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1.
Journal of Infection ; 2022.
Article in English | ScienceDirect | ID: covidwho-1814751

ABSTRACT

Background Variations in the ACE2 activity in saliva could explain the striking differences of susceptibility to infection and risk of severe disease. Methods We analyze the activity of ACE2 in saliva in different population groups across a wide age range and disease status during April to June 2020, and we establish differences between infected people and participants considered resistant (highly exposed healthcare workers and children who cohabited with parents with COVID-19 without isolation and remain IgG negative). Results We included 74 adults, of which 47 (64%) were susceptible and 27 (36%) were resistant, and 79 children, of which 41 (52%) were susceptible and 38 (48%) were resistant. Resistant adults have significantly lower ACE2 activity in saliva than susceptible adults and non-significant higher values than susceptible and resistant children. ACE2 activity is similar in the susceptible and resistant pediatric population (p=0.527). In contrast, we observe an increase in activity as the disease's severity increases among the adult population (mild disease vs. severe disease, 39 vs. 105 FU, p=0.039;severe disease vs. resistant, 105 vs. 31 FU, p<0.001). Conclusions using an enzymatic test, we show that ACE2 activity in saliva correlates with the susceptibility to SARS-Cov-2 infection and disease severity. Children and adults with low-susceptibility to SARS-Cov-2 infection showed the lowest ACE2 activity. These findings could inform future strategies to identify at-risk individuals.

3.
Emerg Infect Dis ; 28(3): 752-753, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1725319

ABSTRACT

Although human infections caused by Mycobacterium mageritense are rare, there are some case reports involving sinusitis, pneumonia, and hospital-acquired infections in adults. We report a case of lymphadenitis caused by M. mageritense in a child in Spain.


Subject(s)
Lymphadenitis , Mycobacteriaceae , Mycobacterium Infections, Nontuberculous , Mycobacterium Infections , Pneumonia , Adult , Child , Family , Humans , Lymphadenitis/diagnosis , Lymphadenitis/microbiology , Mycobacterium Infections, Nontuberculous/diagnosis , Mycobacterium Infections, Nontuberculous/drug therapy , Mycobacterium Infections, Nontuberculous/microbiology
4.
J Pediatric Infect Dis Soc ; 2022 Feb 21.
Article in English | MEDLINE | ID: covidwho-1709612

ABSTRACT

The SARS-CoV-2 pandemic has caused an increase in antibiotic use in different settings. We describe the antibiotic prescribing prevalence, associated factors and trends, as well as concomitant bacterial infections in children hospitalized with COVID-19 or multisystemic inflammatory syndrome related to SARS-CoV-2 in Spain.

5.
J Chem Inf Model ; 61(12): 6094-6106, 2021 12 27.
Article in English | MEDLINE | ID: covidwho-1701672

ABSTRACT

SARS-CoV-2 is a type of coronavirus responsible for the international outbreak of respiratory illness termed COVID-19 that forced the World Health Organization to declare a pandemic infectious disease situation of international concern at the beginning of 2020. The need for a swift response against COVID-19 prompted to consider different sources to identify bioactive compounds that can be used as therapeutic agents, including available drugs and natural products. Accordingly, this work reports the results of a virtual screening process aimed at identifying antiviral natural product inhibitors of the SARS-CoV-2 Mpro viral protease. For this purpose, ca. 2000 compounds of the Selleck database of Natural Compounds were the subject of an ensemble docking process targeting the Mpro protease. Molecules that showed binding to most of the protein conformations were retained for a further step that involved the computation of the binding free energy of the ligand-Mpro complex along a molecular dynamics trajectory. The compounds that showed a smooth binding free energy behavior were selected for in vitro testing. From the resulting set of compounds, five compounds exhibited an antiviral profile, and they are disclosed in the present work.


