Citations 4
Six-Month Outcomes in Children With COVID-19 or Multisystem Inflammatory Syndrome in Children
Howard, Leigh M. , Calvert, Alexis, Stopczynski, Tess , Klintworth, Steven R., Soslow, Jonathan H., Spieker, A, Hilmes, Melissa A. , Dalal, Aarti S., Ruth, Natasha, Mahle, William T. , Schneider, James, Michaels, Marian G., Acker, Karen P. , Danziger-Isakov, Lara, Gans, H, Orr, William B. , Choueiter, Nadine , Kantor, Paul F., Chandani, Harsha K., Chakraborty, Rana, Narula, Pramod, Rossano, Joseph, Singh, Rakesh K. , Trachtman, Rebecca, Pascual, Virginia , Martinez, Olivia M. , Diamond, Betty, Sanz, Ignacio, Boss, Jeremy M., Goldmuntz, E, Morrison, Yvonne, Welch, Beverly, Halasa, Natasha , Webber, Steven A. , Diamond, Betty , Dalal, Aarti , Wilkinson, James D. , Soslow, Jonathan H. , Spieker, Andrew J. , Moore, Paul E. , Ruth, Natasha M. , Michaels, Marian G , Danziger‐Isakov, Lara , Kelly, Matthew S. , Kantor, Paul Fraser , Chandnani, Harsha K., Chakraborty, Rana , Rossano, Joseph, Arditi, Moshe , Trachtman, Rebecca A. , Krams, Sheri M. , Sanz, Igñacio , Boss, Jeremy M. , Bridges, Nancy D. , Goldmuntz, Ellen
Hospital Pediatrics | May 14, 2026 | Volume: 16 | Issue: 6 | Pages: 525-535
OBJECTIVES We aimed to characterize the frequency of major complications of acute COVID-19 and multisystem inflammatory syndrome in children (MIS-C) and adolescents present at 6 months after initial presentation. METHODS The Pediatric Research Immune Network on SARS-CoV-2 and MIS-C (PRISM) study was a prospective cohort at 20 US pediatric academic medical centers. Individuals aged younger than 21 years meeting any of the following were enrolled: SARS-CoV-2 detection within 7 days, Centers for Disease Control and Prevention (CDC) MIS-C criteria, or CDC MIS-C criteria except having involvement of 1 organ system. The study was designed to assess the proportion of children with major complications (cardiovascular, pulmonary, gastrointestinal/hepatic, renal, and/or neurologic) 6 months after presentation. RESULTS Data were analyzed on 229 hospitalized participants: 59 with COVID-19 (mean age 10.4 years; SD, 5.5) and 170 with MIS-C (mean age 10.1 years; SD, 4.8). Overall, 42.8% were female, making up 55.9% and 38.2% of the COVID-19 and MIS-C groups, respectively. Overall, the frequencies of major complications at 6 months after initial presentation were: 16/195 (8.2%) cardiovascular, 11/154 (7.1%) pulmonary, 11/154 (7.1%) gastrointestinal/hepatic, 3/152 (2.0%) renal, and 3/189 (1.6%) neurologic. Organ system complications did not differ significantly between the COVID-19 and MIS-C groups. Six of 14 (42.9%) COVID-19 and 21/26 (80.7%) MIS-C participants with at least 1 six-month complication had no underlying medical condition that may have been associated with their complication(s). CONCLUSIONS Major complications were infrequent but observed in children without underlying medical conditions, underscoring the importance of prospective follow-up to optimize management and elucidate the complications associated with severe SARS-CoV-2 infection in children.
