Acute acral eruptions in children during the COVID-19 pandemic: Characteristics of 103 children and their family clusters.

BACKGROUND: A marked increase in frequency of acute acral eruptions (AAE) was observed in children during the COVID-19 pandemic in the spring period. OBJECTIVES: In this observational multicenter study, based on children with AAE, we aimed to assess the proportion of household members possibly infected by SARS-CoV-2. METHODS: We collected data from all children observed with AAE, prospectively from April 7, 2020 to June 22, 2020, and retrospectively since February 28, 2020. The primary outcome was the household infection rate, defined as the proportion of family clusters having at least one member with COVID-19 infection other than the child with AAE ("index child"). The definition of a case was based on characteristic clinical signs and a positive PCR or serology. RESULTS: The study included 103 children in 10 French departments and in Quebec. The median age was 13 years and the interquartile range [8-15], with a female-to-male ratio of 1/1.15. In children with AAE, all PCR tests were negative (n=18), and serology was positive in 2/14 (14.3%) cases. We found no significant anomalies in the lab results. A total of 66 of the 103 families (64.1%) of included children had at least one other infected member apart from the index child. The total number of household members was 292, of whom 119 (40.8%) were considered possibly infected by SARS-CoV-2. No index children or households exhibited severe COVID-19. DISCUSSION: Among the 103 households included, 64.1% had at least one infected member. Neither children with AAE nor their households showed severe COVID-19.

Risk of morbidity and mortality inCOVID-19 patients with cancer

Introduction: Morbidity and mortality of cancer patients with COVID-19 have not been examined. The goal of thisanalysis was to compare the demographics and clinical characteristics of COVID-19 cancer patients to the rest ofCOVID-19 patients and assess whether cancer is associated with morbidity or mortality. Methods: COVID-19-positive patients with an inpatient or emergency encounter at the Mount Sinai Health Systembetween 03/01/20-05/27/20 were included in the analysis. Patients were compared across cancer status(noncancer, non-solid cancers, and solid cancers) on demographics and clinical characteristics. Multivariable logisticregressions were used to model the associations of cancer status with sepsis, acute venous thromboembolism, andmortality. Results: There were 5,516 COVID-19 positive patients included, 96 (1.7%) with non-solid cancers and 325 (5.8%)with solid cancers. Those with solid cancers were significantly older (mean: 70.9 vs. 63.8 and 63.2 years) and morelikely to be non-Hispanic Black (26.5% vs. 23.9% and 22.9%) than noncancer and non-solid cancers patients. Those with cancer had significantly more additional comorbid conditions (42.7% and 49.8% ≥2 comorbidities for non-solidand solid cancers, vs. 30.4% for noncancer). Platelets (mean [noncancer]: 223.8, mean [non-solid cancer]: 182.6, mean [solid cancer]: 218.3 × 10 /μL), white blood cell count (mean [noncancer]: 8.4, mean [non-solid cancer]: 6.7, mean [solid cancer]: 8.0 × 10 /μL), hemoglobin (mean [noncancer]: 13.1, mean [non-solid cancer]: 11.2, mean [solidcancer]: 12.0 g/dL), and red blood cell count (mean [non-cancer]: 4.5, mean [non-solid cancer]: 3.7, mean [solid cancer]: 4.1 × 10 /μL) were significantly lower in cancer patients, and lowest in those with non-solid cancers. Afteradjustment and compared to noncancer patients, those with cancer had significantly higher risk of acute venousthromboembolism (OR : 1.77, 95% CI: 1.01-3.09) and sepsis (OR : 1.34, 95% CI: 1.09-1.64). There was nosignificant difference in mortality (OR : 1.02, 95% CI: 0.81-1.29). There was no significant difference in alloutcomes for solid and non-solid cancer types. Conclusion: COVID-19 patients with cancer, particularly solid tumors, are significantly older, with morecomorbidities than those without cancer. There was no statistically significant difference in mortality for COVID-19patients with cancer, but a significantly higher risk of thromboembolism and sepsis. Further research into the effectthat cancer treatments may have in inflammatory and immune responses to COVID is warranted.