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1.
Emerging Infectious Diseases ; 28(13 Supplement):S288-S298, 2022.
Article in English | EMBASE | ID: covidwho-2215152

ABSTRACT

At the onset of the COVID-19 pandemic, protocols for community-based management of acute malnutrition (CMAM) were implemented to support continuity of essential feeding services while mitigating COVID-19 transmission. To assess correlations between adaptation timing and CMAM program indicators, we evaluated routine program data in Uganda, Ethiopia, and Somalia for children 6-59 months of age. We specifically analyzed facility-level changes in total admissions, average length of stay (ALOS), total children screened for admission, and recovery rates before and after adaptations. We found no statistically significant changes in program indicators after adaptations. For Somalia, we also analyzed child-level changes in ALOS and in weight and mid-upper arm circumference at admission and discharge. ALOS significantly increased immediately after adaptations and then decreased to preadaptation levels. We found no meaningful changes in either weight or mid-upper arm circumference at admission or discharge. These findings indicate that adapted CMAM programs can remain effective. Copyright © 2022 Centers for Disease Control and Prevention (CDC). All rights reserved.

2.
Pediatric Critical Care Medicine Conference: 11th Congress of the World Federation of Pediatric Intensive and Critical Care Societies, WFPICCS ; 23(11 Supplement 1), 2022.
Article in English | EMBASE | ID: covidwho-2190788

ABSTRACT

BACKGROUND AND AIM: we report the impact of COVID-19 on the follow-up in pediatric cardiology consultations and its implications on the delay in management, especially for patients with congenital heart disease at the Mohammed VI University Hospital in Marrakech METHOD: This is a telephone survey concerning 200 patients followed in pediatric cardiology consultation at the Mother Child Hospital of the Mohammed VI University Hospital in Marrakech during the period from March 2020 to June 2020. RESULT(S): We identified 200 patients among 317 during the telephone survey, 117 were unreachable by telephone;the mean age was 5 years and 6 months with intervals ranging from 11 months to 16 years. Most of our patients had a low socio-economic level, 60% followed by an average of 39%. As for the reason why the patients missed their consultations: 38% had not been able to consult because of the confinement, 28% thought that there were no more consultations, 25% were afraid of being contaminated by the covid -19 in the hospital, 12% had no means of transport, 11% had no authorization to travel, 10% were confined to more than 200 km from the hospital, 6% were unaware that appointments were postponed and finally 2% had not been able to consult for lack of means. CONCLUSION(S): It is necessary to take measures to recover patients who have missed their consultation because of this pandemic.

3.
Paediatrics and Child Health (Canada) ; 27(Supplement 3):e42-e43, 2022.
Article in English | EMBASE | ID: covidwho-2190153

ABSTRACT

BACKGROUND: Public health preventive measures have been a necessary intervention in preventing COVID-19 transmission. OBJECTIVE(S): The objectives of this study were 1) To investigate how the adherence to COVID-19 public health measures among parents and children in Ontario changed over time;2) To determine if provincial lockdowns were associated with higher adherence to public health measures among parents;3) To determine if school closures were associated with higher adherence to public health measures among children. DESIGN/METHODS: A longitudinal study was conducted in children aged 0-10 years and their parents through the TARGet Kids! COVID-19 Study of Children and Families in the Greater Toronto Area, Canada (April 2020 -May 2021). Parents completed weekly questionnaires on sociodemographics and public health practices. The primary exposure was calendar date. Secondary exposures were provincial lockdowns and school closures. The primary outcome was adherence to public health preventive measures (staying home, limiting visitors in the home, avoiding contact with others, socially distancing, and handwashing, measured as number of days practicing per week) measured separately for parents and children. Linear mixed effects regression and piecewise linear splines mixed effects models were conducted. RESULT(S): 819 children and their parents contributed 13,220 observations to the study over 13 months. Mean age was 5.6 years (SD=2.7) and 373 were female (45.5%). 273 children (35.1%) had a parent who worked as an essential worker and 254 (35.4%) of families lived in a COVID-19 'hotspot'. The number of days per week that parents adhered to all 5 public health measures decreased by 0.029 days (p<0.001), and by 0.146 days for children (p<0.001) over the study duration. For parents, adherence to the five public health measures decreased over time during the first lockdown (beta=- 0.06, p<0.001) and first reopening (beta=-0.01, p<0.001), but increased again during the second lockdown (beta=0.01, p<0.001). For children, adherence to the five public health measures decreased over time during the first school closure, increased during the second closure, and decreased during second reopening (beta=-0.04, p<0.01). See Figure 1. CONCLUSION(S): Parents and children both decreased in their adherence to social distancing, staying at home, and avoiding contact with others over time. Lockdown after a period of reopening increased parent adherence to public health measures and school closures increased adherence in children. Supports may be necessary to help children and parents maintain adherence to public measures over prolonged periods of lockdown and school closure. .

