1
|
Borgi A, Meftah K, Trabelsi I, Kyaw MH, Zaghden H, Bouafsoun A, Mezghani F, Missaoui N, Abdel Ali A, Essaddam L, Khemiri H, Haddad-Boubaker S, Boussetta K, Khemiri M, Ben Becher S, Boukthir S, Triki H, Menif K, Smaoui H. Retrospective Analysis of Clinical Characteristics and Disease Outcomes in Children and Adolescents Hospitalized Due to COVID-19 Infection in Tunisia. Viruses 2024; 16:779. [PMID: 38793660 PMCID: PMC11125722 DOI: 10.3390/v16050779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 05/03/2024] [Accepted: 05/07/2024] [Indexed: 05/26/2024] Open
Abstract
Due to low susceptibility of coronavirus disease of 2019 (COVID-19) in children, limited studies are available regarding COVID-19 in the pediatric population in Tunisia. The current study evaluated the incidence, clinical characteristics, and outcomes of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infection among children hospitalized at Béchir Hamza Children's Hospital. A retrospective cohort analysis was conducted using the hospital database between March 2020 and February 2022 with children aged ≤15 years with SARS-CoV-2 infection (confirmed by RT-PCR). A total of 327 COVID-19 hospitalized patients with a mean age of 3.3 years were included; the majority were male. Neurological disease (20%) was the most common comorbidity, while fever (95.3%) followed by cough (43.7%) and dyspnea (39.6%) were the most frequent symptoms reported. Severe disease with oxygen requirement occurred in 30% of the patients; 13% were admitted in the Intensive Care Unit. The overall incidence rate of COVID-19 hospitalization (in Tunis governorates) was 77.02 per 100,000 while the inpatient case fatality rate was 5% in the study population. The most prevalent circulating variant during our study period was Delta (48.8%), followed by Omicron (26%). More than 45% of the study population were <6 months and one-fourth (n = 25, 26.5%) had at least one comorbidity. Thus, the study findings highlight the high disease burden of COVID-19 in infants.
Collapse
Affiliation(s)
- Aida Borgi
- Pediatric Intensive Care Unit, Children’s Hospital of Tunis, Tunis 1007, Tunisia; (A.B.); (K.M.)
| | - Khaoula Meftah
- Laboratory of Microbiology, Children’s Hospital of Tunis, Tunis 1007, Tunisia; (K.M.)
| | - Ines Trabelsi
- Pediatric Department B, Children’s Hospital of Tunis, Tunis 1007, Tunisia; (I.T.)
| | | | | | - Aida Bouafsoun
- Laboratory of Microbiology, Children’s Hospital of Tunis, Tunis 1007, Tunisia; (K.M.)
| | - Fatma Mezghani
- Pediatric Department A, Children’s Hospital of Tunis, Tunis 1007, Tunisia
| | - Nada Missaoui
- Pediatric Department C, Children’s Hospital of Tunis, Tunis 1007, Tunisia
| | - Alya Abdel Ali
- Department of Pediatrics and Emergency, Children’s Hospital of Tunis, Tunis 1007, Tunisia
| | - Leila Essaddam
- Department of Pediatrics and Emergency, Children’s Hospital of Tunis, Tunis 1007, Tunisia
| | - Haifa Khemiri
- Laboratory of Clinical Virology, WHO Regional Reference Laboratory for Poliomyelitis and Measles for the EMR, Institute Pasteur of Tunis, Tunis 1002, Tunisia
| | - Sondes Haddad-Boubaker
- Laboratory of Clinical Virology, WHO Regional Reference Laboratory for Poliomyelitis and Measles for the EMR, Institute Pasteur of Tunis, Tunis 1002, Tunisia
| | - Khedija Boussetta
- Pediatric Department B, Children’s Hospital of Tunis, Tunis 1007, Tunisia; (I.T.)
| | - Monia Khemiri
- Pediatric Department A, Children’s Hospital of Tunis, Tunis 1007, Tunisia
| | - Saida Ben Becher
- Department of Pediatrics and Emergency, Children’s Hospital of Tunis, Tunis 1007, Tunisia
| | - Samir Boukthir
- Pediatric Department C, Children’s Hospital of Tunis, Tunis 1007, Tunisia
| | - Henda Triki
- Laboratory of Clinical Virology, WHO Regional Reference Laboratory for Poliomyelitis and Measles for the EMR, Institute Pasteur of Tunis, Tunis 1002, Tunisia
| | - Khaled Menif
- Pediatric Intensive Care Unit, Children’s Hospital of Tunis, Tunis 1007, Tunisia; (A.B.); (K.M.)
| | - Hanen Smaoui
- Laboratory of Microbiology, Children’s Hospital of Tunis, Tunis 1007, Tunisia; (K.M.)
| |
Collapse
|
2
|
Singh L, Kumar A, Rai M, Basnet B, Rai N, Khanal P, Lai KS, Cheng WH, Asaad AM, Ansari S. Spectrum of COVID-19 induced liver injury: A review report. World J Hepatol 2024; 16:517-536. [PMID: 38689748 PMCID: PMC11056898 DOI: 10.4254/wjh.v16.i4.517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 01/20/2024] [Accepted: 02/28/2024] [Indexed: 04/24/2024] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has caused changes in the global health system, causing significant setbacks in healthcare systems worldwide. This pandemic has also shown resilience, flexibility, and creativity in reacting to the tragedy. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection targets most of the respiratory tract, resulting in a severe sickness called acute respiratory distress syndrome that may be fatal in some individuals. Although the lung is the primary organ targeted by COVID-19 viruses, the clinical aspect of the disease is varied and ranges from asymptomatic to respiratory failure. However, due to an unorganized immune response and several affected mechanisms, the liver may also experience liver cell injury, ischemic liver dysfunction, and drug-induced liver injury, which can result in respiratory failure because of the immune system's disordered response and other compromised processes that can end in multisystem organ failure. Patients with liver cirrhosis or those who have impaired immune systems may be more likely than other groups to experience worse results from the SARS-CoV-2 infection. We thus intend to examine the pathogenesis, current therapy, and consequences of liver damage concerning COVID-19.
Collapse
Affiliation(s)
- Lokjan Singh
- Department of Microbiology, Karnali Academy of Health Science, Teaching Hospital, Jumla 21200, Karnali, Nepal
| | - Anil Kumar
- Department of Microbiology, Karnali Academy of Health Science, Teaching Hospital, Jumla 21200, Karnali, Nepal
| | - Maya Rai
- Department of Microbiology, Karnali Academy of Health Science, Teaching Hospital, Jumla 21200, Karnali, Nepal
| | - Bibek Basnet
- Health Sciences, Asian College of Advance Studies, Purbanchal University, Satdobato 24122, Lalitpur, Nepal
| | - Nishant Rai
- Department of Biotechnology, Graphic Era (Deemed to be University), Dehradun 248002, Uttarakhand, India
| | - Pukar Khanal
- Department of Pharmacology & Toxicology, KLE College of Pharmacy, Belagavi, KLE Academy of Higher Education and Research, Belagavi 590010, Karnataka, India
| | - Kok-Song Lai
- Division of Health Sciences, Abu Dhabi Women's College, Higher Colleges of Technology, Abu Dhabi 41012, United Arab Emirates
| | - Wan-Hee Cheng
- Health and Life Sciences, INTI International University, Nilai 71800, Malaysia
| | - Ahmed Morad Asaad
- Department of Microbiology, College of Medicine, Zagazig University, Zagazig 44519, Egypt
| | - Shamshul Ansari
- Division of Health Sciences, Abu Dhabi Women's College, Higher Colleges of Technology, Abu Dhabi 41012, United Arab Emirates.
| |
Collapse
|
3
|
Chen LN, Shou ZX, Jin X. Interaction Between Genetic Susceptibility and COVID-19 Pathogenesis in Pediatric Multisystem Inflammatory Disorders: The Role of Immune Responses. Viral Immunol 2024; 37:1-11. [PMID: 38271561 DOI: 10.1089/vim.2023.0074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024] Open
Abstract
Numerous studies have highlighted the emergence of coronavirus disease (COVID-19) symptoms reminiscent of Kawasaki disease in children, including fever, heightened multisystem inflammation, and multiorgan involvement, posing a life-threatening complication. Consequently, extensive research endeavors in pediatric have aimed to elucidate the intricate relationship between COVID-19 infection and the immune system. COVID-19 profoundly impacts immune cells, culminating in a cytokine storm that particularly inflicts damage on the pulmonary system. The gravity and vulnerability to COVID-19 are closely intertwined with the vigor of the immune response. In this context, the human leukocyte antigen (HLA) molecule assumes pivotal significance in shaping immune responses. Genetic scrutiny of HLA has unveiled the presence of at least one deleterious allele in children afflicted with multisystem inflammatory syndrome in children (MIS-C). Furthermore, research has demonstrated that COVID-19 exploits the angiotensin-converting enzyme 2 (ACE-2) receptor, transmembrane serine protease type 2, and various other genes to gain entry into host cells, with individuals harboring ACE-2 polymorphisms being at higher risk. Pediatric studies have employed diverse genetic methodologies, such as genome-wide association studies (GWAS) and whole exome sequencing, to scrutinize target genes. These investigations have pinpointed two specific genomic loci linked to the severity and susceptibility of COVID-19, with the HLA locus emerging as a notable risk factor. In this comprehensive review article, we endeavor to assess the available evidence and consolidate data, offering insights into current clinical practices and delineating avenues for future research. Our objective is to advance early diagnosis, stabilization, and appropriate management strategies to mitigate genetic susceptibility's impact on the incidence of COVID-19 in pediatric patients with multisystem inflammation.
Collapse
Affiliation(s)
- Li-Na Chen
- Department of Pediatric, Affiliated Hospital of Shaoxing University, Shaoxing, China
| | - Zhang-Xuan Shou
- Department of Pharmacy, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Xue Jin
- Department of Pharmacy, Center for Clinical Pharmacy, Cancer Center, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, China
| |
Collapse
|
4
|
Celik IH, Ozkaya Parlakay A, Canpolat FE. Management of neonates with maternal prenatal coronavirus infection and influencing factors. Pediatr Res 2024; 95:436-444. [PMID: 37857851 DOI: 10.1038/s41390-023-02855-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 09/09/2023] [Accepted: 10/02/2023] [Indexed: 10/21/2023]
Abstract
The coronavirus disease 2019 (COVID-19) in pregnancy causes adverse outcomes for both the mother and the fetus. Neonates are at risk of vertical transmission and in-utero infection. Additionally, intensive care unit (ICU) admission and impairment in the organ systems of the mother are associated with neonatal outcomes, including impaired intrauterine growth, prematurity, and neonatal ICU admission. The management of neonates born from infected mothers has changed over the progress of the pandemic. At the beginning of the pandemic, cesarean section, immediate separation of mother-infant dyads, isolation of neonates, and avoiding of skin-to-skin contact, breast milk, and breastfeeding were the main practices to reduce vertical and horizontal transmission risk in the era of insufficient knowledge. The effects of antenatal steroids and delayed cord clamping on COVID-19 were also not known. As the pandemic progressed, data showed that prenatal, delivery room, and postnatal care of neonates can be performed as pre-pandemic practices. Variants and vaccines that affect clinical course and outcomes have emerged during the pandemic. The severity of the disease and the timing of infection in pregnancy also influence maternal and neonatal outcomes. The knowledge and lessons from COVID-19 will be helpful for the next pandemic if it happens. IMPACT: Prenatal infection with COVID-19 is associated with adverse maternal and neonatal outcomes. Our review includes the management of neonates with prenatal COVID-19 infection exposure, maternal-fetal, delivery room, and postnatal care of neonates, clinical features, treatment of neonates, and influencing factors such as variants, vaccination, severity of maternal disease, and timing of infection during pregnancy. There is a growing body of data and evidence about the COVID-19 pandemic. The knowledge and lessons from the pandemic will be helpful for the next pandemic if it happens.
Collapse
Affiliation(s)
- Istemi Han Celik
- University of Health Sciences Turkey; Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Department of Pediatrics, Division of Neonatology, Ankara, Türkiye.
| | - Aslinur Ozkaya Parlakay
- Ankara Yildirim Beyazit University; Ankara Bilkent City Hospital, Department of Pediatrics, Pediatric Infectious Diseases Unit, Ankara, Türkiye
| | - Fuat Emre Canpolat
- University of Health Sciences Turkey, Ankara Bilkent City Hospital, Department of Pediatrics, Division of Neonatology, Ankara, Türkiye
| |
Collapse
|
5
|
Ahmed IS, Tapponi SL, Widatallah ME, Alakkad YM, Haider M. Unmasking the enigma: An in-depth analysis of COVID-19 impact on the pediatric population. J Infect Public Health 2023; 16:1346-1360. [PMID: 37433256 PMCID: PMC10299956 DOI: 10.1016/j.jiph.2023.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 06/18/2023] [Accepted: 06/21/2023] [Indexed: 07/13/2023] Open
Abstract
OBJECTIVES COVID-19, caused by the novel coronavirus, has had a profound and wide-reaching impact on individuals of all age groups across the globe, including children. This review article aims to provide a comprehensive analysis of COVID-19 in children, covering essential topics such as epidemiology, transmission, pathogenesis, clinical features, risk factors, diagnosis, treatment, vaccination, and others. By delving into the current understanding of the disease and addressing the challenges that lie ahead, this article seeks to shed light on the unique considerations surrounding COVID-19 in children and contribute to a deeper comprehension of this global health crisis affecting our youngest population. METHODS A comprehensive literature search was conducted to gather the most recent and relevant information regarding COVID-19 in children. Multiple renowned databases, including MEDLINE, PubMed, Scopus, as well as authoritative sources such as the World Health Organization (WHO), the U.S. Food and Drug Administration (FDA), the European Medicines Agency (EMA), and the National Institutes of Health (NIH) websites and others were thoroughly searched. The search included articles, guidelines, reports, clinical trials results and expert opinions published within the past three years, ensuring the inclusion of the latest research findings on COVID-19 in children. Several relevant keywords, including "COVID-19," "SARS-CoV-2," "children," "pediatrics," and related terms were used to maximize the scope of the search and retrieve a comprehensive set of articles. RESULTS AND CONCLUSION Three years since the onset of the COVID-19 pandemic, our understanding of its impact on children has evolved, but many questions remain unanswered. While SAR-CoV-2 generally leads to mild illness in children, the occurrence of severe cases and the potential for long-term effects cannot be overlooked. Efforts to comprehensively study COVID-19 in children must continue to improve preventive strategies, identify high-risk populations, and ensure optimal management. By unraveling the enigma surrounding COVID-19 in children, we can strive towards safeguarding their health and well-being in the face of future global health challenges.
