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1. Paediatric inflammatory multisystem syndrome in Canada: population-based surveillance and role of SARS-CoV-2 linkage

Author

El Tal, Tala, Morin, Marie-Paule, Morris, Shaun K., Farrar, Daniel S., Berard, Roberta A., Kakkar, Fatima, Moore Hepburn, Charlotte, Baerg, Krista, Beaufils, Camille, Bennett, Terri-Lyn, Benseler, Susanne M., Beaudoin-Bussières, Guillaume, Chan, Kevin, Cyr, Claude, Dahdah, Nagib, Donner, Elizabeth J., Drouin, Olivier, Edjoc, Rojiemiahd, Eljaouhari, Maryem, Embree, Joanne E., Farrell, Catherine, Finzi, Andrés, Forgie, Sarah, Giroux, Ryan, Kang, Kristopher T., King, Melanie, Laffin Thibodeau, Melanie, Lang, Bianca, Laxer, Ronald M., Luu, Thuy Mai, McCrindle, Brian W., Orkin, Julia, Papenburg, Jesse, Pound, Catherine M., Price, Victoria E., Proulx-Gauthier, Jean-Philippe, Purewal, Rupeena, Sadarangani, Manish, Salvadori, Marina I., Thibeault, Roseline, Top, Karina A., Viel-Thériault, Isabelle, Haddad, Elie, Scuccimarri, Rosie, and Yeung, Rae S. M.

Published
2023
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6. Risk factors for severe COVID-19 in hospitalized children in Canada: A national prospective study from March 2020–May 2021

Author

Farrar, Daniel S., Drouin, Olivier, Moore Hepburn, Charlotte, Baerg, Krista, Chan, Kevin, Cyr, Claude, Donner, Elizabeth J., Embree, Joanne E., Farrell, Catherine, Forgie, Sarah, Giroux, Ryan, Kang, Kristopher T., King, Melanie, Laffin Thibodeau, Melanie, Orkin, Julia, Ouldali, Naïm, Papenburg, Jesse, Pound, Catherine M., Price, Victoria E., Proulx-Gauthier, Jean-Philippe, Purewal, Rupeena, Ricci, Christina, Sadarangani, Manish, Salvadori, Marina I., Thibeault, Roseline, Top, Karina A., Viel-Thériault, Isabelle, Kakkar, Fatima, and Morris, Shaun K.

Published
2022
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13. Viral Dynamics of the SARS-CoV-2 Omicron Variant in Pediatric Patients: A Prospective Cohort Study.

Author

Science, Michelle, Orkin, Julia, Maguire, Bryan, Bitnun, Ari, Bourns, Laura, Corbeil, Antoine, Johnstone, Jennie, Macdonald, Liane, Schwartz, Kevin L, Barrett, Cindy Bruce, Reinprecht, Jessica, Heisey, Alice, Nasso, Stephanie, Jüni, Peter, and Campigotto, Aaron

Subjects
*VIRAL load, *VIRAL physiology, *POLYMERASE chain reaction, *COVID-19 testing, *DESCRIPTIVE statistics, *PEDIATRICS, *LONGITUDINAL method, *COVID-19, *PROPORTIONAL hazards models
Abstract

Background There are limited data on the viral dynamics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in children. Understanding viral load changes over the course of illness and duration of viral shedding may provide insight into transmission dynamics to inform public health and infection-control decisions. Methods We conducted a prospective cohort study of children aged 18 years and younger with polymerase chain reaction–confirmed SARS-CoV-2 between 1 February 2022 and 14 March 2022. SARS-CoV-2 testing occurred on daily samples for 10 days; a subset of participants completed daily rapid antigen tests (RATs). Viral RNA trajectories were described in relation to symptom onset and resolution. The associations between both time since symptom onset/resolution and non-infectious viral load were evaluated using a Cox proportional hazards model. Results Among 101 children aged 2 to 17 years, the median time to study-defined non-infectious viral load was 5 days post–symptom onset, with 75% meeting this threshold by 7 days and 90% by 10 days. On the day of and day after symptom resolution, 43 (49%) and 52 (60%) of 87 had met the non-infectious thresholds, respectively. Of the 50 participants completing a RAT, positivity at symptom onset and on the day after symptom onset was 67% (16/24) and 75% (14/20). On the first day where the non-infectious threshold was met, 61% (n = 27/44) of participant RAT results were positive. Conclusions Children often met the study-defined non-infectiousness threshold on the day after symptom resolution. The RATs were often negative early in the course of illness and should not be relied on to exclude infection. Clinical Trials Registration. clinicaltrials.org; NCT05240183. [ABSTRACT FROM AUTHOR]

