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Korzeniewska-Eksterowicz A, Brzezinska O, Dryja U, Matczak D, Sopilnyak A, Szuszkiewicz E, Przysło Ł, Szmyd K, Jabłońska K, Krych P, Wojtków-Zielińska A, Wąsińska E, Niedźwiecki M. COVID-19 in pediatric palliative care patients: Multicenter, retrospective cohort study. Palliat Med 2024; 38:150-155. [PMID: 37937380 DOI: 10.1177/02692163231206928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
BACKGROUND Studies have shown the risk factors for COVID-19 severity in children, including comorbidities, but information on the infection course in children with life-limiting conditions is sparse. AIM To describe the effect of COVID-19 on pediatric patients receiving palliative care due to life-limiting conditions. DESIGN We conducted retrospective cohort study. The WHO Clinical Progression Scale was used to measure COVID-19 severity. SETTING/PARTICIPANTS Seven of the 24 invited pediatric palliative care centers participated in this study. We analyzed the medical records of children under palliative care with confirmed COVID-19 (January 2020-April 2022). RESULTS Records of 60 patients with COVID-19 aged 0.24 to 21.6 years (mean (SD); 9.8 (6.6)) were collected. The largest group of patients with COVID-19 was children with congenital malformations and chromosomal abnormalities (42%); the most common manifestation was fever (85%). Bacterial coinfection was confirmed in 17 (28%) children. Fifteen (25%) children required hospitalization, including four admitted to the Intensive Care Unit. Mild COVID-19 was identified in 44 (73%) children, moderate in 11 (18%), severe in 3 (5%), and death in 2 (3%). Six of the 20 eligible children were vaccinated against SARS-CoV-2, followed by 16 mothers and fathers. CONCLUSION In the study population initial presentation of COVID-19 was predominantly a mild; however, the small sample size precluded definitive conclusions. For children under palliative care, we should identify if they have an advance care plan for COVID-19, such as desires for intensive care support. Further studies are needed to define the short and long-term effects of COVID-19 in children with life-limiting conditions.
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Affiliation(s)
- Aleksandra Korzeniewska-Eksterowicz
- Pediatric Palliative Care Unit, Department of Pediatrics, Oncology and Hematology, Medical University of Lodz, Lodz, Poland
- Gajusz Foundation-Pediatric Palliative Care Center, Lodz, Poland
| | - Olga Brzezinska
- Department of Rheumatology With Subdepartment of Internal Medicine, Medical University of Lodz, Lodz, Poland
| | - Urszula Dryja
- Gajusz Foundation-Pediatric Palliative Care Center, Lodz, Poland
| | - Dominka Matczak
- Gajusz Foundation-Pediatric Palliative Care Center, Lodz, Poland
| | - Andriy Sopilnyak
- Pediatric Palliative Care Unit, Department of Pediatrics, Oncology and Hematology, Medical University of Lodz, Lodz, Poland
- Gajusz Foundation-Pediatric Palliative Care Center, Lodz, Poland
| | | | - Łukasz Przysło
- Department of Developmental Neurology and Epileptology, Research Institute of Polish Mother's Memorial Hospital, Lodz, Poland
| | - Krzystof Szmyd
- Hospice for Children of Lower Silesia "Formula Dobra," Wrocław, Poland
| | | | - Piotr Krych
- Home Children's Hospice Promyczek, Otwock, Poland
| | | | | | - Maciej Niedźwiecki
- Department of Pediatrics, Hematology and Oncology, Medical University of Gdansk, Gdansk, Poland
