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Alqanatish J, Almojali A, Alfadhel A, Albelali A, Ahmed A, Alqahtani A, Alrasheed A, Alsewairi W, Alghnam S. COVID-19 and Pediatric Rheumatology: A Comprehensive Study from a Leading Tertiary Center in Saudi Arabia. J Epidemiol Glob Health 2023; 13:676-684. [PMID: 37594620 PMCID: PMC10686932 DOI: 10.1007/s44197-023-00142-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 07/24/2023] [Indexed: 08/19/2023] Open
Abstract
The Coronavirus disease 2019 (COVID-19) pandemic has emerged as a significant global health concern, impacting millions of individuals worldwide. However, there remains a notable gap in the literature regarding pediatric studies, specifically focusing on children with rheumatic diseases and the potential risk factors associated with COVID-19 contraction in this specific patient population. Patients with rheumatic diseases are often undergoing immunemodulator/immunosuppressant therapies, which can further complicate their immune system response to infections. This is a retrospective cohort study conducted at King Abdullah Specialized Children's Hospital (KASCH), the largest tertiary care children's hospital in Saudi Arabia. The aim was to investigate the rate, clinical manifestations, risk factors, and outcomes of COVID-19 infection in pediatric patients with rheumatic diseases. All rheumatology patients (< 19 years) who presented to the hospital as outpatients, inpatients, and/or ER visits during the period of March 2020 to March 2022 were reviewed for confirmed diagnosis of COVID-19. Among 482 patients included in this study, 126 (26.1%, 95% CI 21.8-31.1) had COVID-19 infection, and no factors were identified to increase the risk of contracting the virus. Fever (55.6%, n = 70) followed by respiratory symptoms (55.6%, n = 70) were the most common clinical manifestations, and around 30% of the patients were asymptomatic. Though most of the patients recovered without complications (97.6%, n = 123), mortality was reported in 3 patients (2.38%). The risk of hospitalization was almost 6 times higher in males (OR = 5.97), and higher in patients receiving t-DMARDs (OR = 17.53) or glucocorticoids (OR = 6.69). The study also revealed that vaccinated children were at lower risk of hospitalization due to COVID-19 than non-vaccinated children. The findings of this study help to identify the risk factors for COVID-19 among children with rheumatic diseases and provide insight into the impact of the pandemic on this group. Overall, while most cases were mild and resolved on their own, unvaccinated patients and those receiving t-DMARDs or glucocorticoids needs vigilant monitoring during the COVID-19 infection. Furthermore, we strongly advocate for the widespread promotion of COVID-19 vaccination among pediatric rheumatology patients as it significantly reduces their risk of COVID-19-related hospitalization.
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Affiliation(s)
- Jubran Alqanatish
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, 14611, Riyadh, Saudi Arabia.
- King Abdullah International Medical Research Center (KAIMRC), 14611, Riyadh, Saudi Arabia.
- King Abdullah Specialized Children's Hospital, King Abdulaziz Medical City (National Guard Health Affairs), 14611, Riyadh, Saudi Arabia.
| | - Abdullah Almojali
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, 14611, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center (KAIMRC), 14611, Riyadh, Saudi Arabia
- King Abdullah Specialized Children's Hospital, King Abdulaziz Medical City (National Guard Health Affairs), 14611, Riyadh, Saudi Arabia
| | - Abdulmajeed Alfadhel
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, 14611, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center (KAIMRC), 14611, Riyadh, Saudi Arabia
- King Abdullah Specialized Children's Hospital, King Abdulaziz Medical City (National Guard Health Affairs), 14611, Riyadh, Saudi Arabia
| | - Areej Albelali
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, 14611, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center (KAIMRC), 14611, Riyadh, Saudi Arabia
- King Abdullah Specialized Children's Hospital, King Abdulaziz Medical City (National Guard Health Affairs), 14611, Riyadh, Saudi Arabia
| | - Amal Ahmed
- King Abdullah Specialized Children's Hospital, King Abdulaziz Medical City (National Guard Health Affairs), 14611, Riyadh, Saudi Arabia
| | - Abdullah Alqahtani
- King Abdullah International Medical Research Center (KAIMRC), 14611, Riyadh, Saudi Arabia
| | - Abdulrhman Alrasheed
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, 14611, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center (KAIMRC), 14611, Riyadh, Saudi Arabia
- King Abdullah Specialized Children's Hospital, King Abdulaziz Medical City (National Guard Health Affairs), 14611, Riyadh, Saudi Arabia
| | - Wafaa Alsewairi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, 14611, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center (KAIMRC), 14611, Riyadh, Saudi Arabia
- King Abdullah Specialized Children's Hospital, King Abdulaziz Medical City (National Guard Health Affairs), 14611, Riyadh, Saudi Arabia
| | - Suliman Alghnam
- King Abdullah International Medical Research Center (KAIMRC), 14611, Riyadh, Saudi Arabia
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Mohammedsaeed W, Alsehli F, Alfarsi L, Bakhsh A, Alzahrani M, Almarwani M, Alharbi Y. COVID-19 in Pediatric Patients: A Study Based on Biomarker Levels. Cureus 2023; 15:e39408. [PMID: 37378147 PMCID: PMC10291959 DOI: 10.7759/cureus.39408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected people of all ages, but limited data are available on children with mild and severe coronavirus disease 2019 (COVID-19). METHODS Clinical characteristics, inflammation, and other biochemical biomarkers have been described, but information is scarce in asymptomatic and mild cases. Laboratory investigations were performed with pediatric patients (n=70) for liver function and kidney function, along with C-reactive protein (CRP). RESULTS Mild clinical characteristics and symptoms were observed in pediatric patients. Even in moderate cases of COVID-19, elevated levels of biomarkers indicate altered liver and kidney function in children. The levels of liver enzymes, bilirubin, creatinine, and CRP varied significantly between the three classes, particularly between asymptomatic and moderate cases. Liver enzymes, bilirubin, and creatinine levels in moderate COVID-19 pediatric cases were twice as elevated as in asymptomatic cases. Liver enzymes and CRP levels were moderately elevated. CONCLUSION Monitoring blood biomarkers consistently can assist in the accurate identification of infection in young patients as well as in the prevention of its spread and the administration of appropriate treatment.
