UPDATED RECOMMENDATIONS FOR THE PREVENTION, DIAGNOSIS AND TREATMENT OF COVID-19 IN CHILDREN IN POLAND. RECOMMENDATIONS FOR PEDIATRICIANS AND GENERAL PRACTITIONERS (18.02.2022).

The course of COVID-19 in pediatric patients is usually mild or asymptomatic, but with the dominance of new virus variants, more children become symptomatic and require hospitalization. Since the end of 2021, a significant increase in the percentage of children infected with SARS-CoV-2 has been observed. This paper aimed to update the recommendations on the management of a child with COVID-19 in outpatient and inpatient settings. The current possibilities of prophylaxis, diagnostics, and antiviral treatment were discussed, indicating the limited availability of therapy for children. The mainstay of COVID-19 treatment in most pediatric patients is symptomatic and supportive treatment, as well as measures aimed at reducing the spread of SARS-CoV-2 infection.Copyright © 2022, Wydawnictwo Czelej Sp. z o.o.. All rights reserved.

GUIDELINES FOR IMMUNIZATION OF CHILDREN FOLLOWING MULTISYSTEM INFLAMMATORY SYNDROME IN CHILDREN (MIS-C).

Multisystem inflammatory syndrome in children, MIS-C is also referred to as a paediatric inflammatory multisystem syndrome, PIMS. It is a late complication of SARS-CoV-2 infec-tion. The underlying cause is immunological dysregulation, leading to severe inflammatory processes. Children with PIMS require hospital treatment, the use of immunomodulating drugs, and often intensive care. The high effectiveness of COVID-19 vaccination has been demonstrated in the prevention of MIS-C in adolescents. However, there are no explic-it vaccination recommendations for children who have already suffered from MIS-C. We present a summary of current knowledge on vaccinations against COVID-19 in the context of MIS-C and the Polish guidance of vaccinations for children following MIS-C.Copyright © 2022, Wydawnictwo Czelej Sp. z o.o.. All rights reserved.

Approach to a child with pediatric inflammatory multisystem syndrome with COVID-19 recommendations by the Polish pediatric society expert group and the national consultant in the field of pediatrics

Pediatric inflammatory multisystem syndrome associated with COVID-19 (PIMS) is a new entity, occurring in children and young adults, associated with the SARS-CoV-2 infection. The first cases of PIMS were found in Poland in May 2020. Since October 2020, a significant increase in the incidence of this new disease has been observed in Poland, which reflects the increased incidence of COVID-19 in adults. PIMS development results from dysregulation of the immune system occurring after 2-4 weeks after the SARS-CoV-2 in-fection. Diagnosis is based on a set of clinical features (including fever and features of mul-tiple organ damage) and laboratory abnormalities, with the exclusion of other causes. Most common complications involve cardiovascular system: myocarditis with decreased left ven-tricular ejection fraction, shock and/or coronary artery aneurysms. Mortality is around 2%. Appropriate management, including vital functions support and immunomodulating treat-ment, allows for a quick recovery of the vast majority of patients. The following document is a proposal for diagnostic and therapeutic management of children with suspected PIMS in Poland. Copyright © 2020, Wydawnictwo Czelej Sp. z o.o.. All rights reserved.

Management of a child with COVID-19 recommendations for pediatricians and family medicine physicians in primary healthcare and hospital settings

Recently, a significant increase in the number of patients infected with SARS-CoV-2 has been observed, including children. The available data indicate, that children are less sus-ceptible to SARS-CoV-2 infection compared to adults and may play a lesser role in the transmission of the infection. Children get infected much less frequently than adults, most of them do not have comorbidities, and in 80-90% of cases in children, the clinical course of COVID-19 is mild (oligo-or asymptomatic). The aim of this paper is to discuss the management of a child with COVID-19 in outpatient and inpatient settings. The current options and indications for antiviral therapy (including remdesivir), tociliziumab, and convalescent plasma, were discussed, indicating the limited availability of therapies in children. The mainstay of COVID-19 treatment in most pediatric patients is symptomatic and supportive treatment as well as measures aimed at reducing the spread of SARS-CoV-2 infection. Copyright © 2020, Wydawnictwo Czelej Sp. z o.o.. All rights reserved.

