scholarly journals Epidemiological and Clinical Characteristics of Children with Coronavirus Disease 2019

2020 ◽  
Author(s):  
Qin Wu ◽  
Yuhan Xing ◽  
Lei Shi ◽  
Wenjie Li ◽  
Yang Gao ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Clinical Manifestations ◽  
Epidemiological Data ◽  
Good Prognosis ◽  
Pcr Analysis ◽  
Respiratory Pathogens ◽  
Upper Respiratory Tract ◽  
Radiologic Findings ◽  
Epidemiological Characteristics

BackgroundSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a newly identified pathogen which mainly spreads by droplets. Most published studies focused on adult patients with coronavirus disease 2019 (COVID-19), but data concerning pediatric patients is limited. This study aimed to determine epidemiological characteristics and clinical features of pediatric patients with COVID-19.MethodsWe reviewed and analyzed data on pediatric patients with laboratory-confirmed COVID-19, including basic information, epidemiological history, clinical manifestations, laboratory and radiologic findings, treatment, outcome and follow-up results.ResultsFrom January 20th to February 27th of 2020, a total of 74 pediatric patients with COVID-19 were included in this study. Of the 68 cases whose epidemiological data were complete, 65 (65/68, 95.59%) cases were household contacts of adults whose symptoms developed earlier. Forty (59.46%) of the infected children were male, and the median age and body weight are 6 (0.10-15.08) years and 24 (4.20-87.00) kg, respectively. Except for one critically ill case, 20 (27.03%) patients did not show any symptoms of infection, 24 (32.43%) patients had acute upper respiratory tract infection and 29 (39.19%) patients were diagnosed with mild pneumonia. Cough (24/74, 32.43%) and fever (20, 27.03%) were the predominant symptoms of 44 (59.46%) symptomatic patients at onset of the illness. Abnormalities in leukocyte count were found in 23 (31.08%) children and 10 (13.51%) children presented with abnormal lymphocyte count. Of the 34 (45.95%) patients who had nucleic acid testing results for common respiratory pathogens, 19 (19 / 34, 51.35%) showed co-infection with other pathogens other than SARS-CoV-2.Ten (13.51%) children had RT-PCR analysis of SARS-CoV-2 for fecal specimens and 8 of them showed prolonged existence of SARS-CoV-2 RNA 11 (5-23) days after nasopharynx swabs turning negative. Abnormalities in chest imaging were observed in 37 (50.00%) patients and 28 (37.84%) of them only presented with nontypical changes.All children had good prognosis with a median hospitalization duration of 11 days and follow-up period of 16.5 days. During the follow-up period, all the patients remained in quarantine at designated site and home for two 14-day obervation periods and showed no clinical manifestation,but 3 of the 8 cases with prolonged fecal shedding of SARS-CoV-2 still showed positive result of feces test.

scholarly journals 1632. Comparing the epidemiology and clinical characteristics of childhood tuberculosis through active and passive case finding

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S807-S808
Author(s):  
Saki Ikeda ◽  
Andrea T Cruz ◽  
Jeffrey R Starke
Keyword(s):  
Clinical Manifestations ◽  
Central Nervous System Disease ◽  
Data Safety Monitoring Board ◽  
Case Finding ◽  
Childhood Tuberculosis ◽  
Contact Tracing ◽  
System Disease ◽  
Radiologic Findings ◽  
Mediastinal Adenopathy ◽  
Epidemiological Characteristics