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Affiliation(s)
- Walaa Mohammedsaeed
- Diabetes and Endocrinology, Clinical Biochemistry, Taibah University, Madinah, SAU
| | | | | | - Ameen Bakhsh
- Laboratory, Maternity and Children Hospital, Madinah, SAU
| | - Mansour Alzahrani
- Laboratory, Poison control and Forensic Chemistry Center, Madinah, SAU
| | | | - Yousef Alharbi
- Laboratory, Maternity and Children Hospital, Madinah, SAU
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Ali EAH, Alanazi MIH, Alanazi IAR, Alanazi BAM, Alanazi KA. Prevalence and Outcome of Management of Respiratory Distress Syndrome: A Systematic Review. ARCHIVES OF PHARMACY PRACTICE 2023. [DOI: 10.51847/sf0lhijq5j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
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Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) is usually mild and self-limited in children. However, a few Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infections in children may progress to severe disease with respiratory distress or can result in a multisystem inflammatory syndrome (MIS-C) associated with COVID-19. The immune mechanisms for these differential clinical outcomes are largely unknown. METHODS A prospective cohort study was performed to analyze the laboratory parameters, antibody response, immune phenotypes and cytokine profiles of 51 children with different clinical presentations of COVID-19. RESULTS We found that the absolute lymphocyte counts gradually decreased with disease severity. Furthermore, SARS-CoV-2 IgG levels in the acute phase and convalescence were not significantly different in patients with different disease severity. A decrease in CD3 + , CD4 + and CD8 + T cells was observed as disease severity increased. Both CD4 + and CD8 + T cells were activated in children with COVID-19, but no difference in the percentage of HLADR + -expressing cells was detected across the severity groups. In contrast, MIS-C patients exhibited augmented exhausted effector memory CD8 + T cells. Interestingly, the cytokine profile in sera of moderate/severe and MIS-C patients revealed an increase in anti-inflammatory IL-1RA and a suppression of tumor necrosis factor-α, RANTES, eotaxin and PDGF-BB. MIS-C patients also exhibited augmented IL-1β. CONCLUSIONS We report distinct immune profiles dependent on severity in pediatric COVID-19 patients. Further investigation in a larger population will help unravel the immune mechanisms underlying pediatric COVID-19.
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Al-Eyadhy A, Almazyad M, Hasan G, Almuhaideb Q, AbuDujain N, Alhaboob AAN, Alfawaz F, Alshenaifi S, Alfayez F, Aljebrin Y, Alsohime F, Alabdulhafid M, Temsah MH. The burden of viral infections in pediatric intensive care unit between endemic and pandemic coronavirus infections: A tertiary care center experience. J Infect Chemother 2022; 29:20-25. [PMID: 36103948 PMCID: PMC9464359 DOI: 10.1016/j.jiac.2022.09.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 09/04/2022] [Accepted: 09/05/2022] [Indexed: 11/30/2022]
Abstract
Objectives To measure the prevalence of viral infections, length of stay (LOS), and outcome in children admitted to the pediatric intensive care unit (PICU) during the period preceding the COVID-19 pandemic in a MERS-CoV endemic country. Methods A retrospective chart review of children 0–14 years old admitted to PICU with a viral infection. Results Of 1736 patients, 164 patients (9.45%) had a positive viral infection. The annual prevalence trended downward over a three-year period, from 11.7% to 7.3%. The median PICU LOS was 11.6 days. Viral infections were responsible for 1904.4 (21.94%) PICU patient-days. Mechanical ventilation was used in 91.5% of patients, including noninvasive and invasive modes. Comorbidities were significantly associated with intubation (P-value = 0.025). Patients infected with multiple viruses had median pediatric index of mortality 2 (PIM 2) scores of 4, as compared to 1 for patients with single virus infections (p < 0.001), and a median PICU LOS of 12 days, compared to 4 in the single-virus group (p < 0.001). Overall, mortality associated with viral infections in PICU was 7 (4.3%). Patients with viral infections having multiple organ failure were significantly more likely to die in the PICU (p = 0.001). Conclusion Viral infections are responsible for one-fifth of PICU patient-days, with a high demand for mechanical ventilation. Patients with multiple viral infections had longer LOS, and higher PIM 2 scores. The downward trend in the yearly rate of PICU admissions for viral infections between the end of the MERS-CoV outbreak and the start of the COVID-19 pandemic may suggest viral interference that warrants further investigations.
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Affiliation(s)
- Ayman Al-Eyadhy
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Pediatric Intensive Care Unit, Department of Pediatrics, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.
| | - Mohammed Almazyad
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Pediatric Intensive Care Unit, Department of Pediatrics, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Gamal Hasan
- Pediatric Intensive Care Unit, Department of Pediatrics, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia; Assiut Faculty of Medicine, Assiut University, Egypt; Pediatric Critical Care Unit, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | | | | | - Ali A N Alhaboob
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Pediatric Intensive Care Unit, Department of Pediatrics, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | | | | | - Fahad Alfayez
- College of Medicine, King Saud University, Saudi Arabia
| | | | - Fahad Alsohime
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Pediatric Intensive Care Unit, Department of Pediatrics, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Majed Alabdulhafid
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Pediatric Intensive Care Unit, Department of Pediatrics, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Mohamad-Hani Temsah
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Pediatric Intensive Care Unit, Department of Pediatrics, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
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Dandachi I, Aljabr W. Prognosis of COVID-19 in the middle eastern population, knowns and unknowns. Front Microbiol 2022; 13:974205. [PMID: 36118201 PMCID: PMC9471247 DOI: 10.3389/fmicb.2022.974205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 08/09/2022] [Indexed: 01/08/2023] Open
Abstract
Since its emergence in China in 2019, the SARS-CoV-2 virus has affected all countries worldwide. The virus is easily transmitted from one person to another via infected aerosols or contaminated surfaces. Unlike its counterparts, the prognosis of COVID-19 ranges from asymptomatic to critical disease or death. Several factors play a role in determining the severity of the disease in infected patients. Among others, is the pre-existence of an underlying medical condition such as diabetes, cancer, and others. Furthermore, although children are less prone to the severe form of the COVID-19 disease, they require attention due to the report of many atypical presentations of the infection, post-asymptomatic exposure. In the Middle East, little is known about the prognosis of the SARS-CoV-2 infection in high-risk categories, notably patients with diabetes, cancer, and pregnant women. The aim of this review is to summarize the current knowledge about this group of population in the middle eastern region as well as to highlight the gap in the literature. We have found that the majority of the papers were from the Gulf countries. Although, few studies were conducted; high-risk patients appear to have an increased risk of morbidity and mortality from COVID-19 compared to their counterparts. Higher levels of inflammatory markers, C-reactive protein, erythrocyte sedimentation rate, D-dimer, and ferritin levels were also observed. Children are often asymptomatic or present with atypical presentations. More studies should be conducted to determine the clinical biomarkers of COVID-19 in high-risk categories to help in patient risk stratification and management in the middle eastern population.
