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Article ; Online: The clinical epidemiology of coronavirus disease 2019 in children and adolescents mirrors the widening gap in healthcare disparities.

Zirinsky, Elissa / Paintsil, Elijah / Oliveira, Carlos R

2021 Volume 33, Issue 3, Page(s) 281–285

Abstract: Purpose of review: The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic has exacerbated the longstanding racial/ethnic health disparities in the USA, with a disproportionately negative effect on children of color. This review ... ...

Abstract	Purpose of review: The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic has exacerbated the longstanding racial/ethnic health disparities in the USA, with a disproportionately negative effect on children of color. This review summarizes recently published studies that describe the clinical epidemiology and racial/ethnic disparities associated with SARS-CoV-2 in children. Recent findings: Children with SARS-CoV-2 infections manifest with a wide spectrum of disease. Most are either asymptomatic or mildly symptomatic with fever, gastrointestinal, and/or upper respiratory disease. Some children can progress to develop severe lower respiratory disease or a hyper-inflammatory, Kawasaki-like syndrome leading to cardiovascular shock. Although SARS-CoV-2-related deaths in children are rare, more children died within the first nine months of the pandemic than have died during any influenza season over the last decade.Black and Hispanic children represent less than 41% of the US population but account for three out of every four SARS-CoV-2-related hospitalizations and deaths in the USA. The drivers of these disparities in children are complex and likely a combination of societal, biological, and behavioral influences. Summary: This pandemic brought to light longstanding health disparities in historically marginalized populations, and minority children have suffered tremendously. It provides an opportunity to understand how a virus hijacked deep-rooted inequities, address these inequities, and work to prevent this outcome in future pandemics/epidemics.
MeSH term(s)	Adolescent ; COVID-19 ; Child ; Healthcare Disparities ; Hispanic or Latino ; Humans ; Pandemics ; SARS-CoV-2
Language	English
Publishing date	2021-04-14
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Review
ZDB-ID	1049374-8
ISSN	1531-698X ; 1040-8703
ISSN (online)	1531-698X
ISSN	1040-8703
DOI	10.1097/MOP.0000000000001018
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Routine saliva testing for SARS-CoV-2 in children: Methods for partnering with community childcare centers.

Rayack, Erica J / Askari, Hibah Mahwish / Zirinsky, Elissa / Lapidus, Sarah / Sheikha, Hassan / Peno, Chikondi / Kazemi, Yasaman / Yolda-Carr, Devyn / Liu, Chen / Grubaugh, Nathan D / Ko, Albert I / Wyllie, Anne L / Spatz, Erica S / Oliveira, Carlos R / Bei, Amy K

Frontiers in public health

2023 Volume 11, Page(s) 1003158

Abstract: While considerable attention was placed on SARS-CoV-2 testing and surveillance programs in the K-12 setting, younger age groups in childcare centers were largely overlooked. Childcare facilities are vital to communities, allowing parents/guardians to ... ...

Abstract	While considerable attention was placed on SARS-CoV-2 testing and surveillance programs in the K-12 setting, younger age groups in childcare centers were largely overlooked. Childcare facilities are vital to communities, allowing parents/guardians to remain at work and providing safe environments for both children and staff. Therefore, early in the COVID-19 pandemic (October 2020), we established a PCR-based COVID-19 surveillance program in childcare facilities, testing children and staff with the goal of collecting actionable public health data and aiding communities in the progressive resumption of standard operations and ways of life. In this study we describe the development of a weekly saliva testing program and provide early results from our experience implementing this in childcare centers. We enrolled children (aged 6 months to 7 years) and staff at seven childcare facilities and trained participants in saliva collection using video chat technology. Weekly surveys were sent out to assess exposures, symptoms, and vaccination status changes. Participants submitted weekly saliva samples at school. Samples were transported to a partnering clinical laboratory or RT-PCR testing using SalivaDirect and results were uploaded to each participant's online patient portal within 24 h. SARS-CoV-2 screening and routine testing programs have focused less on the childcare population, resulting in knowledge gaps in this critical age group, especially as many are still ineligible for vaccination. SalivaDirect testing for SARS-CoV-2 provides a feasible method of asymptomatic screening and symptomatic testing for children and childcare center staff. Given the relative aversion to nasal swabs in younger age groups, an at-home saliva collection method provides an attractive alternative, especially as a routine surveillance tool. Results can be shared rapidly electronically through participants' private medical chart portals, and video chat technology allows for discussion and instruction between investigators and participants. This study fosters a cooperative partnership with participating childcare centers, parents/guardians, and staff with the goal of mitigating COVID-19 transmission in childcare centers. Age-related challenges in saliva collection can be overcome by working with parents/guardians to conceptualize new collection strategies and by offering parents/guardians continued virtual guidance and support.
MeSH term(s)	Humans ; Child ; SARS-CoV-2 ; COVID-19/diagnosis ; COVID-19 Testing ; Saliva ; Pandemics/prevention & control ; Child Care
Language	English
Publishing date	2023-02-03
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
ZDB-ID	2711781-9
ISSN	2296-2565 ; 2296-2565
ISSN (online)	2296-2565
ISSN	2296-2565
DOI	10.3389/fpubh.2023.1003158
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Routine saliva testing for SARS-CoV-2 in children

