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1.
J Med Virol ; 93(8): 4748-4755, 2021 08.
Article in English | MEDLINE | ID: covidwho-1610624

ABSTRACT

Respiratory infections are one of the most frequent reasons for medical consultations in children. In low resource settings such as in Lao People's Democratic Republic, knowledge gaps and the dearth of laboratory capacity to support differential diagnosis may contribute to antibiotic overuse. We studied the etiology, temporal trends, and genetic diversity of viral respiratory infections in children to provide evidence for prevention and treatment guidelines. From September 2014 to October 2015, throat swabs and nasopharyngeal aspirates from 445 children under 10 years old with symptoms of acute respiratory infection were collected at the Children Hospital in Vientiane. Rapid antigen tests were performed for influenza A and B and respiratory syncytial virus. Real-time reverse-transcription polymerase chain reactions (RT-PCRs) were performed to detect 16 viruses. Influenza infections were detected with a higher sensitivity using PCR than with the rapid antigen test. By RT-PCR screening, at least one pathogen could be identified for 71.7% of cases. Human rhinoviruses were most frequently detected (29.9%), followed by influenza A and B viruses combined (15.9%). We identify and discuss the seasonality of some of the infections. Altogether these data provide a detailed characterization of respiratory pathogens in Lao children and we provide recommendations for vaccination and further studies.


Subject(s)
Coinfection/epidemiology , Respiratory Tract Infections/epidemiology , Virus Diseases/epidemiology , Viruses/genetics , Acute Disease/epidemiology , Child , Child, Preschool , Coinfection/virology , Female , Humans , Infant , Infant, Newborn , Influenza, Human/diagnosis , Influenza, Human/epidemiology , Influenza, Human/virology , Laos/epidemiology , Male , Prevalence , Respiratory Syncytial Virus Infections/diagnosis , Respiratory Syncytial Virus Infections/epidemiology , Respiratory Syncytial Virus Infections/virology , Respiratory Tract Infections/virology , Viruses/classification , Viruses/isolation & purification
2.
Clin Infect Dis ; 73(11): e4154-e4165, 2021 12 06.
Article in English | MEDLINE | ID: covidwho-1559099

ABSTRACT

BACKGROUND: Children and older adults with coronavirus disease 2019 (COVID-19) display a distinct spectrum of disease severity yet the risk factors aren't well understood. We sought to examine the expression pattern of angiotensin-converting enzyme 2 (ACE2), the cell-entry receptor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and the role of lung progenitor cells in children and older patients. METHODS: We retrospectively analyzed clinical features in a cohort of 299 patients with COVID-19. The expression and distribution of ACE2 and lung progenitor cells were systematically examined using a combination of public single-cell RNA-seq data sets, lung biopsies, and ex vivo infection of lung tissues with SARS-CoV-2 pseudovirus in children and older adults. We also followed up patients who had recovered from COVID-19. RESULTS: Compared with children, older patients (>50 years.) were more likely to develop into serious pneumonia with reduced lymphocytes and aberrant inflammatory response (P = .001). The expression level of ACE2 and lung progenitor cell markers were generally decreased in older patients. Notably, ACE2 positive cells were mainly distributed in the alveolar region, including SFTPC positive cells, but rarely in airway regions in the older adults (P < .01). The follow-up of discharged patients revealed a prolonged recovery from pneumonia in the older (P < .025). CONCLUSIONS: Compared to children, ACE2 positive cells are generally decreased in older adults and mainly presented in the lower pulmonary tract. The lung progenitor cells are also decreased. These risk factors may impact disease severity and recovery from pneumonia caused by SARS-Cov-2 infection in older patients.