Collapse
Affiliation(s)
- Iman Saad Ahmed
- Department of Pharmaceutics & Pharmaceutical Technology, College of Pharmacy, University of Sharjah, Sharjah 27272, United Arab Emirates; Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates.
| | - Sara Luay Tapponi
- Department of Pharmaceutics & Pharmaceutical Technology, College of Pharmacy, University of Sharjah, Sharjah 27272, United Arab Emirates
| | - Marwa Eltahir Widatallah
- Department of Pharmaceutics & Pharmaceutical Technology, College of Pharmacy, University of Sharjah, Sharjah 27272, United Arab Emirates
| | - Yumna Mohamed Alakkad
- Department of Pharmaceutics & Pharmaceutical Technology, College of Pharmacy, University of Sharjah, Sharjah 27272, United Arab Emirates
| | - Mohamed Haider
- Department of Pharmaceutics & Pharmaceutical Technology, College of Pharmacy, University of Sharjah, Sharjah 27272, United Arab Emirates; Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates
| |
Collapse
|
6
|
Hébert S, Schmidt M, Topf G, Rieger D, Klinge J, Vermehren J, Fusch C, Grillhösl C, Schroth M, Toni I, Reutter H, Morhart P, Hanslik G, Mulzer L, Woelfle J, Hohberger B, Hoerning A. "Multisystem Inflammatory Syndrome in Children" (MIS-C) after COVID-19 Infection in the Metropolitan Area of Nuremberg-Erlangen, Germany-Expectations and Results of a Two-Year Period. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1363. [PMID: 37628362 PMCID: PMC10453116 DOI: 10.3390/children10081363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 07/11/2023] [Accepted: 07/25/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND Multisystemic Inflammatory Syndrome in children (MIS-C) is a rare autoimmune disorder occurring after a latency period following acute SARS-CoV-2 infection. The therapeutic regime of MIS-C is adapted to the therapy of the Kawasaki disease, as clinical symptoms are similar. Since the Kawasaki disease can potentially result in severe symptoms, which may even affect long-term health, it is essential to gain further knowledge about MIS-C. Thus, we aimed to investigate the incidence, symptoms, therapeutical procedure and outcome of MIS-C patients in the metropolitan area of Nuremberg-Erlangen during the SARS-CoV2 pandemic. MATERIAL AND METHODS Retrospective analysis of clinical charts of MIS-C patients was carried out at three children's hospitals covering the medical care of the metropolitan area of Nuremberg-Erlangen in Germany. Demographic characteristics and symptoms at first visit, their clinical course, therapeutic regime and outcome were recorded within the time period January 2021-December 2022. RESULTS Analysis of 10 patients (5 male, 5 female) with MIS-C resulting in an incidence of 2.14/100.000 children. The median time between COVID-19 infection and admission to hospital was 5 weeks. The median age was 7 years. Symptoms comprised fever (100%), rash (70%), bilateral non-purulent conjunctivitis (70%) and urticaria (20%). At the time of presentation, diagnosis-defining inflammation parameters were increased and the range for C-reactive protein was 4.13 mg/dL to 28 mg/dL, with a median of 24.7 mg/dL. Procalcitonin was initially determined in six patients (1.92 ng/mL to 21.5 ng/mL) with a median value of 5.5 pg/mL. Two patients displayed leukocytosis and two displayed leukopenia. None of the patients presented coronary pathologies. Nine of the ten patients received intravenous immunoglobulin (IVIG) therapy. In addition, patients received intravenous steroids (80%) and acetylsalicylic acid (80%). CONCLUSION SARS-CoV virus may rarely exert multiorgan manifestations due to hyperinflammatory immunological processes. Within two years of the COVID-19 pandemic, we identified ten patients with COVID-induced MIS-C in the metropolitan area Nuremberg-Erlangen. In the description of the patient collective, we can confirm that MIS-C is distinguished from the Kawasaki disease by the lack of coronary manifestations. Interestingly, although having monitored all pediatric facilities in the investigated area, we find lower incidences of MIS-C compared to findings in the literature. In conclusion, an overestimation of incidences in the upcoming MIS-C during the pandemic needs to be considered.
Collapse
Affiliation(s)
- Steven Hébert
- Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, 91054 Erlangen, Germany
| | - Marius Schmidt
- Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, 91054 Erlangen, Germany
| | - Georg Topf
- Hospital for Children and Adolescents Furth, 90766 Furth, Germany
| | - Daniel Rieger
- Hospital for Children and Adolescents Furth, 90766 Furth, Germany
| | - Jens Klinge
- Hospital for Children and Adolescents Furth, 90766 Furth, Germany
| | - Jan Vermehren
- Pediatrics—Children’s Department Nuremberg Hospital South, 90471 Nuremberg, Germany
| | - Christoph Fusch
- Pediatrics—Children’s Department Nuremberg Hospital South, 90471 Nuremberg, Germany
| | - Christian Grillhösl
- Cnopf Children’s Hospital, Diakoneo Klinikum Hallerwiese Nuremberg, 90419 Nuremberg, Germany
| | - Michael Schroth
- Cnopf Children’s Hospital, Diakoneo Klinikum Hallerwiese Nuremberg, 90419 Nuremberg, Germany
| | - Irmgard Toni
- Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, 91054 Erlangen, Germany
| | - Heiko Reutter
- Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, 91054 Erlangen, Germany
| | - Patrick Morhart
- Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, 91054 Erlangen, Germany
| | - Gregor Hanslik
- Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, 91054 Erlangen, Germany
| | - Linda Mulzer
- Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, 91054 Erlangen, Germany
| | - Joachim Woelfle
- Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, 91054 Erlangen, Germany
| | - Bettina Hohberger
- Department of Ophthalmology, University Hospital Erlangen, 90766 Erlangen, Germany
| | - André Hoerning
- Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, 91054 Erlangen, Germany
| |
Collapse
|
7
|
Totapally BR, Nadiger M, Hassor S, Laufer M, Etinger V, Ramos O, Biehler J, Meyer K, Melnick S. Identification of Multisystem Inflammatory Syndrome in Children Classes and Development of Hyperinflammation Score in Pediatric COVID-19. J Pediatr Intensive Care 2023; 12:137-147. [PMID: 37082465 PMCID: PMC10113008 DOI: 10.1055/s-0041-1730932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 04/21/2021] [Indexed: 01/08/2023] Open
Abstract
The aim of this study is to describe characteristics and hospital course of children admitted with COVID-19 to a tertiary care pediatric center in Southeastern United States, and to present the frequency of three classes of multisystem inflammatory syndrome in children (MIS-C) and develop pediatric COVID-19 associated hyperinflammation score (PcHIS). A retrospective cohort study of 68 children was performed. Critical illness was defined as any child requiring respiratory or cardiovascular support or renal replacement therapy. PcHIS was developed by using six variables: fever, hematological dysfunction, coagulopathy, hepatic injury, macrophage activation, and cytokinemia. Centers for Disease Control and Prevention criteria were used to identify MIS-C, and three classes of MIS-C were identified based on the findings of recently published latent class analysis (Class 1: MIS-C without Kawasaki like disease, Class 2: MIS-C with respiratory disease, and Class 3: MIS-C with Kawasaki like disease). The median age was 6.4 years. Fever, respiratory, and gastrointestinal were common presenting symptoms. MIS-C was present in 32 (47%), critical COVID-19 illness in 11 (16%), and 17 (25%) were admitted to the PICU. Children with critical illness were adolescents with elevated body mass index and premorbid conditions. PcHIS score of 3 had a sensitivity of 100% and a specificity of 77% for predicting critical COVID-19 illness. Among MIS-C patients, 15 (47%) were in Class 1, 8 (25%) were in Class 2, and 9 (28%) were in Class 3. We conclude that most children with COVID-19 have mild-to-moderate illness. Critical COVID-19 is mainly seen in obese adolescents with premorbid conditions. Three Classes of MIS-C are identifiable based on clinical features. Validation and clinical implication of inflammation score in pediatric COVID-19 need further investigation.
Collapse
Affiliation(s)
- Balagangadhar R. Totapally
- Division of Critical Care Medicine, Nicklaus Children's Hospital, Miami, Florida, United States
- Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, United States
| | - Meghana Nadiger
- Division of Critical Care Medicine, Nicklaus Children's Hospital, Miami, Florida, United States
| | - Sophia Hassor
- Division of Hospital Medicine, Nicklaus Children's Hospital, Miami, Florida, United States
| | - Marcelo Laufer
- Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, United States
- Division of Infectious Diseases, Nicklaus Children's Hospital, Miami, Florida, United States
| | - Veronica Etinger
- Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, United States
- Division of Hospital Medicine, Nicklaus Children's Hospital, Miami, Florida, United States
| | - Otto Ramos
- Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, United States
- Division of Infectious Diseases, Nicklaus Children's Hospital, Miami, Florida, United States
| | - Jefry Biehler
- Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, United States
| | - Keith Meyer
- Division of Critical Care Medicine, Nicklaus Children's Hospital, Miami, Florida, United States
- Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, United States
| | - Steven Melnick
- Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, United States
- Department of Pathology, Nicklaus Children's Hospital, Miami, Florida, United States
| |
Collapse
|
8
|
Clinical and Cytokine Profile of Children With COVID-19: A Report From Turkey. Cureus 2023; 15:e37139. [PMID: 37034144 PMCID: PMC10078166 DOI: 10.7759/cureus.37139] [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: 04/04/2023] [Indexed: 04/07/2023] Open
Abstract
Background We aimed to analyze the expression of infection-related biomarkers and inflammatory cytokines in laboratory-confirmed cases and compare the differences between clinically severe and non-severe ones. Method We randomly selected 35 patients who were hospitalized with the diagnosis of coronavirus disease 2019 (COVID-19). Blood serum was obtained at the time of admission to the hospital, on the third to the fifth day, and at the time of discharge. Result The median age of our patients was 56.5±69.7 months (range: 1-205 months). The mean pro-B-type natriuretic peptide (pro-BNP) was significantly higher at the time of admission than on the third to the fifth day of illness. The mean pro-B-type natriuretic peptide levels at three time points were significantly higher in patients with severe cases than in mild-moderate cases. However, there was no significant difference between the clinical severity with regard to the cytokine levels at disease onset and recovery. Conclusion In the study, it was shown that cytokines play an important role in the pathogenesis of COVID-19. Therefore, it may be beneficial to use agents such as tocilizumab in the treatment.
Collapse
|
9
|
Aydoğan S, Zenciroglu A, Çitli R, Dilli D, Özdem S. Evaluation of Newborns Diagnosed with COVID-19: A Single-Center Experience. Am J Perinatol 2023; 40:567-574. [PMID: 35790179 DOI: 10.1055/s-0042-1753522] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVE The causative agent of the severe acute respiratory syndrome is a new type of coronavirus infection called coronavirus disease-2019 (COVID-19) which has spread around the world. COVID-19 is thought to rarely affect infants, so pandemic planning focuses on adults. This study aimed to share our 1-year experience with COVID-19-positive newborns in a tertiary neonatal intensive care unit (NICU). STUDY DESIGN Hospitalized newborns after a reverse transcription polymerase chain reaction (RT-PCR) for COVID-19 were evaluated in this retrospective, cohort study between March 2020 and March 2021. The clinical course, laboratory tests, imaging studies, and outcomes of affected newborns were collected from medical records. RESULTS Eleven COVID-19-diagnosed newborns were analyzed in our study. Four (36.6%) patients had contact with a COVID-19-positive individual in their families. The main symptoms were fever (81.8%), hypoxemia (63.6%), and tachypnea (63.6%). Bacterial coinfection was identified in two newborns. Aortic coarctation was detected as an accompanied disease by a newborn who was referred to our hospital with a suspicion of congenital heart disease and two patients had a bacterial coinfection. We did not detect any cases of neonatal multisystem inflammatory syndrome. All patients were discharged in good health. None of the newborns had any complications and repeated infection with another variant during the first-year follow-up. CONCLUSION Contrary to popular belief, newborns are a sensitive age group for COVID-19 and need a high rate of hospitalization. Congenital heart diseases and coinfections should not be overlooked in COVID-19-infected newborns. The acquired immunity due to COVID-19 infection protects newborns from recurrent COVID-19 infections in their first year of life. The absence of COVID-19-positive individual in the family in most cases suggests that PCR-negative adults may also play a role in the transmission of the disease. KEY POINTS · COVID-19 is still a pandemic all over the world.. · COVID-19 is dangerous for newborns.. · PCR-negative adults may also play a role in the transmission of the disease to the newborn..
Collapse
Affiliation(s)
- Seda Aydoğan
- Department of Neonatology, University of Health Sciences, Dr Sami Ulus Maternity and Children Research and Training Hospital, Ankara, Turkey
| | - Aysegul Zenciroglu
- Department of Neonatology, University of Health Sciences, Dr Sami Ulus Maternity and Children Research and Training Hospital, Ankara, Turkey
| | - Rumeysa Çitli
- Department of Neonatology, University of Health Sciences, Dr Sami Ulus Maternity and Children Research and Training Hospital, Ankara, Turkey
| | - Dilek Dilli
- Department of Neonatology, University of Health Sciences, Dr Sami Ulus Maternity and Children Research and Training Hospital, Ankara, Turkey
| | - Suna Özdem
- Department of Pediatric Infectious Diseases, University of Health Sciences, Dr Sami Ulus Maternity and Children Research and Training Hospital, Ankara, Turkey
| |
Collapse
|
10
|
Casassola GM, Schmidt CJ, Affeldt GH, Morais DS, Alvarenga LKB, Miller C, Ziegler B. Functional status of hospitalized pediatric patients with COVID-19 in southern Brazil: a prospective cohort study. J Bras Pneumol 2023; 48:e20220153. [PMID: 36651435 PMCID: PMC9747171 DOI: 10.36416/1806-3756/e20220153] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 09/27/2022] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE The present study aimed to assess the functional status of children diagnosed with COVID-19 at the time of hospitalization and the associations with clinical features. METHODS This prospective cohort study was carried out with children diagnosed with COVID-19 admitted to a tertiary hospital. The patients' functioning was assessed using the pediatric Functional Status Scale (FSS). RESULTS A total of 62 children with a median age of 3 years old were included in the study, and 70% had some comorbidity prior to the diagnosis of COVID-19. The median length of stay was nine days, during which period five patients died. The FSS assessment of the sample showed that approximately 55% had some functional alteration. The group of patients with the highest FSS scores presented a lengthier hospital stay (p = 0.016), required more oxygen therapy (p < 0.001), mechanical ventilation (p = 0.001), and intensive care unit admissions (p = 0.019), and had more cardiac (p = 0.007), neurological (p = 0.003), and respiratory (p = 0.013) comorbidities. In the multivariate analysis, there was an association between the dependent variable length of stay and the total FSS score (b = 0.349, p = 0.004) and the presence of comorbidities (b = 0.357, p = 0.004). CONCLUSIONS We observed that more than half of the children hospitalized due to COVID-19 had some level of functional change. Greater alterations in functional status were associated with the presence of previous comorbidities, a greater need for ventilatory support, and longer hospital stays.