Subject(s)
Biological Products , COVID-19 , Antiviral Agents/pharmacology , Biological Products/pharmacology , Humans , Molecular Docking Simulation , Molecular Dynamics Simulation , Peptide Hydrolases , Protease Inhibitors/pharmacology , SARS-CoV-2
6.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-307653

ABSTRACT

The prevalence of asthma in children in Europe is an average of 10.3%. The role of asthma as a risk factor for COVID-19 in children is unknown. Our aim was to study the prevalence of asthma in children with SARS-CoV-2 infection and to compare them in hospitalized children and those with mild ambulatory symptoms. We conducted an observational retrospective study in 99 children (between 3- 17 years of age) with a confirmed SARS-CoV-2 infection between March and December 2020. The existence of a history of asthma was investigated using the validated ISAAC questionnaire and clinical data on COVID-19 were compiled. The median age was 10 years (IQR=13-5), and 60/99 (60.6%) patients had mild infections controlled as outpatient, while 39/99 (39.4%) required admission. The prevalence of asthma ─affirmative response to question 6 of the ISAAC questionnaire─ was 11.1% (11/99). The prevalence of asthma in children who required admission increased to 17.9% and to 21.4% in patients requiring PICU, while in outpatients children was 6.7% (p=0.079). We found a significant association between the use of salbutamol during the last year and the need for admission (23.1% in hospitalized patients vs 3.3% in outpatients;OR= 8.7, 95%CI 1.7-42.8). Likewise, budesonide treatment in the last year (17.9% vs 1.7%, OR= 12.9, 95%CI 1.5-109.5) was also a risk factor for admission. Therefore, a history of asthma was not a risk factor for SARS-CoV-2 infection in our series, but active asthma could be a risk factor for severity and need for hospitalization for COVID-19 in children

7.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-307024

ABSTRACT

Fever without source (FWS) in infants is a frequent cause of consultation at the emergency department and the emergence of SARS-CoV-2 could affect the approach to those infants. The aim of this study is to define the clinical characteristics and rates of bacterial coinfections of infants < 90 days with FWS as the first manifestation of SARS-CoV-2 infection. This is a cross-sectional study of infants under 90 days of age with FWS and positive SARS-CoV2 PCR in nasopharyngeal swab/aspirate, attended at the emergency departments of 49 Spanish hospitals (EPICO-AEP cohort) from March 1st to June 26th, 2020. Three hundred and thirty-three children with COVID-19 were included in EPICO-AEP. A total of 67/336 (20%) were infants less than 90 days old, and 27/67(40%) presented with FWS. Blood cultures were performed in 24/27(89%) and were negative in all but one (4%) who presented a Streptococcus mitis bacteremia. Urine culture was performed in 26/27(97%) children and was negative in all, except in two (7%) patients. Lumbar puncture was performed in 6/27(22%) cases, with no growth of bacteria. Two children had bacterial coinfections: 1 had UTI and bacteremia, and 1 had UTI. C-reactive was protein over 20 mg/L in two children (one with bacterial coinfection), and procalcitonin was normal in all. One child was admitted to the Pediatric Intensive Care Unit because of apnea episodes. No patients died. Conclusion: FWS was frequent in infants under 90 days of age with SARS-CoV-2 infection. Standardized markers to rule out bacterial infections remain useful in this population, and the outcome is generally good.

