scholarly journals A case series of children and young people admitted to a tertiary care hospital in Germany with COVID-19

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jonathan Remppis ◽  
Tina Ganzenmueller ◽  
Malte Kohns Vasconcelos ◽  
Oliver Heinzel ◽  
Rupert Handgretinger ◽  
...  
Keyword(s):  
Severe Disease ◽  
Tertiary Care ◽  
Fatal Outcome ◽  
Case Series ◽  
Respiratory Illness ◽  
Care Hospital ◽  
Course Of Disease ◽  
Mild Disease ◽  
Underlying Diseases ◽  
Inflammatory Syndrome

Abstract Background While our knowledge about COVID-19 in adults has rapidly increased, data on the course of disease and outcome in children with different comorbidities is still limited. Methods Prospective, observational study at a tertiary care children’s hospital in southern Germany. Clinical and virology data from all paediatric patients admitted with SARS-CoV-2 infection at our hospital were prospectively assessed. Results Between March and November 2020, 14 patients were admitted with COVID-19. One patient was admitted a second time with COVID-19 6 months after initial disease. Among seven patients with severe underlying comorbidities, three developed multisystem inflammatory syndrome (MIS-C), two were admitted to the paediatric intensive care unit. One patient needed invasive ventilation. Another patient died shortly after discharge of COVID-19-related complications. Conclusions While COVID-19 generally causes mild disease in children, severe respiratory illness and MIS-C occur, in some cases with fatal outcome. Children with underlying diseases might be at special risk for severe disease.

scholarly journals CLINICAL PROFILE OF COVID-19 PATIENTS ADMITTED IN A TERTIARY CARE COVID HOSPITAL-AN OBSERVATIONAL STUDY

2020 ◽  
pp. 15-16
Author(s):  
S. Durga Prasad ◽  
K.V. Seshaiah ◽  
K.S.S.S.Surya Prakash ◽  
N. Lavanya ◽  
Ch.Akhil Reddy ◽  
...  
Keyword(s):  
Observational Study ◽  
Viral Infections ◽  
Clinical Symptoms ◽  
Severe Disease ◽  
Tertiary Care ◽  
Care Hospital ◽  
Cross Sectional ◽  
Multiple Systems ◽  
Mild Disease ◽  
System Methodology

BACKGROUND: Since the origin of Covid-19, a plethora of symptoms have been described in the past few months, which indicate involvement of multiple systems with much more impact on the respiratory system. METHODOLOGY: We retrospectively evaluated from the medical records of 100 Covid-19 patients diagnosed with RT-PCR. It was a cross-sectional observational study of Covid-19 patients admitted in our tertiary COVID care hospital, Vijayawada, Andhra Pradesh during the period of two months i.e.,01-04-2020 to 31-05-2020. RESULTS: We observed the different clinical symptoms with varying frequency in Covid-19 patients. In our study the clinical symptoms in the descending order of frequency were fever (59%), cough (48%), diarrhoea (6%), dyspnoea (4%), running nose (3%), headache (3%), chest pain (1%). These symptoms are not specific to covid-19 but similar to those found in other viral infections. CONCLUSION: Based on clinical picture, disease has been classified as mild, moderate and severe. More than 80% patients have mild disease and will recover.14% will have severe disease and 5% will progress to respiratory failure, shock and multiorgan dysfunction.1-2% are fatal.

scholarly journals OUTCOMES OF COVID-19 INFECTIONS IN CHILDREN: A SINGLE-CENTER RETROSPECTIVE STUDY

2021 ◽  
Author(s):  
MUSTAFA GENÇELİ ◽  
Ozge Metin Akcan ◽  
Sevgi Pekcan ◽  
Fatih Akın ◽  
Mehmet Özdemir ◽  
...  
Keyword(s):  
Negative Impact ◽  
Severe Disease ◽  
Tertiary Care ◽  
Age Groups ◽  
Clinical Findings ◽  
First Year ◽  
Care Hospital ◽  
Mild Disease ◽  
Reactive Protein ◽  
One Year

