ABSTRACT
BACKGROUND AND AIM: Results from cohort studies evaluating the severity of respiratory viral co-infections are conflicting. The aim of this study to describe the frequency of viral pathogens in patients hospitalized for lower respiratory tract infection (LRTI) in our pediatric intensive care unit (PICU) and report the clinical characteristics and outcomes of these patients. Another aim of the study was to characterize the distribution of viral pathogens in patients admitted to the PICU due to seasonal viral infections before and during the COVID-19 pandemic. METHOD(S): This single-center study included patients who were hospitalized in our PICU for LRTI caused by viral pathogens other than SARS-CoV-2 between November 1, 2019 and April 1, 2021 (17 months). Based on their date of admission, the patients included in the study were divided into the pre-pandemic group (November 1, 2019 to March 10, 2020) and pandemic group (March 11, 2020 to March 31, 2021). RESULT(S): Of the 84 patients who presented with signs of LRTI and were tested for seasonal viruses, the 67 (79.7%) patients with positive respiratory viral panel were included in the study. Apart from some important differences, we found that in general, clinical outcomes did not differ between pediatric pneumonia patients with single and multiple viruses. CONCLUSION(S): The detection of single or multiple viruses in the respiratory tract samples of children does not impact the clinical management or outcome of these patients. Our results demonstrate that admissions to the PICU for LRTIs caused by seasonal viruses decreased during the pandemic.
ABSTRACT
Objective Multisystemic inflammatory syndrome in children (MIS-C) is characterized by persistent fever, systemic hyperinflammation, and multiple-organ dysfunction. There are a few reports about MIS-C presenting with acute abdomen. The aim of this study is to demonstrate the clinical characteristics and treatment options for MIS-C-related acute abdomen and appendicitis. Methods This was a retrospective study conducted between April 2020 and October 2020 in our pediatric intensive care unit in Turkey. Patients between the ages of 1 month and 18 years who presented with acute abdomen and were ultimately diagnosed with MIS-C were included. Results Seven patients with a median age of 12.5 (interquartile range 10.5-13) years were enrolled. Four were females. The most frequent symptoms were fever, abdominal pain, and vomiting. Three patients had involvement of the appendix that required surgical intervention. All pathology reports were compatible with appendicitis. The other patients also had an acute abdomen. One patient had malignant hyperthermia during induction of anesthesia, so surgery was postponed and medical management was commenced. The clinical picture regressed with immunomodulation. All patients were treated with intravenous immunoglobulin and steroids. Four patients with acute abdomens improved with immunomodulation, and surgery was not needed. Conclusion MIS-C may present with an acute abdomen. Immunomodulation should be considered instead of surgery if the clinical course is not complicated.