Clinical Characteristics of Children with COVID-19: A Multicenter Study in the United Arab Emirates (Preprint)

2021 ◽  
Author(s):  
Farah Ennab ◽  
Mariam ElSaban ◽  
Eman Khalaf ◽  
Hanieh Tabatabaei ◽  
Amar Hassan Khamis ◽  
...  
Keyword(s):  
United Arab Emirates ◽  
Multicenter Study ◽  
Clinical Characteristics ◽  
Pediatric Population ◽  
Contact Tracing ◽  
Severe Illness ◽  
Published Data ◽  
Presenting Symptoms ◽  
Asymptomatic Children ◽  
Significant Difference

BACKGROUND Coronavirus disease 2019 (COVID-19) has infected over 123 million people globally. The first confirmed case in the United Arab Emirates (UAE) was reported on 29th January 2020.  COVID-19 has fared mildly in the pediatric population according to available literature out of early epicenters of the pandemic. To date there is a lack of published data about COVID-19 infection among children in the Arabian region. OBJECTIVE Investigate the clinical characteristics, laboratory findings, treatment, and outcomes of children with COVID-19. METHODS This cross-sectional multicenter study included children with confirmed COVID-19 infection admitted between March 1st and June 15th, 2020 to three large hospitals in Dubai, UAE. Serial COVID-19 polymerase chain reaction (PCR) testing was collected, and patients' demographics, pre-morbid clinical characteristics and inpatient hospital course were investigated. RESULTS 111 children were included in our study and represented 22 nationalities. Fifty-nine (53.2%) were boys. The mean age was 7 years (±5.3). 15.3% of children were younger than 1 year. Only 4 (3.6%) of the patients had pre-existing asthma all of whom had uneventful courses. At presentation 43 (38.7%) were asymptomatic, 68 (61.2%) had mild or moderate symptoms and none had severe illness requiring intensive care. Fever (20.7%), cough (19.8%) and rhinorrhea (15.3%) were the most common presenting symptoms and most symptoms resolved by day 5 of hospitalization. Most patients had no abnormality on chest x-ray. The most common laboratory abnormalities on admission included variations in neutrophil count (24.7%), aspartate transaminase (22.5%), alkaline phosphatase (36.7%) and lactate dehydrogenase (42.5%). Children were infrequently prescribed targeted medications, with only 4 (3.6%) receiving antibiotics. None of the 52 patients tested for viral co-infections were positive. COVID-19 PCR turned negative at a median of 10 days [6-14] after first positive test. Overall, there was no significant difference of time to negative PCR results between symptomatic and asymptomatic children. CONCLUSIONS This study of COVID19 presentations and characteristics presents a first look into the burden of COVID19 infection in the pediatric population in the UAE. We conclude that a large percentage of children experienced no symptoms, and severe disease is uncommon in the UAE. Various laboratory abnormalities were observed despite clinical stability. Ongoing surveillance, contact tracing and public health measures will be important to contain future outbreaks.

scholarly journals #7: Clinical Characteristics of Children with COVID-19: A Multicenter Study in the United Arab Emirates

2021 ◽  
Vol 10 (Supplement_2) ◽  
pp. S17-S18
Author(s):  
Farah Ennab ◽  
Mariam ElSaban ◽  
Eman Khalaf ◽  
Hanieh Tabatabaei ◽  
H K Amar ◽  
...  
Keyword(s):  
United Arab Emirates ◽  
Multicenter Study ◽  
Clinical Characteristics ◽  
Severe Illness ◽  
Published Data ◽  
Gulf Region ◽  
Presenting Symptoms ◽  
Asymptomatic Children ◽  
Pediatric Study ◽  
Significant Difference