4.
Journal of Pediatric Endoscopic Surgery ; 4(Supplement 2):S35, 2022.
Article in English | EMBASE | ID: covidwho-2175608

ABSTRACT

Background: To evaluate the effect of Covid-19 pandemic on clinical course and management of cases that underwent bronchoscopy for suspected foreign body aspiration (FBA) in children. Method(s): The patients underwent bronchoscopy with a presumptive diagnosis of FBA between July 2018 and December 2021 was evaluated for demographic features, clinical findings, management details and outcomes. Patients divided in two groups;before pandemics (Group A) and during pandemics (Group B). The groups were compared according to the abovementioned parameters. Result(s): Totally 79 cases with median age of 5 years (4-5) in Group A (n = 47) and 3 years (2-3) in Group B (n = 32) were included (p<0.05). The witnessed aspiration was significantly higher in Group B (90.6%) when compared to Group A (53%) (p<0.05). Admission time was less than 48 h in 30 cases (64%) in Group A, 23 cases (72%) in Group B (p = 0.002). The intervention time was less than 24 h in 30 cases (64%) in Group A, 9 cases (28%) in Group B (p = 0.002). Bronchoscopy performed after Covid-19 PCR testing in all cases in Group B. The positive FBA rate was 38% (n = 18) in Group A, and 59% (n = 19) in Group B (p = 0.067). Conclusion(s): During pandemics, bronchoscopy for FBA was performed in younger infants than before pandemics and witnessed aspiration was significantly more common in that period. The differences in age groups and symptoms may be explained by spending more time at home during pandemics. Although waiting for the PCR test results causes delays in the intervention, this delay did not cause any respiratory distress in the present study.

5.
Innovations in Clinical Neuroscience ; 19(10-12):40-42, 2022.
Article in English | EMBASE | ID: covidwho-2169602

ABSTRACT

The mental health of children and adolescents has been significantly affected by the COVID-19 pandemic, and recent data suggests there had been an upsurge of psychiatric morbidity in this subgroup of population. Nonpharmacological behavioral intervention in the form of play therapy has been regarded as one of the best treatment strategies in children with emotional disorders. During lockdown, we attempted a play therapy via telemedicine. In this case report, we describe the case of a four-year-old girl who had sudden-onset behavioral problems following an unplanned hair cut during the lockdown, which was managed with teleplay therapy. Copyright © 2022, Matrix Medical Communications. All rights reserved.

6.
European Psychiatry ; 65(Supplement 1):S501, 2022.
Article in English | EMBASE | ID: covidwho-2153999

ABSTRACT

Introduction: Clinical practice has shown that SARS-CoV-2 viral infection increases the likelihood of developing mental disorders. Clinical practice has shown that SARS-CoV-2 viral infection increases the likelihood of developing mental disorders. Objective(s): To analyze clinical indicators of patients with COVID- 19 with mental disorders and to identify predictors of adverse outcomes associated with mental state on its basis. Method(s): The study included 97 patients, 41 men and 56 women (62.3+/-15.3 years of age). During the observation period, 26 people died and 71 people recovered. Data collection was carried out using a questionnaire (109 variables). Binary logistic regression and Cox proportional hazards regression were used. Result(s): In the study group, death occurred on average after 11.5 days. In this group, the mental state of patients was more severe with a predominance of cases of delirium.With age, the probability of a fatal outcome increased by 1.03 with each year of life.The severity of mental disorder had a greater impact onthe risk of deathcompared to age (p=0.003). Improvement of the mental state of patients during psychotropic therapywas associated with a reduction in the risk of an unfavorable outcome of coronavirus infection by 11.11 times. The greatest contribution to the unfavorable outcome was made by the severity of infection: the risk of death increased by 33.17 times. Conclusion(s): Asevere or extremely severemental state increased the risk of death by 4.55 times. The most significant factor in predicting mortality was associated with the severity of the underlying disease.

