Characteristics of Eight Pediatric Patients with Coronavirus Disease 2019

Background: Coronavirus Disease 2019 (COVID-19) has attracted global attention for unexpected rapid transmission among countries. Currently, little is known about the attributes of pediatric patients with COVID-19. Objectives: To describe the characteristics of pediatric patients with COVID-19. Methods: We retrospectively analyzed the epidemiological, laboratory, imaging, and clinical data of pediatric patients with COVID-19 from January 31 to February 24, 2020. Results: A total of eight patients with COVID-19 were enrolled in this study. Two patients had underlying diseases. Seven children (87.5%) belonged to a family cluster outbreak. The most common symptoms were fever (50%), cough (37.5%), expectoration (37.5%), and Sore throat (37.5%). For the laboratory findings, all patients had positive nCoV-RNA results, three patients (37.5%) with abnormal white blood cell counts, and six patients (75%) with higher lymphocyte counts. Chest computed tomography (CT) showed ground-glass opacity or patchy shadows in 7 patients (87.5%). All patients received antiviral therapy. Additionally, four patients (50%) were treated with antibiotics, one with glucocorticoid atomization (12.5%), one with interferon atomization (12.5%), four patients (50%) with traditional Chinese medicine. All patients discharged within three weeks, without poor prognosis or recurrence after 14 days follow-up. Conclusions: Pediatric patients with COVID-19 were mainly transfected through family cluster outbreaks. The clinical manifestations were mild without a typical pattern. High-resolution CT and nCoV-RNA tests have great value for early-stage diagnosis. Antiviral therapy is effective in treating viral pneumonia.

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Distinctive clinical and laboratory features of COVID-19 and H1N1 influenza infections among hospitalized pediatric patients

World Journal of Pediatrics ◽

10.1007/s12519-021-00432-1 ◽

2021 ◽

Author(s):

Ali Alsuheel Asseri ◽

Ayed A. Shati ◽

Saleh M. Al-Qahtani ◽

Ibrahim A. Alzaydani ◽

Ahmed A. Al-Jarie ◽

...

Keyword(s):

Pediatric Patients ◽

Unit Length ◽

Clinical Manifestations ◽

Gastrointestinal Symptoms ◽

H1n1 Influenza ◽

Laboratory Findings ◽

Number Of Children ◽

Cell Counts ◽

Number Of Patients ◽

Total Intensive Care Unit

Abstract Background It had been documented in many studies that pediatric coronavirus disease 2019 (COVID-19) is characterized by low infectivity rates, low mortalities, and benign disease course. On the other hand, influenza type A viruses are recognized to cause severe and fatal infections in children populations worldwide. This study is aimed to compare the clinical and laboratory characteristics of COVID-19 and H1N1 influenza infections. Methods A retrospective study comprising 107 children hospitalized at Abha Maternity and Children Hospital, Southern region of Saudi Arabia, with laboratory-confirmed COVID-19 and H1N1 influenza infections was carried out. A complete follow-up for all patients from the hospital admission until discharge or death was made. The clinical data and laboratory parameters for these patients were collected from the medical records of the hospital. Results Out of the total enrolled patients, 73 (68.2%) were diagnosed with COVID-19, and 34 (31.8%) were diagnosed with H1N1 influenza. The median age is 12 months for COVID-19 patients and 36 months for influenza patients. A relatively higher number of patients with influenza had a fever and respiratory symptoms than COVID-19 patients. In contrast, gastrointestinal symptoms were observed in a higher number of COVID-19 patients than in influenza patients. A statistically significant increase in white cell counts is noted in COVID-19 but not in influenza patients (P < 0.05). There are no obvious variations in the mean period of duration of hospitalization between COVID-19 and influenza patients. However, the total intensive care unit length of stay was longer for influenza compared to COVID-19 patients. Conclusions A considerable number of children infected with COVID-19 and H1N1 influenza were noted and reported in this study. There were no significant variations in the severity of the symptomatology and laboratory findings between the two groups of patients. Significant differences between these patients in some hospitalization factors and diagnosis upon admission also were not observed. However, more severe clinical manifestations and serious consequences were observed among pediatric patients hospitalized with influenza infections than among those with COVID-19.

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Gottron Papules and Gottron Sign with Ulceration: A Distinctive Cutaneous Feature in a Subset of Patients with Classic Dermatomyositis and Clinically Amyopathic Dermatomyositis

The Journal of Rheumatology ◽

10.3899/jrheum.160024 ◽

2016 ◽

Vol 43 (9) ◽

pp. 1735-1742 ◽

Cited By ~ 16

Author(s):

Hua Cao ◽

Qunli Xia ◽

Meng Pan ◽

Xiaoqing Zhao ◽

Xia Li ◽

...