8.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-323050

ABSTRACT

Background: Patients with rheumatic diseases have been considered at risk of COVID-19. A significant percentage of infections in children are asymptomatic or mild and can go unnoticed. This study aims to describe the seroprevalence of SARS-CoV-2 in a cohort of children with rheumatic diseases and assess possible risk factors. Methods: : A cross-sectional study was performed in a pediatric rheumatology unit from a reference hospital in Madrid, from September 2020 to February 2021. Serology of SARS-CoV-2 was performed at the same time as their routine laboratory tests, and a specific questionnaire was completed by parents. Demographics, treatment and disease activity from laboratory-confirmed COVID-19 patients were compared to the data of patients without laboratory-confirmed COVID-19. Findings: A total of 105 children were included. SARS-CoV-2 infection was demonstrated in 27 patients (25.7%): 6 PCR and 21 positive IgG serology. The mean age was 11.8 years , and the majority of the patients were females (72.4%). Most of the children were diagnosed with juvenile idiopathic arthritis (JIA) (70.3%;19/27), followed by PFAPA (11.1%;3/27). Immunosuppresive treatment was given in 88% of cases (24/27). Overall, 44.4% (12/27) of infected patients were asymptomatic. Three patients required hospital admission because of COVID-19, however none of them required oxygen supplementation. A total of 66.7% (18/27) of patients did not require any treatment or medical assistance. The seroprevalence in our cohort was 20% in contrast to the 7.7% population seroprevalence observed during the same study period in Spanish children. SARS-CoV-2 confirmed children with positive IgG or PCR were less frequently in remission (52% vs 72%;p 0.014). Moderate disease activity and treatment with oral corticosteroids were associated with higher risk for COVID-19 (OR 5.05;CI 95%: 1.56 - 16.3 and OR 4.2;CI 95%: 1.26 - 13.9 respectively). Conclusions: In a cohort of pediatric patients with rheumatic disease and immunosuppressive therapy, moderate disease activity and oral corticosteroids were associated with COVID-19 positive patients. Seroprevalence was significantly higher compared to the same age healthy population. The clinical manifestations were mild and there were no severe infections among the patients.

9.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-322383

ABSTRACT

Background: We aimed to identify the spectrum of disease in children with COVID-19, and the risk factors for admission in paediatric intensive care units (PICUs). Methods: : We conducted a multicentre, prospective study of children with SARS-CoV-2 infection in 76 Spanish hospitals. We included children with COVID-19 or multi-inflammatory syndrome (MIS-C) younger than 18 years old, attended during the first year of the pandemic. Results: We enrolled 1 200 children. A total of 666 (55.5%) were hospitalized, and 123 (18.4%) required admission to PICU. Most frequent major clinical syndromes in the cohort were: mild syndrome (including upper respiratory tract infection and flu-like syndrome, skin or mucosae problems and asymptomatic), 44.8%;bronchopulmonary syndrome (including pneumonia, bronchitis and asthma flare), 18.5%;fever without a source, 16.2%;MIS-C, 10.6%;and gastrointestinal syndrome, 10%. In hospitalized children, the proportions were: 28.5%, 25.7%, 16.5%, 19.1% and 10.2%, respectively. Risk factors associated with PICU admission were MIS-C (odds ratio [OR]: 37.5,95% CI 22.7 to 57.8), moderate or severe liver disease (OR: 9,95% CI 1.6 to 47.6), chronic cardiac disease (OR: 4.8,95% CI 1.8 to 13) and asthma or recurrent wheezing (OR: 2.8,95% CI 1.3 to 5.8). However, asthmatic children were admitted into the PICU due to MIS-C or pneumonia, not due to asthma flare. Conclusion: Hospitalized children with COVID-19 usually present as one of five major clinical phenotypes of decreasing severity. Risk factors for PICU include MIS-C, elevation of inflammation biomarkers, asthma, moderate or severe liver disease and cardiac disease.

10.
Euro Surveill ; 26(45)2021 Nov.
Article in English | MEDLINE | ID: covidwho-1630353

ABSTRACT

We report a rapid increase in enterovirus D68 (EV-D68) infections, with 139 cases reported from eight European countries between 31 July and 14 October 2021. This upsurge is in line with the seasonality of EV-D68 and was presumably stimulated by the widespread reopening after COVID-19 lockdown. Most cases were identified in September, but more are to be expected in the coming months. Reinforcement of clinical awareness, diagnostic capacities and surveillance of EV-D68 is urgently needed in Europe.