Infants Admitted to US Intensive Care Units for RSV Infection During the 2022 Seasonal Peak
Halasa, Natasha , Zambrano, Laura D. , Stewart, Laura S , Newhams, Margaret M. , Levy, Emily R. , Carroll, Christopher L. , Fitzgerald, Julie C. , Bline, Katherine , Cullimore, Melissa L. , Loftis, Laura L. , Jeyapalan, Asumthia , Schwarz, Adam J. , Zinter, Matt S. , Irby, Katherine , Kuebler, Joseph D. , Babbitt, Christopher , Gaspers, Mary Glas , Nofziger, Ryan A. , Kong, Michele , Coates, Bria M. , Schuster, Jennifer E. , Gertz, Shira J. , Mack, Elizabeth H. , White, Benjamin R. , Harvey, Helen , Butler, Andrew , Bradford, Tamara T. , Rowan, Courtney M. , Staat, Mary Allen , Aguiar, Cassyanne L. , Randolph, Adrienne G. , Campbell, Angela P. , Investigators, RSV-PIC, Tomcany, Merry, Price, Heather E. , Sanders, Ronald C., Dixon, Lexie, Kücükak, Suden, McNamara, Elizabeth R, Chen, Sabrina R., Listerud, Eve, Vargas-Shiraishi, Ofelia, Oberle, Betty, Zorensky, Frances, Mansour, Rachel, Jumarang, Jaycee , Johnston, Marla , Bush, Jenny L., Dickey, Shawn, Sullivan, Melissa, Kietzman, Abigail , Colston, Candice , Murdock, Meghan, Kelley, Heather M., Wright-Sexton, Laura, Martin, Maygan, Malloch, Lacy , Patterson, Kayla, Sanders, Cameron , Rohlfs, Chelsea , Rice, Marilyn, Howard, Miranda, Murphy, M. Gail, Soma, Vijaya L, Job, Megan , Mennie, Colleen, Simkhada, Kamala, Drapeau, Noelle M., Hayek, Haya , Maranto, Molly, Waters, Aubrie, Flowers, Maggie, Havlin, Kevin , Furlong-Dillard, Jamie , Porter, Melissa , Nason, Jennifer, Ray, Madison, Gossett, Kristen, Crandall, Hillary , Heller, Evan G, Foley, Jennifer, Rasal, Rajashri, Marlow, Christine, Senthil, Anurithi, Myers, Kimberly, Tudor, Betsy, Garcia, Nereyda, Treister, Natalie, Sun, Kathleen, Villarreal-Chico, Denise, Kainaroi, Sophia, Levy, Emily R , Randolph, Adrienne G , Kong, Michele , Staat, Mary A , Gertz, Shira J , Bline, Katherine E , Amarin, Justin Z. , Shein, Steven L. , Michaels, Marian G , Montgomery, Vicki , Pannaraj, Pia S. , Cvijanovich, Natalie Z , Maddux, Aline B. , Bembea, Melania M. , Zerr, Danielle M. , Hobbs, Charlotte V. , Dapul, Heda , Wellnitz, Kari , Hymes, Saul , Investigators, RSV-PIC, Michelson, Kelly Nicole , Typpo, Katri , Harwayne‐Gidansky, Ilana , Bush, Jenny, Hill, Shannon, Kelley, Heather, Martin, Lora , Rice, Marilyn, Howard, Miranda, Murphy, Makayla, Ratner, Adam J. , Behl, Supriya , Betters, Kristina Ann , Maranto, Molly , Nason, Jennifer, Marlow, Christine, Myers, Kimberly, Adler, Amanda , Garcia, Nereyda, McQuillen, Patrick S. , Williams, John V.
JAMA Network Open | August 15, 2023 | Volume: 6 | Issue: 8 | Pages: e2328950
10.1001/jamanetworkopen.2023.28950
ImportanceRespiratory syncytial virus (RSV) is the leading cause of lower respiratory tract infections (LRTIs) and infant hospitalization worldwide.ObjectiveTo evaluate the characteristics and outcomes of RSV-related critical illness in US infants during peak 2022 RSV transmission.Design, Setting, and ParticipantsThis cross-sectional study used a public health prospective surveillance registry in 39 pediatric hospitals across 27 US states. Participants were infants admitted for 24 or more hours between October 17 and December 16, 2022, to a unit providing intensive care due to laboratory-confirmed RSV infection.ExposureRespiratory syncytial virus.Main Outcomes and MeasuresData were captured on demographics, clinical characteristics, signs and symptoms, laboratory values, severity measures, and clinical outcomes, including receipt of noninvasive respiratory support, invasive mechanical ventilation, vasopressors or extracorporeal membrane oxygenation, and death. Mixed-effects multivariable log-binomial regression models were used to assess associations between intubation status and demographic factors, gestational age, and underlying conditions, including hospital as a random effect to account for between-site heterogeneity.ResultsThe first 15 to 20 consecutive eligible infants from each site were included for a target sample size of 600. Among the 600 infants, the median (IQR) age was 2.6 (1.4-6.0) months; 361 (60.2%) were male, 169 (28.9%) were born prematurely, and 487 (81.2%) had no underlying medical conditions. Primary reasons for admission included LRTI (594 infants [99.0%]) and apnea or bradycardia (77 infants [12.8%]). Overall, 143 infants (23.8%) received invasive mechanical ventilation (median [IQR], 6.0 [4.0-10.0] days). The highest level of respiratory support for nonintubated infants was high-flow nasal cannula (243 infants [40.5%]), followed by bilevel positive airway pressure (150 infants [25.0%]) and continuous positive airway pressure (52 infants [8.7%]). Infants younger than 3 months, those born prematurely (gestational age <37 weeks), or those publicly insured were at higher risk for intubation. Four infants (0.7%) received extracorporeal membrane oxygenation, and 2 died. The median (IQR) length of hospitalization for survivors was 5 (4-10) days.Conclusions and RelevanceIn this cross-sectional study, most US infants who required intensive care for RSV LRTIs were young, healthy, and born at term. These findings highlight the need for RSV preventive interventions targeting all infants to reduce the burden of severe RSV illness.
