High cholesterol, overweight and reduced physical stamina are long COVID sequelae in young adults

Authors: University of Zurich Summary: 6, 2022:Science Daily

As the Covid-19 pandemic evolves, the issue of post-infection consequences is growing in significance. Does Long Covid impact previously healthy young adults? Although this group is of great societal importance, representing the next generation and the backbone of the workforce, the intermediate-term and long-term effects of SARS-CoV-2 infections have scarcely been researched in this population. Available original research tends to focus on sufferers who were hospitalized, the elderly or those with multiple morbidities, or restricts evaluations to a single organ system.

Long Covid implications in young Swiss military personnel

A new study, funded by the Swiss Armed Forces, and conducted under the leadership of Patricia Schlagenhauf, Professor at the Epidemiology, Biostatistics and Prevention Institute of the University of Zurich (UZH), has now evaluated possible Long Covid implications in young Swiss military personnel. The study, published in the journal Lancet Infectious Diseases, was done between May and November 2021 with 29 female and 464 male participants with a median age of 21. 177 participants had confirmed Covid-19 more than 180 days prior to the testing day, and the control group was made up of 251 SARS-CoV-2 serologically negative individuals. Unlike other studies the novel test battery also evaluated cardiovascular, pulmonary, neurological, ophthalmological, male fertility, psychological and general systems.

Despite overall recovery also sequelae after recent infections remain

The findings show that young, previously healthy, non-hospitalized individuals largely recover from mild infection and that the impact of the SARS-CoV-2 virus on several systems of the body is less than that seen in older, multi-morbid or hospitalized patients. However, the study also provided evidence that recent infections — even mild ones — can lead to symptoms such as fatigue, reduced sense of smell and psychological problems for up to 180 days, as well as having a short-term negative impact on male fertility. For non-recent infections — more than 180 days back — these effects were no longer significant.

Specific constellation carries risk of developing metabolic disorders

For those with non-recent infections, however, the study — which had a long follow-up — provided evidence of a potentially risky constellation: “Increased BMI, high cholesterol and lower physical stamina is suggestive of a higher risk of developing metabolic disorders and possible cardiovascular complications,” says principal investigator Patricia Schlagenhauf. “These results have societal and public-health effects and can be used to guide strategies for broad interdisciplinary evaluation of Covid-19 sequelae, their management, curative treatments, and provision of support in young adult populations.”

Significant landmark study points the way

The study, conducted in collaboration with clinics at the University Hospital Zurich and Spiez Laboratory, is novel in that it quantitatively evaluated multi-organ function using a sensitive, minimally invasive test battery in a homogenous group of people several months after a Covid-19 infection. A valuable facet of the study was the control group, serologically confirmed to have had no SARS-CoV-2 exposure. “This combination of a unique test battery, a homogenous cohort and a control group make this a very powerful, landmark study in the evidence base on Long Covid in young adults,” says Schlagenhauf.

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Materials provided by University of ZurichNote: Content may be edited for style and length.


Journal Reference:

  1. Jeremy Werner Deuel, Elisa Lauria, Thibault Lovey, Sandrine Zweifel, Mara Isabella Meier, Roland Züst, Nejla Gültekin, Andreas Stettbacher, Patricia Schlagenhauf. Persistence, prevalence, and polymorphism of sequelae after COVID-19 in unvaccinated, young adults of the Swiss Armed Forces: a longitudinal, cohort study (LoCoMo)The Lancet Infectious Diseases, 2022; DOI: 10.1016/S1473-3099(22)00449-2

UK Bans COVID Vax for Kids – Investigation Finds Vaccine Affects Sexual Development in Little Boys

Authors:  Jim Hoft September 7, 2022 Gateway Pundit

The UK Health Security Agency banned the COVID vaccine from childrenwho had not turned five by the end of last month. The UK will no longer offer the vaccine to children aged 5 to 11.

Wolf also discussed a recent investigation that revealed the devastating affects of the vaccine on little boys. According to Dr. Naomi Wolf, the vaccine is hindering the development of the testes of pre-adolescent boys. This is a catastrophe.

The vaccines hurt the testes and hurt the parts of the testes that develop the masculinity and secondary sex characteristics of little boys, and baby boys, and teenage boys. So they literally harm the chances of your little boy child to grow up normally as a male human adult.

Study: Kids with COVID more likely to develop blood clots

Authors: David Olsen August 6, 2022 Newsday

Children who test positive for COVID-19 are much more likely to develop blood clots and cardiac problems weeks after their infection, compared with kids who did not contract the virus, a newly released study found.

The study, published Thursday by the Centers for Disease Control and Prevention, also found significantly higher rates of kidney failure and diabetes in those infected with the virus.

“A lot of the things they’re reporting are things that we’re seeing,” said Dr. Howard Balbi, chief of pediatric infectious diseases at Good Samaritan Hospital in West Islip.

Many of the kids who develop complications a few weeks after infection, including some who ended up in intensive care, initially had mild or no COVID-19 symptoms, he said.

WHAT TO KNOW

  • Children who tested positive for the coronavirus were significantly more likely to develop blood clots, cardiac problems, kidney failure and diabetes than kids who did not, a newly released CDC study found.
  • Long Island doctors said the study backs up what they’ve been seeing in hospitals. Many of the children who later developed complications initially had only mild COVID-19 or no symptoms at all, one pediatrician said.
  • Even though children are less likely to get severe COVID-19 than adults, the study shows that a small number of kids will develop serious health conditions, doctors say.

Dr. Andrew Handel, a pediatric infectious disease specialist at Stony Brook Children’s Hospital, said the study’s results “confirm our suspicions.”

“We know that most children who get COVID do not have severe infections from it,” he said. “But a small portion of these children are going to go on to have permanent organ damage as a result of the infection.”

The study is the largest ever in the United States on “post-COVID-19” effects on children, defined as symptoms and conditions four or more weeks after infection. CDC researchers examined medical records of more than 3.1 million children and adolescents, from infants to 17-year-olds, a quarter of whom had tested positive for the coronavirus and the rest who had not. The children were followed for between 60 days and a year.

Kids who had COVID-19 were twice as likely to have blood clots or lung-artery blockages caused by blood clots. They also were twice as likely to have cardiomyopathy, a disease of the heart muscle, or myocarditis, an inflammation of the heart muscle.

Last year, the CDC warned of rare cases of myocarditis among adolescent and young-adult males who received the Pfizer-BioNTech and Moderna vaccines. Some parents interviewed by Newsday and other media outlets said fear of myocarditis was a factor in not getting their children vaccinated.

But a CDC study released in April found that COVID-19 is far more likely than coronavirus vaccines to cause myocarditis, even among young males. The new study reiterates that COVID-19 is a greater myocarditis threat, Handel said.

In addition, he said, “What we’ve seen anecdotally in clinic [at Stony Brook] but also in research itself is that the myocarditis that kids get from the vaccine tends to be much, much, much less severe than when they experience it as a result of the infection itself. Generally, when kids get myocarditis after getting vaccinated, they can have some mild symptoms that usually just resolve on their own within a day or two. But myocarditis that you get with COVID infection itself can be devastating.”

