Restriction of follow-up of premature infants in the COVID-19 pandemic: a mixed approach / Restrição do acompanhamento de lactentes prematuros na pandemia da COVID-19: abordagem mista / Restricción del seguimiento de lactantes prematuros en la pandemia de COVID-19: enfoque mixto

Resumo Objetivo Analisar os fatores associados à restrição do acompanhamento de lactentes que nasceram prematuros e/ou baixo peso durante a pandemia da COVID-19 e a percepção de mães e profissionais de saúde quanto a essa realidade. Métodos Pesquisa de método misto com delineamento paralelo convergente, realizada com 14 mães de lactentes que nasceram prematuros e/ou baixo peso acompanhados no ambulatório de follow-up de uma maternidade em um município da Paraíba, e quatro profissionais de saúde desse serviço. A coleta de dados foi realizada no período de junho a julho de 2020, concomitantemente, em fonte de dados secundários, constituída de todos os 140 prontuários dos respectivos lactentes para abordagem quantitativa, por meio de entrevista semiestruturada, para abordagem qualitativa. A análise quantitativa ocorreu por estatística descritiva e inferencial, e a qualitativa, conforme análise temática indutiva. Resultados Houve associação significativa entre a idade dos lactentes e a restrição do seu acompanhamento no follow-up durante a pandemia, com priorização do atendimento presencial dos menores de seis meses, contatos pontuais com os familiares, via ligação telefônica ou aplicativo digital, e lacunas na atualização do calendário vacinal dos que tiveram o acompanhamento interrompido. Isso gerou insatisfação das mães e receio de prejuízos ao desenvolvimento dos lactentes. Também não houve continuidade do cuidado desses na unidade básica de saúde. Conclusão Houveram restrições no acompanhamento dos lactentes nascidos prematuros no serviço de follow-up durante a pandemia, gerando insatisfação materna e receio de prejuízos ao desenvolvimento de seus filhos.

Resumen Objetivo Analizar los factores asociados a la restricción del seguimiento de lactantes que nacieron prematuros o de bajo peso durante la pandemia de COVID-19 y la percepción de madres y profesionales de la salud respecto a esta realidad. Métodos Estudio de método mixto con diseño paralelo convergente, realizado con 14 madres de lactantes que nacieron prematuros o de bajo peso atendidos en consultorios externos de follow-up de una maternidad en un municipio del estado de Paraíba, y cuatro profesionales de la salud de este servicio. La recopilación de datos fue realizada en el período de junio a julio de 2020, simultáneamente en fuente de datos secundarios, compuesta por las 140 historias clínicas de los respectivos lactantes para el enfoque cuantitativo, por medio de entrevista semiestructurada, para el enfoque cualitativo. El análisis cuantitativo se llevó a cabo por estadística descriptiva e inferencial, y el cualitativo mediante análisis temático inductivo. Resultados Hubo relación significativa entre la edad de los lactantes y la restricción de su seguimiento en el follow-up durante la pandemia, con priorización de atención presencial a los menores de seis meses, contactos puntuales con los familiares, vía llamada telefónica o aplicación digital, y vacíos en la actualización del calendario de vacunación de los que tuvieron el seguimiento interrumpido. Esto generó insatisfacción de las madres y temor de perjudicar el desarrollo de los lactantes. Tampoco hubo continuidad del cuidado de estos en la unidad básica de salud. Conclusión Hubo restricciones en el seguimiento de los lactantes nacidos prematuros en el servicio de follow-up durante la pandemia, lo que generó insatisfacción materna y temor de perjudicar el desarrollo de sus hijos.