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Pokorska-Śpiewak M, Talarek E, Pawłowska M, Mania A, Hasiec B, Żwirek-Pytka E, Stankiewicz M, Stani M, Frańczak-Chmura P, Szenborn L, Zaleska I, Chruszcz J, Majda-Stanisławska E, Dryja U, Gąsiorowska K, Figlerowicz M, Mazur-Melewska K, Faltin K, Ciechanowski P, Peregrym M, Łasecka-Zadrożna J, Rudnicki J, Szczepańska B, Pałyga-Bysiecka I, Rogowska E, Hudobska-Nawrot D, Domańska-Granek K, Sybilski A, Kucharek I, Franczak J, Sobolewska-Pilarczyk M, Kuchar E, Wronowski M, Paryż M, Kalicki B, Toczyłowski K, Sulik A, Niedźwiecka S, Gorczyca A, Marczyńska M. The Influence of SARS-CoV-2 Variants B.1.1.7 and B.1.617.2 on a Different Clinical Course and Severity of COVID-19 in Children Hospitalized in 2021 Compared With 2020. Pediatr Infect Dis J 2023; 42:584-589. [PMID: 37053572 PMCID: PMC10289062 DOI: 10.1097/inf.0000000000003918] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/20/2023] [Indexed: 04/15/2023]
Abstract
BACKGROUND This study aimed to analyze the differences in the epidemiologic and clinical characteristics of coronavirus disease 2019 (COVID-19) in children hospitalized in 2021, when the severe acute respiratory syndrome coronavirus 2 variants B.1.1.7 (alpha) and B.1.617.2 (delta) dominated, compared with 2020. METHODS In this multicenter study based on the pediatric part of the national SARSTer register (SARSTer-PED), we included 2771 children (0-18 years) with COVID-19 diagnosed between March 1, 2020, and December 31, 2021, from 14 Polish inpatient centers. An electronic questionnaire, which addressed epidemiologic and clinical data, was used. RESULTS Children hospitalized in 2021 were younger compared with those reported in 2020 (mean 4.1 vs. 6.8 years, P = 0 .01). Underlying comorbidities were reported in 22% of the patients. The clinical course was usually mild (70%). A significant difference in the clinical course assessment between 2020 and 2021 was found, with more asymptomatic patients in 2020 and more severely ill children in 2021. In total, 5% of patients were severely or critically ill, including <3% of the participants in 2020 and 7% in 2021. The calculated mortality rate was 0.1% in general and 0.2% in 2021. CONCLUSION Infections with severe acute respiratory syndrome coronavirus 2 variants alpha and delta lead to a more severe course of COVID-19 with more pronounced clinical presentation and higher fatality rates than infection with an original strain. Most of the children requiring hospitalization due to COVID-19 do not have underlying comorbidities.
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Affiliation(s)
- Maria Pokorska-Śpiewak
- From the Department of Children’s Infectious Diseases, Medical University of Warsaw; Regional Hospital of Infectious Diseases in Warsaw
| | - Ewa Talarek
- From the Department of Children’s Infectious Diseases, Medical University of Warsaw; Regional Hospital of Infectious Diseases in Warsaw
| | - Małgorzata Pawłowska
- Department of Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz
| | - Anna Mania
- Department of Infectious Diseases and Child Neurology, Poznan University of Medical Sciences
| | - Barbara Hasiec
- Department of Children’s Infectious Diseases, Provincial Jan Boży Hospital in Lublin
| | - Elżbieta Żwirek-Pytka
- Department of Children’s Infectious Diseases, Provincial Jan Boży Hospital in Lublin
| | - Magdalena Stankiewicz
- Department of Children’s Infectious Diseases, Provincial Jan Boży Hospital in Lublin
| | - Martyna Stani
- Department of Children’s Infectious Diseases, Provincial Jan Boży Hospital in Lublin
| | | | - Leszek Szenborn
- Department of Pediatrics and Infectious Diseases, Wroclaw Medical University
| | - Izabela Zaleska