COVID-19 causes inflammation, so it’s not surprising that the inflammation can continue for a longer period of time in some kids, said Dr. Mundeep Kainth, a pediatric infectious disease specialist at Cohen Children’s Medical Center in New Hyde Park.

“There is definitely already a known risk for that for anybody with COVID,” she said.

Children with COVID-19 also were about 1.3 times more likely to have kidney failure and roughly 1.2 times more likely to develop type 1 or type 2 diabetes or have issues with taste or smell, the study found.

The rate of malaise and fatigue among kids who had COVID-19 was only 1.05 times higher.

Studies have found that fatigue is the most common symptom of adults with “long COVID,” which the CDC defines as symptoms lasting at least three months after first contracting the virus.

Handel said he’s not surprised the rates of fatigue among kids aren’t higher.

“The symptoms that go along with what we’re calling long COVID — fatigue, body aches, difficulty thinking and maybe some psychiatric symptoms — those are really much less common in children for reasons that we don’t quite understand,” he said.

Kainth said the lower rates of fatigue also are probably because kids in general are more active than adults on average, and less likely to be fatigued.

Even so, Balbi said, multiple parents have told him that even though their kids who had gotten infected may not have severe post-COVID symptoms, “To quote the parent, ‘They’re just not themselves four months later. … They’re not back to normal. They’re not as active, they’re not as interested in doing things.’ ”

Researchers cautioned that the study was not representative of the U.S. pediatric population. About 70% of the kids were enrolled in Medicaid managed care. In addition, the analysis was based on medical records — meaning the children in the study who did not contract the coronavirus “were seeking medical care,” Kainth said. “These were not completely healthy kids.”

If healthier children had been part of the study, there may have been an even larger gap between kids who had COVID-19 and those who had not, she said.

Delta reinfection risk low among unvaccinated children

But scientists warn that the findings do not mean that children should not be vaccinated against COVID-19.

Authors: Heidi Ledford July 4, 2022 NATURE

Children and adolescents who had not been vaccinated against COVID-19 mounted a long-lasting immune response to infection with the Delta variant of the coronavirus SARS-CoV-2, according to a large study of Israeli health records1. The study, which has been published as a preprint on medRxiv, has not yet been peer reviewed.

A year and a half after an infection, the resulting immune response was still about 80% effective at preventing reinfection, the study found. But it isn’t clear how the results will translate to infections by coronavirus variants of the Omicron lineage, which is now dominant in many countries. “There is a much less-robust immune response to Omicron among previously infected and/or vaccinated individuals,” says Yvonne Maldonado, chief of paediatric infectious diseases at Stanford School of Medicine in California. “Such immune responses are also significantly less durable.”

Even so, the study — which includes data from about 300,000 children and adolescents — is a welcome addition to the relatively small pool of knowledge about immune responses to SARS-CoV-2 in children, says paediatrician Nigel Crawford at the Murdoch Children’s Research Institute in Melbourne, Australia, who studies vaccinology. “They’re a group for which we haven’t seen a huge amount of data to date,” he says.

When Delta dominated

The study’s authors collected data on coronavirus infections from Maccabi Healthcare Services, an Israeli health-insurance plan. They focused on the risk of infection from 1 July to 13 December 2021, when the Delta variant was dominant in Israel.

The team found that unvaccinated children and adolescents were 89% less likely to be infected with SARS-CoV-2 3–6 months after their first infection than were children who had not previously been infected. For the 12–18 age group, this protection against reinfection dropped to 82.5% from 9 months to a year after infection and remained at around that level until up to 18 months post-infection.

Children aged 5–11, however, maintained the same level of protection. That, says Crawford, could fit with observations that young children often experience milder COVID-19 than do adolescents and adults.

The study authors are now working to collect data on Omicron infections, but that analysis will be more difficult because many people in Israel switched from PCR tests to at-home rapid antigen testing in December 2021. This means that fewer positive test results have since been reported in electronic health records.

Overall, the study design is robust, says clinical data scientist Hossein Estiri at Harvard Medical School in Boston, Massachusetts. He notes that some Twitter users have picked up on the preprint and are touting it as evidence that children who have had SARS-CoV-2 infections do not need to be vaccinated. But Estiri says it’s not clear from the study how well protection from natural infection stacks up to that from vaccines, because the researchers did not include a head-to-head comparison. “This study doesn’t say that those children don’t need to be vaccinated.”

Don’t discount vaccines

And because severe COVID-19 is rare in children, the study could not make strong conclusions about protection from serious illness and hospitalization. “We know that a lot of vaccine efficacy is against severe disease,” he says.

In addition, Crawford notes that people who have both been vaccinated and had a SARS-CoV-2 infection often experience a super-charged immune response compared with those who have had only a vaccine or infection. “You wouldn’t want to rely purely on infection alone for immunity,” he says. “We have no idea what the next wave will bring.”

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.

Association of COVID-19 Vaccination During Pregnancy With Incidence of SARS-CoV-2 Infection in Infants

Authors: Ellen Øen Carlsen, MD1Maria C. Magnus, PhD1Laura Oakley, PhD1,2et alDeshayne B. Fell, PhD3,4Margrethe Greve-Isdahl, MD5Jonas Minet Kinge, PhD1,6Siri E. Håberg, MD, PhD

JAMA Intern Med. Published online June 1, 2022. doi:10.1001/jamainternmed.2022.2442

Key Points

Question  Is maternal COVID-19 vaccination during the second or third trimester of pregnancy associated with reduced risk of COVID-19 within the first 4 months of life in their infants?

Findings  In this register-based cohort study of all live-born infants in Norway, there was a lower incidence of a positive SARS-CoV-2 test result in infants born to women vaccinated with a messenger RNA vaccine during pregnancy. The risk was lower during the period dominated by the Delta variant than during the Omicron-dominated period.

Meaning  The study results suggest that maternal COVID-19 vaccination during pregnancy could protect against infant SARS-CoV-2 infection in the early months of life.

Abstract

Importance  Pregnant women are recommended to receive COVID-19 vaccination to reduce risk of severe COVID-19. Whether vaccination during pregnancy also provides passive protection to infants after birth remains unclear.

Objective  To determine whether COVID-19 vaccination in pregnancy was associated with reduced risk of COVID-19 in infants up to age 4 months during COVID-19 pandemic periods dominated by Delta and Omicron variants.

Design, Setting, and Participants  This nationwide, register-based cohort study included all live-born infants born in Norway between September 1, 2021, and February 28, 2022.

Exposures  Maternal messenger RNA COVID-19 vaccination during second or third trimester compared with no vaccination before or during pregnancy.

Main Outcomes and Measures  The risk of a positive polymerase chain reaction test result for SARS-CoV-2 during an infant’s first 4 months of life by maternal vaccination status during pregnancy with either dose 2 or 3 was estimated, as stratified by periods dominated by the Delta variant (between September 1 and December 31, 2021) or Omicron variant (after January 1, 2022, to the end of follow-up on April 4, 2022). A Cox proportional hazard regression was used, adjusting for maternal age, parity, education, maternal country of birth, and county of residence.

