COVID-19 in Children With Inflammatory Bowel Disease: A Systematic Review

Background: Considering the chronic immunosuppression in Inflammatory Bowel Disease (IBD) patients, it is necessary to evaluate the course of COVID-19 in these patients. Studies have shown various results in adult IBD patients. This study aimed to find out the course of this infection in pediatric IBD patients. Methods: This was a systematic review study according to the PRISMA 2020 guideline. International databases including Scopus, PubMed, and the Web of Science were searched with a combination of "COVID-19" AND "IBD" or synonyms until October 16, 2021. Studies that have reported the outcomes of COVID-19 infection in patients less than 19 years of age were selected. Name of author, country, study duration and type, IBD type and drugs, and COVID-19 outcomes were extracted. Results: From the initially retrieved 2215 articles, finally 16 articles were eligible. Data from 1040 pediatric IBD patients were reported. Twenty-four patients were hospitalized, 5 developed patients multisystem inflammatory syndrome in children, and others had a mild disease course and were outpatient. Steroid use, severe IBD activity, and comorbidities were shown to increase risk of hospitalization and disease severity. Conclusions: COVID-19 is a benign and self-limited disease in pediatric IBD patients. Comorbidities, steroid use, and severe IBD activity affect the outcomes.

The correlation between viral shedding duration and blood biomarkers in COVID-19-infected patients

Background: Since December 2019, the world is struggling with an outbreak of coronavirus disease-2019 (COVID-19) infection mostly represented as an acute respiratory distress syndrome and has turned into the most critical health issue worldwide. Limited information is available about the association between dynamic changes in the naso/oropharyngeal viral shedding in infected patients and biomarkers, aiming to be assessed in the current study. Materials and Methods: This quasi-cohort study was conducted on 31 patients with moderate severity of COVID-19 manifestations, whose real-time polymerase chain reaction (RT-PCR) test was positive for severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) RNA at baseline. RT-PCR was rechecked for patients every 3-4 days until achieving two negative ones. In parallel, biomarkers, including lymphocyte count, lactate dehydrogenase (LDH), and C-reactive protein (CRP), were assessed every other day, as well. Viral shedding also was assessed. Results: Spearman's correlation test revealed a significant direct correlation between the viral shedding from the symptom onset and the time, in which CRP (P = 0.0015, r = 0.54) and LDH (P = 0.001, r = 0.6207) return to normal levels after symptom onset, but not for lymphocyte count (P = 0.068, r = 0.34). Conclusion: Based on the current study's findings, the duration of SARS-CoV-2 RNA shedding was directly correlated with the required time for LDH and CRP return to normal levels. Therefore, these factors can be considered the determinants for patients' discharge, isolation, and return to social activities;however, further investigations are required to generalize the outcomes.

On admission hemoglobin and albumin, as the two novel factors associated with thrombosis in COVID-19 pneumonia

Introduction: The unrelenting storm of coronavirus disease (COVID-19) since late 2019 has turned into a crucial health matter of the globe. There is increasing evidence in terms of a hypercoagulable state by this infection. Objectives: The current study aims to clarify the association between thromboembolic events in COVID-19 and the patient, the infection and in-hospital related characteristics. Patients and Methods: The current case-control study has been conducted on 243 COVID-19 pneumonia patients including 83 cases with thrombotic events and 160 controls without thrombosis. The thrombotic events included deep venous thrombosis (DVT) (n = 9), pulmonary thromboembolism (PTE) (n = 48), acute myocardial infarction (AMI) (n = 17), cerebrovascular accidents (CVA) (n = 4) and arterial thrombosis (n = 5). On admission, hemodynamic parameters, on admission laboratory assessments, mobility during hospitalization, type of oxygenation, intensive care unit (ICU) admission requirement and duration of ICU and also hospital stay were recorded in the checklist. Results: According to logistic regression assessment, on admission O2 saturation (OR: 0.97, 95% CI: 0.94-0.99), hemoglobin level (OR: 0.87, 95% CI: 0.77-0.97) and albumin level (OR: 0.53, 95% CI: 0.3-0.86) were independently correlated with thrombosis due to COVID-19. Other factors, including demographic, infection severity, laboratory and in-hospital characteristics, were not significantly associated with thrombotic events. Conclusion: Based on this study's findings, hemoglobin and albumin levels were the independent factors associated with the thrombotic events in COVID-19 patients.