Factors affecting disease severity of multisystem inflammatory syndrome in children

Purpose: Multisystem inflammatory syndrome that occurs after SARS-Cov-2 infection with fever, cardiogenic shock and hyperinflammation in children, can be life threatening. In this study, it was aimed to investigate the effects of the complaint and duration at diagnosis on the severity of multisystem inflammatory syndrome in children. Materials and methods: The medical records of 99 pediatric patients, who were diagnosed multisystem inflammatory syndrome between September 2020 and August 2021 according to Centers for Disease Control and Prevention, were evaluated retrospectively. Demographic features, initial findings, and admission time of patients were noted. Patients were categorized according to intensive care necessity. Results: The median age of the patients was 10 (2-18) and 62 (62.6%) of patients were male. The median duration before admission was 4 (1-10) days. All patients has fever, 81.8% had gastrointestinal and 75.8% had cardiovascular involvement at admission. The patients (56.6%) who were accepted as severe and moderate MIS-C required intensive care. Prolonged fever, delayed admission, cardiovascular involvement, high inflammatory markers, lymphopenia and thrombocytopenia were found to key parameters determining the need for intensive care. Conclusion: Multisystem inflammatory syndrome in children is a new disease characterized by fever, signs of inflammation and organ dysfunction associated with SARS-CoV-2 infection. Delayed admission, high cardiac and inflammatory markers at diagnosis increase the need for intensive care. © 2022, Pamukkale University. All rights reserved.

High Serum Transaminase Due to COVID-19 Infection

Although COVID-19 was first described as a respiratory disease, current data has shown that it is a disease with multisystemic involvement in-cluding respiratory, cardiovascular, gastrointestinal, neurological, hema-tological and immune systems. COVID-19 associated liver injury may be due to various potential mechanisms. Direct viral cytotoxic effect, im-mun mediated injury, drugs, ischemic injury due to hypoxia-hypoperfu-sion are among these mechanisms. Here we present a five year-old male patient who had no known history of liver disease admitted to our clinic due to elevated transaminase during the course of COVID-19 infection.

Evaluation of COVID-19 Vaccine Refusal in Healthcare Workers

Introduction: Healthcare workers are at the frontline of the COVID-19 pandemic and identified as a priority group for COVID-19 vaccines. We aimed to determine to COVID-19 vaccine acceptance rate and reasons for vaccine refusal in healthcare workers in our hospital. Materials and Methods: A questionnaire consisting of eight questions was applied to healthcare workers working at Ankara City Hospital for 7.5 months after the start of the COVID-19 vaccine in our country, including COVID-19 vaccination, previous years' influenza vaccination, and reasons for vaccine rejection. Results: Six hundred twenty-eight healthcare workers participated in the study. Two hundred fifty-six (40%) of them were doctors. Ninenty-nine of the participants were not vaccinated, the rate of vaccine rejection was 15.7%. The rate of vaccine rejection was the lowest (8.2%) among doctors, and lower among doctors working in the fields of COVID-19 (p= 0.041). While the rates of getting the COVID-19 vaccine were significantly higher in those who had regular or intermittent influenza vaccination every year in the previous years, those who had never had the influenza vaccine did not receive the COVID-19 vaccine either (p= 0.000). The most common reason for vaccine rejection was 'fear of the side effects of the vaccine' (24%), while 'I believe the disease is mild' and `I want to gain immunity naturally' were other common reasons. Conclusion: Vaccination of healthcare workers has gained even more importance in the COVID-19 pandemic, with both risky and severe working conditions and mortality rates. Determining the reasons for vaccine refusal, finding effective solutions, emphasizing the necessity of vaccination with scientific evidence are important for the control of the pandemic. Vaccination of health workers is a guide in community immunization.

Evaluation of COVID-19 Vaccine Refusal in Healthcare Workers.

Introduction: Healthcare workers are at the frontline of the COVID-19 pandemic and identified as a priority group for COVID-19 vaccines. We aimed to determine to COVID-19 vaccine acceptance rate and reasons for vaccine refusal in healthcare workers in our hospital. Material(s) and Method(s): A questionnaire consisting of eight questions was applied to healthcare workers working at Ankara City Hospital for 7.5 months after the start of the COVID-19 vaccine in our country, including COVID-19 vaccination, previous years' influenza vaccination, and reasons for vaccine rejection. Result(s): Six hundred twenty-eight healthcare workers participated in the study. Two hundred fifty-six (40%) of them were doctors. Ninenty-nine of the participants were not vaccinated, the rate of vaccine rejection was 15.7%. The rate of vaccine rejection was the lowest (8.2%) among doctors, and lower among doctors working in the fields of COVID-19 (p= 0.041). While the rates of getting the COVID-19 vaccine were significantly higher in those who had regular or intermittent influenza vaccination every year in the previous years, those who had never had the influenza vaccine did not receive the COVID-19 vaccine either (p= 0.000). The most common reason for vaccine rejection was 'fear of the side effects of the vaccine' (24%), while 'I believe the disease is mild' and 'I want to gain immunity naturally' were other common reasons. Conclusion(s): Vaccination of healthcare workers has gained even more importance in the COVID-19 pandemic, with both risky and severe working conditions and mortality rates. Determining the reasons for vaccine refusal, finding effective solutions, emphasizing the necessity of vaccination with scientific evidence are important for the control of the pandemic. Vaccination of health workers is a guide in community immunization.Copyright © 2022 Bilimsel Tip Yayinevi. All rights reserved.