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Alghamdi AKH, Al Ghamdi KS, Kim SY. Epidemiology in Middle School Science Curricula: a COVID-19 Pre-post Intervention. JOURNAL OF SCIENCE EDUCATION AND TECHNOLOGY 2022; 31:583-593. [PMID: 35730014 PMCID: PMC9188273 DOI: 10.1007/s10956-022-09975-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/23/2022] [Indexed: 06/15/2023]
Abstract
It is of great importance that science educators teach COVID-19 and related pandemics to boost students' scientific literacy. A mixed methods research design (pre-post test instrument [N = 86] and semi-structured interviews [N = 11]-August 2020 to June 2021) evaluated the ability of an intervention (12 h, three-session, 3-day, online workshop) to augment middle school inservice science teachers' (Eastern Saudi Arabian province) ability to teach about medical terminology and the epidemiology of diseases. Teachers' cognitive gains were measured through evaluating their knowledge, comprehension, and application of workshop content before and after the intervention. Descriptive statistics and inferential t tests revealed statistically significant cognitive differences overall (p < .01) (posttest mean = 26.26/30, SD 2.83, t value 18.51) and along knowledge (posttest mean = 5.72/7), comprehension (mean = 7.50/8), and application (mean = 13.05/15). A high effect size coefficient n2 indicated a large effect on cognitive gains. Thematic analysis about participants' subsequent efforts teaching workshop content to students revealed positive and negative experiences. The former included improved student engagement with the curriculum, community connections via project-based learning, and opportunities to teach colleagues about COVID-19. The latter concerned insufficient time, an obligation to teach the current curriculum without adding COVID-19 content, and administrative resistance. Recommendations pertain to augmenting the workshop curriculum and likeminded research initiatives.
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Affiliation(s)
- Amani Khalaf H. Alghamdi
- College of Education, Curriculum and Pedagogy, Imam Abdulrahman Bin Faisal University, PO Box 1982, Dammam, 31441 Kingdom of Saudi Arabia
| | - Kholoud S. Al Ghamdi
- College of Medicine, Higher Studies & Scientific Research, Imam Abdulrahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia
| | - Sun Young Kim
- Department of Biology Education, College of Education, Chosun University, 61452 Gwangju, South Korea
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In-Person Schooling Amidst Children’s COVID-19 Vaccination: Exploring Parental Perceptions Just after Omicron Variant Announcement. Vaccines (Basel) 2022; 10:vaccines10050768. [PMID: 35632524 PMCID: PMC9147905 DOI: 10.3390/vaccines10050768] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/09/2022] [Accepted: 05/10/2022] [Indexed: 12/16/2022] Open
Abstract
Background: The SARS-CoV-2 Omicron spread fast globally and became the predominant variant in many countries. Resumption of public regular life activities, including in-person schooling, presented parents with new sources of worry. Thus, it is important to study parental worry about the Omicron variant, willingness to vaccinate their children, and knowledge about school-based COVID-19 precautionary measures. Methods: A national, cross-sectional, pilot-validated online questionnaire targeting parents in the Kingdom of Saudi Arabia (KSA) was distributed between 31 December 2021, and 7 January 2022. The survey included sociodemographic, COVID-19 infection data, parental and children vaccination status, attitudes towards booster vaccine, parents’ Omicron-related perceptions and worries, and attitude towards in-person schooling. Results: A total of 1340 participants completed the survey, most (65.3%) of whom were mothers. Of the parents, 96.3% either received two or three doses of the COVID-19 vaccine. Only 32.1% of the parents were willing to vaccinate their young children (5–11 years of age). In relation to their children 12–18 years of age, 48% had already had them vaccinated, 31% were planning to vaccinate them, and 42.8% were willing to administer a booster dose. Only 16% were more worried about the Omicron variant compared to the Delta variant. Residents of western KSA were more worried about Omicron compared to Delta. Parents worried about the Omicron variant and male participants were significantly less aware of school-based COVID-19 precautionary measures. Parents with post-graduate degrees and those having more children were significantly more inclined to send their children to school even if COVID-19 outbreaks could occur in schools, while parents who were more worried about the Omicron variant and were more committed to infection prevention measures were significantly less inclined to do so. Conclusions: Overall, parents had lower worry levels about the Omicron variant compared to the Delta variant. They had a higher willingness to vaccinate their older children compared to the younger ones. In addition, our cohort of parents showed high willingness to send their children to schools and trusted the school-based preventative measures. These findings can inform policy makers when considering school related decisions during the current or future public health crises.
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Duabie B, Alfattani A, Althawadi S, Taha A, Javaid HA, Mobarak O, Albanyan E. Epidemiological characteristics, clinical course, and laboratory investigation of pediatric COVID-19 patients in a Tertiary Care Center in Saudi Arabia. Int J Pediatr Adolesc Med 2022; 9:153-159. [PMID: 35664238 PMCID: PMC9148723 DOI: 10.1016/j.ijpam.2022.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 03/21/2022] [Accepted: 05/10/2022] [Indexed: 11/08/2022]
Abstract
Background Since the initial emergence of the novel SARS-CoV-2 coronavirus responsible for the 2019 coronavirus disease (COVID-19) pandemic, many studies have been exploring the nature and characteristics of this virus and its associated clinical manifestations. The present study aimed to describe the clinical presentation and outcomes of COVID-19 infections in pediatric patients. Methods A retrospective review of findings associated with 143 pediatric patients (age <14 years) with a confirmed COVID-19 diagnosis who had undergone inpatient or outpatient treatment at King Faisal Specialist Hospital and Research Center in Riyadh, Saudi Arabia, between March 2020 and October 2020, was conducted. The analyzed data included patient demographic information, pre-existing medical conditions, symptoms, interventions, and outcomes. Results The median age of this patient population was 7 years. Of these 143 patients, 67 (46.8%) had known pre-existing medical conditions including bronchial asthma (12.8%), chronic lung disease (CLD) (3%), congenital heart disease (CHD) (17%), primary immunodeficiencies (1.5%), malignancies (9.8%), and 7.5% were post-transplant patients. Thirty-seven patients (26%) were overweight or obese. Sixty-three of these patients (51%) were symptomatic, with the most common symptom being fever (55%). Ultimately, 45 patients (31%) required admission to the hospital, with a median duration of hospitalization of 9.6 days for admitted patients. There were no documented cases of infection-related mortality among this pediatric cohort, although 11 patients experienced post-infectious complications that primarily manifested as a loss of taste and smell. Conclusion These findings suggest that pediatric COVID-19 patients tend to experience mild forms of the disease, without any significant differences in disease severity as a function of patient gender or immune status.
