Tag: children

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Severe COVID-19 increases risk of future cardiovascular events

Study: COVID-19 severity and risk of subsequent cardiovascular events. Image Credit: Yurchanka Siarhei / Shutterstock.com

To date, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is the virus responsible for the coronavirus disease 2019 (COVID-19), has infected over 603 million individuals and claimed more than 6.4 million lives worldwide.

About 30% of COVID-19 survivors continue to experience a wide range of persistent symptoms for several weeks since their initial diagnosis. This condition is commonly referred to as post-acute sequelae of SARS-CoV-2 infection (PASC) or “long COVID.”

Study: COVID-19 severity and risk of subsequent cardiovascular events. Image Credit: Yurchanka Siarhei / Shutterstock.com

Study: COVID-19 severity and risk of subsequent cardiovascular events. Image Credit: Yurchanka Siarhei / Shutterstock.com

Background

Even though multisystem inflammatory syndrome is the most common PASC syndrome in adults and children, a wide range of other symptoms, including sleep difficulties, persistent fatigue, type 1 diabetes, and neurological disorders, have been reported. The incidence of these symptoms varies from one person to another based on their demographic and clinical characteristics.

Several studies have indicated the manifestation of multiple cardiovascular complications, such as arrhythmia, hypertension, acute myocardial infarction, thromboembolism, and cerebrovascular accidents, in individuals who have recovered from COVID-19. However, a limited number of studies have confirmed that severe COVID-19 leads to a high risk of cardiovascular diseases.

A recent Clinical Infectious Diseases journal study determines the relationship between COVID-19 severity and risk of subsequent cardiovascular events (CVEs) in a large cohort.

Study findings

A retrospective cohort study was performed using nationwide health insurance claims data of adults from the United States Health Verity Real-Time Insights and Evidence database. Increased COVID-19 severity was found to enhance the risk of developing subsequent CVEs among individuals without a cardiac history in previous years. 

As compared to COVID-19 patients who required outpatient care, those who required hospital admission were more likely to experience CVEs. Among COVID-19 hospitalized patients, those admitted to the intensive care unit (ICU) were almost 80% more likely to develop CVEs than non-ICU hospitalized patients.

In fact, non-ICU hospitalized patients exhibited only a 28% possibility of experiencing CVEs thirty days after initial COVID-19 symptoms. Additionally, as compared to COVID-19 outpatients, hospitalized patients were more likely to be admitted for a CVE after recovering from COVID-19.

In younger adults, the incidence of cardiovascular sequelae was lower as compared to older adults. Aside from CVEs, other severe outcomes, such as thrombotic events and cerebrovascular accidents, were observed in patients who recovered from severe COVID-19. However, such observations were less likely in COVID-19 patients who required only outpatient care.

The study findings emphasize the importance of vaccination, as demonstrated by its ability to reduce severe disease. Similarly, prompt antiviral treatment of acute COVID-19 has been recommended, which would help reduce the possibility of transition to severe illness.

Both COVID-19 vaccination and timely therapeutic interventions would alleviate the risk of severe COVID-19 and subsequently decrease the possibility of experiencing CVEs.

The findings of the present study are consistent with previous research that has reported a higher incidence of myocarditis and pericarditis in patients who recovered from severe SARS-CoV-2 infection. Nevertheless, it was observed that elevated cardiovascular risk after acute infection may not be exclusive to COVID-19.

In fact, some other diseases that have been associated with an increased risk of long-term CVEs are influenza and pneumonia bacteremia. Additionally, 22-65% of sepsis survivors are at an increased risk of CVEs.

The underlying mechanism responsible for the increased risk of CVEs following SARS-CoV-2 infection has not been determined. SARS-CoV-2 infects cardiac myocytes through their interaction with the angiotensin-converting enzyme 2 (ACE-2) receptor, which might remain persistent; therefore, this interaction induces chronic inflammatory responses and subsequent tissue damage or fibrosis.

Another mechanism related to the development of CVEs following recovery from COVID-19 is an autoimmune response to cardiac antigens that causes delayed damage to cardiac tissues. Anti-heart antibodies also correlated with cardiovascular manifestation and COVID-19.