Results  Of 21 643 live-born infants, 9739 (45.0%) were born to women who received a second or third dose of a COVID-19 vaccine during pregnancy. The first 4 months of life incidence rate of a positive test for SARS-CoV-2 was 5.8 per 10 000 follow-up days. Infants of mothers vaccinated during pregnancy had a lower risk of a positive test compared with infants of unvaccinated mothers and lower risk during the Delta variant–dominated period (incidence rate, 1.2 vs 3.0 per 10 000 follow-up days; adjusted hazard ratio, 0.29; 95% CI, 0.19-0.46) compared with the Omicron period (incidence rate, 7.0 vs 10.9 per 10 000 follow-up days; adjusted hazard ratio, 0.67; 95% CI, 0.57-0.79).

Conclusions and Relevance  The results of this Norwegian population-based cohort study suggested a lower risk of a positive test for SARS-CoV-2 during the first 4 months of life among infants born to mothers who were vaccinated during pregnancy. Maternal COVID-19 vaccination may provide passive protection to young infants, for whom COVID-19 vaccines are currently not available.

Introduction

The risk of critical illness because of COVID-19 has been reported to be higher in infants younger than 1 year compared with older children.1 To our knowledge, no COVID-19 vaccines are currently available for infants or children younger than 5 years. Transplacental transfer of maternal vaccine-derived antibodies against pertussis and seasonal influenza has been demonstrated following vaccination during pregnancy, and maternal immunization provides passive protection against infection to infants during the first months after birth.2,3 It is plausible that COVID-19 vaccination during pregnancy could provide passive protection from COVID-19 to infants during their first months of life.4 Vaccine-derived maternal antibodies have been identified in cord blood after COVID-19 vaccination during pregnancy, and a recent study found maternal vaccination to be associated with a 61% reduced risk of infant hospitalization for COVID-19.57 This study evaluated the association between maternal COVID-19 vaccination during pregnancy and incidence of infant SARS-CoV-2 infection during the first 4 months of life, as well as whether the association differed according to Delta variant and Omicron variant–dominated time periods.811

Methods

Study Population and Data Sources

All live births in Norway between September 1, 2021, and February 28, 2022, were identified in the Medical Birth Registry of Norway (Figure 1),12 which captures all pregnancies ending after completion of gestational week 12. Newborns were excluded if the mother or infant did not have a permanent national identification number, which was used to link information across registries.

All data used in this study were provided by the Emergency Preparedness Register for COVID-19 (Beredt C19),13 which is run by the Norwegian Institute of Public Health. This register was established in response to the COVID-19 pandemic in 2020 in accordance with the Health Preparedness Act §2-4 and contains daily updated data from the Norwegian health registries.

COVID-19 Vaccination During Pregnancy

The Norwegian Immunization Register14 contains registrations of all COVID-19 vaccinations, including dates of all doses and the type of vaccine product. Vaccine doses reported fewer than 20 days after the previous dose were not included. Women who received a second or third dose of a messenger RNA (mRNA) vaccine after gestational day 83 and up to 14 days before delivery were considered vaccinated. Infants born to women who received their third or fourth vaccine dose between 13 and 7 days before birth were excluded, as they would be censored before birth in the statistical analyses. We excluded infants born to women vaccinated outside Norway while pregnant and those vaccinated exclusively before pregnancy or who only received dose 1 during pregnancy because the maternal antibody level and possible transplacental transfer of antibodies for these scenarios are uncertain.1517

SARS-CoV-2 Infection

During the study period (September 1, 2021, to April 4, 2022), the date of testing and results of all SARS-CoV-2 polymerase chain reaction (PCR) tests were registered in the Norwegian Surveillance System for Communicable Diseases.18 We included the first positive PCR test for SARS-CoV-2 registered at least 1 day after birth and within 122 days after birth (4 months of age). Similarly, we identified women with a positive SARS-CoV-2 test 14 days or more before giving birth. In Norway, PCR tests were free of charge and widely available.

Covariates

From the Medical Birth Registry of Norway, we derived maternal age at conception (<24, 25-29, 30-34, 35-39, ≥40 years) and extracted information on parity (0, 1, or ≥2) and calendar week of birth. The registered gestational age in the birth registry was estimated from routine ultrasonography assessments or last menstrual period if there were no ultrasonography estimates. From the Population Registry of Norway, we obtained information on maternal country of birth (Scandinavian country [Norway, Denmark, and Sweden], or non-Scandinavian countries) and current county of residence (Oslo, Viken, or other Norwegian county). From Statistics Norway we obtained information on the highest maternal educational level as of 2019 (no higher education, higher education ≤4 years, >4 years of higher education, or missing).

Statistical Analysis

We calculated incidence rates of SARS-CoV-2 infection (number of infants with positive tests among all infants at risk at the day of testing) in infants within 4 months after birth by maternal vaccination status. We split the follow-up time on December 31, 2021, by introducing a variable with 2 categories that corresponded to the time before this date (proxy for the Delta-dominated period) and after this date (proxy for the Omicron-dominated period). Using a Cox proportional hazards model, we estimated hazard ratios (HRs) for infant SARS-CoV-2 infection using calendar time (in days) as the time axis. Infant follow-up began on the date of birth. Observations were censored at age 4 months, death or emigration, date of when a woman received a vaccine dose outside Norway, or on April 4, 2022, whichever came first. For women vaccinated at the end of pregnancy or after pregnancy, infants were censored 14 days after the vaccination date of dose 1 and 7 days after dose 3 or 4. This was done because maternal vaccination within the last 14 days of pregnancy could potentially provide an exclusive protective effect from antibody transfer through breastfeeding or cocooning (ie, immunizing primary caretakers).19,20

We assessed differences in the Delta and Omicron periods by using linear combinations of the coefficients for vaccination status and an interaction term between vaccination status and period. Multivariable analyses adjusted for maternal age at conception, parity, educational level, county of residence, and maternal country of birth.

Sensitivity Analyses

First, we excluded infants born to women who had a positive SARS-CoV-2 test more than 14 days before delivery, as women with a history of COVID-19 might be less likely to become vaccinated during pregnancy and could transfer anti–SARS-CoV-2 antibodies across the placenta.5 Second, in separate analyses, we restricted the sample to (1) term-born infants, (2) infants who had the opportunity to reach 42 completed gestational weeks by the end of the inclusion period to avoid oversampling preterm births, (3) infants born to Scandinavian-born women, (4) infants born to first-time mothers, and (5) infants born to women who only received mRNA vaccines for all doses. Third, to obtain more robust results for the Omicron-dominated period, we used an alternative follow-up period starting on January 15, 2022, as after this date the circulating virus was more certain to be Omicron. Finally, as testing and risk of infection may differ by infant age, we used infant age in days as the time axis, while adjusting for week of birth.

Secondary Analyses

Using the Norwegian Patient Registry,21 we explored the risk of infant hospitalization for COVID-19. All hospital admissions were registered with admission and discharge dates, as well as diagnostic codes, using the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10). We identified all infants with a hospitalization with the ICD-10 code U07.1 (COVID-19, virus identified) as the main diagnosis within the first 4 months of life and reported the crude proportions by maternal vaccination status.

