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1.
Pediatr Allergy Immunol ; 2020 Aug 05.
Article in English | MEDLINE | ID: covidwho-694186
2.
J Pediatr ; 2020 Aug 05.
Article in English | MEDLINE | ID: covidwho-694167

ABSTRACT

Myocardial dysfunction and coronary artery dilation have been reported in the acute setting of severe acute respiratory syndrome coronavirus disease-2-related multisystem inflammatory syndrome in children. Through a longitudinal echocardiographic single-center study of 15 children, we report the short-term outcomes of cardiac dysfunction and coronary artery dilation in severe acute respiratory syndrome coronavirus disease-2-related multisystem inflammatory syndrome in children.

3.
Cyberpsychol Behav Soc Netw ; 2020 Jul 27.
Article in English | MEDLINE | ID: covidwho-690437

ABSTRACT

In this study, we examined parents' (n = 260) perceptions of their own and their children's use of social media and other types of communication technologies in the beginning stages of coronavirus disease 2019 (COVID-19) related sanctions (e.g., social distancing) in the United States. We also examined associations between social media and technology use and anxiety. On average, parents reported that both they and their children (especially teenagers aged 13-18) had increased technology and social media use since the beginning of social distancing. Moreover, even after controlling for demographic factors, structural equation models showed that parents and children with higher levels of anxiety (as reported by parents) were more likely to increase their technology use and use social media and phones to connect. Among parents, higher anxiety was related to using social media for both social support and information seeking. Based on these results, we advocate for the utilization of social media by public health officials for collecting, collating, and dispersing accurate crisis-related information. As social media use is widespread, and there is potential for false rumors to cause erroneous behavioral action and/or undue stress and anxiety, we also suggest that social media campaigns be thoughtfully designed to account for individual differences in developmental stages and psychological vulnerabilities.

4.
Transl Behav Med ; 2020 Jul 25.
Article in English | MEDLINE | ID: covidwho-676002

ABSTRACT

COVID-19 has led to substantial challenges in continuing to deliver behavioral health care to all patients, including children with chronic diseases. In the case of diabetes, maintaining strong connections among children, their families, and their care team is essential to promote and sustain daily adherence to a complex medical regimen. The purpose of this paper is to describe COVID-19 pandemic-related practices and policies affecting the continuity of behavioral health care among children with diabetes. Challenges and opportunities were encountered at the provider, patient, and family levels throughout the rapid transition period from in-person to online care to ensure continuity of services. Institutional, regional, and national policies that impacted the care team's capacity to respond swiftly to patients' changing needs were counterbalanced by those related to standards of care, education and training, and resource constraints. At the policy level, COVID-19 re-exposed a number of long-standing and complicated issues about professional licensure among behavioral health providers at the local and state levels and national long-distance practice restrictions during times of crisis. Issues of insurance reimbursement and regulations intended to protect the public may need to adapt and evolve as the practice of behavioral medicine increasingly takes place remotely, online, and over great distances. The sudden transition to telehealth instigated by COVID-19, in addition to the increasing recognition of the benefits of telehealth to favorably affect the reach and impact of traditional behavioral medicine services, offers an unprecedented opportunity to reimagine the medical home and continuity of care for children with diabetes.

7.
Cardiol Young ; : 1-4, 2020 Jul 20.
Article in English | MEDLINE | ID: covidwho-669227

ABSTRACT

INTRODUCTION AND AIM: Hydroxychloroquine alone or in combination with azithromycin has been increasingly used for patients with coronavirus disease 2019, in both children and adults. Drugs are generally well tolerated in clinical practice; however, both can cause corrected QT prolongation. We aimed to report our experience of QT interval evaluation associated with the use of hydroxychloroquine with concurrent azithromycin among children testing positive for coronavirus disease 2019. METHODS: Our single-centre; retrospective, study evaluated children with coronavirus disease 2019 disease admitted to the Pediatric Department at Sancaktepe Training and Research Hospital Istanbul, Turkey from 10 March, 2020 to 10 April, 2020. The data including demographics, clinical symptoms, co-morbid diseases, laboratory, radiological findings as well as electrocardiographs of the patients were obtained from our records. Electrocardiograms were evaluated before, one day after and at the termination of the treatment. RESULTS: 21 patients aged 9 to 18 years were evaluated. The median age was 170 months (range 112-214), 51.1% of them were girls and 48.9% were boys. Their laboratory results did not reveal any abnormalities. None of them needed intensive care. We did not detect QT prolongation during or at the termination of the treatment. CONCLUSION: We did not detect QT prolongation during or at the termination of the treatment in our patients due to the fact that they were not severely affected by the disease. Patients were treated in our inpatient clinic and none of them required intensive care. Laboratory results were also insignificant. Furthermore, they did not need other medications.

8.
NASN Sch Nurse ; 35(4): 196-197, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-657165

ABSTRACT

Annually, the National Association of School Nurses (NASN) sets advocacy goals. The goals include legislative and policy priorities. This article sets forth current NASN legislative priorities and results of advocacy that benefit students. The NASN Board of Directors are instrumental in moving policy priorities forward. In addition, this article shares NASN advocacy during the COVID-19 pandemic.


Subject(s)
Betacoronavirus , Prejudice/legislation & jurisprudence , Prejudice/prevention & control , School Health Services/standards , School Nursing/standards , Tobacco Smoking/legislation & jurisprudence , Tobacco Smoking/prevention & control , Adolescent , Child , Coronavirus Infections/prevention & control , Female , Guidelines as Topic , Humans , Lunch , Male , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , United States
10.
Fam Process ; 59(3): 1060-1079, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-653144

ABSTRACT

During the recent COVID-19 outbreak in Spain, we explored the individual and relational well-being of people confined together with their partners and/or children during the first 3 weeks of state-regulated lockdown. Adults 18 years or older (N = 407) completed an online survey that included demographic, household, and employment information along with standardized measures of psychological distress (State-Trait Anxiety and Beck Depression) and relationship functioning-either the Dyadic Adjustment Scale if there were no children in the household or a Basic Family Relations Evaluation Questionnaire (CERFB) measuring conjugal, parental, and coparental functions. Qualitative analyses of responses to an open-ended question about perceived changes in couple or family dynamics during lockdown revealed nine specific themes comprising two overarching categories: relational improvement and deterioration. The overall prevalence of improvement themes (61.7%) exceeded deterioration themes (41.0%), with increased (re)connection and conflict atmosphere cited most often. Quantitative analyses found elevated levels of state anxiety but not trait anxiety or depression during lockdown. Consistent with the qualitative results, couples having no children at home reported high levels of dyadic adjustment, but with children present CERFB parental functioning exceeded conjugal functioning, a pattern sometimes associated with child triangulation into adult conflicts. Although correlates of psychological distress (e.g., unemployment, perceived economic risk) were relatively stable across subgroups, predictors of relationship functioning varied substantially with household/parental status (e.g., telecommuting and employment facilitated conjugal functioning only for couples with children).