Subject(s)
COVID-19 , Enterovirus D, Human , Enterovirus Infections , Enterovirus , Myelitis , Respiratory Tract Infections , Communicable Disease Control , Disease Outbreaks , Enterovirus D, Human/genetics , Enterovirus Infections/diagnosis , Enterovirus Infections/epidemiology , Europe/epidemiology , Humans , Myelitis/epidemiology , SARS-CoV-2
11.
Enferm Infecc Microbiol Clin ; 2021 Dec 22.
Article in Spanish | MEDLINE | ID: covidwho-1611702

ABSTRACT

INTRODUCTION: The epidemiology of respiratory syncytial virus (RSV) infection has changed during the COVID-19 pandemic. Our objectives were to describe the RSV epidemic in 2021 and compare it with the previous years to the pandemic. METHODS: Retrospective study performed in Madrid (Spain) in a large paediatric hospital comparing the epidemiology and clinical data of RSV admissions during 2021 and the two previous seasons. RESULTS: 899 children were admitted for RSV infection during the study period. During 2021, the outbreak peaked in June and the last cases were identified in July. Previous seasons were detected in autumn-winter. The number of admissions in 2021 was significantly lower than in previous seasons. There were no differences between seasons regarding age, sex or disease severity. CONCLUSION: RSV hospitalizations during 2021 in Spain moved to summer with no cases in autumn and winter 2020-2021. Unlike other countries, clinical data were similar between epidemics.

12.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-296904

ABSTRACT

Pneumonia is a frequent manifestation of COVID-19 in hospitalized children. Methods The study involved 80 hospitals in the SARS-CoV-2 Spanish Pediatric National Cohort. Participants were children <18 years, hospitalized with SARS-CoV-2 community-acquired pneumonia (CAP). We compared the clinical characteristics of SARS-CoV-2-associated CAP with CAP due to other viral etiologies from 2012 to 2019. Results In total, 151 children with SARS-CoV-2-associated CAP and 138 with other viral CAP included. Main clinical features of SARS-CoV-2-associated CAP were cough 117/151(77%), fever 115/151(76%) and dyspnea 63/151(46%);22/151(15%) patients were admitted to a pediatric intensive care unit (PICU), and 5/151(3%) patients died. Lymphopenia was found in 63/147(43%) patients. Chest X-ray revealed condensation (64/151[42%]) and other infiltrates (87/151[58%]). Compared with CAP from other viral pathogens, COVID-19 patients were older (8 vs.1 year;odds ratio [OR] 1.42 [95% confidence interval, CI 1.23;1.42]), with lower CRP levels (23 vs.48 mg/L;OR 1 [95%CI 0.99;1]), less wheezing (17 vs.53%;OR 0.18 [95%CI 0.11;0.31]) and greater need of mechanical ventilation, MV (7 vs.0.7%, OR 10.8 [95%CI 1.3;85). Patients with non-SARS-CoV-2-associated CAP had a greater need for oxygen therapy (77 vs.44%, OR 0.24 [95%CI 0.14;0.40]). There were no differences in the use of CPAP or HVF or PICU admission between groups. Conclusion SARS-CoV-2-associated CAP in children presents differently to other virus-associated CAP: children are older and rarely have wheezing or high CRP levels;they need less oxygen but more CPAP or MV. However, several features overlap, and differentiating the etiology may be difficult. The overall prognosis is good.

13.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-296546

ABSTRACT

Objectives: Prolonged symptoms after acute COVID-19 have been described in the pediatric population. Our objective was to know the prevalence of prolonged symptoms in children with confirmed SARS-CoV-2 infection, and to describe their clinical characteristics and possible risk factors.Patients & methodsMulticentre retrospective study carried by telephone questionnaire of all children under 18 years old diagnosed of symptomatic COVID-19, both hospitalized and outpatient attended in three hospitals in Spain between March and December 2020. Long-COVID was defined as the presence of symptoms longer than 12 weeks. A control group of children attended by other causes was also contacted and compared.Results451 children met criteria and agreed to participate;370/451 (82%) presented mild outpatient infection, and 23 required admission in PICU (5.1%). The mean age was 5.9 years old (SD 5.3). A control group of 98 children was included.In 66 cases (14.6%) at least one symptom lasted longer than 12 weeks. Insomnia, concentration problems, apathy or sadness and anxiety were the longest (median >90 days). Age above 5 years (48/66;72.7%, OR: 3, CI 95% (1.8-5));admission (OR 3.9 CI 95% (2.2-6.8)), the need for PICU (OR 4.3 CI 95% (1.8-10.4)), and to have a relative with prolonged symptoms (OR 2.8 CI 95% (1.5-5.2)) were significantly associated with Long-COVID. When comparing with controls age above 5 years old, myalgia, asthenia, and loss of appetite were significantly associated with Long-COVID.ConclusionsOur study shows that children also suffer prolonged symptoms after COVID-19 infection, and require specific attention.