Subject(s)
Angiotensin-Converting Enzyme 2/genetics , COVID-19 , Stem Cells , Aged , Child , Humans , Lung/cytology , Middle Aged , RNA-Seq , Retrospective Studies , Severity of Illness Index
3.
Public Adm Rev ; 2021 Mar 29.
Article in English | MEDLINE | ID: covidwho-1526400

ABSTRACT

While Coronavirus Disease 2019 (COVID-19) does not discriminate against particular groups, our social structures and systems mean some people are more at risk in a pandemic context-from both the disease and the social and policy responses to the pandemic. This is particularly so for people with disability, in part because they often have poorer health outcomes from underlying conditions but also due to discrimination and social exclusion. Here, we draw from a survey about the impacts of the COVID-19 pandemic on Australian children and young people with disability and their families. Respondents faced a range of inequities prior to the pandemic, and COVID-19 has further exposed and often exacerbated them. We conclude that recent developments in the Australian disability context to personalize services have arguably made people with disability and their families less safe within a pandemic context, and we outline some ways in which these issues might be addressed.

4.
J Dev Behav Pediatr ; 42(8): 672-676, 2021.
Article in English | MEDLINE | ID: covidwho-1517916

ABSTRACT

OBJECTIVE: This study examines the media use of children from low-income homes during school closings during the COVID-19 pandemic. METHODS: Caregivers of 151 kindergarteners from low-income homes completed questionnaires as part of a larger study. Caregivers reported how much time children spent watching television/videos and using apps on the most recent weekday and weekend days. Caregivers also reported how their child's current use of media for several different purposes compared with how much the child usually uses media for that purpose. RESULTS: Weekly average media use was 46.3 hours or 6.6 hours per day. Counter to previous research, weekday media use was higher than weekend media use, suggesting that media was likely used as a replacement for time usually spent in school. Caregivers reported increased child media use for positive purposes, such as education and maintaining relationships with family and friends outside of the home, and potentially useful but less socially valued purposes, such as occupying the child's time while caregivers were completing other tasks. Having more children in the household was related to higher media use, and girls used media for maintaining remote relationships more than boys. CONCLUSION: These findings provide reason for both concern and optimism for the impacts of pandemic closures on low-income children. High levels of media use seem to be prevalent in this population. However, the diverse purposes for media use suggest that caregivers relied on media to supplement children's academic and social growth at a time when school and socializing were not safe in their typical forms.


Subject(s)
COVID-19 , Poverty , Television , Caregivers , Child, Preschool , Family Characteristics , Female , Humans , Male , Ohio , Pandemics , Television/statistics & numerical data
5.
Clin Infect Dis ; 73(9): e3036-e3041, 2021 11 02.
Article in English | MEDLINE | ID: covidwho-1501049

ABSTRACT

BACKGROUND: With the pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ongoing in Europe in June 2020, day care centers were reopened in the state of Hesse, Germany, after the lockdown. The role young children play in the dynamics of the transmission was unknown. METHODS: We conducted a longitudinal study over 12 weeks and 2 days (18 June 2020-10 September 2020) to screen attendees and staff from day care centers in the state of Hesse, Germany, for both respiratory and gastrointestinal shedding of SARS-CoV-2. A total of 859 children (age range, 3 months-8 years) and 376 staff members from 50 day care centers, which were chosen representatively from throughout the state, participated in the study. Parents were asked to collect both a buccal mucosa and an anal swab from their children once a week. Staff were asked to self-administer the swabs. Reverse transcriptas polymerase chain reaction for SARS-CoV-2 was performed in a multiple-swab pooling protocol. RESULTS: A total of 7366 buccal mucosa swabs and 5907 anal swabs were analyzed. No respiratory or gastrointestinal shedding of SARS-CoV-2 was detected in any of the children. Shedding of SARS-CoV-2 was detected in 2 staff members from distinct day care centers. One was asymptomatic at the time of testing, and one was symptomatic and did not attend the facility on that day. CONCLUSION: Detection of either respiratory or gastrointestinal shedding of SARS-CoV-2 RNA in children and staff members attending day care centers was rare in the context of limited community activity and with infection prevention measures in the facilities in place.