Abstract Background To date, coronavirus disease-2019 (COVID-19) has infected over 82 million people globally. The first confirmed case in the United Arab Emirates (UAE)was reported on 29th January 2020. Current data suggests that children with COVID-19 have a mild disease course. There is a lack of extensive published data about COVID-19 infection among children in the Arabian Gulf region. Methods This cross-sectional multicenter study included children with confirmed COVID-19 infection admitted between March 1st and June 15th, 2020 to three large hospitals in Dubai, UAE. Serial nasal swabs for COVID-19 polymerase chain reaction (PCR) testing were collected during hospitalization. We investigated patients’ demographics,clinical characteristics, radiological and laboratory investigations during their inpatient hospital course. Results 111 children were included in our study and represented 22 nationalities. Fifty-nine (53.2%) were boys. The mean age was 7 years (±5.3), and 15.3% of children were younger than 1 year. Only 4 (3.6%) children had pre-existing asthma, all of whom had an uneventful clinical course. At presentation 43 (38.7%) were asymptomatic, 68 (61.2%) had mild or moderate symptoms and none had severe illness requiring intensive care. Fever (20.7%), cough (19.8%) and rhinorrhea (15.3%) were the most common presenting symptoms, most of which resolved by day 5 of hospitalization. Most of our patients had a normal chest x-ray. The most common laboratory abnormalities on admission included variations in neutrophil count (24.7%), aspartate transaminase (22.5%), alkaline phosphatase (36.7%) and lactate dehydrogenase (42.5%). Children were infrequently prescribed targeted medications, with only 4 (3.6%) receiving antibiotics. None of the 52 patients tested for viral co-infections were positive. COVID-19 PCR turned negative at a median of 10 days [6–14 days] after the first positive test. Overall, there was no significant difference in time to negative PCR between symptomatic and asymptomatic children. Conclusion This pediatric study of COVID-19 presents a first look into the burden of COVID-19 infection among children in the UAE. Patients had various laboratory abnormalities despite clinical stability. We conclude that a large percentage of children with COVID-19 infection experience no symptoms, and severe disease is uncommon in the UAE. Ongoing surveillance, contact tracing and public health measures will be essential in containing future outbreaks.

scholarly journals Orbital Apex Lesions: A Diagnostic and Therapeutic Challenge

2017 ◽  
Vol 79 (04) ◽  
pp. 386-393 ◽  
Author(s):  
Sung-Woo Cho ◽  
Won-Wook Lee ◽  
Dae Ma ◽  
Ji-hoon Kim ◽  
Doo Han ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Clinical Characteristics ◽  
Inflammatory Pseudotumor ◽  
Definitive Treatment ◽  
Fungal Sinusitis ◽  
Orbital Apex ◽  
Radiological Findings ◽  
Presenting Symptoms ◽  
Invasive Fungal Sinusitis ◽  
Significant Difference

Objective To analyze the clinical characteristics of and treatment outcomes for orbital apex lesions according to their pathological diagnosis and identify clinical characteristics that could aid in their differential diagnosis. Design Retrospective analysis design was used for this study. Setting The study was conducted in a single tertiary institution. Participants Patients with pathologically confirmed lesions centered in the orbital apex who were admitted between January 2011 and December 2015. Main Outcome Measures Clinical characteristics, including demographics, predisposing factors, presenting symptoms, radiological findings, intraoperative findings, biopsy results, and treatment outcomes. Results Nine patients with invasive fungal sinusitis, six with inflammatory pseudotumor, and six with neoplastic or tumorous lesions were enrolled. The most common presenting symptom was orbital pain or headache, followed by ophthalmoplegia and vision loss, which exhibited overall recovery rates of 62.5% and 33.3%, respectively, after definitive treatment. The prognosis was worse for patients with invasive fungal sinusitis. There was no significant difference in age, underlying medical conditions, absolute neutrophil count, C-reactive protein level, and radiological findings among the three groups. Grossly necrotic tissues around the orbital apex area at biopsy were more frequently found in patients with invasive fungal sinusitis than in the other patients. In most cases, pain ameliorated after surgical intervention. There were no surgery-related morbidities. Conclusions Lesions centered in the orbital apex included invasive fungal sinusitis, inflammatory pseudotumor, and tumorous lesions. However, clinical features that clearly differentiated chronic invasive fungal sinusitis from inflammatory pseudotumor could not be identified. Our findings suggest that prompt biopsy is warranted for timely diagnosis, symptom relief, and early implementation of definitive treatment.

