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COV
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K
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C
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Po
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Pre
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T
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to
s
tan
d
ar
d
ize
ca
r
e
an
d
r
esear
ch
.
As
to
th
ese
c
r
iter
ia,
th
e
illn
ess
u
s
u
ally
m
a
n
if
ests
with
in
th
r
ee
m
o
n
th
s
o
f
b
e
g
in
n
in
g
in
c
h
ild
r
en
an
d
ad
o
lescen
ts
wh
o
h
a
v
e
a
h
is
to
r
y
o
f
s
u
s
p
ec
ted
o
r
p
r
o
v
en
SAR
S
-
C
o
V
-
2
in
f
ec
tio
n
.
T
h
e
s
y
m
p
to
m
s
m
u
s
t
r
em
ain
f
o
r
at
least
two
m
o
n
th
s
an
d
ca
n
n
o
t
b
e
attr
i
b
u
ted
to
a
n
y
o
th
e
r
d
iag
n
o
s
is
(
W
HO,
2
0
2
3
)
.
T
h
e
n
ee
d
f
o
r
p
ed
iatr
ic
-
f
o
cu
s
ed
r
esear
ch
is
em
p
h
asized
b
y
th
is
d
ef
i
n
itio
n
,
wh
ich
also
u
n
d
er
lin
es si
g
n
if
ican
t
d
is
p
ar
ities
in
p
r
esen
tatio
n
b
etwe
en
c
h
i
ld
r
en
an
d
ad
u
lts
[
4
]
,
[
5
]
.
A
s
ig
n
if
ican
t
p
er
ce
n
tag
e
o
f
c
h
ild
r
en
ex
p
er
ien
ce
p
er
s
is
ten
t
s
y
m
p
to
m
s
m
o
n
th
s
af
ter
i
n
f
ec
tio
n
,
ev
en
th
o
u
g
h
p
r
ev
ale
n
ce
esti
m
ates
v
ar
y
g
r
ea
tly
d
ep
en
d
in
g
o
n
m
et
h
o
d
o
lo
g
y
,
ac
c
o
r
d
in
g
to
r
ec
e
n
t
lar
g
e
-
s
ca
le
s
tu
d
ies
lik
e
th
e
UK
C
L
o
C
K
co
h
o
r
t
an
d
th
e
US
NI
H
R
E
C
OVE
R
e
f
f
o
r
t
[
4
]
–
[
6
]
.
T
h
e
id
en
tifie
d
r
is
k
f
ac
to
r
s
in
clu
d
e
o
ld
er
ag
e
with
in
ch
ild
h
o
o
d
,
p
r
e
-
ex
is
tin
g
r
esp
ir
ato
r
y
o
r
aller
g
ic
co
n
d
itio
n
s
,
o
b
esit
y
,
s
ev
er
e
ac
u
te
C
OVI
D
-
1
9
,
an
d
h
o
s
p
italizatio
n
.
Ad
o
lescen
ts
s
ee
m
to
b
e
m
o
r
e
a
f
f
ec
ted
t
h
an
y
o
u
n
g
er
ch
ild
r
e
n
[
7
]
–
[
1
0
]
.
Vir
al
p
e
r
s
is
ten
ce
,
im
m
u
n
o
lo
g
ical
d
y
s
r
eg
u
latio
n
,
an
d
au
to
im
m
u
n
ity
,
d
y
s
au
t
o
n
o
m
ia,
e
n
d
o
th
elial
d
y
s
f
u
n
ct
io
n
,
m
icr
o
v
ascu
lar
d
am
ag
e,
an
d
ch
a
n
g
es
in
m
i
to
c
h
o
n
d
r
ial
o
r
m
icr
o
b
io
m
e
f
u
n
ctio
n
ar
e
s
o
m
e
o
f
th
e
m
ec
h
an
is
ti
c
th
eo
r
ies
f
o
r
p
o
s
t
-
C
OVI
D
-
1
9
s
y
n
d
r
o
m
e
in
c
h
ild
r
en
[
1
1
]
–
[
1
3
]
.
T
h
ese
p
r
o
ce
s
s
es
m
ig
h
t
ch
an
g
e
d
e
p
en
d
i
n
g
o
n
th
e
d
ev
elo
p
m
en
tal
s
tag
e,
wh
ich
co
u
l
d
ex
p
lain
wh
y
p
ed
iatr
ic
p
o
p
u
latio
n
s
h
av
e
s
u
ch
d
i
v
er
s
e
clin
ical
ch
ar
ac
ter
is
tics
.
New
v
ar
iatio
n
s
,
b
r
o
ad
p
ast
in
f
ec
tio
n
s
,
an
d
r
is
in
g
v
ac
cin
atio
n
r
ate
s
h
av
e
all
co
n
tr
i
b
u
ted
to
t
h
e
p
an
d
em
ic'
s
o
n
g
o
in
g
ev
o
lu
tio
n
.
Alth
o
u
g
h
ca
u
tio
n
is
s
till
r
eq
u
ir
ed
,
th
e
in
cid
en
ce
o
f
MI
S
-
C
h
as d
ec
r
ea
s
ed
i
n
co
m
p
ar
is
o
n
to
th
e
ea
r
ly
p
an
d
em
ic
[
1
4
]
,
[
1
5
]
.
Ad
d
itio
n
ally
,
p
r
elim
in
ar
y
d
ata
in
d
icate
th
at
th
e
C
OVI
D
-
1
9
v
ac
cin
e
m
ay
lo
wer
ch
ild
r
en
'
s
r
is
k
o
f
p
o
s
t
-
ac
u
te
s
eq
u
elae
,
alt
h
o
u
g
h
r
esu
lts
ar
e
co
n
f
lictin
g
a
n
d
n
ee
d
m
o
r
e
r
esear
ch
[
1
6
]
,
[
1
7
]
.
Un
ce
r
tain
ties
r
em
ain
ab
o
u
t
th
e
o
cc
u
r
r
e
n
ce
,
d
u
r
atio
n
,
r
is
k
f
ac
to
r
s
,
an
d
lo
n
g
-
ter
m
co
n
s
eq
u
en
ce
s
o
f
p
o
s
t
-
C
OVI
D
-
1
9
s
y
n
d
r
o
m
e
in
ch
ild
r
en
,
d
esp
ite
th
e
r
a
p
id
ly
g
r
o
win
g
b
o
d
y
o
f
in
f
o
r
m
atio
n
b
etwe
en
2
0
2
0
a
n
d
2
0
2
5
.
T
o
m
a
p
th
e
s
co
p
e
o
f
ex
is
tin
g
r
esear
ch
,
p
in
p
o
in
t
k
n
o
w
led
g
e
g
a
p
s
,
an
d
el
u
cid
ate
s
y
m
p
to
m
clu
s
ter
s
,
r
is
k
f
ac
to
r
s
,
an
d
u
n
d
er
ly
in
g
m
ec
h
a
n
is
m
s
,
a
s
co
p
in
g
r
ev
iew
is
n
e
ce
s
s
ar
y
.
T
h
is
r
ev
iew
s
p
ec
if
ica
lly
aim
s
to
an
s
wer
th
e
f
o
llo
win
g
q
u
esti
o
n
:
W
h
at
ar
e
t
h
e
lo
n
g
-
ter
m
s
y
m
p
t
o
m
s
,
r
is
k
f
ac
t
o
r
s
,
an
d
o
u
tco
m
es
i
d
en
tifie
d
i
n
p
a
p
er
s
p
u
b
lis
h
ed
b
etwe
en
2
0
2
0
an
d
2
0
2
5
f
o
r
c
h
ild
r
en
a
n
d
ad
o
lescen
t
s
with
p
o
s
t
-
C
OVI
D
-
1
9
co
n
d
itio
n
s
,
in
clu
d
in
g
MI
S
-
C
?
T
o
s
u
p
p
o
r
t
b
etter
c
h
ild
r
en
a
n
d
f
a
m
ilies
af
f
ec
ted
b
y
p
o
s
t
-
C
OVI
D
-
1
9
d
is
o
r
d
e
r
s
,
th
i
s
s
tu
d
y
attem
p
ts
to
p
r
o
v
id
e
in
s
ig
h
ts
th
at
will
g
u
i
d
e
r
eh
a
b
ilit
atio
n
an
d
e
d
u
ca
tio
n
al
p
lan
n
in
g
,
im
p
r
o
v
e
clin
ica
l
m
an
ag
em
en
t,
an
d
s
h
ap
e
p
u
b
lic
h
ea
lth
m
ea
s
u
r
es
b
y
co
m
b
in
in
g
th
e
av
ailab
le
d
a
ta
[
4
]
,
[
1
8
]
.
2.
T
H
E
O
RI
E
S O
R
CO
NC
E
P
T
UAL F
RA
M
E
WO
RK
C
o
n
s
tr
u
al
lev
el
th
e
o
r
y
(
C
L
T
)
s
er
v
es
as
th
e
co
n
ce
p
tu
al
f
o
u
n
d
atio
n
th
at
d
ir
ec
ts
th
is
in
v
esti
g
atio
n
.
Acc
o
r
d
in
g
to
p
s
y
c
h
o
lo
g
ical
d
i
s
tan
ce
,
th
e
p
er
ce
i
v
ed
s
ep
ar
ati
o
n
b
etwe
en
o
n
eself
a
n
d
a
n
ev
en
t
in
ter
m
s
o
f
tim
e
(
tem
p
o
r
al
d
is
tan
ce
)
,
s
p
ac
e
(
s
p
atial
d
is
tan
ce
)
,
s
o
cial
i
n
ter
ac
tio
n
s
(
s
o
cial
d
is
tan
ce
)
,
o
r
lik
eli
h
o
o
d
(
h
y
p
o
t
h
etica
l
d
is
tan
ce
)
,
C
L
T
d
escr
ib
es
h
o
w
p
eo
p
le
v
iew,
ass
ess
,
a
n
d
r
ea
ct
to
e
v
en
ts
[
1
9
]
,
[
2
0
]
.
I
n
co
n
tr
ast
to
p
s
y
c
h
o
lo
g
ically
d
is
tan
t
ev
en
ts
,
wh
ich
ar
e
p
r
o
ce
s
s
ed
in
m
o
r
e
ab
s
tr
ac
t,
g
en
er
alize
d
way
s
,
ev
en
ts
ex
p
er
ien
ce
d
as
clo
s
er
in
d
is
tan
ce
ar
e
in
te
r
p
r
eted
c
o
n
cr
etely
a
n
d
in
d
e
p
th
.
On
e
o
f
th
e
m
ai
n
ch
ar
ac
ter
is
tics
o
f
h
u
m
an
co
g
n
itio
n
is
th
e
ca
p
ac
ity
to
m
en
tally
m
o
v
e
b
ey
o
n
d
th
e
p
r
esen
t
to
th
in
k
a
b
o
u
t
th
e
p
ast,
th
e
f
u
tu
r
e,
o
r
h
y
p
o
th
etica
l sit
u
atio
n
s
.
T
h
r
o
u
g
h
lo
c
k
d
o
wn
s
,
is
o
latio
n
,
an
d
p
r
o
tr
ac
ted
u
n
ce
r
tain
t
y
,
th
e
C
OVI
D
-
1
9
p
an
d
e
m
ic
e
x
ac
er
b
ated
s
o
cial
an
d
tem
p
o
r
al
g
ap
s
an
d
ca
u
s
ed
h
ith
er
to
u
n
h
ea
r
d
-
o
f
d
is
r
u
p
tio
n
s
to
h
ea
lth
s
y
s
tem
s
an
d
d
aily
life
.
Un
d
er
s
tan
d
in
g
h
o
w
ch
ild
r
e
n
an
d
f
am
ilies
v
iewe
d
th
ese
d
i
s
r
u
p
tio
n
s
an
d
h
o
w
th
o
s
e
p
er
ce
p
tio
n
s
in
f
lu
en
ce
d
co
p
in
g
a
n
d
a
d
ap
tatio
n
is
m
a
d
e
ea
s
ier
with
th
e
h
elp
o
f
C
L
T
[
2
1
]
,
[
2
2
]
.
Fo
r
in
s
tan
ce
,
wh
er
e
as
p
ar
en
ts
,
d
o
cto
r
s
,
an
d
ed
u
ca
to
r
s
m
a
y
th
in
k
m
o
r
e
ab
s
tr
ac
tly
ab
o
u
t
t
h
e
lo
n
g
-
ter
m
ef
f
ec
ts
,
c
h
ild
r
en
m
ay
c
o
n
ce
n
tr
ate
o
n
t
h
e
im
m
ed
iate
an
d
p
alp
ab
le
s
y
m
p
to
m
s
.
W
h
en
ap
p
lied
to
ch
ild
r
e
n
'
s
p
o
s
t
-
C
OVI
D
-
1
9
co
n
d
i
tio
n
,
C
L
T
ex
p
lain
s
th
e
v
ar
iatio
n
in
p
er
ce
p
tio
n
s
an
d
ap
p
r
o
ac
h
es
to
m
a
n
ag
in
g
lin
g
e
r
in
g
s
y
m
p
to
m
s
.
