scholarly journals Distinctive clinical and laboratory features of COVID-19 and H1N1 influenza infections among hospitalized pediatric patients

2021 ◽  
Author(s):  
Ali Alsuheel Asseri ◽  
Ayed A. Shati ◽  
Saleh M. Al-Qahtani ◽  
Ibrahim A. Alzaydani ◽  
Ahmed A. Al-Jarie ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Unit Length ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
H1n1 Influenza ◽  
Laboratory Findings ◽  
Number Of Children ◽  
Cell Counts ◽  
Number Of Patients ◽  
Total Intensive Care Unit

Abstract Background It had been documented in many studies that pediatric coronavirus disease 2019 (COVID-19) is characterized by low infectivity rates, low mortalities, and benign disease course. On the other hand, influenza type A viruses are recognized to cause severe and fatal infections in children populations worldwide. This study is aimed to compare the clinical and laboratory characteristics of COVID-19 and H1N1 influenza infections. Methods A retrospective study comprising 107 children hospitalized at Abha Maternity and Children Hospital, Southern region of Saudi Arabia, with laboratory-confirmed COVID-19 and H1N1 influenza infections was carried out. A complete follow-up for all patients from the hospital admission until discharge or death was made. The clinical data and laboratory parameters for these patients were collected from the medical records of the hospital. Results Out of the total enrolled patients, 73 (68.2%) were diagnosed with COVID-19, and 34 (31.8%) were diagnosed with H1N1 influenza. The median age is 12 months for COVID-19 patients and 36 months for influenza patients. A relatively higher number of patients with influenza had a fever and respiratory symptoms than COVID-19 patients. In contrast, gastrointestinal symptoms were observed in a higher number of COVID-19 patients than in influenza patients. A statistically significant increase in white cell counts is noted in COVID-19 but not in influenza patients (P < 0.05). There are no obvious variations in the mean period of duration of hospitalization between COVID-19 and influenza patients. However, the total intensive care unit length of stay was longer for influenza compared to COVID-19 patients. Conclusions A considerable number of children infected with COVID-19 and H1N1 influenza were noted and reported in this study. There were no significant variations in the severity of the symptomatology and laboratory findings between the two groups of patients. Significant differences between these patients in some hospitalization factors and diagnosis upon admission also were not observed. However, more severe clinical manifestations and serious consequences were observed among pediatric patients hospitalized with influenza infections than among those with COVID-19.

scholarly journals Clinical and laboratory findings of patients with the possible diagnosis of influenza hospitalized in affiliated hospitals of Babol University of Medical Sciences, 2015-2016

2018 ◽  
Vol 31 (3) ◽  
pp. 113-116 ◽  
Author(s):  
Mostafa Javanian ◽  
Arefeh Babazadeh ◽  
Soheil Ebrahimpour ◽  
Mehran Shokri ◽  
Masomeh Bayani
Keyword(s):  
Clinical Laboratory ◽  
Clinical Symptoms ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Medical Sciences ◽  
Laboratory Findings ◽  
Cross Sectional ◽  
Number Of Patients ◽  
Epidemiological Characteristics

Abstract The clinical and para clinical manifestations of influenza in various patients have range from an autoimmune disease to a life-threatening respiratory infection. In addition, the severity of the disease is influenced by factors such as demographic factors, underlying diseases, and immune response. Therefore, in this study, we evaluated the clinical, laboratory and epidemiological characteristics of patients with this type of influenza in Babol (north of Iran). This study was conducted as a descriptive cross-sectional study from October 2015 to March 2016. Subsequently, in this study, records of 123 patients with clinical signs of the influenza-like disease who have undergone the clinical sign in hospitals affiliated to Babol University of Medical Sciences were reviewed. Of 123 patients admitted to a possible diagnosis of influenza, 58 patients (47.2%) were PCR positive for H1N1, while seventy nine (64.2%) participants were women and 21 (17.1%) had diabetes or underlying lung disease. Most of the involved age groups were of individuals above the age of 50. These were followed by the 21-35 years-old. Fever (78%), cough (65.9%), shivering (58.5%) and myalgia (56.1%) were the most common clinical symptoms. Increased levels of transaminases (43.1%), leukocytosis (35.8%) and thrombocytopenia (34.2%) were as well reported in patients as the most frequently reported para clinical findings. In the present study, the most usual clinical symptoms were fever, cough, chill, and myalgia, while gastrointestinal symptoms were also noticeably observed in patients. In an experimental study, a significant number of patients showed leukocytosis and thrombocytopenia and increased transaminases.