7.
British Journal of Surgery ; 109(Supplement 5):v123, 2022.
Article in English | EMBASE | ID: covidwho-2134879

ABSTRACT

A 5-year-old boy was referred acutelytoThe on-call ENT doctor following multiple remote consultations with his General practitioner with 2 months history of worsening left-sided foul-smelling nasal discharge and bleeding. He underwent examination under anaesthesia and removal of nasal foreign body which was subsequently identified as a button battery (intra-operative as well as imaging pictures included). This case highlights The challenges posed to clinicians during The COVID-19 pandemic but also serves as a reminder to keep a high index of suspicion and low threshold for clinical examination in suspected cases of nasal foreign body. It also highlights that since COVID19 omicron variant has emerged it is more than significant to evaluate cases that are assessed remotely with increased care to avoid any further misses or mistakes.

8.
Clinical and Experimental Rheumatology ; 40(10):83-84, 2022.
Article in English | EMBASE | ID: covidwho-2067774

ABSTRACT

Objectives. To determine characteristics associated with a more severe COVID-19 outcome in people with Sjogren's disease (SJD). Methods. People with SJD and COVID-19 reported to two international registries (Sjogren Big Data Consortium and COVID-19 Global Rheumatology Alliance) from March 2020 to October 2021 were included. An ordinal COVID-19 severity scale was defined: (1) not hospitalized, (2) hospitalized with no ventilation, (3) hospitalized requiring non-invasive ventilation, (4) hospitalized requiring invasive ventilation, and (5) death. Odds ratios (OR) were estimated using a multivariable ordinal logistic regression model adjusted for age, sex, comorbidities and anti-rheumatic medications included as covariates. Results. A total of 898 people with SJD were included (825 (91.8%) women, mean age SARS-CoV-2 infection diagnosis: 55.5 years), including 652 patients with primary SJD and 246 with other associated systemic rheumatic diseases. 33.9% were hospitalized, 14.5% required ventilation, and 4.3% died. In the multivariable model, older age (OR 1.03, 95% CI 1.02 to 1.05), male sex (OR 1.81, 95% CI 1.10 to 2.92), two or more comorbidities (OR 2.99, 95% CI 1.92 to 4.67;vs none), baseline therapy with corticosteroids (OR 2.04, 95% CI 1.20 to 3.46), immunosuppressive agents (OR 2.09, 95% CI 1.30 to 3.38) and B-cell depleting agents (OR 5.38, 95% CI 2.77 to 10.47) were associated with worse outcomes (reference for all medications: hydroxychloroquine only). Conclusions. More severe COVID-19 outcomes in individuals with Sjogren's are largely driven by demographic factors and baseline comorbidities. Patients using immunosuppressants, especially rituximab, also experienced more severe outcomes.

9.
Open Access Macedonian Journal of Medical Sciences ; 10(C):257-260, 2022.
Article in English | EMBASE | ID: covidwho-2066672

ABSTRACT

BACKGROUND: Psoriasis is a chronic inflammatory disease that affects 2% of population. About 0.5–2% of psoriatic cases develop during pediatric age. In most cases, the condition is responsive to topical treatment. However, a small percentage of children require systemic treatment with conventional systemic drugs or biological agents, such as anti-tumor necrosis factor (TNF)-α. Adalimumab (ADA) is an anti-TNF-α recently approved for pediatric psoriasis in the European Union (from 4 years of age, 2015). CASE PRESENTATION: We describe our experience treating a 5-year-old female patient affected by severe plaque psoriasis with ADA biosimilar during SARS-CoV-2 pandemic outbreak also using teledermatology. CONCLUSION: The case reported in this article highlights the safety and the effectiveness of ADA biosimilar MSB11022 (Idacio®) in the treatment of a 5-year-old female affected by plaque psoriasis and paves the way to bigger trials for a more extensive use of TNF-α inhibitor biosimilars for psoriasis in pediatric population.

10.
ARS Medica Tomitana ; 27(1):31-35, 2021.
Article in English | EMBASE | ID: covidwho-2065353

ABSTRACT

Childhood inflammatory multisystemic syndrome (CIS-C) is a serious late complication of SARS-CoV-2 infection that can develop in some children and young adults. Criteria for defining SIM-C in children include fever>= 38.0degreeC, laboratory findings suggestive of an inflammatory process increased - C-reactive protein, D-dimer, VSH, ferritin, LDH, IL-6, neutrophils, procalcitonin, venous blood gas and lactate levels, brain natriuretic peptide;decreased - lymphocytes, platelets, serum albumin, serum sodium, manifestations of multisystem involvement with >2 organs/systems (cardiac, renal, respiratory, haematological, gastrointestinal, dermatological or neurological), absence of plausible alternative diagnosis, recent or currently positive COVID-19 infection, or contact with confirmed COVID-19 case within 4 weeks prior to onset of symptoms. The authors present the case of a 3-year-old girl aged 3 years and 5 months, admitted to the Pediatric Clinic of the Hospital Clinic Judetean de Urgenta Constanta in January 2022, for fever (39.5degreeC), microerythematous rash, semi-productive cough. and dyspnea. Investigations detected anticovid antibodies present, with no SARS cov2 infection diagnosed in the personal pathological history. Copyright © 2021 Badescu Anca Gabriela et al., published by Sciendo.

