RESUMO
OBJECTIVES: To compare demographic/clinical/laboratory/treatments and outcomes among children and adolescents with laboratory-confirmed coronavirus disease 2019 (COVID-19). METHODS: This was a cross-sectional study that included patients diagnosed with pediatric COVID-19 (aged <18 years) between April 11, 2020 and April 22, 2021. During this period, 102/5,951 (1.7%) of all admissions occurred in neonates, children, and adolescents. Furthermore, 3,962 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection samples were processed in patients aged <18 years, and laboratory-confirmed COVID-19 occurred in 155 (4%) inpatients and outpatients. Six/155 pediatric patients were excluded from the study. Therefore, the final group included 149 children and adolescents (n=97 inpatients and 52 outpatients) with positive SARS-CoV-2 results. RESULTS: The frequencies of sore throat, anosmia, dysgeusia, headache, myalgia, nausea, lymphopenia, pre-existing chronic conditions, immunosuppressive conditions, and autoimmune diseases were significantly reduced in children and adolescents (p<0.05). Likewise, the frequencies of enoxaparin use (p=0.037), current immunosuppressant use (p=0.008), vasoactive agents (p=0.045), arterial hypotension (p<0.001), and shock (p=0.024) were significantly lower in children than in adolescents. Logistic regression analysis showed that adolescents with laboratory-confirmed COVID-19 had increased odds ratios (ORs) for sore throat (OR 13.054; 95% confidence interval [CI] 2.750-61.977; p=0.001), nausea (OR 8.875; 95% CI 1.660-47.446; p=0.011), and lymphopenia (OR 3.575; 95% CI 1.355-9.430; p=0.010), but also had less hospitalizations (OR 0.355; 95% CI 0.138-0.916; p=0.032). The additional logistic regression analysis on patients with preexisting chronic conditions (n=108) showed that death as an outcome was significantly associated with pediatric severe acute respiratory syndrome (SARS) (OR 22.300; 95% CI 2.341-212.421; p=0.007) and multisystem inflammatory syndrome in children (MIS-C) (OR 11.261; 95% CI 1.189-106. 581; p=0.035). CONCLUSIONS: Half of the laboratory-confirmed COVID-19 cases occurred in adolescents. Individuals belonging to this age group had an acute systemic involvement of SARS-CoV-2 infection. Pediatric SARS and MIS-C were the most important factors associated with the mortality rate in pediatric chronic conditions with COVID-19.
Assuntos
Humanos , Recém-Nascido , Criança , Adolescente , COVID-19/complicações , Estudos Transversais , Estudos de Coortes , Síndrome de Resposta Inflamatória Sistêmica , Centros de Atenção Terciária , SARS-CoV-2Assuntos
Humanos , Criança , Adolescente , Educação de Pacientes como Assunto , Doença Crônica/terapiaRESUMO
O achado de nematelmintos como agentes de diarreia persistente e raro. Os autores relatam o caso de uma crianca que desenvolveu diarreia persistente na presenca destes agentes e de varias outras condicoes que propiciam a doenca. Discutem os fatores de risco, a fisiopatologia e o manejo clinico, enfatizando a terapeutica nutricional
Assuntos
Masculino , Criança , Humanos , Diarreia/etiologia , Ancylostoma , Estrongiloidíase/complicações , Necatoríase/complicações , Fatores de Risco , Diarreia/dietoterapia , Diarreia/fisiopatologia , Ancylostoma/patogenicidade , Distúrbios Nutricionais/dietoterapia , Desidratação/terapia , Síndrome de DownRESUMO
Dot-ELISA para deteccao de antigenos polissacaridicos de pneumococos foi padronizado em vista da necessidade de se ter um diagnostico rapido e eficaz para pneumonia pneumococica aguda. Um total de 480 amostras de liquido pleural sendo 442 de criancas com diagnostico clinico e laboratorial de pneumonia bacteriana e 38 de pacientes com tuberculose, mais 20 amostras dos soros sanguineos de criancas sadias foram avaliados no Dot-ELISA. As amostras foram tratadas previamente a 90ºC por 10 min com EDTA 0,1 M de pH 7,5 e aplicadas sobre membrana de nitrocelulose. Para a deteccao de antigeno pneumococico foi empregado omniserum pneumococico diluido a 1:200. Os resultados de Dot-ELISA avaliados em comparacao com os resultados de cultura bacteriana, contra-imunoeletroforese e latex-aglutinacao apresentaram indices de 0,940 para a sensibilidade, 0,830 para especificidade e 0,760 para concordancia. Omniserum pneumococico mostrou ser um otimo soro polivalente para a deteccao de antigenos pneumococicos em Dot-ELISAe, essa tecnica provou se uma alternativa pratica e eficaz para o diagnostico de pneumonias pneumococicas.