To assess associations between maternal vaccination, even if not fully vaccinated, and incidence of a positive PCR test for SARS-CoV-2 among infants, we conducted a secondary analysis in which we compared the risk of a positive SARS-CoV-2 test in infants born to unvaccinated women with those with mothers who had received a first dose of an mRNA vaccine during the second or third trimester (these were excluded from the main analysis). Infants were censored 14 days after a woman received the second dose postpartum or during the last 14 days of pregnancy and 14 days after the first dose among the unvaccinated group. We compared the timing of vaccination in pregnancy in those who received only 1 dose in pregnancy with those who were fully vaccinated. Furthermore, we conducted a secondary analysis stratifying on whether the woman received COVID-19 vaccine dose number 2 or 3 during pregnancy.

To explore possible differences in the likelihood of being tested in infants among vaccinated and unvaccinated mothers, we assessed the proportions in each group that had at least 1 registered SARS-CoV-2 PCR test (positive or negative) before age 4 months. We calculated crude incidence rates for registration of a PCR test by maternal vaccination status. Again, infants were censored at time of death, emigration, or maternal receipt of a vaccine dose outside Norway. All analyses were conducted using Stata, version 16.0 SE (StataCorp).

Results

Of 21 643 newborns included in the study, 9739 (45%) were born to women who received a second or third dose of a COVID-19 mRNA vaccine during the last 2 trimesters of pregnancy (Table 1). Fewer than 5 women received a fourth dose in pregnancy. Compared with vaccinated mothers, unvaccinated mothers were younger, had higher parity and lower education, and fewer were born in Scandinavia. The proportion of infants born to a vaccinated mother increased during the study period (eFigure 1A in the Supplement). Most newborns with a positive SARS-CoV-2 test during the fall of 2021 were born to unvaccinated mothers (eFigure 1B in the Supplement), but an infant’s age at the time of a positive test was similar between the groups (eFigure 1C in the Supplement). The number of tested infants decreased by mid-February 2022 (eFigure 1D in the Supplement).

Incidence of SARS-CoV-2 in Infants

A total of 906 infants (4.1%) were registered with a positive PCR test for SARS-CoV-2 during the first 4 months of life. Infants born to vaccinated mothers had a lower incidence of SARS-CoV-2 (Figure 2). During the Delta-dominated period (before January 1, 2022), crude incidence rates for a positive test were 1.2 per 10 000 follow-up days among infants born to vaccinated mothers and 3.0 per 10 000 follow-up days among infants born to unvaccinated mothers. The corresponding adjusted HR (aHR) for the Delta-dominated period was 0.29 (95% CI, 0.19-0.44) (Table 2). During the Omicron-dominated period (starting on January 1, 2022), the crude incidence rates for a positive SARS-CoV-2 test were 7.0 per 10 000 follow-up days among infants born to vaccinated mothers and 10.9 per 10 000 follow-up days among infants born to unvaccinated mothers (aHR, 0.67; 95% CI, 0.57-0.79) (Table 2). We observed no violation of the proportional hazard assumption.

Sensitivity Analyses

Results were robust in sensitivity analyses, although estimates were attenuated when restricting to infants born to Scandinavian-born women (eTables 1-6 in the Supplement). The results for the Omicron-dominated period when restricted to January 15 and later were similar to the main analyses (eTable 7 in the Supplement). Using the infant age as the time scale attenuated the association slightly (eTable 8 and eFigure 2 in the Supplement).

Secondary Analyses

The proportion of infants hospitalized with COVID-19 as the main diagnosis before age 4 months or April 4, 2022, was 0.07% in both groups. The numbers were too low to perform formal comparative analyses by maternal vaccination status (Table 1).

In addition to the 21 463 infants in the main analysis, 2839 infants were born to women who only received 1 dose of an mRNA vaccine during the second or third trimester of pregnancy and at least 14 days before delivery. The timing of vaccine doses was differentially distributed by calendar time and time interval before birth between those who received only 1 vs a second or third dose in pregnancy (eFigures 3 and 4 in the Supplement), and the mean follow-up time was shorter. Among those born to women who received 1 dose of vaccine, 36 infants had a positive SARS-CoV-2 PCR test, including fewer than 5 during the Delta-dominated period. The aHR for a positive test in infants during the Omicron-dominated period born to women with 1 dose of vaccine compared with infants born to unvaccinated women was 0.72 (95% CI, 0.50-1.03) (eTable 9 in the Supplement).

Among 824 infants born to women who received their third vaccine dose during pregnancy, none had a positive SARS-CoV-2 test during the Delta-dominated period. The risk of a positive test was lower for the Omicron-dominated period for those with a third dose (aHR, 0.22; 95% CI, 0.12-0.43) compared with those with a second dose (aHR, 0.70; 95% CI, 0.59-0.83) (eTable 10 in the Supplement).

The proportion of infants who had at least 1 PCR test for SARS-CoV-2 during follow-up differed by maternal vaccination status: 2309 infants (19.4%) born to unvaccinated mothers and 1206 infants (12.4%) born to vaccinated mothers (Table 1). Corresponding incidence rates were 19.7 per 10 000 follow-up days among infants born to unvaccinated women and 15.1 per 10 000 follow-up days among infants born to vaccinated women.

Discussion

This cohort study of all live births in Norway between September 1, 2021, and February 28, 2022, found that COVID-19 vaccination during pregnancy was associated with a reduced risk of an infant receiving a positive PCR test for SARS-CoV-2 during the first 4 months of life. This association was present during periods dominated by the Delta and Omicron variants, although it was stronger in the former. Results were robust in sensitivity analyses, although the number of cases during the Delta-dominated period was low in some of the subgroups. The association was somewhat attenuated when restricted to infants born to Scandinavian-born women.

It is not unexpected that maternal COVID-19 vaccination during pregnancy could reduce infant risk of COVID-19, as similar protective benefits against infant infection have been documented for pertussis and influenza vaccination during pregnancy in randomized clinical trials and observational studies.2,3 Because the newborn’s immune system is naive, with limited antibody response during the first months of life, an important protection against infection comes from maternally transferred antibodies.2,3 Infants are at higher risk of severe COVID-19 compared with older children.1 As to our knowledge no COVID-19 vaccines are licensed for use in children younger than 5 years, an added benefit of maternal vaccination during pregnancy could be a protection of infants against SARS-CoV-2 infection during the first months of life.4

We observed a lower risk of infection among infants born to women who received their third dose in pregnancy compared with the second, suggesting a stronger level of protection following the booster dose. This aligns with studies showing a waning of vaccine effect after the second dose unless a booster is received.11 Infants born to women with only 1 mRNA vaccine dose received during pregnancy also had a lower risk of a positive SARS-CoV-2 test than those born to unvaccinated women, but results were not statistically significant.