Collapse
Affiliation(s)
| | | | - Guilherme Hoff Affeldt
- . Programa de Pós-Graduação em Pneumologia, Universidade Federal do Rio Grande do Sul, Porto Alegre (RS), Brasil
| | | | | | - Cristina Miller
- . Hospital de Clínicas de Porto Alegre, Porto Alegre (RS), Brasil
| | - Bruna Ziegler
- . Hospital de Clínicas de Porto Alegre, Porto Alegre (RS), Brasil
| |
Collapse
|
11
|
COVID-19 Vaccination in Pediatrics: Was It Valuable and Successful? Vaccines (Basel) 2023; 11:vaccines11020214. [PMID: 36851090 PMCID: PMC9964251 DOI: 10.3390/vaccines11020214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/12/2023] [Accepted: 01/13/2023] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND The mass vaccination of children against coronavirus 2019 disease (COVID-19) has been frequently debated. The risk-benefit assessment of COVID-19 vaccination versus infection in children has also been debated. AIM This systematic review looked for answers to the question "was the vaccination of our children valuable and successful?". METHODS The search strategy of different articles in the literature was based on medical subject headings. Screening and selection were based on inclusion/exclusion criteria. RESULTS AND DISCUSSION The search results revealed that the majority of the reported adverse events after COVID-19 vaccination in pediatrics were mild to moderate, with few being severe. Injection site discomfort, fever, headache, cough, lethargy, and muscular aches and pains were the most prevalent side effects. Few clinical studies recorded significant side effects, although the majority of these adverse events had nothing to do with vaccination. In terms of efficacy, COVID-19 disease protection was achieved in 90-95% of cases for mRNA vaccines, in 50-80% of cases for inactivated vaccines, and in 58-92% of cases for adenoviral-based vaccines in children and adolescents. CONCLUSIONS Based on available data, COVID-19 immunizations appear to be safe for children and adolescents. Furthermore, multiple studies have proven that different types of vaccines can provide excellent protection against COVID-19 in pediatric populations. The efficacy of vaccines against new SARS-CoV-2 variants and the reduction in vaccine-related long-term adverse events are crucial for risk-benefit and cost-effectiveness assessments; therefore, additional safety studies are required to confirm the long-term safety and effectiveness of vaccinations in children.
Collapse
|
12
|
Karaahmetoğlu FS, Pehlivan E, Özcan ZB. The activity levels and quality of life of physically disabled children who continued or did not continue rehabilitation during the COVID-19 pandemic. Work 2023; 76:1285-1291. [PMID: 37393478 DOI: 10.3233/wor-220705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/03/2023] Open
Abstract
BACKGROUND Social isolation during the COVID-19 pandemic had a harmful impact on the psychological and physical health of children and teenagers. It is known that interruptions in rehabilitation can cause soft tissue contractures, bone deformities and a decline in motor functions among other complications. OBJECTIVE The aim of this study was to compare the quality of life and physical activity levels of physically disabled children who continued and did not continue rehabilitation during the COVID-19 pandemic. METHOD The gross motor levels of 18 children who continued special education and rehabilitation during the COVID-19 pandemic and 18 children who did not continue were determined with the Gross Motor Function Classification System (GMFCS). The International Physical Activity Questionnaire Short Form (IPAQ) and Children's Quality of Life Scale (PedsQL) questionnaires were administered. RESULTS The study participants comprised 54.1% females and 45.9% males with a mean age of 9.02 years. No significant differences were detected between the two groups in respect of demographic, clinical and functional characteristics (p > 0.05). The walking parameters of PedsQL (p = 0.02) and IPAQ-SF scores (p = 0.03) were determined to be statistically significantly better in the group that continued rehabilitation. CONCLUSION The results of this study demonstrated that the quality of life and walking capacity of children who continued rehabilitation during the COVID-19 pandemic were better. Methods should be developed to ensure that rehabilitation is not interrupted during isolation periods of any future pandemic.
Collapse
Affiliation(s)
- Fulya Senem Karaahmetoğlu
- Department of Physiotherapy and Rehabilitation, Hamidiye Institute of Health Sciences, University of Health Sciences Turkey, Istanbul, Türkiye
| | - Esra Pehlivan
- Department of Physical Therapy and Rehabilitation, Faculty of Hamidiye Health Sciences, University of Health Sciences Turkey, Istanbul, Türkiye
| | - Zeynep Betül Özcan
- Department of Physiotherapy and Rehabilitation, Hamidiye Institute of Health Sciences, University of Health Sciences Turkey, Istanbul, Türkiye
| |
Collapse
|
13
|
Wang JY, Li TN, Zhou CL, Zhao J, Wang M, Wang Y, Jiang Y, Dong HN, Qi QR, Mu H. Clinical and immunological features of convalescent pediatric patients infected with the SARS-CoV-2 Omicron variant in Tianjin, China. Virol Sin 2022; 37:850-859. [PMID: 36328182 PMCID: PMC9621613 DOI: 10.1016/j.virs.2022.10.009] [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] [Received: 04/24/2022] [Accepted: 10/27/2022] [Indexed: 11/06/2022] Open
Abstract
COVID-19 has spread surprisingly fast worldwide, and new variants continue to emerge. Recently, the World Health Organization acknowledged a new mutant strain "Omicron", with children were accounting for a growing share of COVID-19 cases compared with other mutant strains. However, the clinical and immunological characteristics of convalescent pediatric patients after Omicron infection were lacking. In this study, we comparatively analyzed the clinical data from pediatric patients with adult patients or healthy children and the effects of SARS-CoV-2 vaccine on the clinical and immune characteristics in convalescent pediatric patients. Our results indicated that convalescent pediatric patients had unique clinical and immune characteristics different from those of adult patients or healthy children, and SARS-CoV-2 vaccination significantly affected on the clinical and immune characteristics and the prevention of nucleic acid re-detectable positive (RP) in convalescent patients. Our study further deepens the understanding of the impact of Omicron on the long-term health of pediatric patients and provides a valuable reference for the prevention and treatment of children infected with Omicron.
Collapse
Affiliation(s)
- Jing-Yu Wang
- Department of Clinical Lab, Tianjin First Central Hospital, Tianjin, 300192, China
| | - Tian-Ning Li
- Department of Clinical Lab, Tianjin First Central Hospital, Tianjin, 300192, China
| | - Chun-Lei Zhou
- Department of Clinical Lab, Tianjin First Central Hospital, Tianjin, 300192, China
| | - Jie Zhao
- Department of Clinical Lab, Tianjin First Central Hospital, Tianjin, 300192, China
| | - Meng Wang
- Department of Clinical Lab, Tianjin First Central Hospital, Tianjin, 300192, China
| | - Yuan Wang
- Department of Clinical Lab, Tianjin First Central Hospital, Tianjin, 300192, China
| | - Yan Jiang
- Department of Clinical Lab, Tianjin First Central Hospital, Tianjin, 300192, China
| | - He-Nan Dong
- The First Central Clinical College, Tianjin Medical University, Tianjin, 300192, China
| | - Qian-Ru Qi
- Department of Clinical Lab, Tianjin Children's Hospital, Tianjin, 300074, China
| | - Hong Mu
- Department of Clinical Lab, Tianjin First Central Hospital, Tianjin, 300192, China,Corresponding author
| |
Collapse
|
14
|
Neurological Manifestations in Pediatric COVID-19 Patients Hospitalized at King Abdulaziz University Hospital, Jeddah, Saudi Arabia: A Retrospective Study. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121870. [PMID: 36553314 PMCID: PMC9776438 DOI: 10.3390/children9121870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 11/26/2022] [Accepted: 11/28/2022] [Indexed: 12/05/2022]
Abstract
There are limited data about neurological manifestations in pediatric COVID-19 patients from all over the world, including Saudi Arabia. This study was performed to identify characteristics of pediatric COVID-19 cases with neurologic involvement hospitalized at King Abdulaziz University Hospital (KAUH), Saudi Arabia. This retrospective cross-sectional study included hospitalized patients aged 0-19 years with confirmed SARS-CoV-2 from April 2020 to February 2022. The required data were retrieved from patients' medical records. Ninety-four cases were included. The median ages of the studied group, those with neurological manifestations, and those without neurologic manifestations, were 6.5, 11.0, and 5.0 years, respectively. Neurological manifestations occurred in 29 COVID-19 patients (30.9%) with headache and decreased consciousness being the most common recorded manifestations in 8.5% and 6.4% of patients, respectively. Specific neurological manifestations were rare, as only two infants developed encephalopathy with fatal outcome. Most patients with and without neurological manifestations survived. Neuroimaging abnormalities were detected in 8 cases with neurological manifestations. Neurological manifestations were common in 31% of hospitalized pediatric COVID-19 cases. However, most of the neurological manifestations were mild and nonspecific, with headache being the most common one. Specific neurological manifestations were rare; however, pediatric COVID-19 patients, particularly young infants, were at risk of developing severe encephalopathy with fatal outcome.
Collapse
|
15
|
Amin UA, Parveen AP. Impact of COVID-19 on children. MIDDLE EAST CURRENT PSYCHIATRY 2022. [PMCID: PMC9668239 DOI: 10.1186/s43045-022-00256-3] [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] [Indexed: 11/17/2022] Open
Abstract
Background The COVID-19 global pandemic has spread throughout the world, posing an extremely dangerous health risk for almost everyone. While dealing with such a large-scale viral disease, the healthcare infrastructure is under strain. Young adults who were thought to have been clinically affected fared better than their older counterparts. This pandemic has affected millions of children, especially those from low-economic backgrounds, who are otherwise highly susceptible and underprivileged. Children of frontline workers and single parents face particular challenges. Children from disadvantaged backgrounds are more vulnerable to infection and may experience long-lasting negative effects of the pandemic, such as child labor, child trafficking, child marriage, sexual exploitation, and even death. To lessen the psychological negative effects of COVID-19 on children and adolescents, parents, physicians, psychologists, social workers, and hospital administrators, government and non-governmental organizations have essential responsibilities to play. Priority one is to ensure that all children from all socioeconomic strata have access to the necessities of life, including social security, health care, and education. Moreover, some positive changes may result from the global crisis. This research paper discusses the potential consequences of this pandemic. Summary Some of the hypotheses being investigated while looking at the low case fatality rate among pediatric age groups include the peak of immunity and differences in immune system response. The vulnerability of the comorbid pediatric age group, on the other hand, is comparable to that of their older counterparts. During the severe acute respiratory syndrome and Middle Eastern respiratory syndrome outbreaks, similar results were observed. The inoculation of a mother during pregnancy was found to be effective in protecting her progeny. Results This is a review article, thus not applicable. Conclusions Children are quite discouraged when school is abruptly stopped, when planned outings are canceled, when they are confined to the house, and when they are afraid of the unknown with regard to the continuing epidemic. Even though almost all studies suggest that COVID-19 has a relatively mild clinical manifestation in children, one must be cautious due to the novel coronavirus’s rapid mutation rate. More research is needed to determine the relationship between COVID-19 and pediatric age groups.
Collapse
|
16
|
Pasaribu AP, Saragih RH, Fahmi F, Pasaribu S. Transmission and Profile of COVID-19 in Children in North Sumatera, Indonesia. ARCHIVES OF IRANIAN MEDICINE 2022; 25:737-741. [PMID: 37543898 PMCID: PMC10685854 DOI: 10.34172/aim.2022.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 12/07/2021] [Indexed: 08/08/2023]
Abstract
BACKGROUND In December 2019, a cluster of viral pneumonia cases, later identified as coronavirus disease 2019 (COVID-19), was first reported in Wuhan, China, and then continued to spread to other parts of the world. COVID-19 is thought to be more prevalent in adults than children; therefore, information about COVID-19 burden and characteristics in children is lacking. METHODS We gathered data on the profile and transmission in children with COVID-19 from data collected by the North Sumatera Provincial Health Office team. Data were presented as mean±SD and percentage. Statistical analysis was performed using STATA version 15.0. RESULTS From April to October 2020, there were 1125 confirmed COVID-19 cases in children in North Sumatera, representing approximately 8.9% of all cases. Death occurred in 0.62% of the patients, and the children who died had underlying diseases. Four major clusters of COVID-19 infection in children were found in three Islamic boarding schools and one refugee shelter. CONCLUSION A high number of children in North Sumatera were affected by COVID-19, and mortality was found to be higher in children with underlying diseases. Major clusters were found in places with prolonged and repeated activities in close contact, such as boarding schools and a refugee shelter.
Collapse
Affiliation(s)
- Ayodhia Pitaloka Pasaribu
- Department of Child Health, Medical Faculty, Universitas Sumatera Utara, Medan, Indonesia
- Emerging Infectious Diseases Team, North Sumatera COVID-19 Task Force, Medan, Indonesia
| | - Restuti Hidayani Saragih
- Emerging Infectious Diseases Team, North Sumatera COVID-19 Task Force, Medan, Indonesia
- Department of Internal Medicine, Medical Faculty, Universitas Sumatera Utara, Medan, Indonesia
| | - Fahmi Fahmi
- Department of Electrical Engineering, Engineering Faculty, Universitas Sumatera Utara, Medan, Indonesia
| | - Syahril Pasaribu
- Department of Child Health, Medical Faculty, Universitas Sumatera Utara, Medan, Indonesia
| |
Collapse
|
17
|
Öcal DF, Öztürk FH, Şenel SA, Sinaci S, Yetişkin FDY, Keven C, Dinç B, Turgut E, Oluklu D, Tekin ÖM, Şahin D. The influence of COVID-19 pandemic on intrauterine fetal demise and possible vertical transmission of SARS-CoV-2. Taiwan J Obstet Gynecol 2022; 61:1021-1026. [PMID: 36427967 PMCID: PMC9482846 DOI: 10.1016/j.tjog.2022.03.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2022] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE The impact of COVID-19 on intrauterine fetal demise (IUFD) and vertical transmission of the SARS-CoV-2 from the mother to the fetus are crucial issues of the COVID-19 pandemic. In the current study, we aimed to detect the pandemic's influence on the IUFD and evaluate the vertical transmission of the SARS-CoV-2 through analysis of placental tissues collected from PCR positive women with IUFD above 20 weeks of gestation. MATERIALS AND METHODS The pregnant women above 20 weeks of gestation and had a fetus intrauterine demised during pandemic were included in the study. The pregnant women screened for COVID-19. Vertical transmission searched from placental tissues of COVID-19 positive women by RT-PCR tests for the presence of SARS-CoV-2 RNA. The number of IUFD before the pandemic and during the pandemic compared to assess the influence of the COVID-19 pandemic on the IUFD ratio. RESULTS Among 138 pregnant women with IUFD, 100 of them could screen for COVID-19 status. RT-PCR test results of 6 of the screened pregnant women were positive for SARS-CoV-2. Placental tissues of these six women were analyzed, and one test result was positive for SARS-CoV-2 RNA. The IUFD ratio was significantly increased during the pandemic. CONCLUSION It is clear that COVID-19 increases the IUFD ratio. Previous data for vertical transmission of SARS-CoV-2 during the second trimester is limited. We present the third case of literature that has positive placental results for SARS-CoV-2 RNA in the second trimester of pregnancy.
