Recommendations for Fully Vaccinated People
COVID-19 Homepage
Clinical Care Considerations
Clinical considerations for care of children and adults with confirmed COVID-19
This page provides clinicians and public health professionals with key information and evidence for clinical considerations when diagnosing and managing patients infected with SARS-CoV-2, the virus that causes COVID-19. For evidence-based treatment recommendations for COVID-19, visit the National Institutes of Health (NIH) COVID-19 Treatment Guidelines prepared by the COVID-19 Treatment Guidelines Panel. Also see Variants of the Virus and Vaccines for COVID-19.
Table of Contents
Key Points
- The clinical presentation of COVID-19 varies from asymptomatic infection to critical illness; symptoms can change during the course of illness.
- When testing for current SARS-CoV-2 infection, CDC recommends that clinicians use molecular (polymerase chain reaction [PCR] or nucleic acid amplification test [NAAT]) or antigen tests (viral tests) that detect SARS-CoV-2 or its components, not a serologic test that detects antibodies. A chest radiograph or computed tomography (CT) images alone are not recommended to diagnose COVID-19, but might be helpful in assessing and managing COVID-19 patients.
- Clinicians caring for populations including children, pregnant and recently pregnant people, people who are moderately or severely immunocompromised, people with confirmed or suspected multisystem inflammatory syndrome, and people with post-COVID conditions may have additional clinical considerations.
- When treating patients with COVID-19, the National Institutes of Health (NIH) recommends clinicians consider treating patients according to risk of progression to severe COVID-19 or the severity of COVID-19. Patients who are reinfected with SARS-CoV-2 likely will experience less severe illness than during the initial infection, but some patients will experience more severe illness.
Co-circulation of Influenza Viruses and SARS-CoV-2
Clinicians can find useful resources below to help in their decision making and action when influenza and SARS-CoV-2 are co-circulating.
- Information for Clinicians on Influenza Virus Testing: Clinical algorithms to assist clinicians with influenza testing and treatment of patients with acute respiratory illness symptoms during periods of community co-circulation of influenza viruses and SARS-CoV-2.
- Influenza Antiviral Medications: Information on antiviral treatment of influenza.
- NIH COVID-19 Treatment Guidelines: Panel recommendations for management of patients with COVID-19.
- NIH COVID-19 Treatment Guidelines – Special Populations: Summary recommendations including patients with possible influenza and COVID-19.
Summary of Updates
NewAs of May 27, 2022
- Updated information on the clinical presentation and course of COVID-19 among adults and children, including information about SARS-CoV-2 variants and reinfection
- New section about pregnancy and recent pregnancy
- New section on moderately or severely immunosuppressed populations
- Details on multisystem inflammatory syndrome
- Clarification of post-COVID conditions
As of February 12, 2021
- New information on potential for under-detection of occult hypoxemia by pulse oximetry, especially among persons with dark skin
- New information on dermatologic manifestations associated with COVID-19
- New information on prolonged shedding of replication-competent SARS-CoV-2 in severely immunocompromised persons
- New information on reports of reinfection with variant viruses
As of November 3, 2020
- New information for Laboratory and Radiographic Findings
- New information for Pediatric Considerations
- Revisions for clarity and significant updates to footnotes throughout
- Influenza alert box
- Information on FDA approval of remdesivir
As of October 27, 2020
- Updated content to Reinfection
As of September 10, 2020
- Updated content to Reinfection
As of June 20, 2020, to reflect the following:
- Updated content to Clinical Presentation
- New information about Reinfection
- New information about Therapeutics