Strengths and Limitations

The strengths of this study include the use of registry data covering the whole Norwegian population and many individuals vaccinated during pregnancy. Mandatory reporting to registries (including all COVID-19 vaccinations) limited potential selection bias and provided detailed information on clinical and sociodemographic variables. We believe our study results are generalizable to other pregnant populations. This assumption is strengthened by the fact that the findings align with the results from the US study examining maternal COVID-19 vaccination and risk of infant hospitalization for COVID-19.6

The limitations of this study included the lack of information on the infant’s test with a SARS-CoV-2 variant. However, there were distinct periods of dominance with the different variants in Norway during the study period, and we believe the defined periods capture risk with the different variants. The differences we observed in estimates for the Delta and Omicron-dominated periods support this, as the vaccines generally have been shown to be less effective against Omicron than Delta.8,11

Although we did not include vaccinations during the last 14 days of pregnancy or after pregnancy in the vaccinated group to allow for sufficient time of transplacental transfer of antibodies before birth,22 there could be a possible added effect of transfer of SARS-CoV-2 antibodies through breastmilk in these children,23,24 as more than 90% of infants in Norway are breastfed.25,26 We did not have individual-level information on breastfeeding and were unable to directly address whether this differed by maternal vaccination status.

We adjusted for potential confounders, which did not substantially affect the estimates. Still, there may be residual confounding because of healthy vaccinee bias27 or other unmeasured differences in characteristics between women who got vaccinated during pregnancy and those who did not.

The distribution of follow-up time in the vaccinated and unvaccinated groups varied across the 2 periods. We used calendar time as the underlying time scale in the analyses to ensure that comparisons were made on the same calendar days. This was important, as maternal vaccination status and risk of SARS-CoV-2 infection varied substantially over the study period. Although we did not have information on the number of household members or positive SARS-CoV-2 tests among them, we adjusted for maternal parity as a proxy.

We did not have information on disease symptoms in the infants. Thus, we could not assess the severity of the infections and whether this differed by maternal vaccination status. As the number of infants hospitalized for COVID-19 was low, we could not perform robust analyses to discern whether this differed by maternal vaccination status. We found that infants born to unvaccinated women were more likely to be tested for SARS-CoV-2, and this could be because of higher incidence of COVID-19 or a higher likelihood of symptomatic disease leading to testing. Although we cannot exclude differential test behavior according to maternal vaccination status, we believe it is unlikely. However, women who got vaccinated may have behaved differently (ie, taking more or fewer precautions to limit infant infection risk), which could have biased the estimates. Still, this is unlikely to account for all of the substantial reduction in risk that we observed.

Conclusions

In this nationwide registry-based cohort study, we found that infants born to women who received a second or third COVID-19 vaccine dose during the last 2 trimesters of pregnancy had a lower incidence of SARS-CoV-2 infection within the first 4 months of life compared with infants born to unvaccinated women. The reduction in infant infection risk was greater during the Delta-dominated period compared with the Omicron-dominated period. The findings of this study provide early evidence to suggest that infants benefit from passive protection from SARS-CoV-2 infection following maternal COVID-19 vaccination during pregnancy.

References

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7.Rottenstreich  A, Zarbiv  G, Oiknine-Djian  E,  et al.  Timing of SARS-CoV-2 vaccination during the third trimester of pregnancy and transplacental antibody transfer: a prospective cohort study.   Clin Microbiol Infect. 2022;28(3):419-425. doi:10.1016/j.cmi.2021.10.003PubMedGoogle ScholarCrossref

8.Ferdinands  JM, Rao  S, Dixon  BE,  et al.  Waning 2-dose and 3-dose effectiveness of mRNA vaccines against COVID-19–associated emergency department and urgent care encounters and hospitalizations among adults during periods of Delta and Omicron variant predominance—VISION Network, 10 states, August 2021-January 2022.   MMWR Morb Mortal Wkly Rep. 2022;71(7):255-263. doi:10.15585/mmwr.mm7107e2PubMedGoogle ScholarCrossref

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Adhikari  EH, MacDonald  L, SoRelle  JA, Morse  J, Pruszynski  J, Spong  CY.  COVID-19 cases and disease severity in pregnancy and neonatal positivity associated with Delta (B.1.617.2) and Omicron (B.1.1.529) variant predominance.   JAMA. 2022;327(15):1500-1502. doi:10.1001/jama.2022.4356
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11.Andrews  N, Stowe  J, Kirsebom  F,  et al.  Covid-19 vaccine effectiveness against the Omicron (B.1.1.529) variant.   N Engl J Med. 2022;386(16):1532-1546. doi:10.1056/NEJMoa2119451PubMedGoogle ScholarCrossref

12.Norwegian Institute of Public Health. Medical Birth Registry of Norway. Accessed February 16, 2022. https://www.fhi.no/en/hn/health-registries/medical-birth-registry-of-norway/medical-birth-registry-of-norway/

13.Norwegian Institute of Public Health. Emergency preparedness register for COVID-19 (Beredt C19). Accessed February 16, 2022. https://www.fhi.no/en/id/infectious-diseases/coronavirus/emergency-preparedness-register-for-covid-19/

14.Trogstad  L, Ung  G, Hagerup-Jenssen  M, Cappelen  I, Haugen  IL, Feiring  B.  The Norwegian immunisation register–SYSVAK.   Euro Surveill. 2012;17(16):17. doi:10.2807/ese.17.16.20147-enPubMedGoogle ScholarCrossref

15.Hall  V, Foulkes  S, Insalata  F,  et al; SIREN Study Group.  Protection against SARS-CoV-2 after Covid-19 vaccination and previous infection.   N Engl J Med. 2022;386(13):1207-1220. doi:10.1056/NEJMoa2118691PubMedGoogle ScholarCrossref

16.Maertens  K, Tran  TMP, Hens  N, Van Damme  P, Leuridan  E.  Effect of prepregnancy pertussis vaccination in young infants.   J Infect Dis. 2017;215(12):1855-1861. doi:10.1093/infdis/jix176PubMedGoogle ScholarCrossref

17.Rottenstreich  A, Zarbiv  G, Oiknine-Djian  E,  et al.  The effect of gestational age at BNT162b2 mRNA vaccination on maternal and neonatal SARS-CoV-2 antibody levels.   Clin Infect Dis. 2022;ciac135. doi:10.1093/cid/ciac135PubMedGoogle ScholarCrossref

18.Norwegian Institute of Public Health. Norwegian Surveillance System for Communicable Diseases (MSIS). Accessed February 16, 2022. https://www.fhi.no/en/hn/health-registries/msis/

19.Carcione  D, Regan  AK, Tracey  L,  et al.  The impact of parental postpartum pertussis vaccination on infection in infants: a population-based study of cocooning in Western Australia.   Vaccine. 2015;33(42):5654-5661. doi:10.1016/j.vaccine.2015.08.066PubMedGoogle ScholarCrossref

20.Quinn  HE, Snelling  TL, Habig  A, Chiu  C, Spokes  PJ, McIntyre  PB.  Parental Tdap boosters and infant pertussis: a case-control study.   Pediatrics. 2014;134(4):713-720. doi:10.1542/peds.2014-1105PubMedGoogle ScholarCrossref

21.Bakken  IJ, Ariansen  AMS, Knudsen  GP, Johansen  KI, Vollset  SE.  The Norwegian Patient Registry and the Norwegian Registry for Primary Health Care: research potential of two nationwide health-care registries.   Scand J Public Health. 2020;48(1):49-55. doi:10.1177/1403494819859737PubMedGoogle ScholarCrossref

