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  1. AU="Sumner, Madeleine W"
  2. AU=Huang Kai
  3. AU="Flavia Bustreo"
  4. AU="Collins, Jamie"
  5. AU="Quinn, Patrick J"
  6. AU="Debnath Pal"
  7. AU="Kamali Kakhki, Reza"
  8. AU=Mortele Koenraad J
  9. AU="Skaarup, Søren H"
  10. AU="Lin, Li-Er"
  11. AU=Goulard Marie
  12. AU=Rosner Mitchell H
  13. AU="Murphy, Bríd"
  14. AU="Tsuneyoshi, Isao"
  15. AU="Tram, Le Thi Hong"
  16. AU="Veli-Pekka Jaakola"
  17. AU="Erduğan, Hüseyin"

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  1. Artikel ; Online: Liver transaminase concentrations in children with acute SARS-CoV-2 infection.

    Sumner, Madeleine W / Florin, Todd A / Kuppermann, Nathan / Xie, Jianling / Tancredi, Daniel J / Freedman, Stephen B

    Clinical biochemistry

    2023  Band 118, Seite(n) 110588

    Abstract: Objective: To evaluate the relationship between SARS-CoV-2 infection and liver injury by comparing transaminase concentrations among children tested for SARS-CoV-2 and other respiratory viruses in pediatric emergency departments.: Design & methods: ... ...

    Abstract Objective: To evaluate the relationship between SARS-CoV-2 infection and liver injury by comparing transaminase concentrations among children tested for SARS-CoV-2 and other respiratory viruses in pediatric emergency departments.
    Design & methods: Eligible children were <18 years with suspected SARS-CoV-2, tested using molecular approaches in emergency departments between March 7, 2020, and June 15, 2021 (Pediatric Emergency Research Network), and between August 6, 2020, and February 22, 2022 (Pediatric Emergency Research Canada). We compared aspartate (AST) and alanine aminotransferase (ALT) concentrations at presentation for SARS-CoV-2 and other respiratory viruses through a multivariate linear regression model, with the natural log of serum transaminase concentrations as dependent variables.
    Results: Of 16,892 enrolled children, 2,462 (14.6%) had transaminase concentrations measured; 4318 (25.6%) were SARS-CoV-2 positive, and 3932 (23.3%) were tested for additional respiratory viruses. Among study participants who had additional respiratory virus testing performed, the most frequently identified viruses were enterovirus/rhinovirus [8.7% (343/3,932)], respiratory syncytial virus [4.6% (181/3,932)], and adenovirus [2.6% (103/3,932)]. Transaminase concentrations were elevated in 25.6% (54/211) of children with isolated SARS-CoV-2 detection and 21.6% (117/541) of those with no virus isolated; P = 0.25. In the multivariable model, isolated SARS-CoV-2 detection was not associated with elevated ALT (adjusted geometric mean ratio (IU/L): 0.96; 95%Confidence Interval (CI): 0.84, 1.08) or AST (adjusted geometric mean ratio (IU/L): 1.03; 95%CI: 0.92, 1.16) concentrations, with negative respiratory panel as the referent group. Ninety-day follow-up was completed in 82.2% (3,550/4,318) of SARS-CoV-2 positive children; no cases of new-onset liver disease were reported.
    Conclusion: Among those tested, transaminase concentrations did not vary between SARS-CoV-2-positive children and those with a negative respiratory viral panel. In multivariate analysis, SARS-CoV-2 infection was not associated with increased initial transaminase concentrations compared to other respiratory viruses.
    Mesh-Begriff(e) Humans ; Child ; COVID-19 ; SARS-CoV-2 ; Liver Diseases ; Alanine Transaminase
    Chemische Substanzen Alanine Transaminase (EC 2.6.1.2)
    Sprache Englisch
    Erscheinungsdatum 2023-05-30
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ZDB-ID 390372-2
    ISSN 1873-2933 ; 0009-9120
    ISSN (online) 1873-2933
    ISSN 0009-9120
    DOI 10.1016/j.clinbiochem.2023.110588
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  2. Artikel: Severe Outcomes Associated With SARS-CoV-2 Infection in Children: A Systematic Review and Meta-Analysis.

    Sumner, Madeleine W / Kanngiesser, Alicia / Lotfali-Khani, Kosar / Lodha, Nidhi / Lorenzetti, Diane / Funk, Anna L / Freedman, Stephen B

    Frontiers in pediatrics

    2022  Band 10, Seite(n) 916655

    Abstract: Objective: To estimate the proportion of SARS-CoV-2 infected children experiencing hospitalization, intensive care unit (ICU) admission, severe outcomes, and death.: Data sources: PubMed, Embase, and MedRxiv were searched for studies published ... ...

