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1.
Vaccines ; 10(4), 2022.
Article in English | EMBASE | ID: covidwho-1822464

ABSTRACT

Background: Mixing two different vaccines has been utilized to minimize the impact of any supply chain interruptions and to combat the COVID-19 pandemic in Saudi Arabia. We conducted this study to evaluate the side effects, if any, associated with the mixed vaccination approach. Methods: An online survey study was administered among COVID-19 vaccine recipients in Saudi Arabia. Symptoms post vaccination were assessed in 311 vaccinated participants with two matched doses of either Oxford–AstraZeneca or Pfizer–BioNTech vaccines, or two mixed doses, respectively. Results: After the second dose, around 31% of the matched vaccine group reported no symptoms, while only 6% of the mixed vaccine group reported no symptoms. Most of the side effects after the second dose associated with matched vaccines were injection site pain (46%), while the mixed vaccines group reported significantly more symptoms compared with the matched vaccine group, which included fever (41%), fatigue (66%), muscle pain (44%), chills (17%) and injection site pain (60%). Conclusion: The data suggest the overall safety of the mixed vaccination protocol;however, it might be associated with side effects such as fever, fatigue, muscle pain, chills, and injection site pain. Further studies with a larger cohort size could shed more light on this aspect, which would be imperative for deciding to utilize a mixed vaccination approach.

2.
Antibiotics ; 11(4), 2022.
Article in English | EMBASE | ID: covidwho-1822410

ABSTRACT

The containment measures following COVID-19 pandemic drastically reduced airway infections, but they also limited the access of patients to healthcare services. We aimed to assess the antibiotic prescription patterns in the Italian paediatric primary care setting before and after the containment measures implementation. For this retrospective analysis, we used a population database, Pedianet, collecting data of patients aged 0–14 years enrolled with family paediatricians (FP) from March 2019 to March 2021. Antibiotic prescriptions were classified according to WHO AWaRe classification. An interrupted time series evaluating the impact of the containment measures implementation on the monthly antibiotic index, on the access to watch index, and on the amoxicillin to co-amoxiclav index stratified by diagnosis was performed. Overall, 121,304 antibiotic prescriptions were retrieved from 134 FP, for a total of 162,260 children. From March 2020, the antibiotic index dropped by more than 80% for respiratory infections. The Access to Watch trend did not change after the containment measures, reflecting the propensity to prescribe more broad-spectrum antibiotics for respiratory infections even during the pandemic. Similarly, co-amoxiclav was prescribed more often than amoxicillin alone for all the diagnoses, with a significant variation in the trend slope for upper respiratory tract infections prescriptions.

3.
Frontiers in Pediatrics ; 10, 2022.
Article in English | EMBASE | ID: covidwho-1822391

ABSTRACT

Acute interstitial nephritis (AIN) has been recently recognized as one of the infrequent kidney involvement phenotypes among adult patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Although SARS-CoV-2 associated intrinsic kidney disease has been scarcely reported in children, only one case of AIN temporally associated with the infection has been described in the pediatric population so far. We presented a case of a 12-year old boy who presented with fatigue, anorexia, and polydipsia following an RT-PCR that confirmed SARS-CoV-2 infection seven weeks prior to admission. Initial workup revealed increased serum creatinine (235 μmol/L), glucosuria, low-molecular-weight proteinuria, mild leukocyturia, and microhematuria with hyaline and granular casts on microscopy. Antibodies against the SARS-CoV-2 S protein receptor-binding domain confirmed prior infection with high titers. Kidney biopsy showed diffuse active interstitial nephritis with negative immunofluorescence and positive immunohistochemistry for SARS-CoV-2 in the inflammatory cells within the interstitium. Electron microscopy revealed several SARS-CoV-2-like particles. Kidney function continued to deteriorate despite several days of supportive therapy only (peak serum creatinine 272 μmol/L);thus, treatment with methylprednisolone pulse-dose therapy was initiated and was followed by oral prednisolone with gradual tapering. Kidney function completely recovered after 3 weeks post-discharge and remained normal after 11 weeks of follow-up (last estimated glomerular filtration rate 106 ml/min/1.73 m2) with only residual microhematuria. Our case adds to the emerging evidence of SARS-CoV-2 as a potential etiological agent of AIN in children and also suggests that interstitial kidney injury may result from secondary inflammatory damage. Epidemiological history, serologic testing, and SARS-CoV-2 detection in biopsy should be considered in the work-up of children with AIN of unknown etiology.

