Death of a 3 Month-Old Infected Infant with Dilated Cardiomyopathy after COVID-19 Infection: A Case Report

Background: Several numbers of studies have reported that coronavirus disease-2019 (COVID-19) in infants and children have shown milder symptoms and a better prognosis than in adult patients. However, there is no sufficient evidence on the effect of cardiovascular involvement in COVID-19 in the infant. Case Report: Here, we report an infant infected with COVID-19 with the manifestations of dilated myocarditis. The patient was referred to Pediatric Emergency with lethargy and tachypnea. On physical examination, she had holosystolic murmur with grade 3/6. The laboratory examinations showed anemia as well as increased alkaline phosphatase (ALP) levels. Due to respiratory distress, she was intubated and put under mechanical ventilation. The diagnosis of COVID-19 infection was confirmed by real-time polymerase chain reaction (RT-PCR) using a pharyngeal specimen. Finally, dilated cardiomyopathy (DCM) was diagnosed and one day after hospitalization the infant was died due to complications of DCM. Conclusion: It seems that in the infant with severe underlying disease, even a mild COVID-19 infection, may be lethal. Focal viral myocarditis is a very rare condition described by localized disturbance of the myocardium occurring in ventricular dysfunction with significant morbidity and mortality. Thus, due to the possibility of cardiac injury in infected neonates with COVID-19 disease and the manifestation of myocarditis, effective measurement is recommended.

Association between FVL G1691A, MTHFR C677T and A1298C Polymorphisms with Risk for Retinopathy of PrematurityAssociation between FVL G1691A, MTHFR C677T and A1298C Polymorphisms with Risk for Retinopathy of Prematurity

Background: Retinopathy of prematurity (ROP) is an important cause of preventable blindness in children. The aim of this study was to examine the association of the polymorphisms at Factor V Leiden (FVL) and methylene tetrahydrofolate reductase (MTHFR) gene with risk of ROP. Methods: A total of 106 neonates with ROP and 110 healthy neonates were enrolled. The FVL G1691A and MTHFR C677T and A1298C polymorphisms were genotyped by PCR-RFLP assay. Results: There was a significant association between FVL G1691A polymorphism and an increased risk of ROP. However, the MTHFR C677T and A1298C polymorphisms were not associated with risk of ROP. Conclusion: FVL G1691A polymorphism may be risk factor for development of ROP in neonates. However, there was no significant association between MTHFR C677T and A1298C polymorphisms and risk of ROP. However, it is critical that larger and well-designed studies in different ethnicities are needed to confirm our conclusions.

A Survey on Cardiac Complications of COVID-19 in Infants

Congenital heart disease (CHD) may have serious effects on the course of COVID-19. Limited data were available on CHD in neonates with COVID-19. This study aimed to review the cardiac complications in neonates infected with COVID-19. Some studies showed that myocardial injury in adult patients is often correlated with a fatal outcome. But, scientific evidence in infants is rare, although several reports were published with the description of cardiac involvement in COVID-19 pediatric patients. In these young subjects, a background of surgically treated CHD seems to be a predisposing factor. Numerous studies showed Multisystem inflammatory syndrome in children (MIS-c) is a deadly demonstration of COVID-19 with cardiac involvement. The underlying pathophysiology of COVID-19-associated cardiovascular complications is not fully understood, although direct viral infection of the myocardium, systemic inflammatory response, coagulation abnormalities and thrombosis and hypoxia have been suggested as possible mechanisms of cardiac complications. It seems COVID-19 can affect different parts of the heart; however, the myocardium is more involved. The mechanisms of pathogenesis of cardiovascular implications in adults and infants are similar but CHD and MIS-c in infants are more important. Further studies on the effects of COVID-19 on the neonatal cardiovascular system are needed.