L
o
n
g
-
last
in
g
s
y
m
p
to
m
s
m
ay
b
e
s
ee
n
d
if
f
e
r
en
tly
b
y
ad
o
lescen
ts
wh
o
ar
e
d
ev
elo
p
m
en
tally
m
o
r
e
o
r
ien
ted
to
war
d
ab
s
tr
ac
t
an
d
f
u
tu
r
e
-
f
o
cu
s
ed
th
in
k
in
g
th
an
b
y
y
o
u
n
g
er
ch
ild
r
en
,
wh
ich
co
u
ld
h
a
v
e
an
im
p
ac
t
o
n
co
p
i
n
g
m
ec
h
an
is
m
s
,
r
esil
ien
ce
,
an
d
h
ea
lth
-
s
ee
k
in
g
ac
tiv
ities
[
1
3
]
,
[
2
3
]
.
H
o
wev
e
r
,
p
ar
e
n
ts
an
d
m
e
d
ical
p
r
o
f
e
s
s
io
n
als
f
r
eq
u
en
tly
in
ter
p
r
et
th
ese
r
esu
lts
o
n
a
lo
n
g
er
-
ter
m
,
m
o
r
e
c
o
m
p
r
e
h
e
n
s
iv
e
s
ca
le,
d
ir
ec
tin
g
t
r
ea
tm
en
ts
an
d
s
u
p
p
o
r
t
s
y
s
tem
s
.
Ad
d
itio
n
ally
,
C
L
T
illu
m
in
ates
th
e
p
s
y
ch
o
lo
g
ical
to
ll
o
f
p
r
o
lo
n
g
ed
C
OVI
D.
A
ch
ild
'
s
cu
r
r
en
t
ex
p
er
ien
ce
an
d
th
e
an
ticip
atio
n
o
f
"f
u
ll
r
ec
o
v
er
y
"
a
r
e
p
s
y
c
h
o
lo
g
ically
s
ep
ar
ated
b
y
p
er
s
is
ten
t
s
y
m
p
to
m
s
,
in
clu
d
in
g
ex
h
a
u
s
tio
n
,
m
o
o
d
s
win
g
s
,
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8
8
0
6
I
n
t J Pu
b
lic
Hea
lth
Sci
,
Vo
l.
1
5
,
No
.
1
,
Ma
r
ch
20
2
6
:
8
-
22
10
an
d
co
g
n
itiv
e
f
o
g
.
T
h
is
d
is
tan
ce
ca
n
in
f
lu
en
ce
f
am
ily
r
esil
ien
ce
an
d
ad
a
p
tatio
n
w
h
ile
also
lo
wer
in
g
m
o
tiv
atio
n
f
o
r
ed
u
ca
tio
n
,
s
o
ci
al
in
ter
ac
tio
n
,
an
d
r
eh
a
b
ilit
atio
n
[
3
]
,
[
4
]
.
T
h
is
s
tu
d
y
em
p
h
asizes
h
o
w
p
s
y
ch
o
lo
g
ical
d
is
tan
ce
s
h
ap
e
s
ch
ild
r
en
'
s
an
d
f
am
ilies
'
p
er
ce
p
tio
n
s
o
f
d
is
ea
s
e
an
d
r
ec
o
v
er
y
b
y
p
lac
in
g
p
o
s
t
-
C
OVI
D
-
1
9
s
y
n
d
r
o
m
e
with
in
C
L
T
.
Alo
n
g
with
m
o
r
e
g
e
n
er
al
s
o
cial
-
co
g
n
itiv
e
v
iewp
o
in
ts
,
C
L
T
o
f
f
er
s
a
f
r
am
ewo
r
k
f
o
r
co
m
p
r
eh
en
d
in
g
th
e
b
eh
av
i
o
r
al
an
d
co
g
n
itiv
e
m
ec
h
an
is
m
s
th
at
h
elp
k
id
s
an
d
f
am
ilies
d
ea
l
with
th
e
lo
n
g
-
ter
m
e
f
f
ec
ts
o
f
C
OVI
D,
as
well
a
s
f
o
r
in
ter
p
r
etin
g
th
e
d
is
ea
s
e'
s
clin
ical
m
an
if
estatio
n
s
[
2
4
]
.
Ma
tp
lo
tlib
C
h
ar
t
in
Fig
u
r
e
1
.
C
o
n
ce
p
tu
al
d
iag
r
a
m
r
elatin
g
p
o
s
t
-
C
OVI
D
-
19
s
y
n
d
r
o
m
e
in
ch
ild
r
en
to
C
L
T
.
I
t
d
em
o
n
s
tr
ates
h
o
w
tem
p
o
r
al,
s
o
cial,
s
p
atial,
a
n
d
h
y
p
o
th
etica
l
d
is
tan
ce
d
im
en
s
io
n
s
in
f
lu
en
ce
ch
ild
r
e
n
'
s
an
d
f
am
ilies
'
p
er
ce
p
tio
n
s
o
f
s
ick
n
ess
.
T
h
ese
p
er
ce
p
tio
n
s
,
in
tu
r
n
,
im
p
ac
t
o
u
tco
m
es su
ch
as c
o
p
in
g
,
r
esil
ien
ce
,
s
ch
o
o
l e
n
g
ag
em
e
n
t
,
an
d
f
am
ily
ad
ap
tatio
n
.
Fig
u
r
e
1
.
Ma
tp
lo
tlib
ch
ar
t
3.
M
E
T
H
O
D
3
.
1
.
Study
des
ig
n
T
h
e
r
ev
iew
m
eth
o
d
o
l
o
g
y
ad
h
er
ed
to
Ar
k
s
ey
an
d
O’
Ma
lley
[
2
5
]
,
[
2
6
]
s
co
p
in
g
r
e
v
iew
ap
p
r
o
ac
h
an
d
its
later
im
p
r
o
v
em
e
n
ts
[
2
7
]
.
U
s
in
g
asp
ec
ts
o
f
th
e
PR
I
SMA
2
0
2
0
s
tatem
en
t
f
o
r
s
y
s
tem
atic
r
ev
iews
[
2
8
]
,
it
was
f
u
r
th
er
lin
k
ed
with
th
e
PR
I
SMA
ex
ten
s
io
n
f
o
r
s
co
p
i
n
g
r
ev
iews
(
PR
I
SMA
-
Sc
R
)
[
2
8
]
to
g
u
ar
a
n
tee
tr
an
s
p
ar
en
cy
a
n
d
r
ep
ea
tab
ilit
y
.
Usi
n
g
liter
atu
r
e
r
elea
s
ed
b
etwe
en
J
an
u
ar
y
2
0
2
1
an
d
Au
g
u
s
t
2
0
2
5
,
t
h
is
m
eth
o
d
en
ab
led
a
s
y
s
tem
atic
s
y
n
th
es
is
o
f
th
e
d
ata
ab
o
u
t
th
e
lo
n
g
-
ter
m
im
p
ac
ts
o
f
C
OVI
D
-
1
9
an
d
m
u
ltis
y
s
tem
in
f
lam
m
ato
r
y
s
y
n
d
r
o
m
e
in
c
h
i
ld
r
en
(
MI
S
-
C
)
in
p
ed
iatr
ic
p
o
p
u
latio
n
s
.
3
.
2
.
Da
t
a
s
o
urce
s
a
nd
s
ea
rc
h str
a
t
eg
y
Six
d
atab
ases
:
Go
o
g
le
Sch
o
la
r
,
T
h
o
r
ea
u
,
SAGE
J
o
u
r
n
als,
B
io
Me
d
C
en
tr
al,
Me
d
lin
e,
an
d
C
I
NAHL
wer
e
th
o
r
o
u
g
h
l
y
s
ea
r
ch
ed
.
On
ly
E
n
g
lis
h
-
lan
g
u
ag
e
p
u
b
l
icatio
n
s
p
u
b
lis
h
ed
b
etwe
en
J
an
u
ar
y
2
0
2
0
an
d
Dec
em
b
er
2
0
2
5
wer
e
i
n
clu
d
ed
in
t
h
e
s
ea
r
ch
.
T
h
e
B
o
o
l
ea
n
o
p
e
r
ato
r
s
m
e
r
g
ed
an
d
u
s
ed
o
u
tc
o
m
e
ar
e:
(
“c
h
ild
r
en
”
OR
“a
d
o
lescen
ts
”
OR
“y
o
u
th
”)
AND
(
“lo
n
g
-
t
er
m
ef
f
ec
ts
”
OR
“p
o
s
t
-
C
OVI
D”
OR
“M
I
S
-
C
”)
.
Sear
ch
s
tr
ateg
ies
wer
e
tailo
r
ed
to
th
e
i
n
d
ex
in
g
r
e
q
u
ir
em
e
n
ts
o
f
ea
ch
d
atab
ase.
I
n
ad
d
itio
n
,
th
e
r
e
f
er
en
ce
lis
ts
o
f
r
elev
a
n
t r
ev
iews we
r
e
s
cr
ee
n
ed
to
ca
p
tu
r
e
ad
d
itio
n
al
elig
i
b
le
s
tu
d
ies.
3
.
3
.
Scre
ening
a
nd
s
elec
t
io
n pro
ce
s
s
T
h
er
e
wer
e
1
,
0
4
6
item
s
f
o
u
n
d
i
n
th
e
f
ir
s
t
s
ea
r
ch
.
Fo
llo
win
g
d
ed
u
p
licatio
n
,
two
r
ev
iewe
r
s
in
d
ep
en
d
en
tly
ch
ec
k
ed
ab
s
tr
a
cts
an
d
titl
es
ag
ain
s
t
th
e
in
clu
s
io
n
an
d
ex
clu
s
io
n
c
r
iter
ia
(
T
ab
le
1
)
.
Du
e
to
t
h
eir
lack
o
f
f
o
c
u
s
o
n
p
ed
iatr
ic
lo
n
g
-
ter
m
C
OVI
D
-
1
9
o
u
tc
o
m
es,
d
u
p
licatio
n
,
o
r
ir
r
elev
a
n
ce
,
ar
t
icles
th
at
d
id
n
o
t
f
it
th
e
cr
iter
ia
wer
e
elim
in
ated
.
Af
ter
th
at,
f
u
ll
-
tex
t
p
u
b
licatio
n
s
o
f
p
o
s
s
ib
ly
q
u
alif
y
in
g
r
esear
ch
wer
e
ev
alu
ate
d
f
o
r
u
ltima
te
i
n
clu
s
io
n
.
R
ev
ie
wer
s
'
d
is
ag
r
ee
m
en
ts
wer
e
s
ettled
th
r
o
u
g
h
d
ialo
g
u
e
u
n
til
an
ag
r
ee
m
e
n
t
was
r
ea
ch
ed
.
T
h
e
PR
I
SMA
-
ScR
f
l
o
w
d
iag
r
am
s
h
o
ws th
e
s
tu
d
y
s
elec
tio
n
p
r
o
ce
d
u
r
e
(
Fig
u
r
e
2
)
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J Pu
b
lic
Hea
lth
Sci
I
SS
N:
2252
-
8
8
0
6
P
o
s
t
-
C
OV
I
D
-
1
9
s
yn
d
r
o
me
in
ch
ild
r
en
:
a
s
co
p
i
n
g
r
ev
iew
(
R
a
p
h
a
el
F
o
lo
r
u
n
s
h
o
Olu
w
a
s
in
a
B
a
b
a
to
l
a
)
11
Fig
u
r
e
2
.
Prism
a
f
lo
w
c
h
ar
t
T
ab
le
1
.
I
n
clu
s
io
n
an
d
ex
clu
s
i
o
n
cr
iter
ia
I
n
c
l
u
s
i
o
n
c
r
i
t
e
r
i
a
Ex
c
l
u
si
o
n
c
r
i
t
e
r
i
a
W
e
r
e
p
u
b
l
i
s
h
e
d
b
e
t
w
e
e
n
J
a
n
u
a
r
y
2
0
2
0
a
n
d
D
e
c
e
m
b
e
r
2
0
2
5
,
W
e
r
e
p
u
b
l
i
s
h
e
d
o
u
t
si
d
e
t
h
e
sp
e
c
i
f
i
e
d
d
a
t
e
r
a
n
g
e
,
R
e
p
r
e
se
n
t
e
d
o
r
i
g
i
n
a
l
r
e
se
a
r
c
h
,
r
e
p
o
r
t
s
,
o
r
r
e
v
i
e
w
s,
D
i
d
n
o
t
f
o
c
u
s
o
n
t
h
e
l
o
n
g
-
t
e
r
m
e
f
f
e
c
t
s
o
f
C
O
V
I
D
-
1
9
o
r
M
I
S
-
C,
F
o
c
u
se
d
o
n
t
h
e
l
o
n
g
-
t
e
r
m e
f
f
e
c
t
s
o
f
C
O
V
I
D
-
1
9
o
r
M
I
S
-
C
i
n
c
h
i
l
d
r
e
n
,
a
d
o
l
e
s
c
e
n
t
s
,
o
r
y
o
u
t
h
,
a
n
d
D
i
d
n
o
t
i
n
v
o
l
v
e
c
h
i
l
d
r
e
n
,
a
d
o
l
e
sc
e
n
t
s,
o
r
y
o
u
t
h
,
W
e
r
e
w
r
i
t
t
e
n
i
n
E
n
g
l
i
sh
.
W
e
r
e
d
u
p
l
i
c
a
t
e
s,
o
r
W
e
r
e
n
o
n
-
p
e
e
r
-
r
e
v
i
e
w
e
d
s
o
u
r
c
e
s.
3
.
4
.