Keyword(s):

Interstitial Pneumonia ◽

Amyopathic Dermatomyositis ◽

Laboratory Findings ◽

Clinically Amyopathic Dermatomyositis ◽

Acute Interstitial Pneumonia ◽

Cell Counts ◽

Lower Baseline ◽

Increased Risk ◽

Positive Rate ◽

White Blood Cell Counts

Objective.Gottron papules and Gottron sign are characteristic and possibly pathognomonic cutaneous features of classic dermatomyositis and clinically amyopathic dermatomyositis (DM/CADM). However, the Gottron papules/Gottron sign with cutaneous ulceration (ulcerative Gottron papules/Gottron sign) are less common. We aimed to clarify the clinical characteristics of patients with DM/CADM who have ulcerative Gottron papules/Gottron sign.Methods.Clinical features, laboratory findings, and prognosis of patients with DM/CADM who had Gottron papules/Gottron sign with or without ulceration were analyzed and compared.Results.Occurrences of acute interstitial pneumonia/subacute interstitial pneumonia (AIP/SIP) were significantly higher in patients with ulcerative Gottron papules/Gottron sign (19/26) versus patients with Gottron papules/Gottron sign without ulceration (2/66, p < 0.001). We also observed that the white blood cell counts (mean ± SD 4.2 ± 1.6 vs 6.9 ± 2.9; p < 0.001) and creatine kinase (CK) levels (198.0 ± 377.7 vs 1364.0 ± 2477.0; p = 0.019) were significantly lower, whereas the positive rate of antimelanoma differentiation-associated gene 5 antibody (anti-MDA5; 88.5% vs 6.1%, p < 0.001) and serum ferritin levels (665.2 ± 433.5 vs 256.2 ± 279.0, p < 0.001) were significantly higher in the patients with ulcerative Gottron papules/Gottron sign. Moreover, the cumulative survival rate of the group with ulcerative Gottron papules/Gottron sign was significantly lower (p < 0.001).Conclusion.Patients with DM/CADM who have ulcerative Gottron papules/Gottron sign, positive anti-MDA5 antibody, and significantly lower baseline CK level are at increased risk of interstitial lung disease, especially AIP/SIP. A new designation for this subgroup of patients should be established to draw more attention to this clinical entity.

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Dynamic profiles of SARS-Cov-2 infection from five Chinese family clusters in the early stage of the COVID-19 pandemic

Scientific Reports ◽

10.1038/s41598-020-79035-1 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Xiang-Gen Kong ◽

Jin Geng ◽

Tao Zhang ◽

Bin Wang ◽

An-Zhao Wu ◽

...

Keyword(s):

Early Stage ◽

Laboratory Data ◽

Clinical Findings ◽

Chinese Family ◽

Limited Data ◽

Immune Markers ◽

Laboratory Findings ◽

Family Cluster ◽

The Family ◽

Basic Characteristics

AbstractAlthough several cases of family clusters with SARS-Cov-2 infection have been reported, there are still limited data preventing conclusions from being drawn regarding the characteristics and laboratory findings in the COVID-19 population within family clusters. In the present study, we retrospectively collected five family clusters with COVID-19 and summarized the dynamic profiles of the clinical characteristics, laboratory findings, immune markers, treatment and prognosis of this population. Furthermore, we also compared clinical and laboratory data between the SARS-Cov-2 infection with family cluster (n = 21) and those without family cluster (n = 16). We demonstrated that the duration of SARS-Cov-2 replication might be varied based on the different family clusters due to their different genetic backgrounds. The onset improved lung radiology might start at the end of the SARS-Cov-2 positive period. Furthermore, the obtained results demonstrated that similar basic characteristics and clinical findings seem to exist between the cases with SARS-Cov-2 and without family clusters. The serum level of ferritin might have a different biological function and be a new biomarker for the family cluster. Further studies with larger numbers of patients are required.

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Early clinical and CT features of COVID-19 and community-acquired pneumonia from a fever observation ward in Ningbo, China

Singapore Medical Journal ◽

10.11622/smedj.2021004 ◽

2021 ◽

Author(s):

G Qian ◽

Y Lin ◽

AHY Ma ◽

X Zhang ◽

G Li ◽

...