4.
Clinical Rheumatology ; 2022.
Article in English | EMBASE | ID: covidwho-1820937

ABSTRACT

SARS-CoV-2 infections in children are frequently asymptomatic or mild and can go unnoticed. This study aimed to describe the seroprevalence and clinical course of SARS-CoV-2 in a cohort of children with rheumatic diseases in a real-life setting and assess possible risk factors. A cross-sectional study was performed in a paediatric rheumatology unit (September 2020 to February 2021). At inclusion, a specific questionnaire was completed and SARS-CoV-2 serology was performed. Demographics, treatment and disease activity of patients with and without laboratory-confirmed SARS-CoV-2 infection were compared. A total of 105 children were included. SARS-CoV-2 infection was demonstrated in 27 patients (25.7%). The mean age was 11.8 years, and most patients were females (72.4%). The most frequent underlying condition was juvenile idiopathic arthritis (70.3%;19/27). Patients received immunosuppressive treatment in 78% of cases (21/27). Overall, 44.4% (12/27) of infected patients were asymptomatic. A total of 66.7% (18/27) of patients did not require medical assistance. Three patients required hospital admission because of COVID-19. Children with confirmed SARS-CoV-2 infection 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 SARS-CoV-2 (OR 5.05;CI 95%: 1.56–16.3 and OR 4.2;CI 95%: 1.26–13.9, respectively). In a cohort of Spanish paediatric patients with rheumatic diseases, clinical course of COVID-19 was mild, with more than one third of asymptomatic cases. Higher disease activity and oral corticosteroids appear to be risk factors for SARS-CoV-2 infection.Key Points• We aimed to investigate the seroprevalence of SARS-CoV-2 infection in a cohort of Spanish paediatric patients with RD, testing both symptomatic and asymptomatic patients. We also compared treatment and disease activity of patients with and without laboratory-confirmed SARS-CoV-2 infection.• In our cohort of 105 paediatric patients with rheumatic diseases, the clinical course of COVID-19 was mild and 44% of cases were asymptomatic. Three cases required hospital admission with no complications. Seroprevalence was 20%.• No association was found between disease activity or treatment with corticosteroids and symptomatic or asymptomatic infection. Higher disease activity and treatment with oral corticosteroids appeared to be risk factors for laboratory-confirmed SARS-CoV-2 infection.

5.
Progress in Nutrition ; 24(1), 2022.
Article in English | EMBASE | ID: covidwho-1819020

ABSTRACT

Objective: Body dissatisfaction is an increasing problem in adolescents, and it is thought that mindful eating and body image are related. These problems have become more serious during the pandemic period. This current study was carried out to examine the relationship between adolescents’ mindful eating, body image, and anthropometric measurements during COVID-19 pandemic. Methods: A total of 200 adolescents (100 boys and 100 girls) aged 11-17 years, were involved in the study. The data were collected by the researcher using the face-to-face interview method through a questionnaire. The Mindful Eating Questionnaire was used to determine mindful eating. The Stunkard body image scale was employed to evaluate the body image of individuals, and all anthropometric measurements were made by the researcher in accordance with technique. Results: The mean age of the individuals was 14.2±2.04 years, and more than half (52%) attended high school. 60.0% of obese boys and 38.0% of obese girls considered themselves obese. A statistically significant difference was found depending on gender in terms of body perception (p<0.05). No significant difference was found between the mindful eating scores of participants according to their body perception (p>0.05). A negative statistically significant correlation was determined between the total mindful eating score of those who described themselves as underweight, overweight, and obese, and BMI (kg/m2), waist circumference (cm), hip circumference (cm), and body fat (%) (p<0.05). It was also found there were negative significant relationships between mindful eating subscales, anthropometric measurements, and BMI (p<0.05). Conclusion: It was concluded that body image in adolescents was affected by gender and BMI, and anthropometric measurements were associated with mindful eating.

