What are the scientific facts about the symptoms and treatment of COVID-19 in the pediatric population? A systematic review with overview

Considering the lower prevalence of pediatric patients with COVID-19, health professionals are more familiar with interventions aimed at adults; thus, understanding the symptoms and which approaches can be useful for pediatric patients with COVID-19 is of great importance for health professionals. The study aimed to aggregate scientific data on procedures and treatments performed on pediatric patients (aged 6 to 17 years) with COVID-19. A systematic literature search was performed in five electronic databases (i.e., PubMed, CINAHL, Google Scholar, and LILACS). Literature analyses were performed in English and Chinese, between November 2019 and December 2020. For data classification, the web application Rayyan® was used. Studies have shown that in most cases, children are asymptomatic. However, when symptomatic, they present fever, cough, intestinal infection, and vomiting. It is noteworthy that the respiratory rate and stool tests were significant indicators of the disease. Regarding treatment, oxygen support is essential during the hospitalization of patients and, antiviral therapy with Lopinavir and Ritonavir has shown significant results in a few isolated cases. It is concluded that the main symptoms of SARS-CoV-2 in pediatric patients are mild symptoms similar to those of common flu. In addition, respiratory rate and examinations based on fecal samples are good indicators of the disease in children of both sexes, as well as antiviral therapies and early isolation at the beginning of the disease are significant for the healing process.

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Pediatric Cardiac Surgery and Pain Management: After 40 Years in the Desert, Have We Reached the Promised Land?

World Journal for Pediatric and Congenital Heart Surgery ◽

10.1177/2150135118755977 ◽

2018 ◽

Vol 9 (3) ◽

pp. 315-325 ◽

Cited By ~ 4

Author(s):

Uri Pollak ◽

Alain Serraf

Keyword(s):

Cardiac Surgery ◽

Pain Management ◽

Health Professionals ◽

Pediatric Patients ◽

Pediatric Population ◽

Assessment Tools ◽

Clinical Severity ◽

Promised Land ◽

The Right ◽

Adequate Pain Management

Pain prevention in the pediatric population is mandatory and an integrative aspect of medical practice. Optimal pain management is the right of all patients and the responsibility of all health professionals. The key to adequate pain management is assessing its presence and severity, identifying those who require intervention, and appreciating treatment efficacy. The population of pediatric patients undergoing cardiac surgery is unique in both clinical severity and hemodynamic response to painful stimuli, thus making pain management even more challenging. In this review, we will describe the different pain assessment tools as well as intra- and postoperative regimens of pain management.

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Burn Hypertrophic Scar in Pediatric Patients: Clinical Case

Textbook on Scar Management ◽

10.1007/978-3-030-44766-3_60 ◽

2020 ◽

pp. 517-521

Author(s):

Roohi Vinaik ◽

Joel Fish ◽

Marc G. Jeschke

Keyword(s):

Laser Therapy ◽

Hypertrophic Scar ◽

Clinical Case ◽

Pediatric Patients ◽

Pediatric Population ◽

Symptomatic Relief ◽

Treatment Options ◽

Healing Process ◽

Hypertrophic Scars ◽

Limited Mobility

AbstractRecent improvements in burn care have resulted in greater patient survival of severe burns. With improved survival, treatment of the resulting permanent burn hypertrophic scars requires extensive care. Hypertrophic scarring occurs due to aberrations in the normal healing process, resulting in excessive inflammation and collagen deposition at the site of injury. These scars are accompanied by symptoms such as pain, pruritus, erythema, and limited mobility. The high scar prevalence in pediatric patients and accompanying physical, psychological, and social burden warrant a better understanding of the possible treatment options. Currently, several therapeutic strategies exist for hypertrophic scar management in the pediatric patient, although none are completely effective. Recently, laser therapy has emerged as a potential therapy for symptomatic relief and scar modulation. Here, we provide an up-to-date review of treatment options for hypertrophic scars in the pediatric population. In addition, we discuss a clinical case, outlining the potential merits of addition of laser therapy and surgical revision for the treatment of hypertrophic scars.