Abstract Objective To analyze the factors associated with restricting the follow-up of infants who were born premature and/or low birth weight during the COVID-19 pandemic and mothers' and health professionals' perception regarding this reality. Methods This is mixed methods research with a parallel convergent design, carried out with 14 mothers of infants who were born premature and/or low birth weight, followed up at a follow-up outpatient clinic of a maternity hospital in a municipality in Paraíba, and four health professionals from this service. Data collection was carried out from June to July 2020, concomitantly, in a secondary data source, consisting of all 140 medical records of the respective infants for a quantitative approach, through a semi-structured interview, for a qualitative approach. Quantitative analysis was performed using descriptive and inferential statistics, and qualitative analysis, according to inductive thematic analysis. Results There was a significant association between infant age and the restriction of their follow-up during the pandemic, with prioritization of one-to-one care for children under six months of age, occasional contacts with family members, via phone call or digital application, and gaps in updating the vaccination schedule of those whose follow-up was interrupted. This generated dissatisfaction on the part of mothers and fear of harm to the development of infants. There was also no continuity of care for these in the Basic Health Unit. Conclusion There were restrictions on follow-up of premature infants in the follow-up service during the pandemic, generating maternal dissatisfaction and fear of damage to the development of their children.

Identifying and Validating Pediatric Hospitalizations for MIS-C Through Administrative Data.

BACKGROUND: Individual children's hospitals care for a small number of patients with multisystem inflammatory syndrome in children (MIS-C). Administrative databases offer an opportunity to conduct generalizable research; however, identifying patients with MIS-C is challenging. METHODS: We developed and validated algorithms to identify MIS-C hospitalizations in administrative databases. We developed 10 approaches using diagnostic codes and medication billing data and applied them to the Pediatric Health Information System from January 2020 to August 2021. We reviewed medical records at 7 geographically diverse hospitals to compare potential cases of MIS-C identified by algorithms to each participating hospital's list of patients with MIS-C (used for public health reporting). RESULTS: The sites had 245 hospitalizations for MIS-C in 2020 and 358 additional MIS-C hospitalizations through August 2021. One algorithm for the identification of cases in 2020 had a sensitivity of 82%, a low false positive rate of 22%, and a positive predictive value (PPV) of 78%. For hospitalizations in 2021, the sensitivity of the MIS-C diagnosis code was 98% with 84% PPV. CONCLUSION: We developed high-sensitivity algorithms to use for epidemiologic research and high-PPV algorithms for comparative effectiveness research. Accurate algorithms to identify MIS-C hospitalizations can facilitate important research for understanding this novel entity as it evolves during new waves.

Target-agnostic drug prediction integrated with medical record analysis uncovers differential associations of statins with increased survival in COVID-19 patients.

Drug repurposing requires distinguishing established drug class targets from novel molecule-specific mechanisms and rapidly derisking their therapeutic potential in a time-critical manner, particularly in a pandemic scenario. In response to the challenge to rapidly identify treatment options for COVID-19, several studies reported that statins, as a drug class, reduce mortality in these patients. However, it is unknown if different statins exhibit consistent function or may have varying therapeutic benefit. A Bayesian network tool was used to predict drugs that shift the host transcriptomic response to SARS-CoV-2 infection towards a healthy state. Drugs were predicted using 14 RNA-sequencing datasets from 72 autopsy tissues and 465 COVID-19 patient samples or from cultured human cells and organoids infected with SARS-CoV-2. Top drug predictions included statins, which were then assessed using electronic medical records containing over 4,000 COVID-19 patients on statins to determine mortality risk in patients prescribed specific statins versus untreated matched controls. The same drugs were tested in Vero E6 cells infected with SARS-CoV-2 and human endothelial cells infected with a related OC43 coronavirus. Simvastatin was among the most highly predicted compounds (14/14 datasets) and five other statins, including atorvastatin, were predicted to be active in > 50% of analyses. Analysis of the clinical database revealed that reduced mortality risk was only observed in COVID-19 patients prescribed a subset of statins, including simvastatin and atorvastatin. In vitro testing of SARS-CoV-2 infected cells revealed simvastatin to be a potent direct inhibitor whereas most other statins were less effective. Simvastatin also inhibited OC43 infection and reduced cytokine production in endothelial cells. Statins may differ in their ability to sustain the lives of COVID-19 patients despite having a shared drug target and lipid-modifying mechanism of action. These findings highlight the value of target-agnostic drug prediction coupled with patient databases to identify and clinically evaluate non-obvious mechanisms and derisk and accelerate drug repurposing opportunities.