6.
Archivos Venezolanos de Farmacologia y Terapeutica ; 41(1):8-12, 2022.
Article in Spanish | EMBASE | ID: covidwho-1818550

ABSTRACT

COVID-19 is an infectious disease caused by the SARS-CoV-2 virus that was first identified in December 2019 in the city of Wuhan, Hubei province in the People’s Republic of China, the virus is transmitted from one person to another in the respiratory secretions that are dispersed when the infected person coughs, speaks or sneezes. With 10.93 deaths per million people from coronavirus as of April 6, 2020, Ecuador has one of the highest mortality rates from COVID-19 in Latin America, with only 7.46 Polymerase Chain Reaction tests. (RT-PCR) per 10,000 people. Pediatric cases were rare in the first days of the COVID-19 outbreak, but with the appearance of family aggregation, they began to appear, registering the first cases on March 27th. The pediatric group is always susceptible to upper respiratory tract infections because their immune system is developing. This report describes the epi-demiological situation of pediatric patients in Ecuador, where it was shown that adolescents aged 15 to 18 years were more susceptible to contracting COVID-19 and the group with the highest mortality was from 0 to 9 years old, it was also shown that of the total diagnostic tests performed, 63.6% were RT-PCR tests and 36.3% were rapid tests.

7.
Pediatria Polska ; 97(1):66-70, 2022.
Article in English | EMBASE | ID: covidwho-1818534

ABSTRACT

Paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 infection (PIMS-TS) is a new disease in children, connected with the COVID-19 pandemic. The main cause of this disease is dysregulation of the immune homeostasis. We report the first case of PIMS-TS in the Polish Mother’s Memorial Hospital Research Institute in Lodz. Many non-specific symptoms presented by the patient were the cause of the primary care physician’s therapeutic failure, which resulted in the boy being transferred to the district hospital and then to the institute in Lodz. During the complex diagnostic process anti-SARS-CoV-2 antibodies in the IgM and IgG classes were detected. The initial diagnosis of PIMS-TS was made, and treatment with immunoglobulins and acetylsalicylic acid was initiated. The patient’s condition improved the following day. The aim of this report is to emphasize that typical symptoms do not always determine known disease entities, and to point out the need to constantly improve one’s knowledge.

8.
Lung India ; 39(2):191-194, 2022.
Article in English | EMBASE | ID: covidwho-1818451

ABSTRACT

Pulmonary veno-occlusive disease (PVOD) is an important cause of pulmonary arterial hypertension (PAH) and is classified under idiopathic cause of PAH. Over a period of time, PVOD has been studied in detail in the western countries and various diagnostic criteria are formulated. Being a rapidly progressive disease, early diagnosis is of utmost importance which helps to initiate appropriate treatment. Recent studies suggest that PVOD has a genetic predisposition and has an autosomal recessive pattern of inheritance. Here, we discuss the case of siblings diagnosed with PVOD to have such genetic predisposition for this disease.

9.
Frontiers in Endocrinology ; 13, 2022.
Article in English | EMBASE | ID: covidwho-1817935

ABSTRACT

Prader–Willi syndrome (PWS) is a genetic disorder caused by the lack of expression of genes on the paternally inherited chromosome region 15q11.2-q13. It is a multisystem disorder that is characterized by severe hypotonia with poor suck and feeding difficulties in early infancy, followed in early childhood by excessive eating and gradual development of morbid obesity. The incidence of type 2 diabetes mellitus is high, particularly in obese patients. Non-alcoholic fatty liver disease has also been reported in some patients with PWS. Liver adenomatosis is a benign vascular lesion of the liver, defined by the presence of >10 adenomas, in the otherwise healthy liver parenchyma. We report the first case of a patient with PWS with severe obesity, type 2 diabetes mellitus, and non-alcoholic fatty liver who also developed liver adenomatosis, review the pediatric literature on liver adenomatosis, and discuss the potential underlying mechanisms.

