ABSTRACT
OBJECTIVES: To prospectively evaluate demographic, anthropometric and health-related quality of life (HRQoL) in pediatric patients with laboratory-confirmed coronavirus disease 2019 (COVID-19) METHODS: This was a longitudinal observational study of surviving pediatric post-COVID-19 patients (n=53) and pediatric subjects without laboratory-confirmed COVID-19 included as controls (n=52) was performed. RESULTS: The median duration between COVID-19 diagnosis (n=53) and follow-up was 4.4 months (0.8-10.7). Twenty-three of 53 (43%) patients reported at least one persistent symptom at the longitudinal follow-up visit and 12/53 (23%) had long COVID-19, with at least one symptom lasting for >12 weeks. The most frequently reported symptoms at the longitudinal follow-up visit were headache (19%), severe recurrent headache (9%), tiredness (9%), dyspnea (8%), and concentration difficulty (4%). At the longitudinal follow-up visit, the frequencies of anemia (11% versus 0%, p=0.030), lymphopenia (42% versus 18%, p=0.020), C-reactive protein level of >30 mg/L (35% versus 0%, p=0.0001), and D-dimer level of >1000 ng/mL (43% versus 6%, p=0.0004) significantly reduced compared with baseline values. Chest X-ray abnormalities (11% versus 2%, p=0.178) and cardiac alterations on echocardiogram (33% versus 22%, p=0.462) were similar at both visits. Comparison of characteristic data between patients with COVID-19 at the longitudinal follow-up visit and controls showed similar age (p=0.962), proportion of male sex (p=0.907), ethnicity (p=0.566), family minimum monthly wage (p=0.664), body mass index (p=0.601), and pediatric pre-existing chronic conditions (p=1.000). The Pediatric Quality of Live Inventory 4.0 scores, median physical score (69 [0-100] versus 81 [34-100], p=0.012), and school score (60 [15-100] versus 70 [15-95], p=0.028) were significantly lower in pediatric patients with COVID-19 at the longitudinal follow-up visit than in controls. CONCLUSIONS: Pediatric patients with COVID-19 showed a longitudinal impact on HRQoL parameters, particularly in physical/school domains, reinforcing the need for a prospective multidisciplinary approach for these patients. These data highlight the importance of closer monitoring of children and adolescents by the clinical team after COVID-19.
Subject(s)
Humans , Male , Child , Adolescent , COVID-19/complications , Quality of Life , Prospective Studies , Tertiary Care Centers , COVID-19 Testing , SARS-CoV-2 , Latin AmericaABSTRACT
ABSTRACT Objective: To describe the characteristics of patients diagnosed with tuberculosis and latent tuberculosis infection. Methods: A retrospective study, between 2012 and 2015, with data from patients of Programa Einstein na Comunidade de Paraisópolis. To evaluate possible factors associated with patient's sex and diagnoses of tuberculosis and latent tuberculosis infection, χ2 or Fisher's exact tests were used for qualitative variables, and Mann-Whitney test for quantitative or ordinal qualitative variables. Results: A total of 77 patients were evaluated. Age ranged from 6 months to 13.4 years, with a majority of males (54.5%), aged zero to 4 years (54.5%), diagnosed with latent tuberculosis infection (64.9%), and classified as eutrophic (71.2%). The tuberculin test was positive in 92% and in most cases the values were above 10mm (68.0%). Approximately three-quarters of chest X-ray tests were normal (72.7%). After chest X-ray, computed tomography of thorax was the most ordered exam (29.9%), followed by smear and culture for Mycobacterium tuberculosis in the gastric aspirate (28.6%). The frequencies of altered chest X-ray (70.4% versus 4.0%), computed tomography of thorax requests (55.6% versus 16.0%) and other tests requested (81.5% versus 38.0%) were significantly higher in patients with a diagnosis of tuberculosis, relative to those with latent tuberculosis infection, respectively. Conclusion: In our sample, proportions of altered chest X-ray, and performing computed tomography of thorax and other tests in patients diagnosed with tuberculosis were higher than in those with latent tuberculosis infection.
RESUMO Objetivo: Descrever as características de pacientes com diagnóstico de tuberculose e de infecção latente por tuberculose. Métodos: Estudo retrospectivo, entre os anos de 2012 e 2015, com os dados dos pacientes do ambulatório do Programa Einstein na Comunidade de Paraisópolis. Para se avaliarem possíveis fatores associados ao sexo e aos diagnósticos de tuberculose e infecção latente por tuberculose, foram utilizados os testes χ2 ou exato de Fisher, para variáveis qualitativas, e de Mann-Whitney, para variáveis quantitativas ou qualitativas ordinais. Resultados: Foram avaliados 77 pacientes. A idade variou de 6 meses a 13,4 anos, sendo a maioria do sexo masculino (54,5%), na faixa etária de zero a 4 anos (54,5%), com diagnóstico de infecção latente por tuberculose (64,9%) e categorizada como eutrófica (71,2%). Em 92% dos casos, a prova tuberculínica foi positiva, e a maioria mostrou valores acima de 10mm (68,0%). Cerca de três quartos dos exames de raio X de tórax resultaram normais (72,7%). Depois do raio X de tórax, a tomografia computadorizada de tórax foi o segundo exame mais solicitado (29,9%), seguida da baciloscopia e da cultura do bacilo Mycobacterium tuberculosis no aspirado gástrico (28,6%). As frequências de raio X de tórax alterado (70,4% versus 4,0%), solicitações de tomografia computadorizada de tórax (55,6% versus 16,0%) e outros exames (81,5% versus 38,0%) foram significativamente maiores nos pacientes com diagnóstico de tuberculose, em relação àqueles com infecção latente por tuberculose, respectivamente. Conclusão: Em nossa amostra, as proporções de raio X de tórax alterados e de realização de tomografia computadorizada de tórax e de outros exames nos pacientes com diagnóstico de tuberculose foram maiores em relação àqueles com infecção latente por tuberculose.