- Department of Pediatrics and Infectious Diseases, Wroclaw Medical University
| | - Joanna Chruszcz
- Department of Pediatrics and Infectious Diseases, Wroclaw Medical University
| | | | - Urszula Dryja
- Department of Pediatric Infectious Diseases, Medical University of Lodz
| | | | - Magdalena Figlerowicz
- Department of Infectious Diseases and Child Neurology, Poznan University of Medical Sciences
| | | | - Kamil Faltin
- Department of Infectious Diseases and Child Neurology, Poznan University of Medical Sciences
| | | | - Michał Peregrym
- Department of Pediatrics and Infectious Diseases, Regional Hospital in Szczecin
| | | | - Józef Rudnicki
- Department of Pediatrics and Infectious Diseases, Regional Hospital in Szczecin
| | | | | | | | | | | | - Adam Sybilski
- 2nd Department of Pediatrics, Centre of Postgraduate Medical Education, Warsaw
- Department of Pediatrics and Neonatology with Allergology Center, Central Clinical Hospital of the Ministry of the Interior, Warsaw
| | - Izabela Kucharek
- 2nd Department of Pediatrics, Centre of Postgraduate Medical Education, Warsaw
- Department of Pediatrics and Neonatology with Allergology Center, Central Clinical Hospital of the Ministry of the Interior, Warsaw
| | - Justyna Franczak
- Department of Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz
| | - Małgorzata Sobolewska-Pilarczyk
- Department of Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz
| | - Ernest Kuchar
- Department of Pediatrics with Clinical Assessment Unit, Medical University of Warsaw
| | - Michał Wronowski
- Department of Pediatrics with Clinical Assessment Unit, Medical University of Warsaw
| | - Maria Paryż
- Department of Pediatrics, Pediatric Nephrology and Allergology, Military Institute of Medicine, Warsaw
| | - Bolesław Kalicki
- Department of Pediatrics, Pediatric Nephrology and Allergology, Military Institute of Medicine, Warsaw
| | - Kacper Toczyłowski
- Department of Pediatric Infectious Diseases, Medical University of Bialystok
| | - Artur Sulik
- Department of Pediatric Infectious Diseases, Medical University of Bialystok
| | - Sławomira Niedźwiecka
- Department of Pediatric Infectious Diseases, Pomeranian Center of Infectious Diseases and Tuberculosis in Gdańsk
| | - Anna Gorczyca
- The Ward of Pediatric Infectious Diseases and Hepatology, The John Paul II Hospital in Krakow
| | - Magdalena Marczyńska
- From the Department of Children’s Infectious Diseases, Medical University of Warsaw; Regional Hospital of Infectious Diseases in Warsaw
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Pawłowska M, Pokorska-Śpiewak M, Talarek E, Mania A, Hasiec B, Żwirek-Pytka E, Stankiewicz M, Stani M, Frańczak-Chmura P, Szenborn L, Zaleska I, Chruszcz J, Majda-Stanisławska E, Dryja U, Gąsiorowska K, Figlerowicz M, Mazur-Melewska K, Faltin K, Ciechanowski P, Peregrym M, Łasecka-Zadrożna J, Rudnicki J, Szczepańska B, Pałyga-Bysiecka I, Rogowska E, Hudobska-Nawrot D, Domańska-Granek K, Sybilski A, Kucharek I, Franczak J, Sobolewska-Pilarczyk M, Kuchar E, Wronowski M, Paryż M, Kalicki B, Toczyłowski K, Sulik A, Niedźwiecka S, Flisiak R, Marczyńska M. Clinical Course and Severity of COVID-19 in 940 Infants with and without Comorbidities Hospitalized in 2020 and 2021: The Results of the National Multicenter Database SARSTer-PED. J Clin Med 2023; 12:jcm12072479. [PMID: 37048562 PMCID: PMC10095202 DOI: 10.3390/jcm12072479] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/10/2023] [Accepted: 03/23/2023] [Indexed: 04/14/2023] Open
Abstract
