ABSTRACT
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.
ABSTRACT
The introduction of direct-acting antivirals (DAAs) for the treatment of chronic hepatitis C (CHC) has revolutionized the treatment of this disease. DAAs are almost 100% effective, have a good safety profile, with a short duration of therapy. The first DAAs were registered for children in 2017. Currently, the first real-life therapeutic program is conducted in Po-land, in which children aged 12-18 from all over Poland with chronic hepatitis C are treated using DAAs. Pandemic caused by severe acute respiratory syndrome coronavirus (SARS--CoV-2), which disrupted the functioning of the healthcare systems around the world, also affected the possibility of continuing therapeutic programs for chronic hepatitis C. This paper presents current recommendations on antiviral therapy in children with chronic hepatitis C during the COVID-19 pandemic, with particular emphasis on the role and cooper-ation between specialistic treatment centers, pediatricians, and primary care physicians. Copyright © 2020, Wydawnictwo Czelej Sp. z o.o.. All rights reserved.
ABSTRACT
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.
ABSTRACT
The coronavirus disease 2019 (COVID-19) pandemic has caused many problems in the health and education of children. For most children, the benefits of returning to school (im-proved access to education, fewer psychological problems, social interactions, economic aspects) outweigh the risks of COVID-19. The proper functioning of educational institutions is influenced by many factors depending on the type and capacity of the given school, the involvement of the management and the teaching staff, as well as the parents. Howev-er, the most important issue is to provide the authorities of educational institutions various possibilities of their functioning and available preventive measures, so that they can devel-op a management plan that will enable proper education and reduce the risk of COVID-19. The paper presents recommendations based on the latest recommendations of the World Health Organization (EHO), the United Nations Children's Fund (UNICEF), the Center for Disease Prevention and Control (CDC), the European Center for Disease Prevention and Control (ECDC), the European Agency for Safety and Health at Work (EU-OSHA) and scientific societies such as the American Academy of Paediatrics (AAP) and the European Academy of Pediatrics (EAP). The paper pays attention to the safe return of children to school, the organization of school work, and flu vaccinations. Another key issue discussed is the necessity of such political strategies of both central and local authorities, that will shape the well-being of our societies in the years to come, and that will make the world better for children, was also emphasized. Copyright © 2020, Wydawnictwo Czelej Sp. z o.o.. All rights reserved.
ABSTRACT
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.
ABSTRACT
INTRODUCTION Coronavirus disease-2019 (COVID-19) is an emerging disease with a wide spread, multiorgan involvement beyond pulmonary manifestations and unknown cardiovascular (CV) consequences. Therefore our aim was to assess the myocardial injury in patients recovered from COVID-19 in cardiovascular magnetic resonance (CMR). MATERIAL AND METHODS This was a multicenter, prospective study involving 5 Polish CMR labs with a high and long-standing experience in CV diseases. All the consecutive patients recovered from COVID-19 (confirmed in reverse transcription polymerase chain reaction [RT-PCR] test) and scheduled for CMR due to cardiac symptoms and a clinical suspicion of myocarditis were enrolled into the study. Patients with a history of previous cardiac injury were excluded from the study. All the patients underwent a contrast-enhanced CMR with conventional myocarditis protocol, including a late gadolinium enhancement (LGE). RESULTS The study group included 250 patients (age 45 ± 12 years old;53% females) with hypertension (24%), diabetes (6%), obesity (67%) and chronic pulmonary disease (6%) sent for cardiac imaging. The main single indications were: a suspicion of myocarditis (42%) or unexplained fatigue (22%) or arrhythmia (12%). Sixty patients had at least moderate COVID-19 requiring hospitalization and the CMR was performed up to 6 months after the disease with the majority of cases performed within 3 months (76%). The left ventricle (LV) function was normal in 91,5% (mean ejection fraction [EF] 62 ± 14%) with a moderate or severe dysfunction in 17 and 4 pts. The right ventricle (RV) function was normal in 85% (mean EF 56.2 ± 8%) with a borderline dysfunction (EF 45-50%) in 17 patients and dysfunction in 20 patients. The enlargement of ventricles (indexed to body surface area) was found in 19 (LV) and 7 (RV) cases. The pericardial effusion was found in 29 pts (11%) and active pericarditis in 21 cases (8%). Finally, active myocarditis and/or edema was noticed in 28 (11%) individuals and myocarditis-like LGE as a post-myocarditis injury in LV myocardium was found in 129 patients (51%). However, 79% of patients showed LGE limited to four or less segments and great majority of the injured segments (92%) revealed only a mild range of LGE (<25% of segment). There was a trend and a weak association between the time of recovery and number of injured segments (r = 0.1;P = 0.05) and no association between the number of injured segments and age (P = ns). CONCLUSIONS Half of the patients recovered from COVID-19 were found to have a myocarditis-like LGE injury in LV, mostly with limited myocardial extent and preserved systolic function. Every fifth of them revealed signs of active inflammation within perior myocardium. The long-term clinical consequences of our findings are unknown.
ABSTRACT
In this case report we present a nine-year-old boy from a family cluster with SARS-CoV-2 and influenza virus co-infection. He presented with the most common manifestations of COVID-19 reported in paediatric population - fever and cough. Severe acute respiratory syndrome coronavirus 2 infection was diagnosed by RT-PCR assay, and influenza type A by rapid immunochromatic assay testing. The course of disease was mild, despite co-infection with two viruses. In the time of COVID-19 pandemic testing for influenza, respiratory syncytial virus (RSV), and SARS-CoV-2 in suspected cases is essential for establishing a diagnosis, and it has important implications for patient management. © Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0)