14.
J Chem Inf Model ; 61(12): 6094-6106, 2021 12 27.
Article in English | MEDLINE | ID: covidwho-1559820

ABSTRACT

SARS-CoV-2 is a type of coronavirus responsible for the international outbreak of respiratory illness termed COVID-19 that forced the World Health Organization to declare a pandemic infectious disease situation of international concern at the beginning of 2020. The need for a swift response against COVID-19 prompted to consider different sources to identify bioactive compounds that can be used as therapeutic agents, including available drugs and natural products. Accordingly, this work reports the results of a virtual screening process aimed at identifying antiviral natural product inhibitors of the SARS-CoV-2 Mpro viral protease. For this purpose, ca. 2000 compounds of the Selleck database of Natural Compounds were the subject of an ensemble docking process targeting the Mpro protease. Molecules that showed binding to most of the protein conformations were retained for a further step that involved the computation of the binding free energy of the ligand-Mpro complex along a molecular dynamics trajectory. The compounds that showed a smooth binding free energy behavior were selected for in vitro testing. From the resulting set of compounds, five compounds exhibited an antiviral profile, and they are disclosed in the present work.


Subject(s)
Biological Products , COVID-19 , Antiviral Agents/pharmacology , Biological Products/pharmacology , Humans , Molecular Docking Simulation , Molecular Dynamics Simulation , Peptide Hydrolases , Protease Inhibitors/pharmacology , SARS-CoV-2
15.
J Pediatr ; 241: 126-132.e3, 2022 02.
Article in English | MEDLINE | ID: covidwho-1527773

ABSTRACT

OBJECTIVES: To determine the time to reverse transcription-polymerase chain reaction (RT-PCR) negativity after the first positive RT-PCR test, factors associated with longer time to RT-PCR negativity, proportion of children seroconverting after proven severe acute respiratory syndrome coronavirus 2 infection, and factors associated with the lack of seroconversion. STUDY DESIGN: The Epidemiological Study of Coronavirus in Children of the Spanish Society of Pediatrics is a multicenter study conducted in Spanish children to assess the characteristics of coronavirus disease 2019. In a subset of patients, 3 serial RT-PCR tests on nasopharyngeal swab specimens were performed after the first RT-PCR test, and immunoglobulin G serology for severe acute respiratory syndrome coronavirus 2 antibodies was performed in the acute and follow-up (<14 and ≥14 days after diagnosis) phase. RESULTS: In total, 324 patients were included in the study. The median time to RT-PCR negativity was 17 days (IQR, 8-29 days), and 35% of patients remained positive more than 4 weeks after the first RT-PCR test. The probability of RT-PCR negativity did not differ across groups defined by sex, disease severity, immunosuppressive drugs, or clinical phenotype. Globally, 24% of children failed to seroconvert after infection. Seroconversion was associated with hospitalization, persistence of RT-PCR positivity, and days of fever. CONCLUSIONS: Time to RT-PCR negativity was long, regardless of the severity of symptoms or other patient features. This finding should be considered when interpreting RT-PCR results in a child with symptoms, especially those with mild symptoms. Seroprevalence and postimmunization studies should consider that 11 in 4 infected children fail to seroconvert.