Erica J. Rayack / Hibah Mahwish Askari / Elissa Zirinsky / Sarah Lapidus / Hassan Sheikha / Chikondi Peno / Yasaman Kazemi / Devyn Yolda-Carr / Chen Liu / Nathan D. Grubaugh / Albert I. Ko / Anne L. Wyllie / Erica S. Spatz / Carlos R. Oliveira / Amy K. Bei

Frontiers in Public Health, Vol

Methods for partnering with community childcare centers

2023 Volume 11

Abstract	While considerable attention was placed on SARS-CoV-2 testing and surveillance programs in the K-12 setting, younger age groups in childcare centers were largely overlooked. Childcare facilities are vital to communities, allowing parents/guardians to remain at work and providing safe environments for both children and staff. Therefore, early in the COVID-19 pandemic (October 2020), we established a PCR-based COVID-19 surveillance program in childcare facilities, testing children and staff with the goal of collecting actionable public health data and aiding communities in the progressive resumption of standard operations and ways of life. In this study we describe the development of a weekly saliva testing program and provide early results from our experience implementing this in childcare centers. We enrolled children (aged 6 months to 7 years) and staff at seven childcare facilities and trained participants in saliva collection using video chat technology. Weekly surveys were sent out to assess exposures, symptoms, and vaccination status changes. Participants submitted weekly saliva samples at school. Samples were transported to a partnering clinical laboratory or RT-PCR testing using SalivaDirect and results were uploaded to each participant's online patient portal within 24 h. SARS-CoV-2 screening and routine testing programs have focused less on the childcare population, resulting in knowledge gaps in this critical age group, especially as many are still ineligible for vaccination. SalivaDirect testing for SARS-CoV-2 provides a feasible method of asymptomatic screening and symptomatic testing for children and childcare center staff. Given the relative aversion to nasal swabs in younger age groups, an at-home saliva collection method provides an attractive alternative, especially as a routine surveillance tool. Results can be shared rapidly electronically through participants' private medical chart portals, and video chat technology allows for discussion and instruction between investigators and participants. ...
Keywords	SARS-CoV-2 ; routine testing ; childcare ; COVID-19 ; SalivaDirect ; saliva ; Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2023-02-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Routine Saliva Testing for SARS-CoV-2 in Children: Partnering with Childcare Centers in the Greater New Haven Community

Rayack, Erica / Askari, Hibah Mahwish / Zirinsky, Elissa / Lapidus, Sarah / Sheikha, Hassan / Peno, Chikondi / Kazemi, Yasaman / Yolda-Carr, Devyn / Liu, Chen / Grubaugh, Nathan D. / Ko, Albert I. / Wyllie, Anne L. / Spatz, Erica S. / Oliveira, Carlos R. / Bei, Amy K.

medRxiv

Abstract: Background: While considerable attention was placed on SARS-CoV-2 testing and surveillance programs in the K-12 setting, younger age groups in childcare centers were largely overlooked. Childcare facilities are vital to communities, allowing parents/ ... ...

Abstract	Background: While considerable attention was placed on SARS-CoV-2 testing and surveillance programs in the K-12 setting, younger age groups in childcare centers were largely overlooked. Childcare facilities are vital to communities, allowing parents/guardians to remain at work and providing safe environments for both children and staff. Therefore, early in the COVID-19 pandemic, we established a PCR-based COVID-19 surveillance program in childcare facilities, testing children and staff with the goal of collecting actionable public health data and aiding communities in the progressive resumption of standard operations and ways of life. In this study we describe the development of a weekly saliva testing program and provide early results from our experience implementing this in childcare centers. Methods: We enrolled children (aged 6 months to 7 years) and staff at 8 childcare facilities and trained participants in saliva collection using video chat technology. Weekly surveys were sent out to assess exposures, symptoms, and vaccination status changes. Participants submitted weekly saliva samples at school. Samples were transported to a partnering clinical laboratory for RT-PCR testing using SalivaDirect and results were uploaded to each participant9s online patient portal within 24 hours. Results: This study fostered a cooperative partnership with participating childcare centers, parents/guardians, and staff with the goal of mitigating COVID-19 transmission in childcare centers. Age-related challenges in saliva collection were overcome by working with parents/guardians to conceptualize new collection strategies and by offering parents/guardians continued virtual guidance and support. Conclusion: SARS-CoV-2 screening and routine testing programs have focused less on the childcare population, resulting in knowledge gaps in this critical age group, especially as many are still ineligible for vaccination. SalivaDirect testing for SARS-CoV-2 provides a feasible method of asymptomatic screening and symptomatic testing for children and childcare center staff. Given the relative aversion to nasal swabs in the childcare age group, especially as a routine surveillance tool, an at-home saliva collection method provides an attractive alternative. Results can be shared rapidly electronically through participants9 private medical chart portals, and video chat technology allows for discussion and instruction between investigators and participants.
Keywords	covid19
Language	English
Publishing date	2022-05-09
Publisher	Cold Spring Harbor Laboratory Press
Document type	Article ; Online
DOI	10.1101/2022.05.05.22274434
Database	COVID19