- Minor revisions for clarity and updates to footnotes throughout
As of May 29, 2020
- Refer to updated symptoms of Coronavirus
As of May 25, 2020
- Refer to new multisystem inflammatory syndrome in children (MIS-C) guidance for healthcare providers
As of May 20, 2020
- Refer to new guidance for Evaluation and Management Considerations for Neonates At Risk for COVID-19
As of May 12, 2020
- New information about COVID-19-Associated Hypercoagulability
- Updated content and resources to include new NIH Treatment Guidelines
- Minor revisions for clarity
References
- Alene M, Yismaw L, Assemie MA, Ketema DB, Gietaneh W, Birhan TY. Serial interval and incubation period of COVID-19: a systematic review and meta-analysis. BMC Infect Dis. Mar 11 2021;21(1):257. doi:10.1186/s12879-021-05950-x
- Grant R, Charmet T, Schaeffer L, et al. Impact of SARS-CoV-2 Delta variant on incubation, transmission settings and vaccine effectiveness: Results from a nationwide case-control study in France. The Lancet Regional Health - Europe. 2022/02/01/ 2022;13:100278. doi:https://doi.org/10.1016/j.lanepe.2021.100278
- Jansen L, Tegomoh B, Lange K, et al. Investigation of a SARS-CoV-2 B.1.1.529 (Omicron) Variant Cluster - Nebraska, November-December 2021. MMWR Morb Mortal Wkly Rep. Dec 31 2021;70(5152):1782-1784. doi:10.15585/mmwr.mm705152e3
- Song JS, Lee J, Kim M, et al. Serial Intervals and Household Transmission of SARS-CoV-2 Omicron Variant, South Korea, 2021. Emerg Infect Dis. Mar 2022;28(3):756-759. doi:10.3201/eid2803.212607
- Stokes EK, Zambrano LD, Anderson KN, et al. Coronavirus Disease 2019 Case Surveillance - United States, January 22-May 30, 2020. MMWR Morb Mortal Wkly Rep. Jun 19 2020;69(24):759-765. doi:10.15585/mmwr.mm6924e2
- Roxby AC, Greninger AL, Hatfield KM, et al. Detection of SARS-CoV-2 Among Residents and Staff Members of an Independent and Assisted Living Community for Older Adults - Seattle, Washington, 2020. MMWR Morb Mortal Wkly Rep. Apr 10 2020;69(14):416-418. doi:10.15585/mmwr.mm6914e2
- Kimball A, Hatfield KM, Arons M, et al. Asymptomatic and Presymptomatic SARS-CoV-2 Infections in Residents of a Long-Term Care Skilled Nursing Facility - King County, Washington, March 2020. MMWR Morb Mortal Wkly Rep. Apr 3 2020;69(13):377-381. doi:10.15585/mmwr.mm6913e1
- Sheehan MM, Reddy AJ, Rothberg MB. Reinfection Rates Among Patients Who Previously Tested Positive for Coronavirus Disease 2019: A Retrospective Cohort Study. Clinical Infectious Diseases. 2021;73(10):1882-1886. doi:10.1093/cid/ciab234
- Kronbichler A, Kresse D, Yoon S, Lee KH, Effenberger M, Shin JI. Asymptomatic patients as a source of COVID-19 infections: A systematic review and meta-analysis. International Journal of Infectious Diseases. 2020/09/01/ 2020;98:180-186. doi:https://doi.org/10.1016/j.ijid.2020.06.052
- Yang J, Zheng Y, Gou X, et al. Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2: a systematic review and meta-analysis. Int J Infect Dis. May 2020;94:91-95. doi:10.1016/j.ijid.2020.03.017
- Tenforde MW, Billig Rose E, Lindsell CJ, et al. Characteristics of Adult Outpatients and Inpatients with COVID-19 - 11 Academic Medical Centers, United States, March-May 2020. MMWR Morb Mortal Wkly Rep. Jul 3 2020;69(26):841-846. doi:10.15585/mmwr.mm6926e3
- Clifford CT, Pour TR, Freeman R, et al. Association between COVID-19 diagnosis and presenting chief complaint from New York City triage data. The American Journal of Emergency Medicine. 2021/08/01/ 2021;46:520-524. doi:https://doi.org/10.1016/j.ajem.2020.11.006
- Nasiri N, Sharifi H, Bazrafshan A, Noori A, Karamouzian M, Sharifi A. Ocular Manifestations of COVID-19: A Systematic Review and Meta-analysis. J Ophthalmic Vis Res. Jan-Mar 2021;16(1):103-112. doi:10.18502/jovr.v16i1.8256
- Tan E, Song J, Deane AM, Plummer MP. Global Impact of Coronavirus Disease 2019 Infection Requiring Admission to the ICU: A Systematic Review and Meta-analysis. Chest. 2021/02/01/ 2021;159(2):524-536. doi:https://doi.org/10.1016/j.chest.2020.10.014
- Genovese G, Moltrasio C, Berti E, Marzano AV. Skin Manifestations Associated with COVID-19: Current Knowledge and Future Perspectives. Dermatology. 2021;237(1):1-12. doi:10.1159/000512932
