Publications by authors named "Manjula D Nugawela"
Article Synopsis
- - The study explores the long-term effects of SARS-CoV-2 in children and young people (CYP), identifying a condition called post-COVID-19 condition (PCC) and examining symptoms and impacts up to 24 months post-infection.
- - Out of 31,012 eligible CYP, 12,632 participated, revealing that 7.2% consistently met the PCC criteria over two years, with around 20-25% reporting three or more symptoms, and symptom severity was found to be higher in older and more deprived groups.
- - The findings emphasize the necessity of longitudinal research to better understand both the prevalence and severity of PCC symptoms in CYP, as well as the importance of monitoring clinical impairment over
Background: Predicting which children and young people (CYP) are at the highest risk of developing post-COVID-19 condition (PCC) could improve care pathways. We aim to develop and validate prediction models for persistent PCC up to 24 months post-infection in CYP.
Methods: CYP who were PCR-positive between September 2020 and March 2021, with follow-up data up to 24-months post-infection, were analysed.
Article Synopsis
- - The study examines the methodological challenges in assessing Long Covid in children and young people (CYP), particularly regarding issues like non-response and attrition that could lead to biased findings.
- - It aims to create survey weights for the CLoCk study to better understand the prevalence of symptoms (like shortness of breath and tiredness) over time in both SARS-CoV-2 positive and negative CYP.
- - The successful development and application of flexible survey weights allow for the adjustment of findings, making them more generalizable to the overall CYP population in England and emphasizing the need to account for selection biases when analyzing such studies.
Article Synopsis
- Cognitive impairment, referred to as "brain fog," was reported in 7.0% of first-time PCR-positive children and young people (CYP) and 7.5% of reinfected CYP 12 months after SARS-CoV-2 infection, indicating no significant difference by infection status.
- Most cases of cognitive impairment either appeared at the time of testing or within three months post-test, with similar prevalence observed across both groups.
- A majority of those with cognitive issues were aged 15 to 17, suggesting a potential age-related trend in the manifestation of cognitive impairments related to the infection.
Our previous study in children and young people (CYP) at 3- and 6-months post-infection showed that 12-16% of those infected with the Omicron (B.1.1.
View Article and Find Full Text PDFBackground: Pediatric Post-COVID-Condition (PPCC) clinics treat children despite limited scientific substantiation. By exploring real-life management of children diagnosed with PPCC, the International Post-COVID-Condition in Children Collaboration (IP4C) aimed to provide guidance for future PPCC care.
Methods: We performed a cross-sectional international, multicenter study on used PPCC definitions; the organization of PPCC care programs and patients characteristics.
Background: Little is known about the long-term mental health consequences of the pandemic in children and young people (CYP), despite extremely high levels of exposure to the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) virus and the disruption to schooling and leisure activities due to the resultant restrictions. There are mixed findings from systematic reviews of how the pandemic affected CYP's mental health, which may be due to heterogeneous methods and poor quality studies. Most, but not all, suggest deterioration in mental health but population level studies may obscure the differing experiences of subgroups.
View Article and Find Full Text PDFBackground: Post-COVID services have been set up in England to treat children with ongoing symptoms of Long COVID. To date, the characteristics of children seeking treatment from these services has not been described.
Purpose: (1) to describe the characteristics of children aged 11-17 referred to the Pan-London Post-COVID service and (2) to compare characteristics of these children with those taking part in the United Kingdom's largest research study of Long COVID in children (CLoCk).
Article Synopsis
- The study investigates the impact of the COVID-19 pandemic on loneliness among children and young people (CYP), noting an increase from 6.5% feeling lonely before the pandemic to 17.4% during it.
- A total of 31,017 participants from the Children with Long COVID (CLoCk) study completed an online survey addressing loneliness in relation to demographics, lifestyle, and health.
- Results show significant associations between loneliness and factors such as age, gender, ethnicity, family size, and socioeconomic status, highlighting the need for targeted interventions and ongoing support for affected CYP.
Background: Although 99% of children and young people have been exposed to SARS-CoV-2, the long-term prevalence of post-COVID-19 symptoms in young people is unclear. The aim of this study is to describe symptom profiles 12 months after SARS-CoV-2 testing.
Method: A matched cohort study of a national sample of 20,202 children and young people who took a SARS-CoV-2 PCR test between September 2020 and March 2021.
To describe the prevalence of long COVID in children infected for the first time (n = 332) or reinfected (n = 243) with Omicron compared with test-negative children (n = 311). Overall, 12%-16% of those infected with Omicron met the research definition of long COVID at 3 and 6 months after infection, with no evidence of difference between cases of first positive and reinfected (P = 0.17).
View Article and Find Full Text PDFBackground: Little is known about the prevalence and natural trajectory of post-COVID symptoms in young people, despite very high numbers of young people having acute COVID. To date, there has been no prospective follow-up to establish the pattern of symptoms over a 6-month time period.