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Article ; Online: Severe Acute Respiratory Syndrome Coronavirus 2 Clinical Syndromes and Predictors of Disease Severity in Hospitalized Children and Youth.

Fernandes, Danielle M / Oliveira, Carlos R / Guerguis, Sandra / Eisenberg, Ruth / Choi, Jaeun / Kim, Mimi / Abdelhemid, Ashraf / Agha, Rabia / Agarwal, Saranga / Aschner, Judy L / Avner, Jeffrey R / Ballance, Cathleen / Bock, Joshua / Bhavsar, Sejal M / Campbell, Melissa / Clouser, Katharine N / Gesner, Matthew / Goldman, David L / Hammerschlag, Margaret R /

Hymes, Saul / Howard, Ashley / Jung, Hee-Jin / Kohlhoff, Stephan / Kojaoghlanian, Tsoline / Lewis, Rachel / Nachman, Sharon / Naganathan, Srividya / Paintsil, Elijah / Pall, Harpreet / Sy, Sharlene / Wadowski, Stephen / Zirinsky, Elissa / Cabana, Michael D / Herold, Betsy C

The Journal of pediatrics

2020 Volume 230, Page(s) 23–31.e10

Abstract: Objective: To characterize the demographic and clinical features of pediatric severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) syndromes and identify admission variables predictive of disease severity.: Study design: We conducted a ... ...

Abstract	Objective: To characterize the demographic and clinical features of pediatric severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) syndromes and identify admission variables predictive of disease severity. Study design: We conducted a multicenter, retrospective, and prospective study of pediatric patients hospitalized with acute SARS-CoV-2 infections and multisystem inflammatory syndrome in children (MIS-C) at 8 sites in New York, New Jersey, and Connecticut. Results: We identified 281 hospitalized patients with SARS-CoV-2 infections and divided them into 3 groups based on clinical features. Overall, 143 (51%) had respiratory disease, 69 (25%) had MIS-C, and 69 (25%) had other manifestations including gastrointestinal illness or fever. Patients with MIS-C were more likely to identify as non-Hispanic black compared with patients with respiratory disease (35% vs 18%, P = .02). Seven patients (2%) died and 114 (41%) were admitted to the intensive care unit. In multivariable analyses, obesity (OR 3.39, 95% CI 1.26-9.10, P = .02) and hypoxia on admission (OR 4.01; 95% CI 1.14-14.15; P = .03) were predictive of severe respiratory disease. Lower absolute lymphocyte count (OR 8.33 per unit decrease in 10 Conclusions: We identified variables at the time of hospitalization that may help predict the development of severe SARS-CoV-2 disease manifestations in children and youth. These variables may have implications for future prognostic tools that inform hospital admission and clinical management.
MeSH term(s)	Adolescent ; Biomarkers/analysis ; C-Reactive Protein/analysis ; COVID-19/blood ; COVID-19/epidemiology ; Child ; Child, Preschool ; Connecticut/epidemiology ; Female ; Hospitalization ; Humans ; Hypoxia/epidemiology ; Infant ; Intensive Care Units ; Lymphocyte Count ; Male ; Multivariate Analysis ; New Jersey/epidemiology ; New York/epidemiology ; Pediatric Obesity/epidemiology ; Procalcitonin/blood ; Prospective Studies ; Retrospective Studies ; Severity of Illness Index ; Systemic Inflammatory Response Syndrome/blood ; Systemic Inflammatory Response Syndrome/epidemiology ; Troponin/blood ; Young Adult
Chemical Substances	Biomarkers ; Procalcitonin ; Troponin ; C-Reactive Protein (9007-41-4)
Keywords	covid19
Language	English
Publishing date	2020-11-14
Publishing country	United States
Document type	Journal Article ; Multicenter Study
ZDB-ID	3102-1
ISSN	1097-6833 ; 0022-3476
ISSN (online)	1097-6833
ISSN	0022-3476
DOI	10.1016/j.jpeds.2020.11.016
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: SARS-CoV-2 Clinical Syndromes and Predictors of Disease Severity in Hospitalized Children and Youth