Subject(s)
COVID-19 Nucleic Acid Testing , COVID-19/diagnosis , COVID-19/immunology , Reverse Transcriptase Polymerase Chain Reaction , Seroconversion , Adolescent , COVID-19/epidemiology , COVID-19 Serological Testing , Child , Child, Preschool , Female , Follow-Up Studies , Humans , Infant , Infant, Newborn , Kaplan-Meier Estimate , Male , Registries , Seroepidemiologic Studies , Spain/epidemiology , Time Factors
16.
An Pediatr (Barc) ; 95(5): 382.e1-382.e8, 2021 Nov.
Article in Spanish | MEDLINE | ID: covidwho-1514128

ABSTRACT

Since the COVID-19 pandemic was declared in March 2020, we have learned a lot about the SARS-CoV-2 coronavirus, and its role in pediatric pathology.Children are infected in a rate quite similar to adults, although in most cases they suffer mild or asymptomatic symptoms. Around 1% of those infected require hospitalization, less than 0.02% require intensive care, and mortality is very low and generally in children with comorbidities. The most common clinical diagnoses are upper or lower respiratory infections, gastrointestinal infection and, more seriously, multisystemic inflammatory syndrome (MIS-C). Most episodes do not require treatment, except for MIS-C. Remdesivir has been widely used as a compassionate treatment and its role has yet to be defined.The newborn can become infected, although vertical transmission is very low (<1%) and it has been shown that the baby can safely cohabit with its mother and be breastfed. In general, neonatal infections have been mild.Primary care has supported a very important part of the management of the pandemic in pediatrics. There has been numerous collateral damage derived from the difficulty of access to care and the isolation suffered by children. The mental health of the pediatric population has been seriously affected. Although it has been shown that schooling has not led to an increase in infections, but rather the opposite. It is essential to continue maintaining the security measures that make schools a safe place, so necessary not only for children's education, but for their health in general.

17.
J Clin Virol ; 145: 105027, 2021 12.
Article in English | MEDLINE | ID: covidwho-1509982

ABSTRACT

INTRODUCTION AND OBJECTIVES: The COVID-19 pandemic and the widespread associated use of non-pharmaceutical interventions have impacted viral circulation and the incidence of respiratory tract infections. We compared Pediatric Emergency Department visits, bronchiolitis admissions, and respiratory syncytial virus (RSV) cases in 2020 with those documented for the preceding four years. METHODS: This was a retrospective multicentric national survey study, driven by the Pediatric Spanish Society, and gathering monthly data from Spanish hospitals between 1st January 2016 and 31st December 2020. An Interrupted Time Series Analysis and Poisson regression models were performed for each index. RESULTS: Thirty-eight hospitals representing most of the different regions of Spain participated. Compared to the preceding four years, in 2020, Pediatric emergency department visits significantly decreased immediately after initiation of the national lockdown. The median number of visits averted per month was 39,754 (IQR 26,539-50,065). RSV diagnoses during the 2020 winter season nearly disappeared with only 21 cases being documented among participating hospitals. The expected seasonal peak of bronchiolitis hospitalizations never occurred. The median number of admissions in 2020 averted per month was 100 (IQR 37-185) compared to 2016-2019. Only 3 hospitalized cases were RSV-confirmed. Reopening of schools and kindergarten was not associated with a remarkable increase in RSV cases or bronchiolitis hospitalizations. CONCLUSION: A dramatic reduction of bronchiolitis admissions and near disappearance of RSV cases was observed in Spanish hospitals coinciding with the peak of the COVID-19 pandemic.


Subject(s)
Bronchiolitis , COVID-19 , Respiratory Syncytial Virus Infections , Respiratory Syncytial Virus, Human , Bronchiolitis/epidemiology , Child , Communicable Disease Control , Humans , Pandemics , Respiratory Syncytial Virus Infections/epidemiology , Retrospective Studies , SARS-CoV-2 , Seasons , Spain/epidemiology
18.
Eur J Pediatr ; 181(3): 1105-1115, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1504861