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Albuali WH, AlGhamdi AA, Aldossary SJ, AlHarbi SA, Al Majed SI, Alenizi A, Al-Qahtani MH, Lardhi AA, Al-Turki SA, AlSanea AS, Bubshait DK, Kobeisy SA, Herzallah NH, Alqarni WA, AlHarbi AH, Albuali HW, Aldossary BJ, AlQurashi FO, Yousef AA. Clinical profile, risk factors and outcomes of ric COVID-19: a retrospective cohort multicentre study in Saudi Arabia. BMJ Open 2022; 12:e053722. [PMID: 35277403 PMCID: PMC8919130 DOI: 10.1136/bmjopen-2021-053722] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To describe the risk factors, clinical profile and outcomes of COVID-19 in the paediatric population. DESIGN Multicentre, retrospective observational study. SETTING Four tertiary hospitals in Saudi Arabia. PATIENTS We recruited 390 paediatric patients aged 0-18 years who presented from March to December 2020 and tested positive for COVID-19 on PCR. MAIN OUTCOME MEASURES We retrospectively analysed medical records for sociodemographics, health indicators, clinical presentations, laboratory findings, clinical complications, and outcomes. RESULTS The mean participant age was 5.66±4.90 years, and the mean hospital stay was 2.17±3.48 days. Forty patients, mostly school-aged children (16, 40.00%; p=0.005) and children with comorbidities (25, 62.50%; p<0.001), received more than just supportive care. Complications were seen in 15 (3.9%) patients, bacterial infection being the most common (6, 40.00%). Patients presented with dyspnoea (OR 6.89; 95% CI 2.89 to 20.72), abnormal chest radiographs (OR 6.11; 95% CI 1.26 to 29.38), lethargy (OR 9.04; 95% CI 2.91 to 28.06) and elevated ferritin (OR 14.21; 95% CI 4.18 to 48.37) and D-dimer (OR 48.40; 95% CI 14.32 to 163.62), with higher odds of developing complications. The odds of paediatric intensive care unit (ICU) admission were higher for patients with dyspnoea (adjusted OR 4.66; 95% CI 1.24 to 17.50) and elevated white blood cell count (adjusted OR 3.54; 95% CI 1.02 to 12.30). CONCLUSIONS COVID-19 complications were limited among our patients. However, dyspnoea, abnormal chest radiographs, lethargy and elevated ferritin and D-dimer were associated with an increased risk of complications. Dyspnoea, leucocytosis, comorbidities and abnormal chest radiographs at presentation increased the risk of ICU admission.
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Affiliation(s)
- Waleed H Albuali
- Department of Pediatrics, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, AlKhobar, Saudi Arabia
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Amal A AlGhamdi
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Shaikha J Aldossary
- Department of Pediatrics, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, AlKhobar, Saudi Arabia
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Saleh A AlHarbi
- Department of Pediatrics, Umm Al-Qura University, Makkah, Saudi Arabia
- Department of Pediatrics, Dr Soliman Fakeeh Hospital, Jeddah, Saudi Arabia
| | - Sami I Al Majed
- Department of Pediatrics, John Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
| | - Ahmed Alenizi
- Pediatric Pulmonology and Sleep Medicine Department, King Saud Medical City, Riyadh, Saudi Arabia
| | - Mohammad H Al-Qahtani
- Department of Pediatrics, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, AlKhobar, Saudi Arabia
- Department of Pediatrics, Imam Abdulrahman Bin Faisal University College of Medicine, Dammam, Saudi Arabia
| | - Amer A Lardhi
- Department of Pediatrics, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, AlKhobar, Saudi Arabia
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Shams A Al-Turki
- Department of Pediatrics, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, AlKhobar, Saudi Arabia
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Abdulaziz S AlSanea
- Department of Pediatrics, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, AlKhobar, Saudi Arabia
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Dalal K Bubshait
- Department of Pediatrics, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, AlKhobar, Saudi Arabia
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Sumayyah A Kobeisy
- Department of Pediatrics, Dr Soliman Fakeeh Hospital, Jeddah, Saudi Arabia
| | - Noor H Herzallah
- Department of Pediatrics, John Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
| | - Wejdan A Alqarni
- Department of Pediatrics, John Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
| | - Abeer H AlHarbi
- Pediatric Pulmonology and Sleep Medicine Department, King Saud Medical City, Riyadh, Saudi Arabia
| | - Hamad W Albuali
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Bader J Aldossary
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Faisal O AlQurashi
- Department of Pediatrics, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, AlKhobar, Saudi Arabia
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Abdullah A Yousef
- Department of Pediatrics, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, AlKhobar, Saudi Arabia
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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AlGhamdi A, Al Talhi Y, Al Najjar A, Sobhi A, Al Juaid A, Ibrahim A, Alshengeti A, Al-Hebshi A, Farahat F, Al Qurainees G, Al Saif M, Hamdan N, Al Jehani S, Al Mansouri W, AlDabbagh M. Epidemiology, clinical characteristics and risk factors of COVID-19 among children in Saudi Arabia: a multicenter chart review study. BMC Pediatr 2022; 22:86. [PMID: 35151286 PMCID: PMC8840071 DOI: 10.1186/s12887-021-02959-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 10/07/2021] [Indexed: 12/15/2022] Open
Abstract
Background The Coronavirus Disease 2019 (COVID-19) has affected over 100 million cases worldwide. Children accounted for 1–5% of all cases with less reported symptoms and better prognosis compared to adults. This study aimed to describe the epidemiological characteristics and outcomes of pediatric COVID-19 cases in Saudi Arabia in addition to identifying risk factors associated with disease severity. Methods This was a multicenter, cross-sectional retrospective study that included confirmed SARS-CoV-2 infection among pediatric patients (< 14 years) from the time of initial identification in March 2020 to the end of July 2020 in 6 centers across the country. Patients were classified based on clinical severity. Study outcomes included time to recovery, need for invasive ventilation, and mortality. Multivariate logistic regression analysis was conducted to explore factors associated with increased disease severity. Results The study enrolled 567 children with (51.5%) were males, and (44.6%) aged from 6 to 14 years old. Asymptomatic patients accounted for 38.98% of the cases: while 319 patients (56%) had mild disease, and 27 patients (4.76%) had moderate-to-severe disease. Only 10 patients (1.76%) required Pediatric Intensive Care Unit admission. The calculated case-fatality was 0.7%. After performing multivariate regression analysis, chronic lung conditions [adjusted OR = 12.73, 95% CI (2.05–79.12)] and decreased red blood cells (RBCs) count [adjusted OR = 2.43, 95% CI (1.09–5.41] were found to be significant predictors for moderate-to-severe disease (p = 0.006 and 0.030, respectively). Conclusion Most COVID-19 cases in the current study had a benign course of illness and carried an excellent prognosis. Children with chronic lung conditions or low RBCs count are at higher risk to develop moderate-to-severe COVID-19 disease. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-021-02959-8.