Viral toxicity is another possible mechanism that might cause long-term cardiac damage or thrombosis in vasculitis. However, in the future, more research is needed to confirm the mechanisms related to cardiac damage after SARS-CoV-2 infection.

Conclusions

Due to the lack of a COVID-19-negative control group, the authors failed to quantify the elevated risk of CVEs in COVID-19 patients. The unwanted inclusion of patients with a history of CVEs could have overestimated the result as well. The impact of vaccination status on the incidence of CVE was not studied.

Despite these limitations, the present study strongly emphasized that patients who recovered from severe COVID-19 were at a greater risk of developing CVEs. As compared to COVID-19 patients who required outpatient care, those who were admitted to the ICU were at a higher risk of experiencing CVEs.

The importance of COVID-19 vaccination in preventing severe infection was strongly emphasized in this study.

Journal reference:

  • Wiemken, L. T., McGrath, L. J., Andersen, K. M., et al. (2022). COVID-19 severity and risk of subsequent cardiovascular events. Clinical Infectious Diseases. doi:10.1093/cid/ciac661.
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Possible mediators for perioperative respiratory adverse events discussed

Possible mediators for perioperative respiratory adverse events discussed

Perioperative respiratory adverse events (PRAEs) are often seen in children after they get an adenotonsillectomy (AT), one of the most common procedures children receive worldwide. ATs are performed for treating sleep-disordered breathing and obstructive sleep apnea syndrome (OSAS). In a recent study, investigators tested for causes of perioperative respiratory adverse events (PRAEs) in children. The goal of the study was to control factors which lead to respiratory complications.

Benzodiazepine midazolam is the most frequent form of preoperative pharmacologic anxiolysis given to children, though recently α-2 agonist dexmedetomidine has been equally common. These are intranasal formulations, allowing children to take them without intravenous access. However, these medicines, along with analgesics such as opioids and anesthetics, may make PRAEs more likely to appear. This is not certain, as data is inconclusive.

Investigators conducted a clinical trial comparing the appearance of PRAES in 384 children after receiving midazolam, dexmedetomidine, or saline control. The midazolam group had the highest rate of PRAEs at 56.5%, followed by the saline control group at 40.8% and the dexmedetomidine group at 24.2%.

Prior studies indicated that dexmedetomidine and midazolam are similarly effective for anxiolysis, but dexmedetomidine is favorable for preventing emergence delirium. In this study, investigators hypothesized that preoperative midazolam and dexmedetomidine would lead to less PRAEs appearing in children.

Investigators found that PRAEs are 5 times more likely to appear in children with OSAS when they undergo AT. As OSAS also leads to higher sensitivity toward opioids, patients were recommended to be given half of a normal opioid dosing.

The patients in this study were clinically diagnosed with OSAS, and investigators were unsure how accurate these diagnoses were. OSAS diagnoses have been recorded with an accuracy range of 30% to 85%. This led to the patients in the trial possibly having unequal levels of OSAS severity.

At the end of the study, investigators concluded that there was still much complexity surrounding preoperative anxiolytic use, and suggested that all medications be carefully considered in the context of each child’s needs and risks.

Reference

Dalesio NM, Kudchadkar SR. Perioperative respiratory adverse events after pediatric adenotonsillectomy—evaluating the role of preoperative pharmacologic anxiolysis. JAMA Network Open. 2022;5(8):e2225482. doi:10.1001/jamanetworkopen.2022.25482

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Novel algorithm identifies adverse drug events across the seven pediatric development stages

Attendance plummets at LA covid vaccination events

Side effects from pediatric drug treatment are responsible for nearly 10 percent of childhood hospitalizations, with nearly half of those being life-threatening. Despite the need to know more about these drugs and the adverse events they can have on children, little evidence is currently available.

Clinical trials remain the gold standard for identifying adverse drug events (ADEs) for adults, but these have both ethical and methodological concerns for the pediatric population. The rapidly changing biologic and physiologic developments only enhance the challenges of understanding the potential impacts of different drug treatments at various stages of childhood.

