A snapshot of pediatric inpatients and outpatients with COVID-19: a point prevalence study from Turkey.

This multi-center point prevalence study evaluated children who were diagnosed as having coronavirus disease 2019 (COVID-19). On February 2nd, 2022, inpatients and outpatients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were included in the study from 12 cities and 24 centers in Turkey. Of 8605 patients on February 2nd, 2022, in participating centers, 706 (8.2%) had COVID-19. The median age of the 706 patients was 92.50 months, 53.4% were female, and 76.7% were inpatients. The three most common symptoms of the patients with COVID-19 were fever (56.6%), cough (41.3%), and fatigue (27.5%). The three most common underlying chronic diseases (UCDs) were asthma (3.4%), neurologic disorders (3.3%), and obesity (2.6%). The SARS-CoV-2-related pneumoniae rate was 10.7%. The COVID-19 vaccination rate was 12.5% in all patients. Among patients aged over 12 years with access to the vaccine given by the Republic of Turkey Ministry of Health, the vaccination rate was 38.7%. Patients with UCDs presented with dyspnea and pneumoniae more frequently than those without UCDs (p < 0.001 for both). The rates of fever, diarrhea, and pneumoniae were higher in patients without COVID-19 vaccinations (p = 0.001, p = 0.012, and p = 0.027).  Conclusion: To lessen the effects of the disease, all eligible children should receive the COVID-19 vaccine. The illness may specifically endanger children with UCDs. What is Known: • Children with COVID-19 mainly present with fever and cough, as in adults. • COVID-19 may specifically threaten children with underlying chronic diseases. What is New: • Children with obesity have a higher vaccination rate against COVID-19 than children without obesity. • Among unvaccinated children, fever and pneumoniae might be seen at a higher ratio than among vaccinated children.

Evaluation of vaccination status of health care workers for recommended vaccines and their acceptance of SARS-CoV-2 vaccines.

INTRODUCTION: Health care workers (HCWs) are disproportionately exposed to infectious diseases and play a role in nosocomial transmission, making them a key demographic for vaccination. HCW vaccination rates are not optimal in many countries; hence, compulsory vaccination policies have been implemented in some countries. Although these policies are effective and necessary under certain conditions, resolving HCWs' hesitancies and misconceptions about vaccines is crucial. HCWs have the advantage of direct contact with patients; hence, they can respond to safety concerns, explain the benefits of vaccination, and counter antivaccine campaigns that escalate during pandemics, as has been observed with COVID-19. METHOD: A short survey was carried out in May-June 2020 on the vaccination status of HCWs working with pediatric patients with COVID-19. The survey inquired about their vaccination status (mumps/measles/rubella [MMR], varicella, influenza, and diphtheria/tetanus [dT]) and willingness to receive hypothetical future COVID-19 vaccines. The respondents were grouped according to gender, age, occupation, and region. RESULTS: In total, 4927 HCWs responded to the survey. Most were young, healthy adults. The overall vaccination rates were 57.8% for dT in the past 10 years, 44.5% for MMR, 33.2% for varicella, and 13.5% for influenza. Vaccination rates were the highest among physicians. The majority of HCWs (81%) stated that they would be willing to receive COVID-19 vaccines. CONCLUSION: Although vaccination rates for well-established vaccines were low, a majority of HCWs were willing to receive COVID-19 vaccines when available. Education and administrative trust should be enhanced to increase vaccination rates among HCWs.