scholarly journals Characteristics of Eight Pediatric Patients with Coronavirus Disease 2019

2020 ◽  
Vol 30 (5) ◽  
Author(s):  
Gaoyan Chen ◽  
Junhua Li ◽  
Yongchao Jiang ◽  
Haihua Chen ◽  
Rui Pan
Keyword(s):  
Antiviral Therapy ◽  
Pediatric Patients ◽  
Early Stage ◽  
Clinical Manifestations ◽  
Ground Glass Opacity ◽  
Laboratory Findings ◽  
Family Cluster ◽  
Cell Counts ◽  
Rapid Transmission ◽  
White Blood Cell Counts

Background: Coronavirus Disease 2019 (COVID-19) has attracted global attention for unexpected rapid transmission among countries. Currently, little is known about the attributes of pediatric patients with COVID-19. Objectives: To describe the characteristics of pediatric patients with COVID-19. Methods: We retrospectively analyzed the epidemiological, laboratory, imaging, and clinical data of pediatric patients with COVID-19 from January 31 to February 24, 2020. Results: A total of eight patients with COVID-19 were enrolled in this study. Two patients had underlying diseases. Seven children (87.5%) belonged to a family cluster outbreak. The most common symptoms were fever (50%), cough (37.5%), expectoration (37.5%), and Sore throat (37.5%). For the laboratory findings, all patients had positive nCoV-RNA results, three patients (37.5%) with abnormal white blood cell counts, and six patients (75%) with higher lymphocyte counts. Chest computed tomography (CT) showed ground-glass opacity or patchy shadows in 7 patients (87.5%). All patients received antiviral therapy. Additionally, four patients (50%) were treated with antibiotics, one with glucocorticoid atomization (12.5%), one with interferon atomization (12.5%), four patients (50%) with traditional Chinese medicine. All patients discharged within three weeks, without poor prognosis or recurrence after 14 days follow-up. Conclusions: Pediatric patients with COVID-19 were mainly transfected through family cluster outbreaks. The clinical manifestations were mild without a typical pattern. High-resolution CT and nCoV-RNA tests have great value for early-stage diagnosis. Antiviral therapy is effective in treating viral pneumonia.

scholarly journals Clinical and laboratory findings in elderly with Community-Acquired Pneumonia in Babol, northern Iran – 2017-2019

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Saleh Habibi ◽  
Arefeh Babazadeh ◽  
Soheil Ebrahimpour ◽  
Parisa Sabbagh ◽  
Mehran Shokri
Keyword(s):  
Older Adults ◽  
Age Groups ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Vital Signs ◽  
The Elderly ◽  
Community Acquired Pneumonia ◽  
Northern Iran ◽  
Laboratory Findings ◽  
Cross Sectional

Abstract Morbidity and mortality are higher in older adults with community-acquired pneumonia (CAP) than in other age groups. Also, CAP in older adults has various clinical manifestations with other. A higher mortality rate in the elderly with CAP may contribute to a delay in management. Consequently, the purpose of this study was to investigate the clinical and laboratory manifestations of CAP in the elderly. This cross-sectional study was conducted on 221 elderly patients with CAP who were admitted to Ayatollah Rouhani Hospital, in Babol, northern of Iran, in 2017-2019. Patient outcomes included 170 cases that recovered from CAP, and 51 cases that died of complications. Patients were evaluated in terms of their clinical and laboratory manifestations. The most common symptoms of pneumonia were cough (79.6%), sputum (73.8%), weakness (72.9%), fever (56%), dyspnea (46.2%). The most frequent underlying disease was ischemic heart disease (43.9%). In our study, clinical and laboratory characteristics in older patients with CAP were evaluated and compared with other studies confirming past findings, but there were differences in some cases, such as vital signs, gastrointestinal symptoms, and disturbance of the level of consciousness. Therefore, it recommends carefully taking the patients’ initial histories and accurately recording their clinical and laboratory symptoms.

scholarly journals Novel Coronavirus Infection (COVID-19) in Humans: A Scoping Review and Meta-Analysis

2020 ◽  
Vol 9 (4) ◽  
pp. 941 ◽  
Author(s):  
Israel Júnior Borges do Nascimento ◽  
Nensi Cacic ◽  
Hebatullah Mohamed Abdulazeem ◽  
Thilo Caspar von Groote ◽  
Umesh Jayarajah ◽  
...  
Keyword(s):  
Scoping Review ◽  
Clinical Symptoms ◽  
Meta Analysis ◽  
Laboratory Data ◽  
Gastrointestinal Symptoms ◽  
Common Disease ◽  
Imaging Data ◽  
Laboratory Findings ◽  
Number Of Patients ◽  
Novel Coronavirus