- Thompson HA, Mousa A, Dighe A, et al. SARS-CoV-2 setting-specific transmission rates: a systematic review and meta-analysis. Clin Infect Dis. Feb 9 2021;doi:10.1093/cid/ciab100
- Singanayagam A, Patel M, Charlett A, et al. Duration of infectiousness and correlation with RT-PCR cycle threshold values in cases of COVID-19, England, January to May 2020. Euro Surveill. Aug 2020;25(32)doi:10.2807/1560-7917.Es.2020.25.32.2001483
- Eyre DW, Taylor D, Purver M, et al. Effect of Covid-19 Vaccination on Transmission of Alpha and Delta Variants. New England Journal of Medicine. 2022;386(8):744-756. doi:10.1056/NEJMoa2116597
- Lansbury L, Lim B, Baskaran V, Lim WS. Co-infections in people with COVID-19: a systematic review and meta-analysis. Journal of Infection. 2020/08/01/ 2020;81(2):266-275. doi:https://doi.org/10.1016/j.jinf.2020.05.046
- Gerver SM, Guy R, Wilson K, et al. National surveillance of bacterial and fungal coinfection and secondary infection in COVID-19 patients in England: lessons from the first wave. Clinical Microbiology and Infection. 2021/11/01/ 2021;27(11):1658-1665. doi:https://doi.org/10.1016/j.cmi.2021.05.040
- Chandler CM, Reid MC, Cherian S, Sabath DE, Edlefsen KL. Comparison of Blood Counts and Markers of Inflammation and Coagulation in Patients With and Without COVID-19 Presenting to the Emergency Department in Seattle, WA. American Journal of Clinical Pathology. 2021;156(2):185-197. doi:10.1093/ajcp/aqab052
- Levi M, Thachil J, Iba T, Levy JH. Coagulation abnormalities and thrombosis in patients with COVID-19. The Lancet Haematology. 2020/06/01/ 2020;7(6):e438-e440. doi:https://doi.org/10.1016/S2352-3026(20)30145-9
- Sadiq Z, Rana S, Mahfoud Z, Raoof A. Systematic review and meta-analysis of chest radiograph (CXR) findings in COVID-19. Clinical Imaging. 2021/12/01/ 2021;80:229-238. doi:https://doi.org/10.1016/j.clinimag.2021.06.039
- Kanne JP, Bai H, Bernheim A, et al. COVID-19 Imaging: What We Know Now and What Remains Unknown. Radiology. Jun 2021;299(3):E262-e279. doi:10.1148/radiol.2021204522
- Doerschug KC, Schmidt GA. Pulmonary Aspects of COVID-19. Annu Rev Med. Jan 27 2022;73:81-93. doi:10.1146/annurev-med-042220-014817
- Bhaskaran K, Bacon S, Evans SJ, et al. Factors associated with deaths due to COVID-19 versus other causes: population-based cohort analysis of UK primary care data and linked national death registrations within the OpenSAFELY platform. Lancet Reg Health Eur. Jul 2021;6:100109. doi:10.1016/j.lanepe.2021.100109
- Kim L, Garg S, O'Halloran A, et al. Risk Factors for Intensive Care Unit Admission and In-hospital Mortality among Hospitalized Adults Identified through the U.S. Coronavirus Disease 2019 (COVID-19)-Associated Hospitalization Surveillance Network (COVID-NET). Clin Infect Dis. Jul 16 2020;doi:10.1093/cid/ciaa1012
- Kompaniyets L, Pennington AF, Goodman AB, et al. Underlying Medical Conditions and Severe Illness Among 540,667 Adults Hospitalized With COVID-19, March 2020-March 2021. Preventing chronic disease. Jul 1 2021;18:E66. doi:10.5888/pcd18.210123
- Ko JY, Danielson ML, Town M, et al. Risk Factors for COVID-19-associated hospitalization: COVID-19-Associated Hospitalization Surveillance Network and Behavioral Risk Factor Surveillance System. Clin Infect Dis. Sep 18 2020;doi:10.1093/cid/ciaa1419
- Wortham JM, Lee JT, Althomsons S, et al. Characteristics of Persons Who Died with COVID-19 - United States, February 12-May 18, 2020. MMWR Morb Mortal Wkly Rep. Jul 17 2020;69(28):923-929. doi:10.15585/mmwr.mm6928e1
- Yang X, Zhang J, Chen S, et al. Demographic Disparities in Clinical Outcomes of COVID-19: Data From a Statewide Cohort in South Carolina. Open Forum Infect Dis. Sep 2021;8(9):ofab428. doi:10.1093/ofid/ofab428
- Rader B.; Gertz AL, D.; Gilmer, M.; Wronski, L.; Astley, C.; Sewalk, K.; Varrelman, T.; Cohen, J.; Parikh, R.; Reese, H.; Reed, C.; Brownstein J. Use of At-Home COVID-19 Tests — United States, August 23, 2021–March 12, 2022. MMWR Morb Mortal Wkly Rep. April 1, 2022;71(13):489–494. doi:http://dx.doi.org/10.15585/mmwr.mm7113e1
