Characteristics and Outcomes of Children With COVID-19: Evidence From West Nusa Tenggara Province, Indonesia

Background: Globally, COVID-19 is less prevalent in children than adults. However, in Indonesia, the number of infected children is one rise rapidly. Objectives: To describe characteristics and outcomes of children with COVID-19 in West-Nusa-Tenggara Province, Indonesia. Methods: We retrospectively reviewed registries of children with confirmed COVID-19 collected by the Indonesian-Pediatric-Society, West-Nusa-Tenggara. Children diagnosed with COVID-19 by RT-PCR from March 2 to July 12, 2020, were included in the analysis. Results: Of 146 COVID-19-confirmed subjects, 47.9% were symptomatic, 45.2% were aged < 5 years old, 58.2% were male, 54.8% had a history of COVID-19 contact, and 2.7% (n = 4) died. Asymptomatic subjects had older median age (P < 0.01), longer median duration of RT-PCR conversion (P < 0.01) than symptomatic children and 88.2% had a history of COVID-19 contact. Forty-eight (out of 55 hospitalized symptomatic subjects or 87%) were < 5 years old, had younger median age (P < 0.01), and 4 (7.3%) had a history of COVID-19 contact. They also had higher respiratory rate and body temperature (P < 0.01), lower oxygen saturation (P < 0.01), higher white-blood-cell counts (P = 0.01), and lower hemoglobin levels (P = 0.015) compared to the non-hospitalized symptomatic subjects. Forty-three (78%) hospitalized subjects were in severe and critical condition, 49 (89%) were pneumonic, and 28 (51%) had bilateral infiltrates on chest x-ray. All registered deaths were due to acute-respiratory-distress-syndrome. Besides, all deaths were in hospitals without a pediatric-intensive-care-unit. Conclusions: In the present study, we identified both asymptomatic and symptomatic COVID-19 infected children. Most symptomatic COVID-19 cases were in children < 5 years old, presented with severe pneumonia, and few of them had a history of COVID-19 contact.

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Meningococcal Pneumonia in a Young Healthy Male

Case Reports in Infectious Diseases ◽

10.1155/2018/2179097 ◽

2018 ◽

Vol 2018 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Abdullah M. Al Alawi

Keyword(s):

Emergency Department ◽

Lower Lobe ◽

Community Acquired Pneumonia ◽

Cell Counts ◽

History Of ◽

Chest X Ray ◽

White Blood Cell Counts ◽

The Right ◽

Local Guideline

A 23-year-old male presented to the emergency department with one-day history of right-sided pleuritic chest pain, haemoptysis, and fever. In the emergency department, the blood pressure was 140/60 mmHg, heart rate 89/min, body temperature 40°C, respiratory rates 20 breaths/min, and oxygen saturation 98% in room air. Physical examination revealed rales and bronchial breathing in the right infrascapular region. Laboratory analysis showed raised white blood cell counts and elevated inflammation markers. Chest X-ray showed right lower lobe consolidation. Intravenous(IV) ceftriaxone and doxycycline were started for the management of community-acquired pneumonia as per the local guideline. Later, on admission, blood culture was positive for Neisseria meningitidis (N. meningitidis). Ceftriaxone was continued for 4 days, and the patient was discharged while being on oral amoxicillin (1 gm TDS) for another 3 days. He remained well during the outpatient follow-up.

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A Comparative Study on the Clinical Features of Coronavirus 2019 (COVID-19) Pneumonia With Other Pneumonias

Clinical Infectious Diseases ◽

10.1093/cid/ciaa247 ◽

2020 ◽

Vol 71 (15) ◽

pp. 756-761 ◽

Cited By ~ 95

Author(s):

Dahai Zhao ◽

Feifei Yao ◽

Lijie Wang ◽

Ling Zheng ◽

Yongjun Gao ◽

...