11.
Otolaryngology - Head and Neck Surgery ; 167(1 Supplement):P113, 2022.
Article in English | EMBASE | ID: covidwho-2064496

ABSTRACT

Introduction: The SARS-CoV-2 pandemic killed over 6 million people worldwide. Children were described to have predominantly mild or asymptomatic infections and to be less exposed to the virus, at least for the initial variants. In the present study, we describe how SARS-CoV-2 can silently infect tonsils and adenoids in children undergoing adenotonsillectomy. Method(s): In this cross-sectional study we assessed children who underwent adenotonsillectomy between October 2020 and September 2021 in a secondary hospital in Brazil. All the caregivers denied any symptom of acute viral upper airway infection in the month prior to surgery. Briefly, nasal cytobrush (NC), nasal wash (NW) and tonsillar tissue fragments posttonsillectomy were tested by RT-PCR, immunohistochemistry (IHC), in situ immunofluorescence (IF), and flow cytometry. Result(s): A total of 48 children (18 females, median age 5.5 years) were enrolled. None of them had been vaccinated against COVID-19 at the time of surgery. Only 2 had a history of previous COVID-19 diagnosis, 3 and 5 months, respectively, before surgery. SARS-CoV-2 RNA was detected in 25% (12) of patients-20% in palatine tonsils, 16.27% in the adenoids, 10.41% in NC, and 6.25% in NW. IHC labeling showed viral nucleoprotein presence in both adenoids and palatine tonsils, in epithelial surface and lymphoid cells from extrafollicular and follicular regions. In 5 out of 7 patients, in situ IF showed the expression of ACE2 and TMPRSS2 and viral spike protein in the tonsillar tissue. Flow cytometry revealed that SARS-CoV-2 is predominantly observed in CD123+ dendritic cells (10.57% of all tested sites), followed by CD14+ monocytes (6.32%). Conclusion(s): According to these results, the prevalence of SARS-CoV-2 infection seems to be higher than expected and underdiagnosed in children at this age group. Palatine tonsils and adenoids are important sites of infection and may be a reservoir for the virus. Nevertheless, it is still unclear the impact of these results on virus transmission.

12.
Otolaryngology - Head and Neck Surgery ; 167(1 Supplement):P100-P101, 2022.
Article in English | EMBASE | ID: covidwho-2064483

ABSTRACT

Introduction: To evaluate and validate the use of a remote check application in real life to enable cochlear implant (CI) recipients or parent/caregivers to monitor at home their progress and to help their clinicians to determine and plan for clinical visits based on their needs. Method(s): A total of 110 implanted patients (age range: 6-77 years;12-month implant experience and familiarity with vocabulary for digits 0 to 9) were included in this study, in which each subject served as their own control. The test battery includes an implant-site photograph, impedance measurements, datalogs, questionnaires, speech perception, and aided threshold tests. Chi-square test was used for statistical analysis of the results obtained at home vs clinical setting. Result(s): In all but 2 cases (108/110, 98%) the test battery reached the same conclusion as the clinician in determining whether the recipient required any clinical action. Of recipients and parents/ caregivers, 90% (100/110) reported being "satisfied" or "very satisfied" if their clinic visits were based on results from the selfadministered remote test battery (P<.001). Reasons for satisfaction included the convenience of remote monitoring, the ability to request an appointment if needed, and the continued involvement of their clinician. Satisfaction ratings with the remote monitoring concept were moderately to strongly correlated with perceived improvement in convenience and time involved. Conclusion(s): Most respondents recognized that the remote check battery has the potential to save time, reduce costs, and increase the convenience of aftercare. The clinicians with remote check battery are adequately informed regarding patient management, appointment scheduling, and required clinical actions. This may also further support global case management during COVID-19 pandemic time of recommended social distancing.