- Pingali C, Meghani M, Razzaghi H, et al. COVID-19 Vaccination Coverage Among Insured Persons Aged >/=16 Years, by Race/Ethnicity and Other Selected Characteristics - Eight Integrated Health Care Organizations, United States, December 14, 2020-May 15, 2021. MMWR Morb Mortal Wkly Rep. Jul 16 2021;70(28):985-990. doi:10.15585/mmwr.mm7028a1
- Wiltz JL, Feehan AK, Molinari NM, et al. Racial and Ethnic Disparities in Receipt of Medications for Treatment of COVID-19 - United States, March 2020-August 2021. MMWR Morb Mortal Wkly Rep. Jan 21 2022;71(3):96-102. doi:10.15585/mmwr.mm7103e1
- Murthy NC, Zell E, Fast HE, et al. Disparities in First Dose COVID-19 Vaccination Coverage among Children 5-11 Years of Age, United States. Emerg Infect Dis. May 2022;28(5):986-989. doi:10.3201/eid2805.220166
- Saelee R, Zell E, Murthy BP, et al. Disparities in COVID-19 Vaccination Coverage Between Urban and Rural Counties - United States, December 14, 2020-January 31, 2022. MMWR Morb Mortal Wkly Rep. Mar 4 2022;71(9):335-340. doi:10.15585/mmwr.mm7109a2
- Burki TK. The role of antiviral treatment in the COVID-19 pandemic. Lancet Respir Med. Feb 2022;10(2):e18. doi:10.1016/S2213-2600(22)00011-X
- Jayk Bernal A, Gomes da Silva MM, Musungaie DB, et al. Molnupiravir for Oral Treatment of Covid-19 in Nonhospitalized Patients. N Engl J Med. Feb 10 2022;386(6):509-520. doi:10.1056/NEJMoa2116044
- Sjoding MW, Dickson RP, Iwashyna TJ, Gay SE, Valley TS. Racial Bias in Pulse Oximetry Measurement. N Engl J Med. Dec 17 2020;383(25):2477-2478. doi:10.1056/NEJMc2029240
- Jordan TB, Meyers CL, Schrading WA, Donnelly JP. The utility of iPhone oximetry apps: A comparison with standard pulse oximetry measurement in the emergency department. Am J Emerg Med. May 2020;38(5):925-928. doi:10.1016/j.ajem.2019.07.020
- Iuliano AD, Brunkard JM, Boehmer TK, et al. Trends in Disease Severity and Health Care Utilization During the Early Omicron Variant Period Compared with Previous SARS-CoV-2 High Transmission Periods - United States, December 2020-January 2022. MMWR Morb Mortal Wkly Rep. Jan 28 2022;71(4):146-152. doi:10.15585/mmwr.mm7104e4
- Taylor CA, Whitaker M, Anglin O, et al. COVID-19-Associated Hospitalizations Among Adults During SARS-CoV-2 Delta and Omicron Variant Predominance, by Race/Ethnicity and Vaccination Status - COVID-NET, 14 States, July 2021-January 2022. MMWR Morb Mortal Wkly Rep. Mar 25 2022;71(12):466-473. doi:10.15585/mmwr.mm7112e2
- Johnson AG, Amin AB, Ali AR, et al. COVID-19 Incidence and Death Rates Among Unvaccinated and Fully Vaccinated Adults with and Without Booster Doses During Periods of Delta and Omicron Variant Emergence - 25 U.S. Jurisdictions, April 4-December 25, 2021. MMWR Morb Mortal Wkly Rep. Jan 28 2022;71(4):132-138. doi:10.15585/mmwr.mm7104e2
- Danza P, Koo TH, Haddix M, et al. SARS-CoV-2 Infection and Hospitalization Among Adults Aged >/=18 Years, by Vaccination Status, Before and During SARS-CoV-2 B.1.1.529 (Omicron) Variant Predominance - Los Angeles County, California, November 7, 2021-January 8, 2022. MMWR Morb Mortal Wkly Rep. Feb 4 2022;71(5):177-181. doi:10.15585/mmwr.mm7105e1
- Olson SM, Newhams MM, Halasa NB, et al. Effectiveness of BNT162b2 Vaccine against Critical Covid-19 in Adolescents. N Engl J Med. Feb 24 2022;386(8):713-723. doi:10.1056/NEJMoa2117995
- Price AM, Olson SM, Newhams MM, et al. BNT162b2 Protection against the Omicron Variant in Children and Adolescents. N Engl J Med. May 19 2022;386(20):1899-1909. doi:10.1056/NEJMoa2202826
- Zambrano LD, Ellington S, Strid P, et al. Update: Characteristics of Symptomatic Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status - United States, January 22-October 3, 2020. MMWR Morb Mortal Wkly Rep. Nov 6 2020;69(44):1641-1647. doi:10.15585/mmwr.mm6944e3
- Jamieson DJ, Rasmussen SA. An update on COVID-19 and pregnancy. Am J Obstet Gynecol. Feb 2022;226(2):177-186. doi:10.1016/j.ajog.2021.08.054
- Barbero P, Mugüerza L, Herraiz I, et al. SARS-CoV-2 in pregnancy: characteristics and outcomes of hospitalized and non-hospitalized women due to COVID-19. The Journal of Maternal-Fetal & Neonatal Medicine. 2020:1-7. doi:10.1080/14767058.2020.1793320