Long-term follow-up of clinical presentation and outcomes of patients with urinary bladder paragangliomas.

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 507-507
Author(s):  
Kareem Rayn ◽  
Michael Daniel Weintraub ◽  
Gustavo Pena-LaGrave ◽  
Samuel Gold ◽  
Graham R. Hale ◽  
...  
Keyword(s):  
Urinary Bladder ◽  
Symptom Onset ◽  
Clinical Characteristics ◽  
Cancer Recurrence ◽  
Plasma Catecholamine ◽  
Presenting Symptoms ◽  
Surgical Methods ◽  
Significant Difference ◽  
Long Term Follow Up ◽  
Metastatic Sites

507 Background: Urinary bladder paragangliomas (UBPGLs) are extremely rare, accounting for less than 6% of paragangliomas (PGLs) and 0.06% of bladder tumors. The goal of this study is to examine the presentation, clinical characteristics and outcomes of patients with UBPGLs. Methods: We determined the presenting symptoms, clinical characteristics, and outcomes of patients who presented to a single institution with UBPGLs from 2000-2017. Results: 28 patients with an average age of 27 ± 15.6 at symptom onset presented to the NIH from 2000-2017. The majority had standard paraganglioma symptoms (n = 24, 85.7%) defined as headaches, palpitations, pallor and anxiety, and hypertension (n = 20, 71.4%) on presentation. 8 patients (29%) presented with hematuria; hematuria was the only presenting symptom in 1 of these patients. 3 (10.7%) of the patients were completely asymptomatic and were discovered to have bladder paragangliomas incidentally on imaging. Overall, 9 patients (32%) were under 18 (average age = 10.9 ± 3.9) at symptom onset. 14 (50%) patients developed metastasis, with bone (n = 9) and lung (n = 8) being the most common metastatic sites. All but 1 patient received surgical treatment, with 6 patients receiving transurethral resection of bladder tumor (TURBT), 3 receiving robotic-assisted partial cystectomy (RAPC) and the remaining patients undergoing open cystectomy. In total, 2 patients experienced bladder cancer recurrence, both of whom had undergone TURBT. Comparing patients with and without hematuria, metastasis and standard paraganglioma symptoms, we found no statistically significant difference in mean diameter of the largest lesion or plasma catecholamine values. Conclusions: Our experience reveals that most patients with UBPGLs present at an early age with characteristic paraganglioma symptoms. Despite the variety of surgical methods used to manage these patients, the only 2 recurrences were in patients who underwent TURBT. Further work is necessary to establish preoperative indicators of disease severity in patients with UBPGLs. This research was supported by the Intramural Research Program of the National Cancer Institute, NIH and NIH Medical Research Scholars Program

scholarly journals Normative Thyroid Volume by Ultrasonography in a Nigerian Pediatric Population

2018 ◽  
Vol 35 (1) ◽  
pp. 17-21 ◽  
Author(s):  
Felicitas Ugochinyere Idigo ◽  
Ime Edet Okon ◽  
Mark Chukwudi Okeji ◽  
Angel-Mary Chukwunyelu Anakwue
Keyword(s):  
Pediatric Population ◽  
Thyroid Volume ◽  
World Health ◽  
Portable Ultrasound ◽  
Thyroid Screening ◽  
Asymptomatic Children ◽  
Healthy Infants ◽  
Significant Difference ◽  
Nigerian Population ◽  
Health Organization