Keyword(s):

Early Stage ◽

Laboratory Data ◽

Clinical Manifestations ◽

Lower Lobe ◽

Ground Glass Opacity ◽

Ct Images ◽

Community Acquired Pneumonia ◽

Ground Glass ◽

Significant Difference ◽

Eosinophil Counts

Introduction: We aimed to compare the early clinical manifestations, laboratory results and chest computed tomography (CT) images of coronavirus disease 2019 (COVID-19) patients with those of other community-acquired pneumonia (CAP) patients to differentiate COVID-19 before reverse transcription-polymerase chain reaction results are obtained. Methods: The clinical and laboratory data and chest CT images of 51 patients were assessed in a fever observation ward for evidence of COVID-19 between January and February 2020. Results: 24 patients had laboratory-confirmed COVID-19, whereas 27 individuals had negative results. No statistical difference in clinical features was found between COVID-19 and CAP patients except for diarrhoea. There was a significant difference in lymphocyte and eosinophil counts between COVID-19 and CAP patients. 22 (91.67%) COVID-19 patients had bilateral involvement and multiple lesions according to their lung CT images; the left lower lobe (87.50%) and right lower lobe (95.83%) were most often affected, and all lesions were located in peripheral zones of the lung. The most common CT feature of COVID-19 was ground-glass opacity, found in 95.83% of patients, compared to 66.67% of CAP patients. Conclusion: Diarrhoea, lymphocyte counts, eosinophil counts and CT findings (e.g. ground-glass opacity) could help to distinguish COVID-19 from CAP at an early stage of infection, based on findings from our fever observation ward.

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Varicella in Pediatric Patients

Annals of Pharmacotherapy ◽

10.1177/106002809302700723 ◽

1993 ◽

Vol 27 (7-8) ◽

pp. 938-949 ◽

Cited By ~ 15

Author(s):

Laureen A. Drwal-Klein ◽

Carmel A. O'Donovan

Keyword(s):

Varicella Zoster Virus ◽

Antiviral Therapy ◽

Pediatric Patients ◽

Pediatric Population ◽

Varicella Vaccine ◽

Clinical Manifestations ◽

Search Term ◽

Healthy Children ◽

Varicella Zoster ◽

Treatment And Prevention

OBJECTIVE: To summarize the literature describing the epidemiology, transmission, clinical manifestations, diagnosis, treatment, and prevention of varicella in the pediatric population. DATA SOURCES: A literature search of English-language articles from 1982 to 1992 using MEDLINE and bibliographies of relevant articles. The search term used was varicella. STUDY SELECTION: All review articles and original studies addressing the epidemiology, transmission, clinical manifestations, complications, diagnosis, treatment, and prevention of varicella in pediatric patients were reviewed. Emphasis was placed on controlled studies done in the US. DATA EXTRACTION: Data from human studies were extracted by the authors and evaluated according to patient population, sample size, dosing regimen, efficacy, and safety. DATA SYNTHESIS: Varicella-zoster virus is a highly contagious virus that produces a common and costly disease in the pediatric population. The primary manifestation of varicella is the eruption of vesicular lesions. In most cases varicella is benign, but it can be associated with serious complications. Diagnosis is based primarily on clinical findings. Otherwise healthy children have traditionally received only symptomatic treatment for varicella, but recent literature suggests that antiviral therapy may be useful in these patients. Immunocompromised patients benefit from both symptomatic and antiviral therapy. Isolation and varicella-zoster immune globulin are used to prevent varicella. In the future, varicella vaccine will play an important role in preventing the disease. Varicella vaccine has been shown to be immunogenic and clinically effective in both healthy and immunocompromised children. Adverse reactions associated with the vaccine include fever, injection-site reactions, and rash. Although zoster can follow vaccination, the incidence appears to be lower in vaccinated individuals. Preliminary studies have shown that the vaccine provides protection from varicella-zoster virus for an extended period of time. CONCLUSIONS: Varicella is a common, usually benign disease of childhood. All patients may benefit from symptomatic therapy. Current literature does not support the use of antiviral therapy in all pediatric patients with varicella. When commercially available, varicella vaccine will play an important role in prevention. Long-term studies are needed to fully assess the risk of developing varicella and zoster following vaccination.

