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Mania A, Pokorska-Śpiewak M, Figlerowicz M, Pawłowska M, Mazur-Melewska K, Faltin K, Talarek E, Zawadka K, Dobrzeniecka A, Ciechanowski P, Łasecka-Zadrożna J, Rudnicki J, Hasiec B, Stani M, Frańczak-Chmura P, Zaleska I, Szenborn L, Horecka P, Sulik A, Szczepańska B, Pałyga-Bysiecka I, Kucharek I, Sybilski A, Sobolewska-Pilarczyk M, Dryja U, Majda-Stanisławska E, Niedźwiecka S, Kuchar E, Kalicki B, Gorczyca A, Marczyńska M. Pneumonia, gastrointestinal symptoms, comorbidities, and coinfections as factors related to a lengthier hospital stay in children with COVID-19-analysis of a paediatric part of Polish register SARSTer. Infect Dis (Lond) 2022; 54:196-204. [PMID: 34711132 PMCID: PMC8567279 DOI: 10.1080/23744235.2021.1995628] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 10/11/2021] [Accepted: 10/14/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Although COVID-19 is associated with a mild course in children, a certain proportion requires admission to hospital due to SARS-CoV-2 infection and coexisting diseases. The prospective multicenter study aimed to analyze clinical factors influencing the length of the hospital stay (LoHS) in children with COVID-19. METHODS The study included 1283 children from 14 paediatric infectious diseases departments with diagnosed SARS-CoV-2 infection. Children were assessed in respective centres regarding indications for admission to hospital and clinical condition. History data, clinical findings, laboratory parameters, treatment, and outcome, were collected in the paediatric SARSTer register. The group of children with a hospital stays longer than seven days was compared to the remaining patients. Parameters with a statistically significant difference were included in further logistic regression analysis. RESULTS One thousand one hundred and ten children were admitted to the hospital, 763 children were hospitalized >24 h and 173 children >7 days. 268 children had comorbidities. Two hundred and eleven children had an additional diagnosis with coinfections present in 135 children (11%). Factors increasing the risk of higher LoHS included pneumonia [odds ratio-OR 3.028; 95% confidence interval-CI (1.878-4.884)], gastrointestinal symptoms [OR = 1.556; 95%CI (1.049-2.322)], or rash [OR = 2.318; 95%CI (1.216-4.418)] in initial clinical findings. Comorbidities [OR = 2.433; 95%CI (1.662-3.563)], an additional diagnosis [OR = 2.594; 95%CI (1.679-4.007)] and the necessity of the empirical antibiotic treatment [OR = 2.834; 95%CI (2.834-6.713)] were further factors related to higher LoHS. CONCLUSIONS The clinical course of COVID-19 was mild to moderate in most children. Factors increasing the risk of higher LoHS included pneumonia, gastrointestinal symptoms, comorbidities, an additional diagnosis, and the empirical antibiotic treatment.
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Affiliation(s)
- Anna Mania
- Department of Infectious Diseases and Child Neurology, Poznan University of Medical Sciences, Poznan, Poland
| | - Maria Pokorska-Śpiewak
- Department of Children's Infectious Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Magdalena Figlerowicz
- Department of Infectious Diseases and Child Neurology, Poznan University of Medical Sciences, Poznan, Poland
| | - Małgorzata Pawłowska
- Department of Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Katarzyna Mazur-Melewska
- Department of Infectious Diseases and Child Neurology, Poznan University of Medical Sciences, Poznan, Poland
| | - Kamil Faltin
- Department of Infectious Diseases and Child Neurology, Poznan University of Medical Sciences, Poznan, Poland
| | - Ewa Talarek
- Department of Children's Infectious Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Konrad Zawadka
- Department of Children's Infectious Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Anna Dobrzeniecka
- Department of Children's Infectious Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Przemysław Ciechanowski
- Department of Paediatrics and Infectious Diseases, Regional Hospital in Szczecin, Szczecin, Poland
| | - Joanna Łasecka-Zadrożna
- Department of Paediatrics and Infectious Diseases, Regional Hospital in Szczecin, Szczecin, Poland
| | - Józef Rudnicki
- Department of Paediatrics and Infectious Diseases, Regional Hospital in Szczecin, Szczecin, Poland
| | - Barbara Hasiec
- Department of Children's Infectious Diseases, Provincial Jan Boży Hospital in Lublin, Lublin, Poland