Evaluation of COVID-19 Vaccine Refusal in Healthcare Workers

Introduction: Healthcare workers are at the frontline of the COVID-19 pandemic and identified as a priority group for COVID-19 vaccines. We aimed to determine to COVID-19 vaccine acceptance rate and reasons for vaccine refusal in healthcare workers in our hospital. Materials and Methods: A questionnaire consisting of eight questions was applied to healthcare workers working at Ankara City Hospital for 7.5 months after the start of the COVID-19 vaccine in our country, including COVID-19 vaccination, previous years' influenza vaccination, and reasons for vaccine rejection. Results: Six hundred twenty-eight healthcare workers participated in the study. Two hundred fifty-six (40%) of them were doctors. Ninenty-nine of the participants were not vaccinated, the rate of vaccine rejection was 15.7%. The rate of vaccine rejection was the lowest (8.2%) among doctors, and lower among doctors working in the fields of COVID-19 (p= 0.041). While the rates of getting the COVID-19 vaccine were significantly higher in those who had regular or intermittent influenza vaccination every year in the previous years, those who had never had the influenza vaccine did not receive the COVID-19 vaccine either (p= 0.000). The most common reason for vaccine rejection was 'fear of the side effects of the vaccine' (24%), while 'I believe the disease is mild' and 'I want to gain immunity naturally' were other common reasons. Conclusion: Vaccination of healthcare workers has gained even more importance in the COVID-19 pandemic, with both risky and severe working conditions and mortality rates. Determining the reasons for vaccine refusal, finding effective solutions, emphasizing the necessity of vaccination with scientific evidence are important for the control of the pandemic. Vaccination of health workers is a guide in community immunization.

Early Short-Term Use of Different Doses of Corticosteroid in Hospitalized Pediatric Patients with Coronavirus Disease 2019 Pneumonia

Objective Encouraged by reports of favorable outcomes following the use of corticosteroids in patients with moderate-to-severe coronavirus 2019 (COVID-19) pneumonia, we aimed to present our experience with early short-term corticosteroid use at our center in pediatric patients with COVID-19 pneumonia. Methods One hundred and twenty-nine pediatric patients were included in the study. Patients were divided into four groups according to the type and dose of corticosteroids given: Group 1 (those receiving dexamethasone 0.15 mg/kg/d);Group 2 (those receiving methylprednisolone 1 mg/kg/d);Group 3 (those receiving methylprednisolone 2 mg/kg/d);and Group 4 (those receiving pulse methylprednisolone 10-30 mg/kg/d). Results Of 129 patients, 19 (14.7%) patients were assigned to Group 1, 30 (23.3%) patients to Group 2, 30 (23.3%) patients to Group 3, and 50 (38.8%) patients to Group 4. Thirty-two (24.8%) patients were followed in the pediatric intensive care unit (PICU), of whom 13 (10%) required mechanical ventilation, and 7 (%5.4) died. In Group 4, the hospitalization length was significantly longer than in other groups (p < 0.001, p < 0.001). No significant difference was found among the groups in terms of mortality (p = 0.15). The most common comorbidity was obesity (33%). A significant association was found between the presence of comorbidity and mortality (p < 0.001). All patients who died had an underlying disease. Cerebral palsy was the most common underlying disease among the patients who died. Worsening of lymphopenia was significant in patients with severe COVID-19 pneumonia at the time of transfer to the PICU (p = 0.011). Conclusion Although children usually have a milder course of COVID-19 than adults, underlying diseases and obesity increase the severity of disease manifestations also in children. Further studies are needed to define the exact role of corticosteroids in COVID-19 patients. © 2022. Thieme. All rights reserved.

High serum transaminase due to COVID-19 infection

Although COVID-19 was first described as a respiratory disease, current data has shown that it is a disease with multisystemic involvement including respiratory, cardiovascular, gastrointestinal, neurological, hematological and immune systems. COVID-19 associated liver injury may be due to various potential mechanisms. Direct viral cytotoxic effect, immun mediated injury, drugs, ischemic injury due to hypoxia-hypoperfusion are among these mechanisms. Here we present a five year-old male patient who had no known history of liver disease admitted to our clinic due to elevated transaminase during the course of COVID-19 infection.

