scholarly journals Human Adenovirus Coinfection Aggravates the Severity of Mycoplasma pneumoniae Pneumonia in Children

2019 ◽  
Author(s):  
Jiaojiao Gao ◽  
Lili Xu ◽  
Baoping Xu ◽  
Zhengde Xie ◽  
Kunling Shen
Keyword(s):  
Disease Severity ◽  
Mycoplasma Pneumoniae ◽  
Research Group ◽  
Severe Disease ◽  
Clinical Manifestations ◽  
Severe Pneumonia ◽  
Human Adenovirus ◽  
Control Group ◽  
Children's Hospital ◽  
Children’S Hospital

Abstract Background Mycoplasma pneumoniae ( M. pneumoniae ) is an important pathogen of community-acquired pneumonia (CAP) in children. The coinfection rate of M. pneumoniae pneumonia (MPP) can reach 52% in some areas, but the effects of coinfection with different pathogens have not been clearly recognized.Methods The cases of MPP hospitalized in Beijing Children's Hospital from 1/1/2014 to 12/31/2016 were screened. MPP patients coinfected with Human adenovirus (HAdV) were categorized into the research group. Patients with single M. pneumoniae infection were categorized into the control group, matching the research group by age and admission time with a ratio of 1:3. Clinical manifestations, laboratory examinations, and disease severity were compared between these two groups.Results A total of 2,540 hospitalized MPP cases were screened in Beijing Children's Hospital, among which thirty cases were enrolled in the research group and ninety cases were enrolled in the control group. The results indicated that patients in the research group had longer hospital stays, longer fever durations and a higher rate of dyspnea, as well as a larger proportion applications of oxygen therapy and noninvasive continuous positive airway pressure (NCPAP). No obvious differences were found in lab examinations within the two groups. Regarding disease severity, the proportions of extremely severe pneumonia and severe disease defined by the clinical score system were higher in the research group than in the control group.Conclusion Compared with single M. pneumoniae infection, MPP coinfected with HAdV in children was relatively more serious.

STUDY THE CHANGES IN MORPHOLOGY AND LEFT VENTRICULAR FUNCTION IN OVERWEIGHT-OBESE CHILDREN 5-15 YEARS OLD WHO VISITED CHILDREN'S HOSPITAL IN CAN THO

2011 ◽  
pp. 36-42
Author(s):  
Hung Viet Bui ◽  
Thi Cu Nguyen
Keyword(s):  
Left Ventricular Function ◽  
Ventricular Function ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Obese Children ◽  
Ventricular Ejection Fraction ◽  
Children's Hospital ◽  
Number Of Patients ◽  
Children’S Hospital

Objective: In Vietnam, obesity is increasing particularly in many large cities. Adult cardiovascular diseases are often derived from cardiovascular disorders during the children period. The implementation of early measures to prevent atherosclerosis, such as weight control, better lipid control will reduce the cardiovascular complications, such as hypertension (HTA), coronary heart diseases and some other diseases. Materials and Methods: Overweight - obese children from 5 to 15 years old who visited the Children's Hospital in Can Tho from May 2009 to May 2010. Total number of patients were chosen as 50 children. Method: Descriptive cross-sectional. Children in the study underwent Doppler ultrasound exam to evaluate cardiac morphology and cardiac function. Results: There were increases in left ventricular systolic diameter, left ventricular diastolic diameter, LV mass in overweight-obese children in the study compared with controls at all ages (p <0.05 ). Left ventricular ejection fraction in overweight-obese children in the study was lower than the control group at all ages (p> 0.05). The average rate of left ventricular shortening of overweight-obese children in the study was 34.8 ± 4.5(%). There was no difference in the rate of shortening of the left ventricle in overweight-obese children in the study compared with controls (p>0.05). There was no relationship between variation in morphology and left ventricular function with the degree of overweight-obesity in this study. Conclusion: The study showed that disturbances in morphology and left ventricular function in overweight-obese children but did not find a strong association with the disorder degree of overweight-obesity.

scholarly journals Adenovirus viremia may predict adenovirus pneumonia severity in immunocompetent children

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ruimu Zhang ◽  
Hongmei Wang ◽  
Shufeng Tian ◽  
Jikui Deng
Keyword(s):  
Risk Factors ◽  
Viral Load ◽  
Disease Severity ◽  
Mycoplasma Pneumoniae ◽  
Quantitative Polymerase Chain Reaction ◽  
Univariate Analysis ◽  
Clinical Manifestations ◽  
Pneumonia Severity ◽  
Adenovirus Pneumonia ◽  
Blood Viral Load