Psychological readiness to normalization process and burnout level of healthcare workers of pediatric clinic after three months of COVID-19 pandemic

Since December 2019, a new coronavirus, SARS-CoV-2 spread rapidly worldwide within months and caused stress and anxiety both in public and healthcare workers (HCWs). This study was conducted to determine psychologic effect of COVID-19 outbreak on and burnout level among HCWs of Pediatric Clinic while entering normalization process of pandemic. This cross-sectional study was carried out between June 10, 2020 and June 15, 2020 with participation of 261 HCWs. Questionnaire about demographic data, Depression Anxiety Stress Scale-21 (DASS-21), Acceptance and Action Questionnaire-II (AAQ-II), Maslach Burnout Inventory (MBI) were self-reported by the participants. The mean age of participants was 29+/-9.88 years, 78.9% of them was female, 33% were physicians, 40.2% were nurses. In general, psychological outcomes of the participations were determined as depressive symptoms in 143 (54.8%), anxiety in 129 (49.4%), and stress in 87 (33.3%). Being female, having direct contact with COVID-19 patients increased the risk for anxiety, depression, stress, and psychological inflexibility. Younger age, less work experience, and longer working hours had a significant correlation with burnout as well as a its significant correlation with depression, anxiety, stress, psychological inflexibility. In multiple regression analysis psychological inflexibility, stress levels and working hours showed significant predictive effect on burnout. And also, predictive effects of psychological parameters on burnout were found more stronger than the environmental parameters. Psychological factors showed a stronger relationship with burnout scores compared to environmental factors. Even so, organizational strategies like limiting working hours, and doing a fair shift for HCWs who work on the front line and have direct contact with COVID-19 patients will help to reduce the psychological pressure on HCWs. (PsycInfo Database Record (c) 2022 APA, all rights reserved) (Turkish) Aralik 2019'dan bu yana, yeni bir korona virus, SARS-CoV-2 dunya capinda aylar icinde hizla yayildi ve hem halk hem de saglik personelleri (SP) arasinda stres ve kaygiya neden oldu. Bu calisma, normallesme surecine girerken, COVID-19 salgininin Cocuk Sagligi ve Hastaliklari Kliniginde calisan SP uzerindeki psikolojik etkisini ve sebep oldugu tukenmislik duzeylerini belirlemek amaciyla yapildi. Bu kesitsel calisma, 261 saglik calisaninin katilimiyla 10 Haziran 2020 ve 15 Haziran 2020 tarihleri arasinda gerceklestirildi. Demografik verilerle ilgili anket, Depresyon Anksiyete Stres Olcegi-21 (DASS-21), Kabul ve Eylem Anketi-II (AAQ-II), Maslach Tukenmislik Envanteri (MIB) katilimcilar tarafindan doldurdu. Katilimcilarin yas ortalamasi 29+/-9,88 yil, %78,9'u kadin, %33'u hekim, %40,2'si hemsire idi. Genel psikolojik sonuclar 143'unde (%54,8) depresyon belirtileri, 129'unda (%49,4) anksiyete, 87'sinde (%33,3) stres seklinde belirlendi. Kadin olma ve COVID-19 tanili hasta ile dogrudan temasta bulunmanin anksiyete, depresyon, stres ve psikolojik esneklik icin riski artirdigi goruldu. Daha genc olma, is deneyiminin az olmasi ve uzun saatler calismanin depresyon, anksiyete, stres, psikolojik esneklik kaybi ile oldugu gibi, tukenmislik ile de iliskisi vardi. Regresyon analizinde psikolojik esneklik, stress duzeyive calisma saatinin tukenmislik uzerinde anlamli yordayici etkisi oldugu gosterildi. Psikolojik faktorler cevresel faktorlere gore tukenmislik puanlari ile daha guclu bir iliski gostermektedir. Bununla beraber calisma saatlerini sinirlandirmak, on saflarda calisan COVID-19 hastalariyla dogrudan temas halinde olan SP arasinda adil vardiya duzenlemek gibi kurumsal stratejiler, SP uzerindeki psikolojik baskiyi azaltmaya yardimci olacaktir. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Epidemiological, Clinical, and Laboratory Features of Children With COVID-19 in Turkey.

