scholarly journals Iranian Pediatric COVID-19 Epidemiology and Clinical Characteristics

Author(s):  
Shahnaz Armin ◽  
Mohammadreza Mirkarimi ◽  
Zahra Pourmoghaddas ◽  
Marjan Tariverdi ◽  
Azadeh Jafrasteh ◽  
...  

Background. Despite the worldwide spread of Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2), information about the epidemiological and clinical patterns of this infection is still largely unknown in children. In addition, the prevalence of this disease is still very high in some parts of the world, including Iran. Thus, this study aims to evaluate the epidemiological features, laboratory and imaging findings, and the type of treatments in children with novel coronavirus 2019 (COVID-19). Method. This study is conducted from March 2020–March 2021 by using the medical records of hospitalized confirmed COVID-19 children younger than 18 years in five cities of Iran: Tehran, Ahwaz, Isfahan, Bandar-Abbas, and Khorramabad. In addition to demographic and epidemiological data, we also studied clinical signs and treatments. Results. In total 278 confirmed COVID-19 children, the average age was 5.3 years, and 59.4%were boys. A total of 37.8% had an underlying disease, in which the most common was a malignancy. The most common symptoms were fever and cough. In this group of pediatrics, some abnormal laboratory findings have been seen. GGO (Ground-Glass Opacity) had been diagnosed in 58.6% of children. 3.6% needed oxygen therapy with ventilators, and 83.09% had received antibiotic treatments with the majority of ceftriaxone. Also, 10% had got steroids. In this study, the mortality rate was 4.3%. Conclusion. In this study, most of the children who died had an underlying disease, so timely care and action is important in them. Most children admitted to our study received antibiotics and were prescribed antivirals and steroids for a smaller number. Also, a small number of children received oxygen therapy, most of whom were in the age group of 1 to 5 years.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Heidi Luise Schulte ◽  
José Diego Brito-Sousa ◽  
Marcus Vinicius Guimarães Lacerda ◽  
Luciana Ansaneli Naves ◽  
Eliana Teles de Gois ◽  
...  

Abstract Background Since the novel coronavirus disease outbreak, over 179.7 million people have been infected by SARS-CoV-2 worldwide, including the population living in dengue-endemic regions, particularly Latin America and Southeast Asia, raising concern about the impact of possible co-infections. Methods Thirteen SARS-CoV-2/DENV co-infection cases reported in Midwestern Brazil between April and September of 2020 are described. Information was gathered from hospital medical records regarding the most relevant clinical and laboratory findings, diagnostic process, therapeutic interventions, together with clinician-assessed outcomes and follow-up. Results Of the 13 cases, seven patients presented Acute Undifferentiated Febrile Syndrome and six had pre-existing co-morbidities, such as diabetes, hypertension and hypopituitarism. Two patients were pregnant. The most common symptoms and clinical signs reported at first evaluation were myalgia, fever and dyspnea. In six cases, the initial diagnosis was dengue fever, which delayed the diagnosis of concomitant infections. The most frequently applied therapeutic interventions were antibiotics and analgesics. In total, four patients were hospitalized. None of them were transferred to the intensive care unit or died. Clinical improvement was verified in all patients after a maximum of 21 days. Conclusions The cases reported here highlight the challenges in differential diagnosis and the importance of considering concomitant infections, especially to improve clinical management and possible prevention measures. Failure to consider a SARS-CoV-2/DENV co-infection may impact both individual and community levels, especially in endemic areas.


Author(s):  
Tiziana Ciarambino ◽  
filomena pietrantonio ◽  
Sara Rotunno ◽  
Alessandra Fiorentini ◽  
Rosalba Cipriani ◽  
...  

Background: from December 2019 and the spreading of syndemics, a lot of medical centers reg-istered data about their patients. In Italy, the most relevant quantity of patients was hospitalized in internal medicine wards. Methods: In this observational, retrospective cross-sectional study, all data of the COVID-19 patients, admitted Latio hospitals, from March 01 to December 31, 2020, were collected and their Epidemiological data, demographics, signs and symptoms on admission, comorbidities, laboratory findings, chest radiography and CT findings, treatment received and mortality rate were analyzed by gender to find any differences of gravity of disease. Clinician details were registered on database (one for every hospital). Cost analysis was performed by length of stay and antiviral drugs use, using point of view of Italian Healthcare System. Results: 2256 patients with mean age of 71.01 ± 28.02 years were included. For men, frequency of hyper-tension, COPD, use of oxygen therapy, Tocilizumab were significantly higher and epidemiolog-ical link was related to rehabilitation ward and community. The gender difference about hospi-talization was one day more for man. No strong significant difference by gender in the death rate was observed. Considering antiviral drugs and hospitalization, a man costs €1000 more than woman. Conclusions: In male patients, hypertension and COPD were observed more frequently and the epidemiological link was related to rehabilitation ward and community. In female sub-jects, the epidemiological link was related to Hospital and we observed significantly higher atypical chest-X ray. Tocilizumab, oxygen therapy and antiviral drugs were prescribed more in male subjects. No differences by gender we report in other treatments and outcomes. Future studies should be analyzed to get a more comprehensive understanding of COVID-19 by gender.