| | - Martyna Stani
- Department of Children's Infectious Diseases, Provincial Jan Boży Hospital in Lublin, Lublin, Poland
| | - Paulina Frańczak-Chmura
- Department of Children's Infectious Diseases, Provincial Jan Boży Hospital in Lublin, Lublin, Poland
| | - Izabela Zaleska
- Department of Paediatrics and Infectious Diseases, Wroclaw Medical University, Wroclaw, Poland
| | - Leszek Szenborn
- Department of Paediatrics and Infectious Diseases, Wroclaw Medical University, Wroclaw, Poland
| | - Paulina Horecka
- Department of Pediatric Infectious Diseases, Medical University of Bialystok, Bialystok, Poland
| | - Artur Sulik
- Department of Pediatric Infectious Diseases, Medical University of Bialystok, Bialystok, Poland
| | | | | | - Izabela Kucharek
- 2nd Department of Paediatrics, Centre of Postgraduate Medical Education, Warsaw, Poland
- Department of Paediatrics and Neonatology with Allergology Center, Central Clinical Hospital of the Ministry of the Interior, Warsaw, Poland
| | - Adam Sybilski
- 2nd Department of Paediatrics, Centre of Postgraduate Medical Education, Warsaw, Poland
- Department of Paediatrics and Neonatology with Allergology Center, Central Clinical Hospital of the Ministry of the Interior, Warsaw, Poland
| | - Małgorzata Sobolewska-Pilarczyk
- Department of Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Urszula Dryja
- Department of Paediatric Infectious Diseases, Medical University of Lodz, Lodz, Poland
| | | | - Sławomira Niedźwiecka
- Department of Paediatric Infectious Diseases, Pomeranian Center of Infectious Diseases and Tuberculosis in Gdańsk, Gdańsk, Poland
| | - Ernest Kuchar
- Department of Paediatrics with Clinical Assessment Unit, Medical University of Warsaw, Warsaw, Poland
| | - Bolesław Kalicki
- Department of Paediatrics, Paediatric Nephrology and Allergology, Military Institute of Medicine, Warsaw, Poland
| | - Anna Gorczyca
- The Ward of Pediatric Infectious Diseases and Hepatology, The John Paul II Hospital in Krakow, Krakow, Poland
| | - Magdalena Marczyńska
- Department of Children's Infectious Diseases, Medical University of Warsaw, Warsaw, Poland
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Pokorska-Śpiewak M, Talarek E, Mania A, Pawłowska M, Popielska J, Zawadka K, Figlerowicz M, Mazur-Melewska K, Faltin K, Ciechanowski P, Łasecka-Zadrożna J, Rudnicki J, Hasiec B, Stani M, Frańczak-Chmura P, Zaleska I, Szenborn L, Toczyłowski K, Sulik A, Szczepańska B, Pałyga-Bysiecka I, Kucharek I, Sybilski A, Sobolewska-Pilarczyk M, Dryja U, Majda-Stanisławska E, Niedźwiecka S, Kuchar E, Kalicki B, Gorczyca A, Marczyńska M. Clinical and Epidemiological Characteristics of 1283 Pediatric Patients with Coronavirus Disease 2019 during the First and Second Waves of the Pandemic-Results of the Pediatric Part of a Multicenter Polish Register SARSTer. J Clin Med 2021; 10:5098. [PMID: 34768620 PMCID: PMC8585006 DOI: 10.3390/jcm10215098] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 09/16/2021] [Accepted: 10/27/2021] [Indexed: 01/05/2023] Open
Abstract
This prospective multicenter cohort study aimed to analyze the epidemiological and clinical characteristics of coronavirus disease 2019 (COVID-19) in children. The study, based on the pediatric part of the Polish SARSTer register, included 1283 children (0 to 18 years) who were diagnosed with COVID-19 between 1 March 2020 and 31 December 2020. Household contact was reported in 56% of cases, more frequently in younger children. Fever was the most common symptom (46%). The youngest children (0-5 years) more frequently presented with fever, rhinitis and diarrhea. Teenagers more often complained of headache, sore throat, anosmia/ageusia and weakness. One fifth of patients were reported to be asymptomatic. Pneumonia was diagnosed in 12% of patients, more frequently in younger children. During the second wave patients were younger than during the first wave (median age 53 vs. 102 months, p < 0.0001) and required longer hospitalization (p < 0.0001). Significantly fewer asymptomatic patients were noted and pneumonia as well as gastrointestinal symptoms were more common. The epidemiological characteristics of pediatric patients and the clinical presentation of COVID-19 are age-related. Younger children were more frequently infected by close relatives, more often suffered from pneumonia and gastrointestinal symptoms and required hospitalization. Clinical courses differed significantly during the first two waves of the pandemic.