10.
Respirology ; 27(SUPPL 1):193, 2022.
Article in English | EMBASE | ID: covidwho-1816645

ABSTRACT

Introduction/Aim: Harnessing Youth Voice is one of the most effective strategies for communicating with young people. In September 2021, the Youth Voices COVID-19 video competition was created following a need for innovative strategies to disseminate COVID-19 health and wellbeing information to adolescents. The aims were to (1) reach and engage young people to improve COVID-19 health literacy and vaccine uptake among high school students (aged 12- 18 years) and (2) provide an opportunity for adolescent leadership, advocacy and skills development. Methods: The competition was held over 1 month. High school students across NSW were invited to submit a 45 second video addressing (1) COVID-19 vaccinations, (2) looking after your wellbeing during the pandemic, or (3) tackling COVID-19 misinformation. Videos were judged by a panel of health, education and industry experts and prizes awarded to the top three videos within and outside of western Sydney. An evaluation survey was distributed to participants post-competition. Results: The competition engaged 92 students (from 43 high schools), with 84 video entries submitted. The winning videos were uploaded online and to date have been viewed >4000 times. Participants (n = 58) agreed that the competition improved their understanding of COVID-19 (84% agreement) and increased their confidence to receive the vaccine (88% agreement). Participants reported gaining technology skills (71%), confidence (62%) and communication skills (57%) from taking part. Conclusion: The video competition was an innovative and effective strategy for improving the COVID-19 health literacy and vaccine confidence of high school students. Moreover students developed a broad range of translatable skills for real world learning. Youth involvement enables young people to influence practices and decisions that affect them.

11.
Respirology ; 27(SUPPL 1):185, 2022.
Article in English | EMBASE | ID: covidwho-1816637

ABSTRACT

Introduction: PCD is a rare, progressive disease resulting in upper and lower respiratory tract manifestations that increase the risk of sleep disordered breathing. This study is the first to characterize sleep quality in Australian children with PCD and examine it is relationship to mood and health-related quality of life (HrQOL). Methods: Clinically stable children with PCD (1-18 years of age) were recruited. Subjective sleep quality was assessed with the SDSC, PDSS and OSA-18 questionnaires. HrQOL and depressive symptoms were assessed via age-appropriate QOL-PCD and CDI questionnaires. Demographic data including passive smoke exposure was recorded. Pulmonary function testing and ENT assessments were performed. Children underwent overnight polysomnography including transcutaneous CO2 and video monitoring (50% studies complete due to Covid restrictions). Results: Twenty-two participants (10 female) aged 8.1 ± 5.1 (mean ± SD) years were recruited. Mean(±SD) FEV1 was 78.2 ± 21.2%. Ninety-two percent of children assessed were diagnosed with chronic rhinosinusitis and 35% exposed to regular passive cigarette smoke. Polysomnography identified sleep fragmentation in 90% of studies and one case of mild obstructive sleep apnoea. Subjective sleep questionnaires revealed 76% of parents and 50% of children reported clinically significant scores indicating sleep disturbance and excessive daytime somnolence respectively. Twenty-seven percent of parents reported a moderate-severe impact of sleep disturbance on QOL. Forty-six percent of children had elevated depression scores. HrQOL and mood scores were correlated with poor subjective sleep quality. Children exposed to passive cigarette smoke had poorer subjective sleep quality and lower HrQOL and mood. Conclusion: Even in periods of clinical stability, children with PCD exhibit poor sleep quality and excessive daytime sleepiness and this is associated with lower mood and HrQOL. Based on these findings, we recommend routine screening for mental health and symptoms of sleep disturbance in children and adolescents with PCD. The continued education of children and families regarding the effects of cigarette smoke is advised.

