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Andina-Martínez D, Rodríguez-Palero S, Soto-Insuga V, Alonso-Cadenas JA, Bernardino-Cuesta B, Cartas-Carrión S, Cantarín-Extremera V. Peripheral facial nerve palsy in children during the COVID-19 pandemic. Rev Neurol 2022; 74:361-366. [PMID: 35635362 DOI: 10.33588/rn.7411.2022033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVES During the COVID-19 pandemic, an increased frequency of peripheral facial nerve palsy has been described in adults and children. The etiology of the disease during this time remains unclear, since most cases occurred in patients who tested negative for SARS-CoV-2 infection. PATIENTS AND METHODS Retrospective study of pediatric cases of facial nerve palsy treated during the first year of the pandemic in the emergency department of a children´s hospital located in one of the areas with the highest prevalence of COVID-19 in Spain. Data from this period are compared with cases from the previous three years. RESULTS Twenty-nine patients with Bell's palsy were included. Over the previous three years combined, 24 patients presented with the same condition, a more than threefold increase. No clinical differences were found between the groups apart from the fact that fewer patients received corticosteroids during the pandemic (13.8% vs 41.6%; p = 0.022). Fourteen children underwent microbiologic testing for active SARS-CoV-2 infection (12 polymerase chain reaction, two rapid antigen test); all were negative. Thirteen patients received serologic testing, two with a positive IgG (15.3%). CONCLUSION A substantial increase in hospital presentations for facial nerve palsy was observed among children and adolescents during the first year of the pandemic, though findings of microbiologic testing cannot confirm a direct link with SARS-CoV-2 infection in most cases. Patient characteristics did not change between the two time periods. Difficulty accessing primary-care facilities during the pandemic in Spain may have played a role in this increase.
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Affiliation(s)
| | | | - V Soto-Insuga
- Hospital Infantil Universitario Niño Jesús, 28009 Madrid, España
| | | | | | - S Cartas-Carrión
- Hospital Infantil Universitario Niño Jesús, 28009 Madrid, España
| | - V Cantarín-Extremera
- Hospital Infantil Universitario Niño Jesús, 28009 Madrid, España
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER). ISCIII, Madrid, España
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Domínguez-Rodríguez S, Villaverde S, Sanz-Santaeufemia FJ, Grasa C, Soriano-Arandes A, Saavedra-Lozano J, Fumadó V, Epalza C, Serna-Pascual M, Alonso-Cadenas JA, Rodríguez-Molino P, Pujol-Morro J, Aguilera-Alonso D, Simó S, Villanueva-Medina S, Iglesias-Bouzas MI, Mellado MJ, Herrero B, Melendo S, De la Torre M, Del Rosal T, Soler-Palacin P, Calvo C, Urretavizcaya-Martínez M, Pareja M, Ara-Montojo F, Ruiz Del Prado Y, Gallego N, Illán Ramos M, Cobos E, Tagarro A, Moraleda C. A Bayesian Model to Predict COVID-19 Severity in Children. Pediatr Infect Dis J 2021; 40:e287-e293. [PMID: 34250967 DOI: 10.1097/inf.0000000000003204] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND We aimed to identify risk factors causing critical disease in hospitalized children with COVID-19 and to build a predictive model to anticipate the probability of need for critical care. METHODS We conducted a multicenter, prospective study of children with SARS-CoV-2 infection in 52 Spanish hospitals. The primary outcome was the need for critical care. We used a multivariable Bayesian model to estimate the probability of needing critical care. RESULTS The study enrolled 350 children from March 12, 2020, to July 1, 2020: 292 (83.4%) and 214 (73.7%) were considered to have relevant COVID-19, of whom 24.2% required critical care. Four major clinical syndromes of decreasing severity were identified: multi-inflammatory syndrome (MIS-C) (17.3%), bronchopulmonary (51.4%), gastrointestinal (11.6%), and mild syndrome (19.6%). Main risk factors were high C-reactive protein and creatinine concentration, lymphopenia, low platelets, anemia, tachycardia, age, neutrophilia, leukocytosis, and low oxygen saturation. These risk factors increased the risk of critical disease depending on the syndrome: the more severe the syndrome, the more risk the factors conferred. Based on our findings, we developed an online risk prediction tool (https://rserver.h12o.es/pediatria/EPICOAPP/, username: user, password: 0000). CONCLUSIONS Risk factors for severe COVID-19 include inflammation, cytopenia, age, comorbidities, and organ dysfunction. The more severe the syndrome, the more the risk factor increases the risk of critical illness. Risk of severe disease can be predicted with a Bayesian model.