13.
Otolaryngology - Head and Neck Surgery ; 167(1 Supplement):P289-P290, 2022.
Article in English | EMBASE | ID: covidwho-2064406

ABSTRACT

Introduction: Measuring pediatric odor detection in a COVID-19-impacted context is important. Our goal was to determine whether the Pediatric Smell Wheel (PSW) can be used effectively in this clinical setting. Method(s): Consecutive patients at a pediatric otolaryngology clinic who were aged 5-17 years were recruited. Demographics including gender, race, use of nasal topical medications, previous nasal surgery, and previous COVID-19 infection were collected. Each child performed a test of their sense of smell using the PSW (Sensonics International) under direct supervision, and scores were compared. Result(s): Forty-three children were included;mean age was 9.1 years (95% CI, 8.0-10.1);19 (44.2%) were female and 24 (55.8%) male. Thirteen (30.2%) used nasal sprays, 10 (23.2%) had undergone adenoidectomy, and 4 (9.3%) had other nasal surgery. Twenty (46.5%) had a previous COVID-19 infection. Mean and median PSW score out of 11 was 7 (95% CI, 6.4-7.7), ranging from 2 to 10. There was no significant difference in scores based on age, gender, race, use of nasal topicals, previous nasal surgery, or previous COVID-19 infection. Children were able to perform the task as directed. Percentage correct for each odorant on the PSW ranged from 86% for identifying the onion scent to 27.9% for identifying the popcorn scent. Cronbach alpha was 0.54, and deleting any individual item did not improve it above 0.57, indicating low internal consistency of the PSW. Conclusion(s): During the COVID-19 pandemic, children performed more poorly identifying odors on the PSW than previously reported. The reliability of the PSW may not be adequate in today's context.

14.
Archives of Disease in Childhood ; 107(Supplement 2):A409-A410, 2022.
Article in English | EMBASE | ID: covidwho-2064056

ABSTRACT

Aims Background Child and young person (CYP) mental health is a public health priority with 75% of life long mental health problems starting before the age of 25.1 Prevalence of all mental health disorders among children aged 5-15 years is 11.2%.2 Aims * To highlight current in-patient numbers and pathway, from initial presentation to discharge. * Identify any changes that can be made to improve care foryoung people admitted with mental health presentations Methods Patients were identified from daily handover sheets from January 2019 to April 2021. Information on each patient was gathered using electronic patient record. Information gathered included: 1. Number of CAMHS inpatients broken down by age, gender and diagnosis. 2. Patient pathway including time spent waiting in A&E 3. Use of Registered mental health nurse (RMN) 4. Treatments provided on ward 5. Daily review by peadiatric and CAMHS team 6. Length of stay 7. Place of discharge Results 231 CYP admitted under CAMHS between January 2019 and April 2021. See figure 1. Of these admissions 86% were female. 27 patients accounted for a fifth of admissions. Average age at admission 14 years (8-16 years). IntentionalOverdose was the most common reason for admission. See figure 2. Due to changes in computer systems, complete information regarding patient stay was available for patients between April 2020 to April 2021. 72% of patients beached four hour ED wait of which 80% due to waiting for RMN to become available. 86% of patients required an RMN. 13% of patients were under section at some point during admission. Fifth of patients were discharged to tier 4 services. Average time from admission to discharge was 10 days. The longest admission was 264 days. 97% of patients had daily paediatric reviews and 80% of patients had a daily CAMHS reviews. 62% of patientsengaged in alternative therapy during their stay. Eg art therapy or youth support worker. Conclusion Admission rates dropped during the first COVID 19 lockdown and rates tend to be lower during summer months. There tends to be increased mental health admission following return to school in September. Eating disorder patients tend to have more prolonged inpatients stay due to waiting for Tier 4 bed availability. Lack of RMNs lead to prolonged wait time in ED prior to admission. A mental health awareness teaching week was delivered to the department to encourage the team to carry out HEADSSS assessment for all young people admitted and tailor services around the YP to help improve care of patients with mental health issues. (Figure Presented).