Abstract Background Previous studies have demonstrated an association between adenovirus viremia and disease severity in immunocompromised children. However, few studies have focused on this association in immunocompetent children. This study explored the association between adenovirus viremia and adenovirus pneumonia severity in immunocompetent children. Methods We performed a retrospective, observational study of immunocompetent children with adenovirus pneumonia admitted to Shenzhen Children’s Hospital in Shenzhen, China. Pneumonia was classified as severe or mild based on the Chinese guideline for the classification of pneumonia severity. Serum samples from all the children included in the study were tested for adenovirus DNA with a quantitative polymerase chain reaction. Clinical manifestations, laboratory examinations, and disease severity were compared between children with severe and mild pneumonia. Results A total of 111 immunocompetent children with adenovirus pneumonia (60 severe, 51 mild) were included. The median age was 40 months, and 64 patients were male. Five patients were admitted to the intensive care unit, and two underwent endotracheal intubation. All patients were discharged after recovery or improvement. Univariate analysis and binary logistic regression analysis showed that leukocytosis (OR = 1.1; 95% CI: 1.0 to 1.2; P = 0.033), co-infection with Mycoplasma pneumoniae (OR = 5.0; 95% CI: 2.1 to 12.3; P <  0.001), and high blood viral load (OR = 1.5; 95% CI: 1.2 to 2.0; P = 0.001) may be risk factors for severe adenovirus pneumonia. Conclusions Leukocytosis, co-infection with Mycoplasma pneumoniae, and high blood viral load may be risk factors for severe adenovirus pneumonia in immunocompetent children. Blood viral load may predict pneumonia severity.

scholarly journals Hepatic steatosis: a risk factor for increased COVID-19 prevalence and severity—a computed tomography study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Asmaa Ali ◽  
Mona Hasan ◽  
Shaimaa Hamed ◽  
Amir Elhamy
Keyword(s):  
Hepatic Steatosis ◽  
Severe Disease ◽  
Severe Pneumonia ◽  
Liver Disorder ◽  
Control Group ◽  
Case Group ◽  
World Population ◽  
Positive Class ◽  
The Mean ◽  
And Control

Abstract Background Around 25% of the world population was affected by the metabolic-related fatty liver disorder. Hepatic steatosis is frequently observed in conjunction with hypertension, obesity comorbidities, and diabetes. We evaluate the hepatic steatosis frequency found in chest CT exams of COVID-19-positive cases compared to non-infected controls and evaluate the related increased prevalence and severity of COVID. Results Our research includes 355 subjects, 158 with positive PCR for COVID-19 (case group) and 197 with negative PCR and negative CT chest (control group). The mean age in the positive group was 50.6 ± 16 years, and in the control, it was 41.3 ± 16 years (p < 0.001). Our study consists of 321 men (90.5%) and 34 women (9.5%). The number of males in both cases and control groups was greater. In the case group, 93% men vs. 6.9% women, while in controls, 88.3% men vs.11.6% women, p < 0.001. CT revealed normal results in 55.5% of individuals (i.e., CORADs 1) and abnormal findings in 45.5% of participants (i.e., CORADs 2–5). In abnormal scan, CO-RADs 2 was 13.92%, while CO-RADs 3–4 were 20.89% of cases. CO-RADs 5 comprised 65.19% of all cases. Approximately 42.6% of cases had severe disease (CT score ≥ 20), all of them were CO-RADs 5. The PCR-positive class had a greater prevalence of hepatic steatosis than controls (28.5% vs.12.2%, p < 0.001). CO-RADs 2 represented 11.1%, CO-RADs 3–4 represented 15.6%, and CO-RADs 5 represented 73.3% in the hepatic steatosis cases. The mean hepatic attenuation value in the case group was 46.79 ± 12.68 and in the control group 53.34 ± 10.28 (p < 0.001). When comparing patients with a higher severity score (CT score ≥ 20) to those with non-severe pneumonia, it was discovered that hepatic steatosis is more prevalent (73.2% vs. 26.8%). Conclusions Steatosis was shown to be substantially more prevalent in COVID-19-positive individuals. There is a relation among metabolic syndrome, steatosis of the liver, and obesity, as well as the COVID-19 severity.

scholarly journals A Retrospective Study Evaluating the Effectiveness of an Asthma Clinical Pathway in Pediatric Inpatient Practice

