Children’s Doctor News and Updates Fall 2020

Convalescent Plasma May Help Children with Severe COVID-19

Early findings from researchers at CHOP show that convalescent plasma appears to be a safe and possibly effective treatment for children with life-threatening cases of COVID-19. The results were published in Pediatric Blood and Cancer.

This 4-patient study, the first report of convalescent plasma in children, indicated the use of convalescent plasma was not associated with antibody-dependent enhancement, in which antibodies developed during a previous infection cause a worsened response with subsequent infections, a concern that has been described in preclinical models of other coronaviruses. Additionally, convalescent plasma did not suppress endogenous antibody response.

“We believe that convalescent plasma may provide the greatest benefit for patients who are early into their illness and have not yet generated endogenous antibodies,” says hematologist David Teachey, MD, senior author of the study.

Diabetes Studies: Texts Help Type 1 Teens; Black Children Less Likely to Have Pumps

A CHOP study published in the Journal of Diabetes Science and Technology showed that text messaging may help teens better manage their type 1 diabetes.

Researchers combined text messaging with MyDiaText and financial incentives designed to help improve outcomes for adolescents with T1DM. Results showed persistent engagement with and potential for increase in self-care using this intervention. MyDiaText was developed in 2012 by a collaboration with the University of Pennsylvania School of Nursing, the School of Engineering and Applied Sciences and CHOP.

A separate study that compared children with type 1 diabetes seen in 2005 to those seen during 2011, 2013, 2015, 2017, and 2019 showed Black children with type 1 diabetes in the United States are far less likely than white children to be prescribed insulin pumps, even among those with private health insurance.

The total number of children with type 1 diabetes using insulin pumps increased overall in all groups (pump use rose from 9% in 2005 to 57.6% in 2019), but racial disparities persisted. Black children have been only about half as likely as white children to use insulin pumps, while Hispanic children fall in between.

The study, published in the Journal of Pediatric Nursing, did not examine potential causes of the disparities in treatment, but “provider bias has been shown to play a critical role in the prescribing of diabetes technologies. The provider perceptions of a family's ability to incur the costs of new therapies, and of family competence, are important factors in determining the prescribed treatment regimens,” says author Terri H. Lipman, PhD, nurse practitioner in CHOP’s Diabetes Center and professor of nursing at the University of Pennsylvania School of Nursing.

New Locations for CHOP Primary Care Practices

The Nicholas and Athena Karabots Primary Care Center Norristown, opened in August, replaces a smaller primary care facility. The new location was made possible when Nicholas and Athena Karabots, longtime supporters of CHOP, pledged $2 million to support the re-location to 1437 Dekalb Street, Suite 100, Norristown, Pennsylvania, 19401.

In addition to high-quality, comprehensive primary care, the newly renovated, 10,000 square foot space will offer critical services, such as onsite behavioral health and social work, to meet the needs of children and families in the community.

Two long-time practices, West Chester and North Hills, merged and moved into a much larger location at 770 Miles Road, Suite 1, West Chester, Pennsylvania 19380. The new space is more modern than either prior offices, and allows for more appointments and future expanded services, including behavioral health, social work, and CHOP’s early literacy program, Reach Out and Read.

Sleep Problems Associated With Impaired Academic And Psychosocial Functioning

Screen children for sleep problems early and often is the recommendation coming out of a CHOP study published in The Journal of Child Psychology and Psychiatry.

“Our study shows that although those with persistent sleep problems have the greatest impairments when it comes to broad child well-being, even those with mild sleep problems over time experience some psychosocial impairments,” says Ariel A. Williamson, PhD, a psychologist in the CHOP’s Sleep Center. “The range of impairments across academic and psychosocial domains in middle childhood indicate that it is important to screen for sleep problems consistently over the course of a child’s development, especially to target children who experience persistent sleep problems over time.”

Conclusions came from examining data from an Australian birth cohort of more than 5,000 patients and caregivers’ reports on whether their children had sleep problems at multiple points in time, from birth through 10 or 11 years of age. Caregivers and teachers reported on child well-being domains, including self-control, mental health symptoms, and academic skills, when children were 10 or 11 years of age.