Keyword(s):

Clinical Features ◽

Clinical Symptoms ◽

Severe Pneumonia ◽

Ground Glass Opacity ◽

Chest Ct ◽

Rt Pcr ◽

Bilateral Involvement ◽

Radiological Features ◽

History Of ◽

Novel Coronavirus

Abstract Background A novel coronavirus (COVID-19) has raised world concern since it emerged in Wuhan, China in December 2019. The infection may result in severe pneumonia with clusters of illness onsets. Its impacts on public health make it paramount to clarify the clinical features with other pneumonias. Methods Nineteen COVID-19 and 15 other patients with pneumonia (non-COVID-19) in areas outside of Hubei were involved in this study. Both COVID-19 and non-COVID-19 patients were confirmed to be infected using throat swabs and/or sputa with/without COVID-2019 by real-time RT-PCR. We analyzed the demographic, epidemiological, clinical, and radiological features from those patients, and compared the differences between COVID-19 and non-COVID-19. Results All patients had a history of exposure to confirmed cases of COVID-19 or travel to Hubei before illness. The median (IQR) duration was 8 (6–11) and 5 (4–11) days from exposure to onset in COVID-19 and non-COVID-19 cases, respectively. The clinical symptoms were similar between COVID-19 and non-COVID-19. The most common symptoms were fever and cough. Fifteen (78.95%) COVID-19 but 4 (26.67%) non-COVID-19 patients had bilateral involvement while 17 COVID-19 patients (89.47%) but 1 non-COVID-19 patient (6.67%) had multiple mottling and ground-glass opacity on chest CT images. Compared with non-COVID-19, COVID-19 presents remarkably more abnormal laboratory tests, including AST, ALT, γ-GT, LDH, and α-HBDH. Conclusions The COVID-19 infection has onsets similar to other pneumonias. CT scan may be a reliable test for screening COVID-19 cases. Liver function damage is more frequent in COVID-19 than non-COVID-19 patients. LDH and α-HBDH may be considerable markers for evaluation of COVID-19.

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A Fatal Case of COVID-19 in an Infant with Severe Acute Malnutrition Admitted to a Paediatric Ward in Niger

Case Reports in Pediatrics ◽

10.1155/2020/8847415 ◽

2020 ◽

Vol 2020 ◽

pp. 1-3

Author(s):

Alido Soumana ◽

Aboubacar Samaila ◽

Lamine Mahaman Moustapha ◽

Moumouni Kamaye ◽

Balkissa Daouda ◽

...

Keyword(s):

Nasal Swab ◽

Severe Acute Malnutrition ◽

Fatal Case ◽

Acute Malnutrition ◽

Rt Pcr ◽

X Ray ◽

Laboratory Confirmation ◽

History Of ◽

Chest X Ray ◽

The Right

While there have been very few fatal cases, SARS-CoV-2 has been reported in paediatric patients. This study aims to describe a fatal case of COVID-19 in a child with severe acute malnutrition. The eight-month-old child presented with fever, diarrhoea, and difficulty in breathing. The mother of the child had fever and shortness of breath four weeks before she died. Physical examination revealed lethargy, dehydration, and severe weight loss with a weight of 5 kg at a height of 78 cm tall. The weight-for-height index was less than three Z-scores, which corresponds to severe acute malnutrition. The pulmonary examination revealed moderate respiratory distress, and the chest X-ray presented features suggestive of pneumonia in the right lung area. In the context of the COVID-19 outbreak in Niger and the circumstances of the mother’s death, a nasal swab was taken for laboratory confirmation. Treatment provided to the child included intranasal oxygen, antibiotics, and a dietary program with therapeutic milk. The child died 48 hours after his admission. The history of contact with a SARS-CoV-2 suspect or positive patient should lead to screening for infection by using RT-PCR. It is important to investigate malnutrition as a potential risk factor for severe SARS-CoV-2 infection and resultant mortality.

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Clinical Analysis of 9 Cases of Neonatal Influenza A

10.21203/rs.3.rs-151767/v1 ◽

2021 ◽

Author(s):

Yanlan Zhang ◽

Lin Xu ◽

Caiying Wang ◽

Lin Pang

Keyword(s):