The objective was to establish normal thyroid volume in healthy infants and children, in a select Nigerian population. Using a portable ultrasound equipment with a 7.5-MHz transducer, 500 apparently healthy pediatric patients were sonographically evaluated. The volume for each thyroid lobe was obtained, as well as the summation of both left and right thyroid volumes, which represented the total volume. The mean and median thyroid volumes for the subgroups were 0.69 ± 0.38 cm3/0.7 cm3 (<1 year), 1.50 ± 0.68 cm3/1.4 cm3 (1–5 years), 2.75 ± 0.94 cm3/2.6 cm3 (6–10 years), 4.47 ± 2.83 cm3/3.7 cm3 (11–15 years), and 7.47 ± 4.81 cm3/5.9 cm3 (16 and 17 years). There was a significant difference ( P = .000) between the population studied and the World Health Organization/International Council for Control of Iodine Deficiency Disorders reference values. The baseline values derived for thyroid dimensions may form the basis for thyroid screening in these asymptomatic children.

scholarly journals Clinical Characteristics of Children With COVID-19: A Multicenter Study in the United Arab Emirates

2020 ◽  
Author(s):  
Farah Ennab ◽  
Mariam ElSaban ◽  
Eman Khalaf ◽  
Hanieh Tabatabaei ◽  
Amar HK ◽  
...  
Keyword(s):  
United Arab Emirates ◽  
Multicenter Study ◽  
Clinical Characteristics

scholarly journals Clinical characteristics, risk factors and antiviral treatments of influenza in immunosuppressed inpatients in Beijing during the 2015–2020 influenza seasons

2022 ◽  
Vol 19 (1) ◽  
Author(s):  
Yafen Liu ◽  
Yue Wang ◽  
Huan Mai ◽  
YuanYuan Chen ◽  
Baiyi Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Influenza Virus ◽  
Mental Status ◽  
Clinical Characteristics ◽  
Antiviral Treatment ◽  
Altered Mental Status ◽  
Haematopoietic Stem Cell ◽  
Severe Illness ◽  
Presenting Symptoms ◽  
Immunosuppressed Patients

Abstract Background Compared with immunocompetent patients, immunosuppressed patients have higher morbidity and mortality, a longer duration of viral shedding, more frequent complications, and more antiviral resistance during influenza infections. However, few data on this population in China have been reported. We analysed the clinical characteristics, effects of antiviral therapy, and risk factors for admission to the intensive care unit (ICU) and death in this population after influenza infections and explored the influenza vaccination situation for this population. Methods We analysed 111 immunosuppressed inpatients who were infected with influenza virus during the 2015–2020 influenza seasons. Medical data were collected through the electronic medical record system and analysed. Univariate analysis and multivariate logistics analysis were used to identify risk factors. Results The most common cause of immunosuppression was malignancies being treated with chemotherapy (64.0%, 71/111), followed by haematopoietic stem cell transplantation (HSCT) (23.4%, 26/111). The most common presenting symptoms were fever and cough. Dyspnoea, gastrointestinal symptoms and altered mental status were more common in HSCT patients than in patients with immunosuppression due to other causes. Approximately 14.4% (16/111) of patients were admitted to the ICU, and 9.9% (11/111) of patients died. Combined and double doses of neuraminidase inhibitors did not significantly reduce the risk of admission to the ICU or death. Risk factors for admission to the ICU were dyspnoea, coinfection with other pathogens and no antiviral treatment within 48 h. The presence of dyspnoea and altered mental status were independently associated with death. Only 2.7% (3/111) of patients less than 12 months old had received a seasonal influenza vaccine. Conclusion Fever and other classic symptoms of influenza may be absent in immunosuppressed recipients, especially in HSCT patients. Conducting influenza virus detection at the first presentation seems to be a good choice for early diagnosis. Clinicians should pay extra attention to immunosuppressed patients with dyspnoea, altered mental status, coinfection with other pathogens and no antiviral treatment within 48 h because these patients have a high risk of severe illness. Inactivated influenza vaccines are recommended for immunosuppressed patients.

