SPECIAL FEATURE :: DIAGNOSTIC UPDATES


potential treatments for long COVID, which affects the health and wellbeing of millions of Americans. Researchers examined data from 9,764 adults, including 8,646 who had COVID-19 and 1,118 who did not have COVID-19. They assessed more than 30 symptoms across multiple body areas and organs and applied statistical analyses that identified 12 symptoms that most set apart those with and without long COVID: post-exertional malaise, fatigue, brain fog, dizziness, gastrointestinal symptoms, heart palpitations, issues with sexual desire or capacity, loss of smell or taste, thirst, chronic cough, chest pain, and abnormal movements. They then established a scoring system based on patient-re- ported symptoms. By assigning points to each of the 12 symp- toms, the team gave each patient a score based on symptom combinations. With these scores in hand, researchers identified a meaningful threshold for identifying participants with long COVID. They also found that certain symptoms occurred to- gether and defined four subgroups or “clusters” with a range of impacts on health.


Based on a subset of 2,231 patients in this analysis who had a first COVID-19 infection on or after Dec. 1, 2021, when the Omicron variant was circulating, about 10% experienced long- term symptoms or long COVID after six months. The results are based on a survey of a highly diverse set of patients and are not final. Survey results will next be compared for accuracy against an array of lab tests and imaging. The researchers explain studying the underlying biological


mechanisms of long COVID is central to advancing informed interventions and identifying effective treatment strategies. In addition to establishing the scoring system, the researchers


found that participants who were unvaccinated or who had COVID-19 before the Omicron strain emerged in 2021 were more likely to have long COVID and more severe cases of long COVID. Further, reinfections were also linked to higher long COVID frequency and severity, compared to people who only had COVID-19 once.3


NIH funds eight studies to advance rapid diagnosis of COVID-19–related inflammatory syndrome in children The National Institutes of Health has awarded eight re- search grants to refine new technologies for early diagnosis of severe illnesses resulting from SARS-CoV-2 infection in children. The new awards follow grants issued in 2020 to foster methods for diagnosing children at high risk for Multisystem Inflammatory Syndrome in Children (MIS-C), a rare, severe and sometimes fatal after-effect of SARS-CoV-2 infection or exposure in children. The awards are from NIH’s Predicting Viral-Associated Inflam- matory Disease Severity in Children with Laboratory Diagnostics and Artificial Intelligence (PreVAIL kIds) initiative. They are part of the Rapid Acceleration of Diagnostics Radical (RADx- rad) program to support new, non-traditional approaches and reimagined uses of existing tools to address gaps in COVID-19 testing and surveillance. Although some children develop mild or no symptoms from


COVID-19, others will develop more severe effects, including MIS-C, which results in inflammation of one or more organs, including the heart, lungs, kidneys, brain, skin, eyes and gas- trointestinal tract. The 2020 awards supported studies involving more than 7,400 research participants in four countries and yielded pro- totype methods and techniques for potential use in clinics, emergency departments and for hospital inpatients. These PreVAIL kIds studies were supported through NIH’s RADx-rad


initiative and were part of an NIH collaborative research effort called CARING for Children with COVID. Results from these studies include a laboratory technique for detecting specific immune cells associated with MIS-C; databases that help diagnose children at risk for MIS-C and severe COVID-19, based on certain blood proteins and genetic biomarkers; and a database that can distinguish between MIS-C, Kawasaki disease (which has similar symptoms) and fever-causing viral and bacterial infections. The new awards will allow researchers to continue their efforts to develop ways to rapidly diagnose MIS-C and identify those at risk for serious and long-term effects of SARS-CoV-2. Earlier identification of those most at risk will allow for earlier interventions to prevent severe health effects.


Awardees • Jane C. Burns, University of California, San Diego Diagnosing and predicting risk in children with SARS- CoV-2-related illness


• Cedric Manlhiot, Johns Hopkins University, Baltimore Data science approach to MIS-C identification and man- agement associated with SARS


• Ananth V. Annapragada, Baylor College of Medicine, Houston-AICORE-kids: Artificial intelligence COVID-19 risk assessment for kids


• Audrey R. Odom John, Children’s Hospital of Philadelphia Diagnosis of MIS-C in febrile children


• Usha Sethuraman, Central Michigan University, Mount Pleasant Severity predictors integrating salivary transcrip- tomics and proteomics with multineural network intelli- gence in SARS-CoV2 infection in children


• Juan C. Salazar, Connecticut Children’s Medical Center, Hartford Identifying biomarker signatures of prognostic value for MIS-C


• Charles Yen Chiu, University of California, San Francisco Discovery and clinical validation of host biomarkers of disease severity and MIS-C with COVID-19


• Lawrence Kleinman, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey COVID-19 network of networks expanding clinical and translational approaches to predict severe illness in children4


REFERENCES


1. FDA launches pilot program to help reduce risks associated with using laboratory developed tests to identify cancer biomarkers. U.S. Food and Drug Administration. Published June 20, 2023. Accessed June 23, 2023. https://www.fda.gov/news-events/press-announcements/fda-launch- es-pilot-program-help-reduce-risks-associated-using-laboratory-devel- oped-tests-identify.


2. FDA finalizes move to recommend individual risk assessment to determine eligibility for blood donations. U.S. Food and Drug Administration. Published May 11, 2023. Accessed June 23, 2023. https://www.fda.gov/news-events/ press-announcements/fda-finalizes-move-recommend-individual-risk-as- sessment-determine-eligibility-blood-donations.


3. Large study provides scientists with deeper insight into long COVID symptoms. National Institutes of Health (NIH). Published May 25, 2023. Accessed June 23, 2023. https://www.nih.gov/news-events/news-releases/ large-study-provides-scientists-deeper-insight-into-long-covid-symptoms.


4. NIH funds eight studies to advance rapid diagnosis of COVID-19-related inflammatory syndrome in children. National Institutes of Health (NIH). Published January 9, 2023. Accessed June 23, 2023. https://www.nih.gov/ news-events/news-releases/nih-funds-eight-studies-advance-rapid-diag- nosis-covid-19-related-inflammatory-syndrome-children.


www.clr-online.com • MLO • CLR 2023-2024 5


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40