15.
Archives of Disease in Childhood ; 107(Supplement 2):A369-A370, 2022.
Article in English | EMBASE | ID: covidwho-2064047

ABSTRACT

Aims Raised Intracranial Pressure (ICP) is frequently encountered condition amongst children due to neurological and non-neurological etiologies. It contributes towards 20% of the admissions in our PICU at tertiary care institute of North India. Timely diagnosis of raised intracranial pressure is critical for appropriate management. Ultrasonographic measurement of optic nerve sheath diameter (ONSD) is non-invasive point of care tool to recognize raised intracranial pressure however there are very limited studies in pediatric population on this. Aim of this study was to measure the ONSD of children admitted in pediatric intensive care unit (PICU) to identify the difference in ONSD among the pediatric patients with normal and raised ICP and to achieve the cut-off value for diagnosing raised ICP. Methods A Hospital based observational comparative study conducted at PICU of a tertiary care institute of national importance in North India. ONSD measurement of all the patients aged 2-14 years admitted in pediatrics department for >48 hours was done in two phases due to COVID-19 related restrictions in routine admissions for some months. First phase was from 1st January 2020 to 31st March 2021 and second phase started from 15th January 2022. Complete enumeration technique was used for the study. Children receiving treatment for raised ICP based on clinical features (Muir's criteria) and neuroimaging were included in raised ICP group and they were compared with the patients without any signs of raised ICP. Optic nerve sheath diameter was measured in both the groups on Day 1 (i.e. within 24 hours of admission) and Day 2 of admission. Third and last ONSD measurement was done on any day between day 4 and day 7 of admission. On each day, 3 readings were taken from each eye and average of 3 readings was used for final statistical analysis for that particular day. Treating team was unaware of the USG findings throughout the stay of the patient in the department. Results Total 101 patients recruited, among them 16 patients had raised ICP and 85 patients had normal ICP. The mean optic nerve sheath diameter on day 1 was found to be higher in the patients with raised ICP (Mean ONSD = 4.955 +/- 0.80) as compared to those with normal ICP (Mean ONSD = 4.05 +/- 0.43). Their mean difference was 0.90 mm (95% CI 0.07-1.48 p value <0.01). Mean ONSD on day 2 also was higher in raised ICP patients (Mean ONSD = 4.82 +/- 0.73) in comparison to normal ICP patients (Mean ONSD = 4.06 +/- 0.47) which was statistically significant (p value = 0.001). The cut-off ONSD value for detecting the raised ICP was estimated to be 4.35 mm on ROC curve with area under the curve 0.862 (95% CI, 0.721-0.943), sensitivity of 75% and specificity of 76.5%. Conclusion Raised ICP is one of the important neurological entities in children contributing towards significant morbidity. Measurement of ONSD by trans-orbital ultrasound was able to detect raised ICP with excellent discriminatory performance.

16.
Archives of Disease in Childhood ; 107(Supplement 2):A329-A330, 2022.
Article in English | EMBASE | ID: covidwho-2064038

ABSTRACT

Aims Hand sanitizers are increasingly used in most households since the onset of the COVID-19 pandemic. However, improper use and accidental and deliberate ingestion of sanitizer solutions have been associated with numerous health risks to children. This study aimed to assess knowledge and practices regarding safe handling and disposal of alcohol-based hand sanitizers and surface disinfectants among a cohort of parents in urban Sri Lanka. Methods This observational cross-sectional study was performed including parents of children admitted to North Colombo Teaching Hospital for a period of six months from August 2021. Data were collected regarding parental knowledge regarding safe handling and disposal of hand sanitizers, and their health hazards by paediatric post-graduate trainees. Data were collected using a pre-tested interviewer administered questionnaire. All data were analysed using SPSS 17.0. Results Out of 153 children recruited to the study, the mean age was 5.3 years (range: 1 month - 14 years) and male children (92, 60.1%) outnumbered female children (61, 39.9%). The majority of mothers (126, 82.4%) and fathers (133, 86.9%) had received education at least up to secondary school. 124 parents (81%) had been using hand sanitizers at home regularly. Only 113(73.9%) parents believed that preschool children were the most vulnerable for accidental ingestion of sanitizers and 40 parents (26.1%) were unaware that sanitizer solutions can be accidentally inhaled by toddlers. Knowledge was poor regarding occurrence of potential symptoms and side effects such as sore throat (56, 36.6%), irritation of eyes (30, 19.6%), breathing difficulties (40, 26.1%), high heart rate (72, 47%), aspiration (43, 28.1%) and low blood sugar (108, 70.5%). Only 132 parents (86.2%) knew how to clean and disinfect their home premises safely and 29 parents (18.9%) didn't know how to store cleaning products safely. Sixty-four parents (41.8%) were unaware regarding how to get information on safe cleaning practices. Forty-two parents (27.4%) kept sanitizer bottles within easy access to children whilst 85 parents (55.5%) had been storing sanitizers in unlabeled bottles. Ninety-eight parents (64%) were not keen to read the signage alerts in sanitizer storage bottles. Only 25 parents (16.3%) safely disposed sanitizer bottles. Thirty-three parents (21.6%) put sanitizer bottles together with food items in carriage bags from super markets. Conclusion The findings of this study inform that knowledge in parents regarding safe use of sanitizers can further be improved specially, in areas of local and systemic effects of sanitizer poisoning and information resources of safe cleaning practices. As a number of parents use and dispose hand sanitizers unsafely, the effectiveness of awareness programs to improve safety practices among parents should be evaluated.