Guidelines for immunization of children following multisystem inflammatory syndrome in children

Multisystem inflammatory syndrome in children (MIS-C) is a late complication of SARS-CoV-2 infection, either symptomatic or asymptomatic. The underlying cause is immunological dysregulation, leading to severe inflammatory processes. Children with MIS-C require hospital treatment, the use of immunomodulating drugs, and often intensive care. COVID-19 vaccination is safe and highly effective in preventing not only severe COVID-19, but also MIS-C in adolescents. However, there are no explicit vaccination recommendations for children who underwent MIS-C. We present a summary of current knowledge on vaccinations against COVID-19 in the context of MIS-C. Moreover, we propose guidance concerning vaccinations for children following MIS-C.

Updated principles of prevention, diagnosis and treatment of COVID-19 in children in Poland - recommendations for paediatricians and family medicine doctors

Since late 2021, we have observed a significant increase in the proportion of children infected with SARS-CoV-2. The course of the disease in children is usually sparsely symptomatic or asymptomatic. However, the predominance of new virus variants makes children more likely to become symptomatically ill and require hospitalisation. This paper aims to update recommendations for managing a child with COVID-19 in out- and inpatient settings. Current options for prevention and antiviral treatment are discussed, noting the limited availability of therapy for children. In most children with COVID-19, the basis for treatment remains symptomatic and supportive therapy and measures to reduce SARS-CoV-2 infection spread.

Prophylactic vaccinations management in patients undergoing allergen immunotherapy – a review

Allergen immunotherapy (AIT) is the only casual method of allergy treatment. It is based on regular administration of a gradually increasing dose of an allergen to induce immunological tolerance to a particular sensitising factor. Due to proven efficacy, including preventive effect as well as favourable safety profile, it should be widely applicable, particularly among older children and adolescents. While the number of patients suffering from non-communicable diseases, including allergies, is rising, there is a false im-pression that the impact of infectious diseases can be disregarded. Thanks to prophylactic vaccines, many infectious diseases that used to be a threat to people’s lives have been forgotten. In order to tackle familiar and emerging infectious diseases (such as COVID-19), there is a need to keep in mind vaccinations in all age groups. As allergen immunotherapy and prophylactic vaccines affect the immunologic system, performing both interventions in one patient may raise concerns about safety and effectiveness. However, a large-scale study on this topic has not been performed to date. This article summarises immunological responses occurring after contact with pathogens and allergens as well as describes reactions triggered by prophylactic vaccines and AIT. What is more, possible interference of receiving both a prophylactic vaccine and AIT is discussed. © by Wydawnictwo Continuo.

Approach to a child with pediatric inflammatory multisystem syndrome with covid-19 recommendations by the Polish pediatric society expert group update february 2021

Pediatric inflammatory multisystem syndrome associated with COVID-19 (PIMS) is a new entity, occurring in children and young adults, associated with the SARS-CoV-2 infection. The first cases of PIMS were found in Poland in May 2020. Since October 2020, a signi-ficant increase in this new disease incidence has been observed in Poland, reflecting the increased incidence of COVID-19 in the pediatric population. PIMS development results from dysregulation of the immune system occurring after ca. 4 weeks after the SARS-CoV-2 infection. Diagnosis is based on criteria: a set of clinical features (including fever and features of multiple organ damage) and elevated inflammatory markers, excluding other cau-ses. The most common complications involve the cardiovascular system: heart damage with decreased left ventricular ejection fraction, shock, and coronary artery abnormalities. Mortality is around 2%. Appropriate management, including vital functions support and immunomodulating treatment, allows for a quick recovery of the vast majority of patients. The following document is a guideline for the diagnostic and therapeutic management of children with suspected PIMS in Poland. © 2021, Wydawnictwo Czelej Sp. z o.o.. All rights reserved.

