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1.
Hospital Pediatrics ; 15:15, 2022.
Article in English | MEDLINE | ID: covidwho-2162650

ABSTRACT

BACKGROUND AND OBJECTIVE: During the coronavirus disease 2019 pandemic, technology-dependent children are at risk of encountering barriers to hospital discharge because of limits to in-home services. Transition difficulties could increase length of stay (LOS). With this study, we aim to (1) evaluate change in LOS and (2) describe barriers to hospital discharge between prepandemic and early pandemic periods for technology-dependent children.

2.
Journal of Public Health and Emergency ; 5, 2021.
Article in English | Scopus | ID: covidwho-1438955

ABSTRACT

Background: The COVID-19 pandemic has led healthcare systems worldwide to find themselves overburdened and understaffed. The aim of this study is to assess the roles assumed by medical students worldwide to provide insights during this pandemic but also for future global health emergencies. Methods: A global quantitative, descriptive study was held during April 2020 aiming to assess the different roles of medical students during the COVID-19 pandemic. Data was collected through a pretested, self-administered questionnaire disseminated online on the social media platforms of the International Federation of Medical Students' Associations. Results: The questionnaire received 279 responses from 101 countries. Medical students played many roles, with raising awareness (20.3%), medical assistance (14.4%), and answering helplines (13.1%) being reported most often. 16.5% of medical students reported that their wellbeing was negatively impacted by the role that they played, which was most often reported when they played no active role. Conclusions: Our results confirm that medical students should be considered a key component of a nation's public health preparedness. Based on our results, medical students can and should play a role during the pandemic, but a strong ethical consideration of medical students' wellbeing and safety when designing their role for future crises is necessary. © Journal of Public Health and Emergency. All rights reserved.

3.
Journal of Obstetric Anaesthesia and Critical Care ; 10(2):146-147, 2020.
Article in English | Web of Science | ID: covidwho-1285442
4.
Open Forum Infectious Diseases ; 7(SUPPL 1):S338, 2020.
Article in English | EMBASE | ID: covidwho-1185903

ABSTRACT

Background: Background: Multi-system Inflammatory Syndrome of Children (MIS-C) has recently emerged internationally as a serious inflammatory complication of SARS-CoV-2 infection with significant morbidity for the pediatric population. Methods: This observational retrospective cohort study includes 33 children meeting CDC criteria for MIS-C treated between March 15 and June 17, 2020 at Children's National Hospital in Washington DC. Clinical and demographic data were extracted from medical records and are summarized. Results: Of 33 hospitalized MIS-C patients, 42% were critically ill, and 58% were non-critically ill. The median age was 8.9 years (0.7-18.7 years). More males (58 %) than females (43 %) were represented in the MIS-C cohort. The majority (75%) of children had no underlying medical condition. Criteria for incomplete or complete Kawasaki Disease (KD) were present in 39% of patients, while an additional 9% had some features of KD. However the remaining 52% of MIS-C patients presented with other sub-phenotypes including prominent severe abdominal pain and/or nonspecific multiorgan dysfunction. 30% presented with shock requiring volume and/or inotropic support. SARS-CoV-2 antibodies were present in 61% of patients. Virus was detectable by PCR in 36% of patients. At the time of initial evaluation, 39% (13/33) of children had identified cardiac abnormalities including myocardial dysfunction (5/33;15%), coronary ectasia (4/33;12%), coronary aneurysm (3/33;9%), or pericardial effusion 5/33;15%) either alone or in combination. Cytokine profiling identified elevation of several cytokines in this cohort, including IL-6. Treatment has included intravenous immunoglobulin, aspirin, anakinra and other immunomodulatory therapies, with overall rapid response to therapy. No deaths have occurred. Conclusion: The emergence of MIS-C late in the surge of SARS-CoV-2 circulation in the Washington DC metropolitan region has added to the already significant burden of hospitalized and critically ill children in our region. A significant percentage of these children present with cardiac dysfunction and abnormalities, whether or not with KD features at presentation. Detailed characterization of immune responses and long term outcome of these patients is a priority.

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