22.Abu-Raya  B, Maertens  K, Edwards  KM,  et al.  Global perspectives on immunization during pregnancy and priorities for future research and development: an international consensus statement.   Front Immunol. 2020;11:1282. doi:10.3389/fimmu.2020.01282PubMedGoogle ScholarCrossref

23.Gray  KJ, Bordt  EA, Atyeo  C,  et al.  Coronavirus disease 2019 vaccine response in pregnant and lactating women: a cohort study.   Am J Obstet Gynecol. 2021;225(3):303.e1-303.e17, e17. doi:10.1016/j.ajog.2021.03.023PubMedGoogle ScholarCrossref

24.Perl  SH, Uzan-Yulzari  A, Klainer  H,  et al.  SARS-CoV-2–specific antibodies in breast milk after COVID-19 vaccination of breastfeeding women.   JAMA. 2021;325(19):2013-2014. doi:10.1001/jama.2021.5782
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25.Revheim  I, Balthasar  MR, Akerkar  RR,  et al.  Trends in the prevalence of breastfeeding up to 6 months of age using structured data from routine child healthcare visits.   Acta Paediatr. 2022. doi:10.1111/apa.16367PubMedGoogle ScholarCrossref

26Lande  B, Helleve  A. Breastfeeding and infants’ diet. Accessed April 22, 2022. https://www.helsedirektoratet.no/rapporter/amming-og-spedbarns-kosthold-landsomfattende-undersokelse-2013/Amming%20og%20spedbarns%20kosthold%20%E2%80%93%20landsomfattende%20unders%C3%B8kelse%202013.pdf/_/attachment/inline/008eea77-7b4f-4f7b-a6bb-7013b8817af1:da769ba163df13ab13b3d5afc64510c87b32c0f7/Amming%20og%20spedbarns%20kosthold%20%E2%80%93%20landsomfattende%20unders%C3%B8kelse%202013.pdf#:~:text=De%20fleste%20(95%20%25)%20spedbarna,35%20%25%20ved%2012%20m%C3%A5neders%20alder

27.Savitz  DA, Fell  DB, Ortiz  JR, Bhat  N.  Does influenza vaccination improve pregnancy outcome? methodological issues and research needs.   Vaccine. 2015;33(47):6430-6435. doi:10.1016/j.vaccine.2015.08.041PubMedGoogle ScholarCrossref

Dr. Robert Malone: ‘Rotten to the Core’ FDA Knew COVID Vaccines Could Spur Viral Reactivation, But Said Nothing

Authors:  Debra Heine May 17, 2022

American Greatness

The Food and Drug Administration (FDA) was aware early on that the COVID vaccines could spur viral reactivation of diseases like the varicella-zoster virus (shingles) in some people, but chose not to disclose it, according to renowned vaccinologist and physician Dr. Robert Malone.

“They knew about the viral reactivation,” Malone declared during a recent panel discussion hosted by Del Bigtree with fellow Global COVID Summit physicians Dr. Ryan Cole, and Dr. Richard Urso.

Malone, the original inventor of mRNA and DNA vaccination technology, explained that he had been “very actively engaged” with senior personnel at the FDA in the Office of the Commissioner when the vaccines were being rolled out. The group, he noted, included Dr. William DuMouchel, the Chief Statistical Scientist for Oracle Health Sciences.

“We were talking by Zoom on a weekly or twice a week basis,” he said, regarding the early data on what risks were associated with vaccines.

“This is the group that first discovered the signal of the cardiotoxicity, the doctor continued. “They also knew at that time—one of them actually had the adverse event early on of shingles. They knew that the viral reactivation signal—which the CDC has never acknowledged—was one of the major known adverse events.”

Malone told the panel that it was a mistake to assume that the CDC and FDA—because they stayed silent—were unaware of the risk of viral reactivation associated with the vaccines.

“They absolutely did know, and they did not acknowledge it. It’s another one of those things that is inexplicable,” he said.

Malone pointed out that there are supposed to be strict rules in place for clinical researchers developing “these types of products.”

“You have to characterize where it goes, how long it sticks around, and how much protein it makes, or what the active drug product is. None of that stuff was done very well. It wasn’t done rigorously, and there was a series of misrepresentations about what the data were,” he said. “And the thing is, the FDA let them get away with it. They did not perform their function. They’re supposed to be independent gatekeepers.”

Normally, he pointed out, the FDA pays close attention to the the process, and if there are any red flags, the research is halted.

“What happened here is the regulatory bodies gave the pharmaceutical industry a pass,” Dr. Malone said, adding that Big Pharma also “misrepresented key facts about their product.”

“On the basis of that, average docs just assumed that this was something that it wasn’t. They assumed that this was a relatively benign product that didn’t stick around in the body. All of that is false,” he said.

“Many of us have been wracking our brains as you have to understand how this could possibly happen, why it’s possibly happening, and why is our regulatory apparatus, which we as physicians had all come to assume had a function that actually did the job that we could believe in and trust, and what we find out now is the whole house of cards is rotten to the core,” Malone concluded.

On May 11, the Global COVID Summit, a symposium of 17,000 other physicians and medical scientists from around the world, released its fourth declaration demanding that the state of medical emergency be lifted, scientific integrity restored, and crimes against humanity addressed.

COVID policies imposed over the past two years “are the culmination of a corrupt medical alliance of pharmaceutical, insurance, and healthcare institutions, along with the financial trusts which control them,” the signatories declare. “They have infiltrated our medical system at every level, and are protected and supported by a parallel alliance of big tech, media, academics and government agencies who profited from this orchestrated catastrophe.”

This “corrupt alliance” continues, they state,  “to advance unscientific claims by censoring data, and intimidating and firing doctors and scientists for simply publishing actual clinical results or treating their patients with proven, life-saving medicine.”

“These catastrophic decisions came at the expense of the innocent, who are forced to suffer health damage and death caused by intentionally withholding critical and time-sensitive treatments, or as a result of coerced genetic therapy injections, which are neither safe nor effective,” the signatories said.

The Centers for Disease Control and Prevention (CDC) on Friday released new data showing a total of 1,261,149 reports of adverse events following COVID-19 vaccines that were submitted between Dec. 14, 2020, and May 6, 2022, to the Vaccine Adverse Event Reporting System (VAERS).

According to the data, there was a total of 27,968 reports of deaths in that time frame, and 228,477 serious injuries.

Despite these alarming safety signals, the FDA on Tuesday approved of a booster dose of the Pfizer-BioNTech COVID-19 shot for children 5 through 11 years of age, even though research shows that the shots provide no benefit to children, and can, in fact, cause serious adverse effects and death.

Latest CDC Data Shows FULLY Vaccinated Children Have Higher Covid Infection Rates Than Unvaccinated Children

Authors:  Julian Conradson Published May 18, 2022  The Gateway Pundit

As the Biden Administration green-lights another experimental jab of mRNA for 5-11-year-olds, the latest CDC data reveals children of that age have a higher Covid infection rate than their unvaccinated peers. In other words, kids who are jabbed are more likely to catch Covid, which also means the vaccinated are spreading the virus more than the unvaccinated.

So, these kids must take their boosters… Must be that dang science again.