A growing body of literature on the 2019 novel coronavirus (SARS-CoV-2) is becoming available, but a synthesis of available data has not been conducted. We performed a scoping review of currently available clinical, epidemiological, laboratory, and chest imaging data related to the SARS-CoV-2 infection. We searched MEDLINE, Cochrane CENTRAL, EMBASE, Scopus and LILACS from 01 January 2019 to 24 February 2020. Study selection, data extraction and risk of bias assessment were performed by two independent reviewers. Qualitative synthesis and meta-analysis were conducted using the clinical and laboratory data, and random-effects models were applied to estimate pooled results. A total of 61 studies were included (59,254 patients). The most common disease-related symptoms were fever (82%, 95% confidence interval (CI) 56%–99%; n = 4410), cough (61%, 95% CI 39%–81%; n = 3985), muscle aches and/or fatigue (36%, 95% CI 18%–55%; n = 3778), dyspnea (26%, 95% CI 12%–41%; n = 3700), headache in 12% (95% CI 4%–23%, n = 3598 patients), sore throat in 10% (95% CI 5%–17%, n = 1387) and gastrointestinal symptoms in 9% (95% CI 3%–17%, n = 1744). Laboratory findings were described in a lower number of patients and revealed lymphopenia (0.93 × 109/L, 95% CI 0.83–1.03 × 109/L, n = 464) and abnormal C-reactive protein (33.72 mg/dL, 95% CI 21.54–45.91 mg/dL; n = 1637). Radiological findings varied, but mostly described ground-glass opacities and consolidation. Data on treatment options were limited. All-cause mortality was 0.3% (95% CI 0.0%–1.0%; n = 53,631). Epidemiological studies showed that mortality was higher in males and elderly patients. The majority of reported clinical symptoms and laboratory findings related to SARS-CoV-2 infection are non-specific. Clinical suspicion, accompanied by a relevant epidemiological history, should be followed by early imaging and virological assay.

A Review of Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19

2020 ◽  
Vol 24 (4) ◽  
Author(s):  
Alireza Ghodsi ◽  
Abdolreza Malek ◽  
Sara Ghahremani
Keyword(s):  
Clinical Presentation ◽  
Age Groups ◽  
Clinical Manifestations ◽  
Organ Involvement ◽  
High Morbidity ◽  
Laboratory Findings ◽  
Persistent Fever ◽  
Number Of Children ◽  
Relevant Evidence ◽  
Inflammatory Syndrome

: The coronavirus disease 2019 (COVID-19) pandemic, with a high morbidity and mortality rate, has affected all age groups. COVID-19 infection in children usually has minimal symptoms, but the number of children with the inflammatory syndrome with clinical features similar to the Kawasaki disease has increased during the COVID-19 pandemic. Information about this emerging COVID-19 manifestation also called the multisystem inflammatory syndrome in children (MIS-C), is still incomplete. Patients typically present with persistent fever, followed by shock or multi-organ involvement. Laboratory findings and clinical presentation of this multi-organ involvement is part of the diagnostic criteria. Early treatment and multidisciplinary referral to pediatric specialists are essential. The prognosis of MIS-C is not yet fully understood. Although most children survive, several deaths have also been reported. Based on relevant evidence, this study aimed to review the pathophysiology, clinical manifestations, laboratory and imaging findings, diagnosis, treatment recommendations, and prognosis of MIS-C associated with COVID-19.

scholarly journals Clinical Update of Severe Fever with Thrombocytopenia Syndrome

Viruses ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1213
Author(s):  
Jun-Won Seo ◽  
Dayoung Kim ◽  
Nara Yun ◽  
Dong-Min Kim
Keyword(s):  
Antiviral Agents ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Febrile Illness ◽  
Laboratory Diagnosis ◽  
Multiple Organ ◽  
Haemaphysalis Longicornis ◽  
Number Of Patients ◽  
Amblyomma Testudinarium ◽  
Severe Fever