17.
Archives of Disease in Childhood ; 107(Supplement 2):A60, 2022.
Article in English | EMBASE | ID: covidwho-2064016

ABSTRACT

Aims Covid testing and primary care data for Children and Young People (CYP) has not yet been linked at the national level in England. However, such linkage has been established using the Discover Whole System Integrated Care (WSIC) database in Northwest London (NWL). We describe pattern of primary care utilisation, among CYP of 0 - 24 years of age in NWL before and after testing positive for Covid-19 infection. The insights are needed in understanding the impact of Covid-19 infection on both the patient and the health care system. Methods We conducted a retrospective cohort study using routinely collected primary care health care data in NWL from the Discover WSIC de-identified database. It is a local warehouse of electronic patient records for research, the database is de-identified. Four cohorts were studied to represent CYP at various key Covid-19 vaccination focused age groups of 0-4 years, 5-11 years, 12-15 years and 16-24 years. Their GP events 180 days preceding and following the confirmed PCR positive test result were analysed. GP events were counted as number of distinct days with one recorded activity. Results By 16th February 2022, positive PCR results were obtained for 104,702 CYP, 14% (d=745,268) of registered CYP population in NWL. The frequency of GP events in the first seven days of the post-test period was similar to the frequency in the seven days preceding, however outside this period they differed substantially, from 279 per 1,000 pre-test to 92 per 1,000 post-test. The 16-24 year age group showed the largest decrease at 150 to 180 days after a confirmed positive PCR test result, from 1,290 GP events pre-test to 195 post-tests. There was no increase in GP events for any age group from two weeks post confirmed PCR positive test. Conclusion Our analyses showed that there is evidence of increase GP activity by CYP a week before and after a Covid- 19 infection diagnosis. However, we did not find any evidence at population level of prolonged post Covid-19 infection symptoms for which GPs were contacted.

18.
American Journal of Transplantation ; 22(Supplement 3):697-698, 2022.
Article in English | EMBASE | ID: covidwho-2063487

ABSTRACT

Purpose: At the onset of pandemic, no information was available on response of pediatric kidney transplant (PKTX) recipients to COVID19. When COVID19 vac- cines became available, response of immunosuppressed children to the vaccines was also not known. Here we present information on response to COVID19 and its vaccine in PKTX recipients. Method(s): Since March 2020, we systematically collected information on the incidence of COVID19 exposure, COVID19 disease and complications, effects on allograft function in all PKTX followed at Children's National Hospital (CNH). Data on clinical and SARS Cov2 IgG (measured 3-4 weeks after 2nd dose and repeated 1-2 months later if negative) in vaccine recipients was collected. Result(s): Of 112 PKTX (age 2-21 years) at CNH, 12 (10.7%) had COVID19 RNA detected in nasopharyngeal (NP) swabs, 2 children tested negative post exposure. Of 12 with COVID19, 3 were hospitalized with fever and cough but did not require intensive care, 4 had mild symptoms (cough, loss of smell and body aches), and 5 were asymptomatic. Four of 12 with COVID19 developed dnDSA and biopsy proven mixed ACR and AMR;3 of these had non-adherence to immunosuppression. One child lost allograft despite treatment;3 responded partially (figure). Of 50 (>12 years) children eligible for vaccine, 45 (90%,15 LR, 30 DD) received it 4.2+ 3.6 (0.16-14.5) years after transplant. Pfizer vaccine was given to 39, Moderna to 5 and Johnson and Johnson to one. Eight of 45 (17.8%) had mild side effects to the vaccine including sore arm, tiredness, and muscle aches. None required hospitalization nor developed dnDSA, ACR or AMR. Of 41 vaccine recipients tested for SARS Cov2 IgG, 14 (34%) were positive at initial testing, 5 (12.8%) had antibody detected on repeat testing, 22 (53.6%) have remained negative (figure). Of 14 who tested positive upon initial testing, 8 were diagnosed with COVID19 and 2 had COVID19 exposure before receiving the vaccine. No vaccine recipients have been diagnosed with COVID19. Conclusion(s): A minority of pediatric kidney transplant recipients developed COVID19 during the pandemic, most had mild symptoms. A small number of these children developed allograft rejection in combination with non-adherence to immunosuppression. Most children tolerated COVID vaccination without any significant side effects or development of ACR, AMR or dnDSA. Nearly 1/2 of PKTX recipients did not respond to vaccine after completing the original series and may benefit from a booster. It is possible that prior COVID19 disease or exposure may have boosted response to the vaccine in some children. (Figure Presented).