Da
t
a
e
x
t
ra
ct
i
o
n
Data
wer
e
ex
tr
ac
ted
u
s
in
g
a
s
t
an
d
ar
d
ized
f
o
r
m
with
two
r
ev
i
ewe
r
s
in
d
ep
en
d
e
n
tly
wo
r
k
i
n
g
to
ex
tr
ac
t
d
ata,
with
d
is
cr
ep
an
cies
r
eso
lv
ed
b
y
c
o
n
s
en
s
u
s
.
T
h
e
ca
p
tu
r
ed
d
ata
ar
e
in
clu
d
ed
in
T
a
b
le
2
[
4
]
,
[
2
9
]
-
[
5
5
]
(
s
ee
Ap
p
en
d
ix
)
:
i)
Au
th
o
r
(
s
)
an
d
y
ea
r
o
f
p
u
b
licatio
n
;
ii)
Stu
d
y
d
esig
n
an
d
s
ettin
g
;
iii)
Po
p
u
lati
o
n
an
d
s
am
p
le
s
ize
;
iv
)
Key
f
in
d
in
g
s
o
n
lo
n
g
-
ter
m
ef
f
ec
ts
o
f
C
OVI
D
-
1
9
o
r
MI
S
-
C
;
an
d
v
)
R
ep
o
r
ted
lim
itatio
n
s
.
L
o
n
g
-
ter
m
ef
f
ec
ts
,
r
is
k
f
ac
to
r
s
,
an
d
o
u
t
co
m
es
.
[
4
]
,
[
2
9
]
–
[
3
8
]
,
[
3
9
]
–
[
4
8
]
,
[
4
0
]
,
[
4
9
]
–
[
5
2
]
[
5
3
]
–
[
5
5
]
3
.
5
.
Da
t
a
s
y
nthesi
s
T
h
e
r
esu
lts
wer
e
c
o
m
p
iled
n
a
r
r
ativ
ely
a
n
d
th
e
m
atica
lly
in
l
ig
h
t
o
f
th
e
i
n
h
er
e
n
t
v
ar
ia
b
ilit
y
in
s
tu
d
y
d
esig
n
s
,
p
ar
ticip
an
ts
,
an
d
o
u
tco
m
es
th
r
o
u
g
h
o
u
t
th
e
liter
atu
r
e.
Data
was
ex
tr
ac
ted
in
to
f
iv
e
k
ey
,
ac
tio
n
a
b
le
to
p
ics
to
o
r
g
an
ize
th
is
p
r
o
c
ess
:
r
esear
ch
g
ap
s
,
lo
n
g
-
ter
m
s
y
m
p
to
m
s
,
r
is
k
f
ac
to
r
s
,
o
u
tco
m
es,
an
d
s
tu
d
y
d
esig
n
/s
ettin
g
/p
o
p
u
latio
n
.
A
s
y
s
tem
atic
co
m
p
ar
is
o
n
o
f
th
e
ev
id
en
ce
b
etwe
en
l
o
n
g
C
OVI
D
an
d
MI
S
-
C
was
m
ad
e
p
o
s
s
ib
le
b
y
th
is
co
lu
m
n
-
b
ased
th
em
e
ap
p
r
o
ac
h
,
wh
i
ch
also
en
s
u
r
ed
th
at
m
eth
o
d
o
lo
g
ical
co
n
s
tr
ain
ts
Evaluation Warning : The document was created with Spire.PDF for Python.
I
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:
2
2
5
2
-
8
8
0
6
I
n
t J Pu
b
lic
Hea
lth
Sci
,
Vo
l.
1
5
,
No
.
1
,
Ma
r
ch
20
2
6
:
8
-
22
12
wer
e
ev
alu
ated
d
i
r
ec
tly
alo
n
g
s
id
e
s
ig
n
if
ican
t
f
in
d
in
g
s
to
id
en
tif
y
tr
e
n
d
s
,
d
if
f
er
e
n
c
es,
an
d
im
p
o
r
tan
t
k
n
o
wled
g
e
g
ap
s
.
3
.
6
.
Da
t
a
a
na
ly
s
is
T
o
d
etec
t
r
ec
u
r
r
in
g
th
em
es,
c
o
n
clu
s
io
n
s
,
an
d
g
a
p
s
,
d
ata
f
r
o
m
th
e
in
clu
d
ed
p
u
b
licatio
n
s
wer
e
tak
en
o
u
t
an
d
ex
am
in
e
d
.
T
o
id
en
tif
y
r
ec
u
r
r
en
t
tr
en
d
s
in
th
e
lo
n
g
-
ter
m
im
p
ac
ts
o
f
C
OVI
D
-
1
9
an
d
MI
S
-
C
o
n
k
id
s
an
d
teen
a
g
er
s
,
a
th
em
atic
a
n
al
y
s
is
was
ca
r
r
ied
o
u
t.
T
h
e
f
in
d
i
n
g
s
wer
e
c
o
m
b
in
e
d
to
g
iv
e
a
t
h
o
r
o
u
g
h
s
u
m
m
ar
y
th
at
co
v
er
ed
p
o
ten
tial
ca
u
s
es,
lo
n
g
-
ter
m
e
f
f
ec
ts
,
an
d
p
o
ten
tial
r
esear
ch
to
p
ics.
A
s
y
s
te
m
atic
ch
ec
k
lis
t
th
at
co
n
s
id
er
ed
s
tu
d
y
d
esig
n
,
s
am
p
le
s
ize,
m
eth
o
d
o
lo
g
y
,
a
n
d
th
e
r
eliab
ilit
y
o
f
co
n
cl
u
s
io
n
s
was
u
s
ed
to
ev
al
u
ate
th
e
q
u
ality
o
f
th
e
in
clu
d
ed
s
tu
d
ies.
Fin
ally
,
k
ey
f
in
d
in
g
s
,
tec
h
n
iq
u
es,
an
d
id
en
tifie
d
g
ap
s
wer
e
s
u
m
m
ar
ized
in
an
o
r
g
a
n
ized
m
a
n
n
er
.
4.
RE
SU
L
T
S AN
D
D
I
SCU
SS
I
O
N
A
s
u
m
m
ar
y
o
f
th
e
m
ain
co
n
cl
u
s
io
n
s
f
r
o
m
a
s
co
p
in
g
ass
ess
m
en
t
o
f
th
e
liter
atu
r
e
a
b
o
u
t
th
e
p
o
s
t
-
ac
u
te
af
ter
ef
f
ec
ts
o
f
SAR
S
-
C
o
V
-
2
in
f
ec
tio
n
in
ch
ild
r
e
n
a
n
d
a
d
o
lescen
ts
is
p
r
o
v
id
e
d
in
th
is
s
ec
tio
n
.
T
h
e
m
ain
s
o
u
r
ce
o
f
e
v
id
en
ce
is
th
e
ac
c
o
m
p
an
y
in
g
tab
le,
wh
ich
in
clu
d
es
ex
ce
r
p
ts
f
r
o
m
2
3
s
tu
d
ies
co
v
er
in
g
th
e
y
ea
r
s
2021
–
2
0
2
5
,
in
clu
d
i
n
g
p
r
o
s
p
e
ctiv
e
co
h
o
r
ts
,
s
y
s
tem
atic
r
ev
i
ews,
an
d
m
eta
-
an
aly
s
es.
T
h
e
two
m
ai
n
clin
ical
en
titi
es
th
at
f
o
r
m
th
e
b
asis
o
f
th
e
an
aly
s
is
ar
e
Mu
ltis
y
s
tem
I
n
f
lam
m
ato
r
y
Sy
n
d
r
o
m
e
in
C
h
ild
r
en
(
MI
S
-
C
)
an
d
l
o
n
g
C
OVI
D
af
te
r
a
ty
p
ical
SAR
S
-
C
o
V
-
2
in
f
ec
tio
n
.
T
h
e
tab
le
lis
ts
th
e
m
ain
c
o
n
cl
u
s
io
n
s
,
lo
n
g
-
ter
m
s
y
m
p
to
m
s
,
an
d
s
tu
d
y
d
esig
n
f
o
r
ea
c
h
item
.
T
h
is
m
ak
es
it
p
o
s
s
ib
le
to
d
ir
ec
tly
co
m
p
ar
e
th
e
r
esu
lts
,
em
p
h
asizin
g
th
e
d
if
f
e
r
en
ce
b
etwe
en
th
e
m
o
r
e
s
ev
er
e
co
g
n
itiv
e
an
d
f
u
n
ctio
n
al
im
p
air
m
en
ts
o
b
s
er
v
ed
in
a
s
u
b
g
r
o
u
p
o
f
MI
S
-
C
s
u
r
v
iv
o
r
s
an
d
th
e
ty
p
ically
lo
w
s
y
m
p
t
o
m
lo
ad
d
o
c
u
m
en
ted
in
l
o
n
g
C
OVI
D
co
h
o
r
ts
.
T
h
e
s
y
n
th
esis
th
at
f
o
llo
ws
em
p
lo
y
s
th
ese
ex
tr
ac
ted
d
ata
to
u
n
co
v
er
co
n
s
is
ten
t
p
atter
n
s
an
d
im
p
o
r
tan
t
r
esear
ch
g
ap
s
ac
r
o
s
s
th
e
p
ed
iatr
ic
p
o
s
t
-
in
f
ec
tio
n
s
p
ec
tr
u
m
.
4
.
1
.
Sy
no
ps
is
o
f
t
he
ma
in re
s
ea
rc
h r
esu
lt
s
An
o
v
er
v
iew
o
f
MI
S
-
C
an
d
p
ed
iatr
ic
p
o
s
t
-
ac
u
te
C
OVI
D
-
1
9
s
eq
u
elae
.
T
wo
m
ain
m
eth
o
d
o
lo
g
ical
ap
p
r
o
ac
h
es
f
o
r
m
th
e
b
asis
o
f
t
h
e
d
ata
o
n
p
ed
iatr
ic
p
o
s
t
-
in
f
ec
tio
n
s
eq
u
elae
:
p
r
o
s
p
ec
tiv
e,
s
in
g
le
-
ce
n
ter
f
o
llo
w
-
u
p
co
h
o
r
ts
th
at
d
escr
ib
e
o
u
tc
o
m
es
in
h
ig
h
-
r
is
k
g
r
o
u
p
s
,
in
c
lu
d
in
g
MI
S
-
C
s
u
r
v
i
v
o
r
s
,
an
d
lar
g
e
-
s
ca
le
co
h
o
r
t
s
tu
d
ies th
at
p
r
o
v
id
e
p
o
p
u
latio
n
-
lev
el
p
r
e
v
alen
ce
.
4
.
1
.
1
.
Co
ho
rt
s
t
ud
ies a
nd
g
ener
a
l C
O
VID
-
1
9
s
equela
e
L
ar
g
e
-
s
ca
le
co
h
o
r
t
s
tu
d
ies
in
ten
d
ed
to
p
r
o
d
u
ce
r
eliab
le,
p
o
p
u
latio
n
-
lev
el
esti
m
ates
wer
e
th
e
m
ain
s
o
u
r
ce
o
f
in
f
o
r
m
atio
n
r
e
g
ar
d
i
n
g
th
e
p
r
e
v
alen
ce
a
n
d
o
v
er
all
b
u
r
d
e
n
o
f
L
o
n
g
C
OVI
D
af
ter
ac
u
te
SAR
S
-
C
o
V
-
2
in
f
ec
tio
n
.
R
esear
ch
u
s
in
g
th
e
Natio
n
wid
e
Dan
is
h
co
h
o
r
ts
[
3
2
]
,
[
3
3
]
f
alls
u
n
d
e
r
th
is
ty
p
e.
T
h
is
r
esear
c
h
co
m
p
ar
ed
in
f
ec
ted
c
h
ild
r
en
to
s
izab
le
co
n
tr
o
l
g
r
o
u
p
s
u
s
in
g
r
eg
is
tr
y
d
ata,
p
r
o
v
i
d
in
g
ea
r
ly
,
b
r
o
ad
ly
ap
p
licab
l
e
p
r
o
o
f
t
h
at
th
e
s
y
m
p
to
m
lo
a
d
was
lo
w
an
d
d
ec
r
ea
s
ed
o
v
er
t
im
e
[
3
2
]
.
Mu
ltip
le
s
y
s
tem
atic
r
ev
iews
an
d
m
eta
-
an
aly
s
es
o
f
co
n
tr
o
lled
tr
ials
later
co
n
f
ir
m
ed
th
is
f
in
d
in
g
,
d
em
o
n
s
tr
atin
g
m
in
im
al
ab
s
o
lu
te
r
is
k
s
ac
r
o
s
s
a
v
ar
iety
o
f
in
ter
n
atio
n
al
p
o
p
u
latio
n
s
b
u
t
a
n
in
cr
ea
s
ed
r
is
k
o
f
p
er
s
is
ten
t
s
y
m
p
to
m
s
co
m
p
ar
e
d
t
o
co
n
tr
o
ls
[
3
1
]
,
[
4
5
]
.
T
o
f
u
r
th
er
u
n
d
er
s
tan
d
h
ea
lth
ca
r
e
co
n
s
u
m
p
tio
n
a
n
d
u
n
c
o
v
er
n
ew
h
az
a
r
d
s
,
r
esear
ch
e
r
s
also
u
s
ed
lar
g
e
m
u
lticen
ter
elec
tr
o
n
ic
h
ea
lth
r
ec
o
r
d
(
E
HR
)
o
r
cla
im
s
d
ata
[
3
6
]
,
[
5
1
]
.
