Pulmonary Dysfunction after Pediatric COVID-19

  1. Rafael Heiss
  2. Lina Tan
  3. Sandy Schmidt
  4. Adrian P. Regensburger
  5. Franziska Ewert
  6. Dilbar Mammadova
  7. Adrian Buehler
  8. Jens Vogel-Claussen
  9. Andreas Voskrebenzev
  10. Manfred Rauh
  11. Oliver Rompel
  12. Armin M. Nagel
  13. Simon Lévy
  14. Sebastian Bickelhaupt
  15. Matthias S. May
  16. Michael Uder
  17. Markus Metzler
  18. Regina Trollmann
  19. Joachim Woelfle
  20. Alexandra L. Wagner
  21. Ferdinand Knieling

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Abstract

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  1. Version published to 10.1148/radiol.221250
  2. ScreenIT

    SciScore for 10.1101/2022.02.21.22270909: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Ethicsnot detected.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    BlindingThe evaluating radiologist was blinded to clinical features for all analyses.
    Power Analysisnot detected.

    Table 2: Resources

    Antibodies
    SentencesResources
    In the healthy control group, children required a negative medical history, post-hoc negative serological antibody status, and no prior immunization against SARS-CoV-2.
    SARS-CoV-2
    suggested: None
    A blood sample was collected to assess blood count, interleukin 6 (IL-6), C-reactive protein (CrP) and antibodies against SARS-CoV-2 (spike protein and nucleocapsid antibodies, electrochemiluminescence immunoassay (ECLIA) Elecsys® Anti-SARS-Cov-2 S and Anti-SARS-CoV2, Roche, Switzerland); for details see Methods section in Supplementary Appendix).
    blood count, interleukin 6 (IL-6)
    suggested: None
    C-reactive protein (CrP)
    suggested: None
    antibodies against SARS-CoV-2 (spike protein and nucleocapsid antibodies, electrochemiluminescence immunoassay (ECLIA) Elecsys® Anti-SARS-Cov-2 S and Anti-SARS-CoV2, Roche, Switzerland)
    suggested: None
    antibodies against SARS-CoV-2 (spike protein
    suggested: None
    Anti-SARS-CoV2
    suggested: None
    Software and Algorithms
    SentencesResources
    Morphologic lung imaging: For morphological lung assessment, a coronal and transversal Turbo-Spin-Echo (TSE) sequence with BLADE (periodically rotated overlapping parallel lines with enhanced reconstruction) readout and respiration-gating were acquired.
    BLADE
    suggested: (BLADE, RRID:SCR_009132)
    Prism 9, version 9.3.1 (GraphPad Software, California, USA) was used for all statistical analyses.
    GraphPad
    suggested: (GraphPad Prism, RRID:SCR_002798)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Herein damaged lung gas exchange function34 and capillary diffusion limitation35 have been demonstrated. While using contrast agents might be less feasible in pediatric patients, results of 129Xe MRI in adults tie up with the findings of this first LF-MRI study in children and adolescents. In contrast to the consensus to date, assuming less severe Covid-19 infections and sequelae in younger patients, our study demonstrates widespread functional lung alterations are present in children and adolescents. This expands the understanding of pediatric post-acute Covid-19 disease, with the relevance of our findings even increasing as SARS-CoV-2 incidence is rising in most countries.36 Pathophysiology of acute and post-acute pathology of Covid-19 partly originates from direct endothelial damage, local inflammation and prothrombotic milieu.14,37-39 A proposed mechanism is the ACE2-mediated entry of SARS-CoV-2, which allows the virus to directly invade endothelial cells.14,40 This may explain manifestations such as pulmonary microangiopathy and widespread capillary microthrombi seen in autopsies from patients who died from Covid-1914 and fibrotic-like consolidations found in computed tomography.33 Previously described13 persisting signs of inflammatory processes could not be confirmed in our study. Putting into context, that children develop a robust, cross-reactive and sustained immune response after SARS-CoV-2 infection41, the observed pulmonary dysfunction in our study is an unexpect...

    Results from TrialIdentifier: We found the following clinical trial numbers in your paper:

    IdentifierStatusTitle
    NCT04990531RecruitingLow-field Magnetic Resonance Imaging of Pediatric COVID-19

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2022.02.21.22270909v1 on medRxiv