ABSTRACT
Background: COVID 19 infection in children is characterized by a clinical polymorphism, cutaneous manifestations being present in a significant percentage. Data reported in the literature described cutaneous manifestations in the form of measles rash, acral lesions, livedo reticularis and racemosa, acute urticaria, non-pruritic papulo-vesicular rash but also multisystemic inflammatory syndrome. Recognition of these lesions may suggest a diagnosis of acute SARS-COV2 infection, and when anamnestically detected, the rash provides evidence of a possible MIS-C in children that may quickly progress unfavorably. In some cases, newborns who belong to mothers affected by the new coronavirus have a temporary maculopapular rash, with a diffuse appearance, which disappears spontaneously but with an impact on the fetus. Method(s): In conducting this retrospective study we used data extracted from 320 medical records of pediatric patients diagnosed with acute SARS-COV 2 infection, in the Clinical Emergency Hospital for Children 'Sf. Maria' Iasi, Romania, between January 2020 -January 2021. Subsequently, the cases with cutaneous manifestations detected at the time of admission but also those present prior to admission and reported by the parents were selected. There were 3 pregnant patients who met the above criteria. Result(s): Cutaneous manifestations were present in 31% of patients. These had a favorable outcome in most cases. There were 7 cases of MIS-C in which the outcome was unfavorable (2 cases) and slowly favorable (5 cases). In these situations, the cutaneous manifestations lasted longer and in most cases, correlated with the severity of the disease. In pediatric pregnant patients, the outcome was favorable and did not have a negative impact on the newborn. Conclusion(s): Cutaneous manifestations are common in children with acute SARS-COV 2 infection and these appear to be represented by the location of the virus in the superficial blood vessels. The appearance of livedo-type lesions has been associated with microthrombotic processes and have been less frequently found but with a slowly favorable outcome. The diagnosis of MIS-C represents an emergency, cutaneous manifestations playing an important role in the early detection and treatment of these children.
ABSTRACT
Background: The pandemic period demonstrated the epidemiological and clinical evolutionary differences between adult vs. child with asthma infected with COVID 19. One of the challenges for pediatricians was the risk of losing control of asthma but also the risk of serious complications in the asthmatic child. The aim of the study was to study the level of control of asthma in children and on the other hand the incidence of its severe complications in the pandemic period 2020-2021 vs the non-pandemic period 2018-2019. Method(s): Retrospective study on asthmatic patients hospitalized in the period 2020-2021 in the Emergency Clinical Hospital for Children "St Mary" Iasi. Result(s): Total number of cases of asthma-2018- 219, 2019-174, 2020-193,2021- 148;annual asthma control level: controlled asthma: 2018-63%, 2019-59%, 2020-67%, 2021-54%, partially controlled asthma: 2018-29%, 2019-35%, 2020-26%, 2021 -38%, uncontrolled asthma: 2018-8%, 2019-6%, 2020-7%, 2021-8%;annual incidence of exacerbations: controlled asthma -2018: 23%, 2019-27%, 2020-11%, 2021 -14% of which with COVID 19 infection-2%;partially controlled asthma-2018: 41%, 2019-54%, 2020-32% of which with COVID 19 infection-21%;2021-58% of which with COVID19 infection- 42%;uncontrolled asthma-2018- 77%, 2019-73%, 2020-86% of which with COVID19 infection -82%, 2021-81% of which with COVID 19 infection-74%;annual incidence of severe asthma complications hospitalized ICU: 2018-3%, 2019-2%, 2020-5% of which 4% with COVID 19 infection,2021-4% all associated with COVID 19 infection. Conclusion(s): The control rate of asthma in children did not register significant differences between the 2 studied periods;The incidence of severe complications and exacerbations in the context of SARS Cov 2 infection increased during the pandemic period, especially in the partial and especially uncontrolled therapeutic form of asthma in children.
ABSTRACT
The global coronavirus disease pandemic of 2019 (COVID-19) has changed humanity, affecting millions of people with and without various ailments. While the majority of COVID-19 patients recover, a significant percentage of patients experience serious problems, and some even die. The respiratory system, specifically the alveoli, is primarily affected by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) due to direct destruction of infected epithelial cells and the mimicked inflammatory response by the host, resulting in respiratory distress and, in some cases, cardiovascular complications At the same time, pregnant women, not simply the general population, are frequently affected by SARS-CoV-2 infection. As a result, viral infection is linked to higher levels of inflammatory biomarkers including interleukin-6 and dimer D, which could affect severe clinical aspects like thrombosis and cardiac damage. COVID-19-complications are more likely in patients with preexisting cardiovascular or cerebrovascular illness with risk factors such as male gender, elderly patients, hypertension, diabetes, obesity. As a result, these factors have been associated to an increased risk of morbidity and mortality. Although the connections between COVID-19 and cardiovascular inflammation in pregnant women require more exploration, this modest review focuses on the probable pathways by which SARS-CoV-2 infects its host, particularly in pregnant women with cardiovascular illness.
ABSTRACT
The advent of coronavirus-2019 (COVID-19) as a global pandemic has prompted scientists to address an urgent need to clarify the disease's pathogenic mechanisms and treatment. Severe acute respiratory syndrome is the severe complication of coronavirus 2 (SARS-CoV-2). This novel coronavirus uses the angiotensin 2 converting enzyme (ACE2) as a key target for cell surface attachment as well as a possible entry point into the host cell. Thus, for clinical intervention, a correct understanding of the elements that can influence the expression and function of ACE2 in the healthy and diseased body is critical. Over 60% of all persons in Europe have comorbidities, necessitating the usage of a prescription drug. While prior research has focused on the use of reninangiotensin inhibitors (RAS) to regulate ACE2 expression, new evidence in the literature suggests that a number of commonly used medicines for hypertension, heart failure, diabetes, and hyperlipidemia may interfere with COVID-19 infection. The involvement of the renin-angiotensinaldosterone system in the pathology of various complications such as hypertension and chronic kidney disease, through its aldosterone-releasing effects, stimulates coronary vasoconstriction, especially in the already ischemic heart. We offer a brief discussion of the methods through which medications that interfere with the renin-angiotensin system may influence the viral entrance of SARS-CoV-2 into cells, in addition to their known therapeutic effects.