Subject(s)
COVID-19 , SARS-CoV-2 , Child , Child, Preschool , Communicable Disease Control , Day Care, Medical , Germany/epidemiology , Humans , Infant , Longitudinal Studies , RNA, Viral
9.
J Crohns Colitis ; 15(4): 687-691, 2021 Apr 06.
Article in English | MEDLINE | ID: covidwho-1387845

ABSTRACT

Paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 [PIMS-TS] is a newly described condition. It has a spectrum of presentations proposed to occur as part of a post-infectious immune response. We report the first case of PIMS-TS in a child on established anti-tumour necrosis factor alpha [anti-TNFα] therapy; a 10 year-old girl with ulcerative colitis treated with infliximab. The patient had 6 weeks of daily fever with mucocutaneous, gastrointestinal, renal, and haematological involvement. Biomarkers of hyperinflammation were present including: hyperferritinaemia [up to 691 µ/L; normal 15-80 µg/L], C-reactive protein [CRP] [ >100mg/L for  >10 days, normal 0-5 mg/L], erythrocyte sedimentation rate [ESR] consistently  >100mm/h [normal 0-15 mm/h], raised white cell count with neutrophilia, elevated D-dimer and lactate dehydrogenase [LDH], anaemia and Mott cells on bone marrow analysis. Extensive investigations for alternative diagnoses for pyrexia of unknown origin [PUO] were negative. The condition was refractory to treatment with intravenous immunoglobulin [IVIG] but improved within 24 h of high-dose methylprednisolone. Infliximab treatment followed and the patient has remained well at follow-up. Polymerase chain reaction [PCR] and serology for SARS-CoV-2 were negative. Current series report such negative findings in up to half of cases. The patient experienced a milder clinical phenotype without cardiac involvement, shock, or organ failure. Accepting the wide spectrum of PIMS-TS presentations, it is possible that previous anti-TNFα therapy may have attenuated the disease course. Given the uncertainty around therapeutic strategies for PIMS-TS, this case supports the need for further investigation into continuing infliximab as a treatment option for the condition.


Subject(s)
COVID-19/diagnosis , Colitis, Ulcerative/drug therapy , Gastrointestinal Agents/therapeutic use , Infliximab/therapeutic use , Systemic Inflammatory Response Syndrome/diagnosis , COVID-19/complications , COVID-19/therapy , Child , Colitis, Ulcerative/complications , Female , Humans , Systemic Inflammatory Response Syndrome/complications , Systemic Inflammatory Response Syndrome/therapy
10.
Int J Environ Res Public Health ; 18(7)2021 03 30.
Article in English | MEDLINE | ID: covidwho-1378264

ABSTRACT

The use of electronic media (EM) by youths has been widely described in the literature, indicating the relevance of understanding the factors that can protect against its risks. We aimed to explore the protective role of participating in extracurricular activities (ECAs) and of parental mediation in the use of EM by young people. A total of 1413 people (729 students, aged between 11 and 17 years old, and one of their parents) participated in this study. Youths who engaged in ECAs spent significantly less time per week on EM and perceived that the use of EM devices had less of a negative impact. When parents and their children presented a congruent notion of how much time youth spent on EM, parents perceived EM to have less of a negative impact on their children compared to dyads with discrepant assessments. The hierarchical regression results indicated that regardless of time spent per week on EM, engaging in ECAs was a significant predictor of perceiving a less negative impact, playing a role as a protective factor regarding the use of EM. The ubiquity of EM reinforces the importance of the focus of this study, and its results contribute to creating specific guidelines for parental education and educational policies.


Subject(s)
Adolescent Behavior , Adolescent , Child , Educational Status , Electronics , Humans , Protective Factors , Students
11.
Front Immunol ; 12: 654587, 2021.
Article in English | MEDLINE | ID: covidwho-1348485