This study aimed to analyze the differences in severity and clinical characteristics of COVID-19 in infants hospitalized in Poland in 2021, when the dominance of variants of concern (VOCs) alpha and delta was reported, compared to 2020, when original (wild) SARS-CoV-2 was dominant (III-IV vs. I-II waves of the pandemic, respectively). In addition, the influence of the presence of comorbidities on the clinical course of COVID-19 in infants was studied. This multicenter study, based on the pediatric part of the national SARSTer database (SARSTer-PED), included 940 infants with COVID-19 diagnosed between March 1, 2020, and December 31, 2021, from 13 Polish inpatient centers. An electronic questionnaire, which addressed epidemiological and clinical data, was used. The number of hospitalized infants was significantly higher in 2021 than in 2020 (651 vs. 289, respectively). The analysis showed similar lengths of infant hospitalization in 2020 and 2021, but significantly more children were hospitalized for more than 7 days in 2020 (p < 0.009). In both analyzed periods, the most common route of infection for infants was household contact. There was an increase in the percentage of comorbidities, especially prematurity, in children hospitalized in 2021 compared to 2020. Among the clinical manifestations, fever was predominant among children hospitalized in 2021 and 2020. Cough, runny nose, and loss of appetite were significantly more frequently observed in 2021 (p < 0.0001). Severe and critical conditions were significantly more common among children with comorbidities. More infants were hospitalized during the period of VOCs dominance, especially the delta variant, compared to the period of wild strain dominance, even though indications for hospitalization did not include asymptomatic patients during that period. The course of COVID-19 was mostly mild, characterized mainly by fever and respiratory symptoms. Comorbidities, particularly from the cardiovascular system and prematurity, were associated with a more severe course of the disease in infants.
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Affiliation(s)
- Małgorzata Pawłowska
- Department of Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum, Nicolaus Copernicus University, 85-067 Bydgoszcz, Poland
| | - Maria Pokorska-Śpiewak
- Department of Children's Infectious Diseases, Medical University of Warsaw; Regional Hospital of Infectious Diseases in Warsaw, 02-091 Warsaw, Poland
| | - Ewa Talarek
- Department of Children's Infectious Diseases, Medical University of Warsaw; Regional Hospital of Infectious Diseases in Warsaw, 02-091 Warsaw, Poland
| | - Anna Mania
- Department of Infectious Diseases and Child Neurology, Poznan University of Medical Sciences, 61-701 Poznań, Poland
| | - Barbara Hasiec
- Department of Children's Infectious Diseases, Provincial Jan Boży Hospital in Lublin, 20-400 Lublin, Poland
| | - Elżbieta Żwirek-Pytka
- Department of Children's Infectious Diseases, Provincial Jan Boży Hospital in Lublin, 20-400 Lublin, Poland
| | - Magdalena Stankiewicz
- Department of Children's Infectious Diseases, Provincial Jan Boży Hospital in Lublin, 20-400 Lublin, Poland
| | - Martyna Stani
- Department of Children's Infectious Diseases, Provincial Jan Boży Hospital in Lublin, 20-400 Lublin, Poland
| | - Paulina Frańczak-Chmura
- Department of Children's Infectious Diseases, Provincial Jan Boży Hospital in Lublin, 20-400 Lublin, Poland
| | - Leszek Szenborn
- Department of Pediatrics and Infectious Diseases, Wroclaw Medical University, 50-367 Wrocław, Poland
| | - Izabela Zaleska
- Department of Pediatrics and Infectious Diseases, Wroclaw Medical University, 50-367 Wrocław, Poland
| | - Joanna Chruszcz