Objectives: The aim of this study is to identify the epidemiological, clinical, and laboratory features of coronavirus disease 2019 (COVID-19) in children. Methods: A retrospective study was conducted by pediatric infectious disease specialists from 32 different hospitals from all over Turkey by case record forms. Pediatric cases who were diagnosed as COVID-19 between March 16, 2020, and June 15, 2020 were included. Case characteristics including age, sex, dates of disease onset and diagnosis, family, and contact information were recorded. Clinical data, including the duration and severity of symptoms, were also collected. Laboratory parameters like biochemical tests and complete blood count, chest X-ray, and chest computed tomography (CT) were determined. Results: There were 1,156 confirmed pediatric COVID-19 cases. In total, male cases constituted 50.3% (n = 582) and females constituted 49.7% (n = 574). The median age of the confirmed cases was 10.75 years (4.5-14.6). Of the total cases, 90 were younger than 1 year of age (7.8%), 108 were 1-3 years of age (9.3%), 148 were 3-6 years of age (12.8%), 298 were 6-12 years of age (25.8%), 233 were 12-15 years of age (20.2%), and 268 cases were older than 15 years of age (23.2%). The most common symptom of the patients at the first visit was fever (50.4%) (n = 583) for a median of 2 days (IQR: 1-3 days). Fever was median at 38.4°C (38.0-38.7°C). The second most common symptom was cough (n = 543, 46.9%). The other common symptoms were sore throat (n = 143, 12.4%), myalgia (n = 141, 12.2%), dyspnea (n = 118, 10.2%), diarrhea (n = 112, 9.7%), stomachache (n = 71, 6.1%), and nasal discharge (n = 63, 5.4%). When patients were classified according to disease severity, 263 (22.7%) patients were asymptomatic, 668 (57.7%) patients had mild disease, 209 (18.1%) had moderate disease, and 16 (1.5%) cases had severe disease. One hundred and forty-nine (12.9%) cases had underlying diseases among the total cases; 56% of the patients who had severe disease had an underlying condition (p < 0.01). The need for hospitalization did not differ between patients who had an underlying condition and those who do not have (p = 0.38), but the need for intensive care was higher in patients who had an underlying condition (p < 0.01). Forty-seven (31.5%) of the cases having underlying conditions had asthma or lung disease (38 of them had asthma). Conclusions: To the best of our knowledge, this is one of the largest pediatric data about confirmed COVID-19 cases. Children from all ages appear to be susceptible to COVID-19, and there is a significant difference in symptomatology and laboratory findings by means of age distribution.

SARS-CoV-2 associated multisystem inflammatory syndrome in children (MIS-C). A single center's experience.

BACKGROUND: SARS-CoV-2 related multisystem inflammatory syndrome in children (MIS-C) is a newly defined clinical entity in pediatric ages resembles Kawasaki Disease or toxic shock syndrome. Here we aimed to raise awareness about this SARS-CoV-2 related syndrome. METHODS: Children diagnosed with MIS-C and followed in Pediatric Clinic between November 2020 and January 2021, were included in study. Data about patients' demographic characteristics, clinical and laboratory findings, treatment and outcomes were collected from medical records. RESULTS: The median age of 20 children with MIS-C was 80.5 months, 11 of them were male. The most common symptoms at admission were fever (100%), abdominal pain (70%), myalgia (50%), and rash (50%). Lymphopenia, elevated inflammatory markers and cardiac enzymes were their main laboratory findings. Cardiac involvement (90%) consisted of myopericarditis, valvulitis, left ventricular dysfunction, and coronary arteritis. Symptoms mimicking acute appendicitis and ileus were due to gastrointestinal involvement (50%). Macular rash on the trunk, erythema on upper eyelids were striking. Empiric antibiotics and intravenous immunoglobulin were used in all patients, glucocorticoids (90%), anti-thrombotic (65%) and vasoactive (45%) agents were used according to severity of disease. Response to IVIG treatment was poor, whereas glucocorticoids have dramatic affect. Seven patients (35%) were monitored in intensive care unit, none of them required intubation, mechanic ventilation or ECMO. The median recovery time, that is, the period when fever subside and inflammatory markers returned to normal was 9.5 days. CONCLUSIONS: Glucocorticoids has critical role in treatment of MIS-C, early recognition and treatment may decrease need for intensive care by providing rapid recovery.