Follow-up investigation of asymptomatic COVID-19 cases at diagnosis in Busan, Korea.

OBJECTIVES: The objective of the study was to conduct a follow-up investigation of 10 asymptomatic patients at diagnosis among the 98 confirmed coronavirus disease 2019 (COVID-19) cases reported in Busan between February 21, 2020 and March 13, 2020 to determine whether asymptomatic infection and transmission during asymptomatic period are possible. METHODS: The study analyzed 10 asymptomatic, confirmed COVID-19 cases to determine whether asymptomatic infection is possible. We conducted in-depth interviews with patients and guardians; interviews with primary physicians; review of medical records and drug utilization review (DUR) reports; and base station-based location tracking. RESULTS: Among the 98, confirmed COVID-19 cases reported in Busan, the study analyzed 10 (10.2%) asymptomatic patients at diagnosis. The results confirmed that two (2.0%) patients reported to be asymptomatic during the initial epidemiological investigation, but turned symptomatic before diagnosis as per the in-depth interview results. Four cases (4.0%) of early detection led to confirmed diagnosis during the incubation period and presentation of symptoms after diagnosis. In addition, the remaining four patients (4.0%), having no subjective symptoms nor specific findings on chest radiography and computed tomography, remained asymptomatic until the isolation order was lifted. With regard to whether transmission during the asymptomatic period is possible, it was found that one out of 23 household contacts of the confirmed patients was identified as an additional confirmed case after coming in close contact with an index patient during the presymptomatic period. CONCLUSIONS: Among the 98 confirmed cases, asymptomatic infection was confirmed in four cases (4.0%). In addition, there was one additional confirmed case in which the patient was a family member who came in close contact with an index patient during the incubation period, thereby confirming that transmission during the asymptomatic period is possible. The possibility of transmission during the asymptomatic period has been confirmed; therefore, it is necessary to review the measures for expanding contact tracing that is currently being applied starting one day prior to the onset of symptoms.

A preregistered vignette experiment on determinants of health data sharing behavior Willingness to donate sensor data, medical records, and biomarkers.

The COVID-19 pandemic has spotlighted the importance of high-quality data for empirical health research and evidence-based political decision-making. To leverage the full potential of these data, a better understanding of the determinants and conditions under which people are willing to share their health data is critical. Building on the privacy theory of contextual integrity, the privacy calculus, and previous findings regarding different data types and recipients, we argue that established social norms shape the acceptance of novel practices of data collection and use. To investigate the willingness to share health data, we conducted a preregistered vignette experiment. The scenarios experimentally varied the vignette dimensions by data type, recipient, and research purpose. While some findings contradict our hypotheses, the results indicate that all three dimensions affected respondents' data sharing decisions. Additional analyses suggest that institutional and social trust, privacy concerns, technical affinity, altruism, age, and device ownership influence the willingness to share health data.

Comparison of adverse pregnancy and birth outcomes using archival medical records before and during the first wave of the COVID-19 pandemic in Kinshasa, Democratic Republic of Congo: a facility-based, retrospective cohort study.