12.
Brain Injury ; 36(SUPPL 1):42-43, 2022.
Article in English | EMBASE | ID: covidwho-1815750

ABSTRACT

Objectives: The objective of the School Transition After Traumatic Brain Injury (STATBI) project is to rigorously evaluate the impact of BrainSTEPS, a formal return-to-school (RTS) program, on academic, social, and health outcomes for students in grades K-12 who have experienced TBI of any severity, compared to students who have no formal RTS programming. In 2020, the study shifted to examine the effects of COVID-related educational changes on students who experienced a TBI prior to the pandemic. Methods: STATBI uses a mixed method, cohort-controlled research design. The IRB-approved protocol includes electronic survey administration and virtual interviews with parents and children. The data included in this presentation is crosssectional, although the full STATBI protocol is longitudinal. Measures include standardized assessments of executive function, participation, social, and cognitive abilities, in addition to semi-structured interviews with parents, students, teachers, and BrainSTEPS team members. Between 11/2020 and 1/ 2021, 250 families were invited to participate in this portion of the study. Results: Of the 46 families that completed majority of the protocol, the average student age was 14.2 years (SD = 3.3). The sample included students with mild (n = 19), moderate (n = 12), and severe (n = 13) TBI. The average age at injury was 11.8 years (SD = 4.3) and average time since injury was 2.7 years (SD = 2.1). A total of 44 families completed the COVID questionnaire with 6.8% (n = 3) reporting that their students had been diagnosed with COVID, though none required hospitalization. Students with COVID missed 5 or more days of school. 13.6% (n = 6) of families reported a household family member having a diagnosis of COVID. Most families reported that their students were attending school in either a hybrid model (40.9%, n = 18) or fully remote (45.5%, n = 20). Families reported the following areas of accommodation were needed: physical accommodations (25%, n = 11), learning/thinking (36.4%, n = 16), and behavioral/social (22.7%, n = 10). Additional interview data regarding COVID, barriers and facilitators of COVID-related school changes for children with TBI, and performance across all measures in the protocol are currently being analyzed and will be available by the time of presentation. Conclusions: The STATBI project is unique in its focus on RTS for youth with TBI, and this data is particularly pertinent as it highlights the impact of COVID-related school changes on students who experienced a TBI prior to the beginning of the pandemic. Our sample included many students who reported having mild injuries but who continued to have academic needs that warranted a referral to the BrainSTEPS program. Majority of the enrolled participants were engaged in school via hybrid or remote options with a consistent minority requiring academic supports. Implications of COVID-related school changes on students with TBI based on data collected during the first - unique and challenging - year of a longitudinal study will be discussed.

13.
Journal of Pakistan Association of Dermatologists ; 32(1):117-122, 2022.
Article in English | EMBASE | ID: covidwho-1812772

ABSTRACT

Background Pityriasisrosea (PR) is an exanthematous disorder accompanied by systemic recurrence of HHV 6 and/ or 7. Objective To explain the link between levels of vitamin D and CXCL10 in persistent PR during COVID-19. Methods The study encompassed 25 patients (10 males and 15 females, age range: 10-40 years) with persistent PR more than 12 weeks and 25 control subjects (12 males and 13 females, age range: 11- 38 years) examined in the medical Excellence center, Dermatology Outpatient Clinic, National Research Center, Egypt between November 2020 and March 2021. Blood samples were collected from controls and persistent PR patients for more than 12 weeks, 15 days later after topmost clinical symptoms. Assessment of serum CXCL10 was done by ELISA kit. Vitamin D was determined using the chemi-luminescence technique. Results A student unpaired T- test was done at P<0.05 illustrating a significant increase in levels of CXCL10 while a significant decrease in levels of vitamin D in the sera of both male and female patients in comparison to control ones. Conclusion Our study provided evidence that circulating CXCL10 is elevated in persistent PR patients as well as in COVID-19 where PR is one of clinical symptoms of coronavirus. This highlights the immunological response in PR and contributes to a clear explanation of cutaneous defense mechanism. Vitamin D showed a significant reduction in persistent PR patients and has been shown to be safe and guard against acute respiratory infections as in COVID-19

