The burden of viral infections in pediatric intensive care unit between endemic and pandemic coronavirus infections: A tertiary care center experience

Objectives: To measure the prevalence of viral infections, length of stay (LOS), and outcome in children admitted to the pediatric intensive care unit (PICU) during the period preceding the COVID-19 pandemic in a MERS-CoV endemic country. Methods: A retrospective chart review of children 0–14 years old admitted to PICU with a viral infection. Results: Of 1736 patients, 164 patients (9.45%) had a positive viral infection. The annual prevalence trended downward over a three-year period, from 11.7% to 7.3%. The median PICU LOS was 11.6 days. Viral infections were responsible for 1904.4 (21.94%) PICU patient-days. Mechanical ventilation was used in 91.5% of patients, including noninvasive and invasive modes. Comorbidities were significantly associated with intubation (P-value = 0.025). Patients infected with multiple viruses had median pediatric index of mortality 2 (PIM 2) scores of 4, as compared to 1 for patients with single virus infections (p < 0.001), and a median PICU LOS of 12 days, compared to 4 in the single-virus group (p < 0.001). Overall, mortality associated with viral infections in PICU was 7 (4.3%). Patients with viral infections having multiple organ failure were significantly more likely to die in the PICU (p = 0.001). Conclusion: Viral infections are responsible for one-fifth of PICU patient-days, with a high demand for mechanical ventilation. Patients with multiple viral infections had longer LOS, and higher PIM 2 scores. The downward trend in the yearly rate of PICU admissions for viral infections between the end of the MERS-CoV outbreak and the start of the COVID-19 pandemic may suggest viral interference that warrants further investigations. © 2022 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases

The burden of viral infections in pediatric intensive care unit between endemic and pandemic coronavirus infections: A tertiary care center experience

OBJECTIVES: To measure the prevalence of viral infections, length of stay (LOS), and outcome in children admitted to the pediatric intensive care unit (PICU) during the period preceding the COVID-19 pandemic in a MERS-CoV endemic country. METHODS: A retrospective chart review of children 0-14 years old admitted to PICU with a viral infection. RESULTS: Of 1736 patients, 164 patients (9.45%) had a positive viral infection. The annual prevalence trended downward over a three-year period, from 11.7% to 7.3%. The median PICU LOS was 11.6 days. Viral infections were responsible for 1904.4 (21.94%) PICU patient-days. Mechanical ventilation was used in 91.5% of patients, including noninvasive and invasive modes. Comorbidities were significantly associated with intubation (P-value = 0.025). Patients infected with multiple viruses had median pediatric index of mortality 2 (PIM 2) scores of 4, as compared to 1 for patients with single virus infections (p < 0.001), and a median PICU LOS of 12 days, compared to 4 in the single-virus group (p < 0.001). Overall, mortality associated with viral infections in PICU was 7 (4.3%). Patients with viral infections having multiple organ failure were significantly more likely to die in the PICU (p = 0.001). CONCLUSION: Viral infections are responsible for one-fifth of PICU patient-days, with a high demand for mechanical ventilation. Patients with multiple viral infections had longer LOS, and higher PIM 2 scores. The downward trend in the yearly rate of PICU admissions for viral infections between the end of the MERS-CoV outbreak and the start of the COVID-19 pandemic may suggest viral interference that warrants further investigations.

Perception of first-year medical students of virtual video demonstration of the objective structured clinical examination at king saud university medical college in saudi arabia during the covid-19 pandemic

Background: The coronavirus disease of 2019 (COVID-19) has challenged and disrupted medical education worldwide. Objective structured clinical examination (OSCE) is one of the types of assessment for undergraduate medical students that has been conducted for first-year medical students in the College of Medicine. Peer student training on participating in OSCE has been conducted prior to the pandemic. The aim of this study was to assess medical students’ perception of online virtual peer student video training on participating in the OSCE. Methods: Medical student’s council team prepared a video demonstration on the steps of participating in OSCE. In October 2020, the video was provided online for first-year medical students (n = 302) prior to their OSCE. After the completion of the OSCE exam, a 10 – item questionnaire was distributed on the students’ perception on the impact of the peer student video demonstration on students’ orientation about the OSCE. The questionnaire was sent by Google Forms. The results were expressed as a percentage on a Likert scale. Results: About 74.17% (n = 224) of students responded to the online questionnaire. More than half of the students (n = 126, 56%) found the steps of conduction of the OSCE well explained, provided the sufficient orientation (n = 121, 54%), and found the video stimulating (n = 122, 54%). In addition, the majority of students (n = 160, 71%) learned and understood the steps of the OSCE and 152 students (68%) found that the video helped introducing them to the concept of OSCE. Almost half the students found that the video helped lowering the stress level before the OSCE (n = 91, 41%), eased the steps of the OSCE (n = 113, 50%), and found that the materials were well prepared and explained (n = 126, 56%). Conclusions: The virtual video demonstration of the OSCE during the COVID-19 pandemic had an overall positive perception from first-year medical students. However, peer student’s orientation on the OSCE will continue after the pandemic. Further supports for first-year medical students are needed during the pandemic. © 2021 Journal of Nature and Science of Medicine.

Perceived quality of remote handover process during COVID-19 crisis in pediatric intensive care setting: A mixed-method with content analysis

AIMS & OBJECTIVES: A key measure to mitigate COVID-19 has been social distancing. Incorporating videoconferencing Apps in patients' handover process between HCWs can enhance social distancing while maintaining handover elements. This research aimed to describe PICU physicians' experience in using online videoconferencing App for handover during the pandemic. METHODS: This is a qualitative content analysis at a university hospital in Riyadh, KSA. Since May 15th, 2020, due to the pandemic, our PICU utilized Zoom® as a remote conferencing App, instead of face-to-face handover. After the IRB approval, data were collected over two weeks (July 1-14th, 2020) through an online structured questionnaire. Demographic data and open-ended questions about the perceived efficacy of the remote handover were collected. The analysis process included open coding, creating categories, and abstraction. RESULTS: From the 36 PICU physicians who participated, 30 (83.3%) completed the survey. Participants included 6 attendings, 9 specialists, and 21 residents. They had variable previous teleconferencing experience (Table). Most physicians (75%) were comfortable conducting a remote endorsement. The majority found that SBAR handover elements were achieved through this remote handover process (Fig). The perceived advantages of online handover included fewer interruptions, time efficiency, and facilitation of social distancing. Perceived disadvantages were the paucity of non-verbal communication and teaching during virtual meetings. CONCLUSIONS: Videoconferencing Apps utilized for online handover could supplement traditional face-to-face ICU patients' endorsement during infectious disease outbreaks. Some changes should be implemented to optimize the users' experience.