Evidence map›Paper›PMID 40171657›Full record

ArticleStroke2025

Assessing the Impact of the COVID-19 Pandemic on Childhood Arterial Ischemic Stroke: An Unanticipated Natural Experiment.

Heather J Fullerton, Nancy K Hills, Max Wintermark, Nomazulu Dlamini, Christine K Fox, Dana D Cummings, Timothy J Bernard, Lauren A Beslow, Lisa R Sun, Charles Grose and 3 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Stroke, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Heather J FullertonDepartments of Neurology (H.J.F., N.K.H., C.K.F.), University of California San Francisco.ORCID 0000-0002-4828-1687
Nancy K HillsDepartments of Neurology (H.J.F., N.K.H., C.K.F.), University of California San Francisco.ORCID 0000-0002-1041-8182
Max WintermarkDepartment of Radiology, MD Anderson Cancer Center, Houston, TX (M.W.).ORCID 0000-0002-6726-3951
Nomazulu DlaminiDepartment of Paediatrics, Division of Neurology, Hospital for Sick Children, Toronto, Canada (N.D.).ORCID 0000-0001-5927-3132
Christine K FoxDepartments of Neurology (H.J.F., N.K.H., C.K.F.), University of California San Francisco.ORCID 0000-0001-6934-3624
Dana D CummingsDepartment of Pediatrics, Division of Child Neurology, University of Pittsburgh, PA (D.D.C.).ORCID 0000-0003-4972-7879
Timothy J BernardDepartment of Pediatrics, Division of Pediatric Neurology, University of Colorado, Denver (T.J.B.).
Lauren A BeslowDivision of Neurology, Children's Hospital of Philadelphia, Departments of Neurology and Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia (L.A.B.).ORCID 0000-0003-0571-980X
Lisa R SunDepartment of Neurology, Johns Hopkins University, Baltimore, MD (L.R.S.).ORCID 0000-0003-4948-0415
Charles GroseDepartment of Pediatrics, Division of Infectious Diseases/Virology, University of Iowa (C.G.).ORCID 0000-0001-6884-6668
Phillp J NorrisLaboratory Medicine (P.J.N., C.D.G.), University of California San Francisco.ORCID 0000-0003-0526-2088
Clara Di GermanioLaboratory Medicine (P.J.N., C.D.G.), University of California San Francisco.ORCID 0000-0002-6047-211X
VIPS II Investigators

Funding

The Vascular effects of Infection in Pediatric Stroke (VIPS II) StudyR01NS104094 · NINDS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI FULLERTON, HEATHER J · 2017 to 2022
$3.5M
The Vascular effects of Infection in Pediatric Stroke (VIPS II) StudyR56NS062820 · NINDS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI FULLERTON, HEATHER J · 2016 to 2016
$510k
NINDS NIH HHS R01 NS104094NINDS NIH HHS R56 NS062820
6 · The paper itself

Abstract

backgroundThe VIPS (Vascular Effects of Infection in Pediatric Stroke) II prospective cohort study aimed to better understand published findings that common acute infections, particularly respiratory viruses, can trigger childhood arterial ischemic stroke (AIS). The COVID-19 pandemic developed midway through enrollment, creating an opportunity to assess its impact.

methodsTwenty-two sites (North America, Australia) prospectively enrolled 205 children (aged 28 days to 18 years) with AIS from December 2016 to January 2022, including 100 cases during the COVID-19 pandemic epoch, defined here as January 2020 to January 2022. To assess background rates of subclinical infection, we enrolled 100 stroke-free well children, including 39 during the pandemic. We measured serum SARS-CoV-2 nucleocapsid total antibodies (present after infection, not vaccination; half-life of 3-6 months). We assessed clinical infection via parental interview.

resultsThe monthly rate of eligible AIS cases declined from spring through fall 2020, recovering in early 2021 and peaking in the spring. The prepandemic and pandemic cases were similar except pandemic cases had fewer clinical infections in the prior month (17% versus 30%;

conclusionsThe COVID-19 pandemic may have had dual effects on childhood AIS: an indirect protective effect related to public health measures reducing infectious exposure in general, and a deleterious effect as COVID-19 emerged as another respiratory virus that can trigger childhood AIS.

Indexed as

COVID-19Ischemic StrokeAdolescentAntibodies, ViralAustraliaCase-Control StudiesChildChild, PreschoolFemaleHumansInfantInfant, NewbornMalePandemicsProspective StudiesSARS-CoV-2Antibodies, ViralchildCOVID-19ischemic strokepandemicsrespiratory tract infections

Identifiers

PMID40171657
PMCPMC12094252

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.