Relationship with Domestic Spread and Progression of COVID-19 in Children

Objective: SARS-CoV-2 infection in children is usually mild, so the real positivity rate and the effect on children's virus spread are not excatly known. The purpose of this study is investigate the effect of children on the spread of COVID-19. Material and Methods: Children who were followed up and treated with a pre-diagnosis of COVID-19 between April and June 2020 were included in this study. The protocol for this retrospective study was approved by the Ministry of Health, Turkey, and the ethics committee of a university medical school. Data were collected retrospectively from the hospital medical system. Data analysis was done with IBM SPSS v21.0 statistical program. Categorical variables were expressed as n and %, while numerical variables were expressed as mean +/- std and median (min-max). The conformity of the data to the normal distribution was analyzed with the Kolmogorov Smirnov test. Chi-square test and Fisher's exact test were used in the analysis of categorical variables. In compar-isons between groups, Independent-t and Mann-Whitney U tests were used. For correlation between continuous variables, Pearson and Spear-man correlation coefficients were used. p< 0.05 was accepted for statis-tical significance. Results: A total of 205 children were hospitalized in a three-month peri-od with a suspected COVID-19 disease. SARS-CoV-2 RT-PCR was positive in 72.7% of the participants from 86 different families. As the number of siblings and households increased, SARS-CoV-2 RT-PCR positive cases also increased and were found to be statistically significant (p< 0.05). The presence of another SARS-CoV-2 RT-PCR confirmed case in the household under the age of 18 increases the clustering of cases within the family (p< 0.001). There was domestic contact in 74% of the partici-pants;this rate is 91.9% for positive cases and 26.8% for probable cases, which is statistically significant (p< 0.001). WBC, neutrophil, platelet and CRP parameters of positive cases are lower than probable cases. Conclusion: COVID-19 infection in children appears to be asymptomat-ic or mildly symptomatic. Although the role of children in the spread of COVID-19 infection is unclear, the domestic clustering rate of COVID-19 infection is high in families with many children. Therefore, in order to re-duce the spread of the disease, family clustering should be determined and quarantine measures should be taken.

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.

Relationship with domestic spread and progression of COVID-19 in children

Objective: SARS-CoV-2 infection in children is usually mild, so the real positivity rate and the effect on children's virus spread are not excatly known. The purpose of this study is investigate the effect of children on the spread of COVID-19. Material and Methods: Children who were followed up and treated with a pre-diagnosis of COVID-19 between April and June 2020 were included in this study. The protocol for this retrospective study was approved by the Ministry of Health, Turkey, and the ethics committee of a university medical school. Data were collected retrospectively from the hospital medical system. Data analysis was done with IBM SPSS v21.0 statistical program. Categorical variables were expressed as n and %, while numerical variables were expressed as mean +or- std and median (min-max). The conformity of the data to the normal distribution was analyzed with the Kolmogorov Smirnov test. Chi-square test and Fisher's exact test were used in the analysis of categorical variables. In comparisons between groups, Independent-t and Mann-Whitney U tests were used. For correlation between continuous variables, Pearson and Spearman correlation coefficients were used. p< 0.05 was accepted for statistical significance.

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.

The Role of Some Parameters in Diagnosis in the Absence of PCR in the Children with COVID-19

Objective: Infectious diseases cause inflammation in the human body and produce numerical and functional changes in peripheral blood cells. Coronavirus disease-19 (COVID-19) is also an infectious disease diagnosed by the Polymerase Chain Reaction (PCR) test. However, PCR testing may not always be available. The aim of this study is to show the effect of numerical and functional changes in blood parameters on the diagnosis of COVID-19 in children. Methods: In this retrospective study, 296 patients and 286 healthy children were included. Nasopharyngeal swabs were collected. The swabs were analyzed by Real-time PCR. Independent-t/Mann-Whitney-U tests were applied;Receiver Operating Characteristic (ROC) curves and logistic regression modelling were evaluated. Results: Gender and age distributions of the groups were similar (p>0.05). There were significant differences between the two groups in terms of white blood cell (WBC) (p<0.001), neutrophil (p<0.001), thrombocyte (p<0.001), lymphocyte (p<0.001), mean platelet volume (MPV) (p=0.009), lactate dehydrogenase (LDH) (p=0.003), C-reactive protein (CRP) (p<0.001) and aspartate aminotransferase (AST) (p=0.002). It was found in ROC curve analyses, while LDH (p<0.001) and CRP (p<0.001) values were higher in patients, MPV (p=0.03), platelet (p=0.04), and neutrophil (p<0.001) values of them were lower. The best model in logistic regression was the model that included hemoglobin, neutrophil, lymphocyte, thrombocyte, LDH and CRP. Conclusions: Rapid diagnosis of COVID-19 are crucial for public health. PCR, required for definitive diagnosis, may not always be achieved, so easier and cheaper methods are needed. This study supports the diagnosis of COVID-19 in the children in the absence of PCR.

Education of healthcare personnel working with pediatric patients during covid-19 pandemic within the framework of infection control

Objective: In the early stages of any epidemic caused by new emerging pathogens healthcare personnel is subject to a great risk. Pandemic caused by SARS-CoV-2, proved to be no exception. Many healthcare workers died in the early stages of pandemic due to inadequate precautions and insufficient protection. It is essential to protect and maintain the safety of healthcare personnel for the confinement of pandemic as well as continuity of qualified healthcare services which is already under strain. Educating healthcare personnel on appropiate use of personal protective equipment (PPE) is as essential as procuring them. Material and Methods: A survey is conducted on 4927 healthcare personnel working solely with pediatric patients from 32 different centers. Education given on PPE usage were questioned and analyzed depending on age, sex, occupation and region. Results: Among four thousand nine hundred twelve healthcare personnel from 32 different centers 91% (n= 4457) received education on PPE usage. Of those who received education only 36% was given both theoretical and applied education. Although there was no differences among different occupation groups, receiving education depended on regions. Conclusion: It is essential to educate healthcare personnel appropiately nationwidely for the continuity of qualified healthcare services during the pandemic.

Education of Healthcare Personnel Working with Pediatric Patients During COVID-19 Pandemic within the Framework of Infection Control

Objective: In the early stages of any epidemic caused by new emerging pathogens healthcare personnel is subject to a great risk. Pandemic caused by SARS-CoV-2, proved to be no exception. Many healthcare workers died in the early stages of pandemic due to inadequate precautions and insufficient protection. It is essential to protect and maintain the safety of healthcare personnel for the confinement of pandemic as well as continuity of qualified healthcare services which is already under strain. Educating healthcare personnel on appropiate use of personal protective equipment (PPE) is as essential as procuring them. Material and Methods: A survey is conducted on 4927 healthcare personnel working solely with pediatric patients from 32 different centers. Education given on PPE usage were questioned and analyzed depending on age, sex, occupation and region. Results: Among four thousand nine hundred twelve healthcare personnel from 32 different centers 91% (n=4457) received education on PPE usage. Of those who received education only 36% was given both theoretical and applied education. Although there was no differences among different occupation groups, receiving education depended on regions. Conclusion: It is essential to educate healthcare personnel appropiately nationwidely for the continuity of qualified healthcare services during the pandemic.