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Affiliation(s)
- Maria Pokorska-Śpiewak
- Department of Children’s Infectious Diseases, Regional Hospital of Infectious Diseases in Warsaw, Medical University of Warsaw, 01-201 Warsaw, Poland; (M.P.-Ś.); (J.P.); (K.Z.); (M.M.)
| | - Ewa Talarek
- Department of Children’s Infectious Diseases, Regional Hospital of Infectious Diseases in Warsaw, Medical University of Warsaw, 01-201 Warsaw, Poland; (M.P.-Ś.); (J.P.); (K.Z.); (M.M.)
| | - Anna Mania
- Department of Infectious Diseases and Child Neurology, Poznan University of Medical Sciences, 60-572 Poznan, Poland; (A.M.); (M.F.); (K.M.-M.); (K.F.)
| | - Małgorzata Pawłowska
- Department of Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum, Nicolaus Copernicus University, 85-030 Bydgoszcz, Poland; (M.P.); (M.S.-P.)
| | - Jolanta Popielska
- Department of Children’s Infectious Diseases, Regional Hospital of Infectious Diseases in Warsaw, Medical University of Warsaw, 01-201 Warsaw, Poland; (M.P.-Ś.); (J.P.); (K.Z.); (M.M.)
| | - Konrad Zawadka
- Department of Children’s Infectious Diseases, Regional Hospital of Infectious Diseases in Warsaw, Medical University of Warsaw, 01-201 Warsaw, Poland; (M.P.-Ś.); (J.P.); (K.Z.); (M.M.)
| | - Magdalena Figlerowicz
- Department of Infectious Diseases and Child Neurology, Poznan University of Medical Sciences, 60-572 Poznan, Poland; (A.M.); (M.F.); (K.M.-M.); (K.F.)
| | - Katarzyna Mazur-Melewska
- Department of Infectious Diseases and Child Neurology, Poznan University of Medical Sciences, 60-572 Poznan, Poland; (A.M.); (M.F.); (K.M.-M.); (K.F.)
| | - Kamil Faltin
- Department of Infectious Diseases and Child Neurology, Poznan University of Medical Sciences, 60-572 Poznan, Poland; (A.M.); (M.F.); (K.M.-M.); (K.F.)
| | - Przemysław Ciechanowski
- Department of Paediatrics and Infectious Diseases, Regional Hospital in Szczecin, 71-455 Szczecin, Poland; (P.C.); (J.Ł.-Z.); (J.R.)
| | - Joanna Łasecka-Zadrożna
- Department of Paediatrics and Infectious Diseases, Regional Hospital in Szczecin, 71-455 Szczecin, Poland; (P.C.); (J.Ł.-Z.); (J.R.)
| | - Józef Rudnicki
- Department of Paediatrics and Infectious Diseases, Regional Hospital in Szczecin, 71-455 Szczecin, Poland; (P.C.); (J.Ł.-Z.); (J.R.)
| | - Barbara Hasiec
- Department of Children’s Infectious Diseases, Provincial Jan Boży Hospital in Lublin, 20-089 Lublin, Poland; (B.H.); (M.S.); (P.F.-C.)
| | - Martyna Stani
- Department of Children’s Infectious Diseases, Provincial Jan Boży Hospital in Lublin, 20-089 Lublin, Poland; (B.H.); (M.S.); (P.F.-C.)
| | - Paulina Frańczak-Chmura
- Department of Children’s Infectious Diseases, Provincial Jan Boży Hospital in Lublin, 20-089 Lublin, Poland; (B.H.); (M.S.); (P.F.-C.)
| | - Izabela Zaleska
- Department of Paediatrics and Infectious Diseases, Wroclaw Medical University, 50-368 Wroclaw, Poland; (I.Z.); (L.S.)
| | - Leszek Szenborn
- Department of Paediatrics and Infectious Diseases, Wroclaw Medical University, 50-368 Wroclaw, Poland; (I.Z.); (L.S.)
| | - Kacper Toczyłowski
- Department of Pediatric Infectious Diseases, Medical University of Bialystok, 15-274 Bialystok, Poland; (K.T.); (A.S.)
| | - Artur Sulik
- Department of Pediatric Infectious Diseases, Medical University of Bialystok, 15-274 Bialystok, Poland; (K.T.); (A.S.)
| | - Barbara Szczepańska
- 1st Department of Pediatrics, Collegium Medicum Jan Kochanowski University, 25-317 Kielce, Poland; (B.S.); (I.P.-B.)
