ABSTRACT
Objective The frequency of coinfections in pediatric Coronavirus disease 2019 (COVID-19) cases and their impact on the clinical course are not fully understood. We aimed to investigate the viral and bacterial respiratory pathogens in children admitted to the pediatric emergency department (PED), their clinical course, and the presence of coinfections during the early months of the COVID-19 pandemic. Methods Clinical, laboratory and radiological findings, viral and bacterial pathogens detected by multiplex polymerase chain reaction (PCR) tests in nasopharyngeal swabs, clinical course, and treatments of all children who were tested for severe acute respiratory coronavirus 2 (SARS-CoV-2) at the PED between March 16 and May 15, 2020, were recorded. SARS-CoV-2 PCR-positive and negative groups were compared. Results Out of 570 patients tested for SARS-CoV-2 during the study period, 43 were found positive (7.5%). Non-SARS-CoV-2 viral pathogens were more common in the SARS-CoV-2 PCR-negative group than the SARS-CoV-2 PCR-positive group (13.2%, n=68 versus 4.7%, n=2), but this result was not statistically significant. Leukocyte, neutrophil, lymphocyte, and platelet counts were lower in SARS-CoV-2 PCR-positive group. Bacterial panel positivity was significantly higher in the SARS-CoV-2 PCR-positive group compared with the SARS-CoV-2 PCR-negative group (52%, n=12 versus 28%, n=91;p<0.05). The presence of coinfection did not alter the course of therapy in SARS-CoV-2 PCR-positive cases. Conclusion While viral coinfections were rare, bacterial panel positivity was common in children with COVID-19, but this had not influenced management decisions. The limitations of the tests should be kept in mind while interpreting the results.
ABSTRACT
AIMS & OBJECTIVES: We will present the management of three patients with tracheostomies with COVID-19 infection. METHODS: We will present the management of three patients with tracheostomies with COVID-19 infection. RESULTS: The first patient, 13 years old girl, had a diagnosis of osteopetrosis and recurrent osteomyelitis, presented with four days of fever. She had in-house contact and computed tomography was consistent with COVID 19 pneumonia, and PCR was positive. Antibiotic treatment, favipravir, hydroxychloroquine and enoxaparin treatments were began. On the 15th day;ventilator support was given her, after radiological progression and clinical worsening. PCRs were negative on day 13 and 17. Patient was discharged with oxygen support on day 24. The second patient;2-years-old with tracheostomy with BPD admitted for a tracheostomy closure plan. Routine COVID PCR test was positive before the procedure. The patient without complaint had sore throat in her parents, but their COVID 19 PCR test was negative. On the 4th day, she was discharged without any problem. On the 12th day, the COVID PCR test was negative. The third patient, with tracheostomy and gastrostomy, who applied with fever and respiratory distress. In addition to wide antibiotic therapy, favipravir and bemiparin treatments were also began. In the follow-up, mechanical ventilation support was provided. COVID PCR positive taken on the 10th day of treatment;resulted negative on day 17. The patient was discharged on the 20th day. CONCLUSIONS: There is no information about covid 19 pneumonia in pediatric patients with tracheostomy. Followup of these patients will provide insight into the follow-up of patients with future tracheostomy.