High Serum Transaminase Due to COVID-19 Infection

Although COVID-19 was first described as a respiratory disease, current data has shown that it is a disease with multisystemic involvement in-cluding respiratory, cardiovascular, gastrointestinal, neurological, hema-tological and immune systems. COVID-19 associated liver injury may be due to various potential mechanisms. Direct viral cytotoxic effect, im-mun mediated injury, drugs, ischemic injury due to hypoxia-hypoperfu-sion are among these mechanisms. Here we present a five year-old male patient who had no known history of liver disease admitted to our clinic due to elevated transaminase during the course of COVID-19 infection.

Early Short-Term Use of Different Doses of Corticosteroid in Hospitalized Pediatric Patients with Coronavirus Disease 2019 Pneumonia

Objective Encouraged by reports of favorable outcomes following the use of corticosteroids in patients with moderate-to-severe coronavirus 2019 (COVID-19) pneumonia, we aimed to present our experience with early short-term corticosteroid use at our center in pediatric patients with COVID-19 pneumonia. Methods One hundred and twenty-nine pediatric patients were included in the study. Patients were divided into four groups according to the type and dose of corticosteroids given: Group 1 (those receiving dexamethasone 0.15 mg/kg/d);Group 2 (those receiving methylprednisolone 1 mg/kg/d);Group 3 (those receiving methylprednisolone 2 mg/kg/d);and Group 4 (those receiving pulse methylprednisolone 10-30 mg/kg/d). Results Of 129 patients, 19 (14.7%) patients were assigned to Group 1, 30 (23.3%) patients to Group 2, 30 (23.3%) patients to Group 3, and 50 (38.8%) patients to Group 4. Thirty-two (24.8%) patients were followed in the pediatric intensive care unit (PICU), of whom 13 (10%) required mechanical ventilation, and 7 (%5.4) died. In Group 4, the hospitalization length was significantly longer than in other groups (p < 0.001, p < 0.001). No significant difference was found among the groups in terms of mortality (p = 0.15). The most common comorbidity was obesity (33%). A significant association was found between the presence of comorbidity and mortality (p < 0.001). All patients who died had an underlying disease. Cerebral palsy was the most common underlying disease among the patients who died. Worsening of lymphopenia was significant in patients with severe COVID-19 pneumonia at the time of transfer to the PICU (p = 0.011). Conclusion Although children usually have a milder course of COVID-19 than adults, underlying diseases and obesity increase the severity of disease manifestations also in children. Further studies are needed to define the exact role of corticosteroids in COVID-19 patients. © 2022. Thieme. All rights reserved.

Personnel Protective Equipment for Healthcare Professionals During COVID-19 Pandemic

COVID-19 is highly contagious and transmission dynamics of COVID-19 are not yet fully elucidated. It is known that the ill person begins to become contagious before the symptoms of the disease begin. Also asymptomatic person who are infected but does not have symptoms and signs, can infect other individuals. The only way for health workers to protect themselves from COVID-19 is proper use of personal protective equipment and to ensure hand hygiene. COVID-19 is transmitted through close contact and large respiratory droplets and not transmitted by airborne. The surgical mask prevents the passage of respiratory droplets. However, during the aerosol producing procedures performed on the patient, small particles containing infectious particles are scattered to air in high amounts. Healthcare workers are more likely become infected during these procedures. It is recommended to wear respirator during these procedures. Use of masks or respirators must be in conjunction with other recommended PPE and appropriate hand hygiene.

A Confusing Final Diagnosis in the Differential Diagnosis of SARS-Cov-2 Associated Multisystem Inflammatory Syndrome in Children: Salmonellosis

Multisystem Inflammatory Syndrome in Children (MIS-C) is a severe clinical condition associated with the SARS-CoV-2 infection characterized by an increased inflammatory response. MIS-C shares common features with other pediatric inflammatory and infectious conditions including bacterial infections. Salmonella infections should be kept in mind as a causative agent of bacterial gastroenteritis in the differential diagnosis of patients with suspected MIS-C to avoid misdiagnosis. In this report, a case series of pediatric patients with a final diagnosis of salmonellosis were presented, although a primarily diagnosis of MIS-C at admission was considered due to symptoms and findings together with strong laboratory or epidemiological evidence for SARS-CoV-2 infection. Copyright © 2022 Ankara Pediatric Hematology Oncology Training and Research Hospital. All rights reserved.

Should Elective Surgical Procedures Be Delayed in Pediatric Cases in Covid-19 Pandemic? Until When? Is PCR Required in The Preoperative Period?

Objective: The COVID-19 pandemic has led to major changes in healthcare around the world, including postponing elective surgery. The aim of this study is to examine the COVID-19 test results in pediatric patients who are asymptomatic and have no history of contact with a COVID-19 case prior to their scheduled elective surgery. Material(s) and Method(s): This prospective study has evaluated pediatric patients who were asymptomatic and had no contact history with a COVID-19 case and who were scheduled for elective surgery between 01.05.2020-31.10.2020 in one of the world's largest pediatric hospitals. Nasopharyngeal swab (PCR) samples were obtained from all patients one day before the scheduled elective surgery. Result(s): Eight hundred twelve patients in this study had a mean age of 6.98 +/- 4.37 years. The PCR test was positive in 4 patients (0.49%), and one patient had diarrhea during the quarantine period of 15 days. Conclusion(s): The low PCR positivity rate in patients scheduled for elective surgery after a detailed history and physical examination raises the question whether elective surgery can be planned without testing. Pediatric surgeons can continue elective surgical procedures by taking precautions, but without requesting PCR, in patients who are asymptomatic and have no suspicious contact history. Copyright © 2022 Ankara Pediatric Hematology Oncology Training and Research Hospital. All rights reserved.