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Clinical research of primary liver cancer mimicking liver abscess

International Surgery Journal ◽

10.18203/2349-2902.isj20170857 ◽

2017 ◽

Vol 4 (3) ◽

pp. 1033

Author(s):

Kong Jun ◽

Leng Tongmin ◽

Gong Jianping ◽

Tang Maoming

Keyword(s):

Liver Cancer ◽

Liver Abscess ◽

Early Stage ◽

Primary Liver Cancer ◽

Clinical Manifestations ◽

Pyogenic Liver Abscess ◽

Diagnosis And Treatment ◽

Hepatic Arteriography ◽

Laboratory Findings ◽

Post Operation

Background: Aiming at diagnosing at an early stage, minimizing the misdiagnosis rate and improving the prognosis, the author has investigated the clinical characteristics, diagnosis and treatment of primary liver cancer mimicking liver abscess with a summary and discussion.Methods: All of the 11 cases of primary liver cancer mimicking liver abscess, diagnosed during January 2009 to December 2015, were retrospectively viewed in terms of clinical manifestations, laboratory tests, radiological feature, diagnosis and treatment. And statistic analysis was made in all aspects mentioned above with that of pyogenic liver abscess and other types of liver cancer diagnosed in the corresponding period. Results: The clinical manifestations of the 11 cases were mostly characterized by fever, abdominal pain and weight loss. There was no significantly statistic difference between the study group and any of the three matched groups in underlying disease and lab results. All of the 11 patients were treated with enhanced antibiotics as basic therapy. Furthermore, eight cases accepted surgical operation, among them, one object underwent puncture and drainage of the liver abscess by ultrasound (PDLA) twice pre-operation, one object underwent PDLA and hepatic arteriography pre-operation and death in hospital post-operation, one object suffered myocardial infarction post-operation. In addition, three cases received conservative treatment only, in which, one object died in hospital.Conclusions: It is difficult to distinguish primary liver cancer mimicking liver abscess from pyogenic liver abscess as there are no specific clinical manifestations and laboratory findings which is prone to leading to misdiagnosis. What’s worse, the prognosis is so poor that high alert and close follow-up are required as well as early diagnosis and treatment.

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Suppurative Group A β-Hemolytic Streptococcal Infections in Children

PEDIATRICS ◽

10.1542/peds.89.4.743 ◽

1992 ◽

Vol 89 (4) ◽

pp. 743-746

Author(s):

Mobeen H. Rathore ◽

Leslie L. Barton ◽

Edward L. Kaplan

Keyword(s):

Demographic Data ◽

Clinical Manifestations ◽

Healthy Children ◽

Toxic Shock ◽

Cell Counts ◽

Specific Strain ◽

Patient Demographic Data ◽

Group A ◽

White Blood Cell Counts ◽

Suppurative Infection

Group A β-hemolytic streptococci (GABHS) have once again become an important cause of serious suppurative disease in children. A 100% increase in the rate of GABHS bacteremia and an increased frequency in GABHS bacteremia in previously healthy children were observed in 1989 through 1990 compared with 1984 to 1988. Streptococcal isolates were characterized and patient demographic data were tabulated from children hospitalized with GABHS suppurative infections in 1989 through 1990. The differences in clinical manifestations and strains of GABHS were examined in patients with bacteremia, with or without focal site of infection, and in those with focal infections without bacteremia. Bacteremic children were significantly younger and had higher white blood cell counts at admission. No patient had a toxic shock-like syndrome. Although no specific strain was associated with suppurative infections, serum opacity reaction-negative organisms were more frequently associated with focal infections without bacteremia. The data suggest that GABHS may have become more virulent. Physicians should consider GABHS as an important cause of serious suppurative infection in children.

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Covid-19: An update on the clinical features, diagnosis, and treatment strategies.

Coronaviruses ◽

10.2174/2666796701999201204114834 ◽

2020 ◽

Vol 01 ◽

Author(s):

Manan Abdulrahman Alhkbany

Keyword(s):

Treatment Strategies ◽

The Elderly ◽

Diagnosis And Treatment ◽

Transmission Method ◽

Laboratory Findings ◽

Health Crisis ◽

New Public Health ◽

Cell Counts ◽

White Blood Cell Counts ◽

The Right

: The Coronavirus disease 2019 (COVID-2019) has emerged as a new public health crisis with the WHO officially declaring it as a pandemic on 30 January 2020. In December 2019, the virus originated in bats and was transmitted to humans through an unknown intermediary animal in Wuhan, Hubei province, China. As of 18 May 2020, there are 4,730,968 reported cases of Covid-19, with 315,488 deaths. Direct contact among individuals is the most common transmission method, primarily through droplets released during coughing or sneezing. The incubation period of the virus oscillates between 2 to 14 days. The commonly reported symptoms include fatigue, sore throat, cough, and fever. Most of the people are asymptomatic or show mild symptoms. The elderly individuals and people with comorbidities show severe symptoms. The disease is diagnosed by using the real-time reverse transcription-polymerase chain reaction (RT-PCR) testing method. A blood test is also used to detect the antibodies to the virus, which are usually released after infection. The typical laboratory findings indicate elevated C-reactive proteins (CRP) with normal or low white blood cell counts; the chest CT scan demonstrates ground-glass opacities (GGO) and bilateral pneumonia in most patients. Supportive treatment is available, and research on the right treatment using existing drugs is ongoing. Several pharmaceutical companies and research institutions are focusing on the development of a vaccine. The review summarizes and provides an update on the pathogenesis, diagnosis, and treatment strategies in the management of Covid-19.