ABSTRACT

We aimed to identify the spectrum of disease in children with COVID-19, and the risk factors for admission in paediatric intensive care units (PICUs). We conducted a multicentre, prospective study of children with SARS-CoV-2 infection in 76 Spanish hospitals. We included children with COVID-19 or multi-inflammatory syndrome (MIS-C) younger than 18 years old, attended during the first year of the pandemic. We enrolled 1200 children. A total of 666 (55.5%) were hospitalised, and 123 (18.4%) required admission to PICU. Most frequent major clinical syndromes in the cohort were mild syndrome (including upper respiratory tract infection and flu-like syndrome, skin or mucosae problems and asymptomatic), 44.8%; bronchopulmonary syndrome (including pneumonia, bronchitis and asthma flare), 18.5%; fever without a source, 16.2%; MIS-C, 10.6%; and gastrointestinal syndrome, 10%. In hospitalised children, the proportions were 28.5%, 25.7%, 16.5%, 19.1% and 10.2%, respectively. Risk factors associated with PICU admission were age in months (OR: 1.007; 95% CI 1.004 to 1.01), MIS-C (OR: 14.4, 95% CI 8.9 to 23.8), chronic cardiac disease (OR: 4.8, 95% CI 1.8 to 13), asthma or recurrent wheezing (OR: 2.5, 95% CI 1.2 to 5.2) and after excluding MIS-C patients, moderate/severe liver disease (OR: 8.6, 95% CI 1.6 to 47.6). However, asthmatic children were admitted into the PICU due to MIS-C or pneumonia, not due to asthma flare.Conclusion: Hospitalised children with COVID-19 usually present as one of five major clinical phenotypes of decreasing severity. Risk factors for PICU include MIS-C, elevation of inflammation biomarkers, asthma, moderate or severe liver disease and cardiac disease. What is Known: • All studies suggest that children are less susceptible to serious SARS-CoV-2 infection when compared to adults. Most studies describe symptoms at presentation. However, it remains unclear how these symptoms group together into clinically identifiable syndromes and the severity associated with them. What is New: • We have gathered the primary diagnoses into five major syndromes of decreasing severity: MIS-C, bronchopulmonary syndrome, gastrointestinal syndrome, fever without a source and mild syndrome. Classification of the children in one of the syndromes is unique and helps to assess the risk of critical illness and to define the spectrum of the disease instead of just describing symptoms and signs.


Subject(s)
COVID-19 , Adolescent , COVID-19/complications , COVID-19/epidemiology , Humans , Prospective Studies , Risk Factors , SARS-CoV-2 , Systemic Inflammatory Response Syndrome
19.
J Rheumatol ; 48(11): 1761, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1497404
20.
An Pediatr (Engl Ed) ; 95(5): 382.e1-382.e8, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1474326

ABSTRACT

Since the COVID-19 pandemic was declared in March 2020, we have learned a lot about the SARS-CoV-2 coronavirus, and its role in pediatric pathology. Children are infected in a rate quite similar to adults, although in most cases they suffer mild or asymptomatic symptoms. Around 1% of those infected require hospitalization, less than 0.02% require intensive care, and mortality is very low and generally in children with comorbidities. The most common clinical diagnoses are upper or lower respiratory infections, gastrointestinal infection and, more seriously, multisystemic inflammatory syndrome (MIS-C). Most episodes do not require treatment, except for MIS-C. Remdesivir has been widely used as a compassionate treatment and its role has yet to be defined. The newborn can become infected, although vertical transmission is very low (<1%) and it has been shown that the baby can safely cohabit with its mother and be breastfed. In general, neonatal infections have been mild. Primary care has supported a very important part of the management of the pandemic in pediatrics. There has been numerous collateral damage derived from the difficulty of access to care and the isolation suffered by children. The mental health of the pediatric population has been seriously affected. Although it has been shown that schooling has not led to an increase in infections, but rather the opposite. It is essential to continue maintaining the security measures that make schools a safe place, so necessary not only for children's education, but for their health in general.


Subject(s)
COVID-19 , Pandemics , Adult , COVID-19/complications , Child , Female , Humans , Infant , Infant, Newborn , Infectious Disease Transmission, Vertical , SARS-CoV-2 , Systemic Inflammatory Response Syndrome
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