ABSTRACT
Since March 2020, Italy has been one of the countries to record the highest mortality and morbidity rate related to the SARS-CoV-2 pandemic. The measures aimed at contrasting the spread of the virus have led to a rapid and profound reorganization of health services. The Puglia Region has identified in the A.O.U.C. "Policlinico di Bari", 3rd level hospital, the main regional hub for combating the pandemic emergency, providing for the conversion of certain nosocomial complexes into COVID-hospital. This produced a simultaneous reduction in user volumes and outpatient and elective services. With the present study, the death forms relating to patients who died at the Policlinico Hospital in the quarter February 15, 2020 - May 15 of 2020 were analyzed, making a comparison with the same quarter for the years 2011, 2018, and 2019 and evaluating the impact of the first wave" on the number of deaths and their distribution in the operating units of the main hospital of the region. The analysis showed in the first wave" the increase in the rate of emergency hospitalisations and the simultaneous increase in the number of deaths particularly evident in the emergency room and the clinical area units. © 2021 Giuffre Editore SpA. All rights reserved.
ABSTRACT
The coronavirus 19 (COVID-19) pandemic has affected hundreds of millions of people worldwide: in most of cases children and young people developed asymptomatic or pauci-symptomatic clinical pictures. However authors have showed that there are some categories of childhood more vulnerable to COVID-19 infection such as newborns or children with comorbidities. We report for the first time to the best of our knowledge about microvascular dysfunction in three pediatric clinical cases who developed COVID-19 infections with need of pediatric critical care. We found that sublingual microcirculation is altered in children with severe COVID-19 infection. Our findings confirmed most of data already observed by other authors in adult population affected by severe COVID-19 infection, but with distinct characteristics than microcirculation alterations previous observed in a clinical case of MIS-C. However we cannot establish direct correlation between microcirculation analysis and clinical or laboratory parameters in our series, by our experience we have found that sublingual microcirculation analysis allow clinicians to report directly about microcirculation dysfunction in COVID-19 patients and it could be a valuable bedside technique to monitor thrombosis complication in this population.