11.
Clin Neuropsychol ; : 1-21, 2020 Jul 16.
Article in English | MEDLINE | ID: covidwho-652792

ABSTRACT

OBJECTIVE: The Inter Organizational Practice Committee (IOPC) convened a workgroup to provide rapid guidance about teleneuropsychology (TeleNP) in response to the COVID-19 pandemic. METHOD: A collaborative panel of experts from major professional organizations developed provisional guidance for neuropsychological practice during the pandemic. The stakeholders included the American Academy of Clinical Neuropsychology/American Board of Clinical Neuropsychology, the National Academy of Neuropsychology, Division 40 of the American Psychological Association, the American Board of Professional Neuropsychology, and the American Psychological Association Services, Inc. The group reviewed literature, collated federal, regional and state regulations and information from insurers, and surveyed practitioners to identify best practices. RESULTS: Literature indicates that TeleNP may offer reliable and valid assessments, but clinicians need to consider limitations, develop new informed consent procedures, report modifications of standard procedures, and state limitations to diagnostic conclusions and recommendations. Specific limitations affect TeleNP assessments of older adults, younger children, individuals with limited access to technology, and individuals with other individual, cultural, and/or linguistic differences. TeleNP may be contraindicated or infeasible given specific patient characteristics, circumstances, and referral questions. Considerations for billing TeleNP services are offered with reservations that clinicians must verify procedures independently. Guidance about technical issues and "tips" for TeleNP procedures are provided. CONCLUSION: This document provides provisional guidance with links to resources and established guidelines for telepsychology. Specific recommendations extend these practices to TeleNP. These recommendations may be revised as circumstances evolve, with updates posted continuously at OPC.online.

12.
Seizure ; 81: 29-35, 2020 Jul 18.
Article in English | MEDLINE | ID: covidwho-652178

ABSTRACT

INTRODUCTION: The ongoing COVID-19 pandemic and the lockdown measures employed by the government have forced neurologists across the world to look upon telemedicine as the only feasible and practical option to continue providing health care towards children with epilepsy in home isolation. Children with epilepsy are challenging for teleconsultation as direct information from the patient is missing, regarding seizures and adverse effects, especially behavioral and psychological side effects. METHODS: Clinical and epilepsy-related details of telephonic consultations for children 1 month-18 years, performed between 26th March and 17th May 2020 in a tertiary care teaching hospital in Uttarakhand (a state of India known for hilly terrains with low per capita income) were recorded. Suitable changes in the dose/commercial brand of antiepileptic drug (AED) regimen were performed, along with the addition of new AED and referral to local practitioners for immediate hospitalization, when urgent health care issues were detected. Voice call, text message, picture/video message, and all other possible measures were employed to accumulate maximum clinical information in real-time. RESULTS: A total of 153 children(95 males [62 %], 9.45 ±â€¯3.24 years, 140 lower/middle socioeconomic status) were enrolled after screening 237 children with various neurological disorders, whose caregivers contacted for teleconsultation. A total of 278 telephone consultations performed for these 153 children (1-5 telephone calls per patient). Hundred-thirteen children were identified to have a total of 152 significant clinical events (breakthrough seizure/uncontrolled epilepsy (108), AED related (13), and unrelated systemic adverse effects (24), worsening of associated co-morbidities (7). In rest of the patients, the query of the caregiver included unavailability of AED/prescribed commercial brand in the locality, query related to the dose of drugs, proxy for a scheduled routine visit (no active issues), and concern regarding COVID-19 related symptoms and effect of COVID-19 and lockdown in children with epilepsy. Ninety-three (60 %) patients required hiking up of AED dose, whereas 29 (17 %) patients required the addition of a new AED/commercial brand. Five children were advised immediate admission to a nearby hospital. Overall, 147 (96 %) caregivers were satisfied with the quality of medical advice. CONCLUSION: Teleconsultation is one of the few feasible options with good effectiveness for providing medical advice to children with epilepsy during pandemic times.

13.
JMIR Public Health Surveill ; 6(3): e19831, 2020 07 30.
Article in English | MEDLINE | ID: covidwho-651795

ABSTRACT

Before the coronavirus disease (COVID-19), 1 in 3 women and girls, globally, were victimized by an abusive partner in intimate relationships. However, the current pandemic has amplified cases of domestic violence (DV) against women and girls, with up to thrice the prevalence in DV cases compared to the same time last year. Evidence of the adverse effects of the pandemic on DV is still emerging, even as violence prevention strategies are iteratively being refined by service providers, advocacy agencies, and survivors to meet stay-at-home mandates. Emotional and material support for survivors is a critical resource increasingly delivered using digital and technology-based modalities, which offer several advantages and challenges. This paper rapidly describes current DV mitigation approaches using digital solutions, signaling emerging best practices to support survivors, their children, and abusers during stay-at-home advisories. Some examples of technology-based strategies and solutions are presented. An immediate priority is mapping out current digital solutions in response to COVID-19-related DV and outlining issues with uptake, coverage, and meaningful use of digital solutions.


Subject(s)
Coronavirus Infections/epidemiology , Domestic Violence/prevention & control , Intimate Partner Violence/prevention & control , Pandemics , Pneumonia, Viral/epidemiology , Telemedicine/methods , Coronavirus Infections/prevention & control , Domestic Violence/statistics & numerical data , Female , Global Health/statistics & numerical data , Humans , Intimate Partner Violence/statistics & numerical data , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Prevalence , Social Support , Survivors/psychology
15.
J Infect Dis ; 222(8): 1270-1279, 2020 Sep 14.
Article in English | MEDLINE | ID: covidwho-684453

ABSTRACT

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in China as the cause of coronavirus disease 2019 in December 2019 and reached Europe by late January 2020, when community-acquired respiratory viruses (CARVs) are at their annual peak. We validated the World Health Organization (WHO)-recommended SARS-CoV-2 assay and analyzed the epidemiology of SARS-CoV-2 and CARVs. METHODS: Nasopharyngeal/oropharyngeal swabs (NOPS) from 7663 patients were prospectively tested by the Basel S-gene and WHO-based E-gene (Roche) assays in parallel using the Basel N-gene assay for confirmation. CARVs were prospectively tested in 2394 NOPS by multiplex nucleic acid testing, including 1816 (75%) simultaneously for SARS-CoV-2. RESULTS: The Basel S-gene and Roche E-gene assays were concordant in 7475 cases (97.5%) including 825 (11%) SARS-CoV-2 positives. In 188 (2.5%) discordant cases, SARS-CoV-2 loads were significantly lower than in concordant positive ones and confirmed in 105 (1.4%). Adults were more frequently SARS-CoV-2 positive, whereas children tested more frequently CARV positive. CARV coinfections with SARS-CoV-2 occurred in 1.8%. SARS-CoV-2 replaced CARVs within 3 weeks, reaching 48% of all detected respiratory viruses followed by rhinovirus/enterovirus (13%), influenza virus (12%), coronavirus (9%), respiratory syncytial virus (6%), and metapneumovirus (6%). CONCLUSIONS: Winter CARVs were dominant during the early SARS-CoV-2 pandemic, impacting infection control and treatment decisions, but were rapidly replaced, suggesting competitive infection. We hypothesize that preexisting immune memory and innate immune interference contribute to the different SARS-CoV-2 epidemiology among adults and children.

17.
J Pediatric Infect Dis Soc ; 9(3): 362-365, 2020 Jul 13.
Article in English | MEDLINE | ID: covidwho-684002

ABSTRACT

In a family experiencing coronavirus disease 2019, the parents and 2 children aged 2 and 5 years became infected but the youngest child was not infected. Both children initially shed infectious virus, but cleared the virus after 5 to 6 days in the nasopharynx. However, viral RNA was continuously detected in the children's stool for more than 4 weeks.