Researchers at the Columbia University Irving Medical Center developed a novel algorithm that identified nearly 20,000 ADEs signals (information on a new or known side effect that may be caused by a particular drug) across the seven pediatric development stages and made them freely available. This process is strengthened by a novel approach that allows neighboring development stages to enhance the signal detection power, which helps it overcome limited data within individual stages.

This use of predictive modeling on real-world data can help address a critical gap in healthcare research around the understudied pediatric community.

DBMI associate professor Nicholas Tatonetti and Nick Giangreco, a recent Systems Biology PhD graduate at Columbia University, shared these findings in the study A database of pediatric drug effects to evaluate ontogenic mechanisms from child growth and development, which was recently published in Med.

For many reasons, children have historically not been included in clinical trials. There are many ethical issues around including children in trials, and there are several limitations when children are included that make it difficult to assess the effectiveness and safety of drugs.”

Nicholas Tatonetti, DBMI associate professor

Because of these factors, few drugs are specifically approved for use in children, though once drugs are approved for adults, physicians can prescribe them “off-label” to children.

“Since drugs are not studied and approved in children directly, physicians must rely on guidelines for adults,” he added. “Essentially treating children as if they were simply small adults is oftentimes an incorrect assumption. This study is an attempt to elucidate systematically what the potential side effects are when drugs are used off label in children.”

The study goes beyond simply differentiating side effects in children from those in adults. It focuses on ADEs across seven developmental stages, starting at term neonatal and going through late adolescence, and it is powered by sharing information from neighboring developmental stages. For example, the development of infants and toddlers is close enough that there will be more shared characteristics than there would be for infants and those in early or late adolescence.

“Previously, children were essentially grouped together,” Tatonetti said. “There were only a few studies that just focused on children, and they basically focused on people 18 and under or 21 and under in one group. The innovation here is using known developmental stages and our newly introduced DGAMs (disproportionality generalized additive models) to improve power and enable that analysis.”

Tatonetti stressed that these signals are not validated and are primarily meant for researchers. Parents should consult with their pediatricians on specific drug side effects.

Giangreco, currently a Quantitative Translational Scientist at Regeneron, noted one of several side effects that were identified by this model.

“One we corroborated that the FDA had found was that montelukast, an asthma drug, was found to elicit psychiatric side effects,” he said. “We saw that in our database as well, but we were able to pinpoint certain developmental stages where the risk was more significant, especially the second year of life.”

The study also integrates pediatric enzyme expression data and found that pharmacogenes with dynamic childhood expression are associated with pediatric ADEs.

“This was a biologically-inspired modeling strategy,” Giangreco said. “We used what we knew about biological processes occurring during childhood and formed the modeling strategy. These safety signals came from this prior knowledge of the biological processes that are happening. Our data-driven approach really tried to capture what we thought were the important biologically and physiologically dynamic processes that happen during childhood and use that to tease apart observations across the development stages.”

The model was used on a database of 264,453 pediatric reports in the FDA Adverse Event Reporting System (FAERS). The output of the study is available via KidSIDES, a free and publicly available database of pediatric drug safety signals for the research community, as well as the Pediatric Drug Safety portal (PDSportal), which will facilitate evaluation of drug safety signals across childhood growth and development.

“The primary intention is for other researchers to use it, to follow up on signals they may observe,” Tatonetti said. “If they are experts on a particular drug usage, or particular disease domain and have observed these types of effects, they could follow up on them and be reassured, or could look at what the other evidence is for that effect as we aggregate it together. Clinicians can use it as a gut check. Maybe they saw an effect, or they are wondering if others are seeing this effect, and they can check the PDSPortal to see if others are seeing this effect or to prompt them to write another case report to the FDA.”

Source:

Columbia University Irving Medical Center

Journal reference:

Giangreco, N.P., et al. (2022) A database of pediatric drug effects to evaluate ontogenic mechanisms from child growth and development. Med. doi.org/10.1016/j.medj.2022.06.001.

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Santa Maria Public Library extending hours and hosting events for children

Santa Maria Public Library extending hours and hosting events for children

Book lovers and children are in for a treat at the City of Santa Maria Public Library.