Influenza A ◽

Nasal Congestion ◽

Antiviral Treatment ◽

Clinical Analysis ◽

Runny Nose ◽

Reactive Protein ◽

Cell Counts ◽

History Of ◽

White Blood Cell Counts ◽

Medical University

Abstract Background: The population is generally susceptible to influenza A, while neonatal cases are relatively rare. The study aims to explore the clinical characteristics, diagnosis, treatment, and prognosis of neonates with influenza A.Methods: The clinical data from neonates with influenza A who were treated in the neonatal department of Beijing Ditan Hospital affiliated with Capital Medical University from November 2017 to January 2019 were retrospectively analyzed.Results: A total of 9 neonates with influenza A were admitted and treated, with a distribution of 7 males and 2 females. The onset was 1.44 ± 1.46 days (mean ± SD), and age at diagnosis was 21.44 ±6. 53 days. All cases had a history of exposure to febrile patients, The main symptoms are fever, nasal congestion, runny nose, sneezing, coughing, other respiratory symptoms and digestive symptoms such as vomiting milk, choking milk, less milk, diarrhea. Laboratory tests showed 7 cases of decreased white blood cell counts, 3 cases of increased plasma C-reactive protein concentrations. All cases were administered antiviral therapy on the day of admission. Eight neonates reverted to a normal temperature within 48 hours after hospitalization, one neonate’s temperature returned to normal after 48 hours of hospitalization, and all cases' symptoms gradually improved.Conclusion: The symptoms of influenza A in neonates are atypical, once a diagnosis is confirmed, the prognosis is likely to be favorable as long as antiviral treatment with antiviral is initiated as soon as possible.

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Nasal upregulation of CST1 in dog-sensitised children with severe allergic airway disease

ERJ Open Research ◽

10.1183/23120541.00917-2020 ◽

2021 ◽

Vol 7 (2) ◽

pp. 00917-2020

Author(s):

Ulrika Käck ◽

Elisabet Einarsdottir ◽

Marianne van Hage ◽

Anna Asarnoj ◽

Anna James ◽

...

Keyword(s):

Clinical Symptoms ◽

Clinical History ◽

Airway Disease ◽

Forced Expiratory Volume ◽

Allergic Airway Disease ◽

Healthy Controls ◽

Cell Counts ◽

History Of ◽

White Blood Cell Counts ◽

Methacholine Provocation

BackgroundThe clinical presentation of children sensitised to dog dander varies from asymptomatic to severe allergic airway disease, but the genetic mechanisms underlying these differences are not clear. The objective of the present study was to investigate nasal transcriptomic profiles associated with dog dander sensitisation in school children and to reveal clinical symptoms related with these profiles.MethodsRNA was extracted from nasal epithelial cell brushings of children sensitised to dog dander and healthy controls. Blood sample analyses included IgE against dog dander, dog allergen molecules, other airborne and food allergens, basophil activation and white blood cell counts. Clinical history of asthma and rhinitis was recorded, and lung function was assessed (spirometry, methacholine provocation and exhaled nitric oxide fraction).ResultsThe most overexpressed gene in children sensitised to dog dander compared to healthy controls was CST1, coding for Cystatin 1. A cluster of these children with enhanced CST1 expression showed lower forced expiratory volume in 1 s, increased bronchial hyperreactivity, pronounced eosinophilia and higher basophil allergen threshold sensitivity compared with other children sensitised to dog dander. In addition, multi-sensitisation to lipocalins was more common in this group.ConclusionsOverexpression of CST1 is associated with more severe allergic airway disease in children sensitised to dog dander. CST1 is thus a possible biomarker of the severity of allergic airway disease and a possible therapeutic target for the future treatment of airborne allergy.

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Intrathecal Colistin and Sterilization of Resistant Pseudomonas Aeruginosa Shunt Infection

Annals of Pharmacotherapy ◽

10.1345/aph.1e485 ◽

2005 ◽

Vol 39 (5) ◽

pp. 949-952 ◽

Cited By ~ 33

Author(s):

Andrea L Quinn ◽

Jorge P Parada ◽

Jaime Belmares ◽

J Paul O'Keefe

Keyword(s):