Approach to a child with Multisystem Inflammatory Syndrome associated with COVID-19. Recommendations by the Polish Paediatric Society Expert Group. Update - February 2021

Multisystem Inflammatory Syndrome in Children (MIS-C) is a new clinical entity occurring in children and young adults, which is associated with the SARS-CoV-2 infection. The first cases of MIS-C were diagnosed in Poland in May 2020. Since October 2020, a significant increase in the incidence of this new disease has been observed in Poland, reflecting the increased incidence of COVID-19 in the paediatric population. MIS-C develops as a result of dysregulation of the immune system occurring 4 weeks after the SARS-CoV-2 infection. Diagnosis is based on the following criteria: a set of clinical features (including fever and signs of multiple organ damage) and elevated inflammatory markers, with exclusion of other causes. The most common complications involve the cardiovascular system: acute myocardial damage with reduced left ventricular ejection fraction, shock, and coronary artery abnormalities and arrhythmias. Mortality in Western Europe and the United States is around 1-2%. Appropriate management, including vital function support and immunomodulatory treatment, allows for a quick recovery in the vast majority of patients. This document is an updated guideline for the diagnostic and therapeutic management of children with suspected MIS-C in Poland. The most important changes concern treatment, steroid therapy, and antiplatelet therapy in particular.

Recommendations for primary healthcare doctors for the management of acute respiratory infections in children during the SARS-CoV-2 pandemic – Covid compass

Respiratory tract infections are one of the most common health problems among children during the winter season. Viruses are responsible for a vast majority of respiratory tract infections. Bacterial infections usually affect specific locations (for example, otitis media, nasal sinuses, lungs or, sometimes, throat) and are more frequent in risk groups, or they can complicate a previous viral infection. During the ongoing COVID-19 pandemic, it is essential to consider SARS-CoV-2 as a possible causative agent for any infectious disease affecting the respiratory tract. Recommendations aim to establish an optimal manner for management of respiratory infections. Any patient should be pre-screened by telephone consultation to reduce the risk to healthcare workers. Regardless of the infection's etiology and location, the top priority should be to determine the patient's general condition and the place of treatment and treatment method (hospital, home, symptomatic, antimicrobial). For epidemic reasons, it is advisable to exclude infection with the new coronavirus in the case of a doubtful clinical picture, as well as patients with SARS-CoV-2 infection. The primary purpose of any consultation is to choose the best treatment for the patient (ambulatory/hospital/symptomatic/antimicrobial), and it is not always crucial to know the exact etiology of the infection. Due to epidemiologic reasons, it is reasonable to exclude SARS-CoV-2 infection in every patient with atypical symptoms or after contact with a person infected with SARS-CoV-2. © Wydawnictwo Continuo.

The COVID-19 pandemic lockdown causes a decrease in the number of cases of other infectious diseases in Poland

Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a causative agent of the ongoing pandemic. It can be transmitted among people via respiratory droplets generated while talking, coughing, or sneezing by an infected person. There is no known specific treatment or vaccine to prevent the coronavirus disease 2019 (COVID-19). The most effective way of limiting the spread of the virus is physical distancing combined with proper respiratory and hand hygiene. Many countries, including Poland, introduced restrictions in everyday life to control the pandemic. However, it has not been examined how these measures change the incidence of other infectious diseases. Material and methods: Data from biweekly reports on infectious diseases and poisonings published by National Institute of Public Health – National Institute of Hygiene (Narodowy Instytut Zdrowia Publicznego – Państwowy Zakład Higieny) were collected. The incidence of common and serious infectious diseases in the period 1.01.2020 to 15.05.2020 was evaluated and compared to the corresponding period from the year 2019. Results: A significant drop in the number of reported infectious diseases can be seen in the middle and at the end of March. These observations correlate with the time of introducing social distancing in Poland. The total number of reported cases, with the exception of pertussis, in the examined period is lower than in the year 2019. Conclusions: The results indicate that keeping physical distance and proper hygiene undoubtedly reduce the transmission of various infectious agents among people. However, there a long-term study is needed to observe trends in incidence of selected infectious diseases. It can be assumed that before the pandemic Polish society was not aware of the importance of social distancing and did not make use of hygiene as a method of infectious disease prevention. Further education should be continued and intensified. © 2020 Termedia Publishing House Ltd.. All rights reserved.