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Author

Brit Trogen

Other affiliations: Boston Children's Hospital
Bio: Brit Trogen is an academic researcher from New York University. The author has contributed to research in topics: Medicine & Allergy. The author has an hindex of 5, co-authored 15 publications receiving 112 citations. Previous affiliations of Brit Trogen include Boston Children's Hospital.

Papers
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Journal ArticleDOI
TL;DR: In this paper, the authors discuss the Peltzman effect, a phenomenon in which individuals respond to safety measures with a compensatory increase in risky behavior, and how it relates to the COVID-19 pandemic through "pandemic fatigue" and post vaccination behavior.
Abstract: The authors of this commentary discuss the “Peltzman Effect,” a phenomenon in which individuals respond to safety measures with a compensatory increase in risky behavior, and how it relates to the COVID-19 pandemic through “pandemic fatigue” and postvaccination behavior.

48 citations

Journal ArticleDOI
TL;DR: A 17-year-old obese male was admitted to the pediatric intensive care unit after presenting with fluid-responsive septic shock following 7 days of fever, gastrointestinal symptoms and neck pain and repeat echocardiogram demonstrated improved heart function with only residual myocardial dysfunction.
Abstract: A 17-year-old obese male was admitted to the pediatric intensive care unit after presenting with fluid-responsive septic shock following 7 days of fever, gastrointestinal symptoms and neck pain. Initial workup was positive for SARS-CoV-2 and elevated troponin I and brain natriuretic peptide. Echocardiography and cardiac magnetic resonance imaging confirmed acute myocarditis. One week after discharge, repeat echocardiogram demonstrated improved heart function with only residual myocardial dysfunction.

35 citations

Journal ArticleDOI
08 Apr 2021
TL;DR: The vaccine hesitancy may become a defining theme of the next stage of the COVID-19 pandemic as discussed by the authors, as supply meets demand, vaccine shortage becomes a major concern.
Abstract: Vaccines are one of the greatest medical innovations of all time, but there has been skepticism about them throughout history. Although initial concerns about scarcity increased public demand for COVID-19 vaccines, as supply meets demand, vaccine hesitancy may become a defining theme of the next stage of the COVID-19 pandemic.

27 citations

Journal ArticleDOI
TL;DR: A 12-year-old boy presented to the emergency department with findings concerning for multisystem inflammatory syndrome in children as mentioned in this paper, which was subsequently controlled with antiepileptic medications.

14 citations


Cited by
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Journal ArticleDOI
TL;DR: The authors in this article reviewed potential challenges to success in each of these dimensions and discussed policy implications. But having licensed vaccines is not enough to achieve global control of COVID-19: they also need to be produced at scale, priced affordably, allocated globally so that they are available where needed, and widely deployed in local communities.

782 citations

Journal ArticleDOI
TL;DR: In this article, estimates of vaccine effectiveness are urgently needed to support mass vaccination campaigns to prevent coronavirus disease 2019 (Covid-19) are occurring in many countries.
Abstract: Background Mass vaccination campaigns to prevent coronavirus disease 2019 (Covid-19) are occurring in many countries; estimates of vaccine effectiveness are urgently needed to support deci...

572 citations

Journal ArticleDOI
TL;DR: In this article, the authors investigated the range and severity of neurologic involvement among children and adolescents associated with COVID-19 and found that patients with involvement were more likely to have underlying neurologic disorders (81 of 365 [22] compared with those without (113 of 1330 [8%]), but a similar number were previously healthy (195 [53%] vs 723 [54%]) and met criteria for multisystem inflammatory syndrome in children (126 [35%] vs 490 [37%]).
Abstract: Importance Coronavirus disease 2019 (COVID-19) affects the nervous system in adult patients. The spectrum of neurologic involvement in children and adolescents is unclear. Objective To understand the range and severity of neurologic involvement among children and adolescents associated with COVID-19. Setting, Design, and Participants Case series of patients (age Exposures Severe acute respiratory syndrome coronavirus 2. Main Outcomes and Measures Type and severity of neurologic involvement, laboratory and imaging data, and outcomes (death or survival with new neurologic deficits) at hospital discharge. Results Of 1695 patients (909 [54%] male; median [interquartile range] age, 9.1 [2.4-15.3] years), 365 (22%) from 52 sites had documented neurologic involvement. Patients with neurologic involvement were more likely to have underlying neurologic disorders (81 of 365 [22%]) compared with those without (113 of 1330 [8%]), but a similar number were previously healthy (195 [53%] vs 723 [54%]) and met criteria for multisystem inflammatory syndrome in children (126 [35%] vs 490 [37%]). Among those with neurologic involvement, 322 (88%) had transient symptoms and survived, and 43 (12%) developed life-threatening conditions clinically adjudicated to be associated with COVID-19, including severe encephalopathy (n = 15; 5 with splenial lesions), stroke (n = 12), central nervous system infection/demyelination (n = 8), Guillain-Barre syndrome/variants (n = 4), and acute fulminant cerebral edema (n = 4). Compared with those without life-threatening conditions (n = 322), those with life-threatening neurologic conditions had higher neutrophil-to-lymphocyte ratios (median, 12.2 vs 4.4) and higher reported frequency of D-dimer greater than 3 μg/mL fibrinogen equivalent units (21 [49%] vs 72 [22%]). Of 43 patients who developed COVID-19–related life-threatening neurologic involvement, 17 survivors (40%) had new neurologic deficits at hospital discharge, and 11 patients (26%) died. Conclusions and Relevance In this study, many children and adolescents hospitalized for COVID-19 or multisystem inflammatory syndrome in children had neurologic involvement, mostly transient symptoms. A range of life-threatening and fatal neurologic conditions associated with COVID-19 infrequently occurred. Effects on long-term neurodevelopmental outcomes are unknown.