| | - Ilona Pałyga-Bysiecka
- 1st Department of Pediatrics, Collegium Medicum Jan Kochanowski University, 25-317 Kielce, Poland; (B.S.); (I.P.-B.)
| | - Izabela Kucharek
- 2nd Department of Paediatrics, Centre of Postgraduate Medical Education, Department of Paediatrics and Neonatology with Allergology Center, Central Clinical Hospital of the Ministry of the Interior, 02-507 Warsaw, Poland; (I.K.); (A.S.)
| | - Adam Sybilski
- 2nd Department of Paediatrics, Centre of Postgraduate Medical Education, Department of Paediatrics and Neonatology with Allergology Center, Central Clinical Hospital of the Ministry of the Interior, 02-507 Warsaw, Poland; (I.K.); (A.S.)
| | - Małgorzata Sobolewska-Pilarczyk
- Department of Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum, Nicolaus Copernicus University, 85-030 Bydgoszcz, Poland; (M.P.); (M.S.-P.)
| | - Urszula Dryja
- Department of Paediatric Infectious Diseases, Medical University of Lodz, 91-347 Lodz, Poland; (U.D.); (E.M.-S.)
| | - Ewa Majda-Stanisławska
- Department of Paediatric Infectious Diseases, Medical University of Lodz, 91-347 Lodz, Poland; (U.D.); (E.M.-S.)
| | - Sławomira Niedźwiecka
- Department of Paediatric Infectious Diseases, Pomeranian Center of Infectious Diseases and Tuberculosis in Gdansk, 80-214 Gdansk, Poland;
| | - Ernest Kuchar
- Department of Paediatrics with Clinical Assessment Unit, Medical University of Warsaw, 02-091 Warsaw, Poland;
| | - Bolesław Kalicki
- Department of Paediatrics, Paediatric Nephrology and Allergology, Military Institute of Medicine, 04-349 Warsaw, Poland;
| | - Anna Gorczyca
- The Ward of Pediatric Infectious Diseases and Hepatology, The John Paul II Hospital in Krakow, 31-202 Krakow, Poland;
| | - Magdalena Marczyńska
- Department of Children’s Infectious Diseases, Regional Hospital of Infectious Diseases in Warsaw, Medical University of Warsaw, 01-201 Warsaw, Poland; (M.P.-Ś.); (J.P.); (K.Z.); (M.M.)
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Wan K, Su C, Kong L, Liao J, Tian W, Luo H. Clinical characteristics of COVID-19 in young patients differ from middle-aged and elderly patients. Arch Med Sci 2021; 18:704-710. [PMID: 35591815 PMCID: PMC9103402 DOI: 10.5114/aoms/133090] [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: 10/25/2020] [Accepted: 02/05/2021] [Indexed: 11/30/2022] Open
Abstract
Introduction Coronavirus disease-2019 (COVID-19) has spread worldwide. The study aimed to understand the clinical characteristics of young COVID-19 patients. Material and methods Ninety patients with severe COVID-19 infection in western Chongqing were collected from 21 January to 14 March 2020. They were divided into 4 groups based on age: youth (< 39 years), middle-aged (39-48 years), middle-elderly aged (49-60 years), and elderly (> 60 years). The clinical symptoms, laboratory findings, imaging findings, and treatment effects were compared among the groups. Results There were 22, 27, 19, and 22 cases in the youth, middle-aged, middle-elderly, and elderly groups, respectively. There were no significant differences with respect to gender or smoking status among the four groups. The clinical indicators of severe disease in the youth group were significantly different from the other three groups, and included the lymphocyte count (p < 0.001), C-reactive protein level (p = 0.03), interleukin-6 level (p = 0.01), chest computed tomography (CT) findings (p < 0.001), number of mild cases (p = 0.02), education level (p < 0.001), and CD4 + T lymphocyte level (p = 0.02) at the time of admission, and the pneumonia severity index (PSI) at the time of discharge (p < 0.001). The complications (p < 0.001) among the youth group were also significantly different from the other groups. Conclusions Young patients have milder clinical manifestations, which may be related to higher education level, higher awareness and higher acceptance of the prevention and control of the COVID-19 epidemic, as well as their good immune function.