- Grechukhina O, Greenberg V, Lundsberg LS, et al. Coronavirus disease 2019 pregnancy outcomes in a racially and ethnically diverse population. Am J Obstet Gynecol MFM. Nov 2020;2(4):100246. doi:10.1016/j.ajogmf.2020.100246
- Galang RR, Newton SM, Woodworth KR, et al. Risk factors for illness severity among pregnant women with confirmed SARS-CoV-2 infection – Surveillance for Emerging Threats to Mothers and Babies Network, 20 state, local, and territorial health departments, March 29, 2020 -January 8, 2021. medRxiv. 2021:2021.02.27.21252169. doi:10.1101/2021.02.27.21252169
- Jering KS, Claggett BL, Cunningham JW, et al. Clinical Characteristics and Outcomes of Hospitalized Women Giving Birth With and Without COVID-19. JAMA Intern Med. Jan 15 2021;doi:10.1001/jamainternmed.2020.9241
- Matar R, Alrahmani L, Monzer N, et al. Clinical Presentation and Outcomes of Pregnant Women With Coronavirus Disease 2019: A Systematic Review and Meta-analysis. Clin Infect Dis. Feb 1 2021;72(3):521-533. doi:10.1093/cid/ciaa828
- Dubey P, Thakur B, Reddy S, et al. Current trends and geographical differences in therapeutic profile and outcomes of COVID-19 among pregnant women - a systematic review and meta-analysis. BMC Pregnancy Childbirth. Mar 24 2021;21(1):247. doi:10.1186/s12884-021-03685-w
- Wei SQ, Bilodeau-Bertrand M, Liu S, Auger N. The impact of COVID-19 on pregnancy outcomes: a systematic review and meta-analysis. Cmaj. Apr 19 2021;193(16):E540-e548. doi:10.1503/cmaj.202604
- Allotey J, Stallings E, Bonet M, et al. Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis. BMJ. Sep 1 2020;370:m3320. doi:10.1136/bmj.m3320
- DeSisto CL, Wallace B, Simeone RM, et al. Risk for Stillbirth Among Women With and Without COVID-19 at Delivery Hospitalization - United States, March 2020-September 2021. MMWR Morb Mortal Wkly Rep. Nov 26 2021;70(47):1640-1645. doi:10.15585/mmwr.mm7047e1
- Hcini N, Maamri F, Picone O, et al. Maternal, fetal and neonatal outcomes of large series of SARS-CoV-2 positive pregnancies in peripartum period: A single-center prospective comparative study. Eur J Obstet Gynecol Reprod Biol. Feb 2021;257:11-18. doi:10.1016/j.ejogrb.2020.11.068
- Prabhu M, Cagino K, Matthews KC, et al. Pregnancy and postpartum outcomes in a universally tested population for SARS-CoV-2 in New York City: a prospective cohort study. Bjog. Nov 2020;127(12):1548-1556. doi:10.1111/1471-0528.16403
- Siebach MK, Piedimonte G, Ley SH. COVID‐19 in childhood: Transmission, clinical presentation, complications and risk factors. Pediatric Pulmonology. 2021;56(6):1342-1356. doi:10.1002/ppul.25344
- Rubens JH, Akindele NP, Tschudy MM, Sick-Samuels AC. Acute covid-19 and multisystem inflammatory syndrome in children. BMJ. 2021:n385. doi:10.1136/bmj.n385
- Martin B, Dewitt PE, Russell S, et al. Characteristics, Outcomes, and Severity Risk Factors Associated With SARS-CoV-2 Infection Among Children in the US National COVID Cohort Collaborative. JAMA Network Open. 2022;5(2):e2143151. doi:10.1001/jamanetworkopen.2021.43151
- Kompaniyets L, Agathis NT, Nelson JM, et al. Underlying Medical Conditions Associated With Severe COVID-19 Illness Among Children. JAMA Netw Open. Jun 1 2021;4(6):e2111182. doi:10.1001/jamanetworkopen.2021.11182
- Feldstein LR, Tenforde MW, Friedman KG, et al. Characteristics and Outcomes of US Children and Adolescents With Multisystem Inflammatory Syndrome in Children (MIS-C) Compared With Severe Acute COVID-19. JAMA. 2021;325(11):1074. doi:10.1001/jama.2021.2091
- Wanga V, Gerdes ME, Shi DS, et al. Characteristics and Clinical Outcomes of Children and Adolescents Aged <18 Years Hospitalized with COVID-19 - Six Hospitals, United States, July-August 2021. MMWR Morb Mortal Wkly Rep. Dec 31 2021;70(5152):1766-1772. doi:10.15585/mmwr.mm705152a3
- Woodruff RC, Campbell AP, Taylor CA, et al. Risk Factors for Severe COVID-19 in Children. Pediatrics. 2022;149(1):e2021053418. doi:10.1542/peds.2021-053418