Subject(s)
Betacoronavirus , Coronavirus Infections/pathology , Family , Pneumonia, Viral/pathology , Adult , Child, Preschool , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Female , Germany/epidemiology , Humans , Infant , Infectious Disease Incubation Period , Male , Nasopharynx/virology , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Viral Load , Virus Shedding
18.
Pediatr Qual Saf ; 5(4): e326, 2020.
Article in English | MEDLINE | ID: covidwho-683495

ABSTRACT

Background: Community-acquired pneumonia (CAP) is a significant cause of pediatric morbidity and mortality worldwide. Emergency department point of care ultrasound (POCUS) is a first-line modality for diagnosis of CAP. The current coronavirus disease 2019 pandemic creates a unique opportunity to incorporate lung POCUS into the evaluation of a broader range of children. It has increased the utility of lung POCUS in both evaluation and follow-up of pediatric coronavirus cases. An increased use of lung POCUS creates an opportunity for earlier diagnosis while allowing the opportunity for overdiagnosis of small infiltrates and atelectasis. We collated a case series to demonstrate the benefit of lung POCUS in a very broad range of children. Methods: We collected a case series of 5 patients between December 2018 and December 2019 who presented nonclassically and were diagnosed with CAP on POCUS by a pediatric emergency physician. Conclusion: Routine lung POCUS in ill children will allow treating physicians to identify and follow a pulmonary infiltrate consistent with CAP quickly. We anticipate that early and more frequent use of POCUS and earlier diagnosis of CAP may improve outcomes by decreasing healthcare encounters within the same illness and by reducing the incidence of late sequelae of pneumonia such as empyema and effusions. However, we acknowledge that this may come at the expense of the overtreatment of viral infiltrates and atelectasis. Further study is required to improve the specificity of lung POCUS in the evaluation of CAP.

19.
Pediatrics ; 2020 Jul 24.
Article in English | MEDLINE | ID: covidwho-680619

ABSTRACT

BACKGROUND: As the coronavirus disease pandemic spread across the United States and protective measures to mitigate its impact were enacted, parents and children experienced widespread disruptions in daily life. Our objective with this national survey was to determine how the pandemic and mitigation efforts affected the physical and emotional well-being of parents and children in the United States through early June 2020. METHODS: In June 2020, we conducted a national survey of parents with children age <18 to measure changes in health status, insurance status, food security, use of public food assistance resources, child care, and use of health care services since the pandemic began. RESULTS: Since March 2020, 27% of parents reported worsening mental health for themselves, and 14% reported worsening behavioral health for their children. The proportion of families with moderate or severe food insecurity increased from 6% before March 2020 to 8% after, employer-sponsored insurance coverage of children decreased from 63% to 60%, and 24% of parents reported a loss of regular child care. Worsening mental health for parents occurred alongside worsening behavioral health for children in nearly 1 in 10 families, among whom 48% reported loss of regular child care, 16% reported change in insurance status, and 11% reported worsening food security. CONCLUSIONS: The coronavirus disease pandemic has had a substantial tandem impact on parents and children in the United States. As policy makers consider additional measures to mitigate the health and economic effects of the pandemic, they should consider the unique needs of families with children.

20.
J Med Virol ; 2020 Jul 28.
Article in English | MEDLINE | ID: covidwho-680336

ABSTRACT

Respiratory viral infection can cause severe disease and hospitalization, especially among children, the elderly, and patients with comorbidities. In Brazil, the official surveillance system of severe acute respiratory infection (SARI) investigates influenza A (IAV) and B (IBV) viruses, respiratory syncytial virus (RSV), adenovirus (HAdV), and parainfluenza viruses (hPIV 1-3). In Rio Grande do Sul (RS), Brazil, many fatalities associated with SARI between 2013 and 2017 occurred among patients without underlying diseases and for whom the causative agent had not been identified using official protocols. This cross-sectional study analyzed the presence of coronaviruses (HCoV), bocavirus (HBoV), metapneumovirus (hMPV), and rhinovirus in patients who died of SARI despite not having comorbidities, and that were negative for IAV, IBV, RSV, HAdV, and hPIV. Nasopharyngeal aspirates/swabs from patients were used for nucleic acid extraction. The presence of HCoVs OC43, HKU1, NL63, and 229E; HBoV; hMPV; and rhinovirus was assessed by quantitative reverse transcription-polymerase chain reaction. Clinical data were also analyzed. Between 2013 and 2017, 16 225 cases of SARI were reported in RS; 9.8% of the patients died; 20% of all fatal cases were patients without comorbidities and for whom no pathogen was detected using standard protocols. Analysis of 271 of these cases identified HCoV in nine cases; HBoV, hMPV, and rhinovirus were detected in 3, 3, and 10 cases, respectively. Of note, patients infected with HCoV were adults. Results reinforce the importance of including coronaviruses in diagnostic panels used by official surveillance systems because besides their pandemic potential, endemic HCoVs are associated to severe disease in healthy adults.

21.
Pharmacotherapy ; 2020 Jul 26.
Article in English | MEDLINE | ID: covidwho-676739

ABSTRACT

There have been concerns regarding the safety of nonsteroidal antiinflammatory drugs (NSAIDs) in patients with respiratory infections. However, to date, the quality of the evidence has not been systematically assessed. The purpose of this systematic review was to evaluate the role of NSAIDs on pneumonia complications. OVID MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Database of Abstracts of Reviews of Effects, and Google Scholar were searched. Studies that examined pneumonia complications in patients who had taken NSAIDs before onset of symptoms were identified. Quality assessment was conducted using the Risk of Bias in Non-randomized Studies - of Interventions (ROBINS-I) assessment tool, which was adapted to include biases that were pertinent to this question. The search strategy identified 1721 potential studies through the 5 primary databases and searching reference lists. Of these, 10 studies met the inclusion criteria, including 5 nested case-control studies, 2 population-based case-control studies, and 3 cohort studies. In total, 59,724 adults were included from 4 of the studies (range = 57-59,250) and 1217 children from 5 studies (range = 148-540). All studies demonstrated a positive association; in adults (odds ratio/risk ratio range = 1.8-8.1) and children (odds ratio/risk ratio range = 1.9-6.8). Studies were limited by moderate or serious risk of confounding bias, exposure misclassification, and protopathic biases and sparse data bias. The results of this review demonstrate that published studies on the effect of NSAIDs use and risk of pneumonia complications are subject to a number of biases. These results should not be extrapolated as evidence of harm for NSAIDs, including ibuprofen, in respiratory ailments but highlight the need for more methodologically robust studies to evaluate this potential relationship.

25.
Euro Surveill ; 25(25)2020 06.
Article in English | MEDLINE | ID: covidwho-621605

ABSTRACT

Sentinel surveillance of acute hospitalisations in response to infectious disease emergencies such as the 2009 influenza A(H1N1)pdm09 pandemic is well described, but recognition of its potential to supplement routine public health surveillance and provide scalability for emergency responses has been limited. We summarise the achievements of two national paediatric hospital surveillance networks relevant to vaccine programmes and emerging infectious diseases in Canada (Canadian Immunization Monitoring Program Active; IMPACT from 1991) and Australia (Paediatric Active Enhanced Disease Surveillance; PAEDS from 2007) and discuss opportunities and challenges in applying their model to other contexts. Both networks were established to enhance capacity to measure vaccine preventable disease burden, vaccine programme impact, and safety, with their scope occasionally being increased with emerging infectious diseases' surveillance. Their active surveillance has increased data accuracy and utility for syndromic conditions (e.g. encephalitis), pathogen-specific diseases (e.g. pertussis, rotavirus, influenza), and adverse events following immunisation (e.g. febrile seizure), enabled correlation of biological specimens with clinical context and supported responses to emerging infections (e.g. pandemic influenza, parechovirus, COVID-19). The demonstrated long-term value of continuous, rather than incident-related, operation of these networks in strengthening routine surveillance, bridging research gaps, and providing scalable public health response, supports their applicability to other countries.