Published
2024
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14. Viral Dynamics of the SARS-CoV-2 Omicron Variant in Pediatric Patients: A Prospective Cohort Study

Author

Science, Michelle, primary, Orkin, Julia, additional, Maguire, Bryan, additional, Bitnun, Ari, additional, Bourns, Laura, additional, Corbeil, Antoine, additional, Johnstone, Jennie, additional, Macdonald, Liane, additional, Schwartz, Kevin L, additional, Bruce Barrett, Cindy, additional, Reinprecht, Jessica, additional, Heisey, Alice, additional, Nasso, Stephanie, additional, Jüni, Peter, additional, and Campigotto, Aaron, additional

Published
2023
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15. Caracteristiques des hospitalisations au Canada d'enfants ayant contracte une infection aigue par le SRAS-CoV-2 en 2020

Author

Drouin, Olivier, Hepburn, Charlotte Moore, Farrar, Daniel S., Baerg, Krista, Chan, Kevin, Cyr, Claude, Donner, Elizabeth J., Embree, Joanne E., Farrell, Catherine, Forgie, Sarah, Giroux, Ryan, Kang, Kristopher T., King, Melanie, Laffin, Melanie, Luu, Thuy Mai, Orkin, Julia, Papenburg, Jesse, Pound, Catherine M., Price, Victoria E., Purewal, Rupeena, Sadarangani, Manish, Salvadori, Marina I., Top, Karina A., Viel-Theriault, Isabelle, Kakkar, Fatima, and Morris, Shaun K.

Subjects
Infection, Health
Abstract

Contexte : Les facteurs de risque de complications graves de l'infection par le SRAS-CoV-2 n'ont pas ete bien etablis chez les enfants. Nous avons voulu decrire les hospitalisations pediatriques associees au SRAS-CoV-2 au Canada et identifier les facteurs de risque de maladie grave. Methodes : Nous avons procede a une etude prospective nationale en utilisant l'infrastructure du Programme canadien de surveillance pediatrique (PCSP). Les hospitalisations d'enfants ayant contracte une infection par le SRAS-CoV-2 confirmee en laboratoire de microbiologie ont ete rapportees du 8 avril au 31 decembre 2020 au moyen de questionnaires hebdomadaires en ligne distribues au reseau du PCSP, qui compte plus de 2800 pediatres. Nous avons categorise les hospitalisations comme suit : liees a la COVID-19, infections decouvertes fortuitement, ou hospitalisations pour des raisons sociales ou de controle des infections, et degage les facteurs de risque associes a la gravite de la maladie chez les patients hospitalises. Resultats : Sur les 264 hospitalisations d'enfants ayant contracte le SRAS-CoV-2 au cours de la periode de l'etude de 9 mois, 150 (56,8 %) ont ete associees a la COVID-19 et 100 (37,9 %o) etaient des cas decouverts fortuitement (admission pour d'autres raisons et decouverte fortuite du SRAS-CoV-2 par depistage positif). Les nourrissons (37,3 %) et les adolescents (29,6 %) representaient la majorite des cas. Parmi les hospitalisations liees a la COVID-19, 52 patients (34,7 %) etaient atteints d'une forme grave de la mala die, dont 42 (28,0 % des cas lies a la COVID-19) ont eu besoin d'une forme d'assistance respiratoire ou hemodynamique, et 59 (39,3 %o) presentaient au moins 1 comorbidite sous-jacente. Les enfants atteints d'obesite, de maladies neurologiques chroniques ou de maladies pulmonaires chroniques, a l'exclusion de l'asthme, etaient plus susceptibles de presenter une forme grave ou critique de la COVID-19. Interpretation : Parmi les enfants hospitalises au Canada chez lesquels on a diagnostique une infection par le SRAS-CoV-2 au debut de la pandemie de COVID-19, la decouverte fortuite du SRAS-CoV-2 a ete frequente. Chez les enfants hospitalises pour une COVID-19 aigue, l'obesite et les comorbidites neurologiques et respiratoires ont ete associees a une gravite accrue., En date du 31 decembre 2020, le Canada comptait 581 427 cas confirmes d'infection par le SRAS-CoV-2 (1). Comme dans d'autres pays, la plupart des infections confirmees ont ete diagnostiquees [...]

