ABSTRACT
OBJECTIVE: To study clinical characteristics and outcome of children with admitted to a paediatric hospital in Mumbai, India. METHODS: Review of medical records of 969 children admitted between 19 March and 7 August, 2020, to assess the clinico-demographic characteristics, disease severity and factors predicting outcome in COVID-19 children. Variables were compared between children who were previously healthy (Group I) and those with co-morbidity (Group II). RESULTS: 123 (71 boys) children with median (IQR) age of 3 (0.7- 6) years were admitted, of which 47 (38%) had co-morbidities. 39 (32 %) children required intensive care and 14 (11.4%) died. Male sex, respiratory manifestation, oxygen saturation <94%;at admission, mechanical ventilation, inotrope, hospital stay of <10 days were independent predictors of mortality. Oxygen saturation <94% at admission (OR 35.9, 95% CI 1.5-856) and hospital stay <10 days (OR 9.1, 95% CI 1.04-99.1) were significant. CONCLUSION: COVID-19 in children with co-morbidities causes severe disease. Association of mortality with oxygen saturation by pulse oximeter <94% on admission, and hospital stay <10 days, needs further evaluation.
ABSTRACT
OBJECTIVE: To study clinical characteristics and outcome of children with admitted to a paediatric hospital in Mumbai, India. METHODS: Review of medical records of 969 children admitted between 19 March and 7 August, 2020, to assess the clinico-demographic characteristics, disease severity and factors predicting outcome in COVID-19 children. Variables were compared between children who were previously healthy (Group I) and those with co-morbidity (Group II). RESULT: 123 (71 boys) children with median (IQR) age of 3 (0.7- 6) years were admitted, of which 47 (38%) had co-morbidities. 39 (32 %) children required intensive care and 14 (11.4%) died. Male sex, respiratory manifestation, oxygen saturation <94% at admission, mechanical ventilation, inotrope, hospital stay of <10 days were independent predictors of mortality. Oxygen saturation <94% at admission (OR 35.9, 95% CI 1.5-856) and hospital stay <10 days (OR 9.1, 95% CI 1.04-99.1) were significant. CONCLUSION: COVID-19 in children with co-morbidities causes severe disease. Association of mortality with oxygen saturation by pulse oximeter <94% on admission, and hospital stay <10 days, needs further evaluation.
ABSTRACT
At present, the whole world is going through the coronavirus disease 2019 (COVID-19) pandemic, which is taking its toll on healthcare workers (HCWs) as well as patients. In fact, HCWs are not only at risk of acquiring the disease but also suffer from various problems related to prolonged work in a stressful situation with full personal protective equipment (PPE), which may lead to adverse cutaneous effects We used search engines to look for data on the dermatological problems in HCWs owing to frequent handwashing and to the use of PPE. The search terms used were 'COVID-19', 'healthcare worker', 'dermatoses', 'personal protective equipment', and 'hand hygiene.' Healthcare workers are susceptible to various dermatoses caused by multiple confluent factors including working for long hours in PPE, which is usually snug-fitting and includes headgear, masks, goggles, gloves, boot covers, and surgical gowns. They also are subjected to frequent hand cleansing, often more than 20 times a day. All this has led to various dermatoses caused by friction, pressure, humidity, irritation, as well as allergic responses to the equipment used in almost all those who work for prolonged periods in PPE, as shown by various case series and reports. Steps are being formulated to minimize these adverse cutaneous effects through appropriate measures that must be taken by HCWs. Healthcare workers are susceptible to various dermatoses caused by excessive hand hygiene practices and prolonged usage of PPE. Proper counseling minimizes the morbidity by promoting protective measures.
ABSTRACT
Phototherapy is an essential and useful therapeutic procedure wherein the properties of ultraviolet light are used to cure certain dermatological conditions like psoriasis, vitiligo, and atopic dermatitis. This is usually an office-based procedure dependent on the accurate use of sophisticated phototherapy units. Since the advent of the COVID-19 pandemic, phototherapy practices were shut down as they were considered as non-essential services. Here, we attempt to analyze how COVID-19 has affected phototherapy and seek to formulate a working guideline for safe phototherapy operations in these taxing circumstances. We used search engines like PubMed, Google Scholar, and Embase to retrieve articles and guidelines regarding phototherapy in dermatology, using the pertinent search terms. There was a paucity of data with only a couple of research letters and guidelines by the British Association of Dermatology and the American Academy of Dermatology, as well as general guidelines issued by the Indian Association of Dermatologists, Venereologists and Leprologists. After a careful study of various modalities of phototherapy and viral inactivation, we collated a set of guiding instructions toward the appropriate utilization of phototherapy amidst the COVID-19 pandemic. Phototherapy is a viable option for selected patients even amidst the COVID-19 pandemic. However, local and national guidelines have to be followed while selecting the patient and operating the phototherapy machine with adequate protective measures for both the patient and the healthcare worker. Home phototherapy units and PUVASOL are good options for those patients who are unable to attend the phototherapy center due to various reasons.