ABSTRACT
Anti-inflammatory treatment of infections is challenging due to the heterogeneity of etiologic agents and complex immune interactions. Nevertheless, anti-inflammatory medications are commonly used in infections to reduce unpleasant symptoms and to modify host response. They may play a fundamental role in managing infection with over-inflammation by decreasing inflammatory organ damage, e.g., COVID-19. However, by its inherent inhibition of immune functions, they might also contribute to the development of serious bacterial infections. Moreover, reducing a patient's symptoms and signs may provide a false sense of security and delay diagnosing threatening infections. © 2022 Elsevier Inc. All rights reserved.
ABSTRACT
The course of COVID-19 in pediatric patients is usually mild or asymptomatic, but with the dominance of new virus variants, more children become symptomatic and require hospitalization. Since the end of 2021, a significant increase in the percentage of children infected with SARS-CoV-2 has been observed. This paper aimed to update the recommendations on the management of a child with COVID-19 in outpatient and inpatient settings. The current possibilities of prophylaxis, diagnostics, and antiviral treatment were discussed, indicating the limited availability of therapy for children. The mainstay of COVID-19 treatment in most pediatric patients is symptomatic and supportive treatment, as well as measures aimed at reducing the spread of SARS-CoV-2 infection.Copyright © 2022, Wydawnictwo Czelej Sp. z o.o.. All rights reserved.
ABSTRACT
Multisystem inflammatory syndrome in children, MIS-C is also referred to as a paediatric inflammatory multisystem syndrome, PIMS. It is a late complication of SARS-CoV-2 infec-tion. The underlying cause is immunological dysregulation, leading to severe inflammatory processes. Children with PIMS require hospital treatment, the use of immunomodulating drugs, and often intensive care. The high effectiveness of COVID-19 vaccination has been demonstrated in the prevention of MIS-C in adolescents. However, there are no explic-it vaccination recommendations for children who have already suffered from MIS-C. We present a summary of current knowledge on vaccinations against COVID-19 in the context of MIS-C and the Polish guidance of vaccinations for children following MIS-C.Copyright © 2022, Wydawnictwo Czelej Sp. z o.o.. All rights reserved.
ABSTRACT
Implementation of national vaccination programme as well as providing catch-up immunization schedule for war refugees from Ukraine is a challenge for Polish primary care physi-cians. Measles, mumps, rubella, polio and COVID-19 catch-up vaccinations are considered a priority. The Ukrainian Immunization Programme is similar to the Polish one, but it does not include vaccination against pneumococcal disease and rotavirus. Moreover there are differences between Ukrainian and Polish vaccination schedules against pertussis, polio and Haemophilus influenzae. In this article we present principles and practical guidelines for preparing catch-up immunization schedules for refugees from Ukraine, as well as a list of vaccine preparations available in Ukraine and their Polish equivalents. For preparations available only in Ukraine, a vaccine with the most similar composition was proposed.Copyright © 2022, Wydawnictwo Czelej Sp. z o.o.. All rights reserved.
ABSTRACT
Pediatric inflammatory multisystem syndrome associated with COVID-19 (PIMS) is a new entity, occurring in children and young adults, associated with the SARS-CoV-2 infection. The first cases of PIMS were found in Poland in May 2020. Since October 2020, a significant increase in the incidence of this new disease has been observed in Poland, which reflects the increased incidence of COVID-19 in adults. PIMS development results from dysregulation of the immune system occurring after 2-4 weeks after the SARS-CoV-2 in-fection. Diagnosis is based on a set of clinical features (including fever and features of mul-tiple organ damage) and laboratory abnormalities, with the exclusion of other causes. Most common complications involve cardiovascular system: myocarditis with decreased left ven-tricular ejection fraction, shock and/or coronary artery aneurysms. Mortality is around 2%. Appropriate management, including vital functions support and immunomodulating treat-ment, allows for a quick recovery of the vast majority of patients. The following document is a proposal for diagnostic and therapeutic management of children with suspected PIMS in Poland. Copyright © 2020, Wydawnictwo Czelej Sp. z o.o.. All rights reserved.
ABSTRACT
Recently, a significant increase in the number of patients infected with SARS-CoV-2 has been observed, including children. The available data indicate, that children are less sus-ceptible to SARS-CoV-2 infection compared to adults and may play a lesser role in the transmission of the infection. Children get infected much less frequently than adults, most of them do not have comorbidities, and in 80-90% of cases in children, the clinical course of COVID-19 is mild (oligo-or asymptomatic). The aim of this paper is to discuss the management of a child with COVID-19 in outpatient and inpatient settings. The current options and indications for antiviral therapy (including remdesivir), tociliziumab, and convalescent plasma, were discussed, indicating the limited availability of therapies in children. The mainstay of COVID-19 treatment in most pediatric patients is symptomatic and supportive treatment as well as measures aimed at reducing the spread of SARS-CoV-2 infection. Copyright © 2020, Wydawnictwo Czelej Sp. z o.o.. All rights reserved.
ABSTRACT
Multisystem inflammatory syndrome in children (MIS-C) is a late complication of SARS-CoV-2 infection, either symptomatic or asymptomatic. The underlying cause is immunological dysregulation, leading to severe inflammatory processes. Children with MIS-C require hospital treatment, the use of immunomodulating drugs, and often intensive care. COVID-19 vaccination is safe and highly effective in preventing not only severe COVID-19, but also MIS-C in adolescents. However, there are no explicit vaccination recommendations for children who underwent MIS-C. We present a summary of current knowledge on vaccinations against COVID-19 in the context of MIS-C. Moreover, we propose guidance concerning vaccinations for children following MIS-C.