scholarly journals Review of clinical characteristics and laboratory findings of COVID-19 in children-Systematic review and Meta-analysis

2020 ◽  
Author(s):  
Harmeet K Kharoud ◽  
Rizwana Asim ◽  
Lianne Siegel ◽  
Lovepreet Chahal ◽  
Gagan Deep Singh
Keyword(s):  
Systematic Review ◽  
Clinical Characteristics ◽  
Clinical Symptoms ◽  
Nasal Congestion ◽  
Pediatric Population ◽  
Meta Analysis ◽  
Laboratory Findings ◽  
Asymptomatic Children ◽  
Pooled Prevalence ◽  
Reported Data

OBJECTIVE: To conduct a systematic review and meta-analysis to assess the prevalence of various clinical symptoms and laboratory findings of COVID-19 in children. METHODS: PubMed, MEDLINE, and SCOPUS databases were searched to include studies conducted between January 1, 2020, and July 15, 2020 which reported data about clinical characteristics and laboratory findings in laboratory-confirmed diagnosis of COVID-19 in pediatric patients. Random effects meta-analysis using generalized linear mixed models was used to estimate the pooled prevalence. RESULTS: The most prevalent symptom of COVID-19 in children was 46.17% (95%CI 39.18-53.33%), followed by cough (40.15%, 95%CI 34.56-46.02%). Less common symptoms were found to be dyspnea, vomiting, nasal congestion/rhinorrhea, diarrhea, sore throat/pharyngeal congestion, headache, and fatigue. The prevalence of asymptomatic children was 17.19% (95%CI 11.02-25.82%). The most prevalent laboratory findings in COVID-19 children were elevated Creatinine Kinase (26.86%, 95%CI 16.15-41.19%) and neutropenia (25.76%, 95%CI 13.96-42.58%). These were followed by elevated LDH, thrombocytosis, lymphocytosis, neutrophilia, elevated D Dimer, Elevated CRP, elevated ESR, leukocytosis, elevated AST and leukopenia. There was a low prevalence of elevated ALT and lymphopenia in children with COVID- 19. CONCLUSIONS AND RELEVANCE: This study provides estimates of the pooled prevalence of various symptoms and laboratory findings of COVID-19 in the pediatric population.

scholarly journals The relationship of HLA-G 14-bp insertion/deletion genetic polymorphism to the risk of multiple sclerosis and its clinical phenotypes

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Wafaa M. Farghaly ◽  
Heba M. Saad Eldien ◽  
Mohammed A. Sayed ◽  
Hassan M. Elnady ◽  
Ashraf Khodeary ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Genetic Polymorphism ◽  
Clinical Characteristics ◽  
Human Leukocyte ◽  
Healthy Controls ◽  
University Hospitals ◽  
Presenting Symptoms ◽  
Significant Difference ◽  
Degree Of Disability ◽  
G 14

Abstract Background Human leukocyte antigen (HLA)-G molecule has been suggested to have a potential immunomodulatory role in multiple sclerosis (MS). Genetic variant sites of HLA-G molecule have been reported to be associated with autoimmune diseases. Identifying the genetic risk factors of MS may help in preventive strategies and anticipating disease progression. The aim of this work was to investigate the effect of HLA-G 14-base-pair insertion/deletion (14-bp INS/DEL) genetic polymorphism on MS risk and clinical characteristics and to observe the clinical characteristics of the MS patients’ group. The study included 48 MS patients and 50 cross-matched healthy controls, who were recruited from Sohag and Assiut university hospitals. Genetic testing (14-bp Ins/Del gene polymorphism) using polymerase chain reaction (PCR) was performed for patients and control groups. All patients had a detailed clinical assessment and have undergone measurement of disability using the Expanded Disability Status Scale (EDSS). Results No statistically significant difference was found between MS patients and healthy controls (HC) in genotypic and allelic frequencies of HLA-G 14-bp INS/DEL polymorphism (P=0.305). No significant association was found between HLA-G 14-bp INS/DEL polymorphism genotypes and clinical characteristics or degree of disability of MS patients. The most frequent presenting symptoms of MS were motor symptoms. Fatigue was the most reported symptom along the course of MS disease. Conclusion Although it has been long known that HLA-G represents an important MS susceptibility locus, in this study, no significant relation could be detected between the 14-bp INS/DEL polymorphism genotype and MS susceptibility. MS risk susceptibility may be not linked to a single allele but may depend on the combination of different polymorphic genetic sites. In this study, the lack of genetic susceptibility may be attributed to ethnic factor.