ABSTRACT

Background: SARS-CoV-2 occurs in the majority of children as COVID-19, without symptoms or with a paucisymptomatic respiratory syndrome, but a small proportion of children develop the systemic Multi Inflammatory Syndrome (MIS-C), characterized by persistent fever and systemic hyperinflammation, with some clinical features resembling Kawasaki Disease (KD). Objective: With this study we aimed to shed new light on the pathogenesis of these two SARS-CoV-2-related clinical manifestations. Methods: We investigated lymphocyte and dendritic cells subsets, chemokine/cytokine profiles and evaluated the neutrophil activity mediators, myeloperoxidase (MPO), and reactive oxygen species (ROS), in 10 children with COVID-19 and 9 with MIS-C at the time of hospital admission. Results: Patients with MIS-C showed higher plasma levels of C reactive protein (CRP), MPO, IL-6, and of the pro-inflammatory chemokines CXCL8 and CCL2 than COVID-19 children. In addition, they displayed higher levels of the chemokines CXCL9 and CXCL10, mainly induced by IFN-γ. By contrast, we detected IFN-α in plasma of children with COVID-19, but not in patients with MIS-C. This observation was consistent with the increase of ISG15 and IFIT1 mRNAs in cells of COVID-19 patients, while ISG15 and IFIT1 mRNA were detected in MIS-C at levels comparable to healthy controls. Moreover, quantification of the number of plasmacytoid dendritic cells (pDCs), which constitute the main source of IFN-α, showed profound depletion of this subset in MIS-C, but not in COVID-19. Conclusions: Our results show a pattern of immune response which is suggestive of type I interferon activation in COVID-19 children, probably related to a recent interaction with the virus, while in MIS-C the immune response is characterized by elevation of the inflammatory cytokines/chemokines IL-6, CCL2, and CXCL8 and of the chemokines CXCL9 and CXL10, which are markers of an active Th1 type immune response. We believe that these immunological events, together with neutrophil activation, might be crucial in inducing the multisystem and cardiovascular damage observed in MIS-C.


Subject(s)
COVID-19/immunology , Chemokine CXCL10/immunology , Chemokine CXCL9/immunology , Dendritic Cells/immunology , Interferon-gamma/immunology , Plasma Cells/immunology , SARS-CoV-2/immunology , Systemic Inflammatory Response Syndrome/immunology , Child , Child, Preschool , Female , Humans , Infant , Male , Retrospective Studies
12.
Sci Immunol ; 6(59)2021 05 25.
Article in English | MEDLINE | ID: covidwho-1337429

ABSTRACT

Multiple Inflammatory Syndrome in Children (MIS-C) is a delayed and severe complication of SARS-CoV-2 infection that strikes previously healthy children. As MIS-C combines clinical features of Kawasaki disease and Toxic Shock Syndrome (TSS), we aimed to compare the immunological profile of pediatric patients with these different conditions. We analyzed blood cytokine expression, and the T cell repertoire and phenotype in 36 MIS-C cases, which were compared to 16 KD, 58 TSS, and 42 COVID-19 cases. We observed an increase of serum inflammatory cytokines (IL-6, IL-10, IL-18, TNF-α, IFNγ, CD25s, MCP1, IL-1RA) in MIS-C, TSS and KD, contrasting with low expression of HLA-DR in monocytes. We detected a specific expansion of activated T cells expressing the Vß21.3 T cell receptor ß chain variable region in both CD4 and CD8 subsets in 75% of MIS-C patients and not in any patient with TSS, KD, or acute COVID-19; this correlated with the cytokine storm detected. The T cell repertoire returned to baseline within weeks after MIS-C resolution. Vß21.3+ T cells from MIS-C patients expressed high levels of HLA-DR, CD38 and CX3CR1 but had weak responses to SARS-CoV-2 peptides in vitro. Consistently, the T cell expansion was not associated with specific classical HLA alleles. Thus, our data suggested that MIS-C is characterized by a polyclonal Vß21.3 T cell expansion not directed against SARS-CoV-2 antigenic peptides, which is not seen in KD, TSS and acute COVID-19.


Subject(s)
CD4-Positive T-Lymphocytes/immunology , CD8-Positive T-Lymphocytes/immunology , COVID-19/immunology , COVID-19/pathology , Receptors, Antigen, T-Cell, alpha-beta/immunology , Systemic Inflammatory Response Syndrome/immunology , Systemic Inflammatory Response Syndrome/pathology , Adult , Child , Child, Preschool , Cytokines/blood , HLA-DR Antigens/immunology , Humans , Lymphocyte Activation/immunology , SARS-CoV-2/immunology
13.
JMIR Res Protoc ; 10(5): e28673, 2021 May 28.
Article in English | MEDLINE | ID: covidwho-1304552

