Clinical Characteristics of Covid-19 in Children of Different Age Groups

The study is devoted to accessing the clinical and epidemiological features of the coronavirus infection in children of different ages who were hospitalized during the 2020-2021 outbreaks of the epidemic. A retrospective analysis of 530 case histories of children under the age of 18 with coronavirus infection was conducted. The study revealed the predominance of general infectious symptoms and manifestations of upper respiratory tract lesions in children of all ages. A more severe course of the disease was registered in older children and was associated with the lower respiratory tract involvement. Children aged 1 month had relatively lower risks of lower respiratory tract injury compared to other age groups. We also found relatively higher levels of leukocytes, platelets and procalcitonin in children of this age.

Comparison of clinical characteristics of COVID-19 in pregnant women between the Delta and omicron variants of concern predominant periods

Background: Information regarding effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant strains on clinical manifestations and outcomes of coronavirus disease 2019 (COVID-19) in pregnant women is limited. Methods: A retrospective observational study was conducted using the data from the nationwide COVID-19 registry in Japan. We identified pregnant patients with symptomatic COVID-19 hospitalized during the study period. The Delta and Omicron variants of concern (VOC) predominant periods were defined as August 1 to December 31, 2021 and January 1 to May 31, 2022, respectively. Clinical characteristics were compared between the patients in the Delta and Omicron VOC periods. In addition, logistic regression analysis was performed to identify risk factors for developing moderate-to-severe COVID-19. Results: During the study period, 310 symptomatic COVID-19 cases of pregnant women were identified;111 and 199 patients were hospitalized during the Delta and Omicron VOC periods, respectively. Runny nose and sore throat were more common, and fatigue, dysgeusia, and olfactory dysfunction were less common manifestations observed in the Omicron VOC period. In the multivariable logistic regression analysis, onset during the later stage of pregnancy (OR: 2.08 [1.24-3.71]) and onset during the Delta VOC period (OR: 2.25 [1.08-4.90]) were independently associated with moderate-to-severe COVID-19, whereas two doses of SARS-CoV-2 vaccine were protective against developing moderate-to-severe COVID-19 (OR: 0.34 [0.13-0.84]). Conclusions: Clinical manifestations of COVID-19 in pregnant women differed between the Delta and Omicron VOC periods. SARS-CoV-2 vaccination was still effective in preventing severe COVID-19 throughout the Delta and Omicron VOC periods.

Variability in the Clinical Course of COVID-19 in a Retrospective Analysis of a Large Real-World Database.

The COVID-19 pandemic proceeds in waves, with variable characteristics of the clinical picture resulting from the evolution of the SARS-CoV-2 virus. This study aimed to compare the epidemiological characteristics, symptomatology, and outcomes of the disease in patients hospitalized for COVID-19 during periods of different variants dominance. Comparing the periods of dominance of variants preceding the Delta variant, the Delta period was characterized by a higher share of hospitalized females, less frequent comorbidities among patients, and a different age distribution. The lowest need for oxygen therapy and mechanical ventilation was observed under Omicron dominance. The triad of classic COVID-19 symptoms, cough, fever, dyspnoea, and fatigue, were most prevalent during the Delta period, and significantly less common under the Omicron dominance. During the Omicron period, nearly twice as many patients as in the previous periods could be discharged from the hospital within 7 days; the overall 28-day mortality was significantly lower compared to that of the Delta period. It also did not differ between periods that were dominated by the BA.1 and BA.2 subvariants. The study indicates that the Omicron SARS-CoV-2 variant that dominated between January and June 2022 caused a disease which resembled the common cold, and was caused by seasonal alpha and beta-coronaviruses with a low pathogenicity for humans. However, one should note that this effect may not only have been related to biological features of the Omicron lineage, but may additionally have been driven by the increased levels of immunization through natural infections and vaccinations, for which we could not account for due to a lack of sufficient data.

Comparison of the course of multisystem inflammatory syndrome in children during different pandemic waves.

