Sulaiman, F; Hamid, E; Muhajarine, N; Dalidowicz, M; Miller, L. How has COVID-19 and the public health response to COVID-19 impacted mental health outcomes on children 5 to 18 years (school-age)? 2021 Jun 09, Document no.: PH021701 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2021. (CEST table).
Cohort studies identified worsening mental health outcomes, including depression, anxiety, scores on the Strengths and Difficulties Questionnaire (SDQ), and other subjective mental health measures.
Cross-sectional studies reported post-pandemic prevalence rates of 7%-44% for depression, 6%-47.5% for anxiety, and 3%-22% for PTSD. Worsening sleep quality and increased frequency of substance use were also reported. Effects on self-harm and suicidality are inconclusive.
Risk factors for worsening mental health included identifying as female, older age or higher school grade, and increased use of technology or social media. Exercise was found to be protective.
Sulaiman, F; Hamid, E; Muhajarine, N; Dalidowicz, M; Miller, L. How has COVID-19 and the public health response to COVID-19 impacted mental health outcomes on children 5 to 18 years (school-age)? 2021 Jun 09, Document no.: PH021701 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2021. 18 p. (CEST rapid review report).
Dalidowicz, M; Miller, L. How has COVID-19 and the public health response to COVID-19 impacted mental health outcomes on children 5 to 18 years (school-age)? 2021 May 20, Document no.: PH021701v2 ESR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2021. 114 p. (CEST rapid review report).
Pediatric cases of COVID-19 constitute between 1% to 10% of all confirmed cases of COVID-19; variation exists by jurisdiction.
Few case reports exist of confirmed child-to-other transmission. Contact tracing studies suggest that children are unlikely to be transmitters of the disease. Households are the most likely environments for transmission.
A recent large South Korean contact tracing study however (in pre-print) found that household COVID-19 transmission rates for children age 10-19 were significantly higher than in adults; transmission rates for children age 0-9 were relatively low.
AUGUST 7th, 2020 UPDATE: No new studies examining secondary attack rates of pediatric index cases were found. Studies continue to suggest low transmission from pediatric cases, and high proportion of pediatric cases being asymptomatic to mildly symptomatic.
MARCH 9th, 2021 UPDATE: Variants of Concerns are an emerging threat, but literature on pediatric prevalence and transmissibility is sparse. The British variant seems more transmissible (secondary attack rate higher) but follows the same age-related distribution of cases seen earlier in the pandemic.
Sulaiman, F; Coomaran, V; Muhajarine, N; Dalidowicz, M; Miller, L. What are the effects of the new COVID variants on transmission and school reopenings in pediatric populations? 2021 Mar 30; Document no.: PH030801 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 14p. (CEST rapid review report)
Howell-Spooner, B., Mueller, M. What are the effects of the new COVID variants on transmission and school reopenings in pediatric populations? 2021 Aug 18, Document no.: PH030801v2 ESR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2021. 49 p. (CEST evidence search report).
Howell-Spooner, B; Dalidowicz, M. What are the ethical principles that underlie pediatric triage protocols? 2020 Jul 2; Document no.: CAC061802-01 ESR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 24 p. (CEST evidence search report)
· Key principles for the development of triage scoring systems are 1. Urgency 2. Survival 3. Likelihood of rapid benefit
· Triage algorithms should be transparent and accessible, developed by teams with multiple perspectives/expertise
· When all factors are equal, allocation should proceed by random/lottery assignment
· Must balance egalitarian and utilitarian ideologies – providing equitable access while also providing the greatest benefit to the greatest number of people
Howell-Spooner, B; Dalidowicz, M. What are the pediatric triage protocols implemented during the COVID-19 pandemic, other pandemics, or in other resource-scarce situations? 2020 Jul 2; Document no.: CAC061801-01 ESR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 23 p. (CEST evidence search report)
There are currently no validated pediatric triaging scored for COVID
Several US states have pandemic plans, and some pediatric specific for triage and scarce resource allocation
A number of pandemic plans include the use of PELOD-2 either in isolation or in combination with a mortality prognosis (survival > 1 year, death within 5 years despite successful treatment, death within 1 year despite successful treatment for ICU triage
While some states do not have pediatric-specific triage criteria, they do list young age as a prioritization category
Several sources discuss the ethics of scarce resource allocation and pediatric hospitals
Most recommend using a prioritization scale to save the most lives with the least resources vs. “first come, first serve” methods
Badea, A; Groot, G; Howell-Spooner, B; Dalidowicz, M. What are the pediatric triage protocols implemented during the COVID-19 pandemic, other pandemics, or in other resource-scarce situations? 2020 Jul 13; Document no.: CAC061801 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 23 p. (CEST rapid review report)
· Children and adolescents (0 to 18 years) contributed 1- 10% of laboratory confirmed cases of COVID-19 globally.
· Children have been reported to have milder symptoms of COVID-19 and have shown better prognosis as compared to adults.
· Severe cases presenting as a multisystem inflammatory syndrome in children (MIS-C) has been reported in some pediatric cases of COVID-19. Many of these children meet the criteria for complete or incomplete Kawasaki disease, but different clinical presentations of this inflammatory disorder are being reported.
· Underlying medical conditions and comorbidities such as such as sickle cell disease, immunocompromised condition, obesity, cancer, cardiovascular disease, and asthma have been associated with severity and complications from COVID-19 infection in pediatric patients.
· Although rare, death from COVID-19 in children have been reported, with a case fatality rate of less than 0.5%.
Asamoah, G; Muhajarine, N; Dalidowicz, M; Ellsworth, C; Howell-Spooner, B. What is the disease progression and epidemiology of COVID-19 in pediatric populations? 2020 Jul 27; Document no.: EOC072102 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 17 p. (CEST rapid review report)