- Department of Pediatrics and Infectious Diseases, Wroclaw Medical University, 50-367 Wrocław, Poland
| | - Ewa Majda-Stanisławska
- Department of Pediatric Infectious Diseases, Medical University of Lodz, 90-419 Łódź, Poland
| | - Urszula Dryja
- Department of Pediatric Infectious Diseases, Medical University of Lodz, 90-419 Łódź, Poland
| | - Kamila Gąsiorowska
- Department of Pediatric Infectious Diseases, Medical University of Lodz, 90-419 Łódź, Poland
| | - Magdalena Figlerowicz
- Department of Infectious Diseases and Child Neurology, Poznan University of Medical Sciences, 61-701 Poznań, Poland
| | - Katarzyna Mazur-Melewska
- Department of Infectious Diseases and Child Neurology, Poznan University of Medical Sciences, 61-701 Poznań, Poland
| | - Kamil Faltin
- Department of Infectious Diseases and Child Neurology, Poznan University of Medical Sciences, 61-701 Poznań, Poland
| | - Przemysław Ciechanowski
- Department of Pediatrics and Infectious Diseases, Regional Hospital in Szczecin, 71-455 Szczecin, Poland
| | - Michał Peregrym
- Department of Pediatrics and Infectious Diseases, Regional Hospital in Szczecin, 71-455 Szczecin, Poland
| | - Joanna Łasecka-Zadrożna
- Department of Pediatrics and Infectious Diseases, Regional Hospital in Szczecin, 71-455 Szczecin, Poland
| | - Józef Rudnicki
- Department of Pediatrics and Infectious Diseases, Regional Hospital in Szczecin, 71-455 Szczecin, Poland
| | | | | | - Ewelina Rogowska
- Collegium Medicum, Jan Kochanowski University, 25-369 Kielce, Poland
| | | | | | - Adam Sybilski
- 2nd Department of Pediatrics, Centre of Postgraduate Medical Education, 01-813 Warsaw, Poland
- Department of Pediatrics and Neonatology with Allergology Center, Central Clinical Hospital of the Ministry of the Interior, 02-507 Warsaw, Poland
| | - Izabela Kucharek
- 2nd Department of Pediatrics, Centre of Postgraduate Medical Education, 01-813 Warsaw, Poland
- Department of Pediatrics and Neonatology with Allergology Center, Central Clinical Hospital of the Ministry of the Interior, 02-507 Warsaw, Poland
| | - Justyna Franczak
- Department of Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum, Nicolaus Copernicus University, 85-067 Bydgoszcz, Poland
| | - Małgorzata Sobolewska-Pilarczyk
- Department of Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum, Nicolaus Copernicus University, 85-067 Bydgoszcz, Poland
| | - Ernest Kuchar
- Department of Pediatrics with Clinical Assessment Unit, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Michał Wronowski
- Department of Pediatrics with Clinical Assessment Unit, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Maria Paryż
- Department of Pediatrics, Pediatric Nephrology and Allergology, Military Institute of Medicine, 01-755 Warsaw, Poland
| | - Bolesław Kalicki
- Department of Pediatrics, Pediatric Nephrology and Allergology, Military Institute of Medicine, 01-755 Warsaw, Poland
| | - Kacper Toczyłowski
- Department of Pediatric Infectious Diseases, Medical University of Bialystok, 15-089 Białystok, Poland
| | - Artur Sulik
- Department of Pediatric Infectious Diseases, Medical University of Bialystok, 15-089 Białystok, Poland
| | - Sławomira Niedźwiecka
- Department of Pediatric Infectious Diseases, Pomeranian Center of Infectious Diseases and Tuberculosis in Gdańsk, 80-214 Gdańsk, Poland
| | - Robert Flisiak
- Department of Infectious Diseases and Hepatology, Medical University of Bialystok, 15-089 Białystok, Poland
| | - Magdalena Marczyńska
- Department of Children's Infectious Diseases, Medical University of Warsaw; Regional Hospital of Infectious Diseases in Warsaw, 02-091 Warsaw, Poland
