Weekly Review: Clinical Studies – August 31, 2020

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Weekly Review: Clinical Studies – August 31, 2020

Weekly Review: Clinical Studies – August 31, 2020

Clinical Characteristics

This prospective observational cohort study describes the clinical characteristics of 651 children and adolescents from England, Wales, and Scotland, of which 52 met WHO criteria for MIS-C. In addition to the WHO diagnostic criteria, children with MIS-C were more like to present with fatigue (51% (24/47) vs 28% (86/302);
P=0.004), headache (34% (16/47) vs 10% (26/263); P<0.001), myalgia (34% (15/44) vs 8% (21/270); P<0.001), sore throat (30% (14/47) vs (12% (34/284); P=0.003), and lymphadenopathy (20% (9/46) vs 3% (10/318); P<0.001) and to have a platelet count of less than 150 × 109/L (32% (16/50) vs 11% (38/348); P<0.001) than children who did not have MIS-C.

In a cross-sectional study of 192 children in Boston w/ symptoms concerning for SARS-CoV-2 infection, 26% (n = 49) were diagnosed with COVID-19. Nasopharyngeal viral load was highest in children in the first 2 days of symptoms. Age did not impact viral load (although younger children had lower ACE2 expression, p=0.004), and IgM and IgG to the receptor binding domain of the SARS-CoV-2 spike protein were increased in severe MIS-C (p<0.001)

In a cross-sectional study of 216 children, ocular manifestations of COVID-19 infection were typically mild.  The common ocular manifestations were conjunctival discharge (27 [55.1%]), eye rubbing (19 [38.8%]), and conjunctival congestion (5 [10.2%]). Children with systemic symptoms (29.3% vs 14.0%; difference, 15.3%; 95% CI, 9.8%-20.7%; P = .008) or with cough (31.6% vs 17.5%; difference, 14.1%; 95% CI, 8.0%-20.3%; P = .02) were more likely to develop ocular symptoms.

Case report of COVID-19 reinfection

Testing

Within an analysis of 33,041 asymptomatic children, 250 of them were positive for SARS-CoV-2. Across the combined statistical area, the prevalence varied from 0-2.2%, with a pooled prevalence of 0.65% (95%CI, 0.47% to 0.84%, with significant heterogeneity)

Treatment

In a randomized, open-label, phase 3 trial in individuals aged 12 years and older w/ moderate COVID-19, the day 11 clinical status was significantly better for those randomized to a 5-day course of remdesivir compared to those with standard care. No significant difference in clinical status when given a 10 day course of remdesivir, compared to those with standard care.

|2020-08-31T08:33:29-04:00August 31st, 2020|COVID-19 Literature|0 Comments

About the Author: Megan McHenry

Megan McHenry
Megan S. McHenry, MD, MS, FAAP is a pediatrician and an Assistant Professor of Pediatrics in the Ryan White Center for Pediatric Infectious Disease and Global Health at Indiana University School of Medicine. Dr. McHenry's research focuses on early childhood development in children living in resource-limited settings. This work is frequently aligned with community-engaged research and dissemination and implementation science frameworks. She primarily conducts research in collaboration with the Academic Model for Providing Access to Healthcare (AMPATH) Research Network in Kenya. Dr. McHenry currently has a career development award through the National Institutes of Health to develop a neurodevelopmental screening program for children born to HIV-infected mothers in Kenya. Dr. McHenry is also the Director of Pediatric Global Health Education and a co-Director of the Morris Green Physician-Scientist Development Program at Indiana University School of Medicine. In additional to global health lectures, she also educates residents and students on early childhood development, basic biostatistical techniques, research methodologies, and research ethics. She mentors multiple pediatric fellows, residents, and medical students interested in early childhood development within global contexts.

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