Author(s):  
Július Rajčáni ◽  

This review aims to asses the data from recently published literature related to the novel Coronavirus (nCoV), which had been isolated in the automn of 2019. Similarly to the classical Coronavirus (cCoV) isolated nearly 18 years ago, the nCoV has also emerged in China, though in a different region of the same country. The majority of papers published in the current year 2020, clearly demonstrates the actual nature of the given topics. Despite of the unusual criteria used for information selection, all the collected data have turned up useful as the virion structure and its properties concerns. Neither were omitted the clinical signs of virus related disease(s) nor understanding the spread of any other pathological state(s) occurring in infected patients. Last but not least, the presented epidemiological data contribute to understanding the spread of nCoV in human community(ies).


2020 ◽  
Author(s):  
Neha Pant ◽  
A. K. Upadhyay

In December 2019 a series of acute atypical respiratory disease occurred in Wuhan, China. The first clusters of cases were identified in association with the South China Seafood Market. In subsequent investigations it was found to be a novel coronavirus. It is suggested to have zoonotic origin. On December 31st 2019, China notified the outbreak to the World Health Organization. During the New Year, the massive migration of Chinese fuelled the epidemic. Cases in other provinces of China and other countries (South Korea, Thailand and Japan in quick succession) were reported in people who were returning from Wuhan. On 11 February, on the basis of existing rules on taxonomy the virus was names as SARS-CoV-2. SARS-CoV-2 belongs to the family of coronaviruses. It is a positive-sense single-stranded RNA (+ssRNA) virus. It has a single linear RNA segment. On the same day WHO announced the new name for the disease i.e. Coronavirus disease 2019 (COVID-19). The WHO and the US Centers for Disease Control and Prevention (CDC) say it is primarily spread directly due to close contact between people through small droplets produced during coughing, sneezing or talking within a range of about 1-3 meters. It may even transmit through indirect contact via fomites. While there are concerns it may spread by feces, this risk is believed to be low. Soon, the number of cases started increasing exponentially and on March 12, 2020 WHO announced COVID-19 a pandemic. COVID-19 has been impacting a large number of people worldwide, being reported in approximately 200 countries and territories. It was identified that Angiotensin converting enzyme 2 (ACE2) act as a functional receptor for SARS-CoV-2. The pathophysiology of COVID-19 follows sex differences, age differences, race differences in as well as underlying disease conditions i.e. comorbidities aggravated the severity of this disease.  The most common symptoms being reported are fever, dry cough or chest tightness, and dyspnoea. It is now widely recognized that respiratory symptoms of COVID-19 are extremely heterogeneous, ranging from minimal symptoms to significant hypoxia with ARDS. Diagnosis is done with the help of history, clinical signs and serological testing. Real-time reverse transcription polymerase chain reaction (rRT-PCR) is considered the standard method of testing. Several have been tested in clinical trials but none of them have been proven to be a definite therapy yet. The evolution of the current outbreak has seen extraordinary measures put in place to control transmission, including the ‘shut-down’ and ‘quarantine’. Researchers are trying to develop a vaccine against SARS-CoV-2 but at present, no vaccine is available. One should strictly follow all the preventive measures as directed by WHO and CDC and along with this, one should boost up its natural immunity to lessen the chances of getting infection.


Medicina ◽  
2021 ◽  
Vol 57 (2) ◽  
pp. 112
Author(s):  
Jūratė Masalskienė ◽  
Šarūnas Rudaitis ◽  
Renata Vitkevič ◽  
Rimantė Čerkauskienė ◽  
Diana Dobilienė ◽  
...  