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Korzeniewska-Eksterowicz A, Kozinska J, Kozinski K, Dryja U. Prenatal diagnosis of a lethal defect: What next? History of first family in perinatal hospice. Palliat Support Care 2022; 20:906-907. [PMID: 34167606 DOI: 10.1017/s1478951521000870] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Aleksandra Korzeniewska-Eksterowicz
- Pediatric Palliative Care Unit, Department of Pediatrics, Oncology and Hematology, Medical University of Lodz, Lodz, Poland
- Gajusz Foundation, Pediatric Palliative Care Center, Lodz, Poland
| | - Joanna Kozinska
- Parents in Gajusz Foundation, Pediatric Palliative Care Center, Lodz, Poland
| | - Konrad Kozinski
- Parents in Gajusz Foundation, Pediatric Palliative Care Center, Lodz, Poland
| | - Urszula Dryja
- Gajusz Foundation, Pediatric Palliative Care Center, Lodz, Poland
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Sobolewska-Pilarczyk M, Pokorska-Śpiewak M, Stachowiak A, Marczyńska M, Talarek E, Ołdakowska A, Kucharek I, Sybilski A, Mania A, Figlerowicz M, Mazur-Melewska K, Potocka P, Sulik A, Hasiec B, Stani M, Frańczak-Chmura P, Szczepańska B, Pałyga-Bysiecka I, Ciechanowski P, Łasecka-Zadrożna J, Zaleska I, Szenborn L, Dryja U, Kuchar E, Niedźwiecka S, Kalicki B, Flisiak R, Pawłowska M. COVID-19 infections in infants. Sci Rep 2022; 12:7765. [PMID: 35546159 PMCID: PMC9094122 DOI: 10.1038/s41598-022-11068-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 04/05/2022] [Indexed: 01/08/2023] Open
Abstract
The study aimed to analyse the clinical course of COVID-19 in 300 infants, selected from 1283 children diagnosed with COVID-19 between March and December 2020, registered in the SARSTerPED multicenter database. Most of the infants were registered in October and November 2020. 44% of the group were girls, and 56% were boys. At diagnosis, the most common symptoms were fever in 77% of the children, cough in 40%, catarrh in 37%. Pneumonia associated with COVID-19 was diagnosed in 23% of the children, and gastrointestinal symptoms in 31.3%. In 52% of the infants, elevated levels of D-dimers were observed, and in 40%, elevated levels of IL-6 serum concentration were observed. During the second wave of the pandemic, 6 times more infants were hospitalized, and the children were statistically significantly younger compared to the patients during the first wave (3 months vs 8 months, p < 0.0001 respectively). During the second wave, the infants were hospitalized for longer. COVID-19 in infants usually manifests as a mild gastrointestinal or respiratory infection, but pneumonia is also observed with falls in oxygen saturation, requiring oxygen therapy. Gastrointestinal symptoms are common in infants infected with SARS-CoV-2, and infant appetite disorders may lead to hospitalization. The clinical course of the disease differed significantly between the first and second wave of the pandemic. It seems that infants may play a role in the transmission of SARS-COV-2 infections in households, despite mild or asymptomatic courses; eating disorders in infants should be an indication for COVID-19 testing.
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Affiliation(s)
- Małgorzata Sobolewska-Pilarczyk
- Department of Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Maria Pokorska-Śpiewak
- Department of Childrens Infectious Diseases, Medical University of Warsaw, Warsaw, Poland
- Regional Hospital of Infectious Diseases, Warsaw, Poland
| | - Anna Stachowiak
- Department of Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland.