High serum transaminase due to COVID-19 infection

Although COVID-19 was first described as a respiratory disease, current data has shown that it is a disease with multisystemic involvement including respiratory, cardiovascular, gastrointestinal, neurological, hematological and immune systems. COVID-19 associated liver injury may be due to various potential mechanisms. Direct viral cytotoxic effect, immun mediated injury, drugs, ischemic injury due to hypoxia-hypoperfusion are among these mechanisms. Here we present a five year-old male patient who had no known history of liver disease admitted to our clinic due to elevated transaminase during the course of COVID-19 infection.

High Serum Transaminase Due to COVID-19 Infection

Although COVID-19 was first described as a respiratory disease, current data has shown that it is a disease with multisystemic involvement in-cluding respiratory, cardiovascular, gastrointestinal, neurological, hema-tological and immune systems. COVID-19 associated liver injury may be due to various potential mechanisms. Direct viral cytotoxic effect, im-mun mediated injury, drugs, ischemic injury due to hypoxia-hypoperfu-sion are among these mechanisms. Here we present a five year-old male patient who had no known history of liver disease admitted to our clinic due to elevated transaminase during the course of COVID-19 infection. Copyright © 2022 by Pediatric Infectious Diseases and Immunization Society.

SARS-CoV-2 Transmission among Students after the Full Reopening of Schools

Objective Closing of schools within the scope of the pandemic measures and switching to online education have negatively affected the mental and physical health of children as well as their education. The effect of complete reopening of schools on the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is not fully known. In the 2021-2022 academic year, the Ministry of National Education of Turkiye has decided to continue face-to-face education at all levels and in all private and public schools, by following a series of measures. There are no studies on school transmission reported from Turkiye since then. This study aimed to assess the dynamics of coronavirus diseases 2019 (COVID-19) transmission in schools by evaluating the data of the school contact screening outpatient clinic of a tertiary children's hospital. Methods According to the Ministry of National Education guidelines in Turkiye, all students in a class with two polymerase chain reaction (PCR)-confirmed COVID-19 cases are sent to their homes and have a SARS-CoV-2 PCR test on the fifth day. While the students with negative test results return to school, students who test positive continue to stay at home until the 10th day. The current study retrospectively analyzed the screening results of primary, middle, and high school students who presented at the school contact screening polyclinic during the first semester of the 2021-2022 academic season. Discussion There were a total of 11,608 presentations to the school contact screening polyclinic, and 1,107 children tested positive with SARS-CoV-2 PCR (9.5%). The median weekly positivity rate was 9.7% in primary school, 9.4% in middle school, and 5.6% in high school. The weekly positivity rate increased from the 16th week at all school levels;the positivity rates ran in parallel before this time but significantly increased from the 16th week to the half-term break. Conclusion The curve of the positivity rates in schools was similar to Turkiye's pandemic curve. In this respect, the low SARS-CoV-2 transmission in schools correlated with the low number of cases in the community.

Early Short-Term Use of Different Doses of Corticosteroid in Hospitalized Pediatric Patients with Coronavirus Disease 2019 Pneumonia

Objective Encouraged by reports of favorable outcomes following the use of corticosteroids in patients with moderate-to-severe coronavirus 2019 (COVID-19) pneumonia, we aimed to present our experience with early short-term corticosteroid use at our center in pediatric patients with COVID-19 pneumonia. Methods One hundred and twenty-nine pediatric patients were included in the study. Patients were divided into four groups according to the type and dose of corticosteroids given: Group 1 (those receiving dexamethasone 0.15 mg/kg/d);Group 2 (those receiving methylprednisolone 1 mg/kg/d);Group 3 (those receiving methylprednisolone 2 mg/kg/d);and Group 4 (those receiving pulse methylprednisolone 10-30 mg/kg/d). Results Of 129 patients, 19 (14.7%) patients were assigned to Group 1, 30 (23.3%) patients to Group 2, 30 (23.3%) patients to Group 3, and 50 (38.8%) patients to Group 4. Thirty-two (24.8%) patients were followed in the pediatric intensive care unit (PICU), of whom 13 (10%) required mechanical ventilation, and 7 (%5.4) died. In Group 4, the hospitalization length was significantly longer than in other groups (p < 0.001, p < 0.001). No significant difference was found among the groups in terms of mortality (p = 0.15). The most common comorbidity was obesity (33%). A significant association was found between the presence of comorbidity and mortality (p < 0.001). All patients who died had an underlying disease. Cerebral palsy was the most common underlying disease among the patients who died. Worsening of lymphopenia was significant in patients with severe COVID-19 pneumonia at the time of transfer to the PICU (p = 0.011). Conclusion Although children usually have a milder course of COVID-19 than adults, underlying diseases and obesity increase the severity of disease manifestations also in children. Further studies are needed to define the exact role of corticosteroids in COVID-19 patients. Copyright © 2022 Georg Thieme Verlag. All rights reserved.

A Case of Spontaneous Pneumothorax with Persistent Air Leakage During the Course of COVID-19

Development of pneumothorax during the course of COVID-19 is very rare, and may occur secondary to severe pulmonary involvement causing alveolar damage in the parenchyma, or is seen as a complication of respiratory support. Until now, quite a few cases have been reported. Herein, we shared a case of spontaneous pneumothorax with persistent air leakage without any parenchymal or pleural involvement.