2008 ◽  
Vol 13 (4) ◽  
pp. 233-241
Author(s):  
Elisa Edwards ◽  
Kristie Fox
Keyword(s):  
Drug Therapy ◽  
Hospital Stay ◽  
Clinical Pathway ◽  
Length Of Hospital Stay ◽  
Control Group ◽  
Readmission Rates ◽  
Asthma Education ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
Pediatric Inpatient

OBJECTIVE To determine if the asthma clinical pathway implemented at Wolfson Children's Hospital reduces the length of hospital stay. To determine if pathway use affected the use of asthma education, the use of appropriate discharge medications based on asthma classification, and readmission rates. METHODS A list of patients aged 2 to 18 years discharged from Wolfson Children's Hospital between September 1, 2004 and August 31, 2006 with the diagnosis of asthma was generated. Medical records of eligible patients were reviewed for demographic information, asthma pathway use, duration of hospital stay in days, readmission rates, receipt of asthma education, and medications prescribed upon discharge. Patients placed on the asthma clinical pathway were compared to a control group with asthma who were matched based on age and discharge date. Length of stay was averaged for each group. Asthma education, discharge medications, and readmission rates were compared between the two groups. RESULTS Forty-three patients placed on the asthma clinical pathway were compared to a 43 patients in the control group that were matched for age and discharge date. Use of the asthma clinical pathway reduced hospital stay by 0.372 days (P = .0373). Receipt of asthma education (P = .3864), the use of appropriate drug therapy prescribed upon discharge (P = .1398), and readmission rates (P = .5486) were unaffected by pathway use. CONCLUSIONS The asthma clinical pathway used at Wolfson Children's Hospital reduces length of hospital stay, but has no bearing on receipt of asthma education, use of appropriate drug therapy upon discharge, or readmission rates.

scholarly journals Cytokine signatures associate with disease severity in children with Mycoplasma pneumoniae pneumonia

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Mingyue Yang ◽  
Fanzheng Meng ◽  
Man Gao ◽  
Genhong Cheng ◽  
Xiaosong Wang
Keyword(s):  
Disease Severity ◽  
Mycoplasma Pneumoniae ◽  
Bronchoalveolar Lavage Fluid ◽  
Lavage Fluid ◽  
Control Group ◽  
Molecular Phenotype ◽  
Linear Discriminant ◽  
Discriminant Analyses ◽  
And Control ◽  
Mycoplasma Pneumoniae Pneumonia

AbstractHost immune response may be involved in the pathogenesis of children Mycoplasma pneumoniae pneumonia (MPP). In the current study, we investigated the alterations of cytokines levels among control, mild MPP and severe MPP children to determine whether cytokine signatures associate with MPP and correlate with disease severity. We measured 13 cytokines in bronchoalveolar lavage fluid (BALF) of 88 children with MPP and 26 children with foreign body aspiration (FB) using a Luminex system. Linear discriminant analyses were performed to develop predictive models of mild MPP and severe MPP on these children. We observed nearly complete separations of severe MPP group, mild MPP group and control group in linear discriminant analyses. Eleven cytokines significantly increased in children with MPP, and seven cytokines had statistically significant upward linear trends correlated with MPP severity. In addition, compared to control group, both IFNγ/IL4 ratio and IFNγ/IL13 ratio increased in mild MPP and severe MPP groups. Our results suggest that children MPP can alter BALF cytokines signatures which associate with disease severity and can be characterized by a distinct airway molecular phenotype that has elevated Th1/Th2 ratios.

scholarly journals Mycoplasma pneumoniae pneumonia associated thrombosis at Beijing Children’s hospital

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jinrong Liu ◽  
Ruxuan He ◽  
Runhui Wu ◽  
Bei Wang ◽  
Hui Xu ◽  
...  
Keyword(s):  
Mycoplasma Pneumoniae ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
Mycoplasma Pneumoniae Pneumonia

scholarly journals Epidemiology and Clinical Characteristics of Rotavirus and Norovirus Infections in Hospitalized Children Less Than 5 Years of Age With Acute Gastroenteritis in Tehran, Iran

2020 ◽  
Author(s):  
Arash Arashkia ◽  
Behrooz Nejat ◽  
Mahsa Farsi ◽  
Somayeh Jalilvand ◽  
Alireza Nateghian ◽  
...  
Keyword(s):  
Acute Gastroenteritis ◽  
Viral Infections ◽  
Clinical Symptoms ◽  
Clinical Status ◽  
Clinical Manifestations ◽  
Children's Hospital ◽  
Severe Gastroenteritis ◽  
Children’S Hospital ◽  
Stool Specimens ◽  
Commercial Enzyme Immunoassay