Background and Objectives: The data on the prevalence of chronic kidney disease (CKD) in the pediatric population are limited. The prevalence of CKD ranges from 56 to 74.7 cases per million of the age-related population (pmarp). The most common cause of CKD among children is congenital anomalies of the kidney and urinary tract (CAKUT). With progressing CKD, various complications occur, and end-stage renal disease (ESRD) can develop. The aim of the study was to determine the causes, stage, prevalence, and clinical signs of CKD and demand for RRT (renal replacement therapy) among Lithuanian children in 2017 and to compare the epidemiological data of CKD with the data of 1997 and 2006. Materials and Methods: The data of 172 Lithuanian children who had a diagnosis of CKD (stage 2–5) in 1997 (n = 41), in 2006 (n = 65), and in 2017 (n = 66) were retrospectively analyzed. Physical development and clinical signs of children who had CKD (stage 2–5) in 2017 were assessed. Results: The prevalence of CKD stages 2–5 was 48.0 pmarp in 1997; 88.7 in 2006; and 132.1 in 2017 (p < 0.01). Congenital and hereditary diseases of the kidney in 1997 accounted for 66% of all CKD causes; in 2006, for 70%; and in 2017, for 79%. In 2017, children with CKD stages 4 or 5 (except transplanted children) had hypertension (87.5%) and anemia (50%) (p < 0.01). Children under ≤2 years with CKD were at a 3-fold greater risk of having elevated blood pressure (OR = 3.375, 95% CI: 1.186–9.904). Conclusions: There was no change in the number of children with CKD in Lithuania; however, the prevalence of CKD increased due to reduced pediatric population. CAKUT remains the main cause of CKD at all time periods. Among children with CKD stages 4 or 5, there were more children with hypertension and anemia. In children who were diagnosed with CKD at an early age hypertension developed at a younger age.


Author(s):  
Handan A. Akoğlu ◽  
Muhammet Bulut ◽  
Dilek K. Alemdar ◽  
Serdar Aslan ◽  
Kıvanç Çelikkalkan ◽  
...  

Abstract Objective This study aims to evaluate the demographic, epidemiological, and clinical features of novel coronavirus disease 2019 (COVID-19) cases aged between 0 and 18 years. Methods The demographic characteristics of the patients, admission symptoms, contact and travel histories, clinical onset duration, symptoms, treatments, laboratory findings, radiological images, and polymerase chain reaction (PCR) negation times were evaluated in a retrospective manner. Thirty-eight children (19 boys and 19 girls) were included in the study. Discussion The mean age of the patients was 10.36 ± 5.59 years. The average admission times of the patients after the onset of the symptoms was determined as 1.84 ± 2.02 days. Thirteen (34.2%) patients were observed as asymptomatic. The most common identified symptoms were fever, cough, and fatigue (55.2, 34.2, and 13.2%, respectively). Febrile convulsions, myalgia, dizziness, and diarrhea were the least common symptoms. Also, 25-hydroxyvitamin D3 (vitamin D3) levels were low and aspartate aminotransferase (AST) values were higher in the moderate group than the mild group and the relationships were statistically significant (p = 0.044and 0.027). Ferritin levels of the patients with ground glass opacity (GGO) were found statistically and significantly higher than the patients without GGO (p = 0,031). There was more than one lobe and segment involvement in five patients, the average number of affected lobes and segments was 3.8 and 8.8, respectively. High-resolution computed tomography of the 24 patients showed that; GGO in five (20.8%), consolidation + GGO (mixed) in three (12.5%), consolidation (alone) in one, subpleural linear opacities in three (12.5%), and pavement stone opacities in one (4.2%) patient. COVID-19, which is seen less frequently in children, may pose a risk in infants and young children. Conclusion Especially high ferritin levels may present with lung involvement and low vitamin D levels may worsen the aggravation of the lung involvement. There is a great need for further research on this subject.


2021 ◽  
Vol 38 (1) ◽  
pp. 18-26
Author(s):  
Zhilla Damanabad ◽  
Leila Valizadeh ◽  
Sadollah Yeghanedoost ◽  
Fariborz Roshangar

In late December 2019, Wuhan, China, became the center of an unknown outbreak of pneumonia that spread rapidly throughout China and around the world, including Iran, and the World Health Organization (WHO) declared the novel disease a public health emergency with global concern. Since the COVID-19 outbreak, many studies have been performed on epidemiological data and clinical signs in adults. However, coherent studies in this field are very rare in infants, and support and attention to infants in the pandemic situation should be doubled due to the weakness and underdevelopment of the neonatal immune system. Therefore, the present study aimed to review COVID-19 infection in infants in which there are discussions on topics such as diagnostic tests, clinical manifestations, recommendations on breastfeeding, the criteria for discharge, and family education in pandemic conditions. The literature review shows no existing evidence of COVID-19 placental transmission from mother to infant, and that all samples prepared from amniotic fluid, umbilical cord blood and breast milk in mothers with COVID -19 was negative for COVID-19 infection, and the clinical manifestations of COVID-19 were non-specific in infants, especially premature infants. Given that there is a limited number of births from a mother with COVID-19, and because the epidemiological and clinical pattern of COVID-19 in infants is unclear, this review study describes diagnostic tests, clinical manifestations, breastfeeding considerations, discharge criteria, and family education in the current understanding of COVID-19 infection in newborns and provides information for better management of SARS-CoV-2 infection in newborns.