14.
Journal of Biological Regulators and Homeostatic Agents ; 36:177-182, 2022.
Article in English | EMBASE | ID: covidwho-1812676

ABSTRACT

In December 2019, in Wuhan (Hubei, China), the first coronavirus disease 2019 (COVID-19) cases due to severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) have been reported. On March 11th, 2020, the World Health Organization (WHO) declared the pandemic. On July 1st, 2021, more than 180 million people had developed the disease, with more than 3.9 million deaths. In Italy, the most updated data show that, among all cases (n= 4.218.979) and deaths (n=125.058) due to COVID-19, 5.5% (n= 231.338) with 11 deaths concern the 0-9 years age group, while 9.6% (n= 406.460) with 15 deaths concern the 10-19 years age group. This review aims to present a comprehensive overview of COVID-19 in children.

15.
Open Access Macedonian Journal of Medical Sciences ; 10:487-492, 2022.
Article in English | EMBASE | ID: covidwho-1798860

ABSTRACT

BACKGROUND: Recently, cases of coronavirus disease-2019 (COVID-19) have increased significantly since the implementation of the new normal policy in Indonesia. AIM: The purpose of this research was to analyze factors related to the preventive practices in combating COVID-19 following the new normal era in Indonesia. METHODS: This research was an analytic observational study with a cross-sectional design developed in September 2020. The population was the entire population of Indonesia ranged between 12 years old and above. Using accidental sampling technique for samples collection, voluntary respondents were willingly asked to fill in prepared questionnaire through Google Forms that was distributed online through multiple social media platforms (WhatsApp, Facebook, and Instagram). The total collected samples were 3157 voluntary respondents. Moreover, independent variables that were analyzed including age, gender, education level, knowledge, and attitude of respondents. On the other hand, dependent variable was the preventive practices of COVID-19 in the new normal era. Data analysis consisted of univariate, bivariate (Chi-square test), and multivariate analysis (multiple logistic regression). RESULTS: This research proved that the variables of age, gender, education level, knowledge, and attitude had significant relationship with the practices of preventing COVID-19 among Indonesian (p < 0.05). CONCLUSION: Age, gender, education level, knowledge, and attitude had significant relationship with the practices of preventing COVID-19 among Indonesian.

16.
South African Medical Journal ; 112(4):252-258, 2022.
Article in English | EMBASE | ID: covidwho-1798761

ABSTRACT

Articles on teenage pregnancies have been proliferating in both the popular press and the medical media. We analysed data available in the public sector database, the District Health Information System, from 2017 to 2021. During this time, the number of births to young teenagers aged 10 - 14 years increased by 48.7% (from a baseline of 2 726, which is very high by developed-country standards) and the birth rate per 1 000 girls in this age category increased from 1.1 to 1.5. These increases occurred year on year in most provinces. In adolescent girls aged 15 - 19, the number of births increased by 17.9% (from a baseline of 114 329) and the birth rate per 1 000 girls in this age category increased from 49.6 to 55.6. These increases also occurred year on year in a continuous upward trend as well as in all provinces, but at different rates. Generally, rates were higher in the more rural provinces such as Limpopo, Mpumalanga and Eastern Cape than in more urban provinces such as Gauteng and Western Cape. The increases during the past 2 years were particularly large and may be due to disruption of health and school services with decreased access to these as a result of COVID-19. These metrics pose serious questions to society in general and especially to the health, education and social sectors, as they reflect socioeconomic circumstances (e.g. sexual and gender-based violence, economic security of families, school attendance) as well as inadequate health education, life skills and access to health services.