BACKGROUND: Little research has been conducted on the impact of the coronavirus disease 2019 (COVID-19) pandemic on either birth outcomes or the ability of archival medical records to accurately capture these outcomes. Our study objective is thus to compare the prevalence of preterm birth, stillbirth, low birth weight (LBW), small for gestational age (SGA), congenital microcephaly, and neonatal bloodstream infection (NBSI) before and during the first wave of the COVID-19 pandemic in Kinshasa, Democratic Republic of Congo (DRC). METHODS: We conducted a facility-based retrospective cohort study in which identified cases of birth outcomes were tabulated at initial screening and subcategorized according to level of diagnostic certainty using Global Alignment of Immunization Safety Assessment in pregnancy (GAIA) definitions. Documentation of any birth complications, delivery type, and maternal vaccination history were also evaluated. The prevalence of each birth outcome was compared in the pre-COVID-19 (i.e., July 2019 to February 2020) and intra-COVID-19 (i.e., March to August 2020) periods via two-sample z-test for equality of proportions. RESULTS: In total, 14,300 birth records were abstracted. Adverse birth outcomes were identified among 22.0% and 14.3% of pregnancies in the pre-COVID-19 and intra-COVID-19 periods, respectively. For stillbirth, LBW, SGA, microcephaly, and NBSI, prevalence estimates were similar across study periods. However, the prevalence of preterm birth in the intra-COVID-19 period was significantly lower than that reported during the pre-COVID-19 period (8.6% vs. 11.5%, p < 0.0001). Furthermore, the level of diagnostic certainty declined slightly across all outcomes investigated from the pre-COVID-19 to the intra-COVID-19 period. Nonetheless, diagnostic certainty was especially low for certain outcomes (i.e., stillbirth and NBSI) regardless of period; still, other outcomes, such as preterm birth and LBW, had moderate to high levels of diagnostic certainty. Results were mostly consistent when the analysis was focused on the facilities designated for COVID-19 care. CONCLUSION: This study succeeded in providing prevalence estimates for key adverse birth outcomes using GAIA criteria during the COVID-19 pandemic in Kinshasa, DRC. Furthermore, our study adds crucial real-world data to the literature surrounding the impact of the COVID-19 pandemic on maternal and neonatal services and outcomes in Africa.

Predicting health crises from early warning signs in patient medical records.

The COVID-19 global pandemic has caused unprecedented worldwide changes in healthcare delivery. While containment and mitigation approaches have been intensified, the progressive increase in the number of cases has overwhelmed health systems globally, highlighting the need for anticipation and prediction to be the basis of an efficient response system. This study demonstrates the role of population health metrics as early warning signs of future health crises. We retrospectively collected data from the emergency department of a large academic hospital in the northeastern United States from 01/01/2019 to 08/07/2021. A total of 377,694 patient records and 303 features were included for analysis. Departing from a multivariate artificial intelligence (AI) model initially developed to predict the risk of high-flow oxygen therapy or mechanical ventilation requirement during the COVID-19 pandemic, a total of 19 original variables and eight engineered features showing to be most predictive of the outcome were selected for further analysis. The temporal trends of the selected variables before and during the pandemic were characterized to determine their potential roles as early warning signs of future health crises. Temporal analysis of the individual variables included in the high-flow oxygen model showed that at a population level, the respiratory rate, temperature, low oxygen saturation, number of diagnoses during the first encounter, heart rate, BMI, age, sex, and neutrophil percentage demonstrated observable and traceable changes eight weeks before the first COVID-19 public health emergency declaration. Additionally, the engineered rule-based features built from the original variables also exhibited a pre-pandemic surge that preceded the first pandemic wave in spring 2020. Our findings suggest that the changes in routine population health metrics may serve as early warnings of future crises. This justifies the development of patient health surveillance systems, that can continuously monitor population health features, and alarm of new approaching public health crises before they become devastating.

Agreement Between Pregnant Individuals' Self-Report of Coronavirus Disease 2019 (COVID-19) Vaccination and Medical Record Documentation.

For public health research such as vaccine uptake or effectiveness assessments, self-reported coronavirus disease 2019 (COVID-19) vaccination status may be a more efficient measure than verifying vaccination status from medical records if agreement between sources is high. We assessed agreement between self-reported and medical record-documented COVID-19 vaccination status among pregnant individuals followed in a cohort during August 2020-October 2021. At end of pregnancy, participants completed questionnaires about COVID-19 vaccine receipt during pregnancy; staff verified vaccination status using medical records. Agreement was assessed between self-reported and medical record vaccination status using Cohen's kappa. There was high agreement between self-reported and medical record vaccination status (Kappa coefficient=0.94, 95% CI 0.91-0.98), suggesting that self-report may be acceptable for ascertaining COVID-19 vaccination status during pregnancy.