2020 ◽  
Vol 2 (4) ◽  
pp. 367-373
Author(s):  
Nikolaos Chrysanthakopoulos ◽  

In December 2019 in Wuhan, China, the World Health Organization (WHO) declares that a severe pandemic of Coronavirus disease 2019 (COVID-19) was emerged and was spread rapidly resulted in dramatic global economic and health implications. The novel coronavirus, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is responsible for a severe inflammatory reaction and clinically severe complications, although the majority of the infected individuals had mild symptoms and favorable prognosis after recovery. However, cancer patients are a high-risk group as are already susceptible to COVID-19 infection due to their underlying disease and their immunosuppression. Moreover, cancer patients are at increased risk of developing clinically severe complications in case of COVID-19 infection such as, Intensive Care Unit admission, required mechanical ventilation or even death. Another aggravating factor for oncological patients, during that pandemic crisis is the risk of postponing cancer treatment. The present review presents the clinical characteristics accompanied by the corresponding laboratory findings in COVID-19 infected cancer patients and the possible therapeutic role of some known chemo-therapeutic agents based on the recent observations of the International literature.


Biomeditsina ◽  
2020 ◽  
pp. 39-46
Author(s):  
A. S. Samoilov ◽  
Yu. D. Udalov ◽  
M. V. Sheyanov ◽  
A. V. Gholinsky ◽  
A. B. Litvinenko

This communication presents the experience of using mobile pressure chambers in patients with the confi rmed novel coronavirus infection in hospital settings. The obtained preliminary results indicate positive antihypoxic effects of hyperbaric oxygen therapy (HBO) applied in the form of increased saturation. After a session of HBO, patients demonstrated an increase in the oxygen saturation of capillary blood hemoglobin at the average level of 3.71 points. Differences between SatO2 levels prior to and following HBO treatment were signifi cant in the CT2, CT3 and CT4 groups (p0.05). As expected, the effi cacy of HBO in terms of the oxygen saturation of capillary blood hemoglobin was the greatest in the patient groups showing pronounced clinical and radiological changes in the lungs.


Author(s):  
Ali H. Elmokadem ◽  
Dalia Bayoumi ◽  
Sherif A. Abo-Hedibah ◽  
Ahmed El-Morsy

Abstract Background To evaluate the diagnostic performance of chest CT in differentiating coronavirus disease 2019 (COVID-19) and non-COVID-19 causes of ground-glass opacities (GGO). Results A total of 80 patients (49 males and 31 females, 46.48 ± 16.09 years) confirmed with COVID-19 by RT-PCR and who underwent chest CT scan within 2 weeks of symptoms, and 100 patients (55 males and 45 females, 48.94 ± 18.97 years) presented with GGO on chest CT were enrolled in the study. Three radiologists reviewed all CT chest exams after removal of all identifying data from the images. They expressed the result as positive or negative for COVID-19 and recorded the other pulmonary CT features with mention of laterality, lobar affection, and distribution pattern. The clinical data and laboratory findings were recorded. Chest CT offered diagnostic accuracy ranging from 59 to 77.2% in differentiating COVID-19- from non-COVID-19-associated GGO with sensitivity from 76.25 to 90% and specificity from 45 to 67%. The specificity was lower when differentiating COVID-19 from non-COVID-19 viral pneumonias (30.5–61.1%) and higher (53.1–70.3%) after exclusion of viral pneumonia from the non-COVID-19 group. Patients with COVID-19 were more likely to have lesions in lower lobes (p = 0.005), peripheral distribution (p < 0.001), isolated ground-glass opacity (p = 0.043), subpleural bands (p = 0.048), reverse halo sign (p = 0.005), and vascular thickening (p = 0.013) but less likely to have pulmonary nodules (p < 0.001), traction bronchiectasis (p = 0.005), pleural effusion (p < 0.001), and lymphadenopathy (p < 0.001). Conclusions Chest CT offered reasonable sensitivity when differentiating COVID-19- from non-COVID-19-associated GGO with low specificity when differentiating COVID-19 from other viral pneumonias and moderate specificity when differentiating COVID-19 from other causes of GGO.


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