Severe fever with thrombocytopenia syndrome (SFTS) is an acute febrile illness characterized by fever, leukopenia, thrombocytopenia, and gastrointestinal symptoms such as diarrhea, nausea, and vomiting resulting from infection with the SFTS virus (SFTSV). The SFTSV is transmitted to humans by tick bites, primarily from Haemaphysalis longicornis, Amblyomma testudinarium, Ixodes nipponensis, and Rhipicephalus microplus. Human-to-human transmission has also been reported. Since the first report of an SFTS patient in China, the number of patients has also been increasing. The mortality rate of patients with SFTS remains high because the disease can quickly lead to death through multiple organ failure. In particular, an average fatality rate of approximately 20% has been reported for SFTS patients, and no treatment strategy has been established. Therefore, effective antiviral agents and vaccines are required. Here, we aim to review the epidemiology, clinical manifestations, laboratory diagnosis, and various specific treatments (i.e., antiviral agents, steroids, intravenous immunoglobulin, and plasma exchange) that have been tested to help to cope with the disease.

scholarly journals Multisystem inflammatory syndrome in children associated with COVID-19: nursing care

2021 ◽  
Vol 11 (2) ◽  
pp. 10-17
Author(s):  
Sofia Panato Ribeiro ◽  
Simone Boettcher
Keyword(s):  
Nursing Care ◽  
Pediatric Patients ◽  
Quality Care ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Signs And Symptoms ◽  
Viral Disease ◽  
Provide Quality Care ◽  
Generalized Lymphadenopathy ◽  
Inflammatory Syndrome

In 2019, a new viral disease, known as SARS-Cov-2 infection, was identified. Scientists believed that it was a disease with low morbidity for pediatric patients; however, a small percentage of children infected with the new coronavirus developed a multisystem inflammatory response, which aroused the interest of many researchers and health professionals. The objective of the study is to describe the main characteristics related to the Pediatric Multisystemic Inflammatory Syndrome Associated with Covid-19 (MIS-C), its complications and nursing care. The main clinical manifestations of MIS-C are hyperthermia, gastrointestinal symptoms, skin manifestations, generalized lymphadenopathy, cardiac and neurological disorders. The main nursing care was listed according to the signs and symptoms, such as monitoring of neurological and hydroelectrolytic changes. The nurse professional must add knowledge about MIS-C so that he is able to qualify his care and improve his skills to provide quality care to pediatric patients.

Abstract 10: Effect of coincident infections in acute Kawasaki disease

Circulation ◽  
2015 ◽  
Vol 131 (suppl_2) ◽  
Author(s):  
Toshiaki Jibiki ◽  
Yuji Hashimoto ◽  
Masaki Kanazawa ◽  
Izumi Kato ◽  
Yoshinori Morita ◽  
...  
Keyword(s):  
Kawasaki Disease ◽  
Clinical Course ◽  
Acute Otitis Media ◽  
Gastrointestinal Symptoms ◽  
Treatment Decision ◽  
Admission Diagnosis ◽  
Upper Respiratory Tract ◽  
Laboratory Findings ◽  
Number Of Patients ◽  
Acute Kawasaki Disease

We investigated prevalence of coincident infections in acute Kawasaki disease (KD) to know the possible effects of infections on diagnosis of KD, clinical course, therapy decision and coronary outcomes. Single center consecutive 344 KD patients hospitalized in our institution, between January 2009 and December 2013 were retrospectively analyzed. Patients those were positive for bacterial culture, rapid antigen tests or elevated levels of pathogen specific antibodies were counted as KD patients with infection. Pathogen unproven patients those presented with apparent respiratory or gastrointestinal symptoms regarding infections were also counted as KD patients not to underestimate number of patients with suspected infections. Overall, 125 KD patients were grouped as KD patients with infection (Group1). Group1 included 125 patients with 73 upper respiratory tract infection, 21 bronchitis, 7 pneumonia, 3 acute otitis media and 21 gastroenterocolitis, respectively. Remaining 219 KD patients were grouped as KD without infection (Group2). Appropriate antibiotic or antiviral treatments were done for each pathogen proven infection. Distribution of age and sex, day of admission, diagnosis and treatment, prevalence of initial treatment regimen and rate of additional therapy, duration of fever, laboratory findings except serum albumin value, and coronary outcomes were similar between the groups. We showed that presence of coincident infections have no effects on clinical course, treatment decision and coronary outcomes on KD.