Published
2021
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16. Infection Prevention and Control Considerations for Schools during the 2022-2023 Academic Year

Author

Science, Michelle, primary, Thampi, Nisha, additional, Bitnun, Ari, additional, Born, Karen B., additional, Blackman, Nicole, additional, Cohen, Eyal, additional, Cohn, Ronald D., additional, Dubey, Vinita, additional, Gallagher-Mackay, Kelly, additional, Khan, Sarah, additional, Kim, JinHee, additional, Korczak, Daphne, additional, Leifso, Kirk, additional, MacDonald, Liane M., additional, McCready, Janine, additional, Morris, Andrew M., additional, Orkin, Julia, additional, Perkhun, Anna, additional, Pollitt, Krystal, additional, Razak, Fahad, additional, Samson, Lindy, additional, Schwartz, Brian, additional, Siegel, Jeffrey A., additional, Wakegijig, Annelind, additional, and Allen, Upton, additional

Published
2022
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17. Characteristics of children admitted to hospital with acute SARS-CoV-2 infection in Canada in 2020

Author

Drouin, Olivier, Hepburn, Charlotte Moore, Farrar, Daniel S., Baerg, Krista, Chan, Kevin, Cyr, Claude, Donner, Elizabeth J., Embree, Joanne E., Farrell, Catherine, Forgie, Sarah, Giroux, Ryan, Kang, Kristopher T., King, Melanie, Laffin, Melanie, Luu, Thuy Mai, Orkin, Julia, Papenburg, Jesse, Pound, Catherine M., Price, Victoria E., Purewal, Rupeena, Sadarangani, Manish, Salvadori, Marina I., Top, Karina A., Viel-Theriault, Isabelle, Kakkar, Fatima, and Morris, Shaun K.

Subjects
Children -- Diseases, Pediatric research -- 2020 AD, Hospital patients -- Statistics -- Demographic aspects -- 2020 AD, Health
Abstract

Background: Risk factors for severe outcomes of SARS-CoV-2 infection are not well established in children. We sought to describe pediatric hospital admissions associated with SARS-CoV-2 infection in Canada and identify risk factors for more severe disease. Methods: We conducted a national prospective study using the infrastructure of the Canadian Paediatric Surveillance Program (CPSP). Cases involving children who were admitted to hospital with microbiologically confirmed SARS-CoV-2 infection were reported from Apr. 8 to Dec. 31 2020, through weekly online questionnaires distributed to the CPSP network of more than 2800 pediatricians. We categorized hospital admissions as related to COVID-19, incidental, or for social or infection control reasons and determined risk factors for disease severity in hospital. Results: Among 264 hospital admissions involving children with SARS-CoV-2 infection during the 9-month study period, 150 (56.8%) admissions were related to COVID-19 and 100 (37.9%) were incidental infections (admissions for other reasons and found to be positive for SARS-CoV-2 on screening). Infants (37.3%) and adolescents (29.6%) represented most cases. Among hospital admissions related to COVID-19, 52 (34.7%) had critical disease, 42 (28.0%) of whom required any form of respiratory or hemodynamic support, and 59 (39.3%) had at least 1 underlying comorbidity. Children with obesity, chronic neurologic conditions or chronic lung disease other than asthma were more likely to have severe or critical COVID-19. Interpretation: Among children who were admitted to hospital with SARS-CoV-2 infection in Canada during the early COVID-19 pandemic period, incidental SARS-CoV-2 infection was common. In children admitted with acute COVID-19, obesity and neurologic and respiratory comorbidities were associated with more severe disease., As of Dec. 31, 2020, Canada had 581427 confirmed cases of SARS-CoV-2 infection. (1) Similar to other countries, most confirmed infections were in adults, in part because of initial testing [...]

Published
2021
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18. Severe Acute Hepatitis in Children of Unknown Etiology

Author

Ng, Vicky, primary, Science, Michelle, additional, Feld, Jordan, additional, Shah, Hemant, additional, Bitnun, Ari, additional, Bourns, Laura, additional, Campigotto, Aaron, additional, Cohen, Eyal, additional, Gubbay, Jonathan, additional, Jimenez-Rivera, Carolina, additional, Orkin, Julia, additional, Razak, Fahad, additional, Saunders, Andrea, additional, Sayed, Blayne, additional, Salvadori, Marina, additional, Yaffe, Barbara, additional, Zygmunt, Austin, additional, and Allen, Upton, additional

Published
2022
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23. Caregivers’ Experiences With a Web- and Mobile-Based Platform for Children With Medical Complexity and the Role of a Live Platform Coach: Thematic Analysis

Author

Shouldice, Ainslie Claire, primary, Beatty, Madison, additional, Adams, Sherri, additional, Dharmaraj, Blossom, additional, Moore, Clara, additional, Stinson, Jennifer Nan, additional, Desai, Arti, additional, Bartlett, Leah, additional, Culbert, Erin, additional, Cohen, Eyal, additional, and Orkin, Julia, additional