A Meta-Analysis for Prevalence of Cesarean Section, Preterm Birth, Stillbirth, and Low Birth Weight Deliveries in Infected Pregnant Women with COVID-19

Background: The aim of this meta-analysis was to estimate the prevalence of cesarean section (CS), preterm birth, stillbirth, and low birth weight deliveries (LBWD) in pregnant women with SARS-COV-2 infection. Methods: All relevant studies were searched up to 30 February 2021. Results: A total of 47 studies with 5970 infected pregnant women were included. There were 1010 CS, 55 stillbirths, 524 preterm birth, and 82 with LBWD. Pooled data showed that the prevalence of CS, preterm birth, stillbirth, and LBWD among women with SARS-COV-2 infection was 29.6% (95% CI 0.081-0.160), 2.1% (95% CI 0.081-0.160), 11.5% (95% CI 0.081-0.160), and 2.1% (95% CI 0.081-0.160), respectively. Stratified analysis revealed that these pregnancy outcomes among Asian women were higher than Caucasians. Conclusion: Our combined data revealed that the CS prevalence (29.6%) was the highest followed by preterm birth (11.5%), stillbirth (2.1%), and LBWD (2.1%) among women with COVID-19.

Association of IRF6 rs2235371 Polymorphism with Non-Syndromic Cleft Lip/Palate: A Meta-analysis

Background: The previous published data on the association between interferon regulatory factor 6 (IRF6) polymorphisms and non-syndromic Cleft Lip/Palate (NSCL ± P) risk remained inconclusive. The aim of this study was to conduct a meta-analysis to further assess the associations. Methods: A comprehensive search in PubMed, EMBASE, Web of Science, and CNKI for all eligible studies up July 2021. Results: A total of 23 studies with 6,161 cases and 8,919 controls were selected for this meta-analysis. Overall pooled analysis suggest a significant association between IRF6 rs2235371 polymorphism and CL±P risk under all the five genetic models, i.e., allele (A vs. G: OR=0.754, 95% CI 0.628-0.905, P=0.002), homozygote (AA vs. GG: OR=0.621 95% 0.405-0.953, P=0.029), heterozygote (AC vs. GG: OR=0.619, 95% CI 0.485-0.791, P≤0.001), dominant (AA+AG vs. GG: OR=0.550, 95% CI 0.381-0.794, P=0.001) and recessive model (AA vs. AG+GG: OR=0.583, 95% CI 0.423-0.804, P=0.001). Subgroup analysis by ethnicity showed that rs2235371 was associated with NSCL±P risk in Asians. Conclusion: This meta-analysis provides strong evidences that IRF6 rs2235371 might be associated with risk of NSCL ± P.

Prevalence of Urinary Tract Infection in Iranian Newborns with Jaundice: A Meta-Analysis

Background: Jaundice is the most common clinical problem among newborns. It could be caused by different factors, including infections such as urinary tract infection (UTI). We investigated the prevalence of UTI in Iranian newborns with jaundice and prolonged jaundice in this study based on a larger sample of existing data. Methods: We searched the databases of PubMed, Web of Sciences, Scopus, CNKI, SciELO, and Google Scholar for English articles, and a search was also done in Persian in Magiran and Scientific Information Database (SID) published until July 2021. Data analysis was performed by Comprehensive Meta-Analysis (CMA) version 2.0 software. Results: This study included 19 eligible articles out of approximately 240 retrieved articles. The prevalence of UTIs in neonates with jaundice was estimated by pooling the data from 7416 neonates with jaundice. Of those, 369 cases had UTI. Combined data revealed that the prevalence of UTI in neonates with jaundice was 5.4% (95% CI 0.032-0.089, P ≤ 0.001) and there was no publication bias. Conclusion: The overall prevalence of UTI in Iranian newborns with jaundice was 5.4%. However, more studies with a large sample size are required for better results. Also our review showed a screening of UTI should be considered for infants with jaundice, especially prolonged jaundice.