ABSTRACT

BACKGROUND: School closures are a widely implemented strategy for limiting infection spread in the current COVID-19 pandemic. The negative impact of school closures on children and young people is increasingly apparent, however. OBJECTIVE: We aim to evaluate the feasibility of an infection monitoring program in schools to enable targeted quarantining to replace school closures. The program is currently being implemented in two model schools in Magdeburg, Germany, within the framework of the Study of Coronavirus Outbreak Prevention in Magdeburg Schools (Studie zur Ausbruchsvermeidung von Corona an Magdeburger Schulen [STACAMA]). METHODS: Five pupils per class are pseudorandomly selected twice a week and asked to provide a gargle sample over a 16-week evaluation period. RNA is extracted from each sample individually in a laboratory and pooled according to school class for real-time reverse transcription polymerase chain reaction (rRT-PCR) analysis. Immediate individual sample testing will be carried out in the case of a positive pool test. Individual RNA extraction prior to pooling and application of rRT-PCR result in high test sensitivity. Testing will be performed in strict adherence to data protection standards. All participating pupils will receive a 16-digit study code, which they will be able to use to access their test. RESULTS: When the study commenced on December 2, 2020, 520 (52%) pupils and their families or guardians had consented to study participation. The study was suspended after four test rounds due to renewed school closures resulting from rising regional infection incidence. Testing resumed when schools reopened on March 8, 2021, at which time consent to participation was provided for 54% of pupils. We will quantitatively and qualitatively evaluate the logistics and acceptability of the program. CONCLUSIONS: The findings from this study should inform the design of infection surveillance programs in schools based on gargle samples and a PCR-based pool testing procedure, enabling the identification of aspects that may require adaptation before large-scale implementation. Our focus on each step of the logistics and on the experiences of families should enable a robust assessment of the feasibility of such an approach. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/28673.

14.
Biochem Med (Zagreb) ; 31(2): 020706, 2021 Jun 15.
Article in English | MEDLINE | ID: covidwho-1290873

ABSTRACT

INTRODUCTION: The study aimed to investigate the prevalence and titres of anti-SARS-CoV-2 antibodies in children treated at the Children's Hospital Zagreb in the first and the second wave of the COVID-19 pandemic. Statistical significance of difference at two time points was done to determine how restrictive epidemiological measures and exposure of children to COVID-19 infection affect this prevalence in different age groups. MATERIALS AND METHODS: At the first time point (13th to 29th May 2020), 240 samples and in second time point (24th October to 23rd November 2020), 308 serum samples were tested for anti-SARS-CoV-2 antibodies by enzyme-linked immunosorbent assay (ELISA) and electrochemiluminescence immunoassay (ECLIA). Confirmation of results and titre determination was done using virus micro-neutralization test. Subjects were divided according to gender, age and epidemiological history. RESULTS: Seroprevalence of anti-SARS-CoV-2 antibodies differs significantly in two time points (P = 0.010). In first time point 2.9% of seropositive children were determined and in second time point 8.4%. Statistically significant difference (P = 0.007) of seroprevalence between two time points was found only in a group of children aged 11-19 years. At the first time point, all seropositive children were asymptomatic with titre < 8. At the second time point, 69.2% seropositive children were asymptomatic with titre ≥ 8. CONCLUSIONS: The prevalence of anti-SARS-CoV-2 antibodies was significantly lower at the first time point than at the second time point. Values of virus micro-neutralization test showed that low titre in asymptomatic children was not protective at the first time point but in second time point all seropositive children had protective titre of anti-SARS-CoV-2 antibodies.


Subject(s)
Antibodies, Viral/blood , COVID-19/diagnosis , SARS-CoV-2/immunology , Adolescent , COVID-19/epidemiology , COVID-19/virology , Child , Child, Preschool , Croatia/epidemiology , Enzyme-Linked Immunosorbent Assay , Female , Hospitals , Humans , Infant , Male , Pandemics , SARS-CoV-2/isolation & purification
16.
Child Adolesc Ment Health ; 26(3): 272-273, 2021 09.
Article in English | MEDLINE | ID: covidwho-1269724

ABSTRACT

Following COVID-19, there has been increasing concern about the well-being of children and young people across the United Kingdom; however, our major problem is the lack of robust data. We discuss emerging research capturing the impact of restrictions and experiences of COVID-19 on children and young people. We suggest further and more detailed analysis is urgently required to inform an evidence-based response. We conclude that although most of the UK's kids are probably OK, it is essential that those who are in need of support receive timely and informed intervention.