Central Nervous System ◽

Pseudomonas Aeruginosa ◽

Nervous System ◽

Renal Function ◽

Central Nervous System Infections ◽

Gram Negative ◽

Cell Counts ◽

Blood Cell Counts ◽

History Of ◽

White Blood Cell Counts

OBJECTIVE: To report 2 cases of multidrug-resistant (MDR) Pseudomonas aeruginosa meningitis and ventriculo-peritoneal shunt (VPS) infection successfully sterilized with intrathecal colistin 10 mg/day after development of nephrotoxicity associated with intravenous administration. CASE SUMMARIES: Case 1. A 69-year-old African American woman with a history of subarachnoid hemorrhage and hydrocephalus requiring VPS placement was admitted with VPS infection and meningitis. Cerebrospinal fluid (CSF) cultures revealed MDR P. aeruginosa susceptible only to colistin. Intravenous colistin was initiated but rapidly discontinued due to development of renal dysfunction. Intravenous colistin was the probable cause of the adverse effect. Intrathecal colistin was initiated via an externalized VPS, with subsequent improvement in white blood cell counts in the CSF. Follow-up CSF cultures remained sterile and renal function returned to baseline. Case 2. A 69-year-old white woman with a history of subarachnoid hemorrhage, hydrocephalus, and VPS was transferred from an extended-care facility for management of a VPS infection. CSF cultures revealed MDR P. aeruginosa susceptible only to colistin. Intravenous colistin was initiated but subsequently discontinued due to worsening renal function that, as with the first case, probably correlated with colistin administration and persisted despite dose adjustment. Therapy was changed to intrathecal administration, with subsequent normalization of her CSF white blood cell counts and sterilization of cultures. DISCUSSION: The limited availability of antibiotics for treatment of highly resistant or MDR gram-negative organisms has prompted clinicians to reconsider the use of older drugs. Prior reports have suggested that intravenous colistin is a potential alternative for treating highly resistant gram-negative central nervous system infections, specifically Acinetobacter, but its use is limited by nephrotoxicity. Our experience suggests that intrathecal colistin is a potentially curative intervention for the treatment of severe MDR P. aeruginosa meningitis and VPS infections in patients in whom intravenous colistin is not an option. CONCLUSIONS: Intrathecal use of colistin is a potentially safe, effective, and viable treatment option for MDR P. aeruginosa central nervous system infections when intravenous administration is not feasible.

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Clinicoepidemiological profile and outcome in patients of covid 19 with normal chest x-ray: study of 51 patients

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20205840 ◽

2020 ◽

Vol 9 (1) ◽

pp. 181

Author(s):

Huma Firdaus ◽

Nafees Ahmad Khan ◽

Maqsumi Reza ◽

Mansoor Ahmad Khan ◽

Gishnu Krishnan ◽

...

Keyword(s):

Diabetes Mellitus ◽

Age Group ◽

Rt Pcr ◽

X Ray ◽

Good Outcome ◽

Number Of Patients ◽

History Of ◽

Normal Chest ◽

Chest X Ray ◽

Time Of Presentation

Background: Covid 19 was declared a pandemic by WHO on 11 March 2020. Patients usually have pneumonia on chest x-ray at time of presentation however many patients also do not develop pneumonia and have normal chest x-ray.Methods: A total of 51 patients above the age of 15 years diagnosed with covid 19 by RT PCR of nasopharngeal/oropharyngeal samples were included in the study. History of symptoms onset was recorded, chest x-ray and haematological investigations were done of all patients.Results: A total of 51 patients >15 years of age were included in the study. 28 were male and 23 were female patients. Maximum number of patients were in age group 15-30 years. Most common presenting complain was fever (49% patients). Most common comorbidity was diabetes mellitus. There was no mortality reported in patients with normal chest x-ray.Conclusions: We conclude from the current study that patients with normal chest x-ray at the time of presentation have a very good outcome.

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AML1-ETO9a Correlated with C-KIT Overexpression/Mutation and Indicated Poor Disease Outcome in t(8;21) Acute Myeloid Leukemia.

Blood ◽

10.1182/blood.v110.11.1822.1822 ◽

2007 ◽

Vol 110 (11) ◽

pp. 1822-1822

Author(s):

Yang Liang ◽

Bo Jiao ◽

Chuan-Feng Wu ◽

Shu-Min Xiong ◽

Long-Jun Gu ◽

...

Keyword(s):