High Serum Transaminase Due to COVID-19 Infection

Although COVID-19 was first described as a respiratory disease, current data has shown that it is a disease with multisystemic involvement in-cluding respiratory, cardiovascular, gastrointestinal, neurological, hema-tological and immune systems. COVID-19 associated liver injury may be due to various potential mechanisms. Direct viral cytotoxic effect, im-mun mediated injury, drugs, ischemic injury due to hypoxia-hypoperfu-sion are among these mechanisms. Here we present a five year-old male patient who had no known history of liver disease admitted to our clinic due to elevated transaminase during the course of COVID-19 infection. Copyright © 2022 by Pediatric Infectious Diseases and Immunization Society.

Early Short-Term Use of Different Doses of Corticosteroid in Hospitalized Pediatric Patients with Coronavirus Disease 2019 Pneumonia

Objective Encouraged by reports of favorable outcomes following the use of corticosteroids in patients with moderate-to-severe coronavirus 2019 (COVID-19) pneumonia, we aimed to present our experience with early short-term corticosteroid use at our center in pediatric patients with COVID-19 pneumonia. Methods One hundred and twenty-nine pediatric patients were included in the study. Patients were divided into four groups according to the type and dose of corticosteroids given: Group 1 (those receiving dexamethasone 0.15 mg/kg/d);Group 2 (those receiving methylprednisolone 1 mg/kg/d);Group 3 (those receiving methylprednisolone 2 mg/kg/d);and Group 4 (those receiving pulse methylprednisolone 10-30 mg/kg/d). Results Of 129 patients, 19 (14.7%) patients were assigned to Group 1, 30 (23.3%) patients to Group 2, 30 (23.3%) patients to Group 3, and 50 (38.8%) patients to Group 4. Thirty-two (24.8%) patients were followed in the pediatric intensive care unit (PICU), of whom 13 (10%) required mechanical ventilation, and 7 (%5.4) died. In Group 4, the hospitalization length was significantly longer than in other groups (p < 0.001, p < 0.001). No significant difference was found among the groups in terms of mortality (p = 0.15). The most common comorbidity was obesity (33%). A significant association was found between the presence of comorbidity and mortality (p < 0.001). All patients who died had an underlying disease. Cerebral palsy was the most common underlying disease among the patients who died. Worsening of lymphopenia was significant in patients with severe COVID-19 pneumonia at the time of transfer to the PICU (p = 0.011). Conclusion Although children usually have a milder course of COVID-19 than adults, underlying diseases and obesity increase the severity of disease manifestations also in children. Further studies are needed to define the exact role of corticosteroids in COVID-19 patients. Copyright © 2022 Georg Thieme Verlag. All rights reserved.

Education of healthcare personnel working with pediatric patients during covid-19 pandemic within the framework of infection control

Objective: In the early stages of any epidemic caused by new emerging pathogens healthcare personnel is subject to a great risk. Pandemic caused by SARS-CoV-2, proved to be no exception. Many healthcare workers died in the early stages of pandemic due to inadequate precautions and insufficient protection. It is essential to protect and maintain the safety of healthcare personnel for the confinement of pandemic as well as continuity of qualified healthcare services which is already under strain. Educating healthcare personnel on appropiate use of personal protective equipment (PPE) is as essential as procuring them. Material and Methods: A survey is conducted on 4927 healthcare personnel working solely with pediatric patients from 32 different centers. Education given on PPE usage were questioned and analyzed depending on age, sex, occupation and region. Results: Among four thousand nine hundred twelve healthcare personnel from 32 different centers 91% (n= 4457) received education on PPE usage. Of those who received education only 36% was given both theoretical and applied education. Although there was no differences among different occupation groups, receiving education depended on regions. Conclusion: It is essential to educate healthcare personnel appropiately nationwidely for the continuity of qualified healthcare services during the pandemic.

Education of Healthcare Personnel Working with Pediatric Patients During COVID-19 Pandemic within the Framework of Infection Control

Objective: In the early stages of any epidemic caused by new emerging pathogens healthcare personnel is subject to a great risk. Pandemic caused by SARS-CoV-2, proved to be no exception. Many healthcare workers died in the early stages of pandemic due to inadequate precautions and insufficient protection. It is essential to protect and maintain the safety of healthcare personnel for the confinement of pandemic as well as continuity of qualified healthcare services which is already under strain. Educating healthcare personnel on appropiate use of personal protective equipment (PPE) is as essential as procuring them. Material and Methods: A survey is conducted on 4927 healthcare personnel working solely with pediatric patients from 32 different centers. Education given on PPE usage were questioned and analyzed depending on age, sex, occupation and region. Results: Among four thousand nine hundred twelve healthcare personnel from 32 different centers 91% (n=4457) received education on PPE usage. Of those who received education only 36% was given both theoretical and applied education. Although there was no differences among different occupation groups, receiving education depended on regions. Conclusion: It is essential to educate healthcare personnel appropiately nationwidely for the continuity of qualified healthcare services during the pandemic.