    Abstract Objective: To estimate the proportion of SARS-CoV-2 infected children experiencing hospitalization, intensive care unit (ICU) admission, severe outcomes, and death.
    Data sources: PubMed, Embase, and MedRxiv were searched for studies published between December 1, 2019 and May 28, 2021. References of relevant systematic reviews were also screened.
    Study selection: We included cohort or cross-sectional studies reporting on at least one outcome measure (i.e., hospitalization, ICU admission, severe outcomes, death) for ≥100 children ≤21 years old within 28 days of SARS-CoV-2 positivity; no language restrictions were applied.
    Data extraction and synthesis: Two independent reviewers performed data extraction and risk of bias assessment. Estimates were pooled using random effects models. We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.
    Main outcomes and measures: Percentage of SARS-CoV-2 positive children experiencing hospitalization, ICU admission, severe outcome, and death.
    Results: 118 studies representing 3,324,851 SARS-CoV-2 infected children from 68 countries were included. Community-based studies (
    Conclusion and relevance: Among children tested positive for SARS-CoV-2, 3.3% were hospitalized, with rates being higher early in the pandemic. Severe outcomes, ICU admission and death were uncommon, however estimates vary by study population, pandemic timing, study risk of bias, and economic status of the country.
    Systematic review registration: PROSPERO, identifier [CRD42021260164].
    Sprache Englisch
    Erscheinungsdatum 2022-06-09
    Erscheinungsland Switzerland
    Dokumenttyp Systematic Review
    ZDB-ID 2711999-3
    ISSN 2296-2360
    ISSN 2296-2360
    DOI 10.3389/fped.2022.916655
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  3. Artikel ; Online: Comparison of Symptoms Associated With SARS-CoV-2 Variants Among Children in Canada.

    Sumner, Madeleine W / Xie, Jianling / Zemek, Roger / Winston, Kathleen / Freire, Gabrielle / Burstein, Brett / Kam, April / Emsley, Jason / Gravel, Jocelyn / Porter, Robert / Sabhaney, Vikram / Mater, Ahmed / Salvadori, Marina I / Berthelot, Simon / Beer, Darcy / Poonai, Naveen / Moffatt, Anne / Wright, Bruce / Freedman, Stephen B

    JAMA network open

    2023  Band 6, Heft 3, Seite(n) e232328

    Abstract: Importance: Clinical manifestations of SARS-CoV-2 variants have not been systematically compared in children.: Objective: To compare symptoms, emergency department (ED) chest radiography, treatments, and outcomes among children with different SARS- ... ...

    Abstract Importance: Clinical manifestations of SARS-CoV-2 variants have not been systematically compared in children.
    Objective: To compare symptoms, emergency department (ED) chest radiography, treatments, and outcomes among children with different SARS-CoV-2 variants.
    Design, setting, and participants: This multicenter cohort study was performed at 14 Canadian pediatric EDs. Participants included children and adolescents younger than 18 years (hereinafter referred to as children) tested for SARS-CoV-2 infection in an ED between August 4, 2020, and February 22, 2022, with 14 days of follow-up.
    Exposure(s): SARS-CoV-2 variants detected on a specimen collected from the nasopharynx, nares, or throat.
    Main outcomes and measures: The primary outcome was presence and number of presenting symptoms. The secondary outcomes were presence of core COVID-19 symptoms, chest radiography findings, treatments, and 14-day outcomes.
    Results: Among 7272 participants presenting to an ED, 1440 (19.8%) had test results positive for SARS-CoV-2 infection. Of these, 801 (55.6%) were boys, with a median age of 2.0 (IQR, 0.6-7.0) years. Children with the Alpha variant reported the fewest core COVID-19 symptoms (195 of 237 [82.3%]), which were most often reported by participants with Omicron variant infection (434 of 468 [92.7%]; difference, 10.5% [95% CI, 5.1%-15.9%]). In a multivariable model with the original type as the referent, the Omicron and Delta variants were associated with fever (odds ratios [ORs], 2.00 [95% CI, 1.43-2.80] and 1.93 [95% CI, 1.33-2.78], respectively) and cough (ORs, 1.42 [95% CI, 1.06-1.91] and 1.57 [95% CI, 1.13-2.17], respectively). Upper respiratory tract symptoms were associated with Delta infection (OR, 1.96 [95% CI, 1.38-2.79]); lower respiratory tract and systemic symptoms were associated with Omicron variant infection (ORs, 1.42 [95% CI, 1.04-1.92] and 1.77 [95% CI, 1.24-2.52], respectively). Children with Omicron infection most often had chest radiography performed and received treatments; compared with those who had Delta infection, they were more likely to have chest radiography performed (difference, 9.7% [95% CI, 4.7%-14.8%]), to receive intravenous fluids (difference, 5.6% [95% CI, 1.0%-10.2%]) and corticosteroids (difference, 7.9% [95% CI, 3.2%-12.7%]), and to have an ED revisit (difference, 8.8% [95% CI, 3.5%-14.1%]). The proportions of children admitted to the hospital and intensive care unit did not differ between variants.
    Conclusions and relevance: The findings of this cohort study of SARS-CoV-2 variants suggest that the Omicron and Delta variants were more strongly associated with fever and cough than the original-type virus and the Alpha variant. Children with Omicron variant infection were more likely to report lower respiratory tract symptoms and systemic manifestations, undergo chest radiography, and receive interventions. No differences were found in undesirable outcomes (ie, hospitalization, intensive care unit admission) across variants.
    Mesh-Begriff(e) Adolescent ; Male ; Humans ; Child ; Infant ; Child, Preschool ; Female ; SARS-CoV-2 ; COVID-19/epidemiology ; Canada/epidemiology ; Cohort Studies ; Cough/etiology ; Fever/etiology ; Hepatitis D
    Sprache Englisch
    Erscheinungsdatum 2023-03-01
    Erscheinungsland United States
    Dokumenttyp Multicenter Study ; Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 2574-3805
    ISSN (online) 2574-3805
    DOI 10.1001/jamanetworkopen.2023.2328
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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