Research

School Outbreaks

Summer Camp Outbreaks

82 infected at Missouri summer camp

Childcare Outbreaks

Texas coronavirus cases top 1,300 from child care facilities alone

North Carolina childcare and school clusters

Cluster of 6 COVID-19 cases at a child care center in North Carolina

Cluster at a Virginia daycare

18 cases at a daycare in Ohio

Two Denver-area child care clusters

20 cases (8 kids, 12 staff) at an Oregon child care center

16 cases (including 12 of 27 children) at a daycare in Canada

16 cases linked to a daycare in New York (including 2 children who were school age)

Deaths in children

11 year old Florida boy dies of COVID-19

Serious Complications in Children

Multisystem Inflammatory Syndrome in U.S. Children and Adolescents "Multisystem inflammatory syndrome in children associated with SARS-CoV-2 led to serious and life-threatening illness in previously healthy children and adolescents"

Acute myocardial injury: a novel clinical pattern in children with COVID-19 "children with COVID-19 should be closely monitored to recognise cardiac involvement and to prevent a severe and critical course of illness."

Ethnicity and COVID-19 in children with comorbidities "despite the small number of children admitted to hospital, several important themes emerge: the wide range in severity of the disease, frequent multi-organ involvement, and that most patients were from BAME [Black and minority ethnic] populations."

Septic shock presentation in adolescents with COVID-19 - "Although paediatric patients with COVID-19 are mainly reported to show only mild or moderate symptoms, critical COVID-19 and MODS can occur in the paediatric population."

An outbreak of severe Kawasaki-like disease at the Italian epicentre of the SARS-CoV-2 epidemic: an observational cohort study - "In the past month we found a 30-fold increased incidence of Kawasaki-like disease. Children diagnosed after the SARS-CoV-2 epidemic began showed evidence of immune response to the virus, were older, had a higher rate of cardiac involvement, and features of MAS."

Neurologic and Radiographic Findings Associated With COVID-19 Infection in Children - "Of the 27 children with COVID-19 pediatric multisystem inflammatory syndrome, 4 patients (14.8%) who were previously healthy had new-onset neurological symptoms. Symptoms included encephalopathy, headaches, brainstem and cerebellar signs, muscle weakness, and reduced reflexes."

Over 180 children hospitalized with COVID-19 in Florida - 183 hospitalizations and 13 cases of MIS-C as of July 3

Multisystem Inflammatory Syndrome in Children in New York State - 99 cases of MIS-C in New York state

Epidemiology, Clinical Features, and Disease Severity in Patients With Coronavirus Disease 2019 (COVID-19) in a Children’s Hospital in New York City, New York - In a pediatric study, "Approximately one-third of the hospitalized patients (16 [32%]) required some form of respiratory support (eg, nasal cannula, NIPPV, or mechanical ventilation). [...] Two patients had sudden cardiac arrest (pulseless electrical activity) on hospital days 3 and 5, respectively, 1 of whom died."

Clinical Characteristics of 58 Children With a Pediatric Inflammatory Multisystem Syndrome Temporally Associated With SARS-CoV-2 - "Of the 58 children, 29 developed shock (with biochemical evidence of myocardial dysfunction) and required inotropic support and fluid resuscitation (including 23/29 [79%] who received mechanical ventilation); 13 met the American Heart Association definition of KD, and 23 had fever and inflammation without features of shock or KD. Eight patients (14%) developed coronary artery dilatation or aneurysm."

Multisystem Inflammatory Syndrome Related to COVID-19 in Previously Healthy Children and Adolescents in New York City - "This study describes 17 previously healthy children and adolescents who developed an inflammatory phenotype related to COVID-19." "The occurrence of abnormal cardiac findings suggests the need for long-term surveillance."

Serious Complications in Adults

Early evidence of pronounced brain involvement in fatal COVID-19 outcomes - " there are reports of rapid decline and subsequent death in younger patients with no known comorbidities."

Psychiatric and neuropsychiatric presentations associated with severe coronavirus infections: a systematic review and meta-analysis with comparison to the COVID-19 pandemic - Among COVID-19 ICU patients, "there was evidence for delirium (confusion in 26 [65%] of 40 intensive care unit patients and agitation in 40 [69%] of 58 intensive care unit patients in one study" and "At discharge, 15 (33%) of 45 patients with COVID-19 who were assessed had a dysexecutive syndrome in one study."

Risk of Ischemic Stroke in Patients With Coronavirus Disease 2019 (COVID-19) vs Patients With Influenza - "Patients with COVID-19 appear to have a heightened risk of acute ischemic stroke compared with patients with influenza."

Covid-19 causes sudden strokes in young adults, doctors say - "The new coronavirus appears to be causing sudden strokes in adults in their 30s and 40s who are not otherwise terribly ill, doctors reported Wednesday."

Incidence of thrombotic complications in critically ill ICU patients with COVID-19 - "The 31% incidence of thrombotic complications [blood clotting] in ICU patients with COVID-19 infections is remarkably high."

Venous Thrombosis Among Critically Ill Patients With Coronavirus Disease 2019 (COVID-19) - "Mortality of patients with COVID-19 admitted to ICUs has been reported to be high, at 50%. Frequent venous and arterial thrombotic events have been reported, with rates from 27% to 69% of peripheral venous thromboembolism and up to 23% of pulmonary embolism."