220 citations

Journal ArticleDOI
TL;DR: In this article, the authors performed a systematic review and described the epidemiological, clinical, and prognostic characteristics of 953 PIMS-TS/MIS(-C) cases in 68 records.
Abstract: An association between a novel pediatric hyperinflammatory condition and SARS-CoV-2 was recently published and termed pediatric inflammatory multisystem syndrome, temporally associated with SARS-CoV-2 (PIMS-TS) or multisystem inflammatory syndrome (in children) (MIS(-C)). We performed a systematic review and describe the epidemiological, clinical, and prognostic characteristics of 953 PIMS-TS/MIS(-C) cases in 68 records. Additionally, we studied the sensitivity of different case definitions that are currently applied. PIMS-TS/MIS(-C) presents at a median age of 8 years. Epidemiological enrichment for males (58.9%) and ethnic minorities (37.0% Black) is present. Apart from obesity (25.3%), comorbidities are rare. PIMS-TS/MIS(-C) is characterized by fever (99.4%), gastrointestinal (85.6%) and cardiocirculatory manifestations (79.3%), and increased inflammatory biomarkers. Nevertheless, 50.3% present respiratory symptoms as well. Over half of patients (56.3%) present with shock. The majority of the patients (73.3%) need intensive care treatment, including extracorporal membrane oxygenation (ECMO) in 3.8%. Despite severe disease, mortality is rather low (1.9%). Of the currently used case definitions, the WHO definition is preferred, as it is more precise, while encompassing most cases.Conclusion: PIMS-TS/MIS(-C) is a severe, heterogeneous disease with epidemiological enrichment for males, adolescents, and racial and ethnic minorities. However, mortality rate is low and short-term outcome favorable. Long-term follow-up of chronic complications and additional clinical research to elucidate the underlying pathogenesis is crucial. What is Known: • A novel pediatric inflammatory syndrome with multisystem involvement has been described in association with SARS-CoV-2. • To date, the scattered reporting of cases and use of different case definitions provides insufficient insight in the full clinical spectrum, epidemiological and immunological features, and prognosis. What is New: • This systematic review illustrates the heterogeneous spectrum of PIMS-TS/MIS(-C) and its epidemiological enrichment for males, adolescents, and racial and ethnic minorities. • Despite its severe presentation, overall short-term outcome is good. • The WHO MIS definition is preferred, as it is more precise, while encompassing most cases.

219 citations

Journal ArticleDOI
TL;DR: In this paper, the authors applied both human monoclonal anti-SARS-Cov-2 antibodies (spike protein, nucleoprotein) and rabbit polyclonal SARS-CoV-2 antibody (envelope protein, membrane protein) to 55 different tissue antigens.
Abstract: We sought to determine whether immune reactivity occurs between anti-SARS-CoV-2 protein antibodies and human tissue antigens, and whether molecular mimicry between COVID-19 viral proteins and human tissues could be the cause. We applied both human monoclonal anti-SARS-Cov-2 antibodies (spike protein, nucleoprotein) and rabbit polyclonal anti-SARS-Cov-2 antibodies (envelope protein, membrane protein) to 55 different tissue antigens. We found that SARS-CoV-2 antibodies had reactions with 28 out of 55 tissue antigens, representing a diversity of tissue groups that included barrier proteins, gastrointestinal, thyroid and neural tissues, and more. We also did selective epitope mapping using BLAST and showed similarities and homology between spike, nucleoprotein, and many other SARS-CoV-2 proteins with the human tissue antigens mitochondria M2, F-actin and TPO. This extensive immune cross-reactivity between SARS-CoV-2 antibodies and different antigen groups may play a role in the multi-system disease process of COVID-19, influence the severity of the disease, precipitate the onset of autoimmunity in susceptible subgroups, and potentially exacerbate autoimmunity in subjects that have pre-existing autoimmune diseases. Very recently, human monoclonal antibodies were approved for use on patients with COVID-19. The human monoclonal antibodies used in this study are almost identical with these approved antibodies. Thus, our results can establish the potential risk for autoimmunity and multi-system disorders with COVID-19 that may come from cross-reactivity between our own human tissues and this dreaded virus, and thus ensure that the badly-needed vaccines and treatments being developed for it are truly safe to use against this disease.

183 citations