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Status Gizi, Perilaku Merokok di Dalam Rumah dengan Kejadian Pneumonia

CoMPHI Journal: Community Medicine and Public Health of Indonesia Journal ◽

10.37148/comphijournal.v1i1.6 ◽

2020 ◽

Vol 1 (1) ◽

pp. 29-35

Author(s):

Siti Rafidah Yunus ◽

Maria Ekawati ◽

Pritha Maya Savitri

Keyword(s):

Interpersonal Communication ◽

Pediatric Patients ◽

Healing Process ◽

Smoking Behavior ◽

Sampling Technique ◽

Observation Data ◽

Effective Relationships ◽

Qualitative Descriptive ◽

Field Observation Data ◽

Real Picture

Introduction: The doctor-patient relationship is based on good quality of communication and interaction with thepatient, so that it not only can help speed up the healing process, but also make the patient feel comfortable sincethe first visit to the health service. When dealing with pediatric patients, the ability to build a relationship of mutualtrust is done with a more open, honest attitude and understanding what they are feeling. Aim of study: This studyaims to see a real picture of the relationships, interactions and interpersonal communication between doctors andpatients in health care. Method: This study uses a qualitative descriptive study where data is obtained throughinterview transcripts, field observation data notes and photo documentation. A total of 7 participants were obtainedthrough a purposive sampling technique on pediatricians who are accustomed to engaging in effective relationships,interactions and communication with pediatric patients, families and introductors. Data were then analyzed usingthe Miles and Huberman method. Results and Discussions: The results of this study indicate 66.67% of parents orfamily members have smoking habits around children and 66.67% smoke when gathering with family. Most parentsor family members have the habit of opening windows as much as 75.76% of people. The results of bivariateanalysis showed that there was no relationship between nutritional status and the incidence of unde r-fivepneumonia (p = 0.732) and there was a relationship between smoking behavior and under-five pneumonia events (p= 0.021). Besides, smoking behavior at home can increase the incidence of pneumonia in toddlers. Conclusions:Therefore it is necessary to increase family awareness so as not to smoke near children.

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Using an App to monitor postoperative pain at home in pediatric patients

Journal of Child Health Care ◽

10.1177/1367493520919313 ◽

2021 ◽

pp. 136749352091931

Author(s):

Emanuela Tiozzo ◽

Valentina Biagioli ◽

Matilde Brancaccio ◽

Riccardo Ricci ◽

Anna Marchetti ◽

...

Keyword(s):

Postoperative Pain ◽

Pain Intensity ◽

Health Professionals ◽

Pediatric Patients ◽

Pain Scale ◽

Factors Associated ◽

Prospective Comparative Study ◽

Paper And Pencil ◽

The Impact ◽

At Home

A prospective comparative study was conducted in 487 pediatric patients (69% male, mean age = 6.4 ± 4.0) to evaluate (a) the incidence, intensity, and characteristics of pain in pediatric patients at home during the first 24 hours and 5 days after surgery and (b) the factors associated with higher pain intensity, including the impact of an application (App) compared to the paper-and-pencil approach. Postoperative pain was assessed by patients or their parents at home using the ‘Bambino Gesù’ Children’s Hospital (Ospedale Pediatrico Bambino Gesù, OPBG) tool for participants aged 4–17 years or the Faces, Legs, Arms, Cry, and Consolability scale for participants less than four years old. Participants were assigned to two groups: those who used the paper-and-pencil version of the pain scale and those who used the App. Overall, 209 of the 472 (44%) participants reported pain during the first 24 hours, and 92 of the 420 (22%) reported pain between one and five days after surgery. Higher pain intensity scores were associated with being in the App group, directly assessing own pain, and using the OPBG tool. The App was effective in facilitating pain assessment. Health professionals could empower pediatric patients and their parents in assessing pain at home through a dedicated App.