Acute gastroenteritis is one of the most important causes of death in children in developing countries which cause by different enteropathogens, including bacteria, viruses, and parasites. Among these, most of the acute gastroenteritis in children are caused by viral infections mainly by rotavirus and norovirus. This study aimed to study the epidemiological and clinical status of acute gastroenteritis resulting from rotavirus and norovirus in children between June 2015 and June 2016 in Iran. A total of 211 stool specimens were collected from Ali Asghar Children's Hospital and Bahrami Children's Hospital in Tehran, from June 2015 to June 2016. The samples were screened by commercial enzyme immunoassay (EIA) Ridascreen kit and real time RT-PCR to detect rotavirus and norovirus genogroups I and II, respectively. The information on demographic and clinical manifestations was collected, and data analyzed using IBM SPSS statistics version 22. Overall, the detection rate of rotavirus was 25.6 %, and for norovirus infection, it was 17.5%. All norovirus positive specimens belonged to genogroup II. Higher rates of rotavirus infections were observed in children from 7 to 24 months, and higher rates of norovirus infections were detected in children from 1 to 12 months. Clinical symptoms were not different between rotavirus and norovirus case-patients. The present study not only highlights the importance of rotavirus and norovirus infections in Iran but also verifies the relevance of norovirus as the cause of severe gastroenteritis in children.

scholarly journals Implementation and Impact of an Antimicrobial Stewardship Program at a Non-freestanding Children's Hospital

2018 ◽  
Vol 23 (2) ◽  
pp. 84-91 ◽  
Author(s):  
J. Michael Klatte ◽  
Kathleen Kopcza ◽  
Alexander Knee ◽  
Evan R. Horton ◽  
Erica Housman ◽  
...  
Keyword(s):  
Antimicrobial Stewardship ◽  
Interrupted Time Series ◽  
Antibiotic Use ◽  
Antibiotic Usage ◽  
Control Group ◽  
Children's Hospital ◽  
Hospital Readmission Rates ◽  
Stewardship Program ◽  
Children’S Hospital ◽  
Acceptance Rates

OBJECTIVES Pediatric Antimicrobial Stewardship Programs (ASP) have been associated with improvements in antibiotic utilization and patient outcomes; however, ASP studies originating from non-freestanding children's hospitals are lacking. In this study, we present the implementation and impact of a multidisciplinary ASP that employs a collaborative physician and pharmacist driven thrice-weekly prospective audit-with-feedback approach at a non-freestanding children's hospital. METHODS Implementation was assessed via descriptive design. Pediatric inpatients maintained on predefined targeted antibiotics of interest for 48 to 72 hours preceding ASP review were eligible for inclusion. Outcomes evaluated included ASP recommendation and provider acceptance rates (overall and by antibiotic and provider specialty). Impact was examined using an interrupted time series design (with a preimplementation period of August 1, 2013, to July 31, 2014 and postimplementation period of December 1, 2014 to May 31, 2016). Eligibility included all targeted antibiotic usage among pediatric inpatients, with a control group comprising those who received antibiotics requiring preauthorization. Outcomes analyzed included days of antibiotic therapy per 1000 patient days (DOT/1000 PD) and 30-day hospital readmission rates over time. RESULTS Postimplementation, 882 antibiotic reviews were performed on 637 patients, with 327 recommendations generated. Reviews of patients maintained on vancomycin and clindamycin, and of those under care of intensivist and hospitalist physicians, were most likely to prompt recommendations. A mean targeted antibiotic usage decrease of 24.8 DOT/1000 PD (95% confidence interval, −62 to 14) was observed postimplementation, with no change in 30-day readmissions (0.64% during both periods). CONCLUSIONS ASP implementation at a non-freestanding children's hospital was feasible and allowed for identification of areas for targeted quality improvement, while demonstrating modest antibiotic use reduction without adversely impacting patient care.

scholarly journals 81. Children and COVID-19 in Colorado: The Children’s Hospital Colorado Experience

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S172-S173
Author(s):  
Kelly E Graff ◽  
Lori Silveira ◽  
Jane Jarjour ◽  
Shane Curran-Hays ◽  
Lauren Carpenter ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Wide Spectrum ◽  
Severe Disease ◽  
Tertiary Care ◽  
Pediatric Intensive Care ◽  
Respiratory Support ◽  
Logistic Regression Models ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
The Impact