OPTN required SARS‐CoV‐2 lower respiratory testing for lung donors: Striking the balance
Booker, Sarah E. , Jett, Courtney , Fox, Cole, Anesi, Judith A. , Berry, Gerald J. , Dunn, Kelly E., Fisher, Cynthia E. , Goldman, Jason D. , Kittleson, M. , Lee, Dong Heun , Levine, Deborah J. , Marboe, Charles C. , Martinez, Carlos, Sellers, Marty T., Taimur, Sarah , Te, Helen S. , Wood, R. Patrick, Woolley, Ann E. , Klassen, David K. , Danziger‐Isakov, Lara , Razonable, Raymund R , Taimur, Sarah , Trindade, Anil J , Klassen, David K , Danziger-Isakov, Lara , La Hoz, Ricardo M , Berry, Gerald J , Ho, Chak‐Sum , Marklin, Gary , Razonable, Raymund R. , Zaffiri, Lorenzo , Michaels, Marian G , Pouch, Stephanie M. , Hoz, Ricardo M. La
Transplant Infectious Disease | March 3, 2023 | Volume: 25 | Issue: 3 | Pages: No page available
Transplant of organs from donors with positive SARS‐CoV‐2 nucleic acid testing: A report from the organ procurement and transplantation network ad hoc disease transmission advisory committee
Goldman, Jason D. , Pouch, Stephanie M. , Woolley, Ann E. , Booker, Sarah E. , Jett, Courtney , Fox, Cole, Berry, Gerald J. , Dunn, Kelly E., Kittleson, M. , Lee, Dong Heun , Levine, Deborah J. , Marboe, Charles C. , Taimur, Sarah , Te, Helen S. , Fisher, Cynthia E. , Sellers, Marty T. , Levi, Marilyn E. , Klassen, David K. , Danziger‐Isakov, Lara , Lee, Dong Heun , Marklin, Gary , Trindade, Anil J , Michaels, Marian G , La Hoz, Ricardo M , Danziger-Isakov, Lara , Pouch, Stephanie M , Berry, Gerald J , Ho, Chak‐Sum , Razonable, Raymund R. , Anesi, Judith A. , Wood, R. Patrick, Zaffiri, Lorenzo , Hoz, Ricardo M. La
Transplant Infectious Disease | January 25, 2023 | Volume: 25 | Issue: 1 | Pages: No page available
AbstractBackgroundDecisions to transplant organs from severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) nucleic acid test‐positive (NAT+) donors must balance risk of donor‐derived transmission events (DDTE) with the scarcity of available organs.MethodsOrgan Procurement and Transplantation Network (OPTN) data were used to compare organ utilization and recipient outcomes between SARS‐CoV‐2 NAT+ and NAT– donors. NAT+ was defined by either a positive upper or lower respiratory tract (LRT) sample within 21 days of procurement. Potential DDTE were adjudicated by OPTN Disease Transmission Advisory Committee.ResultsFrom May 27, 2021 (date of OTPN policy for required LRT testing of lung donors) to January 31, 2022, organs were recovered from 617 NAT+ donors from all OPTN regions and 53 of 57 (93%) organ procurement organizations. NAT+ donors were younger and had higher organ quality scores for kidney and liver. Organ utilization was lower for NAT+ donors compared to NAT– donors. A total of 1241 organs (776 kidneys, 316 livers, 106 hearts, 22 lungs, and 21 other) were transplanted from 514 NAT+ donors compared to 21 946 organs from 8853 NAT– donors. Medical urgency was lower for recipients of NAT+ liver and heart transplants. The median waitlist time was longer for liver recipients of NAT+ donors. The match run sequence number for final acceptor was higher for NAT+ donors for all organ types. Outcomes for hospital length of stay, 30‐day mortality, and 30‐day graft loss were similar for all organ types. No SARS‐CoV‐2 DDTE occurred in this interval.ConclusionsTransplantation of SARS‐CoV‐2 NAT+ donor organs appears safe for short‐term outcomes of death and graft loss and ameliorates the organ shortage. Further study is required to assure comparable longer term outcomes. image