The purpose of this study is to assess the rate, clinical picture, and management of multisystem inflammatory syndrome in children (MIS-C) during the different COVID-19 variants of concern (VOC) domination periods. This was a retrospective analysis of prospectively collected data. The incidence and clinical picture of MIS-C during the original/Alpha (group 1) and Delta/Omicron (Group 2) variant domination periods were compared. Among 108 eligible patients, 74 (68.5%) were hospitalized during the group 1 domination period, and 34 (31.5%) were hospitalized during the group 2 domination period. The median (Me) patient ages were 76 months (interquartile range [IQR] 35-130) and 73 months (IQR 45-118), and 61% and 65% of patients were male, respectively. There was no significant difference in the presence of positive SARS-CoV 2 antibody test results (IgM or IgG) between the groups (84 vs. 90%; p = 0.54).No differences between groups were observed in fever duration prior to admission (Me [IQR]: 5 days [3-6] vs. 5 days [4-6]; p = 0.26) or the presence of mucocutaneous (95 vs. 100%; p = 0.41), circulatory (70.3 vs. 61.8%; p = 0.86), neurological (6.8 vs. 2.9%; p = 0.662), or gastrointestinal symptoms (84 vs. 79%; p = 0.59). Respiratory symptoms were more common in group 2 (70 vs. 91%; p = 0.015). The need for intensive care unit admission was similar in both groups (16.2 vs. 17.6%, p = 1.0). No deaths occurred in the entire cohort. The studied children were characterized by high C-reactive protein and procalcitonin levels, concentrations of ferritin within normal limits, lymphopenia, moderate hypoalbuminemia, and high B-type natriuretic peptide/brain natriuretic peptide (NT-proBNP) concentrations; however, there were no differences between the groups. Intravenous immunoglobulins were administered as a first-line treatment for almost all patients. There was no significant difference in corticosteroid administration between the groups (87% vs. 74%; p = 0.11); however, the summary dose of methylprednisolone was higher in group 2 (Me [IQR]″ 12.6 mg/kg [10.5-17.8] vs. 16.4 mg/kg [13.3-19.5]; p = 0.03). The median length of stay was 11 days [IQR]: [9-14] and 10 days [8-12], respectively (p = 0.065). CONCLUSION: The clinical course of MIS-C is similar in subsequent pandemic waves; however, the incidence of MIS-C seems to be decreasing. WHAT IS KNOWN: • The clinical picture of COVID-19 is evolving. Multisystem inflammatory syndrome in children (MIS-C) is a relatively new serious disease connected with SARS-CoV-2 infection, and in subsequent waves of the pandemic, new cases of the disease have been recorded. WHAT IS NEW: • The clinical picture of MIS-C is not specific, but the course is still severe. • The incidence of MIS-C during the different pandemic waves is decreasing and the diagnosis in the period of lower prevalance is challenging.

Dynamics of the structure of renal tuberculosis over 20 years

Background. Tuberculosis is a serious medical and social problem that does not lose its importance, despite all the advances in pharmacology and surgery. Diagnosis of urogenital tuberculosis (UGTB), as a rule, is delayed due to low index of suspicion to tuberculosis and the absence of pathognomonic symptoms. Aim. Determining the change in the ratio of clinical forms of renal tuberculosis from 1999 to 2020. Materials and methods. A retrospective cohort comparative non-interventional study on the spectrum of the incidence of extrapulmonary tuberculosis (EPTB) was carried out. Among all 13852 extrapulmonary tuberculosis patients which were diagnosed from 1999 to 2020, patients with renal tuberculosis were selected, and the spectrum of their clinical forms in three periods was analyzed: 1st period 1999–2004 (1155 patients), second period 2005–2014 (2657 patients), and the third period 2015–2020 (671 patients). The clinical features of nephrotuberculosis in 88 patients was also estimated. Results. Over the 20 years of the analyzed period, the number of patients with UGTB decreased by 80.6%;for the year of the COVID-19 pandemic, this figure fell by another third. In the first period, destructive complicated forms of nephrotuberculosis prevailed (922 patients – 79.8%), while the so-called "minor forms" were diagnosed in 233 patients (20.2%). In the second period, the situation was statistically significantly more favorable: the proportion of destructive and complicated forms of renal tuberculosis decreased to 43.8% (1124 patients), "small forms" were diagnosed in 1443 patients (56.2%). In the third period, destructive and complicated forms of nephrotuberculosis were diagnosed in 531 patients (77.6%), and the proportion of "small forms" in comparison with the previous period decreased by half, to 22.4%. Analysis of the clinical features of renal tuberculosis, depending on the prevalence of the destruction, showed that an asymptomatic course is possible, and pain, dysuria, intoxication and renal colic are present with different frequencies, and the clinical picture of tuberculosis of the renal parenchyma differs significantly from the clinical picture of tuberculous papillitis, cavernous nephrotuberculosis and symptoms of renal tuberculosis as whole. Conclusion. Currently, there is no screening on urogenital tuberculosis at all. Patients are diagnosed by referral, with a long history, after receiving multiple courses of antibacterial treatment;mainly through the pathomorphological examination of the operating material. Thus, a sharp decrease in the proportion of UGTB patients does not mean the disappearance of tuberculosis of this localization, but only states the tragic defects in timely diagnosis and low index of suspicion of medical doctors in relation to UGTB. © 2022 Consilium Medikum. All rights reserved.