Fo
r
e
x
am
p
le,
th
ey
f
o
u
n
d
th
at
r
ein
f
ec
tio
n
is
lin
k
ed
to
a
h
i
g
h
e
r
r
is
k
o
f
lo
n
g
C
OVI
D
ch
ar
ac
te
r
is
tics
[
5
1
]
.
4
.
1
.
2
.
H
ig
h
-
risk
c
o
ho
rt
s
:
M
I
S
-
C
a
nd
cr
it
ica
l illnes
s
T
h
e
r
esu
lts
o
f
MI
S
-
C
,
a
h
ig
h
-
s
ev
er
ity
h
y
p
e
r
in
f
lam
m
ato
r
y
co
n
d
itio
n
,
ar
e
th
e
s
u
b
ject
o
f
a
s
ep
ar
ate
an
d
ess
en
ti
al
b
o
d
y
o
f
r
esear
ch
.
T
o
g
et
co
m
p
r
eh
e
n
s
iv
e,
lo
n
g
-
ter
m
p
h
en
o
t
y
p
in
g
in
h
ig
h
-
r
is
k
p
atien
ts
,
th
ese
s
tu
d
ies
u
s
u
ally
u
s
e
p
r
o
s
p
ec
tiv
e,
s
in
g
le
-
o
r
m
u
lticen
ter
f
o
llo
w
-
u
p
g
r
o
u
p
s
.
Fo
r
ex
am
p
le,
m
u
l
ticen
ter
p
r
o
s
p
ec
tiv
e
co
h
o
r
ts
u
s
in
g
ag
e
-
m
atc
h
ed
o
r
d
is
ea
s
e
co
n
tr
o
ls
f
o
llo
wed
h
o
s
p
italized
MI
S
-
C
p
atien
ts
f
o
r
u
p
to
two
y
ea
r
s
in
th
e
Un
ited
States
an
d
I
taly
[
5
0
]
,
[
5
6
]
.
T
h
is
s
tr
ateg
y
was
ess
en
tial
in
d
eter
m
in
in
g
th
at
ap
p
r
o
x
im
ately
2
0
%
o
f
p
atien
ts
h
ad
o
n
g
o
in
g
c
o
g
n
iti
v
e
p
r
o
b
lem
s
,
d
esp
ite
r
elativ
ely
g
o
o
d
p
h
y
s
ical
r
ec
o
v
er
y
[
5
6
]
.
Ad
d
itio
n
ally
,
tar
g
eted
d
ata
o
n
th
e
m
o
s
t
s
e
v
er
ely
af
f
ec
ted
p
atien
ts
wer
e
o
b
tain
ed
f
r
o
m
s
tu
d
ies
co
n
d
u
cted
s
p
ec
if
ically
o
n
Ped
iatr
ic
I
n
ten
s
iv
e
C
ar
e
Un
it
(
PICU)
s
u
r
v
iv
o
r
s
with
C
OV
I
D
-
1
9
/MI
S
-
C
[
4
3
]
,
[
5
3
]
.
T
h
e
cr
u
cial
co
n
tex
t
f
o
r
u
n
d
er
s
tan
d
i
n
g
r
esu
lts
is
p
r
o
v
i
d
ed
b
y
t
h
is
m
eth
o
d
ical
ap
p
r
o
ac
h
,
wh
ich
p
r
o
g
r
ess
e
s
f
r
o
m
p
o
p
u
latio
n
-
le
v
el
d
at
a
to
d
ee
p
p
h
en
o
ty
p
in
g
in
s
u
r
v
iv
o
r
s
o
f
ca
tast
r
o
p
h
ic
illn
ess
es.
A
m
o
r
e
cr
itical
ev
alu
atio
n
o
f
th
e
d
ata
is
p
o
s
s
ib
le
wh
en
o
n
e
is
awa
r
e
o
f
th
e
p
o
p
u
latio
n
s
an
d
r
esear
ch
m
eth
o
d
o
lo
g
ies
th
at
p
r
o
d
u
ce
d
th
ese
r
esu
lts
.
Usi
n
g
th
i
s
b
asic
u
n
d
er
s
tan
d
i
n
g
o
f
s
tu
d
y
s
ettin
g
s
,
th
e
f
o
llo
win
g
s
ec
tio
n
d
escr
ib
es
th
e
p
ar
ticu
lar
lo
n
g
-
t
er
m
s
y
m
p
to
m
s
,
r
is
k
f
ac
to
r
s
,
an
d
o
v
er
all
r
esu
lts
f
o
u
n
d
in
th
ese
two
p
r
im
ar
y
clin
ical
g
r
o
u
p
s
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J Pu
b
lic
Hea
lth
Sci
I
SS
N:
2252
-
8
8
0
6
P
o
s
t
-
C
OV
I
D
-
1
9
s
yn
d
r
o
me
in
ch
ild
r
en
:
a
s
co
p
i
n
g
r
ev
iew
(
R
a
p
h
a
el
F
o
lo
r
u
n
s
h
o
Olu
w
a
s
in
a
B
a
b
a
to
l
a
)
13
4
.
2
.
Sy
nthesis
o
f
lo
ng
-
t
er
m sy
m
pto
m
s
,
risk
f
a
ct
o
rs,
a
nd
o
utc
o
m
es in
pedia
t
ric
po
s
t
-
infe
ct
io
n studies
4
.
2
.
1
.
L
o
ng
CO
VID:
T
ra
ns
ie
nt
f
un
ct
io
na
l sy
m
pto
m
s
a
nd
dem
o
g
ra
ph
ic
risk
s
-
Ob
s
er
v
ed
s
eq
u
elae
: L
o
n
g
-
ter
m
s
y
m
p
to
m
s
,
r
is
k
f
ac
t
o
r
s
,
an
d
o
u
tco
m
es
W
h
ile
h
ig
h
lig
h
tin
g
a
p
o
s
itiv
e
o
v
er
all
p
r
o
g
n
o
s
is
,
th
e
liter
at
u
r
e
o
n
p
ed
iatr
ic
p
o
s
t
-
in
f
ec
tio
n
s
eq
u
elae
co
n
s
is
ten
tly
h
ig
h
lig
h
ts
im
p
o
r
tan
t
s
y
m
p
to
m
atic
clu
s
ter
s
a
n
d
d
em
o
g
r
ap
h
ic/clin
ical
v
ar
i
ab
les
th
at
r
e
q
u
ir
e
o
n
g
o
in
g
ca
r
e
.
T
h
e
m
ain
clin
i
ca
l
en
tity
u
n
d
er
s
tu
d
y
,
s
ev
er
e
h
y
p
e
r
in
f
lam
m
atio
n
(
MI
S
-
C
)
v
s
g
en
er
al
SAR
S
-
C
o
V
-
2
in
f
ec
tio
n
(
lo
n
g
C
OVI
D)
,
n
atu
r
ally
s
ep
a
r
ates th
e
s
y
n
th
esis
.
-
L
o
n
g
C
OVI
D:
T
r
an
s
ien
t f
u
n
ct
io
n
al
s
y
m
p
to
m
s
an
d
d
em
o
g
r
a
p
h
ic
r
is
k
s
T
h
e
m
o
s
t
co
m
m
o
n
lo
n
g
-
ter
m
s
y
m
p
to
m
s
f
o
r
c
h
ild
r
en
af
ter
an
ac
u
te
SAR
S
-
C
o
V
-
2
in
f
ec
tio
n
(
lo
n
g
C
OVI
D)
ar
e
f
u
n
ctio
n
al
an
d
f
r
eq
u
e
n
tly
n
o
n
-
s
p
ec
if
ic.
Acc
o
r
d
in
g
to
s
tu
d
ies,
th
e
m
o
s
t
p
r
ev
alen
t
p
r
o
b
lem
s
th
at
last
lo
n
g
er
th
an
1
2
wee
k
s
ar
e
h
ea
d
ac
h
e,
f
a
tig
u
e,
m
o
o
d
/s
leep
d
is
o
r
d
er
s
,
an
d
co
g
n
itiv
e
s
y
m
p
to
m
s
[
3
0
]
,
[
3
2
]
,
[
4
8
]
.
Alt
h
o
u
g
h
th
ey
ar
e
o
b
s
er
v
ed
,
r
esp
ir
ato
r
y
s
y
m
p
to
m
s
an
d
lo
s
s
o
f
tast
e
an
d
s
m
ell
ar
e
f
r
eq
u
e
n
tly
less
c
o
m
m
o
n
th
a
n
in
ad
u
lts
[
3
3
]
,
[
5
2
]
.
Ad
o
lesc
en
t
ag
e
a
n
d
f
em
ale
s
ex
ar
e
t
h
e
m
o
s
t
co
m
m
o
n
l
y
f
o
u
n
d
r
is
k
f
ac
to
r
s
f
o
r
th
ese
c
h
r
o
n
ic
illn
ess
es
[
4
]
,
[
3
0
]
,
[
5
4
]
.
Ho
s
p
italizatio
n
an
d
in
cr
ea
s
ed
ac
u
te
s
y
m
p
to
m
s
ev
er
ity
ar
e
also
li
n
k
ed
t
o
th
is
[
3
1
]
,
[
5
4
]
.
I
m
p
o
r
tan
tly
,
O
m
icr
o
n
-
er
a
f
in
d
in
g
s
in
d
icate
th
at
r
ein
f
ec
tio
n
ca
n
in
cr
ea
s
e
th
e
lik
elih
o
o
d
o
f
l
o
n
g
C
OVI
D
ch
ar
ac
ter
is
tics
[
5
1
]
.
T
h
er
e
is
b
r
o
a
d
a
g
r
ee
m
en
t
th
a
t
m
o
s
t
ch
ild
r
en
r
ec
o
v
er
a
n
d
t
h
at
s
y
m
p
to
m
s
g
o
awa
y
in
a
m
atter
o
f
m
o
n
th
s
,
a
n
d
o
v
er
all
r
esu
lts
ar
e
f
av
o
r
ab
le
[
3
2
]
,
[
3
3
]
,
[
5
5
]
.
T
h
e
r
esu
lts
f
o
r
th
e
m
in
o
r
i
ty
with
s
y
m
p
t
o
m
s
h
ig
h
lig
h
t
th
e
n
ec
ess
ity
o
f
in
te
r
d
is
cip
lin
ar
y
s
u
p
p
o
r
tiv
e
ca
r
e
an
d
s
tead
y
p
r
o
g
r
ess
o
v
er
tim
e
[
3
0
]
,
[
3
8
]
.
T
h
ese
r
esu
lts
h
ig
h
lig
h
t
a
C
L
T
d
if
f
er
en
ce
:
th
e
p
er
s
is
ten
t
m
in
o
r
ity
n
ee
d
s
h
ig
h
-
co
n
s
tr
u
al
p
lan
n
in
g
ab
o
u
t
s
ch
o
o
lin
g
,
f
u
tu
r
e
h
ea
lth
,
an
d
s
o
cial
r
o
les,
wh
er
ea
s
th
e
m
ajo
r
ity
f
ac
e
p
r
o
x
im
ate,
lo
w
-
co
n
s
tr
u
al
s
ick
n
ess
p
r
o
b
lem
s
.
4
.
2
.
2
.
M
I
S
-
C:
neur
o
ps
y
cho
lo
g
ica
l a
nd
ca
rdia
c
f
o
llo
w
-
up
needs
T
h
e
p
r
o
f
ile
o
f
lo
n
g
-
ter
m
s
y
m
p
to
m
s
in
ch
ild
r
en
wh
o
wen
t
t
h
r
o
u
g
h
th
e
s
ev
er
e
ac
u
te
p
h
ase
o
f
MI
S
-
C
ch
an
g
es
to
em
p
h
asize
s
y
s
tem
ic
an
d
co
g
n
itiv
e
af
ter
e
f
f
ec
ts
.
Alth
o
u
g
h
ea
r
ly
ca
r
d
iac
in
v
o
lv
em
en
t
is
ty
p
ical,
p
er
s
is
ten
t
f
a
tig
u
e,
d
ec
r
ea
s
ed
ex
er
cise
to
ler
an
ce
,
an
d
s
er
io
u
s
co
n
ce
n
tr
atio
n
,
m
o
o
d
,
an
d
s
leep
p
r
o
b
lem
s
ar
e
th
e
m
ain
s
y
m
p
to
m
s
in
t
h
e
later
s
tag
es
[
2
9
]
,
[
5
3
]
,
[
5
6
]
.
Ad
d
itio
n
ally
,
th
e
p
o
ten
tial
f
o
r
a
s
m
all
m
in
o
r
ity
to
h
av
e
lin
g
er
i
n
g
im
m
u
n
o
lo
g
ical
d
y
s
r
eg
u
latio
n
a
n
d
th
e
s
p
o
r
ad
ic
n
ec
ess
ity
f
o
r
l
o
n
g
-
ter
m
ca
r
d
ia
c
s
u
r
v
eillan
ce
[
3
4
]
,
[
4
2
]
.
T
h
e
i
n
ten
s
ity
o
f
th
e
ac
u
te
s
ick
n
ess
is
a
m
ajo
r
r
is
k
f
ac
to
r
f
o
r
lo
n
g
-
last
in
g
im
p
air
m
en
ts
f
o
llo
win
g
MI
S
-
C
.