19.
American Journal of Transplantation ; 22(Supplement 3):731, 2022.
Article in English | EMBASE | ID: covidwho-2063453

ABSTRACT

Purpose: We report the first two pediatric liver transplants utilizing allografts from COVID+ donors, infected at time of organ procurement, demonstrating a pivotal step toward donor pool maximization amid a viral pandemic with poorly understood transmissibility in the pediatric patient. Method(s): This is a prospective and retrospective review of two pediatric liver transplants and their donors who tested positive for SARS-CoV-2 at time of procurement. Data was obtained through the electronic medical record system and UNet DonorNet platform. Result(s): The first donor is a 3-year-old male succumbing to head trauma. 1 of 5 nasopharyngeal swab RT-PCR tests demonstrated COVID-19 positivity while 1 of 3 bronchoalveolar lavage RT-PCR tests indicated SARS-CoV-2 infection. Preceding procurement in the second donor, a 16-month-old male with unknown etiology of cardiorespiratory arrest, 2 nasopharyngeal swab RT-PCR tests and 1 bronchoalveolar lavage RT-PCR test failed to detect SARS-CoV-2 infection. Diagnosis was not made until the Medical Examiner's office repeated a nasopharyngeal swab RT-PCR and archive plasma RT-PCR which were both positive for SARS-CoV-2. The two 2-yearold pediatric liver recipients underwent transplantation in November 2021. Continued follow-up demonstrates successful transplant void of viral transmission or hepatic artery thrombosis as liver chemistries have anticipatorily normalized with excellent graft function. One recipient experienced early portal vein thrombosis treated by interventional radiology with discharge on postoperative day 20. Conclusion(s): This report is the first to describe successful pediatric liver transplants from COVID+ donors. This data reinforces case reports in the adult transplant population of successful use of COVID + donor organs and further supports the judicious use of COVID+ donors for extrapulmonary pediatric organ transplant. The concern for donor-derived transmission must now be weighed against the realized benefit of successful, life-saving transplantation for end stage liver disease in the pediatric patient. (Figure Presented).

20.
Cardiology in the Young ; 32(Supplement 2):S103, 2022.
Article in English | EMBASE | ID: covidwho-2062128

ABSTRACT

Background and Aim: Pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) is a postim-munological reaction after SARS-CoV-2 infection. Various car-diac manifestations of PIMS-TS have been reported, namely pericardial effusion, ventricular arrhythmia, myocarditis, valvular regurgitation, and pericarditis. The aim of this study was to analyze clinical and laboratory features to distinguish any possible predic-tion for cardiac involvement in children with PIMS. Method(s): The PIMS patients under 18 years old treated in our center between July 2020 and December 2021 were included. Data of the patients were retrospectively obtained from their medical records. Result(s): A total of 46 patients with PIMS were examined during the study period. The mean age of study group was 9.4 +/- 4.6 years, 18/46 were female and 3 groups were formed according to their age ranges. Among them, seventeen patients (37%) had cardiac involvement with mean age was 8.7 years. Impaired cardiac func-tions were seen more in male patients (n: 10/17). Coronary artery dilatation seen in seven patients especially with mean age of 5.2 years (Age group 1,2,3;%36.4,%14.3,%0;p = 0.033;respectively) and especially related to high troponin T levels (p = 0.006). In our study group, cardiac involvement was shown more related to ProBNP and Troponin T (p = 0.008;p = 0.003). The cut-off val-ues of proBNP and troponin T for predicting in cardiac dysfunc-tion were 2759 pg/mL (95% confidence interval (CI), 0,83-1;sensitivity, 0.86;specificity, 0.93;AUC:0.92, p lt;0,001). Conclusion(s): Although there is a wide variability of symptoms, MIS-C is a rare, severe, less understood complication of COVID-19 that may cause multisystemic involvement in the patients. Clinicians should be aware of this condition in children with persistent fever and a family history of COVID-19. Cardiac involvement in chil-dren with PIMS may strongly be predicted by levels of Troponin T and ProBNP. Further more younger age and high Troponin T levels are the independent predictors for the coronary artery dila-tation among children with PIMS.

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