ABSTRACT
Background: COVID 19 infection in children is characterized by a clinical polymorphism, cutaneous manifestations being present in a significant percentage. Data reported in the literature described cutaneous manifestations in the form of measles rash, acral lesions, livedo reticularis and racemosa, acute urticaria, non-pruritic papulo-vesicular rash but also multisystemic inflammatory syndrome. Recognition of these lesions may suggest a diagnosis of acute SARS-COV2 infection, and when anamnestically detected, the rash provides evidence of a possible MIS-C in children that may quickly progress unfavorably. In some cases, newborns who belong to mothers affected by the new coronavirus have a temporary maculopapular rash, with a diffuse appearance, which disappears spontaneously but with an impact on the fetus. Method(s): In conducting this retrospective study we used data extracted from 320 medical records of pediatric patients diagnosed with acute SARS-COV 2 infection, in the Clinical Emergency Hospital for Children 'Sf. Maria' Iasi, Romania, between January 2020 -January 2021. Subsequently, the cases with cutaneous manifestations detected at the time of admission but also those present prior to admission and reported by the parents were selected. There were 3 pregnant patients who met the above criteria. Result(s): Cutaneous manifestations were present in 31% of patients. These had a favorable outcome in most cases. There were 7 cases of MIS-C in which the outcome was unfavorable (2 cases) and slowly favorable (5 cases). In these situations, the cutaneous manifestations lasted longer and in most cases, correlated with the severity of the disease. In pediatric pregnant patients, the outcome was favorable and did not have a negative impact on the newborn. Conclusion(s): Cutaneous manifestations are common in children with acute SARS-COV 2 infection and these appear to be represented by the location of the virus in the superficial blood vessels. The appearance of livedo-type lesions has been associated with microthrombotic processes and have been less frequently found but with a slowly favorable outcome. The diagnosis of MIS-C represents an emergency, cutaneous manifestations playing an important role in the early detection and treatment of these children.
ABSTRACT
Background: The pandemic period demonstrated the epidemiological and clinical evolutionary differences between adult vs. child with asthma infected with COVID 19. One of the challenges for pediatricians was the risk of losing control of asthma but also the risk of serious complications in the asthmatic child. The aim of the study was to study the level of control of asthma in children and on the other hand the incidence of its severe complications in the pandemic period 2020-2021 vs the non-pandemic period 2018-2019. Method(s): Retrospective study on asthmatic patients hospitalized in the period 2020-2021 in the Emergency Clinical Hospital for Children "St Mary" Iasi. Result(s): Total number of cases of asthma-2018- 219, 2019-174, 2020-193,2021- 148;annual asthma control level: controlled asthma: 2018-63%, 2019-59%, 2020-67%, 2021-54%, partially controlled asthma: 2018-29%, 2019-35%, 2020-26%, 2021 -38%, uncontrolled asthma: 2018-8%, 2019-6%, 2020-7%, 2021-8%;annual incidence of exacerbations: controlled asthma -2018: 23%, 2019-27%, 2020-11%, 2021 -14% of which with COVID 19 infection-2%;partially controlled asthma-2018: 41%, 2019-54%, 2020-32% of which with COVID 19 infection-21%;2021-58% of which with COVID19 infection- 42%;uncontrolled asthma-2018- 77%, 2019-73%, 2020-86% of which with COVID19 infection -82%, 2021-81% of which with COVID 19 infection-74%;annual incidence of severe asthma complications hospitalized ICU: 2018-3%, 2019-2%, 2020-5% of which 4% with COVID 19 infection,2021-4% all associated with COVID 19 infection. Conclusion(s): The control rate of asthma in children did not register significant differences between the 2 studied periods;The incidence of severe complications and exacerbations in the context of SARS Cov 2 infection increased during the pandemic period, especially in the partial and especially uncontrolled therapeutic form of asthma in children.