Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 13 de 13
Filter
3.
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.

4.
Marchesi, Francesco, Salmanton-Garcia, Jon, Emarah, Ziad, Piukovics, Klára, Nucci, Marcio, Lopez-Garcia, Alberto, Racil, Zdenek, Farina, Francesca, Popova, Marina, Zompi, Sofia, Audisio, Ernesta, Ledoux, Marie-Pierre, Verga, Luisa, Weinbergerova, Barbora, Szotkowski, Tomas, Silva, Maria, Fracchiolla, Nicola Stefano, De Jonge, Nick, Collins, Graham, Marchetti, Monia, Magliano, Gabriele, GarcÍA-Vidal, Carolina, Biernat, Monika, Doesum, Jaap van, Machado, Marina, Demirkan, Fatih, Khabori, Murtadha Al, Zak, Pavel, Visek, Benjamin, Stoma, Igor, MÉNdez, Gustavo-Adolfo, Maertens, Johan, Khanna, Nina, Espigado, Ildefonso, Dragonetti, Giulia, Fianchi, Luana, Principe, Maria Ilaria Del, Cabirta, Alba, Ormazabal-VÉLez, Irati, Jaksic, Ozren, Buquicchio, Caterina, Bonuomo, Valentina, Batinić, Josip, Omrani, Ali, Lamure, Sylvain, Finizio, Olimpia, FernÁNdez, Noemí, Falces-Romero, Iker, Blennow, Ola, Bergantim, Rui, Ali, Natasha, Win, Sein, Praet, Jens V. A. N.; Tisi, Maria Chiara, Shirinova, Ayten, SchÖNlein, Martin, Prattes, Juergen, Piedimonte, Monica, Petzer, Verena, NavrÁTil, Milan, Kulasekararaj, Austin, Jindra, Pavel, Jiří, Glenthøj, Andreas, Fazzi, Rita, de Ramón, Cristina, Cattaneo, Chiara, Calbacho, Maria, Bahr, Nathan, El-Ashwl, Shaimaa Saber, Córdoba, Raúl, Hanakova, Michaela, Zambrotta, Giovanni, Sciumè, Mariarita, Booth, Stephen, Nunes-Rodrigues, Raquel, Sacchi, Maria Vittoria, GarcÍA-PoutÓN, Nicole, MartÍN-GonzÁLez, Juan-Alberto, Khostelidi, Sofya, GrÄFe, Stefanie, Rahimli, Laman, busca, alessandro, Corradini, Paolo, Hoenigl, Martin, Klimko, Nikolai, Koehler, Philipp, Pagliuca, Antonio, Passamonti, Francesco, Cornely, Oliver, pagano, Livio.
EuropePMC;
Preprint in English | EuropePMC | ID: ppcovidwho-328805

ABSTRACT

Patients with acute myeloid leukemia (AML) are at high risk of mortality from coronavirus disease 2019 (COVID-19). The optimal management of AML patients with COVID-19 has not been established. Our multicenter study included 388 adult AML patients with COVID-19 diagnosis between February 2020 and October 2021. The vast majority were receiving or had received AML treatment in the prior 3 months. COVID-19 was severe in 41.2% and critical in 21.1% of cases. The chemotherapeutic schedule was modified in 174 patients (44.8%), delayed in 68 and permanently discontinued in 106. After a median follow-up of 325 days, 180 patients (46.4%) had died. Death was attributed to COVID-19 (43.3%), AML (26.1%) or to a combination of both (26.7%). Active disease, older age, and treatment discontinuation were associated with death, whereas AML treatment delay was protective. Seventy-nine patients had a simultaneous AML and COVID-19 diagnosis, with an improved survival when AML treatment could be delayed. Patients with COVID-19 diagnosis between January and August 2020 had a significantly lower survival. COVID-19 in AML patients was associated with a high mortality rate and modifications of therapeutic algorithms. The best approach to improve survival was to delay AML treatment.

