring invasive mechanical ventilation (aRR, 1.83 [95% CI, 1.36-2.47]) (compared with no respiratory support). The presence of a pulmonary comorbidity other than asthma (aRR, 2.31 [95% CI, 1.15-4.62]) was associated with bacterial coinfection., Conclusions: Community-onset bacterial coinfection in children with critical COVID-19 is infrequent, but empiric antibiotics are commonly prescribed. These findings inform antimicrobial use and support rapid de-escalation when evaluation shows coinfection is unlikely., Competing Interests: Potential conflicts of interest. K. L. M. reports receiving funds from ContraFect as site investigator of a drug study and as patent beneficiary of technology licensed to Affinivax, Inc, outside the submitted work. C. V. H. reports receiving funds from UpToDate, Dynamed.com, and bioMérieux, outside the submitted work. M. W. H. reports receiving licensing fees from Kiadis, consulting fees from AbbVie for service on a data and safety monitoring board, consulting fees from the American Board of Pediatrics for service on a subboard, fees from Sobi for participating in a drug study, and fees from Partner Therapeutics for participating in a drug study, outside the submitted work. E. R. L. reports receiving grants to the institution from the National Institute of Allergy and Infectious Diseases (NIAID; AI 144301-01) and the CDC (CDC 75D30120C07725-01). A. G. R. reports receiving grants from NIAID and funds from UpToDate for editorial work. All other authors report no potential conflicts., (© The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)

Published
2023
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26. Life-Threatening Complications of Influenza vs Coronavirus Disease 2019 (COVID-19) in US Children.

Author

Halasa NB, Spieker AJ, Young CC, Olson SM, Newhams MM, Amarin JZ, Moffitt KL, Nakamura MM, Levy ER, Soma VL, Talj R, Weiss SL, Fitzgerald JC, Mack EH, Maddux AB, Schuster JE, Coates BM, Hall MW, Schwartz SP, Schwarz AJ, Kong M, Spinella PC, Loftis LL, McLaughlin GE, Hobbs CV, Rowan CM, Bembea MM, Nofziger RA, Babbitt CJ, Bowens C, Flori HR, Gertz SJ, Zinter MS, Giuliano JS, Hume JR, Cvijanovich NZ, Singh AR, Crandall HA, Thomas NJ, Cullimore ML, Patel MM, and Randolph AG

Subjects
Humans, Child, SARS-CoV-2, Hospitalization, Respiration, Artificial, Obesity, Retrospective Studies, COVID-19 epidemiology, Influenza, Human complications, Influenza, Human epidemiology
Abstract

Background: Clinical differences between critical illness from influenza infection vs coronavirus disease 2019 (COVID-19) have not been well characterized in pediatric patients., Methods: We compared demographics, clinical characteristics, and outcomes of US children (aged 8 months to 17 years) admitted to the intensive care or high-acuity unit with influenza or COVID-19. Using mixed-effects models, we assessed the odds of death or requiring life support for influenza vs COVID-19 after adjustment for age, sex, race and Hispanic origin, and underlying conditions including obesity., Results: Children with influenza (n = 179) were younger than those with COVID-19 (n = 381; median, 5.2 years vs 13.8 years), less likely to be non-Hispanic Black (14.5% vs 27.6%) or Hispanic (24.0% vs 36.2%), and less likely to have ≥1 underlying condition (66.4% vs 78.5%) or be obese (21.4% vs 42.2%), and a shorter hospital stay (median, 5 days vs 7 days). They were similarly likely to require invasive mechanical ventilation (both 30.2%), vasopressor support (19.6% and 19.9%), or extracorporeal membrane oxygenation (2.2% and 2.9%). Four children with influenza (2.2%) and 11 children with COVID-19 (2.9%) died. The odds of death or requiring life support in children with influenza vs COVID-19 were similar (adjusted odds ratio, 1.30; 95% confidence interval, .78-2.15; P = .32)., Conclusions: Despite differences in demographics and clinical characteristics of children with influenza or COVID-19, the frequency of life-threatening complications was similar. Our findings highlight the importance of implementing prevention measures to reduce transmission and disease severity of influenza and COVID-19., Competing Interests: Potential conflicts of interest. N. B. H. reports grants or contracts from Sanofi and Quidell outside of the submitted work and an educational grant for honorarium from Genentech. M. M. B. reports grants or contracts from the National Institutes of Health (NIH)/National Institute of Neurological Disorders and Stroke, Grifols Investigator Sponsored Research Grant, and NIH/ Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) outside of the submitted work and paid to institution. B. M. C. reports grants or contracts from the NIH, American Thoracic Society, and American Lung Association outside the submitted work and paid to institution and payment to author for expert testimony from Triplett Woolf Garretson, LLC. N. Z. C. reports grants or contracts from the NIH outside of the submitted work. H. R. F. reports grants or contracts from the NIH, National Heart, Lung, and Blood Institute (NHLBI), and NICHD outside of the submitted work; support for attending meetings and/or travel from the Society of Critical Care Medicine; participation on a data and safety monitoring board (DSMB) for a cardiothoracic surgery trial (single center) and a DSMB for an intrathecal chemotherapy trial; an unpaid position on the Michigan Thoracic Society Executive Committed and Pediatric Acute Lung Injury and Sepsis Investigators network Executive Committee; and the following other financial or nonfinancial interests: Lucira Health advisory committee and Aerogen Pharma advisory unfunded. M. W. H. reports grants or contracts from the NIH and royalties from Kiadis outside of the submitted work; participation on a DSMB or advisory board for AbbVie and La Jolla Pharmaceuticals (payment to author); and leadership or fiduciary role on the American Board of Pediatrics (payment to author). J. R. H. reports grants or contracts from the NIH–NICHD outside of the submitted work and participation on a DSMB for an institutional study at the University of Minnesota (no financial reimbursements). M. K. reports grants or contracts from the NIH outside of the submitted work to institution. E. R. L. reports grants or contracts from the NIH outside of the submitted work and paid to institution. M. M. Nakamura reports grants or contracts from Gilead for participation in their remdesivir trial. R. A. N. reports grants or contracts from the NIH outside of the submitted work. C. M. R. reports grants or contracts from the NIH outside of the submitted work and payment for honoraria to author for the Contemporary Critical Care Complications of SCT/Cellular Therapies Conference by MD Anderson. J. E. S. reports grants or contracts from Merck outside of the submitted work and paid to institution. M. S. Z. reports grants or contracts from the NIH outside of the submitted work and paid to institution. A. G. R. reports grants or contracts from the National Institute of Allergy and Infectious Diseases to institution outside of the submitted work; royalties or licenses from UpToDate as a Pediatric Critical Care Section Editor paid to author; and is an unpaid treasurer for International Sepsis Forum. M. L. C. reports grants or contracts to institution for projects unrelated to this work from the CDC. J.C.F. reports an NIH award unrelated to this study and paid to institution. C. V. H. reports payment or honoraria as a consultant for Biofire (bioMérieux). G. E. M. reports payment for expert testimony in a malpractice case involving influenza related death. All remaining authors: No reported conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed., (© The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

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2023
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