T
h
er
e
is
a
c
lear
co
r
r
elatio
n
with
wo
r
s
e
ch
r
o
n
ic
co
g
n
itiv
e
an
d
f
u
n
cti
o
n
al
o
u
tco
m
es
an
d
in
d
icato
r
s
s
u
ch
as
in
ten
s
iv
e
ca
r
e
u
n
it
ad
m
is
s
io
n
,
m
ajo
r
ca
r
d
i
ac
in
v
o
lv
em
en
t,
elev
ate
d
in
f
la
m
m
ato
r
y
m
ar
k
er
s
,
o
r
th
e
n
ee
d
f
o
r
o
r
g
an
s
u
p
p
o
r
t
at
p
r
esen
tatio
n
[
2
9
]
,
[
4
3
]
,
[
5
3
]
,
[
5
6
]
.
Alth
o
u
g
h
co
n
tin
u
o
u
s
m
o
n
it
o
r
in
g
is
r
eq
u
ir
ed
,
th
e
l
o
n
g
-
te
r
m
r
esu
lts
with
MI
S
-
C
ar
e
g
e
n
er
ally
p
o
s
itiv
e.
Stu
d
ies
r
ev
ea
l
th
at
e
v
en
if
ca
r
d
iac
r
ec
o
v
er
y
is
lar
g
ely
co
m
p
lete,
a
s
izab
le
m
in
o
r
ity
(
u
p
to
2
0
%)
s
till
n
e
ed
ass
is
tan
ce
with
m
en
tal
h
ea
lth
,
ed
u
ca
tio
n
,
a
n
d
r
eh
ab
ilit
atio
n
b
ec
a
u
s
e
o
f
o
n
g
o
in
g
co
g
n
itiv
e
o
r
f
u
n
ctio
n
al
im
p
air
m
en
ts
[
5
3
]
,
[
5
6
]
.
4
.
2
.
3
.
P
a
t
ho
ph
y
s
io
lo
g
ica
l
m
e
cha
nis
m
s
C
o
m
p
l
e
x
p
a
t
h
o
p
h
y
s
i
o
l
o
g
i
c
al
p
r
o
c
e
s
s
es
,
i
n
c
l
u
d
i
n
g
i
m
m
u
n
o
l
o
g
i
c
a
l
d
y
s
r
e
g
u
l
a
ti
o
n
,
c
h
r
o
n
i
c
i
n
f
l
a
m
m
a
t
i
o
n
,
a
n
d
e
n
d
o
t
h
e
l
i
a
l
d
y
s
f
u
n
c
t
i
o
n
,
u
n
d
e
r
l
i
e
p
e
r
s
is
t
e
n
t
p
o
s
t
-
C
O
V
I
D
-
19
c
o
n
d
i
t
i
o
n
s
(
PC
S
)
[
1
5
]
,
[
5
7
]
.
A
m
e
c
h
a
n
i
s
t
ic
c
o
n
n
e
c
t
i
o
n
b
e
t
w
ee
n
i
m
m
u
n
e
a
c
t
i
v
a
ti
o
n
a
n
d
n
e
u
r
o
l
o
g
i
c
a
l
o
u
t
c
o
m
e
s
is
s
u
p
p
o
r
t
e
d
b
y
e
m
e
r
g
i
n
g
m
e
c
h
a
n
i
s
t
i
c
i
n
s
i
g
h
ts
t
h
at
i
n
d
i
c
a
t
e
d
y
s
r
e
g
u
l
a
t
e
d
c
y
t
o
k
i
n
e
p
r
o
f
i
l
es
c
o
r
r
e
s
p
o
n
d
w
i
t
h
s
y
m
p
t
o
m
s
p
e
r
s
is
ten
c
e
[
5
8
]
,
[
5
9
]
a
n
d
n
e
u
r
o
i
n
f
l
a
m
m
a
t
o
r
y
m
a
r
k
e
r
s
h
a
v
e
b
e
e
n
d
e
t
e
c
te
d
i
n
a
d
o
l
es
c
en
t
s
wi
t
h
p
r
o
l
o
n
g
e
d
c
o
g
n
i
t
i
v
e
d
e
f
i
c
i
ts
[
3
9
]
.
T
h
e
s
e
b
i
o
c
h
e
m
i
c
a
l
d
is
t
u
r
b
a
n
c
es
h
a
v
e
a
s
i
g
n
i
f
ic
a
n
t
e
f
f
e
ct
o
n
p
s
y
c
h
o
l
o
g
i
c
a
l
h
e
a
lt
h
a
n
d
f
u
n
c
t
i
o
n
;
a
n
x
i
e
t
y
,
m
e
l
a
n
c
h
o
l
y
,
s
o
c
i
a
l
d
is
e
n
g
a
g
e
m
e
n
t
,
a
n
d
d
e
c
r
e
a
s
e
d
a
c
a
d
e
m
ic
e
n
g
a
g
e
m
e
n
t
a
r
e
c
o
m
m
o
n
l
y
d
o
c
u
m
e
n
t
e
d
,
e
s
p
e
c
i
a
l
l
y
i
n
t
e
e
n
a
g
e
r
s
.
A
d
d
i
t
i
o
n
a
l
l
y
,
ce
r
t
a
i
n
i
m
m
u
n
o
lo
g
i
c
a
l
a
n
d
p
r
o
t
e
o
m
i
c
b
i
o
m
a
r
k
e
r
s
m
a
y
b
e
a
b
l
e
t
o
p
r
e
d
i
ct
p
r
o
l
o
n
g
e
d
r
e
c
o
v
e
r
y
t
r
a
j
e
c
t
o
r
ie
s
,
ac
c
o
r
d
i
n
g
t
o
p
r
o
g
n
o
s
t
i
c
s
t
u
d
i
es
[
6
0
]
.
P
s
y
c
h
o
s
o
c
i
a
l
a
n
d
e
n
v
i
r
o
n
m
e
n
t
a
l
f
ac
to
r
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x
a
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b
a
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h
i
s
b
i
o
l
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i
c
a
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v
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i
a
t
i
o
n
,
s
i
n
c
e
s
o
cia
l
d
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r
m
i
n
a
n
t
s
a
n
d
a
l
a
c
k
o
f
s
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p
p
o
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t
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t
w
o
r
k
s
i
n
f
l
u
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n
c
e
r
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i
li
e
n
c
e
a
n
d
l
o
n
g
-
t
e
r
m
a
d
a
p
t
a
t
i
o
n
.
C
o
n
s
t
r
u
a
l
l
e
v
e
l
t
h
e
o
r
y
(
C
L
T
)
i
n
t
e
g
r
at
i
o
n
o
f
f
e
r
s
a
u
s
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f
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l
f
r
a
m
ew
o
r
k
f
o
r
i
n
t
e
r
p
r
e
t
a
t
i
o
n
:
s
it
u
a
t
i
o
n
a
l
f
a
c
t
o
r
s
(
l
o
w
-
l
e
v
e
l
c
o
n
s
t
r
u
a
l
)
d
r
i
v
e
s
h
o
r
t
-
t
e
r
m
ca
r
e
a
d
h
e
r
e
n
c
e,
w
h
e
r
e
a
s
a
b
s
t
r
ac
t
t
h
i
n
k
i
n
g
a
b
o
u
t
i
d
e
n
t
i
t
y
,
s
o
c
i
al
r
o
l
e
s
,
a
n
d
f
u
t
u
r
e
c
o
p
i
n
g
(
h
i
g
h
-
le
v
e
l
c
o
n
s
t
r
u
a
l
)
i
s
n
e
c
es
s
a
r
y
f
o
r
l
o
n
g
-
t
e
r
m
a
d
a
p
t
at
i
o
n
t
o
c
h
r
o
n
ic
s
y
m
p
t
o
m
s
.
T
h
es
e
r
e
s
u
l
ts
h
i
g
h
l
i
g
h
t
t
h
e
n
e
c
e
s
s
i
t
y
o
f
p
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c
i
s
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o
n
m
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d
i
c
i
n
e
s
t
r
a
t
eg
i
e
s
t
o
l
e
s
s
e
n
l
o
n
g
-
t
e
r
m
i
m
p
a
c
t
s
;
y
e
t
,
n
u
m
e
r
o
u
s
m
e
t
h
o
d
o
l
o
g
i
c
a
l
a
n
d
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f
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m
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p
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p
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n
t
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s
ea
r
c
h
m
u
s
t
b
e
f
i
ll
e
d
f
i
r
s
t
.
4
.
3
.
Sy
nthesis
o
f
identif
ied r
esea
rc
h g
a
ps
in pedia
t
ric
po
s
t
-
infe
ct
io
n studies
Sev
er
al
s
ig
n
if
ican
t
an
d
r
ec
u
r
r
in
g
m
eth
o
d
o
lo
g
ical
f
laws
an
d
in
f
o
r
m
atio
n
g
a
p
s
in
th
e
lit
er
atu
r
e
o
n
p
ed
iatr
ic
L
o
n
g
C
OVI
D
an
d
MI
S
-
C
o
u
tco
m
es
ar
e
b
r
o
u
g
h
t
to
lig
h
t
b
y
th
e
s
co
p
in
g
r
ev
ie
w
ex
tr
ac
ts
.
T
h
e
n
ee
d
f
o
r
m
o
r
e
s
tan
d
ar
d
ized
an
d
c
o
n
tr
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r
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m
o
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a
n
d
o
v
er
wh
elm
in
g
g
a
p
f
o
u
n
d
[
3
1
]
,
[
4
5
]
,
[
5
2
]
,
[
5
5
]
.
T
o
en
a
b
le
m
ea
n
i
n
g
f
u
l
co
m
p
ar
is
o
n
ac
r
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lo
ca
tio
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an
d
s
tu
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ies,
r
esear
ch
e
r
s
h
a
v
e
r
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p
ea
ted
ly
ca
lled
f
o
r
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m
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izin
g
d
e
f
in
itio
n
s
an
d
ass
ess
m
en
t
m
eth
o
d
o
lo
g
ies,
as
we
ll
as
u
s
in
g
well
-
co
n
tr
o
lled
lo
n
g
itu
d
in
a
l
co
h
o
r
ts
[
3
1
]
,
[
4
0
]
,
[
5
5
]
.
Po
o
led
p
r
ev
ale
n
ce
esti
m
ates
ar
e
less
r
eliab
le
d
u
e
to
f
ac
to
r
s
s
u
ch
as
r
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ch
d
esig
n
Evaluation Warning : The document was created with Spire.PDF for Python.
I
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2
2
5
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-
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8
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6
I
n
t J Pu
b
lic
Hea
lth
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,
Vo
l.
1
5
,
No
.
1
,
Ma
r
ch
20
2
6
:
8
-
22
14
h
eter
o
g
en
eity
,
co
n
f
lictin
g
s
y
m
p
to
m
d
ef
i
n
itio
n
s
,
an
d
th
e
p
o
s
s
ib
ilit
y
o
f
s
elec
tio
n
b
ias
an
d
r
esid
u
al
co
n
f
o
u
n
d
in
g
,
p
a
r
ticu
lar
ly
in
cl
in
ic
-
b
as
ed
co
h
o
r
ts
with
o
u
t n
o
n
-
C
OVI
D
co
n
tr
o
ls
[
4
]
,
[
3
0
]
,
[
3
1
]
,
[
4
5
]
.
T
h
e
g
ap
s
clu
s
ter
in
to
th
r
ee
p
r
i
m
ar
y
ar
ea
s
:
-
Me
th
o
d
o
lo
g
ical
r
ig
o
r
an
d
b
ias:
Sev
er
al
s
tu
d
ies,
esp
ec
ially
th
e
ea
r
ly
o
n
es,
a
r
e
cr
iticized
f
o
r
th
ei
r
lack
o
f
s
p
ec
if
ied
ea
r
ly
c
h
ild
h
o
o
d
m
e
asu
r
es
[
3
9
]
,
r
elian
ce
o
n
claim
s
-
d
ata
co
d
in
g
ac
c
u
r
ac
y
[
3
6
]
,
attr
itio
n
a
n
d
s
u
r
v
iv
o
r
s
h
ip
b
ias
[
4
3
]
,
[
5
1
]
,
a
n
d
p
ar
e
n
t
-
r
ep
o
r
ted
o
u
tco
m
es
[
3
2
]
.
A
c
o
m
m
o
n
th
em
e
is
th
e
r
eq
u
ir
em
en
t
f
o
r
u
n
if
o
r
m
f
o
llo
w
-
u
p
p
r
o
ce
d
u
r
es
to
r
eliab
ly
r
ec
o
r
d
r
esu
lts
o
v
er
tim
e
[
4
0
]
,
[
4
5
]
.
-
L
o
n
g
-
ter
m
an
d
m
ec
h
an
ical
u
n
d
er
s
tan
d
in
g
:
I
t
is
ac
k
n
o
wled
g
ed
th
at
b
o
th
L
o
n
g
C
OVI
D
an
d
MI
S
-
C
lack
a
th
o
r
o
u
g
h
g
r
asp
o
f
th
e
lo
n
g
-
ter
m
m
ec
h
a
n
ical
f
o
u
n
d
atio
n
s
[
4
2
]
an
d
th
e
en
tire
r
an
g
e
o
f
n
eu
r
o
p
s
y
ch
o
l
o
g
ical
af
ter
ef
f
ec
ts
[
4
4
]
.