Published
2023
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24. Effectiveness of Structured Care Coordination for Children With Medical Complexity

Author

Cohen, Eyal, primary, Quartarone, Samantha, additional, Orkin, Julia, additional, Moretti, Myla E., additional, Emdin, Abby, additional, Guttmann, Astrid, additional, Willan, Andrew R., additional, Major, Nathalie, additional, Lim, Audrey, additional, Diaz, Sanober, additional, Osqui, Lisa, additional, Soscia, Joanna, additional, Fu, Longdi, additional, Gandhi, Sima, additional, Heath, Anna, additional, and Fayed, Nora, additional

Published
2023
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25. Behavioural Science-Informed Strategies for Increasing COVID-19 Vaccine Uptake in Children and Youth

Author

Shapiro, Gilla K., primary, Presseau, Justin, additional, Weerasinghe, Ashini, additional, Allen, Upton, additional, Arnason, Trevor, additional, Bodmer, Nicolas. S, additional, Born, Karen B., additional, Buchan, Judy L., additional, Burns, Rachel, additional, Corace, Kimberly M., additional, Dubey, Vinita, additional, Evans, Gerald A., additional, Fabrigar, Leandre R., additional, Grimshaw, Jeremy M., additional, Maguire, Jonathon L., additional, Manuel, Douglas G., additional, Morris, Shaun K., additional, Mosher, Rhiannon, additional, Orkin, Julia, additional, Perkhun, Anna, additional, Piche-Renaud, Pierre-Philippe, additional, Schwartz, Brian, additional, Science, Michelle, additional, Sivadas, Shuruthisai, additional, Wilson, Sarah E., additional, and Desveaux, Laura, additional

Published
2021
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26. De novo missense variants in RAC3 cause a novel neurodevelopmental syndrome

Author

Costain, Gregory, Callewaert, Bert, Gabriel, Heinz, Tan, Tiong Y., Walker, Susan, Christodoulou, John, Lazar, Tamas, Menten, Björn, Orkin, Julia, Sadedin, Simon, Snell, Meaghan, Vanlander, Arnaud, Vergult, Sarah, White, Susan M., Scherer, Stephen W., Hayeems, Robin Z., Blaser, Susan, Wodak, Shoshana J., Chitayat, David, Marshall, Christian R., and Meyn, M. Stephen

Published
2019
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29. Secondary impacts of the COVID-19 pandemic at a tertiary children’s hospital in Canada: a mixed-methods study

Author

Diskin, Catherine, primary, Orkin, Julia, additional, Dharmaraj, Blossom, additional, Agarwal, Tanvi, additional, Parmar, Arpita, additional, McNaughton, Kelly, additional, Cohen, Eyal, additional, Sunderji, Alia, additional, Faraoni, David, additional, Fecteau, Annie, additional, Fischer, Jason, additional, Maynes, Jason, additional, Mahant, Sanjay, additional, and Friedman, Jeremy, additional

Published
2023
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30. Screening for psychosocial risk in caregivers of children with medical complexity during the COVID-19 pandemic: a cross-sectional study

Author

Pitch, Natalie, primary, Verma, Rahul, additional, Davidson, Laura, additional, Robertson, Taylor, additional, Anagnostopoulos, Gregory, additional, Sunkonkit, Kanokkarn, additional, Qazi, Adam, additional, Ambreen, Munazzah, additional, Mekhuri, Samantha, additional, Miller, Michael R, additional, Orkin, Julia, additional, and Amin, Reshma, additional

Published
2023
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39. The impact of the COVID-19 pandemic on children with medical complexity

Author

Diskin, Catherine, Buchanan, Francine, Cohen, Eyal, Dewan, Tammie, Diaczun, Tessa, Gordon, Michelle, Lee, Esther, MooreHepburn, Charlotte, Major, Nathalie, Orkin, Julia, Patel, Hema, and Gill, Peter J.