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Paranasal Mass in a Healthy Male Toddler

Ear Nose & Throat Journal ◽

10.1177/01455613211007944 ◽

2021 ◽

pp. 014556132110079

Author(s):

Melonie Anne Phillips ◽

Meredith Lind ◽

Gerd McGwire ◽

Diana Rodriguez ◽

Suzanna Logan

Keyword(s):

Differential Diagnosis ◽

Pediatric Patients ◽

Pediatric Population ◽

Age Group ◽

Significant Morbidity ◽

Healthy Male ◽

Neck Tumors ◽

Complete Surgical Resection ◽

Maxilla And Mandible ◽

Benign Mass

Head and neck tumors are rare in pediatric patients but should be kept in the differential when a patient presents with a new swelling or mass. One of these tumors is a myxoma, which is an insidiously growing, benign mass originating from the mesenchyme. They most commonly arise in the myocardium but can also develop in facial structures, particularly in the maxilla and mandible. When arising in facial structures, ocular, respiratory, and digestive systems can be affected based on local invasion. Complete surgical resection is curative but can lead to significant morbidity as well. Here, we present a case of a 15-month-old toddler presenting with a paranasal mass, which was ultimately diagnosed as a maxillary myxoma. This tumor is very rare in the pediatric population, especially in the toddler age-group, reminding clinicians to broaden the differential diagnosis when a patient’s course is atypical.

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1346. Implementation of a Multidisciplinary 48 Hour Antibiotic Timeout in a Pediatric Population

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1528 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S684-S684

Author(s):

Victoria Konold ◽

Palak Bhagat ◽

Jennifer Pisano ◽

Natasha N Pettit ◽

Anish Choksi ◽

...

Keyword(s):

Pediatric Patients ◽

Pediatric Population ◽

Intervention Group ◽

Post Intervention ◽

Days Of Therapy ◽

New Antibiotics ◽

Core Elements ◽

Quasi Experimental ◽

Empirical Antibiotics ◽

The Impact

Abstract Background To meet the core elements required for antimicrobial stewardship programs, our institution implemented a pharmacy-led antibiotic timeout (ATO) process in 2017 and a multidisciplinary ATO process in 2019. An antibiotic timeout is a discussion and review of the need for ongoing empirical antibiotics 2-4 days after initiation. This study sought to evaluate both the multidisciplinary ATO and the pharmacy-led ATO in a pediatric population, compare the impact of each intervention on antibiotic days of therapy (DOT) to a pre-intervention group without an ATO, and to then compare the impact of the pharmacy-led ATO versus multidisciplinary ATO on antibiotic days of therapy (DOT). Methods This was a retrospective, pre-post, quasi-experimental study of pediatric patients comparing antibiotic DOT prior to ATO implementation (pre-ATO), during the pharmacy-led ATO (pharm-ATO), and during the multidisciplinary ATO (multi-ATO). The pre-ATO group was a patient sample from February-September 2016, prior to the initiation of a formal ATO. The pharmacy-led ATO was implemented from February-September 2018. This was followed by a multidisciplinary ATO led by pediatric residents and nurses from February-September 2019. Both the pharm-ATO and the multi-ATO were implemented as an active non-interruptive alert added to the electronic health record patient list. This alert triggered when new antibiotics had been administered to the patient for 48 hours, at which time, the responsible clinician would discuss the antibiotic and document their decision via the alert workspace. Pediatric patients receiving IV or PO antibiotics administered for at least 48 hours were included. The primary outcome was DOT. Secondary outcomes included length of stay (LOS) and mortality. Results 1284 unique antibiotic orders (n= 572 patients) were reviewed in the pre-ATO group, 868 (n= 323 patients) in the pharm-ATO and 949 (n= 305 patients) in the multi-ATO groups. Average DOT was not significantly different pre vs post intervention for either methodology (Table 1). Mortality was similar between groups, but LOS was longer for both intervention groups (Table 1). Impact of an ATO on DOT, Mortality and LOS Conclusion An ATO had no impact on average antibiotic DOT in a pediatric population, regardless of the ATO methodology. Disclosures All Authors: No reported disclosures

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The Specific Characteristics in Children with Obstructive Sleep Apnea and Cor Pulmonale

The Scientific World JOURNAL ◽

10.1100/2012/757283 ◽

2012 ◽

Vol 2012 ◽

pp. 1-6 ◽

Cited By ~ 9

Author(s):

