ABSTRACT
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 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. Results: A total of 205 children were hospitalized in a three-month period 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 participants;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 asymptomatic 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 reduce the spread of the disease, family clustering should be determined and quarantine measures should be taken.
ABSTRACT
[...]in order to reduce the spread of the disease, family clustering should be determined and quarantine measures should be taken. The predominance of with many children traditional lifestyle may cause increased domestic clustering. [...]during this period, various control measures were taken for children, with some restrictions, and travel bans were imposed except when necessary (9). Contact screening and isolation of children is important in epidemic control, due to the detection of asymptomatic SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) positive children and increasing rate of domestic positivity. According to this guideline, in the presence of epidemiological and clinical findings, SARS-CoV-2 RNA RT-PCR positive cases were accepted as confirmed cases, and SARS-CoV-2 RT-PCR negative cases were accepted probable cases (10).
ABSTRACT
Introduction There have been some significant changes regarding healthcare utilization during the COVID-19 pandemic. Majority of the reports about the impact of the COVID-19 pandemic on diabetes care are from the first wave of the pandemic. We aim to evaluate the potential effects of the COVID-19 pandemic on the severity of diabetic ketoacidosis (DKA) and new onset Type 1 diabetes presenting with DKA, and also evaluate children with DKA and acute COVID-19 infection. Methods This is a retrospective multi-center study among 997 children and adolescents with type 1 diabetes who were admitted with DKA to 27 pediatric intensive care units in Turkey between the first year of pandemic and pre-pandemic year. Results The percentage of children with new-onset Type 1 diabetes presenting with DKA was higher during the COVID-19 pandemic (p < 0.0001). The incidence of severe DKA was also higher during the COVID-19 pandemic (p < 0.0001) and also higher among children with new onset Type 1 diabetes (p < 0.0001). HbA1c levels, duration of insulin infusion, and length of PICU stay were significantly higher/longer during the pandemic period. Eleven patients tested positive for SARS-CoV-2, eight were positive for new onset Type 1 diabetes, and nine tested positive for severe DKA at admission. Discussion The frequency of new onset of Type 1 diabetes and severe cases among children with DKA during the first year of the COVID-19 pandemic. Furthermore, the cause of the increased severe presentation might be related to restrictions related to the pandemic;however, need to evaluate the potential effects of SARS-CoV-2 on the increased percentage of new onset Type 1 diabetes.
ABSTRACT
Microbiota composition may play a role in the development, prognosis, or post-infection of COVID-19. There are studies evaluating the microbiota composition at the time of diagnosis and during the course of COVID-19, especially in adults, while studies in children are limited and no study available in children with multisystem inflammatory syndrome in children (MIS-C). This study was planned to compare intestinal microbiota composition in children diagnosed with MIS-C and acute COVID-19 infection with healthy children. In this prospective multicenter study, 25 children diagnosed with MIS-C, 20 with COVID-19 infection, and 19 healthy children were included. Intestinal microbiota composition was evaluated by 16 s rRNA gene sequencing. We observed changes of diversity, richness, and composition of intestinal microbiota in MIS-C cases compared to COVID-19 cases and in the healthy controls. The Shannon index was higher in the MIS-C group than the healthy controls (p < 0.01). At phylum level, in the MIS-C group, a significantly higher relative abundance of Bacteroidetes and lower abundance of Firmicutes was found compared to the control group. Intestinal microbiota composition changed in MIS-C cases compared to COVID-19 and healthy controls, and Faecalibacterium prausnitzii decreased; Bacteroides uniformis, Bacteroides plebeius, Clostridium ramosum, Eubacterium dolichum, Eggerthella lenta, Bacillus thermoamylovorans, Prevotella tannerae, and Bacteroides coprophilus were dominant in children with MIS-C. At species level, we observed decreased Faecalibacterium prausnitzii, and increased Eubacterium dolichum, Eggerthella lenta, and Bacillus thermoamylovorans in children with MIS-C and increased Bifidobacterium adolescentis and Dorea formicigenerasus in the COVID-19 group. Our study is the first to evaluate the microbiota composition in MIS-C cases. There is a substantial change in the composition of the gut microbiota: (1) reduction of F. prausnitzii in children with MIS-C and COVID-19; (2) an increase of Eggerthella lenta which is related with autoimmunity; and (3) the predominance of E. dolichum is associated with metabolic dysfunctions and obesity in children with MIS-C. CONCLUSIONS: Alterations of the intestinal microbiota might be part of pathogenesis of predisposing factor for MIS-C. It would be beneficial to conduct more extensive studies on the cause-effect relationship of these changes in microbiota composition and their effects on long-term prognosis. WHAT IS KNOWN: ⢠Microbiota composition may play a role in the development, prognosis, or post-infection of COVID-19. ⢠However, the number of studies on children is limited, and no study on multisystem inflammatory syndrome in children is currently available (MIS-C). WHAT IS NEW: ⢠In individuals with MIS-C, the composition of the gut microbiota changed dramatically. ⢠Decreased Faecalibacterium prausnitzii have been observed, increased Eggerthella lenta, which was previously linked to autoimmunity, and predominance of Eubacterium dolichum which was linked to metabolic dysfunction and obesity.