Changes in self-harm attempts after the COVID-19 pandemic based on pre-hospital medical records.

Although many concerns have been raised on increased self-harm or suicide attempts since the emergence of the coronavirus disease 2019 (COVID-19) pandemic, the numbers of studies reported no consistent increase. This study aimed to analyze the data on the request for emergency medical service (EMS) in Daegu Metropolitan City in Korea to investigate the effects of the COVID-19 pandemic on the incidence and types of suicidal patients. Data of 4480 cases requesting EMS related to self-harm or suicide 1 year before and after the COVID-19 pandemic were retrospectively comparatively analyzed (February 19, 2019-February 18, 2021). The number of EMS requests for self-harm and suicide increased after the pandemic compared to that before the pandemic (daily mean request 5.83 [±2.597] vs 6.43 [±2.918]). In particular, the number of female patients increased per day on average (2.61 [±1.717] vs 3.17 [±1.893]). With respect to the reasons for the request, committed self-harm and attempts to commit self-harm increased, whereas the presumption against suicide decreased. With respect to consciousness levels, the number of alert patients increased, whereas the number of transport cases decreased. For the method of the attempt, hanging and carbon monoxide/gas poisoning decreased, whereas jumping from a height and drowning increased. The number of patients with psychiatric history and those with other chronic illnesses increased. In multivariate regression analysis, women (OR 1.227, 95% CI = 1.072-1.405, P = .003), patients with psychiatric diseases (OR 1.223, 95% CI = 1.031-1.450, P = .021), patients with other chronic illnesses (OR 1.510, 95% CI = 1.127-2.023, P = .006), and CO or gas poisoning (not attempted) (OR 1.349, 95% CI = 1.038-1.753, P = .025) showed statistically significant differences. Among the request for EMS, requests for committed self-harm and attempts to commit suicide increased. Medical support and measures for mental health and emergency medical systems should be established for female patients and patients with psychiatric or other chronic diseases.

The efficacy of combined therapy of qingfeiPaidu capsule and lianhuaqingwen capsule nursing interventions for hospitalized patients with COVID-19: A retrospective study of medical records.

Coronavirus disease-19 (COVID-19) caused a global pandemic burden, affecting hundreds of thousands of individuals, having life-threatening outcomes. Traditional Chinese Medicine plays a crucial role in the treatment of patients with COVID-19. The purpose of this study was to investigate the efficacy of combined therapy of qingfeiPaidu (QFPD) capsule and lianhuaqingwen (LHQW) capsule nursing interventions in the treatment of patients with COVID-19. A total of 318 patients with COVID-19 were enrolled and randomly received QFPD (n = 106), LHQW (n = 106), and QFPD-LHQW (n = 106). The clinical characteristics of COVID-19, the total lung severity scores, and blood laboratory indices were recorded in each patient in each group before treatment and at the end of treatment. The outcomes demonstrated that QFPD-LHQW group shortened the length of hospitalization, decreased C-reactive protein, creatine kinase, creatine kinase-myocardial band, lactate dehydrogenase, and blood urea nitrogen levels, and improved clinical symptoms, pulmonary inflammation, and prognosis. At the end of treatment, inflammation, immune function, circulating white blood cells, total lymphocyte count, and glutamic-oxaloacetic transaminase levels improved dramatically in 3 groups compared with baseline. All patients met the discharge criteria after 30-day treatment in 3 groups. Combined therapy of QFPD and LHQW demonstrated significant anti-inflammatory effects compared with those of only QFPD or LHQW in patients with mild and moderate COVID-19. The combined therapies may alleviate clinical symptoms of COVID-19 patients by improving inflammation and immune function.

Assessing the feasibility of passive surveillance for maternal immunization safety utilizing archival medical records in Kinshasa, Democratic Republic of the Congo.