The library is extending its hours starting Monday, July 11.

The hours will be Monday through Thursday, 9 a.m. to 7 p.m., and Fridays and Saturdays, 10 a.m. to 6 p.m.

In addition, the library is inviting families and children to an interactive and imaginative program presented by Pyjama Drama on Monday, July 11 at 11 a.m. in the Youth Services Altrusa Theater. The program features play, stories, and songs for children ages 18 months to 3 years old.

Also being held in the theater, preschoolers and caregivers are invited to learn how to create sensory bins on Wednesday, July 13 at 11 a.m.

For hours of operation or to learn more about these events visit www.cityofsantamaria.org/Library .

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More than 30 people, including children, killed in stampede at church event in Nigeria

More than 30 people, including children, were killed in a stampede at a church event in Nigeria. (CNN)


More than 30 people were killed and others injured when a stampede broke out at a church event in the southeastern Nigerian city of Port Harcourt on Saturday, according to police and security officials.


Most of the casualties were children.


The incident took place at a local polo club, where the nearby Kings Assembly Church had organized a gift donation drive, according to Olufemi Ayodele, a regional spokesman for Nigeria’s Civil Defense Corps.


“During the process of distributing the gift items, there was a stampede due to overcrowding,” he said. “Casualties were children mostly.”


The drive had not yet started when the stampede took place, said Grace Woyengikuro Iringe-Koko, a spokeswoman for the state police. Woyengikuro Iringe-Koko said the crowd forced their way into the venue, despite the fact that the gate was closed, resulting in the deadly charge.


Thirty-one people have been confirmed dead, Woyengikuro Iringe-Koko said. Seven injured people were hospitalized after the incident, she added.

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Anxiety in America: COVID ‘Takes a Backseat’ to Global Events

Anxiety in America: COVID 'Takes a Backseat' to Global Events

With two years of COVID-19 in the rearview mirror, anxiety among US adults has turned instead toward global events, results from the annual Healthy Minds Poll from the American Psychiatric Association (APA) show.

“It’s not surprising that recent events, such as the war in Ukraine, racially motivated mass shootings, or the impacts of climate change, are weighing heavily on Americans’ minds,” APA President Vivian Pender, MD, said in a news release. 

“COVID-19 in a way has taken a backseat, but the pandemic and its mental health effects are very much still with us. It’s important that we are cognizant of that and continue to work to ensure people who need psychiatric care, whether the causes are tied to the pandemic or to other issues, can access it,” Pender added.

Results from this year’s poll were released yesterday during the APA 2022 Annual Meeting.

Record Low COVID Anxiety

The poll was conducted by Morning Consult between April 23-24 and included 2210 adult participants.  

Results showed that anxiety about COVID is at its recorded lowest, with 50% of respondents indicating they are anxious about the pandemic. This was down from 65% in 2021 and from 75% in 2020.

Instead, nearly three quarters (73%) of adults are somewhat or extremely anxious about current events happening around the world, 64% are anxious about keeping themselves or their families safe, and 60% worry about their health in general.

Overall, about one third (32%) reported being more anxious now than last year, 46% reported no change in their anxiety level, and 18% were less anxious.

About one quarter (26%) have spoken with a mental healthcare professional in the past few years, which is down from 34% in 2021. In addition, Hispanic (36%) and Black (35%) adults were more likely to have reached out for help than White (25%) adults.

Despite the US Surgeon General’s recent advisory on the mental health crisis among children, the poll results also showed that Americans are less concerned about their children’s mental health than last year. A total of 41% of parents expressed concern about this topic, which was down from 53% in 2021.

Still, 40% of parents said their children had received help from a mental health professional since the pandemic hit. Of that group, 36% sought help before the pandemic, whereas half said the pandemic had caused mental health issues for their children.

“While the overall level of concern has dropped, still 4 in 10 parents are worried about how their children are doing, and a third are having issues with access to care,” Saul Levin, MD, CEO and medical director of the APA, said in the release.