17.
European Journal of Molecular and Clinical Medicine ; 9(3):1425-1429, 2022.
Article in English | EMBASE | ID: covidwho-1798215

ABSTRACT

Background: The present study was conducted to assessthe effect of digital eye strain due to online mode of teaching in school children during COVID Pandemic. Materials & methods:A cross sectional study was conducted among school children during the period 2020-2022to assessthe refractive errors during COVID Pandemic. A total of 4393 (1442,1532, 1419) schoolchildren were enrolled and examined for refractive errors during the year 2020,2021,2022 respectively. Prevalence of various refractive errors was assessed based on refractive error study in children (RESC) survey group. Results:There were 2324(52.9%) male and 2069(47.0%) female students. Ocular examination depicted enhancement of refractive errors in all the age groups. However among the children in the age group of 9 to 12 years, refractive errors were detected among 612/1507(43.1%) children. Conclusion: There has been an increase in use of digital devices after the initiation of the COVID-19 lockdown, and has resulted in deterioration of ocular health of school going children.

18.
Journal of Heart and Lung Transplantation ; 41(4):S326, 2022.
Article in English | EMBASE | ID: covidwho-1796809

ABSTRACT

Purpose: The racial composition of Mississippi is Caucasian (C) 58%, African American (AA) 38%, and others 4%, whereas the SARS-CoV-2 PCR positive rates are 16% in AA, 25% in Hispanics, and 6% in C children. We aimed to study the disparities of MIS-C in Mississippi and whether MIS-C follow the same racial distribution as SARS-CoV-2 infection? Methods: Retrospective study of consecutive MIS-C patients <18 years of age hospitalized at our center over 1 year. We compared demographics, clinical presentation, laboratory findings, and treatment of MIS-C by race/ethnicity. We compared the distribution of MIS-C cases with that of SARS-CoV-2 infection rates. Results: During the study period, 51 MIS-C patients hospitalized. Median age was 9 year, 58% male, 36(71%) were AA, 13(25%) were C, 1 was Asian, and 1 was Hispanic. We found a significant delay between onset of symptoms and hospitalization in AA than C children, 2.3±2.1 vs. 0.6±1.5 days (P=0.002). Cardiac symptoms were present in 24%, and 39% had Kawasaki's disease-like symptoms. Only absolute neutrophil count was associated with cardiac dysfunction (p= 0.01) on multivariate analysis. Creatinine and ferritin levels were associated with ICU admission;p= 0.01 and 0.03, respectively. Differences in inflammatory and cardiac biomarkers between AA and C races are summarized in Figure 1. AA children with MIS-C had increased length of hospitalization (8.1 vs 5.2 days;p=0.04), a higher trend of more admissions to ICU (38.9% vs 23.1%;p=0.3) and cardiac involvement (36.1% vs 23.1%;p=0.5) than C Children (Figure 2). Conclusion: In Mississippi, racial disparity in MIS-C exceeds the differences of SARS-CoV-2 infection rates in children. AA children had delayed hospitalization from the onset of symptoms, severe inflammation, longer length of stay, a higher trend for more cardiac dysfunction and ICU admissions than C children. Our findings could assist health professionals in devising appropriate strategies to target minority children.

19.
Journal of Heart and Lung Transplantation ; 41(4):S508-S509, 2022.
Article in English | EMBASE | ID: covidwho-1796805