Pi-Chang Lee ◽

Betau Hwang ◽

Wen-Jue Soong ◽

C. C. Laura Meng

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Pediatric Patients ◽

Pediatric Population ◽

Clinical Manifestations ◽

Cor Pulmonale ◽

Arousal Index ◽

Obstructive Sleep ◽

Hemodynamic Characteristics ◽

Pulmonary Arterial

Background.The prevalence of obstructive sleep apnea (OSA) in the pediatric population is currently estimated at 1-2% of all children. The purpose of this study was to investigate the clinical and hemodynamic characteristics in pediatric patients with cor pulmonale and OSA.Methods.Thirty children with the diagnosis of OSA were included. These patients consisted of 26 male and 4 female children with a mean age of 7 ± 4 years old. Five of those children were found to be associated with cor pulmonale, and 25 had OSA but without cor pulmonale.Results.The arousal index was much higher in children with OSA and cor pulmonale. The children with OSA and cor pulmonale had much lower mean and minimal oxygen saturation and a higher incidence of bradycardia events. All 5 patients with OSA and cor pulmonale underwent an adenotonsillectomy, and the pulmonary arterial pressure dropped significantly after the surgery.Conclusion.This study demonstrated that the OSA pediatric patients with cor pulmonale had the different clinical manifestations and hemodynamic characteristics from those without cor pulmonale. The adenotonsillectomy had excellent results in both the OSA pediatric patients with and without cor pulmonale.

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MR-Proadrenomedullin as biomarker of renal damage in urinary tract infection in children

BMC Pediatrics ◽

10.1186/s12887-021-02765-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Rafael Peñalver Penedo ◽

Marta Rupérez Lucas ◽

Luis Antonio Álvarez-Sala Walther ◽

Alicia Torregrosa Benavent ◽

María Luisa Casas Losada ◽

...

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Pediatric Patients ◽

Pediatric Population ◽

Adult Population ◽

Roc Curves ◽

Renal Scintigraphy ◽

Reactive Protein ◽

Sensitivity Specificity

Abstract Background Midregional-proadrenomedullin (MR-proADM) is a useful prognostic peptide in severe infectious pathologies in the adult population. However, there are no studies that analyze its utility in febrile urinary tract infection (fUTI) in children. An accurate biomarker would provide an early detection of patients with kidney damage, avoiding other invasive tests like renal scintigraphy scans. Our objective is to study the usefulness of MR-proADM as a biomarker of acute and chronic renal parenchymal damage in fUTI within the pediatric population. Methods A prospective cohort study was conducted in pediatric patients with fUTI between January 2015 and December 2018. Plasma and urine MR-proADM levels were measured at admission in addition to other laboratory parameters. After confirmation of fUTI, renal scintigraphy scans were performed during the acute and follow-up stages. A descriptive study has been carried out and sensitivity, specificity and ROC curves for MR-proADM, C-reactive protein, and procalcitonin were calculated. Results 62 pediatric patients (34 female) were enrolled. Scintigraphy showed acute pyelonephritis in 35 patients (56.5%). Of those patients, the median of plasmatic MR-proADM (P-MR-proADM) showed no differences compared to patients without pyelonephritis. 7 patients (11.3%) developed renal scars (RS). Their median P-MR-proADM levels were 1.07 nmol/L (IQR 0.66–1.59), while in patients without RS were 0.48 nmol/L (0.43–0.63) (p < 0.01). The AUC in this case was 0.92 (95% CI 0.77–0.99). We established an optimal cut-off point at 0.66 nmol/L with sensitivity 83.3% and specificity 81.8%. Conclusion MR-ProADM has demonstrated a poor ability to diagnose pyelonephritis in pediatric patients with fUTI. However, P-MR-proADM proved to be a very reliable biomarker for RS prediction.

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New Daily Persistent Headache in a Pediatric Population

Journal of Child Neurology ◽

10.1177/08830738211004514 ◽

2021 ◽

pp. 088307382110045

Author(s):

Eric Strong ◽

Emily Linda Pierce ◽

Raquel Langdon ◽

Jeffery Strelzik ◽

William McClintock ◽

...