Subject(s)
Hospitals, Pediatric/statistics & numerical data , Immunization Programs/standards , Patient Admission/statistics & numerical data , Population Surveillance/methods , Vaccination/adverse effects , Vaccines/administration & dosage , Australia/epidemiology , Canada/epidemiology , Child , Child, Preschool , Data Accuracy , Health Policy , Hospitalization/statistics & numerical data , Humans , National Health Programs/standards , Public Health Surveillance , Vaccination/statistics & numerical data
26.
Clin Child Psychol Psychiatry ; 25(3): 672-686, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-620478

ABSTRACT

The impact of COVID-19 has challenged the long accepted 'norm' in delivery of psychological therapy. Public policies designed to reduce transmission have made it extremely difficult to meet with service-users safely in the traditional face-to-face context. E-therapies have existed in theory and practice since technological progress has made them possible. They can offer a host of advantages over face-to-face equivalents, including improved access, greater flexibility for service-users and professionals, and cost savings. However, despite the emerging evidence and anticipated positive value, implementation has been slower than anticipated. Concerns have been raised by service-users, clinicians, and public health organisations, identifying significant barriers to the wide spread use of e-therapies. In the current climate, many clinicians are offering e-therapies for the first time, without prior arrangement or training, as the only viable option to continue to support their clients. This paper offers a clinically relevant review of the e-therapies literature, including effectiveness and acceptability dilemmas and challenges that need to be addressed to support the safe use and growth of e-therapies in psychology services. Further research is needed to better understand what might be lost and what gained in comparison to face-to-face therapy, and for which client groups and settings it might be most effective.


Subject(s)
Attitude of Health Personnel , Coronavirus Infections/epidemiology , Patient Acceptance of Health Care , Pneumonia, Viral/epidemiology , Psychiatry , Psychology , Telemedicine , Adult , Betacoronavirus , Child , Humans , Pandemics , Psychotherapy, Group , Telephone , Treatment Outcome , Videoconferencing
27.
Epidemiol Health ; 42: e2020047, 2020.
Article in English | MEDLINE | ID: covidwho-646722

ABSTRACT

OBJECTIVES: To estimate time-variant reproductive number (Rt) of coronavirus disease 19 based on either number of daily confirmed cases or their onset date to monitor effectiveness of quarantine policies. METHODS: Using number of daily confirmed cases from January 23, 2020 to March 22, 2020 and their symptom onset date from the official website of the Seoul Metropolitan Government and the district office, we calculated Rt using program R's package "EpiEstim". For asymptomatic cases, their symptom onset date was considered as -2, -1, 0, +1, and +2 days of confirmed date. RESULTS: Based on the information of 313 confirmed cases, the epidemic curve was shaped like 'propagated epidemic curve'. The daily Rt based on Rt_c peaked to 2.6 on February 20, 2020, then showed decreased trend and became <1.0 from March 3, 2020. Comparing both Rt from Rt_c and from the number of daily onset cases, we found that the pattern of changes was similar, although the variation of Rt was greater when using Rt_c. When we changed assumed onset date for asymptotic cases (-2 days to +2 days of the confirmed date), the results were comparable. CONCLUSIONS: Rt can be estimated based on Rt_c which is available from daily report of the Korea Centers for Disease Control and Prevention. Estimation of Rt would be useful to continuously monitor the effectiveness of the quarantine policy at the city and province levels.


Subject(s)
Basic Reproduction Number/statistics & numerical data , Coronavirus Infections/epidemiology , Epidemics , Pneumonia, Viral/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , Child , Coronavirus Infections/prevention & control , Female , Humans , Male , Middle Aged , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Public Policy , Quarantine , Seoul/epidemiology , Time Factors , Young Adult
28.
J Paediatr Child Health ; 56(6): 992, 2020 06.
Article in English | MEDLINE | ID: covidwho-645348
29.
Fa Yi Xue Za Zhi ; 36(2): 164-168, 2020 Apr.
Article in English, Chinese | MEDLINE | ID: covidwho-627698

ABSTRACT

Abstract: Objective To retrospectively analyze the forensic pathological postmortem examination and clinical data of children who died of viral pneumonia in identification of cause of death cases and to discuss the clinical characteristics and pathological features of viral pneumonia in children, in order to provide reference to pathological diagnosis of viral pneumonia in children caused by 2019 novel coronavirus (2019-nCoV) infection. Methods Postmortem examination data from 61 cases of children whose causes of death were identified as viral pneumonia in recent years were collected from the Center of Forensic Identification, Southern Medical University. The gender, age, clinical symptoms and pathological features were comparatively analyzed. Results Among the 61 cases of children who died of viral pneumonia, most were within 2 years old (83.61%), and a large proportion died within 2 weeks after the onset of the disease (91.80%). Gross changes in postmortem examination included respiratory mucosal hyperemia, pleural effusion, pulmonary swelling, variegated pulmonary pleura and serosa, as well as focal pulmonary hemorrhage and pulmonary edema. A large proportion of sick children had enlarged mesenteric lymph nodes (83.61%) and thymic dysplasia (21.31%). Histopathological changes included edema of alveoli and interstitial substance, pneumorrhagia,shedding of alveolar epithelial cells, serous and (or) fibrous exudation in the alveoli, formation of viral inclusions, formation of transparent membranes, infiltration of inflammatory cells that mainly consisted of macrophages and lymphocytes in interstitial substance and alveoli. Viral infections often affected the heart and gastrointestinal tract. Conclusion The clinical symptoms of children with viral pneumonia are difficult to notice, and because the immune systems of children are not fully developed and they have poor immunity, they can easily become severely ill and even die. Analyzing the forensic autopsies and the histopathological characteristics could provide reference for pathological diagnosis of viral pneumonia.


Subject(s)
Betacoronavirus , Coronavirus Infections , Pandemics , Pneumonia, Viral , Child , Child, Preschool , Humans , Lung , Retrospective Studies
30.
Prospects (Paris) ; : 1-11, 2020 Jul 01.
Article in English | MEDLINE | ID: covidwho-618748

ABSTRACT

The presence of COVID-19 means that the world will not return to a prior normal, but we cannot yet know into what future we will head. The world will have considerably changed from the one in which our subjectivities were first formed. Though curriculum may be the story we tell our children, the presence of this plague has made a severe break in that story. But curriculum might serve as the source of a radical hope that will lead us to a future we cannot yet imagine. In curriculum, we can attend to the world that has now passed, after which nothing happened, and from the scattered fragments of culture begin to construct new subjectivities and provide the space for the rebirth of culture that we cannot yet know or yet even imagine.

31.
International Journal of Environmental Research and Public Health ; 17(13), 2020.
Article | WHO COVID | ID: covidwho-662344

ABSTRACT

Introduction: The national rate of obesity in US Hispanic/Latinos exceeds all other major ethnic subgroups and represents an important health disparity Plant-based diet interventions that emphasize whole plant foods with minimal processing and less refined grains and sugar have shown have shown great promise in control of obesity, but there is a paucity of data translating this treatment effect to disparate populations The objective of our study was to evaluate the efficacy of the Healthy Eating Lifestyle Program (HELP) for accomplishing weight management in a hospital-based, family centered, culturally tailored, plant-based diet intervention for Hispanic/Latino children who were overweight or obese Methods: Our mixed methods evaluation included: (1) A one arm study to measure changes in body mass index (BMI) from pre- to post-intervention, and (2) A stakeholder analysis of the program staff Results: For children ages 5-12 years who were overweight/obese, we found no evidence of excess weight gain evidenced by BMI Z scores (Zpost-pre = -0 02, p = 0 11) Among the parent/guardians who were overweight or obese, we found a decrease in BMI that was stronger in men (BMI post-pre = -0 75 kg/m2, p = 0 01) than in women (BMI post-pre = -0 12 kg/m2, p = 0 30) A program strength was the cultural tailoring of the plant-based diet choices Conclusions: The evaluation raises the possibility that incorporating intervention components of HELP (plant-based food choices, family-based, cultural tailoring) into pediatric weight management can improve the standard of care