INTRODUCTION: Since the establishment of the Global Alignment of Immunization Safety Assessment in pregnancy (GAIA) case definitions in 2015, there has been an urgent need for field validation of pharmacovigilance feasibility in low- and middle-income countries. In this study, we assess the availability and quality of archival medical records at ten randomly selected high-traffic maternity wards in Kinshasa province, Democratic Republic of Congo (DRC). METHODS: A retrospective cohort of mother-child pairs was established from all recorded births taking place at study sites between July 1, 2019 to February 28, 2020 through digitization of medical records. Adverse birth outcomes and maternal vaccination status, where available and linkable, were defined according to GAIA. Basic demographic information on mothers and newborns was also tabulated; birth outcomes were assessed for both intra-site prevalence and a pooled prevalence. RESULTS: A total of 7,697 mother-newborn pair records were extracted, with 37% of infants screening positive as cases of adverse outcomes. Maternal vaccination information was linkable to 67% of those cases. In total, 51% of stillbirths, 98% of preterm births, 100% of low birthweight infants, 90% of small for gestational age infants, 100% of microcephalic infants, and 0% of neonatal bloodstream infections were classifiable according to GAIA standards following initial screening. Forty percent of case mothers had some indication of tetanus vaccination prior to delivery in their medical records, but only 26% of case mothers met some level of GAIA definition for maternal vaccination during the pregnancy of interest. CONCLUSIONS: Archival birth records from delivery centers can be feasibly utilized to screen for stillbirth and maternal tetanus vaccination, and to accurately classify preterm birth, low birthweight, small for gestational age, and congenital microcephaly. Assessment of other neonatal outcomes were limited by inconsistent postpartum infant follow-up and records keeping.

Hypertension as a sequela in patients of SARS-CoV-2 infection.

BACKGROUND: COVID-19 is a respiratory infectious disease caused by SARS-CoV-2, and cardiovascular damage is commonly observed in affected patients. We sought to investigate the effect of SARS-CoV-2 infection on cardiac injury and hypertension during the current coronavirus pandemic. STUDY DESIGN AND METHODS: The clinical data of 366 hospitalized COVID-19-confirmed patients were analyzed. The clinical signs and laboratory findings were extracted from electronic medical records. Two independent, experienced clinicians reviewed and analyzed the data. RESULTS: Cardiac injury was found in 11.19% (30/268) of enrolled patients. 93.33% (28/30) of cardiac injury cases were in the severe group. The laboratory findings indicated that white blood cells, neutrophils, procalcitonin, C-reactive protein, lactate, and lactic dehydrogenase were positively associated with cardiac injury marker. Compared with healthy controls, the 190 patients without prior hypertension have higher AngⅡ level, of which 16 (8.42%) patients had a rise in blood pressure to the diagnostic criteria of hypertension during hospitalization, with a significantly increased level of the cTnI, procalcitonin, angiotensin-II (AngⅡ) than those normal blood pressure ones. Multivariate analysis indicated that elevated age, cTnI, the history of hypertension, and diabetes were independent predictors for illness severity. The predictive model, based on the four parameters and gender, has a good ability to identify the clinical severity of COVID-19 in hospitalized patients (area under the curve: 0.932, sensitivity: 98.67%, specificity: 75.68%). CONCLUSION: Hypertension, sometimes accompanied by elevated cTnI, may occur in COVID-19 patients and become a sequela. Enhancing Ang II signaling, driven by SARS-CoV-2 infection, might play an important role in the renin-angiotensin system, and consequently lead to the development of hypertension in COVID-19.

Experience of the Polish Medical Air Rescue Service During the First Year of the COVID-19 Pandemic and Measures Taken to Protect Patients, Medical Staff, and Air Crew from SARS-CoV-2 Infection.

