Return to School and COVID-19 Vaccination for Pediatric Solid Organ Transplant Recipients in the United States: Expert Opinion for 2021-2022.

2021

2021 Nov 03

2048-7207

<p>The COVID-19 pandemic continues to generate challenges for pediatric solid organ transplant (SOT) recipients and their families. As rates of COVID-19 fluctuate, new SARS-CoV-2 variants emerge, and adherence to and implementation of mitigation strategies vary from community to community, questions remain about the best and safest practices to prevent COVID-19 in vulnerable patients. Notably, decisions about returning to school remain difficult. We assembled a team of specialists in pediatric infectious diseases, transplant infectious diseases, public health, transplant psychology, and infection prevention and control to re-address concerns about school re-entry, as well as COVID-19 vaccines, for pediatric SOT recipients in the United States in 2021. Based on available literature and guidance from national organizations, we generated expert statements specific to pediatric SOT recipients focused on school attendance in 2021.</p>

10.1093/jpids/piab098

J Pediatric Infect Dis Soc

34734268

Return to School for Pediatric Solid Organ Transplant Recipients in the United States During the COVID-19 Pandemic: Expert Opinion on Key Considerations and Best Practices.

2020

2020 Aug 04

2048-7207

<p>The COVID-19 pandemic has created many challenges for pediatric solid organ transplant (SOT) recipients and their families. As the pandemic persists, patients and their families struggle to identify the best and safest practices for resuming activities as areas re-open. In particular, decisions about returning to school remain difficult. We assembled a team of pediatric infectious diseases, transplant infectious diseases, public health, transplant psychology, and infection prevention and control specialists to address the primary concerns about school re-entry for pediatric SOT recipients in the United States. Based on available literature and guidance from national organizations, we generated consensus statements pertaining to school re-entry specific to pediatric SOT recipients. Although data are limited, and the COVID-19 pandemic highly dynamic, our goal was to create a framework from which providers and caregivers can identify the most important considerations for each pediatric SOT recipient to promote a safe return to school this fall.</p>

10.1093/jpids/piaa095

J Pediatric Infect Dis Soc

32750142

A Prospective, International Cohort Study of Invasive Mold Infections in Children.

2015

313-22

2015 Dec

2048-7207

<p><strong>BACKGROUND: </strong>Invasive mold infections (IMIs) are a leading cause of mortality in immunocompromised children, yet there has never been an international epidemiologic investigation of pediatric IMIs.</p>

<p><strong>METHODS: </strong>This international, prospective cohort study was performed to characterize the epidemiology, antifungal therapy, and outcomes of pediatric IMIs. Children (≤18 years) with proven or probable IMIs were enrolled between August 2007 and May 2011 at 22 sites. Risk factors, underlying diagnoses, and treatments were recorded. Outcomes were assessed at 12 weeks after diagnosis using European Organization for Research and Treatment of Cancer/Mycoses Study Group response criteria.</p>

<p><strong>RESULTS: </strong>One hundred thirty-one pediatric patients with IMIs were enrolled; the most common IMI was invasive aspergillosis ([IA] 75%). Children with IA and those with other types of IMIs had similar underlying risk factors, except that children with IMIs caused by non-Aspergillus species were more likely to have received mold-active antifungal agents preceding diagnosis. The most commonly used antifungal classes after diagnosis were triazoles (82%) and polyenes (63%). Combination therapy was used in 53% of patients. Use of combination therapy was associated with an increased risk of adverse events (risk ratio, 1.98; 95% confidence interval, 1.06-3.68; P = .031), although there was no detectable difference in outcome.</p>

<p><strong>CONCLUSIONS: </strong>Although risk factors for IMIs are similar across specific subtypes, preceding antifungal therapy may be an important modifier. Combination antifungal therapy requires further study to determine its true risks and benefits.</p>

10.1093/jpids/piu074

J Pediatric Infect Dis Soc

26582870