Objective: The COVID-19 pandemic is an important cause of morbidity and mortality, which has had a negative impact worldwide. Our aim was to describe clinical findings and outcomes of SARS-CoV-2 viral infection and Covid-19 disease cared for at a large pediatric tertiary care hospital during the first year of the pandemic. Methods: Patients aged 1 month to 18 years who were diagnosed as having COVID-19 between March 2020 and April 2021 were included. The files of patients diagnosed with covid-19 were reviewed retrospectively. Results: 467 children were included in the study. There were 34 (7.3%) patients under one year of age, 111 (23.8%) between 1-5 years, 98 (30.4%) between 5-10 years, 142 (30.4%) between 11-15 years, and 82 (17.6%) age over 15 years. Fever (88.2%), vomiting (32.4%), and diarrhea (29.4%) in patients aged under 1 year, sore throat (36.6%) in patients aged 11-15 years, and dysgeusia (11%), anosmia (14.6%), headache (18.3%), malaise (40.8%), myalgia (28%), and dyspnea (17.1%) in those aged over 15 years of age were found significantly more common compared with the other age groups (p<0.05). Thirty-five (7.5%) patients were asymptomatic, 365 (78.1%) had mild disease, 35 (7.5%) were moderate, 27 (5.8%) were severe, and five (1.07%) were critical. Leukocyte count, erythrocyte sedimentation rate, ferritin, and C-reactive protein values were significantly higher in hospitalized patients. Four patients died during the study period (0.8%, 4/467). Conclusion: While SARS-CoV-2 infection may be asymptomatic and Covid-19 disease usually has a mild clinical course, some children have severe disease or mortality.

scholarly journals Incidental Finding of Nocardia: A Case Series from a Tertiary Care Centre in Uttarakhand

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Aroop Mohanty ◽  
Suneeta Meena ◽  
Subodh Pandey Kumar ◽  
Puneet Kumar Gupta ◽  
Neelam Kaistha ◽  
...  
Keyword(s):  
Incidental Finding ◽  
Normal Population ◽  
Severe Disease ◽  
Tertiary Care ◽  
Case Series ◽  
Tertiary Care Centre ◽  
Course Of Disease ◽  
Pulmonary Nocardiosis ◽  
Immunosuppressed Patients ◽  
Made In

Nocardiosis is a rare bacterial infection that may lead to a severe disease. These infections are rare among normal population and are showing an increasing trend worldwide attributable to the increase in the immunosuppressed population. Most of these patients present with nonspecific clinical features such as fever, productive cough, and exertional dyspnoea as seen in our series of patients which makes it difficult to be diagnosed. Pulmonary nocardiosis is rarely clinically suspected and often diagnosed very late in the course of disease resulting in high mortality. A similar observation was made in one of our cases where the patient was being treated on the lines of pneumonia, and in the end she was diagnosed with pulmonary nocardiosis. In view of the limited literature available, we report here a case series of pulmonary nocardiosis in immunosuppressed patients diagnosed incidentally by fungal KOH mount. The most common conditions causing immunosuppression were type II DM, COPD, and pulmonary tuberculosis.

scholarly journals Serum β2-microglobulin levels in Coronavirus disease 2019 (Covid-19): Another prognosticator of disease severity?

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0247758
Author(s):  
Walter Conca ◽  
Mayyadah Alabdely ◽  
Faisal Albaiz ◽  
Michael Warren Foster ◽  
Maha Alamri ◽  
...  
Keyword(s):  
Disease Severity ◽  
Viral Infections ◽  
Linear Trend ◽  
Severe Disease ◽  
Tertiary Care ◽  
Care Hospital ◽  
Mhc I ◽  
Mild Disease ◽  
Moderate Disease ◽  
Single Center Study

β2-microglobulin (β2-m), a 11.8 kDa protein, pairs non-covalently with the α3 domain of the major histocompatibility class (MHC) I α-chain and is essential for the conformation of the MHC class I protein complex. Shed β2-m is measurable in circulation, and various disorders are accompanied by increases in β2-m levels, including several viral infections. Therefore, we explored whether β2-m levels could also be elevated in Coronavirus disease 2019 (Covid-19) and whether they predict disease severity. Serum β2-m levels were measured in a cohort of 34 patients infected with SARS-CoV-2 on admission to a tertiary care hospital in Riyadh, Saudi Arabia, as well as in an approximately age-sex matched group of 34 uninfected controls. Mean β2-m level was 3.25±1.68 mg/l (reference range 0.8–2.2 mg/l) in patients (mean age 48.2±21.6) and 1.98±0.61 mg/l in controls (mean age 48.2±21.6). 17 patients (mean age 36.9± 18.0) with mean β2-m levels of 2.27±0.64 mg/l had mild disease by WHO severity categorization, 12 patients (mean age 53.3±18.1) with mean β2-m levels of 3.57±1.39 mg/l had moderate disease, and five patients (of whom 2 died; mean age 74.4±13.8) with mean β2-m levels of 5.85±1.85 mg/l had severe disease (P < = 0.001, by ANOVA test for linear trend). In multivariate ordinal regression β2-m levels were the only significant predictor of disease severity. Our findings suggest that higher β2-m levels could be an early indicator of severity of disease and predict outcome of Covid-19. As the main limitations of the study are a single-center study, sample size and ethnicity, these results need confirmation in larger cohorts outside the Arabian Peninsula in order to delineate the value of β2-m measurements. The role of β2-m in the etiology and pathogenesis of severe Covid-19 remains to be elucidated.

scholarly journals Severe Multi-inflammatory syndrome in children amidst tropical fevers– an overlapping spectrum, its clinical and laboratory attributes from a tertiary care centre in India.