Abstract Background Childhood tuberculosis can be found via passive case finding (PCF), diagnosing a symptomatic child, and active case finding (ACF), discovering a child through contact tracing. Most high prevalence areas perform PCF, but as ACF is introduced, the clinical and radiologic findings may differ. We compare clinical, radiographic, microbiologic and epidemiological characteristics of children diagnosed through PCF and ACF. Methods A retrospective cohort study of all patients diagnosed with TB from 01/01/2012-12/31/2019 at Texas Children’s Hospital. ACF is TB in a child who had not previously sought care before identified via contact tracing, immigration screening, or screening for incarceration. Severity of disease was based on location of illness, imaging and bacteriology/histopathology. Associations between PCF/ACF and demographics, disease severity, and microbiology were analyzed. Results Of 178 patients, 80 (45%) were diagnosed via ACF. ACF patients were more likely to be US-born (OR: 2.29, [95% Confidence interval (CI): 1.12-4.67]) and younger (mean 6.18 vs 8.84 years, p= 0.016). Only 2.5% of ACF patients had extrapulmonary disease, compared to 45% of the PCF group (p< 0.0001). All 14 severe extrathoracic cases were in the PCF group (10 central nervous system disease, 3 ocular disease, 1 spondylitis). Fewer patients in the ACF group had severe intrathoracic findings (11% vs 39%, p< 0.001): miliary disease (0% vs 10%, p=0.006), cavity (1% vs 9%, p=0.04), and multilobar involvement (7.5% vs 22.4%, p=0.006). ACF patients had more hilar/mediastinal adenopathy (OR: 2.51, [CI: 1.34-3.72], p=0.004). ACF patients were less often cultured (38% vs 89%, p< 0.0001) and had less microbiological confirmation by cultures or PCR (21% vs 52%, p=< 0.0001). Conclusion Patients in the ACF group were younger, had less severe clinical manifestations, and had almost no extrathoracic disease. Clinicians need to be aware that the common clinical and radiographic presentations in children differ between PCF and ACF. Disclosures Jeffrey R. Starke, MD, Otsuka Pharmaceuticals (Other Financial or Material Support, Member, Data Safety Monitoring Board)

scholarly journals Acute Megakaryocytic Leukemia with or Without Acquired Trisomy 21 in 15 Pediatric Patients

2020 ◽  
Author(s):  
Wenzhi ZHANG ◽  
Hui LI ◽  
Jingzhen LIU ◽  
Jiawei XU ◽  
Jinjin HAO ◽  
...  
Keyword(s):  
Trisomy 21 ◽  
Poor Prognosis ◽  
Clinical Characteristics ◽  
Pediatric Patients ◽  
Laboratory Data ◽  
Clinical Manifestations ◽  
The Other ◽  
Hematopoietic Stem ◽  
Acute Megakaryocytic Leukemia

Abstract The knowledge of clinical characteristics and prognosis of pediatric acute megakaryocytic leukemia (AMKL) with or without acquired +21 was limited. We reported 15 AMKL pediatric patients without Down Syndrome (four cases with acquired +21 and 11 cases without acquired +21) with the clinical manifestations, laboratory data, and prognosis. The clinical features and laboratory data between patients with acquired +21 and patients without acquired +21 are similar. As for prognosis, three of the 11 cases without acquired +21 obtained complete remission (CR) after 1st induction. The median follow-up time of the 11 cases was 9 months. Among four cases with acquired +21, one case gave up treatment during 1st induction, one obtained CR after 1st induction and was still alive after 49 months of follow-up. One case obtained CR after 2nd induction and was still alive for 15 months of follow-up after bone marrow transplantation, the other patient was planning for allogeneic hematopoietic stem cell transplantation (HSCT) without CR. The median follow-up time of the four cases was 12 months. None relapsed in our study. In conclusion, acquired trisomy 21 may not be an indicator for poor prognosis. Cytogenetics analysis can help us for diagnosis stratification, prognostic judgment and individualized treatment of AMKL.

scholarly journals Alveolar Echinococcosis in Children

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Emilija Jonaitytė ◽  
Martynas Judickas ◽  
Eglė Tamulevičienė ◽  
Milda Šeškutė
Keyword(s):  
Surgical Treatment ◽  
Current Literature ◽  
Echinococcus Multilocularis ◽  
Cystic Echinococcosis ◽  
Alveolar Echinococcosis ◽  
Pediatric Patients ◽  
Treatment Options ◽  
Clinical Manifestations ◽  
Diagnostic Methods