According to the latest CDC data, children aged 5-11 have been contracting Covid at a higher rate if they have been fully vaccinated since February, which is the first time the agency recorded more vaccinated Covid cases than unvaccinated.

On Feb. 12, the CDC reported a weekly case rate among fully vaccinated children aged 5-11 of 250.02 per 100,000, compared to 245.82 among the unvaccinated children in the same age group.

Although the vaccines were billed as and promised to be ‘effective,’ they definitely aren’t living up to being anything close to it. Since February, the infection rate among vaccinated children remained higher through the third week of March, which is the latest available data published – and things are trending in the wrong direction.

As of March, the difference in the case rates has nearly doubled, with the most recent numbers showing a -11 gap (36.23 per 100,000 [vaxxed] / 26.98 per 100,000[unvaxxed]).

The breakdown of the case rate for 5-11-year-olds between Feb. and Mar. is as follows:

February 19: 136.61 per 100,000 [vaxxed] / 120.63 per 100,000[unvaxxed]

February 26: 71.81 per 100,000 [vaxxed] / 61.52 per 100,000[unvaxxed]

March 5: 56.67 per 100,000 [vaxxed] / 40.61 per 100,000[unvaxxed]

March 12: 42.56 per 100,000 [vaxxed] / 28.75 per 100,000[unvaxxed]

March 19: 36.23 per 100,000 [vaxxed] / 26.98 per 100,000[unvaxxed]

The Biden Administration and the FDA authorized the experimental vaccine for children in this age group in November of 2021. In just three short months, enough children had become vaccinated and the case rate flipped. Any protection the jab provided quickly wore off, making the fully vaccinated children more susceptible to and more likely to spread the virus than the unvaccinated.

In all, there are over 28 million children aged 5-11 in the United States. Unfortunately, a whopping ~8 million of them (or 28.8%) have been fully vaccinated already, according to the Mayo Clinic. Not only is the virus proven to be effectively non-lethal for children, especially ones of this young age (99.995% or higher recovery rate), but the experimental vaccine has proven to have negative effectiveness – aka higher infection rate – across multiple age groups.

In addition to the poor results, the mRNA vaccine has been directly linked to serious and life-threatening side effects that have become prevalent in the wake of its rollout. Most concerningly of which – myocarditis – is popping up at an unprecedented rate in otherwise healthy children and young people all across the world. According to heart experts like Dr. Peter McCullough, who is the most published Cardiologist in the world, “an extraordinary number of young individuals that are going to have permanent heart damage” because of this experimental jab. 

Keep in mind, Fauci, Biden, and the rest of the tyrannical public health bureaucracy just Ok’d boosters for 5-11-year-olds. Considering everything that’s publicly available, let alone what the federal government has compiled, this is beyond criminal. How much more data is needed to pull these shots off the market?

Japan reports first case of mysterious children’s liver disease as health experts explore possible Covid links

Authors: Karen Gilchrist PUBLISHED TUE, APR 26 2022 CNBC

KEY POINTS

  • Japan has detected its first probable case of a mysterious liver disease that has so far affected over 170 children, largely in Britain.
  • Health experts are exploring its possible links to Covid-19 or a common virus known as adenovirus.
  • Of those infected, one child has died and 17 have required liver transplants.

Japan has detected its first probable case of a mysterious liver disease that has so far affected over 170 children, largely in Britain, as health experts explore its possible links to Covid-19.

Japan’s Health Ministry said Tuesday that a child had been hospitalized with an unidentified type of severe acute hepatitis — or liver inflammation — in what is thought to be the first reported case in Asia.

As of April 23, at least 169 cases of the disease have been detected in 11 countries globally, according to the World Health Organization. The vast majority of those have been in the U.K. (114), followed by Spain (13), Israel (12) and the U.S. (9). The addition of Japan marks the 12th country to identify a case.

Of those infected, one child has died and 17 have required liver transplants.

The WHO said it is “very likely more cases will be detected before the cause can be confirmed.”

Health experts explore Covid links

Children aged five years old or younger have so far been the most widely affected by the disease, though cases have been detected in children aged one month to 16 years.

Common symptoms including gastroenteritis — diarrhea and nausea — followed by jaundice or yellowing of the skin and eyes.

Health experts are now investigating the likely cause of the outbreak, which was first reported in the U.K. in January 2022, and whether it bears any connection to the coronavirus.

Specifically, they are exploring if a lack of prior exposure to common viruses known as adenoviruses during coronavirus restrictions, or a previous infection with Covid-19, may be related. Alternatively, the genetic make-up of hepatitis may have mutated, resulting in an easier triggering of liver inflammation.

Crucially, experts say there is no known link to the Covid-19 vaccine.

A strain of adenovirus called F41 is so far looking like the most probable cause, according to the U.K. Health Security Agency.

“Information gathered through our investigations increasingly suggests that this rise in sudden onset hepatitis in children is linked to adenovirus infection. However, we are thoroughly investigating other potential causes,” Meera Chand, UKHSA’s director of clinical and emerging infections, said.

Adenovirus was the most common pathogen detected in 40 of 53 (75%) of confirmed cases tested in the U.K. Globally, that number was 74.

Covid (SARS-CoV-2) was identified in 20 cases of those tested globally. Adenovirus and Covid-19 co-infection was detected in 19 cases.

The new case from Japan tested negative for adenovirus and the coronavirus, though officials have not revealed other details.

What are the symptoms and how worried should we be?

Typically, children gain exposure — and immunity — to adenoviruses and other common illnesses during their early childhood years. However, pandemic restrictions largely limited that early exposure, leading to more serious immune responses in some.

Adenoviruses, which present cold-like symptoms such as fever and sore throat, are generally mild. However, some strains can display liver tropism, or a favoring of liver tissue, which can lead to more serious consequences like liver damage.

Just how serious this latest outbreak will be is not yet clear and will depend largely on how much it spreads over the coming months, according Dr. Amy Edwards, an assistant professor of pediatrics at the Case Western Reserve School of Medicine.

“Adenovirus is a ubiquitous virus and it’s not seasonal. If this is a more severe form of adenovirus that causes liver disease in children, that’s very concerning. But right now it’s isolated enough and few enough cases not to jump to conclusions,” she told CNBC.

Edwards said health authorities had been placed on alert and would be monitoring the situation.

In the meantime, parents and guardians should be alert to common signs of hepatitis, including jaundice, dark urine, itchy skin and stomach pain, and contact a health care professional if they are concerned.

“Normal hygiene measures such as thorough handwashing (including supervising children) and good thorough respiratory hygiene, help to reduce the spread of many common infections, including adenovirus,” UKHSA’s Chand said.

“Children experiencing symptoms of a gastrointestinal infection including vomiting and diarrhea should stay at home and not return to school or nursery until 48 hours after the symptoms have stopped,” she added.

Children get long Covid, too, and it can show up in unexpected ways

Authors: Jen Christensen, Fri May 6, 2022 CNN

November 10 is a day Kim Ford remembers too well. It was the day last year when her 9-year-old son, Jack, was scheduled to get his Covid-19 vaccine at the school clinic. They were excited that he’d finally have some protection, but on November 9, he had the sniffles. “When he woke up [November 10] and he was feeling even worse, I said, ‘You know what, let’s test you before you go in, because I don’t want you to get the Covid vaccine if you actually have Covid,’ ” the Michigan mom said.