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Affiliation(s)
- Keqiang Wan
- Department of Infectious Diseases, Yongchuan Hospital of Chongqing Medical University, Chongqing, China
| | - Chang Su
- Department of Infectious Diseases, Yongchuan Hospital of Chongqing Medical University, Chongqing, China
| | - Lingxi Kong
- Department of Infectious Diseases, Yongchuan Hospital of Chongqing Medical University, Chongqing, China
| | - Juan Liao
- Central Laboratory, Yongchuan Hospital of Chongqing Medical University, Chongqing, China
| | - Wenguang Tian
- Department of Infectious Diseases, Yongchuan Hospital of Chongqing Medical University, Chongqing, China
| | - Hua Luo
- Department of Respiratory and Critical Care Medicine, YongChuan Hospital of Chongqing Medical University, China
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Chiquete E, Alegre-Díaz J, Ochoa-Guzmán A, Toapanta-Yanchapaxi LN, González-Carballo C, Garcilazo-Ávila A, Santacruz-Benitez R, Ramírez-Reyes R, Wong-Chew RM, Guerrero G, Schmulson M, Berumen J, Sandoval-Rodríguez V, Ruiz-Ruiz E, Cantú-Brito C. Ethnicity and other COVID-19 death risk factors in Mexico. Arch Med Sci 2020; 18:711-718. [PMID: 35591829 PMCID: PMC9103400 DOI: 10.5114/aoms.2020.101443] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Accepted: 10/12/2020] [Indexed: 11/17/2022] Open
Abstract
Introduction Patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may develop coronavirus disease 2019 (COVID-19). Risk factors associated with death vary among countries with different ethnic backgrounds. We aimed to describe the factors associated with death in Mexicans with confirmed COVID-19. Material and methods We analysed the Mexican Ministry of Health's official database on people tested for SARS-CoV-2 infection by real-time reverse transcriptase-polymerase chain reaction (rtRT-PCR) of nasopharyngeal fluids. Bivariate analyses were performed to select characteristics potentially associated with death, to integrate a Cox-proportional hazards model. Results As of May 18, 2020, a total of 177,133 persons (90,586 men and 86,551 women) in Mexico received rtRT-PCR testing for SARS-CoV-2. There were 5332 deaths among the 51,633 rtRT-PCR-confirmed cases (10.33%, 95% CI: 10.07-10.59%). The median time (interquartile range, IQR) from symptoms onset to death was 9 days (5-13 days), and from hospital admission to death 4 days (2-8 days). The analysis by age groups revealed that the significant risk of death started gradually at the age of 40 years. Independent death risk factors were obesity, hypertension, male sex, indigenous ethnicity, diabetes, chronic kidney disease, immunosuppression, chronic obstructive pulmonary disease, age > 40 years, and the need for invasive mechanical ventilation (IMV). Only 1959 (3.8%) cases received IMV, of whom 1893 were admitted to the intensive care unit (96.6% of those who received IMV). Conclusions In Mexico, highly prevalent chronic diseases are risk factors for death among persons with COVID-19. Indigenous ethnicity is a poorly studied factor that needs more investigation.
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Affiliation(s)
- Erwin Chiquete
- Instituto Nacional de Ciencias Médicas y de la Nutrición “Salvador Zubirán”, Mexico City, Mexico
| | - Jesus Alegre-Díaz
- Unidad de Investigación en Medicina Experimental, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
| | - Ana Ochoa-Guzmán
- Instituto Nacional de Ciencias Médicas y de la Nutrición “Salvador Zubirán”, Mexico City, Mexico
| | | | - Carlos González-Carballo
- Instituto Nacional de Ciencias Médicas y de la Nutrición “Salvador Zubirán”, Mexico City, Mexico
| | - Adrián Garcilazo-Ávila
- Instituto Nacional de Ciencias Médicas y de la Nutrición “Salvador Zubirán”, Mexico City, Mexico
| | | | - Raúl Ramírez-Reyes
- Instituto Nacional de Ciencias Médicas y de la Nutrición “Salvador Zubirán”, Mexico City, Mexico
| | | | - Guadalupe Guerrero
- Hospital General de México “Dr. Eduardo Liceaga”, Mexico City, Mexico City, Mexico
| | - Max Schmulson
- Unidad de Investigación en Medicina Experimental, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
| | - Jaime Berumen
- Unidad de Investigación en Medicina Experimental, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
- Hospital General de México “Dr. Eduardo Liceaga”, Mexico City, Mexico City, Mexico
| | | | - Eduardo Ruiz-Ruiz
- Instituto Nacional de Ciencias Médicas y de la Nutrición “Salvador Zubirán”, Mexico City, Mexico
| | - Carlos Cantú-Brito
- Instituto Nacional de Ciencias Médicas y de la Nutrición “Salvador Zubirán”, Mexico City, Mexico
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