7.
An Pediatr (Engl Ed) ; 95(5): 336-344, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1466040

ABSTRACT

INTRODUCTION: Telemedicine is an attractive option for the follow-up of paediatric patients with SARS-CoV-2 infection. The aim of this article is to describe the experience with telephone consultations in a tertiary hospital. PATIENTS AND METHODS: Retrospective descriptive study of children with confirmed or probable diagnosis of COVID-19 attended by telephone consultations in Hospital La Paz (Madrid) between March and June 2020. Patients were referred from the Emergency Department after being discharged from the hospital. Telephone consultations were made every 48 h until symptoms resolved, then weekly until completing 14 days without symptoms. RESULTS: A total of 72 children were included, with median age of 83.5 months [IQR = 16.3-157.5]. Of those 46 (63.9%) were male, and 14 (19.4%) had comorbidities. There were 32 (44.4%) hospital admissions. COVID-19 diagnosis was confirmed in 33 children by RT-PCR, and in 7 by serology tests. The seroconversion rate was 67.7% in those patients with a positive RT-PCR. Other infections were found in 7 patients (5 Mycoplasma pneumoniae, 1 parvovirus, and 1 CMV). Median symptom duration was 25.5 days [IQR = 13.8-37], while median follow-up duration was 28 days [IQR = 21-39]. The median number of telephone consultations per patient was 6 [IQR = 4-8]. Clinical worsening was reported in 19 (26.4%) during follow-up, and 14 (19.4%) were re-evaluated in the Emergency Department. One patient required hospital admission, but he had a favourable outcome. CONCLUSIONS: Children with suspected SARS-CoV-2 infection should be followed-up due to prolonged duration of symptoms, and the risk of clinical deterioration. Telephone consultations are a useful and safe alternative for the follow-up of patients with mild symptoms, and for children discharged from the hospital.


Subject(s)
COVID-19 , Telemedicine , COVID-19 Testing , Child , Follow-Up Studies , Humans , Male , Retrospective Studies , SARS-CoV-2 , Tertiary Care Centers
8.
Diagn Microbiol Infect Dis ; 101(3): 115477, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1293714

ABSTRACT

The aim of this study is to review bacterial isolates from respiratory samples of patients with severe COVID-19 disease during the first 2 months of the first wave in our hospital. A single-center retrospective observational study in critically ill adult patients was performed. A total of 1251 respiratory samples from 1195 patients were processed. Samples from 66 patients (5.52%) were determined to be microbiologically significant by a semi-quantitative culture. All patients received broad spectrum antibiotherapy as an empirical treatment. The isolated bacteria were mainly Enterobacterales followed by Staphylococcus aureus and Pseudomonas aeruginosa. Bacterial co-infections in ICU stay could seem not dependent on the virus that has produced the viral pneumonia similarly as with other respiratory viruses such as Influenza virus.


Subject(s)
COVID-19/complications , Coinfection/diagnosis , Pneumonia, Bacterial/complications , Tertiary Care Centers , Aged , Aged, 80 and over , Anti-Bacterial Agents/therapeutic use , Cross Infection/drug therapy , Cross Infection/microbiology , Female , Humans , Intensive Care Units , Male , Middle Aged , Retrospective Studies , Risk Factors , SARS-CoV-2
9.
Pathogens ; 10(6)2021 Jun 04.
Article in English | MEDLINE | ID: covidwho-1259561

ABSTRACT

BACKGROUND: Antibody dynamics over time after SARS-CoV-2 infection are still unclear, and data regarding children are scarce. METHODS: A prospective cohort study was performed including children infected by SARS-CoV-2 between March and May 2020. Patients were categorized into 3 groups: children admitted with COVID-19; outpatient children with mild COVID-19; and seropositive children participating in a seroprevalence study among cohabitants of infected healthcare workers (HCWs). Six months after the infection, a new serological control was performed. RESULTS: A total of 58 children were included, 50% male (median age 8.3 [IQR 2.8-13.5] years). The median time between the two serological studies was 186 (IQR 176-192) days, and 86% (48/56) of the children maintained positive IgG six months after the infection. This percentage was 100% in admitted patients and 78% among the rest of the included children (p = 0.022). The diagnoses of lower respiratory tract infection and multisystemic inflammatory syndrome were associated with persistence of IgG (p = 0.035). The children of HCWs in the seroprevalence study lost antibodies more often (p = 0.017). Initial IgG titers of the children who remained positive six months after the infection were significantly higher (p = 0.008). CONCLUSIONS: Most children infected by SARS-CoV-2 maintain a positive serological response six months after the infection. Those children who lost their IgG titer were more frequently asymptomatic or mildly symptomatic, presenting with low antibody titers after the infection.

11.
Emerg Infect Dis ; 27(4): 1077-1086, 2021.
Article in English | MEDLINE | ID: covidwho-1067634

ABSTRACT

Pneumonia caused by severe acute respiratory syndrome coronavirus 2 emerged in China at the end of 2019. Because of the severe immunomodulation and lymphocyte depletion caused by this virus and the subsequent administration of drugs directed at the immune system, we anticipated that patients might experience fungal superinfection. We collected data from 186 patients who had coronavirus disease-associated pulmonary aspergillosis (CAPA) worldwide during March-August 2020. Overall, 182 patients were admitted to the intensive care unit (ICU), including 180 with acute respiratory distress syndrome and 175 who received mechanical ventilation. CAPA was diagnosed a median of 10 days after coronavirus disease diagnosis. Aspergillus fumigatus was identified in 80.3% of patient cultures, 4 of which were azole-resistant. Most (52.7%) patients received voriconazole. In total, 52.2% of patients died; of the deaths, 33.0% were attributed to CAPA. We found that the cumulative incidence of CAPA in the ICU ranged from 1.0% to 39.1%.