COVID-19 and Thrombotic or Thromboembolic Disease: Implications for Prevention, Antithrombotic Therapy, and Follow-Up - "Myocardial [heart] injury in COVID-19, as evidenced by elevated cardiac troponin levels or electrocardiographic and echocardiographic abnormalities, is associated with severe disease"

Potential Effects of Coronaviruses on the Cardiovascular System - "Coronavirus disease 2019 is associated with a high inflammatory burden that can induce vascular inflammation, myocarditis, and cardiac arrhythmias"

Association of Coronavirus Disease 2019 (COVID-19) With Myocardial Injury and Mortality - "Thus, it is anticipated that patients with underlying cardiovascular diseases, which are more prevalent in older adults, would be susceptible to higher risks of adverse outcomes and death during the severe and aggressive inflammatory responses to COVID-19 than individuals who are younger and healthier."

The emerging spectrum of COVID-19 neurology: clinical, radiological and laboratory findings - "Preliminary clinical data indicate that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with neurological and neuropsychiatric illness"

Persistent Symptoms in Patients After Acute COVID-19 - "This study found that in patients who had recovered from COVID-19, 87.4% reported persistence of at least 1 symptom, particularly fatigue and dyspnea." "Worsened quality of life was observed among 44.1% of patients."

COVID-19 cases in children

1,645 cases in people 19 and under in Texas

Over 11,000 pediatric cases of COVID-19 in Florida

5,957 cases of COVID-19 in people age 0-19 in Massachusetts

Disproportionate Outcomes/Equity: Race

Ethnicity and COVID-19 in children with comorbidities - "In the UK and USA, which are countries with ethnically diverse populations, mortality is disproportionately high in minority groups."

The Fullest Look Yet at the Racial Inequities of Coronavirus - "Black and Latino people have been disproportionately affected by the coronavirus in a widespread manner that spans the country, throughout hundreds of counties in urban, suburban and rural areas, and across all age groups."

COVID-19 Outbreaks Among Food Production Workers May Intensify Pandemic’s Disproportionate Effects on People of Color - "Outbreaks of coronavirus disease 2019 (COVID-19) among food production workers may worsen the pandemic’s disproportionate effects on people of color and increase underlying health, economic, and social disparities"

Clinical Characteristics and Morbidity Associated With Coronavirus Disease 2019 in a Series of Patients in Metropolitan Detroit - "As of May 14, 2020, African American patients accounted for 32% of cases and 41% of deaths despite composing only 14% of the state [Michigan]’s population"

Cardiovascular Implications of Fatal Outcomes of Patients With Coronavirus Disease 2019 (COVID-19) - "Myocardial injury has a significant association with fatal outcome of COVID-19"

The Disproportionate Burden of COVID-19 for Immigrants in the Bronx, New York - " The limited sociodemographic data available for COVID-19 cases in New York City show that Hispanic or Latinx individuals, who constitutemost immigrants in the Bronx, are considerably more likely to die of COVID-19 than white New York City residents."

Taking a Closer Look at COVID-19, Health Inequities, and Racism - "In the US, black people account for 13% of the population, but 24% of COVID-19 deaths where race is known. And blacks, Latinos, American Indians [and Asian Americans] also represent a disproportionate number of cases."

COVID-19 Took Black Lives First. It Didn’t Have To. - "In Chicago, 70 of the city’s 100 first recorded victims of COVID-19 were black."

Failing Another National Stress Test on Health Disparities - "long-standing systemic inequalities in the US health care system result in the tragically unequal effect of COVID-19"

COVID-19 and African Americans - "Persons who are African American or black are contracting SARS-CoV-2 at higher rates and are more likely to die."

COVID-19 and Racial/Ethnic Disparities - "Geographic locations that reported data by race/ethnicity indicate that African American individuals and, to a lesser extent, Latino individuals bear a disproportionate burden of COVID-19–related outcomes."

People with Disabilities

COVID-19: overcoming the challenges faced by individuals with autism and their families - "individuals with autism spectrum disorder are being identified as part of a group at higher risk for complications from COVID-19."

Possibility of Airborne Transmission

Airborne Spread of SARS-CoV-2 and a Potential Role for Air Disinfection - "available studies are consistent with the potential aerosol spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), not only through coughing and sneezing, but by normal breathing."

PPE Shortages

Personal Protective Equipment Shortages During COVID-19—Supply Chain–Related Causes and Mitigation Strategies - "Since the start of the coronavirus disease 2019 (COVID-19) pandemic, health care systems across the US have reported substantial personal protective equipment (PPE) shortages, compromising their ability to keep health care professionals safe while treating increasing numbers of patients."

“Abandoned” Nursing Homes Continue to Face Critical Supply and Staff Shortages as COVID-19 Toll Has Mounted - "Nursing home representatives and researchers alike have observed that the widespread PPE and testing shortages have gotten far too little attention amidst a plethora of negative news coverage."

Sourcing Personal Protective Equipment During the COVID-19 Pandemic - "PPE, formerly ubiquitous and disposable in the hospital environment, is now a scarce and precious commodity in many locations when it is needed most to care for highly infectious patients."

Density of Schools

Healthy Air Tools for Schools and Districts (American Lung Association) - "Schools typically have four times as many people indoors as an office building with the same floor space."

Massachusetts District Reopening Plans

Lexington Public Schools Back-to-School Blueprint

Other State School Reopening Plans

California - face covers required (medical exemptions only), 6 foot social distancing, protections for staff

Connecticut - face covers required (medical exemptions only)

Oregon - seating at least 6 feet apart