ABSTRACT
Background: The benefits of facilitating breastmilk feeding and close contact between mother and neonate (family-centred care; FCC) in the perinatal period are well-established. The aim of this study was to determine how the delivery of FCC practices were impacted for neonates born to mothers with perinatal SARS-CoV-2 infection during the COVID-19 pandemic. Methods: Neonates born to mothers with confirmed SARS-CoV-2 infection during pregnancy were identified from the 'EsPnIC Covid paEdiatric NeonaTal REgistry' (EPICENTRE) multinational cohort between 10 March 2020 and 20 October 2021. The EPICENTRE cohort collected prospective data on FCC practices. Rooming-in and breastmilk feeding practice were the main outcomes, and factors influencing each were determined. Other outcomes included mother-baby physical contact prior to separation and the pattern of FCC components relative to time and local site guidelines. Findings: 692 mother-baby dyads (13 sites, 10 countries) were analysed. 27 (5%) neonates were positive for SARS-CoV-2 (14 (52%) asymptomatic). Most sites had policies that encouraged FCC during perinatal SARS-CoV-2 infection for most of the reporting period. 311 (46%) neonates roomed-in with their mother during the admission. Rooming-in increased over time from 23% in March-June 2020 to 74% in January-March 2021 (boreal season). 330 (93%) of the 369 separated neonates had no FCC physical contact with their mother prior, and 319 (86%) were asymptomatic. Maternal breastmilk was used for feeding in 354 (53%) neonates, increasing from 23% to 70% between March-June 2020 and January-March 2021. FCC was most impacted when mothers had symptomatic COVID-19 at birth. Interpretation: This is the largest report of global FCC practice during the COVID-19 pandemic to date. The COVID-19 pandemic may have impacted FCC despite low perinatal transmission rates. Fortunately, clinicians appear to have adapted to allow more FCC delivery as the COVID-19 pandemic progressed. Funding: The National Health and Medical Research Council (Australia): Grant ID 2008212 (DGT), Royal Children's Hospital Foundation: Grant ID 2019-1155 (EJP), Victorian Government Operational Infrastructure Support Program.
ABSTRACT
BACKGROUND AND AIM: Burnout Syndrome (BS) is an illness that became more noticeable due to Coronavirus Disease 2019 (COVID-19) pandemic in result of the increased demand of healthcare systems. The objective of this study is to investigate BS in the participating Pediatric Intensive Care Units (PICU). METHOD(S): This is a cross-sectional observational study, in which the same survey was sent in 2020 and 2021 to the same population. It included questions about demographic data and the Maslach Burnout Inventory - Human Services Survey, that comprises three sub scales: Depersonalizaition (DP), Emotional Exhaustion (EE) and Personal Accomplishment (PA). The questionnaire was electronically sent to the healthcare workers caring for children in the PICU of participating hospitals. The units had both patients with COVID-19 and other illnesses. There was an overall response rate of 28% in both years analyzed. The answers were analyzed by interpreting the answers to the MBI-HSS and possible relations to dependent and independent variables. Also, simple and multiple linear regression models were assembled to compare the mean scores between the categories of the independent variables of interest. RESULT(S): In the year 2020 there was a majority of participants with low DP, moderate PA and low EE. In the following year, there was an increase in PA levels, which were now mainly high, and both of the other two sub scales remained the same. CONCLUSION(S): Although the second wave of COVID presented historically, with a higher number of cases in general, the healthcare workers showed some overall improvement regarding their burnout syndrome levels.
ABSTRACT
COVID-19 infection can progress to severe respiratory infection and have high mortality rates. Several pathophysiological factors are observed in fatal cases, with mortality related to multiple organ failure, in addition to the evolution with high levels of serum ferritin, D-dimer, and C-reactive protein. These severe cases often meet the criteria for macrophage activation syndrome with changes in the host's inflammatory response and an inadequate resolution phase. In the present study, the bundle for COVID-19 sepsis is proposed, including early recognition;protection, handwashing and isolation measures;oxygen therapy;early invasive mechanical ventilation;treatment aimed at modifying the clinical course. This strategy may be useful in the control of children with severe COVID-19 cases, as already demonstrated with the implementation of bundles in sepsis and other etiologies.