32.
International Journal of Environmental Research and Public Health ; 17(13), 2020.
Article | WHO COVID | ID: covidwho-662285

ABSTRACT

Food insecurity is a significant public health issue, since it causes malnutrition and engenders millions of deaths every year A significant association is found between water and food insecurity However, it remains unclear what are the pathways through which water shortage impacts food insecurity Hence, a qualitative study was conducted in rural areas in Cameroon to (1) examine water access, its management, and its daily use and (2) investigate common behavior changes and coping strategies adults used in managing limited water availability in their households Three rounds of focus group discussions and six key informant interviews were conducted with men and women The results demonstrated that water access was limited, involving long walking distances and making several trips to the water sources The household size, number of adults vs children, and presence of storage containers affected water availability and its daily use To manage limited water, coping behaviors included skipping drinking, changing cooking plans, and recycling water In conclusion, limited water access increases food insecurity through several pathways Governments, policy makers, and international organizations should recognize the interwoven link between water and food security Joint actions and collaborative efforts are needed to improve success and reduce tradeoffs in achieving Sustainable Development Goals # 2 and # 6

33.
Nutrition ; 78:110872-110872, 2020.
Article | WHO COVID | ID: covidwho-662243

ABSTRACT

OBJECTIVES: The aim of this study was to perform a nutritional assessment of the menus served in school canteens and to verify their effects on the nutrition of schoolchildren METHODS: We selected three collective catering companies that offered ~53 500 menus/d in 369 schools in Spain's Mediterranean area (Valencian Community) The study included four public schools with different management models as well as different supply patterns Considering the weight of the servings, the caloric contribution of the menus was estimated RESULTS: Great diversity was seen both in the same school throughout the week and between the four schools (School 1: 298-946 kcal;School 2: 465-1185 kcal;School 3: 395-656 kcal;and School 4: 374-966 kcal) The energy intake from carbohydrates complied with the recommendations in three of the four schools, the energy provided from proteins was adequate in all of the schools, and the energy from lipids was higher than the recommended values in Schools 1 and 2, lower in School 3, and compliant in School 4 The most abundant fatty acids in the menus were oleic, linoleic, and palmitic acids The sodium content in the rated menus was 229 ± 72 mg/100 g The highest salt content came from menus that included a precooked dish, processed meat, or both CONCLUSION: It is necessary to review school menus and adjust the size of the servings to the age of the children Correct nutritional education is essential for both kitchen staff and school canteen monitors

34.
BMJ Open ; 10(7):e036380-e036380, 2020.
Article | WHO COVID | ID: covidwho-662102

ABSTRACT

INTRODUCTION: Pectus excavatum repair is associated with substantial postoperative pain, despite the use of epidural analgesia and other analgesic regimens Perioperative recorded music interventions have been shown to alleviate pain and anxiety in adults, but evidence for children and adolescents is still lacking This study protocol describes a randomised controlled trial that evaluates the effects of recorded music interventions on postoperative pain relief in children and adolescents after pectus excavatum repair METHODS: A multicentre randomised controlled trial was set up comparing the effects of perioperative recorded music interventions in addition to standard care with those of standard care only in patients undergoing a Nuss procedure for pectus excavatum repair One hundred and seventy subjects (12-18 years of age) will be included in three centres in the Netherlands Patient inclusion has started in November 2018, and is ongoing The primary outcome is self-reported perceived pain measured on the visual analogue scale Secondary outcomes are anxiety level, analgesics consumption, vital parameters such as heart rate, blood pressure and respiratory rate, length of hospital stay, postoperative complications, quality of life and cost-effectiveness ETHICS AND DISSEMINATION: This study is being conducted in accordance with the Declaration of Helsinki The Medical Ethics Review Board of Erasmus University Medical Centre Rotterdam, The Netherlands, has approved this protocol Results will be disseminated via peer-reviewed scientific journals and conference presentations TRIAL REGISTRATION NUMBER: NL6863

35.
Health Rep ; 31(5):16-Sep, 2020.
Article | WHO COVID | ID: covidwho-662094

ABSTRACT

BACKGROUND: Canada recently adopted the 24-Hour Movement Guidelines for Children and Youth (24-Hour Guidelines) for young people aged 5 to 17 years-an international first, providing integrated recommendations for physical activity, sedentary time and sleep Since the release of the guidelines, very few studies have examined the associations of adherence to the 24-Hour Guidelines with health outcomes-and none focus on psychosocial health Therefore, the objective of this study was to assess the associations of meeting the 24-Hour Guidelines and their behaviour-specific recommendations with psychosocial health among Canadian children and youth DATA AND METHODS: This cross-sectional study included 4,250 children and youth aged 5 to 17 years with valid accelerometer data The study data were collected from 2009 to 2015 with the Canadian Health Measures Survey and pooled Moderate-to-vigorous physical activity was measured using accelerometers;screen time, sleep duration and measures of psychosocial health were self- or proxy-reported Multivariate logistic regression models were used to examine the associations of meeting individual or different combined recommendations from the 24-Hour Guidelines with psychosocial health RESULTS: There was low overall adherence to all three 24-Hour Guidelines recommendations, especially among youth (children: 13 9%, youth: 4 8%) Meeting two or more of the recommendations was associated with higher odds of positive psychosocial health among youth (odds ratio [OR] = 3 10;95% confidence interval [CI]: 1 17-8 19) Sleep duration and screen time were strongly associated with social behaviour and psychosocial health among Canadian youth DISCUSSION: Adherence to the 24-Hour Guidelines was significantly associated with better psychosocial health among Canadian youth

36.
International Journal of Environmental Research and Public Health ; 17(13), 2020.
Article | WHO COVID | ID: covidwho-662088

ABSTRACT

Few studies have evaluated the association between ambient air pollution and hospital readmissions among children with asthma, especially in low-income communities This study examined the short-term effects of ambient air pollutants on hospital readmissions for pediatric asthma in South Texas A time-stratified case-crossover study was conducted using the hospitalization data from a children's hospital and the air pollution data, including particulate matter 2 5 (PM2 5) and ozone concentrations, from the Centers for Disease Control and Prevention between 2010 and 2014 A conditional logistic regression analysis was performed to investigate the association between ambient air pollution and hospital readmissions, controlling for outdoor temperature We identified 111 pediatric asthma patients readmitted to the hospital between 2010 and 2014 The single-pollutant models showed that PM2 5 concentration had a significant positive effect on risk for hospital readmissions (OR = 1 082, 95% CI = 1 008-1 162, p = 0 030) In the two-pollutant models, the increased risk of pediatric readmissions for asthma was significantly associated with both elevated ozone (OR = 1 023, 95% CI = 1 001-1 045, p = 0 042) and PM2 5 concentrations (OR = 1 080, 95% CI = 1 005-1 161, p = 0 036) The effects of ambient air pollutants on hospital readmissions varied by age and season Our findings suggest that short-term (4 days) exposure to air pollutants might increase the risk of preventable hospital readmissions for pediatric asthma patients