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Affiliation(s)
- Sara Domínguez-Rodríguez
- From the Fundación de Investigación Biomédica Hospital 12 de Octubre, Instituto de Investigación 12 de Octubre (imas12), Madrid, Spain
- RITIP (Translational Research Network in Paediatric Infectious Diseases), Madrid, Spain
- Paediatric Infectious Diseases Unit, Department of Paediatrics, Hospital Universitario 12 Octubre, Madrid, Spain
| | - Serena Villaverde
- From the Fundación de Investigación Biomédica Hospital 12 de Octubre, Instituto de Investigación 12 de Octubre (imas12), Madrid, Spain
- RITIP (Translational Research Network in Paediatric Infectious Diseases), Madrid, Spain
- Paediatric Infectious Diseases Unit, Department of Paediatrics, Hospital Universitario 12 Octubre, Madrid, Spain
| | | | - Carlos Grasa
- RITIP (Translational Research Network in Paediatric Infectious Diseases), Madrid, Spain
- Paediatrics, Infectious and Tropical Diseases Department, Hospital Universitario La Paz, Instituto Investigación Hospital La Paz (IDIPaz), Madrid, Spain
| | - Antoni Soriano-Arandes
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Barcelona, Catalonia, Spain
| | - Jesús Saavedra-Lozano
- Paediatric Infectious Diseases Unit, Department of Paediatrics, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - Victoria Fumadó
- Paediatric Infectious Diseases Unit, Department of Paediatrics, Hospital Universitario Sant Joan de Deu Barcelona, Barcelona, Spain
| | - Cristina Epalza
- From the Fundación de Investigación Biomédica Hospital 12 de Octubre, Instituto de Investigación 12 de Octubre (imas12), Madrid, Spain
- RITIP (Translational Research Network in Paediatric Infectious Diseases), Madrid, Spain
- Paediatric Infectious Diseases Unit, Department of Paediatrics, Hospital Universitario 12 Octubre, Madrid, Spain
| | - Miquel Serna-Pascual
- From the Fundación de Investigación Biomédica Hospital 12 de Octubre, Instituto de Investigación 12 de Octubre (imas12), Madrid, Spain
- RITIP (Translational Research Network in Paediatric Infectious Diseases), Madrid, Spain
- Paediatric Infectious Diseases Unit, Department of Paediatrics, Hospital Universitario 12 Octubre, Madrid, Spain
| | | | - Paula Rodríguez-Molino
- RITIP (Translational Research Network in Paediatric Infectious Diseases), Madrid, Spain
- Paediatrics, Infectious and Tropical Diseases Department, Hospital Universitario La Paz, Instituto Investigación Hospital La Paz (IDIPaz), Madrid, Spain
| | - Joan Pujol-Morro
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Barcelona, Catalonia, Spain
| | - David Aguilera-Alonso
- Paediatric Infectious Diseases Unit, Department of Paediatrics, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - Silvia Simó
- Paediatric Infectious Diseases Unit, Department of Paediatrics, Hospital Universitario Sant Joan de Deu Barcelona, Barcelona, Spain
| | - Sara Villanueva-Medina
- From the Fundación de Investigación Biomédica Hospital 12 de Octubre, Instituto de Investigación 12 de Octubre (imas12), Madrid, Spain
- RITIP (Translational Research Network in Paediatric Infectious Diseases), Madrid, Spain
- Paediatric Infectious Diseases Unit, Department of Paediatrics, Hospital Universitario 12 Octubre, Madrid, Spain
| | | | | | | | - Susana Melendo
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Barcelona, Catalonia, Spain
| | | | - Teresa Del Rosal
- RITIP (Translational Research Network in Paediatric Infectious Diseases), Madrid, Spain
- Paediatrics, Infectious and Tropical Diseases Department, Hospital Universitario La Paz, Instituto Investigación Hospital La Paz (IDIPaz), Madrid, Spain
| | - Pere Soler-Palacin
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Barcelona, Catalonia, Spain
| | | | | | - Marta Pareja
- Paediatrics Department, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - Fátima Ara-Montojo
- Paediatrics Department, Hospital Universitario Quironsalud Madrid, Madrid, Spain
| | | | - Nerea Gallego
- Paediatrics Department, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - Marta Illán Ramos
- Paediatrics Department, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - Elena Cobos
- From the Fundación de Investigación Biomédica Hospital 12 de Octubre, Instituto de Investigación 12 de Octubre (imas12), Madrid, Spain
- RITIP (Translational Research Network in Paediatric Infectious Diseases), Madrid, Spain
- Paediatric Infectious Diseases Unit, Department of Paediatrics, Hospital Universitario 12 Octubre, Madrid, Spain
| | - Alfredo Tagarro
- From the Fundación de Investigación Biomédica Hospital 12 de Octubre, Instituto de Investigación 12 de Octubre (imas12), Madrid, Spain
- RITIP (Translational Research Network in Paediatric Infectious Diseases), Madrid, Spain
- Paediatric Infectious Diseases Unit, Department of Paediatrics, Hospital Universitario 12 Octubre, Madrid, Spain
- Paediatrics Department, Hospital Universitario Infanta Sofía, Paediatrics Research Group, Universidad Europea de Madrid, Madrid, Spain
| | - Cinta Moraleda
- From the Fundación de Investigación Biomédica Hospital 12 de Octubre, Instituto de Investigación 12 de Octubre (imas12), Madrid, Spain
- RITIP (Translational Research Network in Paediatric Infectious Diseases), Madrid, Spain
- Paediatric Infectious Diseases Unit, Department of Paediatrics, Hospital Universitario 12 Octubre, Madrid, Spain
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