Alveolar echinococcosis (AE) is an infectious zoonotic disease that is caused by Echinococcus multilocularis. The disease is generally identified accidentally because of the long asymptomatic period, has a malignant behaviour, and mainly occurs in the liver. Usually it is diagnosed in adults and is very rare in pediatric patients. We report two cases of AE and 1 differential case between AE and cystic echinococcosis (CE) in children: two of them had lesions in the liver and one had rare extrahepatic presentation of a cyst in the spleen. All our patients received chemotherapy with albendazole because surgical treatment was not recommended. The children were followed-up from 10 to 30 months and no significant improvement was seen. In this report we discuss the difficulties we faced in the treatment and follow-up of these patients. We also review the main clinical manifestations, general diagnostic methods, and treatment options of AE according to the current literature.

scholarly journals Severe Acute Respiratory Syndrome Coronavirus 2(SARS-CoV-2) infection during late pregnancy: A Report of 18 patients from Wuhan, China

2020 ◽  
Author(s):  
Lu Zhang ◽  
Lan Dong ◽  
Lei Ming ◽  
Min Wei ◽  
Jun Li ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Bacterial Pneumonia ◽  
Virus Disease ◽  
Antiviral Treatment ◽  
Clinical Manifestations ◽  
Late Pregnancy ◽  
Neonatal Deaths ◽  
Ordinary Type ◽  
Epidemiological Characteristics

Abstract Background Compared with Severe Acute Respiratory Syndrome(SARS) and Middle East Respiratory Syndrome(MESR), Corona Virus Disease 2019(COVID-19) spread more rapidly and widely. The population was generally susceptible. However, reports on pregnant women infected with SARS-CoV-2 were very limited. By sharing the clinical characteristics, treatments and outcomes of 18 patients with COVID-19 during late pregnancy, we hoped to provide some references for obstetric treatment and management. Methods: A total of 18 patients with COVID-19 treated in Renmin Hospital of Wuhan University were collected. The epidemiological characteristics, clinical manifestations, laboratory tests, chest CT and pregnancy outcomes were performed for analysis. Results: 1.18 cases of late pregnancy infected with SARS-CoV-2 pneumonia were delivered at 35 + 5 weeks to 41 weeks. According to the clinical classification of COVID-19, 1 case was mild type, 16 cases were ordinary type, and 1 case was severe type. 2 . According to Imaging examinations: 15 (83%) cases showed unilateral or bilateral pneumonia, 2 (11%) cases had pulmonary infection with pleural effusion, and 1(6%) case had no abnormal imaging changes. 3. Among the 18 newborns, there were 3 (17%) premature infants, 1 (6%) case of mild asphyxia, 5 (28%) cases of bacterial pneumonia, 1 (6%) case of gastrointestinal bleeding, 1 (6%) case of necrotizing enteritis, 2 (11%) cases of hyperbilirubinemia and 1 (6%) case of diarrhea. All the newborns were negative for the first throat swab test of SARS-CoV-2 after birth. 4. Follow-up to Mar 7, 2020, no maternal and neonatal deaths occurred. Conclusions: The majority of patients in late term pregnancy with COVID-19 were of ordinary type, and they less likely developed into critical pneumonia after early isolation and antiviral treatment. Vertical transmission of SARS-CoV-2 was not detected, but the proportion of neonatal bacterial pneumonia was higher than other neonatal diseases in newborns.

scholarly journals Clinical Manifestations and Long-Term Follow-Up in Pediatric Patients Living at Altitude With Isolated Pulmonary Artery of Ductal Origin

2012 ◽  
Vol 33 (5) ◽  
pp. 775-781 ◽  
Author(s):  
Shinichi Takatsuki ◽  
Jeffrey R. Darst ◽  
Bibhuti B. Das ◽  
Thomas E. Fagan ◽  
Robert Wolfe ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Pediatric Patients ◽  
Clinical Manifestations ◽  
Long Term Follow Up ◽  
Isolated Pulmonary Artery

Vogt-Koyanagi-Harada disease in Spain

2021 ◽  
pp. 112067212110334
Author(s):  
Pedro Arriola-Villalobos ◽  
Aina Moll-Udina ◽  
Mario Carrasco-López-Brea ◽  
Cristina Sacristan ◽  
Maria Jose Capella ◽  
...  
Keyword(s):  
Clinical Course ◽  
Clinical Manifestations ◽  
Acute Stage ◽  
Tertiary Referral ◽  
Stage Disease ◽  
Maintenance Stage ◽  
Multicenter Analysis ◽  
Epidemiological Characteristics ◽  
First Time