Fernandes, Danielle M. / Oliveira, Carlos R. / Guerguis, Sandra / Eisenberg, Ruth / Choi, Jaeun / Kim, Mimi / Abdelhemid, Ashraf / Agha, Rabia / Agarwal, Saranga / Aschner, Judy L. / Avner, Jeffrey R. / Ballance, Cathleen / Bock, Joshua / Bhavsar, Sejal M. / Campbell, Melissa / Clouser, Katharine N. / Gesner, Matthew / Goldman, David L. / Hammerschlag, Margaret R. /

Hymes, Saul / Howard, Ashley / Jung, Hee-jin / Kohlhoff, Stephan / Kojaoghlanian, Tsoline / Lewis, Rachel / Nachman, Sharon / Naganathan, Srividya / Paintsil, Elijah / Pall, Harpreet / Sy, Sharlene / Wadowski, Stephen / Zirinsky, Elissa / Cabana, Michael D. / Herold, Betsy C.

The Journal of Pediatrics ; ISSN 0022-3476

2020

Keywords	Pediatrics, Perinatology, and Child Health ; covid19
Language	English
Publisher	Elsevier BV
Publishing country	us
Document type	Article ; Online
DOI	10.1016/j.jpeds.2020.11.016
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: SARS-CoV-2 Clinical Syndromes and Predictors of Disease Severity in Hospitalized Children and Youth

J. pediatr. (Rio J.)

Abstract: OBJECTIVE: To characterize the demographic and clinical features of pediatric SARS-CoV-2 syndromes and identify admission variables predictive of disease severity. STUDY DESIGN: We conducted a multicenter, retrospective and prospective study of pediatric ...

Abstract	OBJECTIVE: To characterize the demographic and clinical features of pediatric SARS-CoV-2 syndromes and identify admission variables predictive of disease severity. STUDY DESIGN: We conducted a multicenter, retrospective and prospective study of pediatric patients hospitalized with acute SARS-CoV-2 infections and multisystem inflammatory syndrome in children (MIS-C) at eight sites in New York, New Jersey, and Connecticut. RESULTS: We identified 281 hospitalized patients with SARS-CoV-2 infections and divided them into three groups based on clinical features. Overall, 143 (51%) had respiratory disease, 69 (25%) had MIS-C, and 69 (25%) had other manifestations including gastrointestinal illness or fever. Patients with MIS-C were more likely to identify as non-Hispanic black compared with patients with respiratory disease (35% versus 18%, P=.02). Seven patients (2%) died and 114 (41%) were admitted to the ICU. In multivariable analyses, obesity (OR=3.39, 95% CI:1.26-9.10, P=.02) and hypoxia on admission (OR=4.01; 95% CI:1.14-14.15; P=.03) were predictive of severe respiratory disease. Lower absolute lymphocyte count (OR=8.33 per unit decrease in 109 cells/L, 95% CI:2.32-33.33, P=.001) and higher C-reactive protein (OR=1.06 per unit increase in mg/dL, 95% CI:1.01-1.12, P=.017) were predictive of severe MIS-C. Race/ethnicity or socioeconomic status were not predictive of disease severity. CONCLUSIONS: We identified variables at the time of hospitalization that may help predict the development of severe SARS-CoV-2 disease manifestations in children and youth. These variables may have implications for future prognostic tools that inform hospital admission and clinical management.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #922075
Database	COVID19

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Article ; Online: The clinical epidemiology of coronavirus disease 2019 in children and adolescents mirrors the widening gap in healthcare disparities.

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Article ; Online: Routine saliva testing for SARS-CoV-2 in children: Methods for partnering with community childcare centers.

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Article ; Online: Routine saliva testing for SARS-CoV-2 in children

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Article ; Online: Routine Saliva Testing for SARS-CoV-2 in Children: Partnering with Childcare Centers in the Greater New Haven Community

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Article ; Online: Severe Acute Respiratory Syndrome Coronavirus 2 Clinical Syndromes and Predictors of Disease Severity in Hospitalized Children and Youth.

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Article ; Online: SARS-CoV-2 Clinical Syndromes and Predictors of Disease Severity in Hospitalized Children and Youth

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Article: SARS-CoV-2 Clinical Syndromes and Predictors of Disease Severity in Hospitalized Children and Youth

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