Collapse
Affiliation(s)
- Doğa Fatma Öcal
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey,Corresponding author. Akşemsettin Mah., 2308 Sk., No: 1/C-77, Mamak, Ankara, Turkey
| | - Filiz Halıcı Öztürk
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Selvi Aydın Şenel
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Selcan Sinaci
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Fatma Didem Yücel Yetişkin
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Can Keven
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Bedia Dinç
- Department of Medical Microbiology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey,University of Health Sciences, Istanbul, Turkey
| | - Ezgi Turgut
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Deniz Oluklu
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Özlem Moraloğlu Tekin
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey,University of Health Sciences, Istanbul, Turkey
| | - Dilek Şahin
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey,University of Health Sciences, Istanbul, Turkey
| |
Collapse
|
18
|
Kaya Özçora GD, Çetindağ F, Doğan M, Baştemir M. Childhood Multisystem Inflammatory Syndrome With Prominent Neurological Involvement. Pediatr Neurol 2022; 135:56-60. [PMID: 36007373 PMCID: PMC9349338 DOI: 10.1016/j.pediatrneurol.2022.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 07/01/2022] [Accepted: 07/06/2022] [Indexed: 11/18/2022]
Affiliation(s)
- Gül Demet Kaya Özçora
- Division of Pediatric Neurology, Hasan Kalyoncu University, University of Health Sciences, Gaziantep, Turkey.
| | - Ferhan Çetindağ
- Department of Pediatrics, Private Medical Park Hospital, Gaziantep, Turkey
| | - Murat Doğan
- Department of Pediatrics, Private Medical Park Hospital, Gaziantep, Turkey
| | - Murat Baştemir
- Department of Radiology, Private Medical Park Hospital, Gaziantep, Turkey
| |
Collapse
|
19
|
Prosperi S, Chiarelli F. COVID-19 and diabetes in children. Ann Pediatr Endocrinol Metab 2022; 27:157-168. [PMID: 36203266 PMCID: PMC9537670 DOI: 10.6065/apem.2244150.075] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 08/22/2022] [Indexed: 01/08/2023] Open
Abstract
This review describes the impact of coronavirus disease 2019 (COVID-19) in children and adolescents, investigating changes in diabetes presentation during the COVID-19 pandemic, possible links between severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection and diabetes, and mechanisms of pancreatic β-cell destruction. Although glycemic control in individuals with already known diabetes mellitus did not worsen during the pandemic, there was a worrying increase in diabetic ketoacidosis in children with new-onset diabetes, probably due to containment measures and delayed access to emergency departments. Moreover, new evidence suggests that SARS-CoV-2 has the capacity to directly and indirectly induce pancreatic β-cell destruction, and the risk of newly diagnosed diabetes after COVID-19 increased in both children and adults. While long-term studies continue to follow children with SARS-CoV-2 infection, this review discusses available findings on the relationship between COVID-19 and diabetes. It is important to emphasize the need to maintain close links between families of children with chronic conditions and their pediatricians, as well as to promote early access to healthcare services, in order to reduce dangerous delays in diabetes diagnosis and prevent diabetic ketoacidosis.
Collapse
Affiliation(s)
| | - Francesco Chiarelli
- Address for correspondence: Francesco Chiarelli Department of Pediatrics, University of Chieti, Via dei Vestini, 5, I-66100 Chieti, Italy
| |
Collapse
|
20
|
Doğan A, Dumanoğlu Doğan İ, Uyanık M, Köle MT, Pişmişoğlu K. The Clinical Significance of Vitamin D and Zinc Levels with Respect to Immune Response in COVID-19 Positive Children. J Trop Pediatr 2022; 68:6673384. [PMID: 35994727 PMCID: PMC9452162 DOI: 10.1093/tropej/fmac072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIM In this study, we aimed to evaluate serum vitamin D and zinc levels in children diagnosed with coronavirus disease 2019 (COVID-19). MATERIALS AND METHODS In this study, 88 children with COVID-19 disease and 88 healthy children aged 1-18 years were enrolled between 01 July 2021 and 30 October 2021 in the Pediatrics Clinic of Tekirdağ Çorlu State Hospital. Serum vitamin D and zinc levels have been measured and NCSS (Number Cruncher Statistical System) program has been utilized for statistical analysis. RESULTS We included 88 COVID-19 positive pediatric patients [50% (n = 44) female] and 88 healthy children [48.86% (n = 43) female] in this study. The mean serum vitamin D levels of COVID-19 positive patients were statistically significantly lower than the control group (p = 0.0001). The zinc mean values of the study group were found to be statistically significantly lower than the control group (p = 0.0001). There was a statistically significant correlation between serum vitamin D and zinc values in all patient groups (r = 0.245, p = 0.001). CONCLUSION As a result, zinc and vitamin D levels were observed lower in COVID-19 patients than in healthy individuals. Since there is no defined treatment protocol for COVID-19 infection on children yet, zinc and vitamin D supplementation can be used as a supportive treatment in COVID-19 infection.
Collapse
Affiliation(s)
- Ahmet Doğan
- Department of Pediatrics, Tekirdağ Çorlu District State Hospital, Ministry of Health, 59850 Tekirdağ, Turkey
| | - İmran Dumanoğlu Doğan
- Department of Pediatrics, Tekirdağ Çorlu District State Hospital, Ministry of Health, 59850 Tekirdağ, Turkey
| | - Metin Uyanık
- Department of Biochemistry, Tekirdağ Çorlu District State Hospital, Ministry of Health, 59850 Tekirdağ, Turkey
| | - Mehmet Tolga Köle
- Correspondence: Mehmet Tolga Köle, Department of Pediatrics, Kartal Dr. Lütfi Kırdar City Hospital, University of Health Science, Şemsi Denizer Cad. E-5 Karayolu Cevizli Mevkii, 34890 Kartal/İstanbul, Turkey. Tel: +90-506-8564988. E-mail <>
| | - Kemal Pişmişoğlu
- Department of Pediatrics, Kartal Dr. Lütfi Kırdar City Hospital, University of Health Science, 34865 Istanbul, Turkey
| |
Collapse
|
21
|
Müller J, Szűcs-Farkas D, Szegedi I, Csóka M, Garami M, Tiszlavicz LG, Hauser P, Kriván G, Csanádi K, Ottóffy G, Nagy B, Kiss C, Kovács G. Clinical Course of COVID-19 Disease in Children Treated With Neoplastic Diseases in Hungary. Pathol Oncol Res 2022; 28:1610261. [PMID: 35431663 PMCID: PMC9008132 DOI: 10.3389/pore.2022.1610261] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 03/01/2022] [Indexed: 12/25/2022]
Abstract
We report on children with cancer in Hungary suffering from COVID-19, surveying a 13-months-long period of time. We performed a retrospective clinical trial studying the medical documentation of children treated in seven centers of the Hungarian Pediatric Oncology-Hematology Group. About 10% of children admitted to tertiary hemato-oncological centers for anti-neoplastic treatment or diagnosis for de novo malignancies were positive for SARS-CoV-2 infection. Nearly two-thirds of the infected patients were asymptomatic or had only mild symptoms but showed seropositivity by 1–4.5 months after positive PCR. One third of the SARS-CoV-2-positive children were hospitalized due to symptomatic COVID-19. Five children required antiviral treatment with remdesivir. One child was referred to the intensive care unit, requiring intubation and mechanical ventilation. Delay in the scheduled anti-cancer treatment did not exceed 2 weeks in the majority (89%) of cases. There was only one patient requiring treatment deferral longer than a month. There was no COVID-19-related death in patients under 18 years of age, and nor was multisystem inflammatory syndrome diagnosed. In conclusion, SARS-CoV-2 infection did not represent an untoward risk factor among children with cancer in Hungary.
Collapse
Affiliation(s)
- Judit Müller
- Second Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Dóra Szűcs-Farkas
- Department of Pediatrics, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - István Szegedi
- Department of Pediatrics, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Monika Csóka
- Second Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Miklós Garami
- Second Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | | | - Péter Hauser
- Haematology/Oncology and Pediatric Bone Marrow Transplantation Unit, Child Health Centre, Borsod-Abauj-Zemplen County Hospital, Miskolc, Hungary
| | - Gergely Kriván
- Pediatric Bone Marrow Transplantation Department, South-Pest Centrum Hospital, Budapest, Hungary
| | - Krisztina Csanádi
- Hemato-Oncology Unit, Heim Pal Children's Hospital, Budapest, Hungary
| | - Gábor Ottóffy
- Department of Pediatrics, University of Pecs, Pecs, Hungary
| | - Béla Nagy
- Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Csongor Kiss
- Department of Pediatrics, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Gábor Kovács
- Second Department of Pediatrics, Semmelweis University, Budapest, Hungary
| |
Collapse
|
22
|
Abstract
BACKGROUND/OBJECTIVES Infections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may be associated with febrile seizures, but the overall frequency and outcomes are unknown. The objectives of this study are to (1) determine the frequency of pediatric subjects diagnosed with febrile seizures and COVID-19, (2) evaluate patient characteristics, and (3) describe the treatments (medications and need for invasive mechanical ventilation) applied. METHODS This was a retrospective study utilizing TriNetX electronic health record data. We included subjects ranging from 0 to 5 years of age with a diagnosis of febrile seizures (R56.00, R56.01) and COVID-19 (U07.1). We extracted the following data: age, race, ethnicity, diagnostic codes, medications, laboratory results, and procedures. RESULTS During this study period, 8854 pediatric subjects aged 0-5 years were diagnosed with COVID-19 among 34 health care organizations and 44 (0.5%) were also diagnosed with febrile seizures (simple, 30 [68.2%]; complex, 14 [31.8%]). The median age was 1.5 years (1, 2), there were no reported epilepsy diagnoses, and a proportion required hospitalization (11; 25.0%) and critical care services (4; 9.1%). CONCLUSIONS COVID-19 infections in children can be associated with febrile seizures. In our study, 0.5% of COVID-19 subjects were diagnosed with febrile seizures and approximately 9% of subjects were reported to require critical care services. Febrile seizures, although serious, are not a commonly diagnosed neurologic manifestation of COVID-19.
Collapse
Affiliation(s)
- Katsiah Cadet
- Penn State College of Medicine, Hershey, PA, USA,Katsiah Cadet, BS, Penn State College of Medicine, 500 University Drive, PO Box 850, Hershey, PA 17033-0850, USA.
| | - Jessica Boegner
- Pediatrics, Department of Pediatrics, Penn State Hershey Children’s Hospital, Hershey, PA, USA
| | - Gary D. Ceneviva
- Pediatric Critical Care Medicine, Department of Pediatrics, Penn State Hershey Children’s Hospital, Hershey, PA, USA
| | - Neal J. Thomas
- Pediatric Critical Care Medicine, Department of Pediatrics, Penn State Hershey Children’s Hospital, Hershey, PA, USA,Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Conrad Krawiec
- Pediatric Critical Care Medicine, Department of Pediatrics, Penn State Hershey Children’s Hospital, Hershey, PA, USA
| |
Collapse
|
23
|
Solmaz A, Karataş H, Ercan TMF, Erat T, Solmaz F, Kandemir H. Anxiety in Paediatric Patients Diagnosed with COVID-19 and the Affecting Factors. J Trop Pediatr 2022; 68:6541602. [PMID: 35238388 PMCID: PMC8903507 DOI: 10.1093/tropej/fmac018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Children may be greatly affected by events that increase stress in individuals in general and are reported as the vulnerable groups during the coronavirus disease-19 (COVID-19) pandemic. But most of the studies in the literature investigating the mental effects of the pandemic on children were conducted with healthy children and limited study has evaluated the effect on children diagnosed with COVID-19. The aim of this study is to determine the anxiety level in paediatric patients diagnosed with COVID-19 and the affecting factors. METHODS This descriptive study was conducted with 292 children aged 8-18 years who were diagnosed with COVID-19. Data were collected using the Descriptive Characteristics Questionnaire and the Screen for Child Anxiety Related Emotional Disorders (SCARED). Interviews were held by phone. RESULTS Males were 51.4% of participants, the mean age was 16.04 ± 1.93. 84.1% of them had a chronic disease; the transmission source was family/relatives/friends for 41.1%. By social isolation, 49.3% were affected and 33.2% were affected by disease symptoms the most in this process. The most common symptoms were headache (61.6%), and asthenia (59.9%). Mean anxiety scale score was 25.5 ± 14.37. The effect of gender, number of symptoms and transmission source on anxiety score was significant (p < 0.05). CONCLUSION Paediatric patients diagnosed with COVID-19 were found to have high anxiety levels. It is recommended to re-evaluate the duration of children's social participation and support the management of COVID-19 symptoms that affect their anxiety level.