BACKGROUND The emergence of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) and the sudden inflow of patients with severe COVID-19 (coronavirus disease 2019) symptoms increased demand for hospital and pre-hospital care, the latter being provided by emergency medical teams. The Polish Medical Air Rescue Services include the Helicopter Emergency Medical Service (HEMS) and the airplane-based Emergency Medical Service (EMS). This study aimed to present the experience of the Polish Medical Air Rescue Service during the first year of the COVID-19 pandemic and measures taken to protect patients, medical staff, and air crew from SARS-CoV-2 infection. MATERIAL AND METHODS We conducted a retrospective analysis of missions completed by the Polish Medical Air Rescue crews with respect to confirmed SARS-CoV-2 cases. We analyzed data from the medical records of the Polish Medical Air Rescue Service, which included flights to accidents and emergencies, and air patient transport missions, where medical assistance was provided to patients with confirmed SARS-CoV-2 infection in the first year of the pandemic in Poland. RESULTS Among the COVID-19 patients, the most common comorbidity was acute respiratory failure (41.58%). Emergency missions more often concerned older patients with sudden cardiac arrest, dyspnea, upper respiratory tract infection, stroke, and acute coronary syndromes. CONCLUSIONS During the first year of the COVID-19 pandemic in Poland, the Polish Medical Air Rescue Service implemented procedures to protect patients, medical staff, and air crew from SARS-CoV-2 infection. This study highlights the importance of using single-patient isolation units for patient transport between hospitals and for emergency hospital admissions when the SARS-CoV-2 status of the patients were unknown.

Hydrogen-oxygen therapy alleviates clinical symptoms in twelve patients hospitalized with COVID-19: A retrospective study of medical records.

ABSTRACT: A global public health crisis caused by the 2019 novel coronavirus disease (COVID-19) leads to considerable morbidity and mortality, which bring great challenge to respiratory medicine. Hydrogen-oxygen therapy contributes to treat severe respiratory diseases and improve lung functions, yet there is no information to support the clinical use of this therapy in the COVID-19 pneumonia.A retrospective study of medical records was carried out in Shishou Hospital of Traditional Chinese Medicine in Hubei, China. COVID-19 patients (aged ≥ 30 years) admitted to the hospital from January 29 to March 20, 2020 were subjected to control group (n = 12) who received routine therapy and case group (n = 12) who received additional hydrogen-oxygen therapy. The clinical characteristics of COVID-19 patients were analyzed. The physiological and biochemical indexes, including immune inflammation indicators, electrolytes, myocardial enzyme profile, and functions of liver and kidney, were examined and investigated before and after hydrogen-oxygen therapy.The results showed significant decreases in the neutrophil percentage and the concentration and abnormal proportion of C-reactive protein in COVID-19 patients received additional hydrogen-oxygen therapy.This novel therapeutic may alleviate clinical symptoms of COVID-19 patients by suppressing inflammation responses.

No Increase in Kawasaki Disease-Like Illnesses During the COVID-19 Pandemic Compared With 4 Previous Years: A Medical Records Review Analysis.

BACKGROUND: SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection produces a wide variety of inflammatory responses in children, including multisystem inflammatory syndrome in children, which has similar clinical manifestations as Kawasaki disease (KD). METHODS: We performed a chart review of all patients with KD-like illnesses from January 1, 2016, to May 31, 2020, at a tertiary care children's hospital within a larger health system. Relevant symptoms, comorbid illnesses, laboratory results, imaging studies, treatment, and outcomes were reviewed. Descriptive analyses to compare features over time were performed. RESULTS: We identified 81 cases of KD-like illnesses from January 1, 2016, to May 31, 2020. Few clinical features, such as gallbladder involvement, were more prevalent in 2020 than in previous years. A few patients in 2020 required more intensive treatment with interleukin 1 receptor antagonist therapy. There were no other clear differences in incidence, laboratory parameters, number of doses of intravenous immunoglobulin, or outcomes over the years of the study. CONCLUSIONS: There was no difference in incidence, laboratory parameters, or number of doses of intravenous immunoglobulin required for treatment of KD-like illnesses during the COVID-19 pandemic when compared with previous years at our institution. Kawasaki disease-like illnesses, including multisystem inflammatory syndrome in children, may not have changed substantially during the COVID-19 pandemic.