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2.
Pediatr Neurol ; 128: 33-44, 2022 03.
Article in English | MEDLINE | ID: covidwho-1586880

ABSTRACT

BACKGROUND: Our objective was to characterize the frequency, early impact, and risk factors for neurological manifestations in hospitalized children with acute severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection or multisystem inflammatory syndrome in children (MIS-C). METHODS: Multicenter, cross-sectional study of neurological manifestations in children aged <18 years hospitalized with positive SARS-CoV-2 test or clinical diagnosis of a SARS-CoV-2-related condition between January 2020 and April 2021. Multivariable logistic regression to identify risk factors for neurological manifestations was performed. RESULTS: Of 1493 children, 1278 (86%) were diagnosed with acute SARS-CoV-2 and 215 (14%) with MIS-C. Overall, 44% of the cohort (40% acute SARS-CoV-2 and 66% MIS-C) had at least one neurological manifestation. The most common neurological findings in children with acute SARS-CoV-2 and MIS-C diagnosis were headache (16% and 47%) and acute encephalopathy (15% and 22%), both P < 0.05. Children with neurological manifestations were more likely to require intensive care unit (ICU) care (51% vs 22%), P < 0.001. In multivariable logistic regression, children with neurological manifestations were older (odds ratio [OR] 1.1 and 95% confidence interval [CI] 1.07 to 1.13) and more likely to have MIS-C versus acute SARS-CoV-2 (OR 2.16, 95% CI 1.45 to 3.24), pre-existing neurological and metabolic conditions (OR 3.48, 95% CI 2.37 to 5.15; and OR 1.65, 95% CI 1.04 to 2.66, respectively), and pharyngeal (OR 1.74, 95% CI 1.16 to 2.64) or abdominal pain (OR 1.43, 95% CI 1.03 to 2.00); all P < 0.05. CONCLUSIONS: In this multicenter study, 44% of children hospitalized with SARS-CoV-2-related conditions experienced neurological manifestations, which were associated with ICU admission and pre-existing neurological condition. Posthospital assessment for, and support of, functional impairment and neuroprotective strategies are vitally needed.


Subject(s)
COVID-19/complications , Nervous System Diseases/epidemiology , SARS-CoV-2 , Systemic Inflammatory Response Syndrome/epidemiology , Acute Disease , Adolescent , Brain Diseases/epidemiology , Brain Diseases/etiology , COVID-19/epidemiology , Child , Child, Preschool , Cross-Sectional Studies , Female , Headache/epidemiology , Headache/etiology , Humans , Infant , Intensive Care Units, Pediatric/statistics & numerical data , Logistic Models , Male , Nervous System Diseases/etiology , Prevalence , Risk Factors , South America/epidemiology , United States/epidemiology
3.
Dyes Pigm ; 196: 109813, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1415366

ABSTRACT

The phenomenal global upheaval caused by SARS-CoV-2 has produced amazing responses from science and healthcare, particularly in the rapid realisation and production of vaccines. However, until early 2020 global infection control research was highly focused on rapidly increasing rates of conventional antimicrobial resistance (AMR) and the supply of drugs to counter this. Antimicrobial dyes have been suggested by various authors for inclusion in this effort, usually with little return from responsible authorities, and normally on the basis of post-treatment staining or potential toxicity, but this does not deny the fact that such dyes, particularly with photoactivation, are the only class of agents with pan-microbial activity - i.e. against each of bacteria, viruses, fungi and protozoa - regardless of the organism's drug resistance status. Conventional antibacterials, antivirals etc. usually demonstrate activity against one particular section of pathogens only, and disinfectants such as chlorhexidine or benzalkonium salts are too toxic for internal use. This perspective reflects both the background utility of antimicrobial dyes and ways forward for their inclusion in 21st Century infection control protocols.

4.
Neurocrit Care ; 35(2): 283-290, 2021 10.
Article in English | MEDLINE | ID: covidwho-1286191

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic has affected mortality and morbidity across all ages, including children. It is now known that neurological manifestations of COVID-19, ranging from headaches to stroke, may involve the central and/or peripheral nervous system at any age. Neurologic involvement is also noted in the multisystem inflammatory syndrome in children, a pediatric condition that occurs weeks after infection with the causative virus of COVID-19, severe acute respiratory syndrome coronavirus 2. Knowledge about mechanisms of neurologic disease is scarce but rapidly growing. COVID-19 neurologic manifestations may have particularly adverse impacts on the developing brain. Emerging data suggest a cohort of patients with COVID-19 will have longitudinal illness affecting their cognitive, physical, and emotional health, but little is known about the long-term impact on affected children and their families. Pediatric collaboratives have begun to provide important initial information on neuroimaging manifestations and the incidence of ischemic stroke in children with COVID 19. The Global Consortium Study of Neurologic Dysfunction in COVID-19-Pediatrics, a multinational collaborative, is working to improve understanding of the epidemiology, mechanisms of neurological manifestations, and the long-term implications of COVID-19 in children and their families.


Subject(s)
COVID-19 , Nervous System Diseases , Pediatrics , COVID-19/complications , Child , Humans , Nervous System , SARS-CoV-2 , Systemic Inflammatory Response Syndrome
5.
J Photochem Photobiol B ; 212: 111999, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-720629

ABSTRACT

The global dissemination of the novel coronavirus disease (COVID-19) has accelerated the need for the implementation of effective antimicrobial strategies to target the causative agent SARS-CoV-2. Light-based technologies have a demonstrable broad range of activity over standard chemotherapeutic antimicrobials and conventional disinfectants, negligible emergence of resistance, and the capability to modulate the host immune response. This perspective article identifies the benefits, challenges, and pitfalls of repurposing light-based strategies to combat the emergence of COVID-19 pandemic.


Subject(s)
Coronavirus Infections/therapy , Light , Pneumonia, Viral/therapy , Betacoronavirus/isolation & purification , Betacoronavirus/radiation effects , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/pathology , Coronavirus Infections/virology , Humans , Infrared Rays/therapeutic use , Lasers, Solid-State/therapeutic use , Low-Level Light Therapy , Pandemics , Photosensitizing Agents/chemistry , Photosensitizing Agents/therapeutic use , Pneumonia, Viral/epidemiology , Pneumonia, Viral/pathology , Pneumonia, Viral/virology , SARS-CoV-2 , Ultraviolet Rays
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