ABSTRACT
Since late 2021, we have observed a significant increase in the proportion of children infected with SARS-CoV-2. The course of the disease in children is usually sparsely symptomatic or asymptomatic. However, the predominance of new virus variants makes children more likely to become symptomatically ill and require hospitalisation. This paper aims to update recommendations for managing a child with COVID-19 in out- and inpatient settings. Current options for prevention and antiviral treatment are discussed, noting the limited availability of therapy for children. In most children with COVID-19, the basis for treatment remains symptomatic and supportive therapy and measures to reduce SARS-CoV-2 infection spread.
ABSTRACT
The symptoms of SARS-CoV-2 infection and COVID-19 provoked by this virus are poorly described in children. Here we analyse a case of orchiepididymitis associated with COVID-19 in a 14-year-old boy. We discuss the possibility of SARS-CoV-2-associated testicular inflammation. This report strengthens the necessity for more in-depth study of the clinical presentation of paediatric COVID-19 and the potential association with non-respiratory symptoms. © 2021, Health and Medical Publishing Group. All rights reserved.
ABSTRACT
Pediatric inflammatory multisystem syndrome associated with COVID-19 (PIMS) is a new entity, occurring in children and young adults, associated with the SARS-CoV-2 infection. The first cases of PIMS were found in Poland in May 2020. Since October 2020, a signi-ficant increase in this new disease incidence has been observed in Poland, reflecting the increased incidence of COVID-19 in the pediatric population. PIMS development results from dysregulation of the immune system occurring after ca. 4 weeks after the SARS-CoV-2 infection. Diagnosis is based on criteria: a set of clinical features (including fever and features of multiple organ damage) and elevated inflammatory markers, excluding other cau-ses. The most common complications involve the cardiovascular system: heart damage with decreased left ventricular ejection fraction, shock, and coronary artery abnormalities. Mortality is around 2%. Appropriate management, including vital functions support and immunomodulating treatment, allows for a quick recovery of the vast majority of patients. The following document is a guideline for the diagnostic and therapeutic management of children with suspected PIMS in Poland. © 2021, Wydawnictwo Czelej Sp. z o.o.. All rights reserved.
ABSTRACT
The article summarizes the discussion of the expert meeting on February 16, 2021. The meeting concerned the medical care of patients with cow’s milk allergy (CMA). Experts analyzed the impact of the COVID-19 pandemic on patients’ access to medical services, including the diagnostic process and the possibility of a proper dietary management. The analysis of the National Health Fund data showed the most significant (by 25%) reduction in the number of health care consultations, in 2020 compared to 2019, for the pediatric population and limited access to services provided as a personal advice. The discussion facilitated the development of recommendations for the treatment of children with CMA. The experts recommended to support services in the form of personal medical advice, especially in the case of first-time visits, to limit the forms of telephone counseling / video counseling to monitoring or prolonging therapy, provided that there are no new symptoms and a good response to the previously applied procedure. The need to monitor the child’s diet and to verify the acquisition of allergen tolerance through food provocation was also emphasized. Appropriate management of allergy to cow’s milk proteins may be important to reduce the risk of further diseases (allergic march). The recommendations presented in the article should be useful for daily practice in the pediatrician’s office. © 2021, Wydawnictwo Czelej Sp. z o.o.. All rights reserved.
ABSTRACT
Multisystem Inflammatory Syndrome in Children (MIS-C) is a new clinical entity occurring in children and young adults, which is associated with the SARS-CoV-2 infection. The first cases of MIS-C were diagnosed in Poland in May 2020. Since October 2020, a significant increase in the incidence of this new disease has been observed in Poland, reflecting the increased incidence of COVID-19 in the paediatric population. MIS-C develops as a result of dysregulation of the immune system occurring 4 weeks after the SARS-CoV-2 infection. Diagnosis is based on the following criteria: a set of clinical features (including fever and signs of multiple organ damage) and elevated inflammatory markers, with exclusion of other causes. The most common complications involve the cardiovascular system: acute myocardial damage with reduced left ventricular ejection fraction, shock, and coronary artery abnormalities and arrhythmias. Mortality in Western Europe and the United States is around 1-2%. Appropriate management, including vital function support and immunomodulatory treatment, allows for a quick recovery in the vast majority of patients. This document is an updated guideline for the diagnostic and therapeutic management of children with suspected MIS-C in Poland. The most important changes concern treatment, steroid therapy, and antiplatelet therapy in particular.
ABSTRACT
Respiratory tract infections are one of the most common health problems among children during the winter season. Viruses are responsible for a vast majority of respiratory tract infections. Bacterial infections usually affect specific locations (for example, otitis media, nasal sinuses, lungs or, sometimes, throat) and are more frequent in risk groups, or they can complicate a previous viral infection. During the ongoing COVID-19 pandemic, it is essential to consider SARS-CoV-2 as a possible causative agent for any infectious disease affecting the respiratory tract. Recommendations aim to establish an optimal manner for management of respiratory infections. Any patient should be pre-screened by telephone consultation to reduce the risk to healthcare workers. Regardless of the infection's etiology and location, the top priority should be to determine the patient's general condition and the place of treatment and treatment method (hospital, home, symptomatic, antimicrobial). For epidemic reasons, it is advisable to exclude infection with the new coronavirus in the case of a doubtful clinical picture, as well as patients with SARS-CoV-2 infection. The primary purpose of any consultation is to choose the best treatment for the patient (ambulatory/hospital/symptomatic/antimicrobial), and it is not always crucial to know the exact etiology of the infection. Due to epidemiologic reasons, it is reasonable to exclude SARS-CoV-2 infection in every patient with atypical symptoms or after contact with a person infected with SARS-CoV-2. © Wydawnictwo Continuo.