Maternal Anxiety, Depression, and Stress during Pregnancy and Neonatal Growth Indices at Birth

Background: Anxiety, depression, and stress during the pregnancy period are usually overlooked in women despite their detrimental effects on the mother and infant. Studies have shown an increase in the risk of behavioral and psychological problems in an infant's life because of the mother's exposure to negative excitement and stress before childbirth. In the present study, we aimed to assess the effect of maternal anxiety, depression, and stress during pregnancy on neonatal growth indices at birth. Methods: This longitudinal survey was done on 102 pregnant women referred to the obstetrics clinic of Shahid Sadoughi Hospital of Yazd for prenatal care from September 2019 to March 2020. They were asked to fulfill two questionnaires related to the study. After delivery, the further information and growth indices of neonates were extracted by telephone. Results: Regardless of the severity of depression, anxiety, and stress, a significant relationship was found between maternal age and stress (P= 0.033), so in mothers with younger age, pregnancy stress was more. Moreover, the study showed a significant relationship between height and maternal anxiety (P = 0.018). Conclusion: Based on the findings of this study and due to the possible association of neonatal indices with maternal anxiety, depression, and stress during pregnancy, more attention to maternal emotional health seems necessary.

Intracardiac Thrombosis in A Neonate: A Case Report

Background: Life-threatening intracardiac thrombosis is rare. Intracardiac thrombosis may affect neonates from the first months of life. Because of the potential risk of serious bleeding, the use of recombinant plasminogen activator (rt-PA) in neonates along with heparin is controversial. Case Report: We reported a 37- day- old term infant presented with fever, restlessness, malaise, and respiratory acidosis. Right atrial thrombose was identified by ECHO, results of laboratory tests, and examination. She was successfully treated with rt-PA and rivaroxaban. Conclusion: Early echocardiographic detection before the clot grows large and organized, allows complete, safe, and rapid thrombolysis with rt-PA and rivaroxaban.

Association of +505A>G Polymorphism at TAFI Gene with Recurrent Miscarriage in Iranian Women

Background: Recurrent miscarriage (RM) is one of the major problems of public health globally. The thrombin-activatable fibrinolysis inhibitor (TAFI) gene is a plasma zymogen that regulates both fibrinolysis and inflammation. Genetic variants within TAFI gene are presumed to be associated with development of RM. This case-control study aimed to investigate the association of TAFI +505A>G polymorphism with RM in Iranian women referred to Meybod Genetic Center. Methods: Fifty women with RM (at least 2 miscarriages) and 50 healthy women with no history of miscarriage or other fertility complications were participated in this study. The TAFI +505A>G polymorphism was genotyped by allele specific PCR (AS-PCR) assay. Results: The mean age of cases with RM and controls was 27.25 ± 4.31 and 28.42 ± 3.22 years, respectively. The frequency of GG genotype and G allele was 0.00% in patients and controls. There was no significant difference between RM cases and controls in terms of +505A>G genotypes and alleles. Conclusion: This study results indicated that there was no significant relationship between the TAFI +505A>G polymorphism and RM risk in Iranian women. However, further rigorous, studies with a larger sample size and different ethnicity are necessary to confirm our findings.

Application of Golden Nanoparticles against Streptococcus Mutans for Prevention of Caries Lesions

Background: Dental caries also known as baby bottle tooth decay, is a critical public health problem around the world for which Streptococcus mutans (S.mutans) has been introduced as the main infectious etiology. In the past two decades, nanotechnology has permitted the development of new materials with antimicrobial properties. The aim of this study was to compare the bactericidal and bacteriostatic effects of three golden nanoparticles (SP, NR, and CS) on S.mutans. Methods: To determine the minimum inhibitory concentrations (MICs) and the minimum bactericidal concentrations (MBCs), a liquid dilution method was applied. Results: All golden nanoparticles (GNPs) showed antimicrobial activity with no statistically significant differences (> 0.05) in MIC or MBC. Conclusion: Our findings revealed that the size and shape of the nanoparticles did not significantly affect the antimicrobial properties of the GNPs. This finding might be useful for achieving important clinical effects with reduced toxicity in the management of early childhood caries in future in vivo studies.