Kids may serve as COVID-19 reservoirs for variants, study says
Using COVID-19 viral load and viral cultures from 110 children, researchers suggest that children may serve as reservoirs for COVID-19, furthering transmission and viral evolution.
The researchers created a prospective cohort of patients 21 years or younger who sought care at Massachusetts General Hospital or its urgent care clinics between April 2020 and 2021 (median age, 10 years). About 56% were boys, and 38% were Hispanic. Thirty-six children (33%) required hospitalization, of whom 18 required supplemental oxygen or respiratory support of any kind.
Thirty patients (27.3%) were asymptomatic, and they were more likely to be younger than those with mild disease. Those who were hospitalized with low oxygen levels were significantly older than those in both groups.
Asymptomatic children and those with mild disease had significantly higher viral loads than adults hospitalized with COVID-19 with comparable symptom duration, according to the study. No viral load difference was seen with hospitalized pediatric COVID-19 patients and hospitalized adults of similar illness duration. Adult patient data was derived from the Massachusetts General Hospital COVID-19 Biorepository from April to August 2020.
Of 126 pediatric respiratory samples, the researchers cultured live virus from 33, including eight taken from asymptomatic children. Higher viral load was predictive of live virus shedding but similar to viral load observation, age was not associated with viral culture results.
"Our results suggest that the low rates of transmission in settings such as schools and daycares cannot be attributed to low viral loads, low rates of viral shedding, or rapid clearance of virus in younger patient populations," the researchers write, asking policy makers to consider how mitigation efforts for vaccinated adults may affect children. "Our results additionally suggest that pediatric populations have the potential to serve as a community reservoir of actively replicating virus, with implications for both new waves of infection and the evolution of viral variants."
The researchers note that SARS-CoV-2 lineages reflected those in the community of the time: 57 samples from 54 children showed four Alpha (B117) variants, three Iota (B1526.2) variants, and no Delta (B1617.2) variants.
Oct 14 J Infect Dis study
Public-facing COVID experts receive harassment, death threats
In a Nature survey of 321 scientists who spoke out about COVID-19 to the media or on social media, about 42% said they had emotional or psychological distress afterward, 22% have received threats of physical or sexual violence, and 15% have received death threats.
The survey's results, which were included in a Nature news feature yesterday, also found that the more a scientist was attacked, the more they were likely to say their readiness to give future media interviews was affected.
Overall, more than two-thirds of researchers had a negative experience as a result of sharing their opinion or expertise. While the survey respondents were largely from the United Kingdom, Germany, and the United States, the results were similar to a smaller, 50-person survey the Australian Science Media Centre in Adelaide sent to researchers on its COVID-19 media lists in June.
The Nature feature was full of anecdotes of scientists receiving home phone calls, emails, suspicious mailed packages, and malicious tweets, as well as high profile examples, such as when a Belgian military sniper went on the run after stating he was going to target virologists.
According to epidemiologist Gideon Meyerowitz-Katz, MPH, a PhD candidate at the University of Wollongong in Australia, two major triggers are statements about vaccines and the unproven COVID-19 drug ivermectin. "It's anonymous people e-mailing from weird accounts saying 'I hope you die' or 'if you were near me I would shoot you,'" he said.
Two percent of survey respondents said they had experienced physical attacks after their public comment.
About 44% of survey respondents who had been harassed didn't tell their employer, but of those who did, almost 80% found their employer to be at least somewhat supportive (eg, setting up an email filter, identifying and warning harassers).
Oct 13 Nature feature
Obesity linked to COVID-19 death, longer ICU stay
High body mass index (BMI) was independently associated with death and longer intensive care unit (ICU) stays for hospitalized COVID-19 patients, according to a study published yesterday in PLOS One.
The researchers looked at Sweden's nationwide ICU population from Mar 6 to Aug 30, 2020, and found 1,649 adults with COVID-19, of whom 78.3% were at least overweight (25 kilograms per square meter [kg/m2] or more). Besides having an overrepresentation of obese people compared with Sweden's general population (39% in the cohort), the study group also consisted of more men (74.4%). Mean age was 60.1 years.
Higher BMI was associated with the composite outcome of death during ICU stay or an ICU stay longer than 14 days in survivors, even after adjusting for age, sex, comorbidities, and illness severity (odds ratio [OR] per standard deviation increase, 1.30; 95% confidence interval [CI], 1.16 to 1.44). Those with a BMI of 35 kg/m2 or higher (class 2 or 3 obesity) were at double the risk of the composite outcome, the researchers note.
"Based on our findings, we advocate that BMI is included in the severity scoring for patients with COVID-19 admitted to intensive care, and suggest that individuals with obesity should be more closely monitored when hospitalized for COVID-19," write the researchers.
"In a large prospective study [by Matthieu Schmidt, et al], 94% of all participating ICUs reported that the COVID-19 pandemic led to a need of extended number of ICU beds," they add. "Thus, the prolonged [length of stay] is an important factor not only for the individual patient but also as an important factor for health care, putting excess strain on ICUs during the COVID-19 outbreak."
Oct 13 PLOS One study