Desp
ite
th
eir
g
en
er
ally
f
av
o
u
r
a
b
le
r
esu
lts
,
s
tu
d
ies
o
n
MI
S
-
C
o
u
tc
o
m
es
p
o
in
t
o
u
t
lim
itatio
n
s
b
ec
au
s
e
o
f
th
eir
s
m
all
s
am
p
le
s
izes
an
d
th
e
r
eq
u
ir
em
e
n
t
f
o
r
lo
n
g
er
-
te
r
m
,
m
o
r
e
th
o
r
o
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g
h
f
o
llo
w
-
u
p
t
h
an
th
e
s
h
o
r
t
-
to
m
id
-
ter
m
[
2
9
]
,
[
4
7
]
.
-
E
q
u
ity
an
d
co
n
tex
tu
al
f
ac
to
r
s
:
T
h
e
n
ec
ess
ity
o
f
ca
u
s
ati
v
e
an
aly
s
es
to
co
m
p
r
eh
e
n
d
th
e
id
en
tifie
d
s
o
cio
ec
o
n
o
m
ic
an
d
r
ac
ial/eth
n
ic
d
if
f
er
en
ce
s
in
MI
S
-
C
in
ci
d
en
ce
an
d
o
u
tc
o
m
es
is
o
n
e
g
ap
th
at
h
as
b
ee
n
b
r
o
u
g
h
t to
lig
h
t
[
6
1
]
.
I
n
co
n
cl
u
s
io
n
,
to
g
o
b
ey
o
n
d
d
escr
ip
tiv
e
f
i
n
d
in
g
s
an
d
c
lar
if
y
th
e
p
at
h
o
p
h
y
s
io
lo
g
y
a
n
d
lo
n
g
-
ter
m
ca
r
e
r
eq
u
ir
em
e
n
ts
o
f
im
p
ac
ted
c
h
i
ld
r
en
,
f
u
tu
r
e
s
tu
d
ies
m
u
s
t
g
i
v
e
p
r
io
r
ity
to
well
-
co
n
tr
o
lled
,
h
ar
m
o
n
ized
,
an
d
lo
n
g
itu
d
in
al
s
tu
d
y
d
esig
n
s
[
5
2
]
.
4
.
4
.
Su
mm
a
ry
a
nd
im
pli
ca
t
i
o
ns
T
h
e
co
llectiv
e
e
v
id
en
ce
f
r
o
m
th
is
r
esear
ch
in
d
icate
s
th
at
ch
ild
r
en
wh
o
r
ec
o
v
er
f
r
o
m
C
OVI
D
-
19
o
r
MI
S
-
C
m
ay
h
av
e
lo
n
g
-
last
in
g
,
m
u
lti
-
s
y
s
tem
ic,
an
d
f
u
n
c
tio
n
ally
im
p
o
r
tan
t
s
id
e
ef
f
ec
t
s
th
at
im
p
ac
t
th
eir
m
en
tal
an
d
p
h
y
s
ical
well
-
b
ein
g
.
Mu
ltifa
cto
r
ial
r
is
k
f
a
ct
o
r
s
in
clu
d
e
b
io
lo
g
ical,
cli
n
ical,
s
o
cial,
an
d
d
em
o
g
r
a
p
h
ic
asp
ec
ts
.
T
h
e
in
tr
icac
y
o
f
PC
S
is
s
h
o
w
n
b
y
m
ec
h
an
is
tic
s
tu
d
ies,
wh
ich
s
h
o
w
th
at
lo
n
g
-
ter
m
co
n
s
eq
u
en
ce
s
ar
e
d
r
iv
en
b
y
n
eu
r
o
im
m
u
n
e
an
d
h
y
p
e
r
in
f
lam
m
ato
r
y
p
ath
way
s
[
3
9
]
,
[
5
9
]
.
New
f
in
d
in
g
s
o
f
n
eu
r
o
lo
g
ical
i
n
v
o
lv
em
en
t,
b
io
m
ar
k
er
s
o
f
e
x
ten
d
ed
r
ec
o
v
e
r
y
,
an
d
p
s
y
ch
o
s
o
cial
ef
f
ec
ts
ar
e
h
ig
h
lig
h
ted
b
y
em
er
g
i
n
g
r
e
s
ea
r
ch
,
wh
ich
m
ak
es
m
o
n
it
o
r
in
g
,
in
ter
v
en
tio
n
,
an
d
p
o
l
icy
p
lan
n
in
g
m
o
r
e
u
r
g
en
t
[
4
]
,
[
3
9
]
,
[
4
1
]
,
[
4
6
]
,
[
5
9
]
.
C
o
n
s
tr
u
al
lev
el
th
e
o
r
y
(
C
L
T
)
in
teg
r
atio
n
o
f
f
er
s
a
f
r
a
m
e
wo
r
k
f
o
r
co
m
p
r
eh
en
d
in
g
h
o
w
k
id
s
an
d
teen
ag
er
s
r
ea
ct
to
th
e
l
o
n
g
-
ter
m
co
n
s
eq
u
e
n
ce
s
o
f
MI
S
-
C
an
d
C
OVI
D
-
1
9
.
Sh
o
r
t
-
ter
m
b
eh
a
v
io
r
s
lik
e
f
o
llo
win
g
r
ec
o
v
er
y
g
u
id
elin
es
o
r
u
s
in
g
h
ea
lth
ca
r
e
s
er
v
ices
ar
e
in
f
lu
en
ce
d
b
y
s
itu
atio
n
al
an
d
e
n
v
ir
o
n
m
en
tal
f
ac
to
r
s
.
L
o
n
g
-
ter
m
p
atter
n
s
o
f
s
o
cializa
tio
n
,
h
ea
lth
-
r
elate
d
d
ec
is
io
n
-
m
ak
in
g
,
an
d
co
p
i
n
g
with
ch
r
o
n
ic
illn
ess
es
ar
e
in
f
lu
en
ce
d
b
y
m
o
r
e
ab
s
tr
ac
t
elem
en
ts
,
in
cl
u
d
in
g
attitu
d
es,
b
elief
s
,
an
d
s
o
cial
n
o
r
m
s
.
C
lin
ician
s
an
d
p
o
licy
m
ak
er
s
ca
n
b
etter
an
tici
p
ate
p
r
esen
t
an
d
f
u
tu
r
e
n
ee
d
s
b
y
u
s
in
g
C
L
T
to
cu
s
to
m
ize
th
er
ap
ies
th
at
tar
g
et
s
o
cial,
em
o
tio
n
al,
an
d
co
g
n
itiv
e
well
-
b
ein
g
in
ad
d
itio
n
to
p
h
y
s
ical
h
ea
lin
g
.
B
u
ild
in
g
o
n
th
ese
r
e
v
elatio
n
s
,
s
o
m
e
u
s
ef
u
l
s
u
g
g
esti
o
n
s
a
r
e
r
ev
ea
led
:
Ps
y
ch
o
s
o
cial
a
n
d
e
d
u
ca
tio
n
al
s
u
p
p
o
r
t,
in
clu
d
in
g
co
u
n
s
ellin
g
,
s
ch
o
o
l
r
ein
teg
r
atio
n
p
r
o
g
r
a
m
s
,
an
d
co
m
m
u
n
ity
-
b
ased
in
i
tiativ
es
to
m
itig
ate
f
u
n
ctio
n
al
an
d
em
o
tio
n
al
im
p
ac
ts
;
tar
g
eted
in
ter
v
e
n
tio
n
s
f
o
r
h
ig
h
-
r
is
k
ch
ild
r
en
i
n
f
o
r
m
ed
b
y
clin
ical,
s
o
cial,
an
d
b
io
m
ar
k
er
-
b
ased
r
is
k
s
tr
atif
icatio
n
to
r
ed
u
ce
th
e
lik
elih
o
o
d
o
f
p
r
o
lo
n
g
ed
o
r
r
ec
u
r
r
en
t
s
y
m
p
to
m
s
;
an
d
o
n
g
o
in
g
r
esear
ch
to
clar
if
y
m
ec
h
an
is
tic
p
ath
way
s
,
o
p
tim
ize
th
er
ap
e
u
tic
s
tr
ateg
ies,
an
d
r
ef
in
e
ev
id
e
n
ce
-
b
ased
g
u
id
elin
es
f
o
r
lo
n
g
-
ter
m
p
e
d
iatr
ic
ca
r
e.
Pro
lo
n
g
ed
m
o
n
i
to
r
in
g
o
f
p
e
d
iatr
ic
p
o
s
t
-
C
OVI
D
p
atien
ts
u
s
in
g
atten
tio
n
to
m
u
ltis
y
s
tem
an
d
n
eu
r
o
co
g
n
itiv
e
ass
ess
m
en
ts
to
ca
p
tu
r
e
s
u
b
tle
b
u
t
clin
ically
s
i
g
n
if
ican
t o
u
tco
m
es.
Fo
r
ch
ild
r
e
n
r
ec
o
v
er
in
g
f
r
o
m
C
OVI
D
-
1
9
an
d
M
I
S
-
C
,
th
is
in
teg
r
ated
a
p
p
r
o
ac
h
g
u
ar
a
n
tees
th
at
in
ter
v
en
tio
n
s
ar
e
th
o
r
o
u
g
h
,
s
u
p
p
o
r
ted
b
y
ev
i
d
en
ce
,
an
d
s
en
s
itiv
e
to
th
eir
i
m
m
ed
iate
as we
ll a
s
ch
an
g
in
g
n
ee
d
s
.
T
h
e
w
i
d
e
r
s
o
c
i
o
e
c
o
n
o
m
i
c
a
n
d
e
d
u
c
a
t
i
o
n
a
l
e
f
f
e
c
ts
o
f
PC
S
an
d
M
I
S
-
C
s
h
o
u
l
d
al
s
o
b
e
c
o
n
s
i
d
e
r
e
d
in
p
u
b
l
i
c
h
e
a
l
t
h
p
o
l
i
c
y
.
L
o
n
g
-
t
e
r
m
e
m
o
t
i
o
n
a
l
,
c
o
g
n
i
t
i
v
e
,
a
n
d
d
e
v
e
l
o
p
m
e
n
t
a
l
d
e
f
i
ci
t
s
c
a
n
b
e
a
v
o
i
d
e
d
w
i
t
h
e
a
r
l
y
d
e
t
e
c
t
i
o
n
a
n
d
i
n
t
e
r
v
e
n
ti
o
n
,
es
p
e
c
i
a
l
l
y
i
n
s
u
s
c
e
p
t
i
b
l
e
g
r
o
u
p
s
.
St
a
n
d
a
r
d
i
z
e
d
p
r
o
c
e
d
u
r
e
s
f
o
r
e
v
al
u
a
t
i
o
n
a
n
d
f
o
ll
o
w
-
u
p
s
h
o
u
l
d
b
e
a
v
ai
l
a
b
l
e
t
o
h
ea
l
th
c
a
r
e
p
r
o
f
e
s
s
i
o
n
a
ls
,
a
n
d
f
a
m
i
l
ie
s
s
h
o
u
l
d
b
e
g
i
v
e
n
i
n
s
t
r
u
c
t
i
o
n
s
o
n
h
o
w
t
o
i
d
e
n
t
i
f
y
a
n
d
t
r
e
a
t
c
h
r
o
n
i
c
p
r
o
b
l
e
m
s
.
U
lti
m
a
t
e
l
y
,
t
o
s
u
c
c
ess
f
u
l
l
y
a
d
d
r
e
s
s
t
h
e
l
o
n
g
-
t
e
r
m
e
f
f
e
c
ts
o
f
C
O
VI
D
-
1
9
i
n
c
h
i
l
d
r
e
n
,
a
c
o
o
r
d
i
n
a
t
e
d
,
m
u
l
t
i
d
is
c
i
p
li
n
a
r
y
e
f
f
o
r
t
i
n
v
o
l
v
i
n
g
p
e
d
i
a
t
r
i
c
i
an
s
,
p
s
y
c
h
o
l
o
g
i
s
t
s
,
e
d
u
c
at
o
r
s
,
a
n
d
l
e
g
i
s
l
at
o
r
s
is
n
e
c
e
s
s
a
r
y
.
A
ll
t
h
i
n
g
s
c
o
n
s
i
d
e
r
e
d
,
t
h
i
s
d
at
a
e
m
p
h
a
s
i
z
es
h
o
w
c
r
i
t
i
c
al
it
is
t
o
a
d
d
r
e
s
s
t
h
e
lo
n
g
-
t
e
r
m
e
f
f
e
c
t
s
o
f
C
O
V
I
D
-
1
9
a
n
d
M
I
S
-
C
i
n
c
h
il
d
r
e
n
,
m
a
k
i
n
g
s
u
r
e
t
h
at
i
n
t
e
r
v
e
n
t
i
o
n
s
a
r
e
c
o
m
p
r
e
h
e
n
s
i
v
e
,
i
n
t
e
r
d
i
s
ci
p
l
i
n
a
r
y
,
a
n
d
g
r
o
u
n
d
e
d
i
n
n
e
w
f
i
n
d
i
n
g
s
.
P
r
o
a
c
t
i
v
e
l
y
a
d
d
r
es
s
i
n
g
t
h
e
s
e
i
s
s
u
es
w
o
u
l
d
l
es
s
e
n
t
h
e
s
o
ci
e
t
al
b
u
r
d
e
n
o
f
p
o
s
t
-
C
OV
I
D
p
r
o
b
l
e
m
s
i
n
j
u
v
e
n
i
l
e
p
o
p
u
l
at
i
o
n
s
w
h
i
l
e
a
l
s
o
i
m
p
r
o
v
i
n
g
i
n
d
i
v
id
u
a
l
r
e
s
u
l
ts
.