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Efendi D, Hasan F, Natalia R, Utami AR, Sonko I, Asmarini TA, Yuningsih R, Wanda D, Sari D. Nursing care recommendation for pediatric COVID-19 patients in the hospital setting: A brief scoping review. PLoS One 2022; 17:e0263267. [PMID: 35113925 PMCID: PMC8812980 DOI: 10.1371/journal.pone.0263267] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 01/14/2022] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The hospitalization of children during the COVID-19 pandemic has affected their physical and mental health. Pediatric nurses have faced challenges in providing high-quality nursing care for children and their families. However, the pediatric nursing care recommendations for COVID-19 patients in the hospital setting remain unclear. The current scoping review provides recommendations for nursing interventions for pediatric COVID-19 patients in the hospital setting. METHODS AND FINDINGS The selected articles containing management and nursing recommendations for COVID-19 that have occurred in pediatric patients ages 0-19 years old. A search strategy was developed and implemented in seven databases. We included peer-reviewed articles that reported observational or interventional studies, as well as policy papers, guides or guidelines, letters and editorials, and web articles. A total of 134 articles and other documents relevant to this review were included. We categorized the results based on The Nursing Intervention Classification (NIC) taxonomy which consists of six domains (e.g., Physiological: Basic); eleven classes (e.g., Nutrition Support); and eighteen intervention themes (e.g., Positioning, Family Presence Facilitation, Family Support, and Discharge Planning). CONCLUSION Apart from the intervention of physical problems, there is a need to promote patient- and family-centered care, play therapy, and discharge planning to help children and families cope with their new situation.
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Affiliation(s)
- Defi Efendi
- Department of Pediatric Nursing, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
- Neonatal Intensive Care Unit, Universitas Indonesia Hospital, Depok, Indonesia
| | - Faizul Hasan
- School of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Regina Natalia
- School of Nursing, Mitra Bunda Health Institute, Batam, Indonesia
| | - Ayuni Rizka Utami
- Department of Pediatric Nursing, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
| | - Ismaila Sonko
- School of Nursing, Taipei Medical University, Taipei, Taiwan
- Ministry of Health and Social Welfare, The Quadrangle, Banjul, The Gambia, West Africa
| | - Titik Ambar Asmarini
- Department of Pediatric Nursing, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
- Neonatal and Pediatric Intensive Care Unit, Gatot Soebroto Indonesian Central of Army Hospital, Jakarta, Indonesia
| | - Risna Yuningsih
- Neonatal Intensive Care Unit, Dr. Dradjat Prawiranegara General Hospital, Banten, Indonesia
| | - Dessie Wanda
- Department of Pediatric Nursing, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
| | - Dian Sari
- School of Nursing, Prima Nusantara Health Institute, Bukittinggi, Indonesia
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13
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AlMayouf A, AlShahrani D, AlGhain S, AlFaraj S, Bashawri Y, AlFawaz T, AlDosari E, Al-Awdah L, AlShehri M, AlGoraini Y. Clinical Characteristics, Laboratory Findings, Management, and Outcome of Severe Coronavirus Disease 2019 in Children at a Tertiary Care Center in Riyadh, Saudi Arabia: A Retrospective Study. Front Pediatr 2022; 10:865441. [PMID: 35592844 PMCID: PMC9110698 DOI: 10.3389/fped.2022.865441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 03/31/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Numerous studies worldwide have reported COVID-19 in children; however, the clinical symptoms and consequences of COVID-19 in children have only been reported in a few studies in Saudi and gulf region. Therefore, we aimed to investigate the clinical features and outcomes of COVID-19 infection in children and the therapeutic interventions used. METHODS This retrospective cohort study included 96 patients with confirmed severe acute respiratory syndrome coronavirus 2 infection aged ≤14 years who were admitted to a tertiary governmental care hospital in Riyadh, Saudi Arabia between March 2020 and November 2020. Data on children with COVID-19, including demographics, comorbidities, symptoms, imaging and laboratory results, therapies, and clinical outcomes, were analyzed. RESULTS Of 96 children admitted with a confirmed diagnosis of COVID-19, 63.8% were aged ≤ 3 years, 52.1% were male, 56.2% had an unknown source of infection, and 51% had no comorbidities. Most cases had severe infection (71.88%) as they required oxygen, 10.42% of whom were critical. The most common symptoms were respiratory-related (98%), and the common physical sign was fever (49%). High D-dimer (90.7%) and C-reactive protein (72.09%) levels were found in most cases. Oxygen (71.88%) was the most commonly used treatment. Most patients were discharged home and fully recovered (97.92%). We reported two deaths (2.08%). CONCLUSIONS Our findings showed that the majority of the admitted children with COVID-19 were ≤3 years of age (52.1%) and infected with an unknown source (56.2%). Moreover, the majority of the cases had severe COVID-19 infection as they required oxygen (71.88%), although they had favorable outcomes. However, some cases were critical and resulted in death. Future studies will be crucial to better understand the disease spectrum and potential therapeutic options for COVID-19 in children.