37.
BMC Psychol ; 8(1):71-71, 2020.
Article | WHO COVID | ID: covidwho-662075

ABSTRACT

BACKGROUND: Mindfulness programmes as a potential avenue of enhancing pupil wellbeing are beginning to show great promise However, research concerning the effectiveness of mindfulness training for primary aged school children (7-11 years of age) has been neglected METHODS: Building on methodological limitations of prior research, this study employed an active controlled design to assess the longer term wellbeing and emotion regulation outcomes after a 6 week mindfulness programme (Living Mindfully Programme, UK), for a group of school children aged between 9 and 10 The programme was delivered by class teachers as part of their normal curriculum entitlement One hundred and eight children took part from across three schools in North East of England Participants formed a treatment group (n = 64), active control (n = 19) and wait list control (n = 25) Self-report measures of wellbeing, mindfulness and emotion regulation were collected at pre and post training as well as at 3 months follow up RESULTS: Reliable findings, judged by medium to large effect sizes across both post intervention, follow-up and between both controls, demonstrated enhancement in a number of domains Immediately after training and follow up, when compared with the wait list control, children who received mindfulness training showed significant improvements in mindfulness (d = 76 and 77), Positive Outlook (d = 55 and 64) and Life Satisfaction (d = 65 and 0 72) Even when compared to an active control, the effects remained although diminished reflecting the positive impact of the active control condition Furthermore, a significant positive relationship was found between changes in mindfulness and changes in cognitive reappraisal CONCLUSIONS: Taken together, this study provides preliminary evidence that the Living Mindfully Primary Programme is feasibly delivered by school staff, enjoyed by the children and may significantly improve particular components of wellbeing Importantly, higher levels of mindfulness as a result of training may be related to effective emotional regulatory and cognitive reappraisal strategies

38.
Lancet Neurology ; 19(8):639-640, 2020.
Article | WHO COVID | ID: covidwho-658937

ABSTRACT

The 2020 Brain Prize winners, Adrian Bird, a molecular biologist at the University of Edinburgh (Edinburgh, UK), and Huda Zoghbi, a physician scientist at Baylor College of Medicine (Houston, USA), identified mutations in MECP2 as causal for Rett Syndrome, and provided molecular insight into epigenetic regulation in brain development and the maintenance of healthy adult brain function Astonishingly, the activation of a quiescent MECP2 gene corrected all measured phenotypes 6 In parallel, Zoghbi showed that the disease can be triggered in adult mice when, after a period of healthy development, MECP2 deletion is induced 7 She was also able to dissect several potential neural mechanisms underlying Rett syndrome, by identifying transcriptional changes resulting from MECP2 mutations and by showing that MECP2 mutations in different cell types are responsible for distinct aspects of the disease The results from these trials are eagerly awaited, not least by the parents of affected children Because of Adrian Bird and Huga Zoghbi's research, we are closer to a treatment breakthrough for patients with Rett syndrome and MECP2 duplication syndrome, and have come to understand that neurodevelopmental disorders are not necessarily irreversible

40.
SAJCH South African Journal of Child Health ; 14(2):61, 2020.
Article | WHO COVID | ID: covidwho-656752
41.
Community Practitioner ; 93(4):27-29, 2020.
Article | WHO COVID | ID: covidwho-656742

ABSTRACT

Lupus is a long-term autoimmune condition where the body's immune system starts to attack healthy issues, causing inflammation to the joints, skin and organs such as the kidneys, lungs, heart and the brain Th e most common form of lupus is systemic lupus erythematosus (SLE) It's a relatively rare condition that affects around 98 people in every 100,000 (Rees et al, 2014) Around 90% of lupus cases are diagnosed in females and it's most common in women of child-bearing age--but it can also affect people of other ages, including children (Lupus UK, 2020) People from a black and minority ethnic (BAME) background including those of African, Caribbean or Asian origin have an increased risk of developing lupus

42.
BMJ ; 370, 2020.
Article | WHO COVID | ID: covidwho-656380

ABSTRACT

An analysis by Labour of NHS England’s latest figures show that almost 700 children under 16 were admitted to hospital because of obesity in 2018-19—the second highest number on record 1 The data show that less than half of children (47%) are currently meeting physical activity guidelines, and Labour warned that covid-19 lockdowns are likely to worsen childhood obesity levels, with a lack of exercise potentially leading to weight gain for many children [ ]Jonathan Ashworth, Labour’s shadow secretary for health and social care said: “Ministers promised to tackle our growing obesity crisis but have not implemented a single measure in over two years since the second chapter of the childhood obesity report was published Labour are calling for a radical obesity plan including restrictions on advertising of junk food, promoting healthy food choices in shops, mandatory and clearer calorie and nutrition labelling on all food and drinks, and a ban on the sale of energy drinks to children

43.
Community Practitioner ; 93(4):9, 2020.
Article | WHO COVID | ID: covidwho-655448

ABSTRACT

Analysis by the UK's largest children's charities have revealed the double impact of a 'toxic cocktail of cuts', and a 'soaring demand for help' due to COVID-19 The Children's Society, Barnardo's, Action for Children, the NSPCC and the National Children's Bureau said their report shows that local authority children's services have been reduced to 'crisis-driven firefighting' as a result of years of underinvestment This has left them ill-prepared to cope with all the extra challenges presented by COVID-19, the report warned The charities say the government must help local authorities by injecting funds to repair the children's social care system At present, they said, councils are having to spend a larger proportion of funding on children in crisis, rather than on early intervention Barnardo's chief executive Javed Khan conveys that they have long warned about the "perfect storm" facing children's social care, and the gap between demand and resource will widen further as a result of coronavirus

44.
Annals of Cardiac Anaesthesia ; 23(3):255, 2020.
Article | WHO COVID | ID: covidwho-655258

ABSTRACT

[1] What is the effect and role in the younger population and the children during this spread is not clearly known [ ]this disease has given two very important aspects to tackle it [ ]at present, the supportive management in the hospital wards and the intensive care units is the only availability The researchers around the world grappled with the data that emanated from clinical case series and the prospective trials, finding the most suitable medication and the efforts for building up an effective vaccine, and sometimes got caught on the wrong foot [ ]we have yet to succeed in getting the success in that regard

45.
BMJ ; 370, 2020.
Article | WHO COVID | ID: covidwho-650115

ABSTRACT

With the exceptions of children with acute infectious gastroenteritis, where they recommend against the use of probiotics, and preterm infants with low birth weight, where they recommend probiotics for the prevention of necrotising enterocolitis, the guidelines support the use of probiotics only in the context of a clinical trial Caesarean delivery and childhood allergy Increasing rates of caesarean delivery are sometimes blamed for the rising frequency of allergic diseases in children The reason is far from clear, but the investigators speculate about environmental pollutants such as polychlorinated biphenyls or mercury, which are known to accumulate in fish (Am J Epidemiol doi:10 1093/aje/kwaa097)

46.
Journal of clinical medicine ; 9(7), 2020.
Article | WHO COVID | ID: covidwho-649621

ABSTRACT

Understanding the clinical presentation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and prognosis in children is a major issue Children often present mild symptoms, and some severe forms require paediatric intensive care, with in some cases a fatal prognosis Our aim was to identify the epidemiological characteristics, clinical presentation, and prognosis of children with coronavirus disease 2019 (Covid-19) hospitalized in Paris suburb hospitals In this prospective, observational, multicentre study, we included children hospitalized in paediatric departments of Paris suburb hospitals from 23 March 2020 to 10 May 2020, during the national lockdown in France with confirmed SARS-CoV-2 infection (positive RNA test on a nasopharyngeal swab) or highly suspected infection (clinical, biological, and/or radiological data features suggestive for SARS-CoV-2 infection) A total of 192 children were included for confirmed (n = 157) or highly suspected (n = 35) SARS-CoV-2 infection The median age was one year old (interquartile range 0 125-11) with a sex ratio 1 3:1 Fever was recorded in 147 (76 6%) children and considered poorly tolerated in 29 (15 1%) The symptoms ranged from rhinorrhoea (34 4%) and gastrointestinal (35 5%) to respiratory distress (25%) Only 10 (5 2%) children had anosmia and five (2 6%) had chest pain An underlying condition was identified in almost 30% of the children in our study Overall, 24 (12 5%) children were admitted to paediatric intensive care units, 12 required mechanical ventilation, and three died For children in Paris suburbs, most cases of Covid-19 showed mild or moderate clinical expression However, one-eighth of children were admitted to paediatric intensive care units and three died

