COVID-19 Scan for Dec 04, 2020

Severe COVID in healthy younger adults
COVID-19 inflammatory syndrome in kids

CDC: 1 in 5 hospitalized younger adults with COVID-19 need ICU care

While younger adults with no underlying health conditions have been considered safer from COVID-19's severe outcomes, of those who were hospitalized, 22% were admitted to intensive care units (ICUs), 10% needed mechanical ventilation, and 0.6% (3 patients) died, reports a study published yesterday in Clinical Infectious Diseases.

The researchers, led by scientists with the Centers for Disease Control and Prevention's (CDC's) COVID-19–Associated Hospitalization Surveillance Network (COVID-NET) team, used data from the network to look at patients to look at patients hospitalized with COVID-19 from March through August. During this period, 31.8% of the 44,865 patients in the COVID-NET system were adults under 50, of which 513 (3.9%, the study's cohort) had sufficient data to indicate they had no underlying diseases.

The study's patients most commonly experienced cough (61.7%), fever or chills (64.7%), and shortness of breath (63.4%) at the time of admission. According to their discharge records, though, health providers eventually diagnosed pneumonia in 51.1%, acute respiratory failure in 37.4%, and sepsis in 16.6%. The median hospital stay was 4 days, or 5 days if the patient was admitted to the ICU.

While the study did not look at the reasons behind these hospitalizations, the researchers noted that Hispanics represented 42.1% of patients compared with 16% in the general population. Additionally, men made up 74% of cases. The researchers say the association between men's increased angiotensin-converting enzyme 2 levels and COVID-19 severity may contribute to the level of severe disease found in the study population.
Dec 3 Clin Infect Dis study


Report shows connection between COVID-19, child inflammatory syndrome

A French study in Eurosurveillance yesterday shows an association between infection with SARS-CoV-2, the virus that causes COVID-19, and multisystem inflammatory syndrome in children (MIS-C), which is similar to Kawasaki disease. Researchers found 25-fold higher odds of exposure to the virus among patients with MIS-C.

Surges in MIS-C illness reports led to a UK National Health Service alert on Apr 25, which was followed by several regional case studies. No case-control studies—matching patients with and without the disease—have been conducted to date, the authors of the new study say. MIS-C symptoms can include fever, rash, conjunctivitis, abdominal pain, shock, elevated inflammatory markers, and cardiac damage.

This retrospective case-control study included 23 children with MIS-C admitted to a Paris hospital (mean age 6.8 years; range, 0.3 to 16.6 years) and 102 control patients (mean age 5.8 years; range 0.05 to 16.0 years) who visited Paris metropolitan area pediatric clinics from Apr 14 to May 26. Nasal swab samples for all children were tested for SARS-CoV-2 using reverse transcription polymerase chain reaction (RT-PCR), and immunoassay tests of blood serum were used to identify anti–SARS-CoV-2 antibodies.

"Overall, 17 of 23 (74%) cases and 11 of 102 (11%) controls tested positive for SARS-CoV-2 by RT-PCR and/or serology (matched OR [odds ratio]: 26.4; 95% confidence interval (CI): 6.0–116.9)," the study authors found. "The association remained significant when limiting the assessment to RT-PCR results and serological results separately (matched OR: 13.9; 95% CI: 2.8 –68.6 and 27.7; 95% CI, 6.3–122.7, respectively)."

The strong association highlights the need for greater surveillance of infected children. "Clinicians should keep a high level of suspicion for [MIS-C] illness during the COVID-19 pandemic," the authors wrote.
Dec 3 Euro Surveill study

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