| | - Magdalena Marczyńska
- Department of Childrens Infectious Diseases, Medical University of Warsaw, Warsaw, Poland
- Regional Hospital of Infectious Diseases, Warsaw, Poland
| | - Ewa Talarek
- Department of Childrens Infectious Diseases, Medical University of Warsaw, Warsaw, Poland
- Regional Hospital of Infectious Diseases, Warsaw, Poland
| | - Agnieszka Ołdakowska
- Department of Childrens Infectious Diseases, Medical University of Warsaw, Warsaw, Poland
- Regional Hospital of Infectious Diseases, Warsaw, Poland
| | - Izabela Kucharek
- 2Nd Department of Pediatrics, Centre of Postgraduate Medical Education, Warsaw, Poland
- Department of Pediatrics and Neonatology with Allergology Center, Central Clinical Hospital of the Ministry of the Interior, Warsaw, Poland
| | - Adam Sybilski
- 2Nd Department of Pediatrics, Centre of Postgraduate Medical Education, Warsaw, Poland
- Department of Pediatrics and Neonatology with Allergology Center, Central Clinical Hospital of the Ministry of the Interior, Warsaw, Poland
| | - Anna Mania
- Department of Infectious Diseases and Child Neurology, Poznań University of Medical Sciences, Poznan, Poland
| | - Magdalena Figlerowicz
- Department of Infectious Diseases and Child Neurology, Poznań University of Medical Sciences, Poznan, Poland
| | - Katarzyna Mazur-Melewska
- Department of Infectious Diseases and Child Neurology, Poznań University of Medical Sciences, Poznan, Poland
| | - Paulina Potocka
- Department of Pediatric Infectious Diseases, Medical University of Białystok, Białystok, Poland
| | - Artur Sulik
- Department of Pediatric Infectious Diseases, Medical University of Białystok, Białystok, Poland
| | - Barbara Hasiec
- Department of Childrens Infectious Diseases, Provincial Jan Boży Hospital in Lublin, Lublin, Poland
| | - Martyna Stani
- Department of Childrens Infectious Diseases, Provincial Jan Boży Hospital in Lublin, Lublin, Poland
| | - Paulina Frańczak-Chmura
- Department of Childrens Infectious Diseases, Provincial Jan Boży Hospital in Lublin, Lublin, Poland
| | | | | | - Przemysław Ciechanowski
- Department of Pediatrics and Infectious Diseases, Regional Hospital in Szczecin, Szczecin, Poland
| | - Joanna Łasecka-Zadrożna
- Department of Pediatrics and Infectious Diseases, Regional Hospital in Szczecin, Szczecin, Poland
| | - Izabela Zaleska
- Department of Pediatrics and Infectious Diseases, Wrocław Medical University, Wroclaw, Poland
| | - Leszek Szenborn
- Department of Pediatrics and Infectious Diseases, Wrocław Medical University, Wroclaw, Poland
| | - Urszula Dryja
- Department of Pediatrics Infectious Diseases, Medical University of Łódź, Łódź, Poland
| | - Ernest Kuchar
- Department of Pediatrics With Clinical Assessment Unit, Medical University of Warsaw, Warsaw, Poland
| | - Sławomira Niedźwiecka
- Department of Pediatrics Infectious Diseases, Pomeranian Center of Infectious Diseases and Tuberculosis in Gdańsk, Gdansk, Poland
| | - Bolesław Kalicki
- Department of Pediatrics, Pediatrics Nephrology and Allergology, Military Institute of Medicine, Warsaw, Poland
| | - Robert Flisiak
- Department of Infectious Diseases and Hepatology, Medical University of Białystok, Bialystok, Poland
| | - Małgorzata Pawłowska
- Department of Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
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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] [What about the content of this article? (0)] [Affiliation(s)] [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] [What about the content of this article? (0)] [Affiliation(s)] [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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8
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Dryja U, Niwald A, Majda-Stanisławska E. The development of the Sabin–Pinkerton triad despite prenatal screening for congenital toxoplasmosis. Pediatr Med Rodz 2021. [DOI: 10.15557/pimr.2021.0042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The paper presents a case of a boy who developed the symptoms of congenital toxoplasmosis: hydrocephalus, retinitis, choroiditis and intracranial calcifications (the Sabin–Pinkerton triad). Despite prenatal screening in the first trimester of pregnancy (in accordance with the guidelines of the Ministry of Health), which indicated the diagnosis of asymptomatic primary Toxoplasma gondii infection in the pregnant mother, no antiparasitic therapy was used. The presented serological and imaging findings, as well as specialist consultations confirm the intensified effects of congenital infection in the child. Although the child was put on anti-toxoplasma therapy immediately after birth, he developed severe psychophysical development disorders. The paper discusses recommendations for maternal diagnosis and antiparasitic treatment that could have prevented the full-blown congenital toxoplasmosis in the described patient.
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