5.
I
M
P
L
I
CA
T
I
O
N
S F
O
R
CL
I
NICA
L
P
RACT
I
C
E
W
e
h
av
e
o
u
tlin
ed
r
ec
o
m
m
e
n
d
atio
n
s
f
o
r
clin
ical
p
r
ac
tice
an
d
p
o
licy
b
ased
o
n
t
h
e
r
es
u
lts
o
f
th
e
s
y
s
tem
atic
s
tu
d
y
.
W
e
r
ec
o
m
m
en
d
p
u
ttin
g
ea
r
ly
id
en
tific
atio
n
,
in
ter
d
is
cip
lin
ar
y
tr
ea
t
m
en
t,
an
d
f
o
cu
s
ed
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J Pu
b
lic
Hea
lth
Sci
I
SS
N:
2252
-
8
8
0
6
P
o
s
t
-
C
OV
I
D
-
1
9
s
yn
d
r
o
me
in
ch
ild
r
en
:
a
s
co
p
i
n
g
r
ev
iew
(
R
a
p
h
a
el
F
o
lo
r
u
n
s
h
o
Olu
w
a
s
in
a
B
a
b
a
to
l
a
)
15
th
er
ap
ies
in
to
p
r
ac
tice.
T
o
cl
o
s
e
k
n
o
wled
g
e
g
ap
s
an
d
en
h
an
ce
lo
n
g
-
ter
m
r
esu
lts
f
o
r
k
id
s
with
PC
S,
it
's
also
cr
itical
to
k
ee
p
in
v
esti
g
ati
n
g
.
Usi
n
g
th
e
r
esu
lts
o
f
lo
n
g
-
ter
m
f
o
llo
w
-
u
p
r
esear
ch
,
p
o
licy
p
lan
n
in
g
m
u
s
t
s
h
if
t
f
r
o
m
m
an
a
g
in
g
th
e
ac
u
te
p
an
d
em
ic
p
h
ase
to
ad
d
r
ess
in
g
th
e
ch
r
o
n
ic,
m
u
lti
-
s
y
s
tem
ic
n
ee
d
s
o
f
ch
ild
r
en
with
L
o
n
g
C
OVI
D
an
d
p
o
s
t
-
MI
S
-
C
d
is
o
r
d
er
s
.
5
.
1
.
P
ri
o
rit
izing
neuro
ps
y
ch
o
l
o
g
ica
l a
nd
f
un
ct
io
na
l su
pp
o
rt
Alth
o
u
g
h
ac
u
te
ca
r
d
iac
r
is
k
r
ec
eiv
ed
m
o
s
t
o
f
th
e
p
o
licy
atte
n
tio
n
at
f
ir
s
t,
lo
n
g
-
ter
m
d
ata
s
u
g
g
est
th
at
n
eu
r
o
c
o
g
n
itiv
e
a
n
d
m
e
n
tal
h
e
alth
ca
r
e
s
h
o
u
ld
b
e
g
i
v
en
p
r
io
r
ity
.
-
T
ar
g
eted
s
cr
ee
n
in
g
an
d
s
u
p
p
o
r
t
ar
e
two
way
s
to
ac
co
m
p
lis
h
th
is
.
C
o
m
p
r
eh
en
s
iv
e
r
eh
a
b
ilit
atio
n
p
r
o
g
r
am
s
th
at
in
co
r
p
o
r
ate
p
h
y
s
ical,
co
g
n
itiv
e,
an
d
p
s
y
ch
o
s
o
cial
ca
r
e
th
r
o
u
g
h
o
u
t
th
e
d
u
r
atio
n
o
f
illn
ess
m
u
s
t
b
e
f
u
n
d
e
d
b
y
p
o
licy
[
3
7
]
,
[
4
3
]
.
T
h
is
is
im
p
o
r
tan
t
s
in
ce
s
tu
d
ies
with
two
-
y
ea
r
f
o
llo
w
-
u
p
h
av
e
r
ev
ea
led
th
at
u
p
to
2
0
%
o
f
MI
S
-
C
s
u
r
v
iv
o
r
s
h
av
e
o
n
g
o
in
g
co
g
n
itiv
e
p
r
o
b
lem
s
,
s
u
ch
as
m
o
o
d
d
is
o
r
d
er
s
an
d
atten
t
io
n
ab
n
o
r
m
alities
[
5
6
]
.
R
ed
u
ce
d
q
u
ality
o
f
life
an
d
f
u
n
ctio
n
al
d
ef
icien
cies
f
r
eq
u
e
n
tly
p
e
r
s
is
t;
th
er
ef
o
r
e,
s
ch
o
o
l
s
y
s
tem
s
n
ee
d
r
eso
u
r
ce
s
an
d
e
d
u
ca
tio
n
al
m
o
d
if
i
ca
tio
n
s
to
o
f
f
s
et
f
u
n
ctio
n
al
an
d
ac
ad
em
ic
d
is
ad
v
an
tag
es
[
3
4
]
,
[
4
8
]
.
-
Stan
d
ar
d
ized
f
o
llo
w
-
u
p
p
r
o
to
co
ls
:
I
t
r
em
ain
s
ess
en
tial
to
im
p
lem
en
t
ea
r
ly
p
r
im
ar
y
ca
r
e
tr
ea
tm
en
ts
,
s
u
ch
as
s
y
s
tem
atic
s
cr
ee
n
in
g
an
d
p
r
o
m
p
t
id
en
tific
atio
n
o
f
h
i
g
h
-
r
is
k
ca
s
es
[
5
2
]
.
T
h
e
cu
r
r
en
t
liter
atu
r
e's
m
ea
s
u
r
em
en
t
g
ap
s
an
d
h
eter
o
g
en
eity
[
5
2
]
r
eq
u
ir
e
h
ea
lth
s
y
s
tem
s
to
ad
o
p
t
s
tan
d
a
r
d
iz
ed
,
h
a
r
m
o
n
ize
d
f
o
llo
w
-
u
p
s
tr
ateg
ies
[
4
0
]
.
T
h
ese
p
r
o
ce
d
u
r
es
n
ee
d
to
d
o
c
u
m
en
t
s
u
b
tle,
d
elay
ed
r
esu
lts
ac
r
o
s
s
v
ar
io
u
s
d
o
m
ain
s
,
ex
te
n
d
in
g
b
ey
o
n
d
b
asic
v
ital
s
ig
n
s
to
in
clu
d
e
co
m
p
r
eh
en
s
iv
e
f
u
n
ctio
n
al
an
d
n
eu
r
o
p
s
y
ch
o
l
o
g
ical
ass
es
s
m
en
ts
.
5
.
2
.
Ref
ini
ng
clinica
l r
is
k
s
t
ra
t
if
ica
t
io
n a
nd
mo
nito
ring
R
eso
u
r
ce
s
s
h
o
u
ld
b
e
d
is
tr
ib
u
t
ed
b
y
p
o
licies
ac
co
r
d
in
g
to
th
e
p
ar
ticu
lar
s
o
f
t
h
e
s
eq
u
elae
a
n
d
th
e
r
is
k
f
ac
to
r
s
th
at
h
av
e
b
ee
n
r
ec
o
g
n
ized
.
T
h
is
ca
n
b
e
ac
co
m
p
lis
h
ed
th
r
o
u
g
h
:
-
R
is
k
-
in
f
o
r
m
ed
in
ter
v
e
n
tio
n
s
:
Alth
o
u
g
h
it
n
ec
ess
itates
r
ig
o
r
o
u
s
co
s
t
-
b
en
ef
it
an
aly
s
is
,
m
ed
icatio
n
m
an
ag
em
en
t
ca
n
aid
i
n
r
e
d
u
c
in
g
h
o
s
p
ital
o
v
e
r
cr
o
wd
i
n
g
[
4
3
]
.
R
ec
o
g
n
ized
r
is
k
f
ac
to
r
s
m
u
s
t
b
e
u
s
ed
to
cu
s
to
m
ize
p
o
licy
:
Hig
h
ac
u
te
d
is
ea
s
e
s
ev
er
ity
(
I
C
U
h
o
s
p
italizatio
n
,
ca
r
d
iac
in
v
o
l
v
em
en
t)
,
f
em
ale
s
ex
,
an
d
ad
o
lescen
t
ag
e
ar
e
wid
ely
r
ec
o
g
n
ized
as
im
p
o
r
tan
t
r
is
k
f
ac
to
r
s
f
o
r
en
d
u
r
in
g
s
y
m
p
t
o
m
s
[
5
4
]
,
[
5
6
]
.
Ad
d
itio
n
ally
,
th
e
d
is
co
v
er
y
th
at
r
ein
f
ec
tio
n
is
lin
k
ed
to
an
in
cr
ea
s
ed
in
cid
en
ce
o
f
lo
n
g
C
OVI
D
ch
ar
ac
ter
is
tics
[
5
1
]
em
p
h
asizes th
e
n
ec
ess
ity
o
f
o
n
g
o
in
g
p
r
e
v
en
tativ
e
m
ea
s
u
r
es.
-
L
o
n
g
-
ter
m
ca
r
d
io
v
ascu
lar
s
u
r
v
eillan
ce
:
On
e
s
ig
n
if
ican
t
wo
r
r
y
is
ca
r
d
io
v
ascu
lar
p
r
o
b
lem
s
.
T
o
lo
wer
in
f
lam
m
atio
n
an
d
av
o
i
d
m
ed
i
u
m
-
to
lo
n
g
-
ter
m
co
n
s
eq
u
e
n
ce
s
,
ea
r
ly
in
ter
v
en
tio
n
is
r
eq
u
ir
e
d
[
4
7
]
.
As
MI
S
-
C
is
m
o
r
e
u
n
d
er
s
to
o
d
,
c
ar
d
iac
s
u
r
v
eillan
ce
a
n
d
lo
n
g
-
ter
m
f
o
llo
w
-
u
p
a
r
e
ad
v
is
ed
,
p
o
s
s
ib
ly
in
to
ad
u
lth
o
o
d
[
2
9
]
.
T
h
ese
co
n
clu
s
io
n
s
ar
e
s
u
p
p
o
r
ted
b
y
r
ec
e
n
t
r
esea
r
ch
th
at
d
em
o
n
s
tr
ates
m
ild
ca
r
d
io
v
ascu
lar
ab
n
o
r
m
alities
th
at
r
em
ain
in
c
h
ild
r
en
f
o
r
u
p
to
1
8
m
o
n
th
s
af
t
er
in
f
ec
tio
n
[
3
4
]
,
[
4
2
]
.
5
.
3
.
Address
ing
s
o
cia
l a
nd
m
ec
ha
nis
t
ic
g
a
ps
-
E
q
u
ity
in
ca
r
e
Dem
o
g
r
ap
h
ic
an
d
s
o
cio
ec
o
n
o
m
ic
v
ar
iab
les
h
av
e
a
m
aj
o
r
im
p
ac
t
o
n
o
u
tco
m
es
an
d
v
u
ln
er
a
b
ilit
y
[
4
6
]
.
T
o
ad
d
r
ess
in
eq
u
ities
,
p
o
licy
m
u
s
t
s
u
p
p
o
r
t
tar
g
eted
f
am
ily
-
lev
el
an
d
p
s
y
ch
o
s
o
cial
in
ter
v
en
tio
n
s
as
well
as
ca
u
s
al
s
tu
d
ies
[
4
8
]
,
[
6
1
]
.
I
n
a
s
im
ilar
v
ein
,
f
am
ily
-
lev
el
an
d
p
s
y
ch
o
s
o
cial
th
er
ap
ies
m
ay
im
p
r
o
v
e
r
ec
o
v
er
y
,
with
p
ar
en
tal
s
u
p
p
o
r
t a
ctin
g
as
a
b
u
f
f
er
[
3
7
]
.
-
Fu
n
d
in
g
m
e
ch
an
is
tic
r
esear
ch
S
t
u
d
i
es
o
n
c
y
t
o
k
i
n
e
-
m
e
d
i
a
te
d
a
n
d
n
e
u
r
o
i
m
m
u
n
e
m
e
c
h
a
n
i
s
m
s
m
u
s
t
b
e
g
i
v
e
n
t
o
p
p
r
i
o
r
i
t
y
w
h
e
n
p
o
l
i
c
y
m
a
k
e
r
s
m
a
k
e
j
u
d
g
m
e
n
t
s
a
b
o
u
t
l
o
n
g
-
t
e
r
m
t
r
e
a
t
m
e
n
t
t
r
i
a
l
s
[
4
2
]
,
[
5
6
]
.
T
o
f
i
n
d
t
h
e
b
e
s
t
t
r
e
a
t
m
e
n
ts
t
h
a
t
c
a
n
s
t
o
p
c
o
r
o
n
a
r
y
a
r
t
e
r
y
a
n
e
u
r
y
s
m
s
a
n
d
r
e
v
e
r
s
e
i
n
f
l
a
m
m
at
o
r
y
p
r
o
c
e
s
s
e
s
i
n
M
I
S
-
C
,
c
l
i
n
i
c
a
l
t
r
i
a
ls
ar
e
n
e
c
e
s
s
a
r
y
[
4
4
]
.
Fin
ally
,
v
ac
cin
atio
n
co
n
f
id
en
ce
is
s
till
a
cr
u
cial
p
a
r
t
o
f
p
r
ev
en
tativ
e
tactics
[
5
5
]
.