“This is unacceptable and as a nation, we need to invest in the kind of systems that will ensure any parent who’s worried about their child has access to lifesaving treatment,” Levin added.

Workplace Mental Health

In addition, the poll showed employees often have a tough time getting mental health support from employers, or are hesitant to ask for help.

“What’s troubling about the results of this poll is that even as the pandemic has continued and its mental health effects wear on, fewer employees are reporting that they have access to mental health services,” Pender said. 

“Workplaces need to ensure that they are paying attention to what their employees need, particularly now, and moving away from mental health benefits isn’t the right move,” she added.

About half (48%) of those polled said they can discuss mental health openly and honestly with their supervisor, down from 56% in 2021 and 62% in 2020.

Only about half (52%) said they feel comfortable using mental health services with their current employer, compared with 64% in 2021 and 67% in 2020.

In addition, fewer workers felt their employer is offering sufficient mental health resources and benefits. This year, 53% of workers thought resources and benefits were adequate, which was down from 65% in 2021 and 68% in 2020.

“It’s quite concerning to see that fewer people feel comfortable discussing mental health with a supervisor, at a time when people experiencing symptoms of anxiety, depression, and other conditions are on the rise and impact nearly every aspect of work, including productivity, performance, retention, and overall healthcare costs,” Darcy Gruttadaro, JD, director of the APA Foundation’s Center for Workplace Mental Health, said.

“As rates of these conditions rise, we should see more employees knowing about available workplace mental health resources, not less,” Gruttadaro says.

Strong Bipartisan Support 

Perhaps unexpectedly, the poll shows strong support among Democrats, Republicans, and Independents for three APA-backed approaches to improve timely access to mental health care and treatment.

Specifically, about three quarters of those polled support:

  • making it easier to see a mental health professional via telehealth,

  • allowing patients to receive mental health care through a primary care provider,  

  • funding mental health care professionals to work in rural or urban communities that are traditionally underserved.

“We’re in a moment when mental health is a big part of the national conversation, and clearly political party doesn’t matter as much on this issue,” Pender noted. 

“It’s a rare thing in Washington these days to see such a resounding endorsement, but there is strong support for these practical workable solutions that mean more access to mental health care,” she said.

“What you see in this poll is agreement: it’s hard to access mental [health care] but we do have great solutions that could work across party lines,” Levin added.

“Many policymakers, in the administration and in Congress, are already putting these ideas into action, and they should feel encouraged that the public wants to see Congress act on them,” he said.

American Psychiatric Association (APA) 2022 Annual Meeting. Released May 22, 2022.

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Launch event of the Coalition of Action on Healthy Diets from Sustainable Food Systems for Children and All

Launch event of the Coalition of Action on Healthy Diets from Sustainable Food Systems for Children and All event flyer

Launch event of the Coalition of Action on Healthy Diets from Sustainable Food Systems for Children and All event flyer

Background

Health, nutrition and environmental sustainability need to be core, cross-cutting foundations of food systems transformation. During the United Nations Food Systems Summit (UNFSS) of 2021 the call for action to deliver healthy diets from sustainable food
systems echoed through dialogues, social movements and national pathways. Formed as an outcome of the UNFSS, the Coalition of Action for Healthy Diets from Sustainable Food Systems (HDSFS) brings Member States, UN Agencies, Civil Society Organizations,
Academic Institutions and social movements together to deliver on this call. 

The Coalition will strive to act as a mechanism for coordinated action on healthy diets from sustainable food systems that provides countries the opportunity to share, learn and inform. It will foster, maintain and gain momentum from multiple stakeholders
on the issue, and allow for all to inspire and be inspired. 

The workplan of the Coalition revolves around three key functions.

  1. Mobilise and coordinate existing expertise and stakeholders to align action across food systems for collective impact at the country-level.
  2. Facilitate peer-to-peer learning among countries. 
  3. Manage special projects on integrating nutrition, health and sustainability through food, determined by country priorities 

This official launch event aims to celebrate the formation of the Coalition and provide an update on its progress and future activities, inspire current and new members of the Coalition and catalyze supportive action towards its vision. 

