ABSTRACT
Background: Children seem to experience a less severe form of COVID-19 disease than adults, nevertheless, cases of severe infection have been described in a small proportion of patients, requiring hospitalization in 5-10% of cases. Among COVID-19 deaths 0,4% occurred in children and adolescents under 20 years of age. Most hospitalized children with acute COVID-19 had underlying conditions. Moreover, some children with previous COVID-19 infection, may later develop Multisystem Inflammatory Syndrome in Children (MIS-C), a rare but serious condition associated with COVID-19. These data suggest that a specific therapy is necessary in high-risk pediatric population, in order to prevent severe COVID-19, especially in children with underlying conditions. Antiviral paediatric data are currently very few Methods: We conducted a retrospective study on patients < 18 years of age who received Paxlovid (nirmatrelvir-ritonavir) for the treatment of mild-tomoderate COVID-19 at Bambino Gesu Children's Hospital from April 2022 to September 2022. Patients at high risk of progression to severe COVID-19 who had no need of supplemental oxygen received Paxlovid according to AIFA's indications for adults with the Informed Consent of relatives Results: 40 patients aged 1-18 years with confirmed SARS-CoV-2 infection were treated with Paxlovid (Tab 1)The average symptom duration was 4.2 days. No patient developed severe COVID-19 r All patients were treated within 5 days of symptom onset, Four patients received a longer course treatment (10 days) due to the persistence of symptoms combined with the presence of severe comorbidities .The mean time of viral shedding was 12.7 days, with a patient being persistently positive for 56 days. After Paxlovid initiation, only 5 patients (12.5%) experienced adverse reactions: Conclusion(s): Treatment with Paxlovid has proven to be safe. Further pharmacokinetic studies are required species for children < 5 years old.
ABSTRACT
AIM: We describe treatments of acute appendicitis at "Bambino Gesu" Children's Hospital during the peak of the Severe Acute Respiratory Syndrome-Coronavirus 2 (SARS-CoV-2) pandemic in Italy. MATERIAL AND METHODS: From March 1st to May 31st, all suspected appendicitis admitted to hospital entered this study. Following Institutional COVID19-protocol, between March 1st-21st, only patients with respiratory symptoms and/or history of recent travel to risk areas received nasopharyngeal swab. From March 22nd to May 31st, protocol was adapted to worsening epidemic conditions and a pre-triage area has been arranged to accommodate all patients undergoing the swab. RESULTS: 14 out of 53 patients were hospitalized between march 1st-21st, 39 from march 22nd to may 31st. swab was performed in 2 patient of first group and in all of second. DISCUSSION: During the study period, no covid19-contagion occurred in hospital staff by covid19-patients. CONCLUSION: Our covid19-protocol protected staff and patients allowing the maintenance of our standard of treatment. KEY WORDS: Appendicitis, Children, Covid19, Sars-cov-2.
ABSTRACT
Healthcare-Associated Infections (HAIs) and Antimicrobial Resistance (AMR) involve high costs both in health and economic terms for patients and health systems. Implementing Infection Prevention and Control (IPC) programs is critical to decrease infectious agents' transmission in healthcare settings. The aim of this study is to assess if the monitoring of Contact Precautions could decrease the incidence of Multi-Drug Resistant Organisms (MRDOs) infections. This pilot study was conducted in a teaching hospital in Rome. A checklist of 16 items was developed to assess the compliance to Contact Precautions in 11 hospital wards in which MRDOs were detected between November and December 2020. It was administered on-site both interviewing healthcare professionals and through direct observation. A paired t-test with α = 5% was used to compare the number of alert organisms in the first quarter of 2020 respect to the first quarter of 2021 before and after implementing the surveillance checklist. A total of 30 checklists were analyzed. The rate of compliance to Contact Precautions was high for the proper use of personal protective equipment (100%), the intensified room cleaning (100%) and the presence of isolation mark (100%), while it was low for the active screening of contacts (53%). Mean MDROs infections rate decreased from 4.94 to 4.37 for every 1000 hospitalization day, with an average decrease of 0.57. However, the paired t-test showed that there was no statistically significant difference between the mean number of MDROs infections before and after the implementation of the checklist (p > 0.05). Despite the good adherence to IPC program, the low infection rate decrease, is probably due to the impact of COVID-19 on the HAIs surveillance and prevention practices. Even if the check-list administration could be a useful tool to reduce MDROs infections, it should be associated to other prevention strategies during the COVID-19 pandemic in order to achieve a successful outcome. Key messages Preventing Healthcare-Associated Infections represents a priority public health challenge in order to improve patient safety and health system economic sustainability. The COVID-19 pandemic has shown that healthcare facilities should enhance efforts in their IPC programs to reduce Healthcare-Associated Infections.
ABSTRACT
Italy was the first country in Europe to face the coronavirus pandemic. The aim of the study was to analyze healthcare workers' (HCWs) level of information, practice, and risk perception towards COVID-19. We set up a cross-sectional study through SurveyMonkey<sup> R</sup> and distributed the link through Facebook and Whatsapp closed groups. The research instrument was a 31 items questionnaire distributed using Facebook and Whatsapp. It was conducted in Italy from February to May 2020. The study participants were general practitioners, pediatricians and other health professionals. A total of 958 participants were included: 320 (33.4%) general practitioners, 248 (25.9%) pediatricians and 390 (40.7%) other health professionals. The highest response rate was from Northern Italy (48.1%), followed by Central Italy (29.9%) and Southern Italy (22.0%). Less than a half (46%) of respondents felt they had a good level of information of COVID-19 case definition and of national prevention guidelines. Respondents reported to have changed their clinical practice;particularly, they increased the use of masks (87.1%, p < 0.001), disinfection and sanitization of doctors' offices (75.8%, p < 0.001), the use of protective glasses (71.2%, p < 0.001), alcoholic hand solution (71.2%, p < 0.001), and hand washing (31.8%, p = 0.028). HCWs are at high risk of infection;less than a half of them felt adequately prepared to face COVID-19 pandemic, so they need extensive information and awareness of the disease to take adequate precautionary measures, and they are crucial to disseminate good practices.