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Affiliation(s)
| | | | - Salwan AlGhain
- King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
| | - Sarah AlFaraj
- Prince Mohammed Bin Abdulaziz Hospital, Riyadh, Saudi Arabia
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Dondi A, Sperti G, Gori D, Guaraldi F, Montalti M, Parini L, Piraccini BM, Lanari M, Neri I. Epidemiology and clinical evolution of non-multisystem inflammatory syndrome (MIS-C) dermatological lesions in pediatric patients affected by SARS-CoV-2 infection: A systematic review of the literature. Eur J Pediatr 2022; 181:3577-3593. [PMID: 35948654 PMCID: PMC9365226 DOI: 10.1007/s00431-022-04585-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/19/2022] [Accepted: 08/03/2022] [Indexed: 02/07/2023]
Abstract
UNLABELLED COVID-19 can present with a range of skin manifestations, some of which specific of the pediatric age. The aim of this systematic literature review was to determine the type, prevalence, time of onset, and evolution of cutaneous manifestations associated with COVID-19 in newborns, children, and adolescents, after excluding multisystem inflammatory syndrome in children (MIS-C). PubMed, Tripdatabase, ClinicalTrials, and Cochrane Library databases were searched using an ad hoc string for case reports/series and observational studies, published between December 2019 and February 2022. Study quality was assessed using the STROBE and CARE tools. Seventy-three (49 case reports/series and 24 studies) out of 26,545 identified articles were included in the analysis. Dermatological lesions were highly heterogeneous for clinical presentation, time of onset, and association with other COVID-19 manifestations. Overall, they mainly affected the acral portions, and typically presented a favorable outcome. Pseudo-chilblains were the most common. CONCLUSIONS Mucocutaneous manifestations could be the only/predominant and early manifestation of COVID-19 that could precede other more severe manifestations by days or weeks. Therefore, physicians of all disciplines should be familiar with them. WHAT IS KNOWN • A variety of cutaneous manifestations have been reported in association with COVID-19. • Urticaria, maculopapular, or vesicular rashes can occur at any age, while chilblains and erythema multiforme are more common in children and young patients. WHAT IS NEW • Skin lesions related to SARS-CoV-2 infection often show a peculiar acral distribution. • Mucocutaneous lesions of various type may be the only/predominant manifestation of COVID-19; they could present in paucisymptomatic and severely ill patients and occur at different stages of the disease.
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Affiliation(s)
- Arianna Dondi
- Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | - Giacomo Sperti
- School of Pediatrics, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Davide Gori
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Federica Guaraldi
- IRCCS Istituto Delle Scienze Neurologiche Di Bologna, 40139, Bologna, Italy.
| | - Marco Montalti
- School of Hygiene and Preventive Medicine, Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, Public Health and Medical Statistics, University of Bologna, Bologna, Italy
| | - Lorenza Parini
- School of Pediatrics, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Bianca Maria Piraccini
- School of Hygiene and Preventive Medicine, Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, Public Health and Medical Statistics, University of Bologna, Bologna, Italy
| | - Marcello Lanari
- Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | - Iria Neri
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
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15
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Almugti HS, Alotaibi A, Almohammed A, Abuhadi R, Baeshen R, Alharthi Z, Alsharari A, Alotaibi S, Omar Y, Alturki N, Oberi I, Alrehaili A, Alzahrani A, Alghanim F, Ayoub R. Impact of COVID-19 on Saudi Children: Special Focus on Behavioral, Social, and Emotional Aspects, 2020-2021. Cureus 2021; 13:e19856. [PMID: 34963861 PMCID: PMC8704323 DOI: 10.7759/cureus.19856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2021] [Indexed: 11/05/2022] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic has negatively affected many aspects of daily life. In Saudi Arabia, many studies, using a range of assessment approaches, have examined how the pandemic has affected the mental health of both the general public and healthcare workers. However, to develop effective public-health initiatives for such crisis events, it would also be relevant to determine the pandemic's impact on the behavioral, emotional, and social lives of Saudi children. Objective To assess, among Saudi children aged 3-15 years, the behavioral, emotional, and social changes that have occurred in their daily lives due to the COVID-19 pandemic. Materials and methods This study featured a cross-sectional design. Potential participants were approached through the most popular social media in Saudi Arabia, and the final sample size was 651 parents. As, at the time of data collection, the members of the Saudi public were requested to avoid face-to-face meetings where possible, a well-designed electronic questionnaire featuring closed-ended questions was used. Results Descriptive statistics showed that the mean age of the parents was 29±7 years (range: 20-60 years); over half (58%) were female. During the COVID-19 outbreak, one-third of children had asked to sleep in their parents' beds. Furthermore, approximately 30% of children demonstrated increased irritability and mood swings when compared with the period before the pandemic. Concerning adaptive social behaviors, during the pandemic, 22% of children appeared calmer and 14% of children seemed more thoughtful. Our study reports more screen time, less physical activity, and reduced sleep time among children compared with the pre-pandemic period. Conclusion The COVID-19 pandemic has psychologically affected children. The present results highlight the need to reduce this psychological burden by enhancing children's emotional resilience and involving parents in health-promotion programs aimed at mitigating the negative impacts of such public-health crises.
