SARS-CoV-2 reinfection in patients with a history of MIS-C. Presentation of two cases

Pediatric multisystem inflammatory syndrome (MIS-C) is a rare disease. It is unknown whether children who have recovered from MIS-C are at risk of MIS-C recurrence when reinfected with SARS-CoV-2. The objective of this study is to describe the cases of two girls who recovered from MIS-C and presented reinfection with SARS-CoV-2 without recurrence of MIS-C.

Sleep disturbances in children with cystic fibrosis and primary ciliary dyskinesia at the beginning and in the first year of COVID-19 pandemic

Introduction: During the COVID-19 pandemic, the lifestyle and sleep habits of children with chronic lung disease have changed. Aims and objectives: To evaluate the differences in sleep habits in the first year of the pandemic in children with cystic fibrosis (CF) and primary ciliary dyskinesia (PCD). Method(s): Primary caregivers of children with CF and PCD aged 3-16 years who were evaluated for sleep habits at the beginning of the pandemic were re-evaluated at the end of the first year of the pandemic. The Sleep Disturbance Scale for Children (SDSC) was used and questions were asked about sleep habits and weight changes during the first year of the pandemic. Result(s): Primary caregivers of 31 children with CF and 14 children with PCD were included in the study. The median age of the children were 10.0 (7.5-12.0) years, 42.2% of the children were female. The mean BMI of children with CF was 15.8+/-1.8, and 20.0+/-3.5 in children with PCD (p:0.001). The mean daily screen time was 2h (1-3) at the beginning and 5h (4-6) in the first year of the pandemic among children with CF, 2h (1-2.2) at the beginning and 5h (4.7-6) in the first year of the pandemic among children with PCD (p<0.001, p:0.001, respectively). There were no differences in terms of disorders of initiating and maintaining sleep, sleep breathing disorders, disorders of arousal, sleep-wake transition disorders, disorders of excessive somnolence, sleep hyperhidrosis scores between two groups during first year of pandemic. Conclusion(s): While daily screen time increased in children with CF and PCD, sleep disturbances and changes in daily habits continued in the first year of the pandemic.

TH-153. Clinical and Electrophysiological Characteristics of Guillain-Barre Syndrome Before and During the Pandemic: The Multicenter Istanbul Study

Introduction: This study was aimed to assess the clinical features and electrophysiological subtypes of patients with Guillain-Barre syndrome (GBS) in Istanbul, as well as to analyze the probably different characteristics of COVID-associated GBS. Method(s): From the patients who were admitted to the major hospitals in Istanbul between April 2019 and November 2021, those aged over 18 years and diagnosed as having GBS within the 21 days after the initial symptoms were selected for the study. Electrophysiologic examinations were performed twice within the first 6 weeks along with close clinical observation throughout the acute illness. The patients were divided into groups as those admitted in the pre-pandemic and pandemic periods. The characteristics of the patients who developed GBS after COVID infection (C-GBS) were also evaluated separately. Axonal and demyelinating subtypes were determined according to the previously described electrophysiologic criteria. Result(s): From 12 centers, 134 patients were included in the study. The number of patients diagnosed in the pre-pandemic and pandemic periods were 61 and 73, respectively. Eighteen patients developed C-GBS in the pandemic era. According to Uncini's criteria, 33.6% of the patients were classified as axonal GBS (29/45 patients had reversible conduction failure) and electrophysiological distinction could not be made in 8.2% of the patients. In the second electrophysiological examination performed in 116 patients, the subtype diagnosis was changed in 29 who had been classified according to the Hadden's criteria in the first examination and in 17 who had been categorized by using Rajabally's criteria. Sensory symptoms were found in all C-GBS patients and in only 67.9% of all patients diagnosed during the pandemic (p = 0.006). The frequency of demyelinating subtype was 83.3% in the C-GBS group, and this rate was 47.8% in the patients without recent COVID infection (p = 0.026). While MRC sum score, Hughes score, and modified Erasmus outcome score were not found to be different in the pre-pandemic and post-pandemic groups, C-GBS had lower Hughes score (<3) than the other patients diagnosed during the pandemic (p = 0.040). Conclusion(s): The frequency of axonal GBS in Istanbul, a large metropole inhabiting people from every region of Turkey, seems to be placed in between the values reported from high and low incidence countries. The second electrophysiologic examination is important for precise determination of the subtypes. C-GBS seems to cause more frequent sensory symptoms, demyelinating electrophysiologic characteristics, and moderate clinical features. Copyright © 2022

The Impact of The Coronavirus Disease 2019 Outbreak on The Quality of Life of Patients with Epilepsy

Objectives: We aimed to investigate the effects of the coronavirus disease 2019 (COVID-19) outbreak on the quality of life (QOL) of patients with epilepsy. Methods: A total of 104 epilepsy patients admitted to our hospital during October and November of 2019 were evaluated for their QOL using the QOL in Epilepsy-31 questionnaire. These assessments were repeated in July 2020 and August 2020 to evaluate the impact of the epidemic on the QOL of epilepsy patients in the same group. The data of the patients were analyzed in SPSS. Results: During the pandemic period, overall score values decreased significantly compared to the pre-pandemic period (p=0.049). Although most of the subscores worsened with the pandemic, the most significant deterioration was observed in emotional well-being (p=0.021). There were six patients (5.8%) whose seizure frequency increased during the pandemic period. In the multivariate analysis, the only parameter that predicted an increase in seizure frequency during COVID-19 was the overall score. Overall score had a positive correlation with educational level. Disease duration, age, marital status, and number of drugs used were found to be negatively correlated with the overall score of the patients. Conclusion: The COVID-19 epidemic causes a significant deterioration in QOL in patients with epilepsy. During epidemics such as COVID-19, clinicians should consider psychosocial factors. In patients with epilepsy, measures should be taken not only to control seizures but also to prevent deterioration in mental health and QOL.