2021 ◽  
Author(s):  
Arpita Chattopadhyay ◽  
Karnika Saigal Kalra ◽  
Diganta Saikia ◽  
Varshanjali Yadav ◽  
Juhi Chouksey ◽  
...  
Keyword(s):  
Invasive Mechanical Ventilation ◽  
Tertiary Care ◽  
Laboratory Data ◽  
Case Series ◽  
World Health ◽  
Fulminant Myocarditis ◽  
Critically Ill Children ◽  
Care Hospital ◽  
Prospective Case Series ◽  
Inflammatory Syndrome

Abstract Objective: We aim to describe our experience in terms of clinical and laboratory attributes in children with Multi – inflammatory syndrome in children temporally related to COVID-19 (MISC) presenting amidst other prevalent tropical infections.Design: Prospective case series.Setting: A tertiary care hospital pediatric intensive care unit (PICU).Patients: Seventeen children with severe MIS-C managed in PICU.Methods: We did a prospective case series of children (aged ≤ 12 years), admitted to PICU betweenMay 1, 2020 and January 31, 2021, fulfilling the case definition of MIS-C published by World Health Organization (WHO) or Centers for Disease Control and Prevention (CDC). We analysed routinely collected demographic, clinical, laboratory data and echocardiographic findings. We also plotted the variation in trends between survivors and nonsurvivors.Results: 17 critically ill children with no previous comorbidities fulfilled the WHO/CDC classification of MIS-C. Median age at admission was 4 years (range 1y 6 mo-8 years). Fever, rash and conjunctival redness were most prominent symptoms. Myocardial involvement was seen in 70.5% while 76.4% developed shock; Invasive mechanical ventilation was required in 64.7% cases. Inflammation markers were highly raised - median C- reactive protein (mg/L) showed serial reduction in levels - from (median/IQR) 210 (132.6, 246.9) at admission to PICU to 52.3 (42, 120) on Day 3. Median Ferritin (ng/ml) (n=12) was 690 (203, 1324), serum LDH (IU/L) (n=12) was 505 (229.5, 1032) and Mean D-dimer (ng/ml) (n=7) was 5093.85 (1991.65), suggestive of hyperinflammatory syndrome. Although neutrophilia was seen in 16 patients [Mean (SD) - 14,952.9/μl (7175.2)], lymphopenia was uncommon and seen in only 4/17, median (IQR) [3000/μl (2245, 4508)]. 12 patients received intravenous immune globulin, with adjunctive steroid therapy used in two third of the cases. Six patients expired.Conclusions: With our case series we wish to highlight the pattern of clinical and laboratory features in a cohort of severe MISC who were positive for SARSCOV2 antibody. We suggest refining the spectra of phenotypes of MIS-C for tropical countries keeping other exanthematous infections that present with fulminant myocarditis and refractory shock in perspective.

scholarly journals A Clinical Study on Initial Experience of COVID-19 ARDS in Obstetric Patients at a Tertiary Care Centre in India

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Sheeba Marwah ◽  
Reenu Kanwar ◽  
Shahida Naghma ◽  
Anjali Dabral ◽  
Nitesh Gupta
Keyword(s):  
Clinical Presentation ◽  
Respiratory Infections ◽  
Tertiary Care ◽  
Case Series ◽  
Respiratory Illness ◽  
Response To Therapy ◽  
Care Hospital ◽  
Physiological Changes ◽  
Tertiary Care Centre ◽  
In Pregnancy

Coronavirus disease 2019 (COVID-19) is caused by a novel coronavirus (severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)) which causes severe viral pneumonia rapidly leading to acute respiratory distress syndrome (ARDS). Pregnant women are considered more vulnerable to severe viral respiratory infections owing to the physiological changes in pregnancy. In COVID-19, patient can present with a variety of symptoms of which dyspnoea is one that is also commonly seen in the late stages of pregnancy. The clinical presentation as well as response to therapy is highly variable, and since no conclusive proven treatment is available yet, prevention and symptomatic treatment remains the mainstay of management. Thus, we report a case series of four SARS-CoV-2-positive obstetric patients who presented with severe ARDS in a tertiary care hospital, posing diagnostic and therapeutic challenges to the clinician, and were managed with a holistic multidisciplinary stepwise approach. Through this, an effort has been made to sensitize the attending obstetrician on diverse presentation of COVID-19 disease and to emphasize the importance of prevention, early pick up, and timely optimal management of pneumonia in pregnant females with COVID-19. The clinical presentation of respiratory illness due to SARS-CoV-2 in pregnancy can be mistaken for exaggerated physiological changes of pregnancy leading to delay in seeking medical care. During the current pandemic, high suspicion for COVID-19 should be kept. If found symptomatic, immediate care should be sought in a designated facility and managed accordingly preferably with a multidisciplinary approach.