Collapse
Affiliation(s)
- Abdullah Solmaz
- Department of Pediatrics, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Hülya Karataş
- Pediatric Nursing Department, Faculty of Health Sciences, Harran University, Sanliurfa, Turkey,Correspondence: Hülya Karataş, Pediatric Nursing Department, Faculty of Health Sciences, Harran University, Sanliurfa, Turkey. E-mail <>
| | | | - Tuğba Erat
- Department of Pediatric Infectious Diseases, Sanliurfa Egitim ve Arastirma Hastanesi, Sanliurfa, Turkey
| | - Filiz Solmaz
- Department of Nursing, Faculty of Health Sciences, Harran University, Sanliurfa, Turkey
| | - Hasan Kandemir
- Department of Child and Adolescent Psychiatry, Celal Bayar University, Manisa, Turkey
| |
Collapse
|
24
|
Blazkova J, Skalicky P, Bradac O, Benes V. Cerebral venous sinus thrombosis in infant with COVID-19. Acta Neurochir (Wien) 2022; 164:853-858. [PMID: 35043266 PMCID: PMC8766351 DOI: 10.1007/s00701-022-05116-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 01/06/2022] [Indexed: 12/17/2022]
Abstract
We present a rare case of cerebral venous sinus thrombosis in a COVID-19-positive, 2-month-old infant, to this day the youngest described patient with this rare combination of findings. He was hospitalized with focal seizures. The first brain imaging showed subdural hematoma and focal ischemic changes. The subdural hematoma was successfully evacuated. The control imaging, done due to lethargy, showed an extensive cerebral venous sinus thrombosis. The thrombosis was managed with low molecular weight heparin leading to clinical and radiological improvement. With this case report, we would like to add to the information pool of COVID-19 neurological manifestations in children, particularly those younger than 1 year.
Collapse
Affiliation(s)
- Jana Blazkova
- Department of Neurosurgery, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, V Uvalu 84, Prague, 15600, Czech Republic
| | - Petr Skalicky
- Department of Neurosurgery, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, V Uvalu 84, Prague, 15600, Czech Republic
- Department of Neurosurgery and Neurooncology, 1st Faculty of Medicine, Charles University in Prague and Military University Hospital, Prague, Czech Republic
| | - Ondrej Bradac
- Department of Neurosurgery, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, V Uvalu 84, Prague, 15600, Czech Republic.
- Department of Neurosurgery and Neurooncology, 1st Faculty of Medicine, Charles University in Prague and Military University Hospital, Prague, Czech Republic.
| | - Vladimir Benes
- Department of Neurosurgery, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, V Uvalu 84, Prague, 15600, Czech Republic
| |
Collapse
|
25
|
Amir Yazdani P, St-Jean ML, Matovic S, Spahr A, Tran LT, Boucher RM, Poulin C, Osterman B, Srour M, Rosenblatt B, Chenier S, Soucy JF, Laberge AM, Braverman N, D’Agostino MD, Nguyen CTE, Morsa M, Bernard G. Experience of Parents of Children with Genetically Determined Leukoencephalopathies Regarding the Adapted Health Care Services During the COVID-19 Pandemic. J Child Neurol 2022; 37:237-245. [PMID: 34986037 PMCID: PMC9066235 DOI: 10.1177/08830738211065317] [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] [Indexed: 11/15/2022]
Abstract
Parents of children with genetically determined leukoencephalopathies play a major role in their children's health care. Because of the COVID-19 pandemic, many health care services were suspended, delayed or delivered remotely with telemedicine. We sought to explore the experience of parents of children with genetically determined leukoencephalopathies during the pandemic given the adapted health care services. We conducted semistructured interviews with 13 parents of 13 affected children. Three main themes were identified using thematic analysis: perceived impact of COVID-19 on health care services, benefits and challenges of telemedicine, and expectations of health care after the pandemic. Parents perceived a loss/delay in health care services while having a positive response to telemedicine. Parents wished telemedicine would remain in their care after the pandemic. This is the first study assessing the impact of COVID-19 on health care services in this population. Our results suggest that parents experience a higher level of stress owing to the shortage of services and the children's vulnerability.
Collapse
Affiliation(s)
- Pouneh Amir Yazdani
- Child Health and Human Development Program, Research Institute of the McGill University Health Center, Montréal, Québec, Canada,Department of Neurology and Neurosurgery, McGill University, Montréal, Québec Canada,Department of Pediatrics, McGill University, Montréal, Québec, Canada,Université Laval, Québec, Québec, Canada,Geneviève Bernard, MD, MSc, FRCPc; Research Institute of the McGill University Health Centre, 1001 boul Décarie, Montréal, QC H4A 3J1, Canada.
| | - Marie-Lou St-Jean
- Child Health and Human Development Program, Research Institute of the McGill University Health Center, Montréal, Québec, Canada,Department of Neurology and Neurosurgery, McGill University, Montréal, Québec Canada,Department of Pediatrics, McGill University, Montréal, Québec, Canada,Université de Montréal, Montréal, Québec, Canada
| | - Sara Matovic
- Child Health and Human Development Program, Research Institute of the McGill University Health Center, Montréal, Québec, Canada,Department of Neurology and Neurosurgery, McGill University, Montréal, Québec Canada,Department of Pediatrics, McGill University, Montréal, Québec, Canada
| | - Aaron Spahr
- Child Health and Human Development Program, Research Institute of the McGill University Health Center, Montréal, Québec, Canada,Department of Neurology and Neurosurgery, McGill University, Montréal, Québec Canada,Department of Pediatrics, McGill University, Montréal, Québec, Canada
| | - Luan T. Tran
- Child Health and Human Development Program, Research Institute of the McGill University Health Center, Montréal, Québec, Canada,Department of Neurology and Neurosurgery, McGill University, Montréal, Québec Canada,Department of Pediatrics, McGill University, Montréal, Québec, Canada
| | - Renée-Myriam Boucher
- Department of Pediatrics, Division of Pediatric Neurology, Centre Hospitalier de l’Université Laval, Québec, Canada
| | - Chantal Poulin
- Department of Neurology and Neurosurgery, McGill University, Montréal, Québec Canada,Department of Pediatrics, McGill University, Montréal, Québec, Canada
| | - Bradley Osterman
- Department of Neurology and Neurosurgery, McGill University, Montréal, Québec Canada,Department of Pediatrics, McGill University, Montréal, Québec, Canada
| | - Myriam Srour
- Child Health and Human Development Program, Research Institute of the McGill University Health Center, Montréal, Québec, Canada,Department of Neurology and Neurosurgery, McGill University, Montréal, Québec Canada,Department of Pediatrics, McGill University, Montréal, Québec, Canada
| | - Bernard Rosenblatt
- Department of Neurology and Neurosurgery, McGill University, Montréal, Québec Canada,Department of Pediatrics, McGill University, Montréal, Québec, Canada
| | - Sébastien Chenier
- Department of Medical Genetics, University of Sherbrooke, Sherbrooke, Québec, Canada
| | - Jean-Francois Soucy
- Department of Pediatrics, Université de Montréal, Montréal, Québec, Canada,Medical Genetics Division, Centre Hospitalier Universitaire Sainte-Justine, Montréal, Québec, Canada
| | - Anne-Marie Laberge
- Department of Pediatrics, Université de Montréal, Montréal, Québec, Canada,Medical Genetics Division, Centre Hospitalier Universitaire Sainte-Justine, Montréal, Québec, Canada
| | - Nancy Braverman
- Child Health and Human Development Program, Research Institute of the McGill University Health Center, Montréal, Québec, Canada,Department of Pediatrics, McGill University, Montréal, Québec, Canada,Department of Human Genetics, McGill University, Montreal, Québec, Canada,Division of Medical Genetics, Montreal Children's Hospital, Montréal, Québec, Canada,Department of Specialized Medicine, Division of Medical Genetics, McGill University Health Centre, Montréal, Québec, Canada
| | - Maria Daniela D’Agostino
- Department of Human Genetics, McGill University, Montreal, Québec, Canada,Department of Specialized Medicine, Division of Medical Genetics, McGill University Health Centre, Montréal, Québec, Canada
| | - Cam-Tu Emilie Nguyen
- Department of Neurosciences and Pediatrics, Division of Pediatric Neurology, Centre Hospitalier Universitaire Sainte-Justine, Montréal, Québec, Canada
| | - Maxime Morsa
- Université de Montréal, Montréal, Québec, Canada,Sorbonne Paris Nord University, Laboratory of Health Education and Practice, Bobigny, France
| | - Geneviève Bernard
- Child Health and Human Development Program, Research Institute of the McGill University Health Center, Montréal, Québec, Canada,Department of Neurology and Neurosurgery, McGill University, Montréal, Québec Canada,Department of Pediatrics, McGill University, Montréal, Québec, Canada,Department of Human Genetics, McGill University, Montreal, Québec, Canada,Department of Specialized Medicine, Division of Medical Genetics, McGill University Health Centre, Montréal, Québec, Canada
| |
Collapse
|
26
|
Nagano K, Kamimura T, Kawai G. Interaction between a fluoroquinolone derivative and RNAs with a single bulge. J Biochem 2022; 171:239-244. [PMID: 34791286 DOI: 10.1093/jb/mvab124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 11/09/2021] [Indexed: 01/08/2023] Open
Abstract
Interaction analysis between small molecules and RNA as well as structure determination of RNA-small molecule complexes will be the clues to search for compounds that bind to specific mRNA or non-coding RNA in drug discovery. In this study, the RNA-binding ability of a fluoroquinolone derivative, KG022, was examined against single-residue bulge-containing hairpin RNAs as RNA models. Nuclear magnetic resonance analysis indicated that KG022 interacts with the RNAs in the vicinity of the bulge residue, with preferring C and G as the bulge residues. The solution structures of the RNA-KG022 complexes showed that the KG022 binds to the RNAs at the bulge-out regions. Each substituent in KG022 interacts with specific position of RNAs around the bulge-out region probably contributing the specificity of the binding. This work provides a novel member for the RNA-targeted small molecules.
Collapse
Affiliation(s)
- Konami Nagano
- Department of Life and Environmental Sciences, Graduate School of Engineering, Chiba Institute of Technology, Chiba 275-0016, Japan
| | | | - Gota Kawai
- Department of Life and Environmental Sciences, Graduate School of Engineering, Chiba Institute of Technology, Chiba 275-0016, Japan
| |
Collapse
|
27
|
Rustagi V, Bajaj M, Tanvi, Singh P, Aggarwal R, AlAjmi MF, Hussain A, Hassan MI, Singh A, Singh IK. Analyzing the Effect of Vaccination Over COVID Cases and Deaths in Asian Countries Using Machine Learning Models. Front Cell Infect Microbiol 2022; 11:806265. [PMID: 35223534 PMCID: PMC8877421 DOI: 10.3389/fcimb.2021.806265] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 12/16/2021] [Indexed: 12/15/2022] Open
Abstract
Coronavirus Disease 2019 (COVID-19) is spreading across the world, and vaccinations are running parallel. Coronavirus has mutated into a triple-mutated virus, rendering it deadlier than before. It spreads quickly from person to person by contact and nasal or pharyngeal droplets. The COVID-19 database ‘Our World in Data’ was analyzed from February 24, 2020, to September 26, 2021, and predictions on the COVID positives and their mortality rate were made. Factors such as Vaccine data for the First and Second Dose vaccinated individuals and COVID positives that influence the fluctuations in the COVID-19 death ratio were investigated and linear regression analysis was performed. Based on vaccination doses (partial or complete vaccinated), models are created to estimate the number of patients who die from COVID infection. The estimation of variance in the datasets was investigated using Karl Pearson’s coefficient. For COVID-19 cases and vaccination doses, a quartic polynomial regression model was also created. This predictor model helps to predict the number of deaths due to COVID-19 and determine the susceptibility to COVID-19 infection based on the number of vaccine doses received. SVM was used to analyze the efficacy of models generated.
Collapse
|
28
|
COVID-19 and liver dysfunction: Epidemiology, association and potential mechanisms. Clin Res Hepatol Gastroenterol 2022; 46:101793. [PMID: 34428501 PMCID: PMC8380064 DOI: 10.1016/j.clinre.2021.101793] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/21/2021] [Accepted: 08/05/2021] [Indexed: 02/07/2023]
Abstract
Currently, there have been more than one hundred million confirmed cases of coronavirus disease 2019 (COVID-19), with two million deaths worldwide. This has caused a huge medical burden. Severe COVID-19 patients can experience multi-organ damage, including cardiac injury, kidney injury, and liver injury. About 2.0%-4.9% of COVID-19 cases involve patients with preexisting liver diseases. Additionally, preexisting liver diseases were reported and associated with severity (odds ratio (OR) or risk ratio (RR) = 1.48-1.70) and mortality (OR or RR = 1.08-2.65) among COVID-19 patients. Furthermore, the prevalence of liver injury was 16%-29% in COVID-19 patients. Higher prevalence of liver injury may worsen prognosis in patients (severity: OR or RR = 1.9-2.6; mortality: OR or RR = 1.1-4.0). The mechanisms of this association between liver injury and severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infection are complex, including direct cholangiocyte damage induced by SARS-COV-2, cytokine storm, and drug-induced liver injury. In particular, drug-induced liver injury may be the most important reason. This review discusses the epidemiology of COVID-19 and liver dysfunction as well as potential mechanisms underlying the association between COVID-19 and liver dysfunction or other preexisting liver diseases. However, the association between preexisting liver diseases and COVID-19 prognosis and potential mechanisms underlying these associations require further prospective studies.
Collapse
|
29
|
Gatti E, Piotto M, Lelii M, Pensabene M, Madini B, Cerrato L, Hassan V, Aliberti S, Bosis S, Marchisio P, Patria MF. Therapeutic Strategies for COVID-19 Lung Disease in Children. Front Pediatr 2022; 10:829521. [PMID: 35321012 PMCID: PMC8936419 DOI: 10.3389/fped.2022.829521] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 01/20/2022] [Indexed: 12/15/2022] Open
Abstract
The novel Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection has milder presentation in children than in adults, mostly requiring only supportive therapy. The immunopathogenic course of COVID-19 can be divided in two distinct but overlapping phases: the first triggered by the virus itself and the second one by the host immune response (cytokine storm). Respiratory failure or systemic involvement as Multisystem Inflammatory Syndrome in Children (MIS-C) requiring intensive care are described only in a small portion of infected children. Less severe lung injury in children could be explained by qualitative and quantitative differences in age-related immune response. Evidence on the best therapeutic approach for COVID-19 lung disease in children is lacking. Currently, the approach is mainly conservative and based on supportive therapy. However, in hospitalized children with critical illness and worsening lung function, antiviral therapy with remdesivir and immunomodulant treatment could be considered the "therapeutic pillars."
Collapse
Affiliation(s)
| | | | - Mara Lelii
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | | | | | | | - Stefano Aliberti
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, Milan, Italy.,Respiratory Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Milan, Italy
| | - Samantha Bosis
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paola Marchisio
- Università Degli Studi di Milano, Milan, Italy.,Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | |
Collapse
|
30
|
Abstract
BACKGROUND Coronavirus disease-2019 (COVID-19) is characterized predominantly by respiratory symptoms and has affected a small subset of children. Multisystem inflammatory syndrome in children (MIS-C) has been reported in children following COVID-19. There is increasing report that COVID-19 may also lead to neurologic manifestations. Cerebellar lesions may be observed in viral infections. CASE REPORT We report a child with MIS-C related to severe acute respiratory syndrome coronavirus 2, who developed cerebellar lesion during the disease course. Encephalopathy was the first central nervous system symptom. His consciousness improved but he developed clinical signs of cerebellar dysfunction including ataxia, dysarthria and nystagmus. Brain magnetic resonance imaging (MRI) revealed symmetrical pathological signal changes in both cerebellar hemispheres. CONCLUSION We demonstrated the first child with MIS-C to develop cerebellar lesion on brain MRI, suggestive of cerebellitis.