- Preston LE, Chevinsky JR, Kompaniyets L, et al. Characteristics and Disease Severity of US Children and Adolescents Diagnosed With COVID-19. JAMA Netw Open. Apr 1 2021;4(4):e215298. doi:10.1001/jamanetworkopen.2021.5298
- Hobbs CV, Woodworth K, Young CC, et al. Frequency, Characteristics and Complications of COVID-19 in Hospitalized Infants. Pediatr Infect Dis J. Mar 1 2022;41(3):e81-e86. doi:10.1097/inf.0000000000003435
- Marks KJ, Whitaker M, Agathis NT, et al. Hospitalization of Infants and Children Aged 0-4 Years with Laboratory-Confirmed COVID-19 - COVID-NET, 14 States, March 2020-February 2022. MMWR Morb Mortal Wkly Rep. Mar 18 2022;71(11):429-436. doi:10.15585/mmwr.mm7111e2
- Delahoy MJ, Ujamaa D, Whitaker M, et al. Hospitalizations Associated with COVID-19 Among Children and Adolescents - COVID-NET, 14 States, March 1, 2020-August 14, 2021. MMWR Morb Mortal Wkly Rep. Sep 10 2021;70(36):1255-1260. doi:10.15585/mmwr.mm7036e2
- Siegel DA, Reses HE, Cool AJ, et al. Trends in COVID-19 Cases, Emergency Department Visits, and Hospital Admissions Among Children and Adolescents Aged 0-17 Years - United States, August 2020-August 2021. MMWR Morb Mortal Wkly Rep. Sep 10 2021;70(36):1249-1254. doi:10.15585/mmwr.mm7036e1
- Cloete J, Kruger A, Masha M, et al. Paediatric hospitalisations due to COVID-19 during the first SARS-CoV-2 omicron (B.1.1.529) variant wave in South Africa: a multicentre observational study. The Lancet Child & Adolescent Health. 2022;6(5):294-302. doi:10.1016/s2352-4642(22)00027-x
- Torjesen I. Covid-19: Omicron variant is linked to steep rise in hospital admissions of very young children. BMJ. 2022:o110. doi:10.1136/bmj.o110
- Fung M, Babik JM. COVID-19 in Immunocompromised Hosts: What We Know So Far. Clin Infect Dis. Jan 27 2021;72(2):340-350. doi:10.1093/cid/ciaa863
- Belsky JA, Tullius BP, Lamb MG, Sayegh R, Stanek JR, Auletta JJ. COVID-19 in immunocompromised patients: A systematic review of cancer, hematopoietic cell and solid organ transplant patients. The Journal of infection. Mar 2021;82(3):329-338. doi:10.1016/j.jinf.2021.01.022
- Di Fusco M, Lin J, Vaghela S, et al. COVID-19 vaccine effectiveness among immunocompromised populations: a targeted literature review of real-world studies. Expert Rev Vaccines. Apr 2022;21(4):435-451. doi:10.1080/14760584.2022.2035222
- Lee A, Wong SY, Chai LYA, et al. Efficacy of covid-19 vaccines in immunocompromised patients: systematic review and meta-analysis. Bmj. Mar 2 2022;376:e068632. doi:10.1136/bmj-2021-068632
- Embi PJ, Levy ME, Naleway AL, et al. Effectiveness of two-dose vaccination with mRNA COVID-19 vaccines against COVID-19-associated hospitalizations among immunocompromised adults-Nine States, January-September 2021. Am J Transplant. Jan 2022;22(1):306-314. doi:10.1111/ajt.16641
- Tenforde MW, Patel MM, Gaglani M, et al. Effectiveness of a Third Dose of Pfizer-BioNTech and Moderna Vaccines in Preventing COVID-19 Hospitalization Among Immunocompetent and Immunocompromised Adults - United States, August-December 2021. MMWR Morb Mortal Wkly Rep. Jan 28 2022;71(4):118-124. doi:10.15585/mmwr.mm7104a2
- Kwon JH, Tenforde MW, Gaglani M, et al. mRNA Vaccine Effectiveness Against Coronavirus Disease 2019 Hospitalization Among Solid Organ Transplant Recipients. J Infect Dis. Sep 13 2022;226(5):797-807. doi:10.1093/infdis/jiac118
- Parker EPK, Desai S, Marti M, et al. Response to additional COVID-19 vaccine doses in people who are immunocompromised: a rapid review. Lancet Glob Health. Mar 2022;10(3):e326-e328. doi:10.1016/S2214-109X(21)00593-3
- Belay ED, Abrams J, Oster ME, et al. Trends in Geographic and Temporal Distribution of US Children With Multisystem Inflammatory Syndrome During the COVID-19 Pandemic. JAMA Pediatr. Aug 1 2021;175(8):837-845. doi:10.1001/jamapediatrics.2021.0630
- Miller AD, Zambrano LD, Yousaf AR, et al. Multisystem Inflammatory Syndrome in Children-United States, February 2020-July 2021. Clin Infect Dis. Aug 24 2022;75(1):e1165-e1175. doi:10.1093/cid/ciab1007
