Characteristics and risk factors associated with critical illness in pediatric COVID-19

INTRODUCTION: Little is known regarding the course and severity of pediatric COVID-19. We describe critical illness in pediatric patients with PCR+ SARS-CoV2 infection and identify factors associated with PICU admission and organ dysfunction. METHODS: This is a retrospective chart review of 77 pediatric patients age 1 day to 21 years admitted to two New York City pediatric hospitals within the Northwell Health system between February 1 and April 24, 2020 with PCR+ SARS-CoV-2. Descriptive statistics were used to describe the hospital course and laboratory results and bivariate comparisons were performed on variables to determine differences. RESULTS: Forty-seven patients (61%) were admitted to the general pediatric floor and thirty (39%) to the PICU. The majority (97%, n=68) survived to discharge, 1.3% (n=1) remain admitted, and one (1.3%) died. Of PICU patients, 46.7% experienced significant organ dysfunction (pSOFA>=2) during admission. Patients aged 12 years or greater were more likely to be admitted to a PICU compared to younger patients (p=0.015). Presence of an underlying comorbidity was not associated with need for PICU admission (p=0.23) or organ dysfunction (p=0.87). Initial white blood cell count (WBC), platelet count, and ferritin were not associated with need for PICU admission. Initial C-reactive protein was associated with both need for PICU admission (p=0.005) and presence of organ dysfunction (p=0.001). Initial WBC was associated with organ dysfunction (p=0.034). Presenting thrombocytopenia was associated with organ dysfunction (p=0.003). Common indications for PICU admission included hypoxia (50%), hemodynamic instability (20%), diabetic ketoacidosis (6.7%), mediastinal mass (6.7%), apnea (6.7%), acute chest syndrome (6.7%), and cardiac dysfunction (6.7%). CONCLUSIONS: Need for PICU admission in COVID-19 was associated with age over 12 years and elevated initial CRP. Organ dysfunction was associated with elevated admission CRP and WBC and decreased platelet count. These factors may be useful in determining risk for critical illness and organ dysfunction in pediatric COVID-19.

Virtual Reality in Higher Education: An Experience with Medical Students: Research into how Virtual Reality can be used as a powerful training tool for medicine students

COVID-19 has changed how students access to information. In the next years, higher education should increase the number of virtual contents and Virtual Reality is a the best way to achieve it, as it offers a way to access classrooms, get interactive and immersive content and even evaluate the students. This project is born from the exploration of the educational possibilities of Virtual Reality in higher education. Therefore, the objective of this study is to validate the use of the VR platform "Medical Studium"for the teaching-learning process of medical students. For the evaluation a sample of 19 students have been selected from the Faculty of Medicine of the University of Salamanca (Spain), using both quantitative and qualitative data. Objective evidence and a questionnaire have been used as a data collection instrument. The results show that it helps them to better study some concepts that may seem difficult for students, as well as how to solve the limitation problems they have regarding the training of surgical operations. In addition, students are more motivated thanks to interaction with virtual and immersive content and they can reproduce a lesson as many times as they need. These findings can mean a change in both teaching and learning, as it is an improvement for students in their practical training. © 2020 ACM.