Purpose: To describe the clinical and epidemiological characteristics of patients with Vogt-Koyanagi-Harada (VKH) disease in Spain. Methods: This was a retrospective multicenter analysis of data from VKH patients followed for at least 6 months. The data collected were related to demographics, clinical manifestations, treatments, and complications. Results: Participants were 112 patients (224 eyes), from 13 tertiary referral centers, of mean age 37.5 ± 14.7 years; 83.9% were women. Ethnicities were 61.6% Caucasian and 30.4% Hispanic. The disease was classified as complete in 16.1%, incomplete in 55.4%, and probable in 28.6%. When seen for the first time, the clinical course was acute in 69.6%, recurrent chronic in 15.2%, and chronic in 14.3%. The most frequent treatment was corticosteroids (acute stage 42.2%, maintenance stage 55.6%). The most common complications were cataract (41.1%) and ocular hypertension (16.1%). In most eyes, visual acuity was improved (96.7%) or remained stable at the end of follow up. Conclusion: VKH in Spain mostly affects women and presents as incomplete acute stage disease. Visual prognosis is good. Cataract and glaucoma are the two most frequent complications.

scholarly journals The Clinical and Pathological Features of Children With Microscopic Polyangiitis

2021 ◽  
Vol 9 ◽  
Author(s):  
Qian Li ◽  
Li-Chun Yu ◽  
Feng-Xia Li ◽  
Jing Wang ◽  
Yuan Chen ◽  
...  
Keyword(s):  
Microscopic Polyangiitis ◽  
Renal Involvement ◽  
Clinical Manifestations ◽  
Antithyroid Drug ◽  
Good Prognosis ◽  
Factors Associated ◽  
Stage Renal Disease ◽  
End Stage ◽  
Lung Impairment

Objective: The aim of this study was to explore the clinical features, pathological characteristics, and the prognosis of children with microscopic polyangiitis (MPA).Methods: Ten children with MPA that were hospitalized in our hospital were included in this study. The children's pre-diagnosis status, clinical manifestations, renal pathology, treatment, and prognosis data were analyzed retrospectively.Results: All 10 cases included female patients with a median age of 8.9 years old at the time of diagnosis. MPO-ANCA antibody was positive in all cases, combined with a positive anti-GBM antibody in two cases. Nine cases had primary AAV and one had antithyroid drug (ATD)-associated MPA (secondary to methimazole). Renal involvement was found in all 10 patients, lung impairment was present in eight cases, and anemia was present in nine patients. Renal biopsies were performed in all 10 patients. Segmental focal or global glomerular necrosis was observed in 70% of the patients (7/10). The treatment mainly included steroid use combined with Cyclophosphamide and Mycophenolate. The follow-up s of the patients revealed normal renal function in eight patients and progression to end-stage renal disease (ESRD) in two patients.Conclusions: Female predisposition and positive MPO-ANCA antibody were prominent in children with MPA. The patients' kidneys and lungs were the most frequently involved organs. Corticosteroid combined with immunosuppressive therapy was recommended for the treatment of MPA. Early diagnosis, prompt aggressive treatment, and regular follow-ups are also very important factors associated with a good prognosis.

scholarly journals New coronavirus infection in children in the Moscow region: clinical, epidemiological and treatment aspects

2020 ◽  
Vol 49 ◽  
Author(s):  
E. R. Meskina ◽  
M. K. Khadisova ◽  
T. V. Stashko ◽  
A. V. Bitsueva
Keyword(s):  
Pediatric Patients ◽  
Respiratory Infections ◽  
Severe Disease ◽  
Age Distribution ◽  
Clinical Manifestations ◽  
Treatment Strategies ◽  
Signs And Symptoms ◽  
Generation Cephalosporin ◽  
Moscow Region ◽  
Epidemiological Characteristics