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Clinical manifestations and outcome analysis of invasive pulmonary aspergillosis infection: a retrospective study in 43 nonneutropenic patients

Journal of International Medical Research ◽

10.1177/0300060519874901 ◽

2019 ◽

Vol 47 (11) ◽

pp. 5680-5688

Author(s):

Lihong Zhang ◽

Chunli Che

Keyword(s):

Early Stage ◽

Invasive Pulmonary Aspergillosis ◽

Clinical Manifestations ◽

Ground Glass Opacity ◽

Pulmonary Aspergillosis ◽

Halo Sign ◽

Mold Exposure ◽

Wbc Count ◽

Lung Ct ◽

Central Airway

Objective To investigate clinical characteristics of early-onset invasive pulmonary aspergillosis (IPA) in nonneutropenic patients. Methods Retrospective analysis was used to investigate clinical manifestations and auxiliary examination characteristics in 43 patients with IPA and 51 patients with community-acquired pneumonia in the early stage. Results Risk factors of IPA were dust and mold exposure, bronchiectasis, old pulmonary tuberculosis, and nasosinusitis. The incidence rate of complex clinical manifestations was 60.47% during the first week of IPA. The incidence rate of white blood cell (WBC) count >20.0 × 109/L was 51.16%. Lung CT findings indicated incidence rates of single or multiple nodules with a halo sign and central airway expansion with ground glass opacity were 27.9% and 37.21%, respectively. Mortality rates of patients with IPA given empirical and targeted antifungal treatments were 12.0% and 42.9%, respectively. Conclusions Bronchiectasis, old pulmonary tuberculosis, nasosinusitis, and dust and mold exposure may increase the risk of IPA. Single or multiple nodules with a halo sign and central airway expansion with ground glass opacity may be early-stage lung CT findings in patients with IPA. A WBC count >20.0 × 109/L may aid in early diagnosis, and empirical antifungal therapy may reduce mortality in patients with IPA.

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Clinico-Biological Features and Clonal Hematopoiesis in Patients with Severe COVID-19

Cancers ◽

10.3390/cancers12071992 ◽

2020 ◽

Vol 12 (7) ◽

pp. 1992 ◽

Cited By ~ 1

Author(s):

Nicolas Duployez ◽

Jordane Demonchy ◽

Céline Berthon ◽

Julien Goutay ◽

Morgan Caplan ◽

...

Keyword(s):

Orotracheal Intubation ◽

Biological Behavior ◽

Subsequent Aging ◽

Laboratory Findings ◽

Reactive Protein ◽

Clonal Hematopoiesis ◽

Biological Features ◽

Cell Counts ◽

High Prevalence ◽

White Blood Cell Counts

Advanced age or preexisting comorbidities have been characterized as risk factors for severe coronavirus disease 2019 (COVID-19) cases requiring hospitalization and intensive care. In recent years, clonal hematopoiesis (CH) of indeterminate potential (CHIP) has emerged as a risk factor for chronic inflammatory background and subsequent aging-associated diseases. The purpose of this study was to identify biological factors (particularly leukocyte subtypes and inflammatory markers) associated with a risk of clinical deterioration (i.e., orotracheal intubation (OTI)) and to determine whether CH was likely to influence clinical and biological behavior in patients with severe COVID-19 requiring hospitalization. Here, we describe clinical and biological features, including the screening of CHIP mutants in a well-annotated cohort of 122 hospitalized patients with a laboratory-confirmed diagnosis of COVID-19 (55% requiring OTI). We showed that elevated white blood cell counts, especially neutrophils and high C-reactive protein (CRP) levels at admission, were associated with an increased requirement of OTI. We noticed a high prevalence of CH (25%, 38%, 56%, and 82% of patients aged <60 years, 60–70 years, 70–80 years, and >80 years) compared to a retrospective cohort of patients free of hematological malignancy explored with the same pipelines (10%, 21%, 37%, and 44%). However, the existence of CH did not significantly impact clinical outcome, including OTI or death, and did not correlate with other laboratory findings.

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