Jack tested positive for Covid-19 that day and he’s lived with the symptoms ever since. it has kept him from staying at school all day. He has to limit how much he plays baseball with the other neighborhood kids. Even playing Fortnite for too long can leave him feeling sick the next day.

He’s one of potentially millions of kids with long Covid.

“My stomach hurts. It’s kind of hard to breathe. You have a stuffy nose. It’s just an absurd amount of things that you can feel,” Jack Ford said. “It’s really annoying at times. It’s not like a cold, you know, it feels like Covid.”People may think you’re feeling faking it, but you’re not faking it. You feel like you have Covid,” he added.

‘An undiagnosed issue’

It’s not clear how many children go on to develop long Covid, because there’s not enough research on it in this age group, some experts say.

Almost 13 million children have tested positive for Covid-19 since the start of the pandemic, according to the American Academy of PediatricsStudies suggest that between 2% and 10% of those children will develop long Covid, but the number may be larger. Many parents may not know their child has long Covid, or the child’s pediatrician hasn’t recognized it as such. In adults, some research puts the number around 30% of cases .”I personally believe that this is a very much an undiagnosed issue,” said Dr. Sara Kristen Sexson Tejtel, who helps lead a long Covid pediatric clinic at Texas Children’s Hospital in Houston. Many doctors treating children at long Covid clinics across the country say they have long waits for appointments. Some are booked through September.

An unusual range of symptoms

There are no specific tests for long Covid. It’s not clear which children will have it, as it can happen even when a child has a mild case of Covid-19.

“It’s startling how many of these children present and have a range of symptoms that we haven’t fully appreciated. Some are coming in with heart failure after asymptomatic Covid infections,” said Dr. Jeffrey Kahn, chief of the Division of Pediatric Infectious Disease at UT Southwestern Medical Center in Dallas. “What’s striking to me is that it usually occurs about four weeks after infection, and infection can be really asymptomatic, which is really startling. “Even when kids with long Covid are tested for ailments that might cause these symptoms, it’s possible nothing will show up.”The tested me, and it looked like nothing was wrong with me, but they tried their best to find something,” Jack Ford said. His pulmonary function test and EKG came back normal. “The Covid clinic said this is very common in kids with long Covid. Sometimes, all the tests come back normal,” Kim Ford said.

Dr. Amy Edwards, who runs the pediatric long Covid clinic at UH Rainbow Babies & Children’s Hospital in Cleveland, agreed that it happens a lot. “We also scoped them, and their GI tracts are normal. I do a big immune workup, and their immune system appears normal. Everything ‘looks normal,’ but the kids aren’t functioning like normal,” Edwards said. “I tell the families, ‘you have to remember, there are limits to what medical science understands and can test for.’ Sometimes, we’re just not smart enough to know where to look for it. Adults’ problems tend to be more obvious, Edwards said, because they are more likely to have organ dysfunction that shows up on tests. Doctors are still trying to understand why long Covid happens this way in children. They are also figuring out what symptoms define long Covid in children. Some studies in adults show a range of 200 symptoms, but there is no universal clinical case definition.

Public health leaders hope stories about long Covid will motivate more young people to get vaccinatedAt Sexson Tejte’s clinic in Texas, children tend to fall into a few categories. Some have fatigue, brain fog and severe headaches, “to the point where the some kids aren’t able to go to school, grades are failing, those types of issues,” she said.Another group has cardiac issues like heart palpitations, chest pains and dizziness, especially when they go back to their regular activities.Another group has stomach problems. A lot of these kids also have a change in their sense of taste and smell.Sexson Tejte said it isn’t totally different from the symptoms adults have, “but it’s not the mixed bag of different organ system involvement with adults.”

‘Once that bucket is empty, that’s it’

One of Jack Ford’s symptoms affects the amount of energy he has for typical activities.

“Long Covid patients have post-exertional malaise, which is Jack’s biggest issue,” Kim Ford said. “So if he overdoes it — and it doesn’t even have to be physically overdoing it. It could be he was really upset about something the day before, or he could be really mentally engaged with something like watching TV or playing video games sitting in his chair — will knock him out. “Energy has become such a problem that Jack can’t go to school for a full day. His parents started him back with one to two hours a day and have gradually increased it to about 5½ hours a day. “We’ve been trying to bump him up to six, but it hasn’t worked so far,” Kim Ford said. “He’s woken up pretty miserable the next day. “Edwards, who runs the long Covid clinic in Cleveland, says she has to talk to parents about carefully balancing how much energy their children expend. Most healthy people can push through if they’re tired, but those with long Covid can’t. “It’s like they have one bucket of energy, and it has to be used carefully for school, for play, to watch TV. Every single thing they do takes energy, and once that bucket is empty, that’s it,” Edwards said.

‘I barely function some days’: Covid ‘long haulers’ struggle to work amid labor of her teen patients are exhausted just dealing with typical drama at school. “Long-haulers have to think about every single aspect of their day and when they can expend that energy. They have to have that balance. Otherwise, they run out. “Many also have anxiety. Some of that may stem from the ailment itself or from the doubt they’ve heard from doctors or adults when they say they don’t feel well. Experts across the country say they’ve heard from patients whose complaints are ignored, even after a stark change in their health. They’ve been told that they are being dramatic or seeking attention, or that the symptoms are all in their head.

I don’t want to be too critical, but there are some doctors out there who just dismiss it outright,” said Dr. Alexandra Yonts, director of the post-Covid clinic at Children’s National in Washington. “The kids then just struggle. They get passed around from place to place.”Yonts thinks there needs to be better acknowledgment among doctors that long Covid can be a real problem .”I’ve got two kids in wheelchairs after having had Covid who were never in wheelchairs before. There’s one kid on crutches. I’ve got a kid who lost the use of her hands,” Edward said. “These kids should be believed.”

Help is available, but not all have access

There’s no specific treatment for long Covid, but most of these clinics are multi-disciplinary. Interactive: The things Covid victims left behind At Edwards’ clinic, which opened last year, experts can address pulmonary issues, digestive problems, physical rehabilitation, sleep issues, mental health problems and others. There’s a nutritionist on staff, as well as an acupuncturist and a pediatrician who is licensed in Chinese herbal medicine. In addition to working up a child’s schedule so they can determine where to spend their energy and when to take breaks, Edwards’ clinic teaches kids to meditate. They do massage therapy and mind-body exercises. “Children need multiple elements of help. They get significantly better, really they do, if we’re aggressive and they get intensive wraparound support and therapy,” Edwards said. But not all children are able to get into a clinic. “I’ve talked to so many people working with pediatric Covid recovery, and they all say the same thing: ‘We are worried about the kids who aren’t getting the help, who don’t have the parents who can advocate for them or navigate the medical system.’ It keeps me up at night,” Edwards said.

A lot of what her clinic does is to encourage kids to get enough sleep and to eat healthy food, but not all families can afford healthy food.”It terrifies me for those families in particular, because they’re already starting behind. And now they have kids with Covid long-haul,” Edwards said. “You just have to hope more people will become aware of the problem and try to help.”