Subject(s)
Aspergillus fumigatus/isolation & purification , COVID-19 , Intensive Care Units/statistics & numerical data , Pulmonary Aspergillosis , Voriconazole/therapeutic use , Aged , Antifungal Agents/therapeutic use , COVID-19/complications , COVID-19/immunology , COVID-19/mortality , COVID-19/therapy , Female , Humans , Immunologic Factors/administration & dosage , Immunologic Factors/adverse effects , Incidence , International Cooperation , Male , Outcome and Process Assessment, Health Care , Pulmonary Aspergillosis/diagnosis , Pulmonary Aspergillosis/drug therapy , Pulmonary Aspergillosis/mortality , Registries , Respiration, Artificial/methods , Risk Factors , SARS-CoV-2/isolation & purification
12.
An Pediatr (Engl Ed) ; 2020 Nov 02.
Article in Spanish | MEDLINE | ID: covidwho-983642

ABSTRACT

INTRODUCTION: Telemedicine is an attractive option for the follow-up of paediatric patients with SARS-CoV-2 infection. The aim of this article is to describe the experience with telephone consultations in a tertiary hospital. PATIENTS AND METHODS: Retrospective descriptive study of children with confirmed or probable diagnosis of COVID-19 attended by telephone consultations in Hospital La Paz (Madrid) between March and June 2020. Patients were referred from the Emergency Department after being discharged from the hospital. Telephone consultations were made every 48hours until symptoms resolved, then weekly until completing 14 days without symptoms. RESULTS: A total of 72 children were included, with median age of 83.5 months (IQR=16.3-157.5). Of those 46 (63.9%) were male, and 14 (19.4%) had comorbidities. There were 32 (44.4%) hospital admissions. COVID-19 diagnosis was confirmed in 33 children by RT-PCR, and in 7 by serology tests. The seroconversion rate was 67.7% in those patients with a positive RT-PCR. Other infections were found in 7 patients (5 Mycoplasma pneumoniae, 1 parvovirus, and 1 cytomegalovirus). Median symptom duration was 25.5 days (IQR=13.8-37), while median follow-up duration was 28 days (IQR=21-39). The median number of telephone consultations per patient was 6 (IQR=4-8). Clinical worsening was reported in 19 (26.4%) during follow-up, and 14 (19.4%) were re-evaluated in the Emergency Department. One patient required hospital admission, but he had a favourable outcome. CONCLUSIONS: Children with suspected SARS-CoV-2 infection should be followed-up due to prolonged duration of symptoms, and the risk of clinical deterioration. Telephone consultations are a useful and safe alternative for the follow-up of patients with mild symptoms, and for children discharged from the hospital.

13.
Mycoses ; 2020 Aug 04.
Article in English | MEDLINE | ID: covidwho-772393

ABSTRACT

BACKGROUND: Invasive pulmonary aspergillosis (IPA) is a complication of respiratory bacterial and viral infections such as coronavirus disease 2019 (COVID-19). PATIENTS/METHODS: In University Hospital La Paz (Madrid, Spain), we reviewed the clinical and demographic characteristics of 10 patients with positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) PCR and Aspergillus spp. isolate in respiratory samples. We also recovered results of galactomannan tests in serum and/or bronchoalveolar lavage (BAL) samples. RESULTS: Eight male and two female from 51 to 76 years were recovered. They had reported risk factors to develop IPA (haematological malignancies, immunosuppression, diabetes, obesity, intensive care unit stay, among others). Azole susceptible Aspergillus fumigatus was isolated in nine patients and Aspergillus nidulans was isolated in one patient. Only one case was classified as probable aspergillosis, seven cases as putative aspergillosis, and two cases were not classifiable. Eight patients received antifungal treatment. Seven patients died (70%), two are still inpatient due to nosocomial infections and one was discharged referred to another institution. CONCLUSIONS: This clinical entity has high mortality, and therefore, it should be performed surveillance with early galactomannan tests and cultures in respiratory samples in order to improve the outcome of the patients with this condition.

SELECTION OF CITATIONS
SEARCH DETAIL