Collapse
|
31
|
CLINICAL CHARACTERISTICS OF COVID-19 IN CHILDREN OF DIFFERENT AGE GROUPS. WORLD OF MEDICINE AND BIOLOGY 2022. [DOI: 10.26724/2079-8334-2022-4-82-101-106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
|
32
|
Çiftel M, Ateş N, Yılmaz O. Investigation of endothelial dysfunction and arterial stiffness in multisystem inflammatory syndrome in children. Eur J Pediatr 2022; 181:91-97. [PMID: 34212240 PMCID: PMC8249181 DOI: 10.1007/s00431-021-04136-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/25/2021] [Accepted: 05/27/2021] [Indexed: 01/08/2023]
Abstract
Severe acute respiratory syndrome coronavirus 2 infection can result in multisystem inflammatory syndrome in children (MIS-C). MIS-C can lead to myocardial dysfunction, heart failure, and multiorgan failure; the primary finding is hyperinflammation. Endothelial dysfunction has not been evaluated in patients with MIS-C. We investigated endothelial dysfunction and arterial stiffness parameters in patients with MIS-C. The study included 38 pediatric patients (20 males and 18 females aged 4-17 years, mean age 8.89 years) with MIS-C. Thirty-eight age- and sex-matched healthy individuals were enrolled as the control group. Systolic and diastolic ventricular measurements and systolic and diastolic measurements of ascending aorta diameter were performed by M-mode echocardiography. Endothelial dysfunction was evaluated using flow-mediated dilation by measuring the brachial artery diameter with a high-resolution probe. The MIS-C group had lower flow-mediated dilation than did the controls. The MIS-C group had decreased aortic strain and aortic distensibility values and correlations between decreased flow-mediated dilation and reduced aortic strain, aortic distensibility, and reduced ejection fraction.Conclusion: The results show that patients with MIS-C had endothelial dysfunction and arterial stiffness. Furthermore, the degree of endothelial dysfunction correlated with reduced ejection fractions.What is Known:•Endothelial dysfunction and arterial stiffness are unknown in patients with MIS-C.•The effect of endothelial dysfunction and arterial stiffness on decreased cardiac function is unknown.What is New:•MIS-C patients have endothelial dysfunction and arterial stiffness.•There is a link between left ventricular dysfunction and reduced endothelial dysfunction in patients with MIS-C.
Collapse
Affiliation(s)
- Murat Çiftel
- Department of Pediatric Cardiology, Sanlıurfa Training and Research Hospital, Mah. Yenice Yolu No: 1, Yenice, Eyyübiye/Sanliurfa Turkey
| | - Nurgül Ateş
- Harran University, Şanlıurfa-Mardin Road Over 18.Km, Sanliurfa, Turkey
| | - Osman Yılmaz
- Department of Pediatric Cardiology, Etlik Training and Research Hospital, Ankara, Etlik, Turkey
| |
Collapse
|
33
|
Sharma R, Agarwal A, Ranjan A, Jayashree M, Kumar P. Mortality audit of COVID-19 infection among children. Indian J Med Res 2022; 155:505-509. [PMID: 36124499 PMCID: PMC9807188 DOI: 10.4103/ijmr.ijmr_2500_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Background & objectives As severe COVID-19 and mortality are not common in children, there is a scarcity of data regarding the cause of mortality in children infected with SARS-CoV-2. This study was aimed to describe the all-cause mortality and COVID-19 death (disease-specific mortality) in children with SARS-CoV-2 infection admitted to a paediatric COVID facility in a tertiary care centre. Methods Data with respect to clinical, epidemiological profile and causes of death in non-survivors (0-12 yr old) of SARS-CoV-2 infection admitted to a dedicated tertiary care COVID hospital in north India between April 2020 and June 2021 were retrieved and analyzed retrospectively. Results A total of 475 SARS-CoV-2-positive children were admitted during the study period, of whom 47 died [18 neonates, 14 post-neonatal infants and 15 children (1-12 yr of age)]. The all-cause mortality and COVID-19 death (disease-specific mortality) were 9.9 per cent (47 of 475) and 1.9 per cent (9 of 475), respectively. Underlying comorbidities were present in 35 (74.5%) children, the most common being prematurity and perinatal complications (n=11, 24%) followed by congenital heart disease (n=6, 13%). The common causes of death included septic shock in 10 (21%), COVID pneumonia/severe acute respiratory distress syndrome in nine (19%), neonatal illnesses in eight (17%), primary central nervous system disease in seven (15%) and congenital heart disease with complication in six (13%) children. Interpretation & conclusions Our results showed a high prevalence of underlying comorbidities and a low COVID-19 death (disease-specific mortality). Our findings highlight that mortality due to COVID-19 can be overestimated if COVID-19 death and all-cause mortality in children infected with SARS-CoV-2 are not separated. Standardized recording of cause of death in children with SARS-CoV-2 infection is important.
Collapse
Affiliation(s)
- Raman Sharma
- Division of Paediatric Emergency & Critical Care, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Ashish Agarwal
- Division of Paediatric Emergency & Critical Care, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Ankit Ranjan
- Division of Neonatology, Department of Paediatrics, Advanced Paediatrics Centre, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Muralidharan Jayashree
- Division of Paediatric Emergency & Critical Care, Postgraduate Institute of Medical Education & Research, Chandigarh, India,For correspondence: Dr Muralidharan Jayashree, Division of Paediatric Emergency & Critical Care, Department of Paediatrics, Advanced Paediatrics Centre, Postgraduate Institute of Medical Education & Research, Chandigarh 160 012, India e-mail:
| | - Praveen Kumar
- Division of Neonatology, Department of Paediatrics, Advanced Paediatrics Centre, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| |
Collapse
|
34
|
Okur DS. Clinical impact of COVID-19 on Turkish children with neurological and neuromuscular diseases: One center experience. Medicine (Baltimore) 2021; 100:e28401. [PMID: 34941179 PMCID: PMC8702014 DOI: 10.1097/md.0000000000028401] [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: 08/04/2021] [Accepted: 12/01/2021] [Indexed: 01/05/2023] Open
Abstract
This study aims to explore the effects of new type of coronavirus disease (COVID-19) in children with neurological and/or neuromuscular diseasesA retrospective study was conducted at State Hospital of Denizli. Pediatric patients diagnosed with COVID-19 who were hospitalized between March 18, 2020 and January 18, 2021 were included in the study. Children were divided into two groups: those with (group I) and without neurological and /or neuromuscular disorders (group II).Male cases were more than female cases in group I. The difference between group I and group II was significant in terms of seizure (47.3%; 1.7%), dyspnea (36.8%, 6.2%) and number of days with fever (2.6 ± 1.9; 1.58 ± 1.42) (P < .01, P < .01, P = .02). Hypoxemia (7, 11; 36.8%, 4.5%) and abnormal auscultation findings (8, 44; 42.1%, 18.1%) were more common in children in group I, hypertension was more common in group II (0, 8; 0%, 3.3%). Lung involvement of COVID-19 was found to be more severe in group I (P = .04). The frequency of hospitalization in the intensive care unit (P < .01) and application of noninvasive mechanical ventilation (NIMV) (P < .01); the number of days followed-up in the intensive care (P < .01) and in the hospital (P = .02) of the patients in group I were higher than those in group II.It is recognized that children with underlying neurological and/or neuromuscular diseases are severely affected by COVID-19.
Collapse
|
35
|
Iranian Pediatric COVID-19 Epidemiology and Clinical Characteristics. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2021; 2021:4914371. [PMID: 34925657 PMCID: PMC8674083 DOI: 10.1155/2021/4914371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 11/25/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Despite the worldwide spread of Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2), information about the epidemiological and clinical patterns of this infection is still largely unknown in children. In addition, the prevalence of this disease is still very high in some parts of the world, including Iran. Thus, this study aims to evaluate the epidemiological features, laboratory and imaging findings, and the type of treatments in children with novel coronavirus 2019 (COVID-19). METHOD This study is conducted from March 2020-March 2021 by using the medical records of hospitalized confirmed COVID-19 children younger than 18 years in five cities of Iran: Tehran, Ahwaz, Isfahan, Bandar-Abbas, and Khorramabad. In addition to demographic and epidemiological data, we also studied clinical signs and treatments. RESULTS In total 278 confirmed COVID-19 children, the average age was 5.3 years, and 59.4%were boys. A total of 37.8% had an underlying disease, in which the most common was a malignancy. The most common symptoms were fever and cough. In this group of pediatrics, some abnormal laboratory findings have been seen. GGO (Ground-Glass Opacity) had been diagnosed in 58.6% of children. 3.6% needed oxygen therapy with ventilators, and 83.09% had received antibiotic treatments with the majority of ceftriaxone. Also, 10% had got steroids. In this study, the mortality rate was 4.3%. CONCLUSION In this study, most of the children who died had an underlying disease, so timely care and action is important in them. Most children admitted to our study received antibiotics and were prescribed antivirals and steroids for a smaller number. Also, a small number of children received oxygen therapy, most of whom were in the age group of 1 to 5 years.
Collapse
|
36
|
MANDAL H. Achievements of the COVID-19 Turkey Platform in vaccine and drug development with an approach of "co-creation and succeeding together". Turk J Med Sci 2021; 51:3139-3149. [PMID: 34921721 PMCID: PMC8790050 DOI: 10.3906/sag-2112-178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 12/17/2021] [Indexed: 11/18/2022] Open
Abstract
Mobilizing the research ecosystem for accelerating vaccine and drug development has been an important reality of the pandemic. This article reviews the scientific advances that are attained by the COVID-19 Turkey Platform for vaccine and drug development against the SARS-CoV-2 virus. The platform that is coordinated by the Scientific and Technological Research Council of Turkey is established with a "co-creation and succeeding together" approach, which involves 436 researchers across 49 different institutions working on 17 vaccine and drug development projects in total. Recent advances of the COVID-19 Turkey Platform include the fourth virus-like particle-based vaccine candidate in the world to enter clinical studies based on the World Health Organization COVID-19 vaccine tracker that is currently completing phase 2 clinical studies on the path towards initiating phase 3 clinical studies. Moreover, an adjuvanted inactivated vaccine candidate and two drug candidates that have been identified through the virtual scanning of more than 20,000 molecules are currently in clinical studies. Other vaccines and drug candidates involve additional innovative aspects, and a locally synthesized drug is found to have an impact on COVID-19. This review article discusses the advances that are achieved by the COVID-19 Turkey Platform from the ecosystem perspective, emphasizing the important scientific advances that have been achieved in the field of medical sciences.
Collapse
Affiliation(s)
- Hasan MANDAL
- The Scientific and Technological Research Council of Turkey, AnkaraTurkey
| |
Collapse
|
37
|
Immunological evaluation of an inactivated SARS-CoV-2 vaccine in rhesus macaques. MOLECULAR THERAPY-METHODS & CLINICAL DEVELOPMENT 2021; 23:108-118. [PMID: 34462721 PMCID: PMC8387130 DOI: 10.1016/j.omtm.2021.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 08/10/2021] [Indexed: 12/05/2022]
Abstract
Because of the relatively limited understanding of coronavirus disease 2019 (COVID-19) pathogenesis, immunological analysis for vaccine development is needed. Mice and macaques were immunized with an inactivated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine prepared by two inactivators. Various immunological indexes were tested, and viral challenges were performed on day 7 or 150 after booster immunization in monkeys. This inactivated SARS-CoV-2 vaccine was produced by sequential inactivation with formaldehyde followed by propiolactone. The various antibody responses and specific T cell responses to different viral antigens elicited in immunized animals were maintained for longer than 150 days. This comprehensive immune response could effectively protect vaccinated macaques by inhibiting viral replication in macaques and substantially alleviating immunopathological damage, and no clinical manifestation of immunopathogenicity was observed in immunized individuals during viral challenge. This candidate inactivated vaccine was identified as being effective against SARS-CoV-2 challenge in rhesus macaques.
Collapse
|
38
|
Ergün E, Sözduyar S, Gurbanova A, Serttürk F, Çiftçi E, Özdemir H, Arga G, Konca HK, Çınar G, Akdemir Kalkan İ, Gülten E, Selvi Can Ö, Şen Akova B, Suat Fitöz Ö, Vatansever G, Tekin D, Göllü G, Bingöl-Koloğlu M, Yağmurlu A, Çakmak M, Ateş U. An indirect effect of COVID-19 pandemic: Increased pediatric perforated appendicitis rate due to delayed admission. Turk J Surg 2021; 37:318-323. [PMID: 35677491 PMCID: PMC9130943 DOI: 10.47717/turkjsurg.2021.5277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 10/06/2021] [Indexed: 11/23/2022]
Abstract
Objectives Appendicitis is a common surgical emergency among children. The coronavirus pandemic affected the system of hospitals more than any other field, and great amount of people were concerned about visiting the hospitals for any reason. In this study, it was aimed to evaluate the profile of appendicitis by emphasizing perforated and acute appendicitis in the pandemic period and to compare the rates with previous three years. Material and Methods Charts of the children who underwent laparoscopic appendectomy due to appendicitis between March 11-September 30 between 2017-2020 were retrospectively analyzed in terms of demographic data, duration of symptoms, duration between hospital admission and surgery, radiologic imaging and perioperative outcomes. Results This study includes 467 children who underwent laparoscopic appendectomy. There were 97 procedures in 2020, 111 in 2019, 146 in 2018 and 113 in 2017. Multiple comparison tests revealed that age did not show difference; but onset of symptoms in admission (p= 0.004), hospitalization time before surgery (p <0.001), total hospitalization time (p <0.001) showed statistically significant difference between years. Pairwise comparisons showed that these parameters were increased in 2020 compared to other years. Perforated appendicitis rate was significantly increased in 2020 when compared to previous years. Conclusion Although there is no direct relation between appendicitis and COVID-19 infection in the current knowledge, perforated appendicitis was found to be increased in children during the COVID pandemic. Reason of the higher rate of perforated appendicitis may be multifactorial; however, the pandemic appears to have a role in increased morbidity in children with appendicitis indirectly due to delay of hospital admissions.
