THE CHALLENGING AND UNPREDICTABLE SPECTRUM OF COVID-19 IN CHILDREN AND ADOLESCENTS
Why this work is in the frame
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Bibliographic record
Abstract
A novel coronavirus, named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerged in China in the end of 2019 and after less than 6 months its related disease (COVID-19) has already affected more than 6 million individuals in almost all countries worldwide.COVID-19 was declared a pandemic by the World Health Organization on March 11, 2020, becoming one of the most challenging and concerning public health crisis faced by this generation. [1][2]][3][4] A striking feature of COVID-19 pandemic is that children and adolescents seem to be less frequently infected by SARS-CoV-2 comparing to adults.Preliminary evidence also shows that, unlike influenza or respiratory syncytial virus, children do not play a critical role in SARS-CoV-2 transmission in the community. 5Furthermore, although most infected children and adolescents are asymptomatic or present mild symptoms, recent unexpected data showing the emergence of a late-onset severe inflammatory syndrome temporally associated with SARS-CoV-2 highlights the importance of continued surveillance around the world. 6ata from laboratory-confirmed COVID-19 cases in Asia, Europe and North America, by age groups, showed that the prevalence of children and adolescents in these case series ranged from 1.0 to 1.7%.The clinical spectrum of pediatric COVID-19 is wide, ranging from asymptomatic to critically ill cases.Fever and cough were consistently the most common reported symptoms in these case series, although less frequently than in adults, followed by pharyngeal erythema, shortness of breath, rhinorrhea, nausea, abdominal pain, vomiting and diarrhea.Additional symptoms reported included myalgia, tiredness, headache, anosmia and ageusia.More recently, variable cutaneous manifestations have been described in pediatric populations with COVID-19, including erythematous rashes, urticaria, vesicular and chilblain-like lesions. 7eucopenia, lymphopenia and increased inflammatory markers (erythrocyte sedimentation rate, C-reactive protein or procalcitonin) were the most frequently reported laboratorial findings in children and adolescents with COVID-19.Although data is limited comparing to adults, lymphopenia, high levels of C-reactive protein, procalcitonin, D-dimer and creatine kinase muscle and brain (MB) biomarkers were laboratorial findings associated with more severe disease. [1][2]][3][4][5][6][7] Clinical course of COVID-19 in children and adolescents uncommonly resulted in life-threatening illness with severe outcomes.In the largest reported case series from USA, with information on hospitalization status, approximately 20% of the children and adolescents were hospitalized and 2% of them were admitted in Pediatric Intensive Care Units (PICU).Importantly, infants aged <1 year represented the age group with the highest percentage of hospitalization among COVID-19 pediatric patients.Less than 1% of children and adolescents had severe COVID-19 with acute respiratory distress syndrome or multiorgan failure. 8 recent study reporting the outcomes of children and adolescents with COVID-19 admitted to USA and Canadian PICU showed severe disease is less frequent, and early outcomes in children hospitalized are far better comparing to adults.Interestingly, among 46 children and adolescents (median age 13 years) admitted to the PICU, 40 (83%) were found to have chronic underlying health conditions, 18 (38%) of them required invasive ventilatory support and only 2 (4.2%) died.9
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it