scholarly journals Providing safe care for patients in the coronavirus disease 2019 (COVID-19) era: A case series evaluating risk for hospital-associated COVID-19

2021 ◽  
pp. 1-7
Author(s):  
Elizabeth B. Habermann ◽  
Aaron J. Tande ◽  
Benjamin D. Pollock ◽  
Matthew R. Neville ◽  
Henry H. Ting ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Tertiary Care ◽  
Case Series ◽  
Adult Patients ◽  
Care Hospital ◽  
Strict Adherence ◽  
Large Tertiary Care ◽  
Healthcare Associated ◽  
Serology Testing ◽  
Pcr Test

Abstract Objective: We evaluated the risk of patients contracting coronavirus disease 2019 (COVID-19) during their hospital stay to inform the safety of hospitalization for a non–COVID-19 indication during this pandemic. Methods: A case series of adult patients hospitalized for 2 or more nights from May 15 to June 15, 2020 at large tertiary-care hospital in the midwestern United States was reviewed. All patients were screened at admission with the severe acute respiratory coronavirus virus 2 (SARS-CoV-2) polymerase chain reaction (PCR) test. Selected adult patients were also tested by IgG serology. After dismissal, patients with negative serology and PCR at admission were asked to undergo repeat serologic testing at 14–21 days after discharge. The primary outcome was healthcare-associated COVID-19 defined as a new positive SARS-CoV-2 PCR test on or after day 4 of hospital stay or within 7 days of hospital dismissal, or seroconversion in patients previously established as seronegative. Results: Of the 2,068 eligible adult patients, 1,778 (86.0%) completed admission PCR testing, while 1,339 (64.7%) also completed admission serology testing. Of the 1,310 (97.8%) who were both PCR and seronegative, 445 (34.0%) repeated postdischarge serology testing. No healthcare-associated COVID-19 cases were detected during the study period. Of 1,310 eligible PCR and seronegative adults, no patients tested PCR positive during hospital admission (95% confidence interval [CI], 0.0%–0.3%). Of the 445 (34.0%) who completed postdischarge serology testing, no patients seroconverted (0.0%; 95% CI, 0.0%–0.9%). Conclusion: We found low likelihood of hospital-associated COVID-19 with strict adherence to universal masking, physical distancing, and hand hygiene along with limited visitors and screening of admissions with PCR.

A Case Series of SARS-CoV-2 RT-PCR-Positive Hospitalized Infants 60 Days of Age or Younger From 2 New York City Pediatric Emergency Departments

2021 ◽  
Vol 60 (4-5) ◽  
pp. 247-251
Author(s):  
Ameer Hassoun ◽  
Nessy Dahan ◽  
Christopher Kelly
Keyword(s):  
New York ◽  
Case Reports ◽  
Severe Disease ◽  
Case Series ◽  
Pediatric Emergency ◽  
Rt Pcr ◽  
Vulnerable Group ◽  
Mild Disease ◽  
Young Infants ◽  
Novel Coronavirus

The emergence of novel coronavirus disease-2019 poses an unprecedented challenge to pediatricians. While the majority of children experience mild disease, initial case reports on young infants are conflicting. We present a case series of 8 hospitalized infants 60 days of age or younger with coronavirus disease-2019. A quarter of these patients had coinfections (viral or bacterial). None of these infants had severe disease. Continued vigilance in testing this vulnerable group of infants is warranted.

scholarly journals Use of monoclonal antibody therapy for nosocomial SARS-CoV-2 infection in patients at high risk for severe COVID-19: experience from a tertiary-care hospital in Germany

Infection ◽  
2021 ◽  
Author(s):  
Johanna Koehler ◽  
Barbara Ritzer ◽  
Simon Weidlich ◽  
Friedemann Gebhardt ◽  
Chlodwig Kirchhoff ◽  
...  
Keyword(s):  
High Risk ◽  
Tertiary Care Hospital ◽  
Severe Disease ◽  
Treatment Options ◽  
Tertiary Care ◽  
Antibody Therapy ◽  
Additional Treatment ◽  
Care Hospital ◽  
Cross Sectional ◽  
Asymptomatic Patients

AbstractAdditional treatment options for coronavirus disease (COVID-19) are urgently needed, particularly for populations at high risk of severe disease. This cross-sectional, retrospective study characterized the outcomes of 43 patients with nosocomial severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection with and without treatment using monoclonal SARS-CoV-2 spike antibodies (bamlanivimab or casirivimab/imdevimab). Our results indicate that treatment with monoclonal antibodies results in a significant decrease in disease progression and mortality when used for asymptomatic patients with early SARS-CoV-2 infection.

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