Aim: To assess clinical and epidemiological characteristics, as well as treatment results in COVID-19 pediatric patients hospitalized to the Department of infectious disease in the Moscow region.Materials and methods: We retrospectively analyzed medical records of 124 pediatric patients aged from 1 month to 17 years with confirmed (63.7%) and highly probable (proven epidemiological association with the infection source) COVID-19 infection. The children were hospitalized from March 25, 2020 to August 11, 2020. Among patients that were hospitalized during this time period, 43% had pneumonia and 30% had acute respiratory disorders. All cases of pneumonia were confirmed by computed tomography. The children were treated according to the standard Russian guidelines.Results: The children had been infected with SARS-CoV-2 mostly from family members (75%; 95% confidence interval (CI) 66.4–82.3). In the families of the children with pneumonia, the number of pneumonia cases in their relatives was higher than in the families of the children with acute respiratory infections (1.7±1.0 vs. 1.1±0.5 respectively; р<0.001). The mean age of the hospitalized children was 8 years (7.4–9.6), with an even age distribution. The main COVID-19 signs and symptoms were as follows: fever (75.8%; 95% CI 67.3–83.0), cough (66.1%; 95% CI 57.1–74.4]), fatigues (38.7%; 95% CI 30.1–47.9), and hyposmia (33.9%; 95% CI 25.6–42.9). The severe disease course was rare (2.4%; 95% CI 0.5–6.9). The rates of positive reverse transcriptase polymerase chain reaction tests for SARS-CoV-2 were rapidly decreased at repeated tests: at day 3, 63.7% of the tests were positive, at day 7, 21.8% and at day 14, 5.6% (р<0.001). The prevalence of pneumonia was 56.4% without any age differences, with mostly minimal areas of lung abnormalities (78.6%). The severity of pneumonia and duration of clinical manifestations in the patients treated with a III generation cephalosporin or its combination with a macrolide were similar. Cough duration in those, who were treated with ipratropium bromide /fenoterol inhalations including their combination with budesonide, was higher than in those who did not use inhalation treatment. Pyrexia of>5 days duration can be a predictor of pneumonia in a  pediatric patient with COVID-19 (odds ratio 4.55 (2.1–9.9), sensitivity 61.4%, specificity 74.1%).Conclusion: The results obtained are important to develop further treatment strategies for children with COVID-19.

scholarly journals Uncommon Presentation of COVID-19 in Pediatric Patients: Anosmia

2021 ◽  
Vol 16 (02) ◽  
pp. 080-084
Author(s):  
Hatice Y. Dağlı ◽  
Özge M. Akcan ◽  
Sevgi Pekcan ◽  
Mustafa Gençeli ◽  
Hüseyin S. Özdemir ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Early Stage ◽  
Clinical Findings ◽  
World Health ◽  
The Novel ◽  
Uncommon Presentation ◽  
Novel Coronavirus ◽  
Health Organization ◽  
Epidemiological Characteristics

Abstract Objective The novel coronavirus disease 2019 (COVID-19) infection was declared as a pandemic by the World Health Organization on March 11, 2020. Although the complaint of anosmia is well described in adult patients, there is limited knowledge in pediatric patients. We aim to evaluate the epidemiological characteristics and clinical findings of children with anosmia in COVID-19-positive pediatric patients. Methods Patients diagnosed with COVID-19 infection at 1 month to 18 years of age, who admitted to Meram Faculty of Medicine of Necmettin Erbakan University between March and June 2020, were retrospectively reviewed, and the patients who had anosmia or developed anosmia during follow-up were then included in the study. The diagnosis was established by polymerase chain reaction (PCR). Results A total of 71 patients were diagnosed with COVID-19 and 14 (19.7%) of them had anosmia. Mean patient age was 14.07 (range: 10–16) years. Six of our 14 (42.8%) patients had anosmia at the time of diagnosis and anosmia developed in the follow-up among eight patients. The mean duration of anosmia in our patients was 6.9 ± 3.8 days. Recovery time was 1 to 4 days in four patients (28.5%), 5 to 8 days in four patients (28.5%), and 9 to 14 days in six patients (42.8%). Conclusion In this article, it was emphasized that anosmia can be the sole manifestation or concomitant with other symptoms in children with COVID-19 disease. Care and attention is important to identify COVID-19 patients at an early stage of the disease and limit the spread of the virus.

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