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Affiliation(s)
- Hani S Almugti
- Epidemiology and Public Health, Ministry of National Guard Health Affairs, King Abdullah International Medical Research Center, King Saud bin Abdul-Aziz University for Health Sciences, Jeddah, SAU
| | | | - Ali Almohammed
- College of Medicine, Jordan University of Science and Technology, Irbid, JOR
| | - Rana Abuhadi
- College of Medicine, Jazan University, Jazan, SAU
| | | | | | | | | | - Yazan Omar
- College of Medicine, Jazan University, Jazan, SAU
| | - Norah Alturki
- College of Medicine, King Saud University, Riyadh, SAU
| | | | | | | | - Fatimah Alghanim
- College of Medicine, Imam Abdulrahman Bin Faisal University, Khobar, SAU
| | - Raum Ayoub
- College of Medicine, Jazan University, Jazan, SAU
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16
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Alshengeti A, Alahmadi H, Barnawi A, Alfuraydi N, Alawfi A, Al-Ahmadi A, Sheikh M, Almaghthawi A, Alnakhli Z, Rasheed R, Ibrahim A, Sobhi A, Al Shahrani D, Kordy F. Epidemiology, clinical features, and outcomes of coronavirus disease among children in Al-Madinah, Saudi Arabia: A retrospective study. INTERNATIONAL JOURNAL OF PEDIATRICS AND ADOLESCENT MEDICINE 2021; 9:136-142. [PMID: 35663790 PMCID: PMC9152574 DOI: 10.1016/j.ijpam.2021.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/12/2021] [Accepted: 11/02/2021] [Indexed: 12/24/2022] Open
Abstract
Background and Objective Coronavirus disease (COVID-19) is milder with favorable outcomes in children than in adults. However, detailed data regarding COVID-19 in children from Saudi Arabia are scarce. This study aimed to describe COVID-19 among children in Al-Madinah, Saudi Arabia. Methods This retrospective observational study included children <14 years old hospitalized with COVID-19 between May 1, 2020 and July 31, 2020. Clinical data, COVID-19 disease severity, and outcomes were collected. The total number of presenting symptoms and signs were computed by counting those recorded upon presentation. The Kruskal-Wallis non-parametric test was used to compare the number of symptoms and signs across all levels of COVID-19 severity. Result Overall, 106 patients met the inclusion criteria; their ages ranged from 2 weeks to 13 years. Most patients were ≤12 months of age (43.4%). Bronchial asthma was the most common comorbidity (9.4%). Among 99 symptomatic patients, fever was the most common symptom (84.8%); seven patients (7%) were diagnosed with febrile seizure. Most COVID-19 cases were mild (84%); one patient (0.94%) was in critical condition and one patient (0.94%) met the Multisystem Inflammatory Syndrome in children criteria. The mean number of symptoms and signs in children with severe or critical COVID-19 was significantly higher than that in children with mild cases or non-severe pneumonia (P < .001). One patient died owing to COVID-19 (0.94%). Conclusions COVID-19 mortality in children is rare; however, while most children exhibit mild disease with favorable outcomes, children with chronic lung disease may be at higher risk for severe disease.
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Affiliation(s)
- Amer Alshengeti
- Department of Pediatrics, College of Medicine, Taibah University, Al-Madinah, Saudi Arabia
- Infectious Disease Division, Department of Pediatrics, Madinah Maternity and Children Hospital, Al-Madinah, Saudi Arabia
- Infection Prevention and Control Department, Prince Mohammad Bin Abdulaziz Hospital, Ministry of National Guard-Health Affairs, Al-Madinah, Saudi Arabia
- Corresponding author. Department of Pediatrics, College of Medicine, Taibah University, Al-Madinah, Saudi Arabia.
| | - Hatem Alahmadi
- Infectious Disease Division, Department of Pediatrics, Madinah Maternity and Children Hospital, Al-Madinah, Saudi Arabia
| | - Ashwaq Barnawi
- Infectious Disease Division, Department of Pediatrics, Madinah Maternity and Children Hospital, Al-Madinah, Saudi Arabia
| | - Nouf Alfuraydi
- Infectious Disease Division, Department of Pediatrics, Madinah Maternity and Children Hospital, Al-Madinah, Saudi Arabia
| | - Abdulsalam Alawfi
- Department of Pediatrics, College of Medicine, Taibah University, Al-Madinah, Saudi Arabia
| | - Arwa Al-Ahmadi
- Department of Pediatrics, Madinah Maternity and Children Hospital, Al-Madinah, Saudi Arabia
| | - Mohammad Sheikh
- Department of Pediatrics, Madinah Maternity and Children Hospital, Al-Madinah, Saudi Arabia
| | - Amani Almaghthawi
- Department of Pediatrics, Madinah Maternity and Children Hospital, Al-Madinah, Saudi Arabia
| | - Zahera Alnakhli
- Department of Pediatrics, Madinah Maternity and Children Hospital, Al-Madinah, Saudi Arabia
| | - Raghad Rasheed
- Department of Pediatrics, Madinah Maternity and Children Hospital, Al-Madinah, Saudi Arabia
| | - Amany Ibrahim
- Department of Pediatrics, Saudi German Hospital, Al-Madinah, Saudi Arabia
- Diabetes Endocrine and Metabolic Pediatric Unit (DEMPU), Pediatric Department, Cairo University, Cairo, Egypt
| | - Ahmed Sobhi
- Department of Pediatrics, Saudi German Hospital, Al-Madinah, Saudi Arabia
- Pediatric Department, Cairo University, Cairo, Egypt
| | | | - Faisal Kordy
- Infectious Disease Division, Department of Pediatrics, Madinah Maternity and Children Hospital, Al-Madinah, Saudi Arabia
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Shi Q, Wang Z, Liu J, Wang X, Zhou Q, Li Q, Yu Y, Luo Z, Liu E, Chen Y. Risk factors for poor prognosis in children and adolescents with COVID-19: A systematic review and meta-analysis. EClinicalMedicine 2021; 41:101155. [PMID: 34693233 PMCID: PMC8523335 DOI: 10.1016/j.eclinm.2021.101155] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 09/20/2021] [Accepted: 09/22/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND This study provides the first systematic review and meta-analysis to identify the predictors of unfavorable prognosis of COVID-19 in children and adolescents. METHODS We searched literature databases until July 2021 for studies that investigated risk factors for unfavorable prognosis of children and adolescents with COVID-19. We used random-effects models to estimate the effect size with 95% confidence interval (CI). FINDINGS We identified 56 studies comprising 79,104 individuals. Mortality was higher in patients with multisystem inflammatory syndrome (MIS-C) (odds ratio [OR]=58.00, 95% CI 6.39-526.79) and who were admitted to intensive care (OR=12.64, 95% CI 3.42-46.68). Acute respiratry distress syndrme (ARDS) (OR=29.54, 95% CI 12.69-68.78) and acute kidney injury (AKI) (OR=55.02, 95% CI 6.26-483.35) increased the odds to be admitted to intensive care; shortness of breath (OR=16.96, 95% CI 7.66-37.51) increased the need of respiratory support; and neurological diseases (OR=5.16, 95% CI 2.30-11.60), C-reactive protein (CRP) level ≥80 mg/L (OR=11.70, 95% CI 4.37-31.37) and D-dimer level ≥0.5ug/mL (OR=20.40, 95% CI 1.76-236.44) increased the odds of progression to severe or critical disease. INTERPRETATION Congenital heart disease, chronic pulmonary disease, neurological diseases, obesity, MIS-C, shortness of breath, ARDS, AKI, gastrointestinal symptoms, elevated CRP and D-dimer are associated with unfavourable prognosis in children and adolescents with COVID-19.