- Miller AD, Yousaf AR, Bornstein E, et al. Multisystem Inflammatory Syndrome in Children During Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Delta and Omicron Variant Circulation-United States, July 2021-January 2022. Clin Infect Dis. Oct 3 2022;75(Supplement_2):S303-s307. doi:10.1093/cid/ciac471
- Godfred-Cato S, Abrams JY, Balachandran N, et al. Distinguishing Multisystem Inflammatory Syndrome in Children From COVID-19, Kawasaki Disease and Toxic Shock Syndrome. Pediatr Infect Dis J. Apr 1 2022;41(4):315-323. doi:10.1097/inf.0000000000003449
- Abrams JY, Belay ED, Godfred-Cato S, et al. Trends in Treatments for Multisystem Inflammatory Syndrome in Children (MIS-C), United States, February 2020 - July 2021. Clin Infect Dis. Sep 30 2022;75(7):1201-1209. doi:10.1093/cid/ciac072
- Zambrano LD, Newhams MM, Olson SM, et al. BNT162b2 mRNA Vaccination Against COVID-19 is Associated with Decreased Likelihood of Multisystem Inflammatory Syndrome in U.S. Children Ages 5-18 Years. Clin Infect Dis. Aug 4 2022;doi:10.1093/cid/ciac637
- Levy M, Recher M, Hubert H, et al. Multisystem Inflammatory Syndrome in Children by COVID-19 Vaccination Status of Adolescents in France. Jama. Jan 18 2022;327(3):281-283. doi:10.1001/jama.2021.23262
- Nygaard U, Holm M, Hartling UB, et al. Incidence and clinical phenotype of multisystem inflammatory syndrome in children after infection with the SARS-CoV-2 delta variant by vaccination status: a Danish nationwide prospective cohort study. The Lancet Child & adolescent health. Jul 2022;6(7):459-465. doi:10.1016/s2352-4642(22)00100-6
- Belay ED, Godfred Cato S, Rao AK, et al. Multisystem Inflammatory Syndrome in Adults After Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection and Coronavirus Disease 2019 (COVID-19) Vaccination. Clin Infect Dis. Aug 24 2022;75(1):e741-e748. doi:10.1093/cid/ciab936
- Patel P, DeCuir J, Abrams J, Campbell AP, Godfred-Cato S, Belay ED. Clinical Characteristics of Multisystem Inflammatory Syndrome in Adults: A Systematic Review. JAMA Network Open. 2021;4(9):e2126456-e2126456. doi:10.1001/jamanetworkopen.2021.26456
- Melgar M, Haston J, DeCuir J, et al. Multisystem inflammatory syndrome in adults (MIS-A): case finding through systematic review of electronic medical records. Clin Infect Dis. Apr 20 2022;doi:10.1093/cid/ciac303
- Hernandez-Romieu AC, Leung S, Mbanya A, et al. Health Care Utilization and Clinical Characteristics of Nonhospitalized Adults in an Integrated Health Care System 28-180 Days After COVID-19 Diagnosis - Georgia, May 2020-March 2021. MMWR Morb Mortal Wkly Rep. Apr 30 2021;70(17):644-650. doi:10.15585/mmwr.mm7017e3
- Chevinsky JR, Tao G, Lavery AM, et al. Late Conditions Diagnosed 1-4 Months Following an Initial Coronavirus Disease 2019 (COVID-19) Encounter: A Matched-Cohort Study Using Inpatient and Outpatient Administrative Data-United States, 1 March-30 June 2020. Clin Infect Dis. Jul 15 2021;73(Suppl 1):S5-S16. doi:10.1093/cid/ciab338
- Wanga V, Chevinsky JR, Dimitrov LV, et al. Long-Term Symptoms Among Adults Tested for SARS-CoV-2 - United States, January 2020-April 2021. MMWR Morb Mortal Wkly Rep. Sep 10 2021;70(36):1235-1241. doi:10.15585/mmwr.mm7036a1
- Bull-Otterson LB, S.; Saydah, S.; Boehmer, T.; Adjei, S.; Gray, S.; Harris, A. Post–COVID Conditions Among Adult COVID-19 Survivors Aged 18–64 and ≥65 Years — United States, March 2020–November 2021. MMWR Morb Mortal Wkly Rep. May 27, 2022 71(21):713–717. doi:http://dx.doi.org/10.15585/mmwr.mm7121e1
- Sudre CH, Murray B, Varsavsky T, et al. Attributes and predictors of long COVID. Nature medicine. Apr 2021;27(4):626-631. doi:10.1038/s41591-021-01292-y
- Daugherty SE, Guo Y, Heath K, et al. Risk of clinical sequelae after the acute phase of SARS-CoV-2 infection: retrospective cohort study. BMJ. May 19 2021;373:n1098. doi:10.1136/bmj.n1098
- Antonelli M, Pujol JC, Spector TD, Ourselin S, Steves CJ. Risk of long COVID associated with delta versus omicron variants of SARS-CoV-2. Lancet. Jun 18 2022;399(10343):2263-2264. doi:10.1016/S0140-6736(22)00941-2
- Notarte KI, Catahay JA, Velasco JV, et al. Impact of COVID-19 vaccination on the risk of developing long-COVID and on existing long-COVID symptoms: A systematic review. EClinicalMedicine. Nov 2022;53:101624. doi:10.1016/j.eclinm.2022.101624