Subject(s)
Mental Disorders/epidemiology , Mental Health , Neurodevelopmental Disorders/epidemiology , Psychology, Adolescent , Adolescent , Child , Child, Preschool , Family , Family Conflict , Female , Food Supply , Humans , Male , Schools , United Kingdom
17.
Front Psychol ; 12: 648000, 2021.
Article in English | MEDLINE | ID: covidwho-1268291

ABSTRACT

BACKGROUND: Research during 2020 has been rapidly attending to the impact of COVID-19 on various dimensions of wellbeing (e.g., physical, psychological, lifestyle and routines) on adults and children around the world. However, less attention has focused on the psychoeducational impact on children and their families. To our knowledge, no currently available studies have looked specifically at the impact of COVID-19 on students with dyslexia and their families. Research on this topic is needed to offer greater support for this population of students and their families. OBJECTIVE: The main objective of this paper is to examine the psychoeducational impact of the required COVID-19 quarantine in Spain among children with dyslexia and their families. METHOD: A sample of 32 children with dyslexia and their mothers participated in this study. MEASURES: Children and adolescents with dyslexia and their mother completed several measures before the required national quarantine in Spain and again during the quarantine. Children completed measures of depression, state anxiety, reading activity, and reading motivation. Mothers provided demographic information and completed measures related to students' emotional and behavioral difficulties as well as parenting stress, parental distress, and a questionnaire about educational problems during quarantine. RESULTS: Major findings showed that during quarantine, children with dyslexia had increased levels of depression and anxiety symptoms, and parents perceived their children as having more emotional symptoms, hyperactivity-inattention, and conduct problems. During quarantine, children and adolescents with dyslexia also showed less reading activity and less reading motivation. Parents also reported significantly more stress, during quarantine compared to pre-quarantine conditions. Some demographic and psychological variables predicted children's state anxiety as well parental stress. The questionnaire related to impacts of quarantine also revealed several important findings. For example, nearly all parents of children with dyslexia reported (a) difficulties in establishing study routines, (b) that the quarantine negatively affected their child's learning, and (c) that they did not receive sufficient help from teachers on how to support their child's learning. Additionally, the vast majority of the parents were very worried about the child's learning and school success, the child's motivation and interest in reading, the child's peer relations, and the professional skills of the child's teacher. CONCLUSION: This study offers a preliminary investigation into this topic and elucidates several psychoeducational challenges that children with dyslexia and their families have experienced during the quarantine in Spain. Study findings highlight the need to provide immediate support for children with dyslexia and emphasizes the importance of developing prevention programs to mitigate any future negative impacts of COVID-19 on children with dyslexia and their parents.

18.
Glob Pediatr Health ; 8: 2333794X211022250, 2021.
Article in English | MEDLINE | ID: covidwho-1262443

ABSTRACT

Many children needing pediatric intensive care units care require inotropes, which are started peripherally prior to securing a central venous access. However, many hospitals in low- and middle-income countries (LMIC) may not have access to central lines and the vasoactive medications are frequently given through a peripheral venous access. Aim: The aim of our study was to describe the role of peripheral vasoactive inotropes in children. Methods: Children requiring peripheral vasoactive medications were included in this study. We retrospectively collected data at 2 time points on use and complications of peripheral vasoactive medications. Results: Eighty-four children (51 pre-COVID era and 33 COVID pandemic) received peripheral vasoactive medications. Only 3% of children (3/84) developed extravasation injury, all of whom recovered completely. Conclusions: Results from our study suggest that extravasation injury due to peripheral inotrope infusion is very low (3%) and it may be safely administered in children at a diluted concentration.

