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.

Treatment of children with COVID-19

Currently, there is not any specific effective treatment for COVID-19. There are many studies published and ongoing especially on adult patients. Treatment options in pediatric patients are determined according to the agents used in adult patients. Although coronavirus disease 2019 (COVID-19) is mild in nearly all children, a small proportion of pediatric patients develop severe or critical illness. Supportive therapy forms the basis of the treatment as the symptoms and disease course in children are mild. There are currently no randomized controlled trials of drugs that can be used to treat COVID-19 in children. However, in severe clinical cases, the drugs used in adults are evaluated and used on a case-by-case basis. There is a growing need for well-designed controlled clinical trials to better define the safety and efficacy of potential treatments for COVID-19 in children.

A Child with Severe COVID-19 Complicated with Onychomadesis

The most common symptoms of COVID-19 infection are fever and cough;but may cause respiratory, enteric, hepatic, nephrotic, neurological, and skin involvement. Onychomadesis is the proximal separation of the nail plate from the nail matrix due to a temporary cessation of nail growth. Numerous studies about cutaneous manifestations of COVID-19 were reported;however findings of nails were limited. This paper reported a case of onychomadesis which appeared on the nails after a severe COVID-19 infection (MIS-C). Copyright © 2022 Ankara Pediatric Hematology Oncology Training and Research Hospital. All rights reserved.

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.

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.

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.