Long-term outcomes of pediatric infections: from traditional infectious diseases to long covid

: There is limited evidence available on the long-term impact of SARS-CoV-2 infection in children. In this article, the authors analyze the recent evidence on pediatric long covid and lessons learnt from a pediatric post-covid unit in Rome, Italy. To gain a better understanding of the concerns raised by parents and physicians in relation to the potential long-term consequences of this novel infection, it is important to recognize that long-term effect of a post-infectious disease is not a new phenomenon

Self-assembly of catecholic moiety-containing cationic random acrylic copolymers

Amphiphilic polyelectrolytes (APEs), exhibiting particular self-association properties in aqueous media, can be used in different industrial applications, including drug delivery systems. Their typical core shell structure (micelle) depends on the balance of interactions between hydrophobic and ionizable monomer units. In this work, the structure of amphiphilic cationic random copolymers, obtained by employing different molar ratios of two acrylic monomers, one bearing in the side chain a tertiary amine (N,N-diethylethylendiamine, DED) and the other one a hydrophobic catecholic group (hydroxytyrosol, HTy), was investigated by atomistic molecular dynamics (MD) simulation, H-1 NMR analysis, dynamic light scattering (DLS), and zeta potential measurements. The structures of p(AcDED-co-AcHTy) copolymers were compared with that of the cationic homopolymer (pAcDED). MD simulation showed a chain folding in water solution of all polymer materials consistent with the degree of hydrophobicity of the chain, that increases with the number of aromatic residues. This phenomenon was induced by the interaction between the charged amine groups with water and by the associated attraction between aromatic rings inside the molecule. In addition, the p(AcDED-co-AcHTy) 70/30 copolymer had a marked tendency to self-assemble as shown by the radial distribution function among catechol carbon atoms. Electrical conductivity measurements evidenced a micellar arragment for all of the synthesized copolymers, and specially for p(AcDED-co-AcHTy) 70/30, a flower micelle structure seem to be more likely. The stacking interactions among catecholic groups present in the side chain of the copolymers reduced the size and charge density specially for the p(AcDED-co-AcHTy) 70/30 copolymer. Finally, the good antimicrobial activity of all copolymers confirmed the right reached amphiphilic balance. Indeed, a considerable reduction of the minimum inhibitory concentration (from 100 mu g/mL to 40 mu g/mL for pAcDED and p(AcDED-co-AcHTy) 70/30, respectively) was obtained by introducing a hydrophobic group molar fraction of 0.3

Post-COVID Condition in Adults and Children Living in the Same Household in Italy: A Prospective Cohort Study Using the ISARIC Global Follow-Up Protocol

Background: Emerging evidence shows that both adults and children may develop post-acute sequelae of SARS-CoV-2 infection (PASC). The aim of this study is to characterise and compare long-term post-SARS-CoV-2 infection outcomes in adults and children in a defined region in Italy. Methods: A prospective cohort study including children (≤18 years old) with PCR-confirmed SARS-CoV-2 infection and their household members. Participants were assessed via telephone and face-to-face visits up to 12 months post-SARS-CoV-2 diagnosis of household index case, using the ISARIC COVID-19 follow-up survey. Results: Of 507 participants from 201 households, 56.4% (286/507) were children, 43.6% (221/507) adults. SARS-CoV-2 positivity was 87% (249/286) in children, and 78% (172/221) in adults. The mean age of PCR positive children was 10.4 (SD = 4.5) and of PCR positive adults was 44.5 years (SD = 9.5), similar to the PCR negative control groups [children 10.5 years (SD = 3.24), adults 42.3 years (SD = 9.06)]. Median follow-up post-SARS-CoV-2 diagnosis was 77 days (IQR 47-169). A significantly higher proportion of adults compared to children reported at least one persistent symptom (67%, 68/101 vs. 32%, 57/179, p < 0.001) at the first follow up. Adults had more frequently coexistence of several symptom categories at both follow-up time-points. Female gender was identified as a risk factor for PASC in adults (p 0.02 at 1-3 months and p 0.01 at 6-9 months follow up), but not in children. We found no significant correlation between adults and children symptoms. In the paediatric group, there was a significant difference in persisting symptoms between those with confirmed SARS-CoV-2 infection compared to controls at 1-3 months follow up, but not at 6-9 months. Conversely, positive adults had a higher frequency of persisting symptoms at both follow-up assessments. Conclusion: Our data highlights that children can experience persistent multisystemic symptoms months after diagnosis of mild acute SARS-CoV-2 infection, although less frequently and less severely than co-habitant adults. There was no correlation between symptoms experienced by adults and children living in the same household. Our data highlights an urgent need for studies to characterise PASC in whole populations and the wider impact on familie