19.
J Trop Pediatr ; 67(2)2021 05 17.
Article in English | MEDLINE | ID: covidwho-1254837

ABSTRACT

BACKGROUND: Acute kidney injury (AKI) has been recognized as a significant risk factor for mortality among adults with severe acute respiratory syndrome coronavirus infection. AIM: The aim of this study is to assess the prevalence and risk factors for AKI and mortality in children with coronavirus disease 2019 (COVID19) from a resource-limited setting. METHODS: Cross-sectional analysis of laboratory confirmed COVID19 children admitted from 1 March to 30 November 2020 in a tertiary care hospital in New Delhi, India was done. Clinical features and associated comorbidities of COVID19 were noted. Baseline serum creatinine (height-independent Hoste's equation) and peak serum creatinine were used for staging of AKI by the 2012 Kidney Disease Improving Global Outcomes serum creatinine criteria. Univariate analysis and Kaplan-Meier survival analysis were used to compare the overall outcome in the AKI vs. the non-AKI group. RESULTS: A total of 64 810 children between 1 month and 18 years visited the hospital; 3412 were tested for suspected COVID19, 295 tested positive and 105 (54% boys) were hospitalized. Twenty-four hospitalized children (22.8%) developed AKI; 8 in Stage 1 (33.3%), 7 in Stage 2 (29.2%) and 9 in Stage 3 (37.5%) respectively. Overall, three patients received KRT. Highest reported mortality was (66.6%) in AKI Stage 3. Risk factors for AKI included associated sepsis (OR 95% CI, 1.22-9.43, p < 0.01), nephrotic syndrome (OR 95% CI, 1.13-115.5, p < 0.01), vasopressor support (OR 3.59, 95% CI, 1.37-9.40, p value< 0.007), shock at presentation (OR 2.98, 95% CI, 1.16-7.60, p value 0.01) and mechanical ventilation (OR 2.64, 95% CI, 1.04-6.71, p value< 0.03). Mortality (25.71%) was higher in the AKI group (OR 95% CI, 1.14-8.35, p < 0.023) with shock (OR 45.92; 95% CI, 3.44-612.0, p value <0.004) and ventilation (OR 46.24; 95% CI, 1.6-1333.0 p value< 0.02) as significant risk factors for mortality. CONCLUSION: AKI is an important modifiable risk factor for mortality in children with COVID19 in a resource-limited setting. Our study supports the strengthening of kidney replacement therapy and its timely initiation to reduce the progression of AKI and thus mortality in children.


Subject(s)
Acute Kidney Injury , COVID-19 , Acute Kidney Injury/epidemiology , Adult , Child , Child, Hospitalized , Cross-Sectional Studies , Female , Hospital Mortality , Humans , India/epidemiology , Male , Retrospective Studies , Risk Factors , SARS-CoV-2
20.
J Autism Dev Disord ; 52(5): 2149-2155, 2022 May.
Article in English | MEDLINE | ID: covidwho-1252167

ABSTRACT

In March 2020, many schools were closed to prevent the spread of COVID-19 in Japan, and it is predicted that many children, especially those with neurodevelopmental disorders (NDDs), will be affected emotionally and behaviorally. Here, we examined the impact of school closures due to COVID-19 on school-aged children with NDDs using the Child Behavior Checklist. Totally, data on 121 children diagnosed with autism spectrum disorder, attention-deficit hyperactivity disorder, and/or intellectual disorder were analyzed and it was found that externalizing and aggressive behavior increased in all NDDs, regardless of the type of diagnosis. A clear prospect is important for children with NDDs children to lead a stable life, and more generous supports for children with NDDs and their families are needed.


Subject(s)
Attention Deficit Disorder with Hyperactivity , Autism Spectrum Disorder , COVID-19 , Neurodevelopmental Disorders , Attention Deficit Disorder with Hyperactivity/psychology , Autism Spectrum Disorder/epidemiology , Autism Spectrum Disorder/psychology , COVID-19/prevention & control , Child , Humans , Japan/epidemiology , Neurodevelopmental Disorders/diagnosis , Neurodevelopmental Disorders/epidemiology , Neurodevelopmental Disorders/psychology
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