47.
Thorax ; 75(8):619-620, 2020.
Article | WHO COVID | ID: covidwho-646527

ABSTRACT

Several studies, including that by Vijayasingam and colleagues in this current issue of Thorax, provide compelling evidence that patients with CF have an increased risk for hearing impairment 1 The findings of Vijayasingam and colleagues concur with most other studies in CF that hearing impairment is closely associated with cumulative exposure to aminoglycosides and increasing age 1–4 A degree of hearing loss was common, being found in 57 (45%) of 126 individuals Hearing impairment is not the only side effect of aminoglycosides;the prevalence of significant vestibular toxicity and tinnitus symptoms were reported in 9 5% and 7 1% of subjects to Vijayasingam and colleagues—these symptoms can be disabling and distressing and are associated with aminoglycoside use in CF 4 Hearing loss is common in the general adult population with sensorineural age-related hearing loss (presbycusis) being the most frequent cause In the UK, 40% of people aged 50 years old and 71% of people aged 70 years and older have a degree of hearing loss 5 Although some paediatric studies suggest conductive loss is more commonly encountered than sensorineural problems in children with CF,6 most other studies suggest hearing impairment is sensorineural, and has an association with aminoglycoside use 1–4 With greater numbers of people with CF living longer lives, and many already having a degree of sensorineural hearing impairment, hearing loss is likely to be an increasingly encountered and significant problem in an ageing adult CF population The study by Vijayasingam and colleagues has a number of limitations: it is single centre with a relatively small number of adults to provide a more detailed evaluation of some of the initial findings, such as the particular traits of patients who developed more significant hearing loss in frequencies critical for speech recognition, the design is cross-sectional and it relies on retrospective data for evaluation of risk factors

48.
Journal of clinical medicine ; 9(7), 2020.
Article | WHO COVID | ID: covidwho-640481

ABSTRACT

BACKGROUND: Binge drinking and other forms of ethanol abuse are, when present, a serious problem in preteens and adolescents worldwide AIM: The present study has analyzed the trend in alcohol-related intoxications requiring the hospitalization of children, adolescents and young adults aged less than 21 years in Slovenia in the 1999-2018 period METHODS: We performed a retrospective study on patients discharged after hospitalizations due to mental and behavioral disorders due to acute alcohol intoxication (MBDAAI) or hospitalizations due to the toxic effects of alcohol (TEA We considered three groups: children (aged 10-14), adolescents (aged 15-19) and young adults (20-21 years old) Hospitalization rates and time trends were analyzed using joinpoint regression to obtain the annually calculated age- and sex-specific rates and the annual percentage of change (APC) RESULTS: Considering a total of 2912 MBDAAI-hospitalizations, 15-19-year-old subjects showed a significantly higher hospitalization rate compared to the immediately younger and older age groups and a significant increase in hospitalization rates in the period 1999-2011, followed by a significant decrease Considering 1143 TEA-hospitalizations, we observed a continuous decrease in the hospitalization rates for children and young adults and, conversely, a continuous even if less than significant increase for adolescents aged 15-19 CONCLUSIONS: Alcohol consumption in Slovenian children and adolescents is a highly important health concern Special attention to public health problem of severe alcohol abuse requiring hospitalization in children and adolescents is needed, especially with possible crisis of SARS-CoV-2/Covid-19 situation

49.
International Journal of Applied Exercise Physiology ; 9(6):243-249, 2020.
Article | WHO COVID | ID: covidwho-637141

ABSTRACT

This study has been designed to determine the positive/negative opinions of the academicians staying at home due to COVID-19 and their in-home activities The study consists of 20 academicians (f:5, m:15) working in universities in various provinces of Turkey In the research, the data collection process was provided with a semi-structured interview form The form consists of two parts The first part includes a personal information form consisting of six questions, while the second part includes open-ended questions to reveal the perceptions of academicians The content analysis method was used to evaluate the data The data collected from the content analysis were coded and classified These codes were collected under certain categories and themes were created (Figure 3) According to the result of the research, among the activities that contribute to the standards of academicians during COVID-19 are activities such as spending time with the family, conducting academic studies, resting, renewing, following the agenda and among the frequent activities are reading a book, spending time with children, watching television, and giving courses

50.
American Family Physician ; 101(11):721-729, 2020.
Article | WHO COVID | ID: covidwho-625993

ABSTRACT

Despite dramatic reductions in the rates of bacteremia and meningitis since the 1980s, febrile illness in children younger than 36 months continues to be a concern with potentially serious consequences Factors that suggest serious infection include age younger than one month, poor arousability, petechial rash, delayed capillary refill, increased respiratory effort, and overall physician assessment Urinary tract infections are the most common serious bacterial infection in children younger than three years, so evaluation for such infections should be performed in those with unexplained fever Abnormal white blood cell counts have poor sensitivity for invasive bacterial infections;procalcitonin and C-reactive protein levels, when available, are more informative Chest radiography is rarely recommended for children older than 28 days in the absence of localizing signs Lumbar puncture is not recommended for children older than three months without localizing signs;it may also be considered for those from one to three months of age with abnormal laboratory test results Protocols such as Step-by-Step, Laboratory Score, or the Rochester algorithms may be helpful in identifying low-risk patients Rapid influenza testing and tests for coronavirus disease 2019 (COVID-19) may be of value when those diseases are circulating When empiric treatment is appropriate, suggested antibiotics include ceftriaxone or cefotaxime for infants one to three months of age and ampicillin with gentamicin or with cefotaxime for neonates For children three months to three years of age, azithromycin or amoxicillin is recommended if pneumonia is suspected;for urinary infections, suggested antibiotics are cefixime, amoxicillin/clavulanate, or trimethoprim/sulfamethoxazole Choice of antibiotics should reflect local patterns of microbial resistance Copyright (C) 2020 American Academy of Family Physicians

51.
Uro-News ; 24(8-Jul):28-31, 2020.
Article | WHO COVID | ID: covidwho-619982

ABSTRACT

The presence of COVID-19 means that the world will not return to a prior normal , but we cannot yet know into what future we will head The world will have considerably changed from the one in which our subjectivities were first formed Though curriculum may be the story we tell our children, the presence of this plague has made a severe break in that story But curriculum might serve as the source of a radical hope that will lead us to a future we cannot yet imagine In curriculum, we can attend to the world that has now passed, after which nothing happened, and from the scattered fragments of culture begin to construct new subjectivities and provide the space for the rebirth of culture that we cannot yet know or yet even imagine Keywords Pandemic · Curriculum · Learning · Crisis Let me see where we are in these present moments I think this Sunday began week fourteen or fifteen of the shutdown: the sheltering-in-place and the imperative for social dis-tancing, the wearing of facemasks and latex gloves out in the streets and the marketplaces Though the restrictions are easing, the death toll is rising I do not know for how much longer this will go on The directive demands that we keep six feet between us: ironically, I consider, also the depth of a grave The global economy has ground to a halt, and though I suspect that it will rebound, its decline reminds me how fragile are our financial securities Today's news reports that upwards of thirty million people in the United States have applied for unemployment benefits so far, many of whom may never be called back to work The restaurants, the bookstores, the shoe stores, the hair salons and barber shops;the coffee houses, the health clubs, the religious institutions;schools and universities-all, all have been shuttered Many educational organizations have turned to online delivery systems , and I fear that what might be learned from these methodologies will only reveal how

