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Multisystem inflammatory syndrome in children is a novel entity first described in April 2020. It is a complication of COVID-19 that appears with a latency of 2-6 weeks and is characterized by fever, multiorgan involvement, and elevated inflammatory markers. Diagnosis is based on certain diagnostic criteria, and in these recommendations we chose the World Health Organization case definition. Patients should be treated with intravenous immuno-globulin and glucocorticoids together with other symptomatic and supportive measures. Follow-up should be at least a year-long, and even longer in case of cardiac complications. The aim of these recommendations is to help clinicians in diagnosing and treating this disease.Copyright © 2022, University Hospital of Infectious Diseases. All rights reserved.
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AIM: To assess parents' attitudes toward childhood COVID-19 immunization in Croatia. METHOD(S): In this multicenter cross-sectional study, we collected data from four tertiary care facilities in Zagreb, Split, and Osijek between December 2021 and February 2022. During the visit to the Pediatric Emergency Departments, parents were asked to fill out a highly-structured questionnaire about their attitudes toward COVID-19 immunization in children. RESULT(S): The sample consisted of 872 respondents. A total of 46.3% of respondents were hesitant about vaccinating their child against COVID-19, 35.2% definitely did not intend to vaccinate their child, and 18.5% definitely intended to vaccinate their child. Parents who were themselves vaccinated against COVID-19 were more likely than unvaccinated parents (29.2% and 3.2%, P<0.001) to vaccinate their children. Parents agreeing with the epidemiological guidelines were more inclined to vaccinate their children, as were parents of older children and parents of children vaccinated according to the national program schedule. Child comorbidities and respondents' history of COVID-19 were not associated with childhood vaccination intention. Ordinal logistic regression revealed that the most important predictors for a positive parents' attitude toward vaccinating their child were parents' vaccination status and regular vaccination of their child according to the national immunization program schedule. CONCLUSION(S): Our results demonstrate Croatian parents' mostly hesitant and negative attitudes toward childhood COVID-19 immunization. Future vaccination campaigns should target unvaccinated parents, parents with younger children, and parents of children with chronic diseases.
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Aim:To define the effect of the beginning of COVID-19 pandemic on pediatric emergency departments. Materials and methods: The search od PubMed and Web of Science databases was done with predefined parameters. A review of published literature concerning the characteristics and number of visits to pediatric emergency departments globally during the first wave of COVID-19 pandemic was performed. Results: Out of 176 original scientific reports, 25 made the inclusion criteria of this review. 18 countries were included with Canada, USA and Italy producing the most eligible reports (n=3). All the studies compared the pandemic to pre-pandemic data, and all showed a significant reduction in number of visits to the pediatric emergency departments. The number of hospitalizations mostly correlated with the decrease in number of visits. The reduction in number of visits in all studies was due to infectious diseases. There was no notable increase in life-threatening conditions. Conclusions: COVID-19 pandemic directly contributed to the significant reduction in number of visits to the pediatric emergency departments across the world. The general reduction in visits was mostly due to reduction in infectious diseases. Main theorized reasons are increased hygiene, reduced population mobility and fear of catching COVID-19. © 2022 Hrvatski Lijecnicki Zbor. All rights reserved.
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AIM: To assess the number of visits to pediatric emergency departments in Croatia and reasons for visiting before and during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: We reviewed the medical records of pediatric patients visiting emergency departments of four tertiary medical centers between February 25 and April 25, 2018 and 2019, and between February 25 and April 24, 2020. Antimicrobial prescription was analyzed as well. RESULTS: There were altogether 46 544 visits - 18218 in 2018, 19699 in 2019, and 8634 in 2020. The overall number of visits in 2020 significantly decreased compared with 2018 and 2019 (52% and 56% reduction, respectively), mostly due to a decreased number of visits due to certain infectious diseases: acute gastroenteritis (89.2%), sepsis/bacteremia (81.2%), urinary tract infections (55.3%), and lower respiratory tract infections (58%). Most visits were self-referrals regardless of the analyzed period, and the majority of patients did not require hospitalization. There were no significant differences in the number of visits requiring urgent medical care, such as those due to seizures and urgent surgery. The most frequently prescribed antibiotic in all periods was amoxicillin, followed by amoxicillin/clavulanate and oral cephalosporins. CONCLUSION: A significant reduction in the number of pediatric emergency department visits and hospital admissions is indirectly related to the COVID-19 pandemic. Most of the reduction was due to a decreased number of infectious disease cases. However, the number of visits requiring urgent medical intervention did not change.