Collapse
Affiliation(s)
- Ergun Ergün
- Department of Pediatric Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Sümeyye Sözduyar
- Department of Pediatric Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Aynur Gurbanova
- Department of Pediatric Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Fırat Serttürk
- Department of Pediatric Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Ergin Çiftçi
- Division of Pediatric Infectious Disease, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Halil Özdemir
- Division of Pediatric Infectious Disease, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Gül Arga
- Division of Pediatric Infectious Disease, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Hatice Kübra Konca
- Division of Pediatric Infectious Disease, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Güle Çınar
- Department of Infectious Diseases and Clinical Microbiology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - İrem Akdemir Kalkan
- Department of Infectious Diseases and Clinical Microbiology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Ezgi Gülten
- Department of Infectious Diseases and Clinical Microbiology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Özlem Selvi Can
- Department of Anesthesia and Reanimation, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Birsel Şen Akova
- Division of Pediatric Radiology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Ömer Suat Fitöz
- Division of Pediatric Radiology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Göksel Vatansever
- Division of Pediatric Emergency, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Deniz Tekin
- Division of Pediatric Emergency, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Gülnur Göllü
- Department of Pediatric Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Meltem Bingöl-Koloğlu
- Department of Pediatric Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Aydın Yağmurlu
- Department of Pediatric Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Murat Çakmak
- Department of Pediatric Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Ufuk Ateş
- Department of Pediatric Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
| |
Collapse
|
39
|
Dogra N, Ledesma-Feliciano C, Sen R. Developmental Aspects of SARS-CoV-2, Potential Role of Exosomes and Their Impact on the Human Transcriptome. J Dev Biol 2021; 9:54. [PMID: 34940501 PMCID: PMC8708617 DOI: 10.3390/jdb9040054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/12/2021] [Accepted: 11/23/2021] [Indexed: 12/21/2022] Open
Abstract
With over 4.8 million deaths within 2 years, time is of the essence in combating COVID-19. The infection now shows devastating impacts on the younger population, who were not previously predicted to be vulnerable, such as in the older population. COVID-19-related complications have been reported in neonates whose mothers were infected with SARS-CoV-2 during pregnancy, and in children who get infected. Hence, a deeper understanding of the pathophysiology of COVID-19 during various developmental stages and placental transmission is essential. Although a connection has not yet been established between exosomal trafficking and the placental transmission of COVID-19, reports indicate that SARS-CoV-2 components may be trafficked between cells through exosomes. As the infection spreads, the transcriptome of cells is drastically perturbed, e.g., through the severe upregulation of several immune-related genes. Consequently, a major outcome of COVID-19 is an elevated immune response and the detection of viral RNA transcripts in host tissue. In this direction, this review focuses on SARS-CoV-2 virology, its in utero transmission from infected pregnant mothers to fetuses, SARS-CoV-2 and exosomal cellular trafficking, transcriptomic impacts, and RNA-mediated therapeutics against COVID-19. Future research will establish stronger connections between the above processes to develop diagnostic and therapeutic solutions towards COVID-19 and similar viral outbreaks.
Collapse
Affiliation(s)
- Navneet Dogra
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Carmen Ledesma-Feliciano
- Division of Infectious Diseases, School of Medicine, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA;
| | - Rwik Sen
- Active Motif, Incorporated, Carlsbad, CA 92008, USA
| |
Collapse
|
40
|
Tseng YS, Tilford B, Sethuraman U, Cashen K. Combined Hyperglycemic Hyperosmolar Syndrome and Diabetic Ketoacidosis Associated with COVID-19 in a Pediatric Patient. Case Rep Crit Care 2021; 2021:6429710. [PMID: 38442727 PMCID: PMC8627355 DOI: 10.1155/2021/6429710] [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: 06/07/2021] [Revised: 09/15/2021] [Accepted: 10/13/2021] [Indexed: 01/08/2023] Open
Abstract
Although most children with coronavirus disease 2019 (COVID-19) are asymptomatic or only with mild symptoms, many symptomatic children still require admission to the intensive care unit. Multiple cases of diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic syndrome (HHS) associated with COVID-19 have been reported in adults. However, to our knowledge, only few similar cases have been published in the pediatric population. We report one of the first few severe cases of mixed HHS with DKA associated with COVID-19 in an adolescent. Our patient was successfully treated with intravenous immunoglobulin, Remdesivir, and methylprednisolone. As the pandemic continues, clinicians should be aware of this syndrome and consider early use of Remdesivir and corticosteroids. Further studies are required to understand the pathophysiology of this syndrome occurring with COVID-19.
Collapse
Affiliation(s)
- Yu Shan Tseng
- Department of Pediatrics, Division of Pediatric Critical Care, Children's Hospital of Michigan, Detroit, Michigan, USA
| | - Bradley Tilford
- Department of Pediatrics, Division of Pediatric Critical Care, Central Michigan University/Children's Hospital of Michigan, Detroit, Michigan, USA
| | - Usha Sethuraman
- Department of Pediatrics, Division of Pediatric Emergency Medicine, Central Michigan University/Children's Hospital of Michigan, Detroit, Michigan, USA
| | - Katherine Cashen
- Department of Pediatrics, Division of Pediatric Critical Care, Central Michigan University/Children's Hospital of Michigan, Detroit, Michigan, USA
| |
Collapse
|
41
|
Wang L, Li G, Yuan C, Yang Y, Ling G, Zheng J, Zhou Y, Zhang T, Lin W, Lin Z. Progress in the Diagnosis and Treatment of COVID-19 in Children: A Review. Int J Gen Med 2021; 14:8097-8108. [PMID: 34795516 PMCID: PMC8594783 DOI: 10.2147/ijgm.s335888] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 10/27/2021] [Indexed: 12/14/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) has been circulating in many countries around the world, characterized by long incubation period, strong infectivity, strong variability, high population susceptibility and diversified transmission methods. Its causative agent is severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Compared with adult patients, the clinical manifestations of COVID-19 in children are often dominated by mild or asymptomatic infections, but children are also important virus carriers and play an important role in the transmission of the virus. In addition, some children will show excessive inflammatory response and experience serious complications such as multisystem inflammatory syndrome in children (MIS-C). At present, the research on COVID-19 in children is still imperfect. This article will review epidemiological characteristics, the mechanism of action, variant characteristics, clinical manifestations, auxiliary examinations and treatment of children with COVID-19, in order to provide help for the diagnosis, treatment and research of children with COVID-19.
Collapse
Affiliation(s)
- Libo Wang
- Department of Clinical Medicine, Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Gan Li
- Department of Clinical Medicine, Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Chang Yuan
- Department of Clinical Medicine, Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Yuele Yang
- Department of Clinical Medicine, Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Gongxia Ling
- Department of Clinical Medicine, Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Jinyu Zheng
- Department of Clinical Medicine, Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Yiyang Zhou
- Department of Clinical Medicine, Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Tianlei Zhang
- Department of Clinical Medicine, Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Wei Lin
- Department of Pediatrics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Zhenlang Lin
- Department of Pediatrics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People's Republic of China
| |
Collapse
|
42
|
Akcan Yildiz L, Unal B, Aydin O, Oygar PD, Lacinel Gurlevic S, Gungor E, Kaynak MO, Korgal N, Kukul MG, Ilbay S, Alp A, Ozsurekci Y, Teksam O. Respiratory Tract Pathogens in the COVID-19 Era: Data from a Pediatric Emergency Department. J PEDIAT INF DIS-GER 2021. [DOI: 10.1055/s-0041-1736216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Abstract
Objective The frequency of coinfections in pediatric Coronavirus disease 2019 (COVID-19) cases and their impact on the clinical course are not fully understood. We aimed to investigate the viral and bacterial respiratory pathogens in children admitted to the pediatric emergency department (PED), their clinical course, and the presence of coinfections during the early months of the COVID-19 pandemic.
Methods Clinical, laboratory and radiological findings, viral and bacterial pathogens detected by multiplex polymerase chain reaction (PCR) tests in nasopharyngeal swabs, clinical course, and treatments of all children who were tested for severe acute respiratory coronavirus 2 (SARS-CoV-2) at the PED between March 16 and May 15, 2020, were recorded. SARS-CoV-2 PCR-positive and negative groups were compared.
Results Out of 570 patients tested for SARS-CoV-2 during the study period, 43 were found positive (7.5%). Non-SARS-CoV-2 viral pathogens were more common in the SARS-CoV-2 PCR-negative group than the SARS-CoV-2 PCR-positive group (13.2%, n = 68 versus 4.7%, n = 2), but this result was not statistically significant. Leukocyte, neutrophil, lymphocyte, and platelet counts were lower in SARS-CoV-2 PCR-positive group. Bacterial panel positivity was significantly higher in the SARS-CoV-2 PCR-positive group compared with the SARS-CoV-2 PCR-negative group (52%, n = 12 versus 28%, n = 91; p < 0.05). The presence of coinfection did not alter the course of therapy in SARS-CoV-2 PCR-positive cases.
Conclusion While viral coinfections were rare, bacterial panel positivity was common in children with COVID-19, but this had not influenced management decisions. The limitations of the tests should be kept in mind while interpreting the results.
Collapse
Affiliation(s)
- Leman Akcan Yildiz
- Department of Pediatric Emergency, Hacettepe University Ihsan Dogramaci Children's Hospital, Ankara, Turkey
| | - Bahri Unal
- Department of Pediatric Emergency, Hacettepe University Ihsan Dogramaci Children's Hospital, Ankara, Turkey
| | - Orkun Aydin
- Department of Pediatric Emergency, Hacettepe University Ihsan Dogramaci Children's Hospital, Ankara, Turkey
| | - Pembe Derin Oygar
- Department of Pediatric Infectious Diseases, Hacettepe University Ihsan Dogramaci Children's Hospital, Ankara, Turkey
| | - Sibel Lacinel Gurlevic
- Department of Pediatric Infectious Diseases, Hacettepe University Ihsan Dogramaci Children's Hospital, Ankara, Turkey
| | - Emre Gungor
- Department of Pediatric Emergency, Hacettepe University Ihsan Dogramaci Children's Hospital, Ankara, Turkey
| | - Mustafa Oguz Kaynak
- Department of Pediatric Emergency, Hacettepe University Ihsan Dogramaci Children's Hospital, Ankara, Turkey
| | - Nilay Korgal
- Department of General Pediatrics, Hacettepe University Ihsan Dogramaci Children's Hospital, Ankara, Turkey
| | - Musa Gurel Kukul
- Department of Pediatric Infectious Diseases, Hacettepe University Ihsan Dogramaci Children's Hospital, Ankara, Turkey
| | - Sare Ilbay
- Department of Pediatric Infectious Diseases, Hacettepe University Ihsan Dogramaci Children's Hospital, Ankara, Turkey
| | - Alpaslan Alp
- Department of Clinical Microbiology, Hacettepe University Medical School, Ankara, Turkey
| | - Yasemin Ozsurekci
- Department of Pediatric Infectious Diseases, Hacettepe University Ihsan Dogramaci Children's Hospital, Ankara, Turkey
| | - Ozlem Teksam
- Department of Pediatric Emergency, Hacettepe University Ihsan Dogramaci Children's Hospital, Ankara, Turkey
| |
Collapse
|
43
|
Serra AM, Ventura AMC, Xavier LF, Simões AB, Duarte-Neto AN. SARS-CoV-2 identification in an acute appendicitis case: Acute abdomen as manifestation of Multisystem Inflammatory Syndrome in a child with COVID-19. Braz J Infect Dis 2021; 25:101651. [PMID: 34774470 PMCID: PMC8580246 DOI: 10.1016/j.bjid.2021.101651] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/28/2021] [Accepted: 10/17/2021] [Indexed: 11/16/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) pandemic is a global health emergency. The clinical course of COVID-19 in children is mild in most of the cases, but multisystem inflammatory syndrome in children (MIS-C) is recognized as a potential life-threatening complication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Acute abdomen as a presentation of COVID-19 is rare, and its correlation to COVID-19 features and prognosis remains undetermined. Herein, we describe a case of appendicitis in a child with confirmed diagnosis of COVID-19 and subsequent SARS-CoV-2 identification in appendix tissue.
Collapse
Affiliation(s)
- Amanda Munhoz Serra
- Unidade de Terapia Intensiva Pediátrica, Departamento de Pediatria, Hospital Universitário da Universidade de São Paulo, SP, Brazil.
| | - Andréa Maria Cordeiro Ventura
- Unidade de Terapia Intensiva Pediátrica, Departamento de Pediatria, Hospital Universitário da Universidade de São Paulo, SP, Brazil
| | - Lucas Freitas Xavier
- Unidade de Terapia Intensiva Pediátrica, Departamento de Pediatria, Hospital Universitário da Universidade de São Paulo, SP, Brazil
| | - Angélica Braz Simões
- Departamento de Patologia, Hospital Universitário da Universidade de São Paulo, SP, Brazil
| | | |
Collapse
|
44
|
Banga Ndzouboukou JL, Zhang YD, Lei Q, Lin XS, Yao ZJ, Fu H, Yuan LY, Fan XL. Human IgM and IgG Responses to an Inactivated SARS-CoV-2 Vaccine. Curr Med Sci 2021; 41:1081-1086. [PMID: 34741251 PMCID: PMC8571008 DOI: 10.1007/s11596-021-2461-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 10/13/2021] [Indexed: 12/28/2022]
Abstract
Objective The ongoing COVID-19 pandemic warrants accelerated efforts to test vaccine candidates. To explore the influencing factors on vaccine-induced effects, antibody responses to an inactivated SARS-CoV-2 vaccine in healthy individuals who were not previously infected by COVID-19 were assessed. Methods All subjects aged 18–60 years who did not have SARS-CoV-2 infection at the time of screening from June 19, 2021, to July 02, 2021, were approached for inclusion. All participants received two doses of inactivated SARS-CoV-2 vaccine. Serum IgM and IgG antibodies were detected using a commercial kit after the second dose of vaccination. A positive result was defined as 10 AU/mL or more and a negative result as less than 10 AU/mL. This retrospective study included 97 infection-naïve individuals (mean age 35.6 years; 37.1% male, 62.9% female). Results The seropositive rates of IgM and IgG antibody responses elicited after the second dose of inactivated SARS-CoV-2 vaccine were 3.1% and 74.2%, respectively. IgG antibody levels were significantly higher than IgM levels (P<0.0001). Sex had no effect on IgM and IgG antibody response after the second dose. The mean anti-IgG level in older persons (⩾42 years) was significantly lower than that of younger recipients. There was a significantly lower antibody level at > 42 days compared to that at 0–20 days (P<0.05) and 21–31 days (P<0.05) after the second dose. Conclusion IgG antibody response could be induced by inactivated SARS-CoV-2 vaccine in healthy individuals (>18 years), which can be influenced by age and detection time after the second dose of vaccination.