scholarly journals Clinical Characteristics of Children with COVID-19: A Cross-Sectional Multicenter Study in the United Arab Emirates (Preprint)

10.2196/29049 ◽  
2021 ◽  
Author(s):  
Farah Ennab ◽  
Mariam ElSaban ◽  
Eman Khalaf ◽  
Hanieh Tabatabaei ◽  
Amar Hassan Khamis ◽  
...  
Keyword(s):  
United Arab Emirates ◽  
Multicenter Study ◽  
Clinical Characteristics ◽  
Cross Sectional

scholarly journals Clinical Characteristics of 24 Asymptomatic Infections with COVID-19 Screened among Close Contacts in Nanjing, China

2020 ◽  
Author(s):  
Zhiliang Hu ◽  
Ci Song ◽  
Chuanjun Xu ◽  
Guangfu Jin ◽  
Yaling Chen ◽  
...  
Keyword(s):  
Nucleic Acid ◽  
Clinical Characteristics ◽  
Close Contact ◽  
Contact Tracing ◽  
Severe Illness ◽  
Asymptomatic Carriers ◽  
Asymptomatic Infections ◽  
Clinical Records ◽  
Close Contacts ◽  
Nucleic Acid Tests

AbstractBackgroundPrevious studies have showed clinical characteristics of patients with the 2019 novel coronavirus disease (COVID-19) and the evidence of person-to-person transmission. Limited data are available for asymptomatic infections. This study aims to present the clinical characteristics of 24 cases with asymptomatic infection screened from close contacts and to show the transmission potential of asymptomatic COVID-19 virus carriers.MethodsEpidemiological investigations were conducted among all close contacts of COVID-19 patients (or suspected patients) in Nanjing, Jiangsu Province, China, from Jan 28 to Feb 9, 2020, both in clinic and in community. Asymptomatic carriers were laboratory-confirmed positive for the COVID-19 virus by testing the nucleic acid of the pharyngeal swab samples. Their clinical records, laboratory assessments, and chest CT scans were reviewed.FindingsNone of the 24 asymptomatic cases presented any obvious symptoms before nucleic acid screening. Five cases (20.8%) developed symptoms (fever, cough, fatigue, etc.) during hospitalization. Twelve (50.0%) cases showed typical CT images of ground-glass chest and 5 (20.8%) presented stripe shadowing in the lungs. The remaining 7 (29.2%) cases showed normal CT image and had no symptoms during hospitalization. These 7 cases were younger (median age: 14.0 years; P = 0.012) than the rest. None of the 24 cases developed severe COVID-19 pneumonia or died. The median communicable period, defined as the interval from the first day of positive nucleic acid tests to the first day of continuous negative tests, was 9.5 days (up to 21 days among the 24 asymptomatic cases). Through epidemiological investigation, we observed a typical asymptomatic transmission to the cohabiting family members, which even caused severe COVID-19 pneumonia.InterpretationThe asymptomatic carriers identified from close contacts were prone to be mildly ill during hospitalization. However, the communicable period could be up to three weeks and the communicated patients could develop severe illness. These results highlighted the importance of close contact tracing and longitudinally surveillance via virus nucleic acid tests. Further isolation recommendation and continuous nucleic acid tests may also be recommended to the patients discharged.

Sign in / Sign up

Export Citation Format

Share Document