Diabetes may increase long COVID risk; COVID while pregnant linked to baby brain development issues

Authors: Nancy Lapid Thu, June 9, 2022,

The following is a summary of some recent studies on COVID-19. They include research that warrants further study to corroborate the findings and that has yet to be certified by peer review.

Diabetes may increase the risk of long COVID, new analyses of seven previous studies suggest.

Researchers reviewed studies that tracked people for at least four weeks after COVID-19 recovery to see which individuals developed persistent symptoms associated with long COVID such as brain fog, skin conditions, depression, and shortness of breath. In three of the studies, people with diabetes were up to four times more likely to develop long COVID compared to people without diabetes, according to a presentation https://eppro02.ativ.me/web/page.php?page=IntHtml&project=ADA22&id=1683 on Sunday at the annual Scientific Sessions of the American Diabetes Association. The researchers said diabetes appears to be “a potent risk factor” for long COVID but their findings are preliminary because the studies used different methods, definitions of long COVID, and follow-up times, and some looked at hospitalized patients while others focused on people with milder cases of COVID-19.

“More high-quality studies across multiple populations and settings are needed to determine if diabetes is indeed a risk factor” for long COVID, the researchers said. “In the meantime, careful monitoring of people with diabetes… may be advised” after COVID-19.

COVID-19 in pregnancy linked with babies’ learning skills

Babies born to mothers who had COVID-19 while pregnant may be at higher than average risk for problems with brain development involved in learning, focusing, remembering, and developing social skills, researchers have found.

They studied 7,772 infants delivered in Massachusetts between March and September 2020, tracking the babies until age 12 months. During that time, 14.4% of the babies born to the 222 women with a positive coronavirus test during pregnancy were diagnosed with a neurodevelopmental disorder, compared to 8.7% of babies whose mothers avoided the virus while pregnant. After accounting for other neurodevelopmental risk factors, including preterm delivery, SARS-CoV-2 infection during pregnancy was linked with an 86% higher risk of a neurodevelopmental disorder diagnosis in offspring, the researchers reported on Thursday in JAMA Network Open https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2793178. The risk was more than doubled when the infection occurred in the third trimester.

The researchers point out that their study was brief and cannot rule out the possibility that additional neurodevelopmental effects will become apparent as the children grow up. On the other hand, they note, larger and more rigorous studies are needed to rule out other potential causes and prove that the coronavirus is to blame.

The rare but life-threatening inflammatory syndrome seen in some children after a coronavirus infection has become even more rare with the Omicron variant causing most infections and more kids vaccinated, according to a new study.

Researchers looked at data from Denmark on more than half a million children and adolescents infected after Omicron became dominant, about half of whom experienced breakthrough infections after vaccination. Overall, only one vaccinated child and 11 unvaccinated children developed Multisystem Inflammatory Syndrome in Children (MIS-C), which causes inflammation in the heart, lungs, kidneys and brain after a mild or asymptomatic SARS-CoV-2 infection. That translates to rates of 34.9 MIS-C cases per million unvaccinated children with COVID-19 and 3.7 cases per million vaccinated young COVID-19 patients, the researchers said on Wednesday in JAMA Pediatrics https://jamanetwork.com/journals/jamapediatrics/fullarticle/2793024. By comparison, rates of MIS-C cases when Delta was predominant were 290.7 per million unvaccinated infected kids and 101.5 per million among the vaccinated who had COVID, they said.

The fact that MIS-C risk was significantly lower in vaccinated children suggests the vaccine is helping to keep the immune system from causing the deadly inflammatory reaction that is an MIS-C hallmark, the researchers said.

COVID virus linked with headaches, altered mental status in hospitalized kids

Authors: UNIVERSITY OF PITTSBURGH Peer-Reviewed Publication

PITTSBURGH, Jan. 21, 2022 – Of hospitalized children who tested or were presumed positive for SARS-CoV-2, 44% developed neurological symptoms, and these kids were more likely to require intensive care than their peers who didn’t experience such symptoms, according to a new study led by a pediatrician-scientist at UPMC and the University of Pittsburgh School of Medicine

The most common neurologic symptoms were headache and altered mental status, known as acute encephalopathy. Published in Pediatric Neurology, these preliminary findings are the first insights from the pediatric arm of GCS-NeuroCOVID, an international, multi-center consortium aiming to understand how COVID-19 affects the brain and nervous system. 

“The SARS-CoV-2 virus can affect pediatric patients in different ways: It can cause acute disease, where symptomatic illness comes on soon after infection, or children may develop an inflammatory condition called MIS-C weeks after clearing the virus,” said lead author Ericka Fink, M.D., pediatric intensivist at UPMC Children’s Hospital of Pittsburgh, and associate professor of critical care medicine and pediatrics at Pitt. “One of the consortium’s big questions was whether neurological manifestations are similar or different in pediatric patients, depending on which of these two conditions they have.” 

To answer this question, the researchers recruited 30 pediatric critical care centers around the world. Of 1,493 hospitalized children, 1,278, or 86%, were diagnosed with acute SARS-CoV-2; 215 children, or 14%, were diagnosed with MIS-C, or multisystem inflammatory syndrome in children, which typically appears several weeks after clearing the virus and is characterized by fever, inflammation and organ dysfunction. 

The most common neurologic manifestations linked with acute COVID-19 were headache, acute encephalopathy and seizures, while youths with MIS-C most often had headache, acute encephalopathy and dizziness. Rarer symptoms of both conditions included loss of smell, vision impairment, stroke and psychosis.  

“Thankfully, mortality rates in children are low for both acute SARS-CoV-2 and MIS-C,” said Fink. “But this study shows that the frequency of neurological manifestations is high—and it may actually be higher than what we found because these symptoms are not always documented in the medical record or assessable. For example, we can’t know if a baby is having a headache.” 

The analysis showed that neurological manifestations were more common in kids with MIS-C compared to those with acute SARS-CoV-2, and children with MIS-C were more likely than those with acute illness to have two or more neurologic manifestations. 

According to Fink, the team recently launched a follow up study to determine whether acute SARS-CoV-2 and MIS-C—with or without neurologic manifestations—have lasting effects on children’s health and quality of life after discharge from hospital.  

“Another long-term goal of this study is to build a database that tracks neurological manifestations over time—not just for SARS-CoV-2, but for other types of infections as well,” she added. “Some countries have excellent databases that allow them to easily track and compare children who are hospitalized, but we don’t have such a resource in the U.S.” 

This study was partly funded by the Neurocritical Care Society Investing in Clinical Neurocritical Care Research (INCLINE) grant. 

Other researchers who contributed to the study include Courtney L. Robertson, M.D., Johns Hopkins Children’s Center; Mark S. Wainwright, M.D., Ph.D., University of Washington and Seattle Children’s Hospital; Juan D. Roa, M.D., Universidad Nacional de Colombia and Fundación Universitaria de Ciencias de la Salud; Michelle E. Schober, M.D., University of Utah, and other GCS-NeuroCOVID Pediatrics investigators who are listed in the paper. 

To read this release online or share it, visit http://www.upmc.com/media/news/012122-Fink-COVID-Children.  


JOURNAL

Pediatric Neurology

DOI

10.1016/j.pediatrneurol.2021.12.010 

METHOD OF RESEARCH

Observational study

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Prevalence and Risk Factors of Neurologic Manifestations in Hospitalized Children Diagnosed with Acute SARS-CoV-2 or MIS-C

ARTICLE PUBLICATION DATE

21-Jan-2022

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