Collapse
Affiliation(s)
- Jo-Lewis Banga Ndzouboukou
- Department of Pathogen Biology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
| | - Yan-di Zhang
- Department of Pathogen Biology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
| | - Qing Lei
- Department of Pathogen Biology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
| | - Xiao-song Lin
- Department of Pathogen Biology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
| | - Zong-jie Yao
- Department of Pathogen Biology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
| | - Hui Fu
- Department of Pathogen Biology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
| | - Le-yong Yuan
- Department of Clinical Laboratory, Southern University of Science and Technology Hospital, Shenzhen, 518055 China
- Hubei Key Laboratory of Wudang Local Chinese Medicine Research, Hubei University of Medicine, Shiyan, 442000 China
| | - Xiong-lin Fan
- Department of Pathogen Biology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
| |
Collapse
|
45
|
Al-Lawama M, Badran E, Ghanim N, Irsheid A, Qtaishat H, Al-Ammouri I, Al-Zyadneh E, Al-Iede M, Daher AH, Bakri FG, Massad G. Perinatal Transmission and Clinical Outcomes of Neonates Born to SARS-CoV-2-Positive Mothers. J Clin Med Res 2021; 13:420-424. [PMID: 34527097 PMCID: PMC8425792 DOI: 10.14740/jocmr4578] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 08/20/2021] [Indexed: 12/25/2022] Open
Abstract
Background The aim of the study was to investigate the clinical outcomes and rate of virus detection in neonates born to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive mothers. Methods This prospective study included neonates born to SARS-CoV-2-positive mothers, documenting their viral polymerase chain reaction results and clinical outcomes. Results Of the 130 neonates born to 122 SARS-CoV-2-positive mothers, 12% tested positive. Most (62%) neonates were delivered via cesarean section at an average gestational age of 36 weeks, with a birth weight of 2,900 g. Only 38% neonates required admission. SARS-CoV-2-positive infants were born at a significantly lower gestational age; had a significantly lower birth weight; and had significantly higher admission rates, surfactant therapy, and bradycardia than SARS-CoV-2-negative infants. There was no significant difference in mortality rates. Conclusion This study documents perinatal transmission of SARS-CoV-2. It reports for the first time the occurrence of neonatal bradycardia as a complication of maternal SARS-CoV-2 infection. Despite that, neonates born to SARS-CoV-2-positive mothers had relatively good short-term outcomes.
Collapse
Affiliation(s)
- Manar Al-Lawama
- Pediatric Department, School of Medicine, The University of Jordan, Amman, Jordan
| | - Eman Badran
- Pediatric Department, School of Medicine, The University of Jordan, Amman, Jordan
| | - Noor Ghanim
- Pediatric Department, School of Medicine, The University of Jordan, Amman, Jordan
| | - Ayah Irsheid
- Pediatric Department, School of Medicine, The University of Jordan, Amman, Jordan
| | - Hiba Qtaishat
- Pediatric Department, School of Medicine, The University of Jordan, Amman, Jordan
| | - Iyad Al-Ammouri
- Pediatric Department, School of Medicine, The University of Jordan, Amman, Jordan
| | - Enas Al-Zyadneh
- Pediatric Department, School of Medicine, The University of Jordan, Amman, Jordan
| | - Montaha Al-Iede
- Pediatric Department, School of Medicine, The University of Jordan, Amman, Jordan
| | - Amira H Daher
- Pediatric Department, School of Medicine, The University of Jordan, Amman, Jordan
| | - Fares G Bakri
- Division of Infectious Diseases, Department of Medicine, Jordan University Hospital, Amman, Jordan.,Infectious Disease and Vaccine Center, The University of Jordan, Amman, Jordan
| | - Ghada Massad
- Nursing Department, Jordan University Hospital, Amman, Jordan
| |
Collapse
|
46
|
Waseem M, Shariff MA, Tay ET, Mortel D, Savadkar S, Lee H, Kondamudi N, Liang T. Multisystem Inflammatory Syndrome in Children. J Emerg Med 2021; 62:28-37. [PMID: 34538678 PMCID: PMC8445772 DOI: 10.1016/j.jemermed.2021.07.070] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 07/22/2021] [Accepted: 07/31/2021] [Indexed: 12/15/2022]
Abstract
Background Multisystem inflammatory syndrome in children (MIS-C) is a newly recognized condition affecting children with recent infection or exposure to coronavirus disease 2019 (COVID-19). MIS-C has symptoms that affect multiple organs systems, with some clinical features resembling Kawasaki disease (KD) and toxic shock syndrome (TSS). Objective of the Review Our goal was to review the current literature and describe the evaluation and treatment algorithms for children suspected of having MIS-C who present to the emergency department. Discussion MIS-C has a wide clinical spectrum and diagnosis is based on a combination of both clinical and laboratory findings. The exact mechanism of immune dysregulation of MIS-C is not well understood. Physical findings may evolve and do not necessarily appear at the same time. Gastrointestinal, cardiac, inflammatory, and coagulopathy manifestations and dysfunction are seen frequently in MIS-C. Conclusions The diagnosis of MIS-C is based on clinical presentation and specific laboratory findings. In the emergency setting, a high level of suspicion for MIS-C is required in patients exposed to COVID-19. Early diagnosis and prompt initiation of therapy offer the best chance for optimal outcomes.
Collapse
Affiliation(s)
- Muhammad Waseem
- Department of Emergency Medicine, NYC Health + Hospitals/Lincoln, Bronx, New York; Weill Cornell Medicine New York and New York Medical College, Valhalla, New York.
| | - Masood A Shariff
- Department of Emergency Medicine, NYC Health + Hospitals/Lincoln, Bronx, New York
| | - Ee Tein Tay
- Department of Emergency Medicine, NYU Langone Health/Bellevue Hospital Center, New York, New York
| | - David Mortel
- Department of Emergency Medicine, Harlem Hospital, New York, New York
| | - Shivraj Savadkar
- Department of Emergency Medicine, Harlem Hospital, New York, New York
| | - Horton Lee
- Department of Emergency Medicine-Pediatrics, NYC Health + Hospitals/Elmhurst Hospital, Queens, New York
| | - Noah Kondamudi
- Department of Pediatrics, The Brooklyn Hospital Center, Brooklyn, New York
| | - Tian Liang
- Department of Emergency Medicine, NYU Langone Health/Bellevue Hospital Center, New York, New York
| |
Collapse
|
47
|
Kim TY, Kim EC, Agudelo AZ, Friedman L. COVID-19 hospitalization rate in children across a private hospital network in the United States: COVID-19 hospitalization rate in children. Arch Pediatr 2021; 28:530-532. [PMID: 34507862 PMCID: PMC8424015 DOI: 10.1016/j.arcped.2021.07.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 05/06/2021] [Accepted: 07/27/2021] [Indexed: 12/24/2022]
Abstract
Objectives There are limited studies with varying results evaluating the rate of hospitalizations of pediatric patients tested for COVID-19 in the United States. More information in the pediatric COVID-19 literature is needed. The objective of this study was to describe the rates of positive tests, hospitalization, severe disease, and mortality for COVID-19 in children. Material and Methods We performed a retrospective analysis of data collected from a data warehouse from 184 hospitals across the United States. All cases of pediatric patients who were tested for COVID-19 were analyzed for test positivity, hospitalization, severe disease, and mortality. A separate subgroup analysis for ages < 1 year, 1–4 years, 5–8 years, 9–14 years, and 15–17 years was performed. Results Of 24,781 patient encounters, we found a test positivity rate of 11.15% (95% CI: 10.76–11.55). There were 142 admissions out of the 2,709 symptomatic patients, 5.24% (95% CI: 4.43–6.15) admission rate. Of those admitted, we found that 54.93% (78/142) were admitted to the PICU, but only 22 of the 142 admissions, 15.49% (95% CI: 9.97–22.51), were determined to have severe COVID-19 disease. One patient died during the study period giving an overall pediatric mortality rate of 0.04% (95% CI: 0.00–0.21). Conclusion In our sample, we found a test positivity rate of 11.15%. We also report a 5.24% hospitalization rate with 15.49% of admitted patients with severe disease. Lastly, we also report a very low mortality rate of 0.04% of all patients who tested positive for COVID-19.
Collapse
Affiliation(s)
- Tommy Y Kim
- HCA Healthcare, Riverside Community Hospital, Department of Emergency Medicine, Riverside, CA, USA.
| | - Esther C Kim
- HCA Healthcare, Riverside Community Hospital, Department of Emergency Medicine, Riverside, CA, USA
| | - Adrian Z Agudelo
- HCA Healthcare, Riverside Community Hospital, Department of Emergency Medicine, Riverside, CA, USA
| | - Lucas Friedman
- HCA Healthcare, Riverside Community Hospital, Department of Emergency Medicine, Riverside, CA, USA
| |
Collapse
|
48
|
Cakir U, Demirel MA, Kanik Yuksek S, Tugcu AU, Tufan N, Tayman C. Case Report of Severe COVID-19 Pneumonia in a Term Newborn. J Trop Pediatr 2021; 67:6362433. [PMID: 34471924 PMCID: PMC8499898 DOI: 10.1093/tropej/fmab023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Coronavirus disease (COVID-19) has been shown to affect all age groups. The data in the literature usually admit a milder form of disease in infants and newborns than adults. COVID-19 is rarely seen in newborns and an urgent diagnosis should be made in any suspicious situation. A 6-day-old female newborn was admitted to our hospital with fever and dyspnea without cough. A rapid reverse-transcription polymerase chain reaction COVID-19 showed a positive result. Chest computed tomography revealed bilateral and widespread pulmonary involvement. After support therapy, the newborn was successfully discharged. We should carefully consider the new type of coronavirus as an agent for pneumonia in newborns with fever and dyspnea together with non-symptomatic family history. Our case was one of the interesting reported cases of severe pneumonia presenting in the perinatal period.
Collapse
Affiliation(s)
- Ufuk Cakir
- Division of Neonatology, Department of Pediatrics, Health Sciences University, Ankara City Hospital, Ankara, Turkey,Correspondence: Ufuk Cakir, Division of Neonatology, Department of Pediatrics, Health Sciences University, Ankara Bilkent City Hospital, 9. Cankaya, Ankara, 06800, Turkey. Tel: +90 505 8581781. Fax: +90 312 306 52 71. E-mail: <>
| | - Merve Akin Demirel
- Department of Pediatrics, Health Sciences University, Ankara City Hospital, Ankara, Turkey
| | - Saliha Kanik Yuksek
- Department of Pediatric Infectious Diseases, Health Sciences University, Ankara City Hospital, Ankara, Turkey
| | - Ali Ulas Tugcu
- Division of Neonatology, Department of Pediatrics, Health Sciences University, Ankara City Hospital, Ankara, Turkey
| | - Nihan Tufan
- Division of Neonatology, Department of Pediatrics, Health Sciences University, Ankara City Hospital, Ankara, Turkey
| | - Cuneyt Tayman
- Division of Neonatology, Department of Pediatrics, Health Sciences University, Ankara City Hospital, Ankara, Turkey
| |
Collapse
|
49
|
Fölster-Holst R. Infectious exanthemas in childhood. J Dtsch Dermatol Ges 2021; 18:1128-1155. [PMID: 33112060 DOI: 10.1111/ddg.14301] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 05/09/2020] [Indexed: 12/15/2022]
Abstract
Most childhood exanthemas are harmless. However, recognizing serious diseases with life-threatening complications at an early stage is important for the timely initiation of adequate therapy. This requires knowledge of the specific patterns of the exanthema, obtained from the medical history and the clinic, including the patient's general condition and physical examination. In unclear cases, additional diagnostic measures are undertaken, such as blood tests and smears (cutaneous, mucocutaneous). Viruses are the most common cause of childhood exanthemas. New variants of infectious agents, improved diagnostics and stays in tropical and subtropical countries have expanded the spectrum of infectious exanthemas.
Collapse
Affiliation(s)
- Regina Fölster-Holst
- Dermatology, Venereology, Allergology, University Hospital Schleswig-Holstein (UKSH), Campus Kiel, Kiel, Germany
| |
Collapse
|
50
|
Mamishi S, Esslami GG, Mohammadi M, Abdolsalehi MR, Sadeghi RH, Mahmoudi S, Pourakbari B. Detection of SARS-CoV-2 antibodies in pediatric patients: An Iranian referral hospital-based study. Hum Antibodies 2021; 29:217-223. [PMID: 34151783 DOI: 10.3233/hab-210448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND As the extent of the pandemic and its seroprevalence pattern has been less clarified in pediatrics to date, we aimed to conduct this study to investigate the clinical and laboratory characteristics of COVID-19 in Iranian children, with a focus on evaluating the antibody prevalence and its relation with the laboratory tests. METHODS All children with highly suspected COVID-19 were included. Anti-nucleoprotein SARS-CoV-2 were measured using SARS-CoV-2 immunoglobulin M (IgM) and SARS-CoV-2 IgG ELISA kits. Hypothesis testing was carried out through SPSS to unravel any association between the measurement tools and important clinical and laboratory characteristics. RESULTS In this study, 254 patients were evaluated and 117 cases (46%) were male. The nucleic acid detection results for patient 55 were negative, but the IgM and IgG results were positive. Totally, 190 patients were tested for IgM in which only 14 (7.3%) had positive tests. Positive IgG was detected in 51 (20%) out of 254 patients; among them, 30 patients had negative SARS-CoV-2 RT-PCR (59%). Lower level of platelets in IgG positive group in comparison with the IgG negative group was observed (P value: 0.015). Moreover, higher alanine aminotransferase (ALT) was observed in the in IgG positive group (P value: 0.02). In patients with positive IgM, relative hypocalcemia (median of 8.25; IQR: 8.02-8.62) was found which appeared to be significant (P value: 0.02). CONCLUSION This is the first largest study describing the SARS-CoV-2 seropositivity among children in Iran and provides important insight about the COVID-19 infection in children.
Collapse
Affiliation(s)
- Setareh Mamishi
- Department of Infectious Diseases, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.,Pediatric Infectious Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Golnaz Ghazizadeh Esslami
- Department of Emergency, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.,Department of Newborn Nursery, Neonates, and Pediatrics, Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran.,Department of Family Medicine, Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Mohammadi
- Non-Communicable Pediatric Diseases Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mohammad Reza Abdolsalehi
- Department of Infectious Diseases, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Shima Mahmoudi
- Pediatric Infectious Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Babak Pourakbari
- Pediatric Infectious Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|