ABSTRACT

Purpose: Many acceptable donor hearts are turned down by pediatric centers with varying criteria for an acceptable donor. Advanced Cardiac Therapy Improving Outcome Network (ACTION) and Pediatric Heart Transplant Society (PHTS) centers convened a multi-institutional donor decision discussion forum (DDDF) aimed at assessing donor acceptance practice and reducing practice variation across centers. Methods: The team hosted an hour-long monthly virtual DDDF among pediatric transplant centers across North America, UK and Brazil. Each call had two case presentations posing a donor decision challenge for the presenting center at the time of donor offer. Following each presentation, the attendee group was polled to obtain insight on donor acceptance practices after which the presenting center's decision was revealed. Then, group discussion occurred including a review of relevant literature and latest PHTS data related to the case. Metrics of participation, participant agreement with presenting center decision and impact on future decision making were collected and analyzed. Results: Over 14 months, 23 cases were discussed;an average of 50 physicians, nurses and fellows attended each call. The mean donor age was 8.2 ± 3.3 years (28.6% infants, 52.4% young adults), and the mean recipient age was 8.36 ± 3.3 years (27.3% infants and 40.9% teenagers). Reason for listing was congenital heart disease in 10, cardiomyopathy in 5 and retransplantation in 3. Risk factors influencing decision making included size discrepancy (4), Infection (5), COVID (2), Prolonged QT (2), Malignancy (2), Drugs (2), Distance (1) Prolonged CPR (1) high inotrope use (1) Dialysis (1) Diabetes (1) HLA mismatch (1). Of the 23 cases, 15 were declined by presenting center. Donor characteristics influenced 45% of the decisions and recipient only 20%, with rest being other factors. Participants agreed with the decision made by the presenting center 55% of the times. The post-presentation discussion resulted in 30% of participants changing their original decision. Conclusion: DDDF identified significant variation in pediatric donor acceptance practices;with donor characteristics most influential in decision-making. Given that the discussions changed decisions in 1/3rd of the participants, DDDF may be a useful format to reduce practice variation, provide education to decision makers and eventually increase donor utilization.

20.
European Heart Journal Cardiovascular Imaging ; 23(SUPPL 1):i250, 2022.
Article in English | EMBASE | ID: covidwho-1795317

ABSTRACT

Background/Introduction: In recent years there has been a growing interest in artificial intelligence (AI) applications in the echocardiography field. This is in order to simplify, reduce time and amplify the use of advanced analyses in the echo lab. Purpose: to compare results of the fully automated analysis and manual tracing analysis using a new intuitive software. Methods: 28 consecutive previously healthy patients less than 18 years old who were screened at our Center for cardiac evaluation within 6 months after an asymptomatic or paucisymptomatic COVID19 infection were enrolled. All they were in sinus rhythm. Standard transthoracic echocardiography (TTE) was performed for each patient using Canon Aplio i900, software 2D Wall Motion Tracking. Optimized apical 4-, 3- and 2- chamber views, mitral valve inflow pattern and LVOT Doppler interrogation were collected. Off-line data analysis of each examination was performed by both fully automated analysis (AI) and pediatric cardiologists with experience in echocardiography i.e. by manual tracing, evaluation and adjustment of the track by the operator (Echocardiographers). Operators were blinded to the AI analysis. To measure intraobserver variability, evaluations of 16 patients datasets were performed twice by both operators and AI. Results: Patients' demographic data were: age 9,8+/-4,7 years;males 22 (78%);height 134,3+/- 34,9 cm;weight 41,8+/-28,7 kg;BSA 1,2+/-0,4 mq, HR 85+/-15/min. The time taken for off-line analysis by AI and echocardiographers was 4-5 and 13-20 minutes, respectively. Reproducibility of echocardiographers' analysis was found to be excellent for left ventricle assessment (IC from 0,88 to 0,98);moderate for LVOT mean gradient (IC 0,73), RV end diastolic area (IC 0,69) and right atrial strain (IC 0,59);poor for deceleration time (IC 0,5), left ventricle strain (IC 0,49), RV FAC and strain (IC from 0,27 to 0,45). Conversely, reproducibility of the AI analysis was found to be excellent for any parameter (ICC from 0,87 to 0,99) (Table 1). About the mitralic valve inflow pattern assessment, despite the excellent reproducibility of AI analysis, the margin of error was found to be high. Particularly, a systematic error was observed with a tendency of the AI to overestimate deceleration time (DT-AI 176,6 ± 63,8 vs DTEcocardiographers 150,4 ± 24,3). Conclusion(s): Fully automated analysis is technically simple, less time consuming and highly reproducible. AI analysis of the mitralic inflow pattern should be optimized, having found a systematic error in the calculation of deceleration time. Reproducibility is the strong point of AI. This reduces the variability of manual measurements between different sonographers and at different times.

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