COVID-19 in children: Pathogenesis and current status

2020 ◽  
Author(s):  
Lawrence Frenkel ◽  
Fernando Gomez ◽  
Joseph A Bellanti
Keyword(s):  
Respiratory Disease ◽  
Respiratory Symptoms ◽  
Distress Syndrome ◽  
Clinical Course ◽  
Current Status ◽  
Current Evidence ◽  
Initial Description ◽  
Relationship Of ◽  
Inflammatory Syndrome ◽  
The Relationship

Background: Since its initial description in December 2019 in Wuhan, China, coronavirus disease 2019 (COVID-19) has rapidly progressed into a worldwide pandemic, which has affected millions of lives. Unlike the disease in adults, the vast majority of children with COVID-19 have mild symptoms and are largely spared from severe respiratory disease. However, thereare children who have significant respiratory disease, and some may develop a hyperinflammatory response similar to thatseen in adults with COVID-19 and in children with Kawasaki disease (KD), which has been termed multisystem inflammatory syndrome in children (MIS-C).Objective: The purpose of this report was to examine the current evidence that supports the etiopathogenesis of COVID-19 in children and the relationship of COVID-19 with KD and MIS-C as a basis for a better understanding of the clinical course, diagnosis, and management of these clinically perplexing conditions.Results: The pathogenesis of COVID-19 is carried out in two distinct but overlapping phases of COVID-19: the first triggered by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) itself and the second by the host immune response. Children with KD have fewer of the previously described COVID-19–associated KD features with less prominent acute respiratory distress syndrome and shock than children with MIS-C.Conclusion: COVID-19 in adults usually includes severe respiratory symptoms and pathology, with a high mortality. Ithas become apparent that children are infected as easily as adults but are more often asymptomatic and have milder diseasebecause of their immature immune systems. Although children are largely spared from severe respiratory disease, they canpresent with a SARS-CoV-2–associated MIS-C similar to KD.

COVID-19 in children: Pathogenesis and current status

2021 ◽  
Vol 42 (1) ◽  
pp. 8-15 ◽  
Author(s):  
Lawrence D. Frenkel ◽  
Fernando Gomez ◽  
Joseph A. Bellanti
Keyword(s):  
Respiratory Disease ◽  
Respiratory Symptoms ◽  
Distress Syndrome ◽  
Clinical Course ◽  
Current Status ◽  
Current Evidence ◽  
Initial Description ◽  
Relationship Of ◽  
Inflammatory Syndrome ◽  
The Relationship

Background: Since its initial description in December 2019 in Wuhan, China, coronavirus disease 2019 (COVID-19) has rapidly progressed into a worldwide pandemic, which has affected millions of lives. Unlike the disease in adults, the vast majority of children with COVID-19 have mild symptoms and are largely spared from severe respiratory disease. However, there are children who have significant respiratory disease, and some may develop a hyperinflammatory response similar to that seen in adults with COVID-19 and in children with Kawasaki disease (KD), which has been termed multisystem inflammatory syndrome in children (MIS-C). Objective: The purpose of this report was to examine the current evidence that supports the etiopathogenesis of COVID-19 in children and the relationship of COVID-19 with KD and MIS-C as a basis for a better understanding of the clinical course, diagnosis, and management of these clinically perplexing conditions. Results: The pathogenesis of COVID-19 is carried out in two distinct but overlapping phases of COVID-19: the first triggered by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) itself and the second by the host immune response. Children with KD have fewer of the previously described COVID-19‐associated KD features with less prominent acute respiratory distress syndrome and shock than children with MIS-C. Conclusion: COVID-19 in adults usually includes severe respiratory symptoms and pathology, with a high mortality. It has become apparent that children are infected as easily as adults but are more often asymptomatic and have milder disease because of their immature immune systems. Although children are largely spared from severe respiratory disease, they can present with a SARS-CoV-2‐associated MIS-C similar to KD.

scholarly journals Avoidant Personality Disorder, Traits, and Type

2012 ◽  
pp. 548-565
Author(s):  
Charles A. Sanislow ◽  
Katelin da Cruz ◽  
May O. Gianoli ◽  
Elizabeth Reagan
Keyword(s):  
Personality Disorder ◽  
Social Anxiety ◽  
Sense Of Self ◽  
Current Status ◽  
Interpersonal Style ◽  
Social Situations ◽  
Avoidant Personality Disorder ◽  
Optimal Organization ◽  
Relationship Of ◽  
The Relationship

In this chapter, the evolution of the avoidant personality disorder (AVPD) diagnosis, its current status, and future possibilities are reviewed. AVPD is a chronic and enduring condition involving a poor sense of self and anxiety in social situations, and it is marked by fears of rejection and a distant interpersonal stance. AVPD may be conceptualized at the severe end of a continuum of social anxiety. In the extreme, traits, mechanisms, and symptoms become integral to chronic dysfunction in personality and interpersonal style. While AVPD is a valid diagnostic construct, the optimal organization of AVPD criteria for the diagnosis, and the relationship of avoidant personality traits to anxiety, remain to be determined.

scholarly journals Multi-System Inflammatory Syndrome in Children (MIS-C) Following SARS-CoV-2 Infection: Review of Clinical Presentation, Hypothetical Pathogenesis, and Proposed Management

Children ◽  
2020 ◽  
Vol 7 (7) ◽  
pp. 69 ◽  
Author(s):  
Natasha A. Nakra ◽  
Dean A. Blumberg ◽  
Angel Herrera-Guerra ◽  
Satyan Lakshminrusimha
Keyword(s):  
Clinical Presentation ◽  
Pediatric Intensive Care ◽  
Severe Illness ◽  
Toxic Shock ◽  
Epidemiologic Evidence ◽  
Organ Systems ◽  
Relationship Of ◽  
Inflammatory Syndrome ◽  
The Relationship ◽  
Secondary Hemophagocytic Lymphohistiocytosis