Objectives

  • To share the vision, collective expertise and actions of the HDSFS Coalition and thereby establish the Coalition as an impactful mechanism for coordinated action on healthy diets from sustainable food systems;  
  • To launch the Coalition’s 2022 work plan and present  the progress on different functions, added value and
    modalities of collaboration; 
  • To gauge interest of new Member States and others to engage with the HDSFS Coalition; and, 
  • To inspire supportive action towards the vision of the HDSFS Coalition at the country, regional and global level.

Agenda

Moderator – Abigail Perry, Director Nutrition, WFP

14:00

Opening remarks, Beth Bechdol, DDG, FAO 

14:10

Opening remarks, Zsuzsanna Jakab, Deputy Director-General, WHO

14:11 – 14:15

Opening remarks, Frontrunner country

14:16 – 14:19

Coalition Video

14:20 – 14:30

Corinna Hawkes, Centre for Food Policy, City, University of London, representing the core team. Remarks highlighting the work plan and what the coalition will accomplish in the short and long term 

14:31 – 14:45

Remarks from 3 Front runner countries highlighting action for 2022, interest, and expected impact of the Coalition (4 minutes each)

14:45 – 14:48

Remarks from youth representative, Lana Weidgenant

14:48 – 14:52

Remarks from Coordinator Hub,Stefanos Fotiou

14:52 – 15:00

Next steps and closing – Brent Loken, Global Food Lead Scientist, WWF

Register

Register for the launch event here: https://fao.zoom.us/webinar/register/WN_9EPxqoYuSfmNCmjTJLPTJw

Or watch the live stream: https://www.fao.org/webcast/home/en/item/5840/icode/ 

Interpretation: available in Arabic, Chinese, English, French, Russian and Spanish

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Ann Arbor Summer Festival’s Kidzone to feature nightly events, activities in June

Ann Arbor Summer Festival’s Kidzone to feature nightly events, activities in June

ANN ARBOR, Mich. – Known for its month-long celebration of all things summer, Ann Arbor Summer Festival has activities for the whole family.

The annual festival offers adults concerts and activities but Tree Town’s littlest residents get their own Kidzone with family-friendly storytime, face painting, karate and more.

Between June 10 and July 3, the Kidzone tent will have free, nightly hands-on activities with community partners, including Ann Arbor Symphony Orchestra, Annie’s Children’s Center and Booksweet.

The 2022 series is sponsored by C.S. Mott Children’s Hospital, said Ann Arbor Summer Festival.

Check out the lineup:

Every summer, Ann Arbor Summer Festival hosts more than 200 free and ticketed events around the city with many taking place in the University of Michigan Ingalls Mall.

More than 80,000 people attend the events and activities, a press release said.

Read: Ann Arbor Summer Festival announces 2022 wellness series

Copyright 2022 by WDIV ClickOnDetroit – All rights reserved.

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Tips for talking with children about tragic events

Tips for talking with children about tragic events

EAU CLAIRE, Wis. (WEAU) -As the community continues to process Lily Peters’ death, it can be difficult or uncomfortable for parents to talk with children about this tragedy.

Alison Jones is a psychiatrist with Marshfield Clinic in Eau Claire.

She said it’s important to talk about tragic events like Lily Peters’ death with your kids.

If you don’t, they’ll likely find the information somewhere.

That information may not be accurate.

For elementary students, Jones said one way you can talk to children is focusing on safety in the community.

Share with them ways they can be aware of their surroundings and what to do if they need help.

She said for both adults and children, community is also key.

“As a psychiatrist in the community, I know that this is a really challenging time, and it’s important to lean on your community members and support services that we have within the region and working together as a community,” Jones said.

Jones also recommends watching for changes in your child’s behavior.

“Kids asking more questions, really perseverating or getting stuck on details about the event or even other things that are happening in their lives,” Jones said. “Maybe being more clingy or wanting to attach to their family or not wanting to go out of the home without their parents.”

Jones said if you do notice changes like this, or if your child starts acting out, reach out to their schools or other resources in the community for help.

Copyright 2022 WEAU. All rights reserved.