Levetiracetam (Keppra) efficacy and safety in the prevention of early-onset seizures following traumatic brain injuries in pediatric patients

2015 ◽  
Vol 5 (4) ◽  
pp. 144-148
Author(s):  
Young Shin ◽  
Sandra Benavides ◽  
Joanie Wurster ◽  
Neil Patel
Keyword(s):  
Early Onset ◽  
Adverse Reactions ◽  
Brain Injuries ◽  
Pediatric Patients ◽  
Emergency Department Visits ◽  
Efficacy And Safety ◽  
Onset Seizure ◽  
Number Of Children ◽  
Seizure Prophylaxis ◽  
Number Of Patients

Abstract Introduction Approximately half a million emergency department visits for traumatic brain injury (TBI) by children and adolescents occur each year. One of the complications of TBI is early-onset seizure. Current guidelines recommend the use of phenytoin for prevention of seizures following a TBI; however, several drug interactions and adverse reactions are associated with its use. Despite studies demonstrating efficacy of levetiracetam in adult patients, the efficacy and safety of levetiracetam in children with TBI is unknown. The purpose of this study was to determine the efficacy and safety of levetiracetam for the prevention of early-onset seizures in pediatric patients following TBI. Methods A retrospective evaluation was conducted, which included children, ages 0 to 17 years, admitted secondary to a nonpenetrating TBI and who received levetiracetam for seizure prophylaxis for up to 7 days. The primary outcome was the number of children who had a seizure within the first 7 days following a TBI, and secondary outcomes included the number of adverse drug reactions. Results A total of 89 pediatrics patients with nonpenetrating TBI were identified and included in the study. Forty-seven patients received a mean dose of 10 mg/kg (SD ± 4.22) of levetiracetam twice a day, and 42 patients received 500 mg 2 times per day (based on adult dosing). Seizure activity was observed in only two patients (2.2%) within the first 7 days following TBI. A total of 13 patients (14.6%) experienced anemia, agitation, and elevation of liver enzymes during levetiracetam therapy. Discussion The study suggests that levetiracetam appears to be an effective and safe agent for early-onset seizure prophylaxis in pediatric patients with TBI as indicated by the low number of patients with seizures. The reported adverse reactions may have resulted from the trauma rather than the use of levetiracetam.

Novel heterozygous PIK3CD mutation presenting with only laboratory markers of combined immunodeficiency

2020 ◽  
Vol 7 (2) ◽  
pp. 49-55
Author(s):  
Amarilla B. Mandola ◽  
Harjit Dadi ◽  
Brenda Reid ◽  
Chaim M. Roifman
Keyword(s):  
Newborn Screening ◽  
Catalytic Domain ◽  
Clinical Course ◽  
Phenotypic Variability ◽  
Severe Combined Immunodeficiency ◽  
Clinical Manifestations ◽  
Combined Immunodeficiency ◽  
Laboratory Findings ◽  
Number Of Patients ◽  
Increased Risk

Introduction: Phosphatidylinositol-4,5-Bisphosphate 3-Kinase Catalytic Subunit Delta (PIK3CD) is one part of a heterodimer forming the enzyme phosphoinositide 3-kinase (PI3K), found primarily in leukocytes. PIK3CD generates phosphatidyl-inositol 3,4,5-trisphosphate (PIP3), and is involved in cell growth, survival, proliferation, motility, and morphology. An increasing number of patients have been described with heterozygous PIK3CD gain-of-function (GOF) mutations, leading to combined immunodeficiency with both B- and T-cell dysfunction. Patients suffer recurrent respiratory infections, often associated with bronchiectasis and ear and sinus damage, as well as severe recurrent or persistent infections by herpesviruses, including EBV-induced lymphoproliferation. Aim: To present the clinical phenotypic variability of a novel PI3KCD mutation within a family. Methods: Patient information was collected prospectively and retrospectively from medical records. Comprehensive immune work up, genetic, and signaling evaluation was performed. Results: We describe here 2 patients, daughter and mother, with heterozygous PIK3CD mutation identified by whole exome sequencing and Sanger confirmation. The child was screen-positive by newborn screening for severe combined immunodeficiency (SCID). Cellular assays revealed an increase in the baseline phosphorylation of T cells in the patient. Furthermore, both patients had hyper-activation of the catalytic domain, resulting in increased phosphorylation of AKT upon activation. Discussion: GOF mutations affecting the PIK3CD gene are associated with an increased risk for lymphoproliferation leading to Activated PIK3-delta syndrome (APDS). The clinical course of APDS is highly variable, ranging from combined immunodeficiency with recurrent infections, autoimmune complications, and requiring stem cell transplantation, through isolated antibody deficiency, to asymptomatic adults. Our patient is the first to be identified by newborn screening for SCID. Surprisingly, the clinical course has so far been unremarkable, as well, the mother appears to be completely asymptomatic. Nevertheless, the persistent lymphopenia indicates PIK3CD dysfunction. Because of the wide gap between laboratory findings and clinical manifestations, this kindred poses both a diagnostic as well treatment challenge. Statement of novelty: We report here a novel PIK3CD mutation diagnosed due to abnormal newborn screen for SCID.

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