Features of diagnosis and course of acute appendicitis during the COVID-19 pandemic

This article provides a brief description of acute appendicitis, methods of its diagnosis, discusses typical clinical cases, examples of tactics for managing patients with acute appendicitis. The sequence of management of a patient with acute appendicitis, steps to a speedy recovery of the patient, including surgical interventions, his discharge with positive dynamics are summarized. Special attention is paid to the course and further development of complications of acute appendicitis during the COVID-19 pandemic. The need for timely treatment of the population for medical care is emphasized in order to avoid the development of complications (in particular, from acute conditions), for a qualitatively better prognosis and a speedy recovery in the postoperative period. Aim of the research: to identify possible complications and course of appendicitis in a pandemic coronavirus infection. Objectives: to study and analyze clinical cases in patients with appendicitis during a pandemic coronavirus infection. Materials and methods: clinical cases, case histories, educational literature. Conclusions: the course of acute appendicitis was accompanied by various complications that developed due to untimely medical care, due to the huge burden on the sphere of health protection of the Russian Federation. There was a tendency for the transition of acute appendicitis to peritonitis, abscess of the stump of the appendix, pileflebitis, due to coronavirus infection. Pathological activity of the immune system was also revealed in patients with appendicitis (lymphatic infiltration of appendix tissues). © 2022 Global Media Technologies. All rights reserved.

Evaluation of epidemiological, paraclinical and imaging findings of patients with COVID-19 hospitalized in intensive care unit of Rasht hospitals in March 2020

The current study sought to examine the clinical, laboratory, and imaging aspects of COVID-19-positive critically sick patients who were admitted to the intensive care units (ICUs) at three hospitals in Rash City, Iran. The goal of this retrospective study was to examine 138 COVID-19 patients who had been hospitalized to the intensive care unit. Data on the study participants' demographics, underlying diseases, laboratory and imaging results, and prognosis of the diseases were taken from their medical records. 138 COVID-19 patients who were hospitalised to the intensive care unit were the subject of this retrospective analysis. Patient records were used to extract information about the patient, including demographic details, underlying diseases, laboratory and imaging results, and disease outcomes. The majority of the patients in this study were male and between the ages of 55 and 69. The most prevalent underlying conditions were diabetes mellitus, hypertension, and chronic heart disease;the most prevalent symptoms were shortness of breath, fever, and cough. The most prevalent lung Computer Tomography (CT) scan finding was ground glass opacities, and the most frequent laboratory findings in the study participants were an increase in LDH, ESR, CRP, neutrophil percentage, and lymphopenia. A 90.58% fatality rate was recorded. This study showed that the majority of patients with severe disease presentations were older, had a history of underlying disease, symptoms of shortness of breath, cough, and fever, substantial lung involvement in imaging, and altered laboratory findings. Despite medical treatment and mechanical ventilation, mortality remained high.

CT findings of normal coronavirus disease 2019 patients during rehabilitation period

This study aimed to investigate the chest imaging finding of patients with coronavirus disease 2019 (COVID-19) in rehabilitation period. The clinical and imaging data of 80 patients with COVID-19 diagnosed as common type by the First People's Hospital of Xiaogan City, Hubei Province from 21 January 2020 to 23 February 2020 were collected. The discharge standard of the convalescent stage contained body temperature returned to normal over 3 days, significant improvement of respiratory tract symptoms and obviously absorbed inflammation as well as two negative consecutive respiratory tract pathogenic nucleic acid tests showed by the pulmonary imaging. HRCT manifestations of patients were dynamically observed and were compared with those at the time of admission. Typical syndrome and lesion distribution and morphology at convalescence stage were observed. HRCT of COVID-19 patients in convalescent period showed that the absorption of "fly swatter breaking sign" and "water inclusion sign" was decreased, with earlier and more obvious absorption of water inclusion sign. Compared with HRCT at the time of admission, localized patchy ground glass foci in the dorsolateral or posterior basal segments of both lungs, multi segmented ground glass density foci and diffusely distributed ground glass foci in the convalescent stage were obvious, the remaining interlobular interstitial and interlobular septal thickening, subpleural are shadow and irregular fibrous cord shadow foci among some patients were found and no obvious mediastinal lymphadenopathy and pleural effusion were found. The decrease of absorption of "broken fly swatter sign" and "wrapped water pipe sign" is a typical manifestation of the improvement of the general COVID-19 in the rehabilitation period. In the rehabilitation period, the discharged patients often left ground glass like changes, thickening of interlobular septum and/or interlobular septum, subpleural are shadow and residual interstitial inflammation. Only by popularizing HRCT in the clinical follow-up can effectively observe the dynamic changes of residual lesions, reduce the residual lesions and lower the risk of developing interstitial fibrosis.