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Affiliation(s)
- Qianling Shi
- The First School of Clinical Medicine, Lanzhou University, Lanzhou 730000, China
- Lanzhou University Institute of Health Data Science, Lanzhou 730000, China
| | - Zijun Wang
- Lanzhou University Institute of Health Data Science, Lanzhou 730000, China
- Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China
| | - Jiao Liu
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400000, China
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400000, China
- Chongqing Key Laboratory of Pediatrics, Chongqing 400000, China
| | - Xingmei Wang
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400000, China
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400000, China
- Chongqing Key Laboratory of Pediatrics, Chongqing 400000, China
| | - Qi Zhou
- Lanzhou University Institute of Health Data Science, Lanzhou 730000, China
- Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China
| | - Qinyuan Li
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400000, China
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400000, China
- Chongqing Key Laboratory of Pediatrics, Chongqing 400000, China
| | - Yang Yu
- Department of Tumor Surgery, Lanzhou University Second Hospital, Lanzhou 730000, China
- The Second School of Clinical Medicine, Lanzhou University, Lanzhou 730000, China
| | - Zhengxiu Luo
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400000, China
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400000, China
- Chongqing Key Laboratory of Pediatrics, Chongqing 400000, China
| | - Enmei Liu
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400000, China
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400000, China
- Chongqing Key Laboratory of Pediatrics, Chongqing 400000, China
| | - Yaolong Chen
- Lanzhou University Institute of Health Data Science, Lanzhou 730000, China
- Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China
- WHO Collaborating Center for Guideline Implementation and Knowledge Translation, Lanzhou 730000, China
- Lanzhou University GRADE Center, Lanzhou 730000, China
- Guideline International Network Asia, Lanzhou 730000, China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou University, Lanzhou 730000, China
- Affiliate of the Cochrane China Network, Lanzhou University, Lanzhou 730000, China
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18
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Alshukairi AN, Doar H, Al-Sagheir A, Bahasan MA, Sultan AA, Al Hroub MK, Itani D, Khalid I, Saeedi MF, Bakhamis S, Layqah L, Almutairi AA, Saifullah M, Hefni L, Al-Omari A, Alraddadi BM, Baharoon SA. Outcome of COVID19 in Patients With Osteogenesis Imperfecta: A Retrospective Multicenter Study in Saudi Arabia. Front Endocrinol (Lausanne) 2021; 12:800376. [PMID: 35095767 PMCID: PMC8792853 DOI: 10.3389/fendo.2021.800376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 12/17/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Although genetic diseases are rare, children with such conditions who get infected with COVID-19 tend to have a severe illness requiring hospitalization. Osteogenesis imperfecta (OI) is a rare genetic disorder of collagen resulting in fractures and skeletal deformities. Kyphoscoliosis, restrictive lung disease, and pneumonia worsen the prognosis of patients with OI. The use of bisphosphonate improves bone mineral density (BMD) and reduces fractures in OI. There is no literature describing the impact of COVID-19 in patients with OI. METHODOLOGY A retrospective multi-center study was performed in three hospitals in Jeddah and Riyadh, Saudi Arabia, from March 1st, 2020, until August 31st, 2021, aiming to evaluate the outcome of COVID-19 in patients with OI. Demographics, vaccination status, underlying kyphoscoliosis, functional status, use of bisphosphonate, BMD, and COVID-19 severity, and course were recorded for all patients. RESULTS Twelve cases of confirmed COVID-19 were identified among 146 patients with OI. 9 (75%) of patients were less than 18 years, 6 (50%) were male, 5 (41%) had kyphoscoliosis, and 5 (41%) were wheelchair-bound. 6 (50%) received bisphosphonate, and 7(58%) had normal BMD. All patients had mild disease and did not require hospitalization. None of OI the patients with COVID-19 were fully vaccinated before the infection, and some were ineligible for vaccination. CONCLUSION Patients with OI and COVID-19 in our study recovered without complications, unlike patients with other genetic diseases. Young age and mild illness contributed to the favorable outcome. Half of the patients received bisphosphonate and had normal BMD.
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Affiliation(s)
- Abeer N. Alshukairi
- Department of Medicine, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia
- College of Medicine, AlFaisal University, Riyadh, Saudi Arabia
- *Correspondence: Abeer N. Alshukairi,
| | - Hazem Doar
- Department of Surgery, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia
| | - Afaf Al-Sagheir
- Department of Pediatrics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Mona A. Bahasan
- Department of Pediatrics, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia
| | - Anas A. Sultan
- Department of Medicine, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia
| | - Mohammad K. Al Hroub
- Department of Infection Control and Hospital Epidemiology, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia
| | - Dina Itani
- Department of Family Medicine, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia
| | - Imran Khalid
- Department of Medicine, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia
- College of Medicine, AlFaisal University, Riyadh, Saudi Arabia
| | - Mohammed F. Saeedi
- Department of Medicine, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia
| | - Sarah Bakhamis
- Department of Pediatrics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Laila Layqah
- Research Office, King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
| | - Afnan A. Almutairi
- Department of Medicine, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia
| | - Mona Saifullah
- Department of Family Medicine, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia
| | - Lama Hefni
- Department of Medicine, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia
| | - Awad Al-Omari
- College of Medicine, AlFaisal University, Riyadh, Saudi Arabia
- Department of Critical Care, Dr Sulaiman Al Habib Medical Group, Riyadh, Saudi Arabia
| | - Basem M. Alraddadi
- Department of Medicine, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia
- College of Medicine, AlFaisal University, Riyadh, Saudi Arabia
| | - Salim A. Baharoon
- Department of Critical Care, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| |
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