Abstract

Background Descriptions of the COVID-19 pandemic’s indirect consequences on children are emerging. We aimed to describe the impacts of the pandemic on children with medical complexity (CMC) and their families. Methods A one-time survey of Canadian paediatricians using the Canadian Paediatric Surveillance Program (CPSP) was conducted in Spring 2021. Results A total of 784 paediatricians responded to the survey, with 70% (n = 540) providing care to CMC. Sixty-seven (12.4%) reported an adverse health outcome due to a COVID-19 pandemic-related disruption in healthcare delivery. Disruption of the supply of medication and equipment was reported by 11.9% of respondents (n = 64). Respondents reported an interruption in family caregiving (47.5%, n = 252) and homecare delivery (40.8%, n = 218). Almost 47% of respondents (n = 253) observed a benefit to CMC due to COVID-19 related changes in healthcare delivery, including increased availability of virtual care and reduction in respiratory illness. Some (14.4%) reported that CMC were excluded from in-person learning when their peers without medical complexity were not. Conclusion Canadian paediatricians reported that CMC experienced adverse health outcomes during the COVID-19 pandemic, including disruptions to family caregiving and community supports. They also describe benefits related to the pandemic including the expansion of virtual care. These results highlight the need for healthcare, community and education policymakers to collaborate with families to optimize their health.

Published
2023
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40. The Experience of Parental Caregiving for Children With Medical Complexity.

Author

Teicher, Jessica, Moore, Clara, Esser, Kayla, Weiser, Natalie, Arje, Danielle, Cohen, Eyal, and Orkin, Julia

Subjects
CHRONIC disease treatment, PARENT attitudes, CAREGIVER attitudes, SERVICES for caregivers, MINDFULNESS, POSITIVE psychology, PSYCHOLOGY of parents, MARRIAGE, HEALTH services accessibility, MEDICINE information services, RESEARCH methodology, SELF-perception, TIME, CHRONIC diseases in children, TERTIARY care, INTERVIEWING, HEALTH status indicators, MENTAL health, SOCIAL factors, MEDICAL care costs, PARENTING, EXPERIENCE, QUALITATIVE research, HEALTH information services, SELF-efficacy, PSYCHOLOGY of caregivers, QUALITY of life, EMPLOYMENT, INTERPERSONAL relations, THEMATIC analysis, PARENT-child relationships, PSYCHOLOGICAL resilience, CHILDREN
Abstract

Children with medical complexity (CMC) have complex chronic conditions with significant functional impairment, contributing to high caregiving demand. This study seeks to explore impacts of parental caregiving for CMC. Fifteen caregivers of CMC followed at a tertiary care hospital participated in semi-structured interviews. Interviews were concurrently analyzed using a qualitative description framework until thematic saturation was reached. Codes were grouped by shared concepts to clarify emergent findings. Four affected domains of parental caregiver experience with associated subthemes (in parentheses) were identified: personal (identity, physical health, mental health), family (marriage, siblings, family quality of life), social (time limitations, isolating lived experience), and financial (employment, medical costs, accessibility costs). Despite substantial challenges, caregivers identified two core determinants of personal resilience: others' support (hands-on, interpersonal, informational, material) and a positive outlook (self-efficacy, self-compassion, reframing expectations). Further research is needed to understand the unique needs and strengths of caregivers for this vulnerable population. [ABSTRACT FROM AUTHOR]

Published
2023
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41. Evaluating Parental Caregivers’ Experiences with an Online Platform for Children with Medical Complexity and the Role of a Live Platform Coach: A Content Analysis (Preprint)

Author

Shouldice, Ainslie Claire, primary, Beatty, Madison Laurel, additional, Adams, Sherri, additional, Dharmaraj, Bloossom Grace, additional, Moore, Clara, additional, Stinson, Jennifer Nan, additional, Desai, Arthi Dilip, additional, Bartlett, Leah Danielle, additional, Culbert, Erin Lia, additional, Cohen, Eyal, additional, and Orkin, Julia, additional

Published
2022
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50. 50 Risk factors for severe COVID-19 in hospitalized children in Canada: A national prospective study from March 2020–May 2021

Author

Farrar, Daniel, primary, Drouin, Olivier, additional, Hepburn, Charlotte Moore, additional, Baerg, Krista, additional, Chan, Kevin, additional, Cyr, Claude, additional, Donner, Elizabeth, additional, Embree, Joanne, additional, Farrell, Catherine, additional, Forgie, Sarah, additional, Giroux, Ryan, additional, Kang, Kristopher, additional, King, Melanie, additional, Laffin-Thibodeau, Melanie, additional, Luu, Thuy-Mai, additional, Orkin, Julia, additional, Ouldali, Naïm, additional, Papenburg, Jesse, additional, Pound, Catherine, additional, Price, Victoria E, additional, Proulx-Gauthier, Jean-Phillippe, additional, Purewal, Rupeena, additional, Sadarangani, Manish, additional, Salvadori, Marina, additional, Thibeault, Roseline, additional, Top, Karina, additional, Viel-Thériault, Isabelle, additional, Kakkar, Fatima, additional, and Morris, Shaun, additional

Published
2022
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