Abstract Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel coronavirus that causes coronavirus disease of 2019 (COVID-19) and has been reported in &gt; 98,000 children in the U.S (5% of reported cases) as of early June 2020. Most published literature focuses on adults with COVID-19, but little is understood on the impact of SARS-CoV-2 in children. We created a database for children with COVID-19 at Children’s Hospital Colorado (CHCO), a large tertiary care pediatric hospital, to better understand the epidemiology and clinical outcomes of this disease in children. Methods We retrospectively reviewed the medical records of all pediatric and youth patients with positive SARS-CoV-2 PCR test results from March-May 2020. Univariate logistic regression models were used to identify predictors of hospital admission, need for critical care, and need for respiratory support among symptomatic patients, with p-values &lt; 0.05 considered statistically significant. Results We identified 246 patients with SARS-CoV-2 (age range: 17 days-25 years). We noted a Hispanic predominance with 68% of all patients with SARS-CoV-2 identifying as Hispanic or Latino, compared to 29% among all CHCO visits in 2019 (Figure 1). The most common symptoms at presentation were fever, cough, or shortness of breath in 94% of symptomatic patients. Sixty-eight patients (28%) were admitted, of which 7 (10%) required admission to the pediatric intensive care unit (PICU) for symptomatic COVID-19 disease (Figure 2). Age 0–3 months, certain symptoms at presentation, and several types of underlying medical conditions were predictors for both hospital admission and need for respiratory support (Figure 3). Initial and peak C-reactive protein (CRP) values were predictors for PICU admission with median peaks of 24.8mg/dL vs. 2.0mg/dL among PICU vs. non-PICU patients (OR 1.27, p=0.004). Figure 3: Predictors for Admission and Respiratory Support Requirement in CHCO Patients with SARS-CoV-2 Conclusion There is a wide spectrum of illness in children with SARS-CoV-2, ranging from asymptomatic to critical illness. Hispanic ethnicity was disproportionately represented in our cohort, which requires further evaluation. We found that young age, comorbid conditions, and CRP appear to be risk factors for severe disease in children. Disclosures Kelly E. Graff, MD, BioFire Diagnostics, LLC (Grant/Research Support)

Clinical Features, Replication Competence, and Innate Immune Responses of Human Adenovirus Type 7 Infection

2020 ◽  
Author(s):  
Qigao Chen ◽  
Jun Liu ◽  
Weiwen Liang ◽  
Yi Chen ◽  
Min Dou ◽  
...  
Keyword(s):  
Ex Vivo ◽  
Severe Disease ◽  
Severe Pneumonia ◽  
Human Adenovirus ◽  
Adenovirus Type ◽  
Innate Immune Responses ◽  
Serum Samples ◽  
Human Lung Tissue ◽  
Monocyte Chemoattractant Protein 1 ◽  
Clinical Presentations

Abstract Background Epidemiologic reports suggest that the most severe or fatal adenoviral disease in children might be associated with human adenovirus (HAdV) type 7. However, the pathogenesis of HAdV-7–induced severe disease remains poorly understood. Methods HAdV-3 and HAdV-7 replication kinetics and the host response to infection were compared using ex vivo human lung tissue cultures. Furthermore, cytokine and chemokine levels and the presence of adenovirus DNA in the serum of hospitalized children infected with HAdV-7 (n = 65) or HAdV-3 (n = 48) were measured (using a multiplex immunoassay and Taqman real-time polymerase chain reaction, respectively). Results Among 471 HAdV-positive specimens, HAdV-3 or HAdV-7 was the most prevalent genotype during 2014–2016 or 2018, respectively. The incidence of severe pneumonia was higher in HAdV-7–infected than in HAdV-3–infected individuals (30.1% vs 4.5%, respectively). HAdV-7 replicated more efficiently than HAdV-3 ex vivo. Interferon-induced protein 10, interleukin 6, and monocyte chemoattractant protein 1 levels were significantly higher in HAdV-7–infected than in HAdV-3–infected children. Adenovirus DNA was detected in serum samples from 40% and 4.2% of HAdV-7– and HAdV-3–infected children, respectively. Furthermore, viremia was strongly associated with severe clinical presentations. Conclusions The pathogenesis of HAdV-7–induced severe disease was probably associated with high replication competence and hyperinflammatory responses. The detection of adenovirus DNA in blood may be useful in assessing risk for severe disease.

Sign in / Sign up

Export Citation Format

Share Document