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Enregistrement W4323652878 · doi:10.1001/jamanetworkopen.2023.2328

Comparison of Symptoms Associated With SARS-CoV-2 Variants Among Children in Canada

2023· article· en· W4323652878 sur OpenAlexafffundabout
Madeleine W. Sumner, Jianling Xie, Roger Zemek, Kathleen Winston, Gabrielle Freire, Brett Burstein, April Kam, Jason G. Emsley, Jocelyn Gravel, Robert Porter, Vikram Sabhaney, Ahmed Mater, Marina I. Salvadori, Simon Berthelot, Darcy Beer, Naveen Poonai, Anne Moffatt, Bruce Wright, Stephen B. Freedman, Samina Ali, Mandi Newton, Waleed Alqurashi, Melissa Lorenzo, Tyrus Crawford, Becky Emerton

Notice bibliographique

RevueJAMA Network Open · 2023
Typearticle
Langueen
DomaineMedicine
ThématiqueCOVID-19 Clinical Research Studies
Établissements canadiensResearch CanadaStollery Children's HospitalKingston Health Sciences CentreQueen's UniversityChildren's Hospital of Eastern OntarioUniversity of ManitobaChildren's Hospital of WinnipegQueen Elizabeth II Health Sciences CentreUniversity of SaskatchewanChildren's Hospital Research Institute of ManitobaBC Children's HospitalUniversity of British ColumbiaUniversity of AlbertaJaneway Children's Health and Rehabilitation CentreCentre Hospitalier Universitaire Sainte-JustineUniversity of OttawaDalhousie UniversityMcGill University Health CentreMcMaster Children's HospitalPublic Health Agency of CanadaLondon Health Sciences CentreMcGill UniversityHospital for Sick ChildrenWestern UniversityUniversity of TorontoMontreal Children's HospitalUniversité de MontréalSickKids FoundationUniversity of Calgary
Organismes subventionnairesCanadian Institutes of Health ResearchPublic Health Agency of CanadaChildren's Hospital FoundationAlberta Children's Hospital FoundationPublic Health AgencyUniversity of Ottawa
Mots-clésMedicineEmergency departmentOdds ratioSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2)PediatricsCohortCoronavirus disease 2019 (COVID-19)Cohort studyInternal medicineDisease

Résumé

récupéré en direct d'OpenAlex

Importance: Clinical manifestations of SARS-CoV-2 variants have not been systematically compared in children. Objective: To compare symptoms, emergency department (ED) chest radiography, treatments, and outcomes among children with different SARS-CoV-2 variants. Design, Setting, and Participants: This multicenter cohort study was performed at 14 Canadian pediatric EDs. Participants included children and adolescents younger than 18 years (hereinafter referred to as children) tested for SARS-CoV-2 infection in an ED between August 4, 2020, and February 22, 2022, with 14 days of follow-up. Exposure(s): SARS-CoV-2 variants detected on a specimen collected from the nasopharynx, nares, or throat. Main Outcomes and Measures: The primary outcome was presence and number of presenting symptoms. The secondary outcomes were presence of core COVID-19 symptoms, chest radiography findings, treatments, and 14-day outcomes. Results: Among 7272 participants presenting to an ED, 1440 (19.8%) had test results positive for SARS-CoV-2 infection. Of these, 801 (55.6%) were boys, with a median age of 2.0 (IQR, 0.6-7.0) years. Children with the Alpha variant reported the fewest core COVID-19 symptoms (195 of 237 [82.3%]), which were most often reported by participants with Omicron variant infection (434 of 468 [92.7%]; difference, 10.5% [95% CI, 5.1%-15.9%]). In a multivariable model with the original type as the referent, the Omicron and Delta variants were associated with fever (odds ratios [ORs], 2.00 [95% CI, 1.43-2.80] and 1.93 [95% CI, 1.33-2.78], respectively) and cough (ORs, 1.42 [95% CI, 1.06-1.91] and 1.57 [95% CI, 1.13-2.17], respectively). Upper respiratory tract symptoms were associated with Delta infection (OR, 1.96 [95% CI, 1.38-2.79]); lower respiratory tract and systemic symptoms were associated with Omicron variant infection (ORs, 1.42 [95% CI, 1.04-1.92] and 1.77 [95% CI, 1.24-2.52], respectively). Children with Omicron infection most often had chest radiography performed and received treatments; compared with those who had Delta infection, they were more likely to have chest radiography performed (difference, 9.7% [95% CI, 4.7%-14.8%]), to receive intravenous fluids (difference, 5.6% [95% CI, 1.0%-10.2%]) and corticosteroids (difference, 7.9% [95% CI, 3.2%-12.7%]), and to have an ED revisit (difference, 8.8% [95% CI, 3.5%-14.1%]). The proportions of children admitted to the hospital and intensive care unit did not differ between variants. Conclusions and Relevance: The findings of this cohort study of SARS-CoV-2 variants suggest that the Omicron and Delta variants were more strongly associated with fever and cough than the original-type virus and the Alpha variant. Children with Omicron variant infection were more likely to report lower respiratory tract symptoms and systemic manifestations, undergo chest radiography, and receive interventions. No differences were found in undesirable outcomes (ie, hospitalization, intensive care unit admission) across variants.

Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.

Comment cette classification a été obtenuedéplier

Prédiction distillée sur la base complète

Imitation des enseignants

Ni prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.

score de la tête « metaresearch » (Codex)0,001
score de la tête « metaresearch » (Gemma)0,007
Version: codex-gemma-dda1882f352aStatut de validation: machine_predicted_unvalidated
Catégories candidatesaucune
Catégories consensuellesaucune
DomaineSignal candidat: aucune · Signal consensuel: aucune
Devis d'étudeSignal candidat: Observationnel · Signal consensuel: Observationnel
GenreSignal candidat: Empirique · Signal consensuel: Empirique
Score de désaccord entre enseignants0,099
Score d'incertitude au seuil0,806

Scores Codex et Gemma par catégorie

CatégorieCodexGemma
Métarecherche0,0010,007
Méta-épidémiologie (sens strict)0,0000,000
Méta-épidémiologie (sens large)0,0010,000
Bibliométrie0,0000,002
Études des sciences et des technologies0,0000,000
Communication savante0,0000,000
Science ouverte0,0000,001
Intégrité de la recherche0,0000,000
Charge utile insuffisante (le modèle a refusé de juger)0,0000,000

Scores machine (provisoires)

Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.

Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.

Tête enseignante Opus0,062
Tête enseignante GPT0,414
Écart entre enseignants0,352 · la distance entre les deux têtes enseignantes sur ce seul travail
Statut de validationscore_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découle

Classification

machine, non validée

Prédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.

Les modèles n’ont appliqué aucune catégorie : rien dans la taxonomie ne correspondait à ce travail.
Devis d'étudeObservationnel
Domainenon disponible
GenreEmpirique

Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».

En bref

Citations38
Publié2023
Routes d'admission3
Résumé présentoui

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