Keyword(s):

Pediatric Patients ◽

Medication Overuse ◽

Pediatric Population ◽

Medication Overuse Headache ◽

Activity Level ◽

New Daily Persistent Headache ◽

Tertiary Referral Center ◽

Preventive Medication ◽

Headache Clinic ◽

Persistent Headache

Introduction: New daily persistent headache (NDPH) is a primary headache disorder characterized by an intractable, daily, and unremitting headache lasting for at least 3 months. Currently, there are limited studies in the pediatric population describing the characteristics of NDPH. Objective: The objective of the current study is to describe the characteristics of NDPH in pediatric patients presenting to a headache program at a tertiary referral center. Methods: The participants in the current study were pediatric patients who attended the Headache Clinic at Children’s National Hospital between 2016 and 2018. All patients seen in the Headache Clinic were enrolled in an institutional review board–approved patient registry. Results: Between 2016 and 2018, NDPH was diagnosed in 245 patients, representing 14% of the total headache population. NDPH patients were predominantly female (78%) and white (72%). The median age was 14.8 years. The median pain intensity was 6 of 10 (standard deviation = 1.52). Most patients reported experiencing migrainous features, namely, photophobia (85%), phonophobia (85%), and a reduced activity level (88%). Overall, 33% of patients had failed at least 1 preventive medication, and 56% had failed at least 1 abortive medication. Furthermore, 36% of patients were additionally diagnosed with medication overuse headache. Conclusion: NDPH is a relatively frequent disorder among pediatric chronic headache patients. The vast majority of these patients experience migrainous headache characteristics and associated symptoms and are highly refractory to treatment—as evidenced by a strong predisposition to medication overuse headache and high rates of failed preventive management.

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Seven years follow-up of corneal cross-linking (CXL) in pediatric patients: Evaluation of treated and untreated eye

European Journal of Ophthalmology ◽

10.1177/11206721211020632 ◽

2021 ◽

pp. 112067212110206

Author(s):

Iliya Simantov ◽

Lior Or ◽

Inbal Gazit ◽

Biana Dubinsky-Pertzov ◽

David Zadok ◽

...

Keyword(s):

Visual Acuity ◽

Pediatric Patients ◽

Pediatric Population ◽

Corneal Thickness ◽

Cross Linking ◽

Uncorrected Distance Visual Acuity ◽

Mild Reduction ◽

Change In The Mean ◽

The Mean

Background: Retrospective cohort study evaluating long term keratoconus progression amongst cross-linking (CXL) treated pediatric patients in the treated and the fellow untreated eyes. Methods: Data on 60 eyes of 30 patients, 18 years old or younger, who underwent CXL in at least one eye was collected and analyzed. Follow-up measurements taken from the treated and untreated eye up to 7 years after CXL treatment, were compared to baseline measurements. Parameters included uncorrected distance visual acuity (UCDVA), best-corrected spectacle visual acuity (BCSVA), manifest refraction, pachymetry, corneal tomography, and topography. Results: Mean age of patients was 16 ± 2.1 years. For the treated eyes, during follow-up period mean UCDVA had improved (from 0.78 ± 0.22 at baseline to 0.58 ± 0.26 logMAR at 7 years; p = 0.13), as well as mean BCSVA (from 0.23 ± 0.107 at baseline to 0.172 ± 0.05 logMAR at 7 years; p = 0.37). The mean average keratometry showed a significant flattening (from 49.95 ± 4.04 to 47.94 ± 3.3 diopters (D); p < 0.001), However there was no change in the mean maximal keratometry. The mean minimal corneal thickness (MCT) showed a significant mild reduction of 26 µm ( p = 0.006). Although statistically insignificant, the mean manifest cylinder was also reduced to 2D ( p = 0.15). During the follow-up period, eight untreated eyes (26.6%) deteriorated and underwent CXL, while only one treated eye (3.33%) required an additional CXL. Conclusion: CXL is a safe and efficient procedure in halting keratoconus progression in the pediatric population, the fellow eye needs to be carefully monitored but only a 25% of the patients will require CXL in that eye during a period of 7 years.

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