Methods: A non-hospitalised, national sample of 3,395 (1,737 SARS-COV-2 Negative;1,658 SARS-COV-2 Positive at baseline) children and young people (CYP) aged 11-17 completed questionnaires 3 and 6 months after PCR-confirmed SARS-CoV-2 infection between January and March 2021 and were compared with age, sex and geographically-matched test-negative CYP.
Objectives: To describe the physical and mental health of children and young people (CYP) 6 months after infection with SARS-CoV-2 and explore whether this varies by COVID-19 vaccination.
Design: A non-hospitalised, national cohort of people aged 11-17 years old with PCR-confirmed SARS-CoV-2 infection and PCR negatives matched at study invitation, by age, sex, region and date of testing who completed questionnaires 6 months after PCR testing. The questionnaire included 21 symptoms and standardised scales (eg, EQ-5D-Y and Chalder Fatigue Scale).
Background: Despite high numbers of children and young people (CYP) having acute COVID, there has been no prospective follow-up of CYP to establish the pattern of health and well-being over a year following infection.
Methods: A non-hospitalised, national sample of 5086 (2909 SARS-COV-2 Positive; 2177 SARS-COV-2 Negative at baseline) CYP aged 11-17 completed questionnaires 6- and 12-months after PCR-tests between October 2020 and March 2021 confirming SARS-CoV-2 infection (excluding CYP with subsequent (re)infections). SARS-COV-2 Positive CYP was compared to age, sex and geographically-matched test-negative CYP.
Background: To update and internally validate a model to predict children and young people (CYP) most likely to experience long COVID (i.e. at least one impairing symptom) 3 months after SARS-CoV-2 PCR testing and to determine whether the impact of predictors differed by SARS-CoV-2 status.
View Article and Find Full Text PDFBackground: Delayed diagnosis and treatment of sight threatening diabetic retinopathy (STDR) is a common cause of visual impairment in people with Type 2 diabetes. Therefore, systematic regular retinal screening is recommended, but global coverage of such services is challenging. We aimed to develop and validate predictive models for STDR to identify 'at-risk' population for retinal screening.
View Article and Find Full Text PDFObjective: The aim of this study was to derive a research definition for 'Long COVID (post-COVID-19 condition)' in children and young people (CYP) to allow comparisons between research studies.
Design: A three-phase online Delphi process was used, followed by a consensus meeting. Participants were presented with 49 statements in each phase and scored them from 1 to 9 based on how important they were for inclusion in the research definition of Long COVID in CYP.
There is little data on ethnic differences in incidence of DR and sight threatening DR (STDR) in the United Kingdom. We aimed to determine ethnic differences in the development of DR and STDR and to identify risk factors of DR and STDR in people with incident or prevalent type II diabetes (T2DM). We used electronic primary care medical records of people registered with 134 general practices in East London during the period from January 2007-January 2017.
View Article and Find Full Text PDFAim: To examine the impact of attainment of primary care diabetes clinical indicators on progression to sight-threatening diabetic retinopathy (STDR) among those with mild non-proliferative diabetic retinopathy (NPDR).
Materials And Methods: An historical cohort study of 18,978 adults (43.63% female) diagnosed with type 2 diabetes before 1 April 2010 and mild NPDR before 1 April 2011 was conducted.
Article Synopsis
- - In September 2014, Bristol Royal Infirmary's liaison psychiatry services received a £250,000 annual investment to boost service hours from 40 to 98 hours per week, aiming to improve patient care for self-harm cases in the emergency department.
- - An analysis of self-harm emergency department data from 2011 to 2017 showed a 13% increase in self-harm attendances, a significant reduction in waiting times for psychosocial assessments, and a notable increase in referrals to other agencies after the service expansion.
- - Overall, the investment led to better patient outcomes, such as quicker assessments and more referrals, with only a minor increase in hospital costs per episode despite the rise in emergency
To evaluate the performance of Madras Diabetes Research Foundation-Indian Diabetes Risk Score (MDRF-IDRS) in different ethnic groups, including Indians, Hispanic, non-Hispanic whites, non-Hispanic blacks, and other American. The MDRF-IDRS is calculated based on a risk equation that includes age, waist circumference, family history of diabetes, and physical activity. The National Health and Nutrition Examination Survey data on American and Chennai Urban Rural Epidemiology Study data on Indians were used in this study.
View Article and Find Full Text PDFObjective: To evaluate the effectiveness and predictive accuracy of early warning scores (EWS) to predict deteriorating patients in pre-hospital settings.
Methods: Systematic review. Seven databases searched to August 2017.
Rapidly Increasing Trend of Recorded Alcohol Consumption Since the End of the Armed Conflict in Sri Lanka.
Alcohol Alcohol
September 2017
Aim: To evaluate temporal changes in recorded alcohol consumption in Sri Lanka during and after the armed conflict 1998-2013.
Methods: District level alcohol sales, and mid-year population data for the whole study period (1998-2013) were consistently available from the Department of Excise and the Department of Census and Statistics for 18 of 25 districts. These data were used to estimate the recorded per capita consumption for the areas that were not directly exposed to the armed conflict.