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may result in the multisystem inflammatory syndrome in children (MIS-C). The clinical presentation of MIS-C includes fever, severe illness, and the involvement of two or more organ systems, in combination with laboratory evidence of inflammation and laboratory or epidemiologic evidence of SARS-CoV-2 infection. Some features of MIS-C resemble Kawasaki Disease, toxic shock syndrome, and secondary hemophagocytic lymphohistiocytosis/macrophage activation syndrome. The relationship of MIS-C to SARS-CoV-2 infection suggests that the pathogenesis involves post-infectious immune dysregulation. Patients with MIS-C should ideally be managed in a pediatric intensive care environment since rapid clinical deterioration may occur. Specific immunomodulatory therapy depends on the clinical presentation. The relationship between the immune response to SARS-CoV-2 vaccines in development and MIS-C requires further study.

Recent observations of humpback whales (Megaptera novaeangliae) in Japanese waters off Ogasawara and Okinawa

1993 ◽  
Vol 71 (2) ◽  
pp. 325-333 ◽  
Author(s):  
J. D. Darling ◽  
K. Mori
Keyword(s):  
North Pacific ◽  
Individual Behavior ◽  
Humpback Whales ◽  
Current Status ◽  
Behavior Patterns ◽  
Mariana Islands ◽  
Northern Mariana Islands ◽  
Japanese Waters ◽  
Relationship Of ◽  
The Relationship

The current status of humpback whales in waters off Ogasawara and Okinawa islands, Japan, and the relationship of these populations to each other and to humpback whales in the central-eastern North Pacific were investigated. Fluke-identification photographs collected from 1987 to 1990 were analyzed to estimate abundance and determine individual behavior patterns, and were compared with humpback photoidentifications from other regions. In total, 177 humpbacks were identified. At the end of the study period the rate of discovery of "new" whales was still high, suggesting a substantially larger overall population. Whales were commonly sighted throughout the Ogasawara archipelago from December to May, and were present during the same period near the Kerama Islands, Okinawa. Humpback whales were not regularly seen near Saipan in the Northern Mariana Islands, or near Kenting, Taiwan. Repeat sightings of individuals indicate that some whales were present for extended periods off Ogasawara. The predominant behavior patterns were those related to calving and mating. Two whales were identified in both the Okinawa and Ogasawara regions in different years, suggesting that both regions are used by the same population. Identification of one whale in both Japan and Hawaii (reported elsewhere) indicates the potential for mixing of western and eastern North Pacific humpback populations; the overall matching effort to date suggests that this interchange is relatively small.

scholarly journals HIV-Associated Neurocognitive Disorders: The Relationship of HIV Infection with Physical and Social Comorbidities

2015 ◽  
Vol 2015 ◽  
pp. 1-13 ◽  
Author(s):  
Ellen M. Tedaldi ◽  
Nancy L. Minniti ◽  
Tracy Fischer
Keyword(s):  
Hiv Infection ◽  
Research Priorities ◽  
Neurocognitive Disorders ◽  
Current Status ◽  
Future Research ◽  
Diagnostic Strategies ◽  
Immunodeficiency Virus ◽  
Relationship Of ◽  
The Relationship

The prevalence of HIV (human immunodeficiency virus) associated neurocognitive disorders (HAND) will undoubtedly increase with the improved longevity of HIV-infected persons. HIV infection, itself, as well as multiple physiologic and psychosocial factors can contribute to cognitive impairment and neurologic complications. These comorbidities confound the diagnosis, assessment, and interventions for neurocognitive disorders. In this review, we discuss the role of several key comorbid factors that may contribute significantly to the development and progression of HIV-related neurocognitive impairment, as well as the current status of diagnostic strategies aimed at identifying HIV-infected individuals with impaired cognition and future research priorities and challenges.

Study on the relationship of air pollution to respiratory disease in schoolchildren

1975 ◽  
Vol 10 (1) ◽  
pp. 14-28 ◽  
Author(s):  
K.F. Kerrebijn ◽  
A.R.M. Mourmans ◽  
K. Biersteker
Keyword(s):  
Air Pollution ◽  
Respiratory Disease ◽  
Relationship Of ◽  
The Relationship

scholarly journals Prominent rash and multisystem inflammatory syndrome in a 29-year-old patient with COVID-19: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Catherine A. Gao ◽  
James M. Walter ◽  
Jane E. Dematte D’Amico
Keyword(s):  
Case Report ◽  
Respiratory Symptoms ◽  
Clinical Course ◽  
Adult Patients ◽  
Inflammatory Biomarkers ◽  
Case Presentation ◽  
Hispanic Patient ◽  
Mucosal Changes ◽  
Inflammatory Syndrome ◽  
Disease Present

Abstract Background Adult patients with coronavirus disease present primarily with respiratory symptoms, but children and some adults may display a more systemic inflammatory syndrome with rash, fever, mucosal changes, and elevated inflammatory biomarkers. Case presentation Here, we report the case of a 29-year-old Hispanic patient presenting with significant rash and multisystem inflammation. We describe his clinical course, review dermatological manifestations of coronavirus disease, and summarize the pathophysiology of coronavirus disease-associated multisystem inflammation. Conclusion This case should alert physicians to the atypical nature of presenting rash with minimal respiratory symptoms in coronavirus disease.

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