Acute Myeloid Leukemia ◽

Myeloid Leukemia ◽

Fusion Gene ◽

Chromosome Translocation ◽

Disease Outcome ◽

Rt Pcr ◽

Cell Counts ◽

Short Overall Survival ◽

White Blood Cell Counts ◽

Acute Myeloid

Abstract AML1-ETO fusion gene is generated from chromosome translocation t(8;21) in acute myeloid leukemia (AML). It is recently reported that its spliced variant AML1-ETO9a induced leukemia rapidly in murine model. Here we detected AML1-ETO9a expression in 58 of 71 (81.7%) patients with t(8;21) AML by using qualitative RT-PCR. Quantitative RT-PCR revealed significantly higher C-KIT levels in the AML1-ETO9a positive group than in the negative group (P=0.0001). Among 29 cases harbored C-KIT mutations, 28 (96.6%) expressed AML1-ETO9a. Clinically, patients expressing AML1-ETO9a exhibited significantly elevated white blood cell counts and a short overall survival time (P=0.0455 and 0.0039, respectively). Morphologically, although there is no difference of leukemic blasts percentage between AML1-ETO9a positive and negative cases (P=0.1169), the latter possessed more aberrant myelocytes (P=0.0462). Taken together, AML1-ETO9a correlated with C-KIT overexpression/mutation and indicated poor disease outcome in t(8;21) AML.

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Can SARS-CoV-2 Viral RNA Continually Persist in an Asymptomatic COVID-19 Patient?

Dubai Medical Journal ◽

10.1159/000510917 ◽

2020 ◽

Vol 3 (3) ◽

pp. 129-132

Author(s):

Sen Variaveettil Thomas ◽

Anjala Nizam ◽

Tarab Iqbal

Keyword(s):

Male Patient ◽

Screening Test ◽

Angiotensin Receptor Blocker ◽

Viral Rna ◽

Angiotensin Receptor ◽

Rt Pcr ◽

X Ray ◽

History Of ◽

Chest X Ray ◽

Isolation Facility

An asymptomatic 39-year-old male patient with well-controlled hypertension on a combination of antihypertensives including angiotensin receptor blocker was screened positive for SARS-CoV-2 by RT-PCR nasopharyngeal (NP) swab and was admitted to an isolation facility in Dubai on March 23, 2020. He had a history of exposure to a COVID-19 patient a few days prior to the screening test. His chest X-ray showed signs of pneumonitis. He was discharged from the isolation facility on day 28 with 2 consecutive negative SARS-CoV-2 RT-PCR NP swab results, 24 h apart. After 14 days of home quarantine, he tested positive again for SARS-CoV-2 on day 44 and was again isolated in our facility. He continued testing positive until day 51, after which he was discharged again following 2 consecutive negative tests 24 h apart.

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Etiology associated with developing posthemispherectomy hydrocephalus after resection-disconnection procedures

Journal of Neurosurgery Pediatrics ◽

10.3171/2013.8.peds13212 ◽

2013 ◽

Vol 12 (5) ◽

pp. 469-475 ◽

Cited By ~ 8

Author(s):

Jennifer Phung ◽

Paul Krogstad ◽

Gary W. Mathern

Keyword(s):

Blood Cell ◽

Univariate Analysis ◽

Cns Infection ◽

Csf Shunts ◽

Maximum Daily Temperature ◽

Cell Counts ◽

Blood Cell Counts ◽

History Of ◽

White Blood Cell Counts ◽

First Time

Object The authors sought to determine if clinical epilepsy variables, maximum daily temperature (Tmax), and blood and CSF findings were associated with the risk of developing hydrocephalus after first-time resection-disconnection hemispherectomy. Methods Patients who underwent cerebral hemispherectomy in whom a standardized perioperative protocol was used, including the use of ventriculostomies (n = 79), were classified into those who developed and those who did not develop hydrocephalus requiring CSF shunts. The authors compared these 2 groups for clinical variables, Tmax, and blood and CSF studies through postoperative Day 12. Results In this cohort, 30% of the patients required CSF shunts, of which 8% developed late hydrocephalus up to 3 years posthemispherectomy. Multivariate analysis found that etiology was associated with developing posthemispherectomy hydrocephalus. Higher shunt rates were observed for patients with hemimegalencephaly (40%; n = 15) and a history of CNS infection (100%; n = 4) compared with cortical dysplasia (17%; n = 23) and Rasmussen encephalitis (17%; n = 12). In univariate analysis, other factors associated with developing hydrocephalus were elevated maximum daily temperatures, elevated white blood cell counts, decreased CSF protein, and increased CSF red blood cell counts. Conclusions The findings of the study indicate that etiology was the factor most strongly associated with developing posthemispherectomy hydrocephalus. These findings suggest that there are variable mechanisms for developing hydrocephalus after cerebral hemispherectomy depending on the procedure, and in resection-disconnection operations the mechanism may involve changes in CSF bulk flow that varies by histopathology.

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