Research and clinical translation progress of SARS-CoV-2 detection approaches based on CRISPR technology

Since the Corona Virus Disease 2019 (COVID-19) caused by the infection of SARS-CoV-2 was first reported in 2019, COVID-19 has spread rapidly around the world, causing serious negative impacts on the daily life and work of people around the world. Recently, several studies on SARS-CoV-2 detection approaches based on Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR) technology have been reported, showing that CRISPR technology can be used to detect SARS-CoV-2 rapidly, sensitively, specifically, visually and on-site. There are already detection kits based on CRISPR technology in clinical application at home and abroad, and good clinical feedback has been obtained. Therefore, the SARS-CoV-2 detection method based on CRISPR technology is expected to overcome the shortcomings of the existing RT-PCR approach in clinical practice, and replace RT-PCR as the gold standard for the next generation of SARS-CoV-2 nucleic acid detection. In this article, the research and progress of SARS-CoV-2 nucleic acid detection methods based on CRISPR technology are introduced, the principle and clinical application of CRISPR technology are reviewed, and the future development of the technology is prospected in order to promote its clinical transformation speed.

Acute kidney damage in COVID-19 patients

The presentation of kidney damage in Coronavirus disease 2019 (COVlD-19) varies significantly. According to recent studies. the development of acute kidney injury (AKI) in severe cases of COVID-l9 infection significantly worsens the prognosis of these patients. The pathological changes in kidneys might be caused directly by the cytopathic effect mediated by local replication of the severe acute respiratory syndrome coronavirus-Z (SARS-CoV-Z) or indirectly because of systemic immune response or by- percoagulation, so-called immunothrombosis. Other causes. such as hypovolemia and hypoxia. may also contribute to AKI. Acute kidney disease often develops in elderly patients with underlying comorbidities or in critically ill patients with severe respiratory failure. It is known that AKJ is a risk factor for mortality in C OVID-l9 patients.

Diagnostic value of determination of plasma CRP, PCT and IL-6 levels in patients with COVID-19

The article's objective was to assess the clinical diagnostic utility of plasma levels of CRP, PCT, and IL-6 in individuals with COVID-19 both alone and in combination. Results showed that according to the ROC curve, PCT and CRP were highly valuable in the diagnosis of COVID-19, and CRP was most valuable in the evaluation of patients with severe and critical COVID-19. The combined detection of the three indexes might increase the evaluation's effectiveness. When evaluating COVID-19 patients who were in severe condition, IL-6 demonstrated a strong predictive value. Therefore, combining the three indicators may increase the diagnostic efficiency and provide crucial reference values for the clinical diagnosis and treatment of COVID-19. CRP, PCT, and IL-6 levels may be potential biomarkers for the diagnosis of COVID-19 and can be used to determine the severity of COVID-19.

Spontaneous pneumothorax in patients of COVID 19 pneumonia

COVID 19 pandemic has put a massive strain on healthcare all over the world. Every day new data is getting released and various complications are being reported in patients of COVID 19 Pneumonia. One such complication is pneumothorax and pneumomediastinum. Both these conditions can lead to an increase in mortality and morbidity in patients with COVID 19 pneumonia. We studied 476 patients of COVID 19 pneumonia at our hospital, out of which 18 (3.78%) had developed pneumothorax and/or pneumomediastinum. While most of these patients were on some form of positive pressure ventilation (invasive/non-invasive), some of them had a HRCT Chest suggestive of either air trapping and/or cyst formation. Three patients had developed bilateral pneumothorax while on non-invasive ventilator. Nine of the 18 patients expired and nine were discharged. Through this article, we would like to emphasize that an acute deterioration in hypoxemia in a COVID-19 patient could indicate a pneumothorax. Pneumothorax as well as pulmonary thromboembolism are reported complications in COVID-19 and clinician vigilance is required during assessment of patients, as both share the common symptom of breathlessness and therefore can mimic each other.