T
o
le
s
s
en
lo
n
g
-
last
in
g
p
o
s
t
-
C
OVI
D
p
r
o
b
lem
s
,
r
ec
en
t
lo
n
g
itu
d
in
al
s
tu
d
ies
[
4
]
,
[
3
7
]
also
ad
v
o
ca
te
co
m
b
i
n
in
g
im
m
u
n
izatio
n
ca
m
p
aig
n
s
with
ed
u
ca
tio
n
al
a
n
d
p
s
y
ch
o
s
o
cial
in
ter
v
en
tio
n
s
.
6.
CO
NCLU
SI
O
N
A
th
o
r
o
u
g
h
ap
p
r
o
ac
h
f
o
r
f
i
n
d
in
g
,
v
ettin
g
,
an
d
e
v
alu
atin
g
p
er
tin
en
t
r
esear
ch
o
n
th
e
lo
n
g
-
ter
m
im
p
ac
ts
o
f
C
OVI
D
-
1
9
an
d
MI
S
-
C
in
k
id
s
an
d
teen
ag
er
s
is
o
f
f
er
ed
b
y
th
is
s
y
s
tem
atic
lite
r
atu
r
e
r
ev
iew.
T
h
is
s
tu
d
y
h
ig
h
lig
h
ts
lo
n
g
-
last
in
g
clin
ical,
n
eu
r
o
lo
g
ical,
an
d
p
s
y
c
h
o
lo
g
ical
co
n
s
eq
u
en
ce
s
,
as
well
as
d
em
o
g
r
ap
h
ic
an
d
s
o
cio
ec
o
n
o
m
ic
f
ac
to
r
s
im
p
ac
tin
g
o
u
tco
m
es,
b
y
c
o
m
b
in
in
g
f
in
d
in
g
s
f
r
o
m
ea
r
ly
an
d
co
n
tem
p
o
r
a
r
y
r
esear
ch
,
in
clu
d
in
g
t
h
o
s
e
co
n
d
u
cted
in
2
0
2
4
–
2
0
2
5
.
T
h
e
s
tu
d
y
s
h
o
ws
a
s
tr
u
ctu
r
ally
d
iv
id
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d
b
o
d
y
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f
ev
id
e
n
ce
,
with
in
ten
s
e
p
r
o
s
p
ec
tiv
e
co
h
o
r
ts
d
escr
ib
in
g
s
ev
er
e
n
eu
r
o
p
s
y
ch
o
lo
g
ical
ab
n
o
r
m
alities
in
a
m
in
o
r
ity
o
f
MI
S
-
C
s
u
r
v
iv
o
r
s
an
d
s
tr
o
n
g
n
atio
n
al
co
h
o
r
ts
d
em
o
n
s
tr
atin
g
a
l
o
w
a
b
s
o
lu
te
r
is
k
f
o
r
lo
n
g
C
OVI
D.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
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l.
1
5
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No
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1
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Ma
r
ch
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2
6
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8
-
22
16
Ad
d
itio
n
ally
,
th
e
s
tu
d
y
h
ig
h
lig
h
ted
th
e
im
p
o
r
ta
n
ce
o
f
co
n
d
u
ctin
g
m
ec
h
an
is
tic
r
esear
ch
o
n
h
y
p
er
in
f
lam
m
ato
r
y
a
n
d
n
eu
r
o
im
m
u
n
e
p
ath
way
s
an
d
r
e
v
e
aled
s
ig
n
if
ican
t
m
eth
o
d
o
lo
g
i
ca
l
in
ad
eq
u
ac
ies.
A
u
s
ef
u
l
in
ter
p
r
etiv
e
p
er
s
p
ec
tiv
e
is
o
f
f
er
ed
b
y
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co
r
p
o
r
atin
g
C
L
T
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wh
ich
co
n
ten
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s
th
at
th
er
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p
ies
s
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o
u
ld
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r
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b
o
th
th
e
h
ig
h
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lev
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a
b
s
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t d
if
f
icu
lties
o
f
lo
n
g
-
ter
m
s
o
cial
an
d
f
u
n
ctio
n
al
ad
ap
tatio
n
as we
ll a
s
th
e
lo
w
-
lev
el,
u
r
g
en
t
p
h
y
s
ical
d
em
an
d
s
.
T
h
e
m
eth
o
d
ical
ap
p
r
o
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h
g
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a
r
an
tees
th
o
r
o
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g
h
co
v
e
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ag
e
o
f
th
e
m
o
s
t
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ec
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t
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esear
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p
r
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v
id
i
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s
ig
h
t
f
u
l
in
f
o
r
m
atio
n
f
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r
clin
ical
p
r
ac
tice
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d
in
f
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itab
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ltid
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en
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n
d
s
tan
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ar
d
ized
f
o
llo
w
-
u
p
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et
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s
.
T
h
e
c
o
n
ce
p
ts
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ec
o
m
m
e
n
d
e
d
i
n
t
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e
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p
d
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d
f
u
t
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r
es
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r
c
h
s
e
cti
o
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f
all
i
n
t
o
t
h
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e
e
m
ai
n
a
r
e
as
,
f
o
c
u
s
ed
o
n
r
es
o
l
v
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m
et
h
o
d
o
l
o
g
ic
al
lim
i
tat
io
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s
a
n
d
a
d
v
a
n
ci
n
g
ca
u
s
al
u
n
d
e
r
s
t
a
n
d
in
g
;
i
)
St
an
d
a
r
d
iz
ed
cl
in
ica
l
a
n
d
lab
o
r
a
t
o
r
y
m
e
asu
r
es:
T
h
e
f
o
c
u
s
h
er
e
is
o
n
d
e
v
el
o
p
in
g
a
n
d
s
t
r
ictl
y
a
p
p
ly
in
g
h
a
r
m
o
n
iz
e
d
m
et
r
ics
a
cr
o
s
s
d
if
f
e
r
en
t
s
tu
d
ies
,
esp
ec
iall
y
f
o
r
c
ap
tu
r
i
n
g
s
u
b
je
cti
v
e
o
u
t
co
m
es
li
k
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f
ati
g
u
e
an
d
co
g
n
i
ti
v
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i
m
p
ai
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m
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t
s
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t
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ta
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co
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p
a
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a
b
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i
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all
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M
u
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p
r
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:
m
o
v
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ay
f
r
o
m
s
m
al
l,
r
et
r
o
s
p
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e
o
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cli
n
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c
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ase
d
s
t
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ies
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o
l
a
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s
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p
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p
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c
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t
h
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g
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r
f
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ll
o
w
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u
p
p
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s
(
b
e
y
o
n
d
m
i
d
-
te
r
m
)
to
a
cc
u
r
ate
ly
t
r
a
c
k
t
h
e
t
r
u
e
,
l
o
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g
-
t
e
r
m
tr
aj
ec
t
o
r
y
o
f
s
y
m
p
to
m
s
;
ii
)
T
a
r
g
et
ed
f
o
ll
o
w
-
u
p
a
n
d
m
o
n
i
to
r
i
n
g
:
r
ese
a
r
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h
s
h
o
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a
d
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p
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cise
p
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ls
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o
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it
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.
F
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AUTHO
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is
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ax
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ed
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au
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h
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tes,
an
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f
ac
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co
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.
Na
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Aut
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v
ely
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lo
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o
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✓
C
:
C
o
n
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p
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t
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:
M
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h
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d
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:
So
f
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Va
:
Va
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a
t
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Fo
:
Fo
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h
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k
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.
T
h
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au
th
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r
s
s
tate
n
o
co
n
f
lict o
f
in
ter
est.
DATA AV
AI
L
AB
I
L
I
T
Y
T
h
e
d
ata
th
at
s
u
p
p
o
r
t
th
e
f
in
d
in
g
s
o
f
th
is
s
tu
d
y
ar
e
o
p
en
ly
av
ailab
le
in
m
o
s
t
o
p
en
-
ac
ce
s
s
r
ep
o
s
ito
r
ies.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J Pu
b
lic
Hea
lth
Sci
I
SS
N:
2252
-
8
8
0
6
P
o
s
t
-
C
OV
I
D
-
1
9
s
yn
d
r
o
me
in
ch
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r
en
:
a
s
co
p
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n
g
r
ev
iew
(
R
a
p
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a
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F
o
lo
r
u
n
s
h
o
Olu
w
a
s
in
a
B
a
b
a
to
l
a
)
17
RE
F
E
R
E
NC
E
S
[
1
]
P
.
D
a
v
i
e
s,
P
.
d
u
P
r
é
,
J.
L
i
l
l
i
e
,
a
n
d
H
.
K
.
K
a
n
t
h
i
m
a
t
h
i
n
a
t
h
a
n
,
“
O
n
e
-
y
e
a
r
o
u
t
c
o
mes
o
f
c
r
i
t
i
c
a
l
c
a
r
e
p
a
t
i
e
n
t
s
p
o
s
t
–
C
O
V
I
D
-
1
9
mu
l
t
i
s
y
st
e
m
i
n
f
l
a
mm
a
t
o
r
y
s
y
n
d
r
o
me
i
n
c
h
i
l
d
r
e
n
,
”
J
A
MA
Pe
d
i
a
t
ri
c
s
,
v
o
l
.
1
7
5
,
n
o
.
1
2
,
p
p
.
1
2
8
1
–
1
2
8
3
,
2
0
2
1
,
d
o
i
:
1
0
.
1
0
0
1
/
j
a
ma
p
e
d
i
a
t
r
i
c
s.
2
0
2
1
.
2
9
9
3
.
[
2
]
J.
I
z
q
u
i
e
r
d
o
-
P
u
j
o
l
a
n
d
o
t
h
e
r
s
,
“
P
o
s
t
C
O
V
I
D
-
1
9
C
o
n
d
i
t
i
o
n
i
n
c
h
i
l
d
r
e
n
a
n
d
a
d
o
l
e
sce
n
t
s:
a
n
e
mer
g
i
n
g
p
r
o
b
l
e
m,”
Fro
n
t
i
e
r
s
i
n
Pe
d
i
a
t
ri
c
s
,
v
o
l
.
1
0
,
2
0
2
2
,
d
o
i
:
1
0
.
3
3
8
9
/
f
p
e
d
.
2
0
2
2
.
8
9
4
2
0
4
.
[
3
]
A
.
D
.
B
r
u
e
g
g
e
ma
n
n
,
P
.
G
.
H
a
r
p
e
r
,
H
.
B
o
y
e
r
,
S
.
F
j
e
s
t
a
d
,
a
n
d
L.
A
.
B
u
r
me
i
st
e
r
,
“
A
Q
u
a
l
i
t
y
i
mp
r
o
v
e
me
n
t
p
r
o
j
e
c
t
o
n
t
e
a
m
-
b
a
s
e
d
c
a
r
e
f
o
r
d
e
p
r
e
ss
i
o
n
s
c
r
e
e
n
i
n
g
b
e
f
o
r
e
a
n
d
d
u
r
i
n
g
t
h
e
C
O
V
I
D
-
1
9
p
a
n
d
e
m
i
c
i
n
a
sp
e
c
i
a
l
t
y
c
l
i
n
i
c
,
”
C
u
r
e
u
s
,
2
0
2
4
,
d
o
i
:
1
0
.
7
7
5
9
/
c
u
r
e
u
s.
7
4
2
3
4
.
[
4
]
T.
S
t
e
p
h
e
n
s
o
n
a
n
d
o
t
h
e
r
s,
“
L
o
n
g
C
O
V
I
D
(
p
o
st
-
C
O
V
I
D
-
1
9
c
o
n
d
i
t
i
o
n
)
i
n
c
h
i
l
d
r
e
n
:
a
m
o
d
i
f
i
e
d
D
e
l
p
h
i
p
r
o
c
e
ss,”
Arc
h
i
v
e
s
o
f
D
i
sea
se
i
n
C
h
i
l
d
h
o
o
d
,
v
o
l
.
1
0
7
,
n
o
.
7
,
p
p
.
6
7
4
–
6
8
0
,
2
0
2
2
,
d
o
i
:
1
0
.
1
1
3
6
/
a
r
c
h
d
i
s
c
h
i
l
d
-
2
0
2
1
-
3
2
3
6
2
4
.
[
5
]
W
o
r
l
d
H
e
a
l
t
h
O
r
g
a
n
i
z
a
t
i
o
n
,
“
P
o
st
C
O
V
I
D
-
1
9
c
o
n
d
i
t
i
o
n
(
Lo
n
g
C
O
V
I
D
)
.
”
2
0
2
5
.
[
O
n
l
i
n
e
]
.
A
v
a
i
l
a
b
l
e
:
h
t
t
p
s
:
/
/
w
w
w
.
w
h
o
.
i
n
t
/
n
e
w
s
-
r
o
o
m
/
f
a
c
t
-
sh
e
e
t
s/
d
e
t
a
i
l
/
p
o
st
-
c
o
v
i
d
-
19
-
c
o
n
d
i
t
i
o
n
-
(
l
o
n
g
-
c
o
v
i
d
)
[
6
]
H
.
R
a
z
z
a
g
h
i
a
n
d
o
t
h
e
r
s,
“
M
a
t
e
r
n
a
l
r
e
sp
i
r
a
t
o
r
y
s
y
n
c
y
t
i
a
l
v
i
r
u
s
v
a
c
c
i
n
a
t
i
o
n
a
n
d
r
e
c
e
i
p
t
o
f
r
e
s
p
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