- Tenforde MW, Olson SM, Self WH, et al. Effectiveness of Pfizer-BioNTech and Moderna Vaccines Against COVID-19 Among Hospitalized Adults Aged >/=65 Years - United States, January-March 2021. MMWR Morb Mortal Wkly Rep. May 7 2021;70(18):674-679. doi:10.15585/mmwr.mm7018e1
- Zimmermann P, Pittet LF, Curtis N. The Challenge of Studying Long COVID: An Updated Review. Pediatr Infect Dis J. May 1 2022;41(5):424-426. doi:10.1097/inf.0000000000003502
- Pellegrino R, Chiappini E, Licari A, Galli L, Marseglia GL. Prevalence and clinical presentation of long COVID in children: a systematic review. European Journal of Pediatrics. 2022/09/15 2022;doi:10.1007/s00431-022-04600-x
- Zimmermann P, Pittet LF, Curtis N. How Common is Long COVID in Children and Adolescents? Pediatr Infect Dis J. Dec 1 2021;40(12):e482-e487. doi:10.1097/inf.0000000000003328
- Kompaniyets L, Bull-Otterson L, Boehmer TK, et al. Post-COVID-19 Symptoms and Conditions Among Children and Adolescents - United States, March 1, 2020-January 31, 2022. MMWR Morb Mortal Wkly Rep. Aug 5 2022;71(31):993-999. doi:10.15585/mmwr.mm7131a3
- Zavala M, Ireland G, Amin-Chowdhury Z, Ramsay ME, Ladhani SN. Acute and Persistent Symptoms in Children With Polymerase Chain Reaction (PCR)-Confirmed Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection Compared With Test-Negative Children in England: Active, Prospective, National Surveillance. Clin Infect Dis. Aug 24 2022;75(1):e191-e200. doi:10.1093/cid/ciab991
- Davis HE, Assaf GS, McCorkell L, et al. Characterizing long COVID in an international cohort: 7 months of symptoms and their impact. EClinicalMedicine. Aug 2021;38:101019. doi:10.1016/j.eclinm.2021.101019
- Groff D, Sun A, Ssentongo AE, et al. Short-term and Long-term Rates of Postacute Sequelae of SARS-CoV-2 Infection: A Systematic Review. JAMA Netw Open. Oct 1 2021;4(10):e2128568. doi:10.1001/jamanetworkopen.2021.28568
- Tillett RL, Sevinsky JR, Hartley PD, et al. Genomic evidence for reinfection with SARS-CoV-2: a case study. Lancet Infect Dis. Jan 2021;21(1):52-58. doi:10.1016/S1473-3099(20)30764-7
- Wang J, Kaperak C, Sato T, Sakuraba A. COVID-19 reinfection: a rapid systematic review of case reports and case series. Journal of investigative medicine : the official publication of the American Federation for Clinical Research. Aug 2021;69(6):1253-1255. doi:10.1136/jim-2021-001853
- Roskosky M, Borah BF, DeJonge PM, et al. Notes from the Field: SARS-CoV-2 Omicron Variant Infection in 10 Persons Within 90 Days of Previous SARS-CoV-2 Delta Variant Infection - Four States, October 2021-January 2022. MMWR Morb Mortal Wkly Rep. Apr 8 2022;71(14):524-526. doi:10.15585/mmwr.mm7114a2
- Slezak J, Bruxvoort K, Fischer H, Broder B, Ackerson B, Tartof S. Rate and severity of suspected SARS-Cov-2 reinfection in a cohort of PCR-positive COVID-19 patients. Clin Microbiol Infect. Dec 2021;27(12):1860 e7-1860 e10. doi:10.1016/j.cmi.2021.07.030
- Abu-Raddad LJ, Chemaitelly H, Bertollini R, National Study Group for C-E. Severity of SARS-CoV-2 Reinfections as Compared with Primary Infections. N Engl J Med. Dec 23 2021;385(26):2487-2489. doi:10.1056/NEJMc2108120
- Statistics OfN. Coronavirus (COVID-19) Infection Survey Technical Article: Impact of vaccination on testing positive in the UK. October 2021;
- Rossler A, Riepler L, Bante D, von Laer D, Kimpel J. SARS-CoV-2 Omicron Variant Neutralization in Serum from Vaccinated and Convalescent Persons. N Engl J Med. Feb 17 2022;386(7):698-700. doi:10.1056/NEJMc2119236
- Leon TM, Dorabawila V, Nelson L, et al. COVID-19 Cases and Hospitalizations by COVID-19 Vaccination Status and Previous COVID-19 Diagnosis - California and New York, May-November 2021. MMWR Morb Mortal Wkly Rep. Jan 28 2022;71(4):125-131. doi:10.15585/mmwr.mm7104e1
- Cavanaugh AM, Spicer KB, Thoroughman D, Glick C, Winter K. Reduced Risk of Reinfection with SARS-CoV-2 After COVID-19 Vaccination - Kentucky, May-June 2021. MMWR Morb Mortal Wkly Rep. Aug 13 2021;70(32):1081-1083. doi:10.15585/mmwr.mm7032e1
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