COVID-19 training for healthcare workers

This article concentrates on the most important COVID-19 data that are relevant to doctors, nurses, and other healthcare professionals who provide clinical care. The "Infodemic," or flood of false information being spread mostly through social media platforms and unofficial social networks, has hindered the use of vaccines, public health prevention measures, and patient care procedures. Healthcare professionals have a crucial role in both caring for their patients and teaching their communities. They are regarded as reliable sources of up-to-date knowledge. Unfortunately, it can be difficult for healthcare professionals to locate easily available, reliable sources of information. The collaboration between AFREHealth and Stanford University seeks to close this gap by offering training resources from reliable sources that will aid medical professionals in their fight against the widespread misinformation present in their communities. AfreHealth and Stanford University are collaborating to spread a free course that teaches medical professionals how to recognize and treat COVID-19 patients. Evidence to date shows that prompt diagnosis and top-notch treatment can significantly lower mortality rates and stop the spread of infections. In order to effectively care for their patients and be important information sources for their communities, healthcare staff must enhance what they already know with trustworthy information.

Characteristics, symptom management and outcomes in COVID-19 patients referred to palliative care in a tertiary hospital

Introduction: Coronavirus disease 2019 (COVID-19) variants pose unique challenges with inevitable premature death when cases of severe disease exponentially rise in a healthcare system. It is imperative that palliative care is provided with a proactive approach to symptom recognition, assessment, management and treatment escalation to ensure comfort throughout the course of this illness. Objectives:To evaluate the characteristics, symptom burden, palliative care management and outcomes of COVID-19 patients referred to a palliative care unit (PCU) in a single tertiary hospital. Clinical outcomes specifically observed the management of agitation in these patients based on their Richmond Agitation and Sedation Scale (RASS) scores.

Post-COVID-19 syndrome/impairment. definition, diagnosis and classification. a brief position paper of the Czech Pneumological and Phthisiological Society (June 2021 update)

The Working Group of the Czech Pneumological and Phthisiological Society proposed a simple classification of post-COVID-19 patients into four originally established clinical groups. These groups (A-B-C-D) are based on the presence or absence of respiratory symptoms (dyspnea, cough, chest pain) and signs of pulmonary involvement (decreased Theo, latent respiratory insufficiency, lung impairment according to chest X-ray/HRCT) at least three months after COVID-19 diagnosis.

Changes of serum LXA4, Card9 and PTX-3 in patients with severe acute pancreatitis and their predictive value for complicated MODS

Objective: To investigate the changes of serum lipoxin A4 (LXA4), caspase recruitment domain containing protein 9 (Card9), and pentraxin 3 (PTX-3) in patients with severe acute pancreatitis (SAP) and their predictive value of multiple organ dysfunction syndrome (MODS).

Imaging aspects (chest radiographic and CT scan findings) of COVID-19 with clinical classifications

Chest radiographic (CXR) and chest computed tomography (CT) scans have been used to diagnose coronavirus (COVID-19) disease as an important counterpart to the reverse transcription polymerase chain reaction (RT-PCR) diagnostic protocol. This work explores the application of CXR and CT scans as diagnostic instruments for COVID-19. Numerous databases were searched from 01/01/2020 till 2020 late for COVID-19 articles which documented the clinical features of CXR and CT scans. The documented cases were based on the evaluation of the imaging characteristics. Chest radiographic findings may be confirmed with the most basic CT scans. Peripheral, bilateral and primary ground-glass distortion are the most prominent CT results with COVID-19 infections. In conclusion, unique and ambiguous terms such as pneumonia, blurred opacities, airspace disease, patchy opacities, and infiltrates make it difficult to perceive the different chest radiographic findings.

Comparison of the clinical characteristics of the first and second waves of COVID-19 in a public hospital in Peru

During the COVID-19 pandemic, doctors faced an unprecedented mass admission of patients with viral atypical pneumonia. The objective of the study was to compare the clinical characteristics of the first and second waves of the pandemic. An analytical observational study was carried out on patients with COVID-19 pneumonia who were admitted to Hospital Carrion de Huancayo, Peru located at more than 3000 meters above sea level. Two study periods were determined, group one represented by the first wave characterized by massive restriction and strict quarantine and the second wave where productive activities had already normalized to a great extent. Of a total of 252 patients with COVID-19, the average age was 56 years in the first wave and 52 years in the second wave, the male sex was more frequent in both 74% and 57%, mortality was 27% and 23%, the time of illness was 8 days and 10 days, respectively. On the other hand, the percentage of use of antibiotics, ivermectin and hydroxychloroquine was higher in the first wave. The use of corticosteroids and prolonged hospital stay was more frequent in the second wave. Comparison of both waves shows differences in age, mortality and time of illness, which may be due to the new molecular variants of SARS-COV-2.