52.
American Journal of Public Health ; 110(7):935-936, 2020.
Article | WHO COVID | ID: covidwho-618147

ABSTRACT

Many women will be forced to carry an unwanted or dangerous pregnancy to term, a violation of human rights law, which recognizes the right to decide on the number and spacing of children 3 The consequences of restricting access to abortion include the physical health risks inherent in pregnancy, which are more dangerous than abortion at any time in the gestation 4 The mortality rate ofwomen and girls undergoing childbirth is approximately 14 times higher than those undergoing abortion 5 The physical health consequences to women who are unable to have a desired abortion are substantial [ ]the counterfactual scenarios when abortion is restricted are clear: increased burdens to seek needed care;self-managed abortion (about which we know little at ‡20 weeks);unsafe abortion, which is associated with a high risk of morbidity and mortality;or continuing an unwanted or dangerous pregnancy to term 6 Abortion is an essential component of health care7 and will always be necessary [ ]of writing this editorial, we are awaiting the US Supreme Court decision on June Medical Sendees v Russo (previously v Gee) regarding the 2014 Louisiana law requiring abortion providers to obtain admitting privileges at nearby hospitals, which would effectively eliminate abortion access in the state

53.
YC Young Children ; 75(3):28-35, 2020.
Article | WHO COVID | ID: covidwho-617962

ABSTRACT

Hearing of children's experiences and fears can bring back unhappy memories that temporarily paralyze or haunt you [ ]if your program or home is in a neighborhood characterized by violence or poverty, you are likely to experience the same ongoing traumas as the children you teach According to the NCTSN (2011) and the Administration for Children & Families (n d ), the terms STS and compassion fatigue are interchangeable and refer to the same condition Other symptoms resemble those experienced by individuals with post-traumatic stress disorder (PTSD), such as fear, guilt, anxiety, apathy, sense of hopelessness, sleep disturbances, nightmares and intrusive thoughts, hypervigilance, short-temperedness, and a denial of problems Here are some ideas: * Physical needs: regularly eat nutritiously balanced meals;sleep adequately;exercise regularly;and monitor and attend to your health needs, making and keeping needed doctor and dental appointments and taking any medications as prescribed * Social needs: cultivate and maintain close friendships

54.
YC Young Children ; 75(3):68-69, 2020.
Article | WHO COVID | ID: covidwho-617877

ABSTRACT

After finishing her master's degree at the University of Houston's Children's Learning Centers, she returned to Puerto Rico to work as a physical education instructor at the Universidad Interamericana "At least once a week, I go to a refugee camp or school to train Head Start and elementary teachers on how they can fulfill curriculum competencies through the healing properties of art and also play," she explains For four years, Young Children has published Member Spotlight, a column that features NAEYC members' exemplary work with and for young children

55.
British Journal of Psychiatry ; 217(1):A27, 2020.
Article | WHO COVID | ID: covidwho-617724

ABSTRACT

While on the subject of mental health in childhood, Basu et al (pp 377–382) carried out the first prospective longitudinal population-based study of school-aged children and adolescents with a range of stress disorders to examine rates of incident psychiatric disorders [ ]where we began, the external validity of research should always be patient facing Through examination of the Longitudinal Study of Australian Children Kindergarten cohort, they conclude that a large proportion of children with persisting, and worsening, high levels of mental health problems do not receive care meeting minimal treatment guidelines

56.
YC Young Children ; 75(3):5-Apr, 2020.
Article | WHO COVID | ID: covidwho-617699

ABSTRACT

Sierra L Brown, Allison McCobin, Stephanie Easley, and Kara E McGoey, in "Supporting Anxious Children in the Preschool Classroom," offer strategies for recognizing and relieving anxiety through intentional activities drawn from the work of mental health professionals In "Preventing Compassion Fatigue: Caring for Yourself," excerpted from the upcoming NAEYC book Trauma and Young Children: Teaching Strategies to Support and Empower Children, authors Sarah Erdman, Laura J Colker, and Elizabeth C Winter focus on self-care strategies for teachers to help prevent compassion fatigue [ ]Ellen Galinsky, in "Words Matter: Moving from Trauma-Informed to Asset-Informed Care," stresses the need to remain hopeful about children, especially children who have experienced trauma

57.
Indian Journal of Ophthalmology ; 68(7):1391-1392, 2020.
Article | WHO COVID | ID: covidwho-617499

ABSTRACT

Playing doctor with children Working with kids and clinically examining children is difficult, while a proper ophthalmic examination is even more difficult Besides the obvious difficulty in getting a reliable history, one needs special skills and a kid-friendly personality to do a complete pediatric eye examination Pediatric ophthalmology outpatient departments are often specially designed with pictures, toys, entertainment, treats and play areas to put the children at ease so that parents and doctors can cajole the kids to allow a good eye examination Photo slit lamps and fundus cameras are used to send clinical images to the ophthalmologist, while vision, refraction and intraocular pressures are measured by the skilled personnel with specialized equipment

58.
Pediatric diabetes ; 2020.
Article | WHO COVID | ID: covidwho-617466

ABSTRACT

The incidence of diabetes, both type 1 and type 2, is increasing Health outcomes in pediatric diabetes are currently poor, with trends indicating that they are worsening Minority racial/ethnic groups are disproportionately affected by suboptimal glucose control and have a higher risk of acute and chronic complications of diabetes Correct clinical management starts with timely and accurate classification of diabetes, but in children this is becoming increasingly challenging due to high prevalence of obesity and shifting demographic composition The growing obesity epidemic complicates classification by obesity's effects on diabetes Since the prevalence and clinical characteristics of diabetes vary among racial/ethnic groups, migration between countries leads to changes in the distribution of diabetes types in a certain geographical area, challenging the clinician's ability to classify diabetes These challenges must be addressed to correctly classify diabetes and establish an appropriate treatment strategy early in the course of disease for all This may be the first step in improving diabetes outcomes across racial/ethnic groups This review will discuss the pitfalls in the current diabetes classification scheme that is leading to increasing overlap between diabetes types and heterogeneity within each type It will also present proposed alternative classification schemes and approaches to understanding diabetes type that may improve the timely and accurate classification of pediatric diabetes type This article is protected by copyright All rights reserved

59.
YC Young Children ; 75(3):62-67, 2020.
Article | WHO COVID | ID: covidwho-617445

ABSTRACT

To maintain public accountability, providers should periodically be audited and should be required to demonstrate they are serving CCDBG-eligible children in those slots 2 Cover the cost of quality Helping programs budget for consistency is an important step;helping them budget for quality is the next States that commit to using federal and state dollars to pay at or above current market rates and that sustain those increases each year will attract and incentivize a diverse range of high-quality providers, recruit and retain talented early childhood educators, give families real choice, and help young children get the best start in life, all resulting in economic benefits to the state and its workers 3 Pay early childhood educators what they are worth Throughout the COVID-19 crisis, health care workers have rightfully been lauded for their heroic efforts, but child care providers have routinely been overlooked While we have spent tens of millions of dollars on QRIS systems-including coaches, assessors, data systems, validation and evaluation systems, and cost of quality studies-early childhood educators are, on the whole, not earning more money, and child care programs continue to operate on razor-thin margins If we had made the same investments in the drivers of quality related to the workforce and to the program environment, including compensation, market rate payments, scholarships to support the attainment of post-secondary degrees, and early learning and higher education program accreditation, I contend our outcomes would be startlingly different now 5

60.
Postdigital Science and Education ; 2020.
Article | WHO COVID | ID: covidwho-680643

ABSTRACT

We are the children of a passionate truth and a truthful passion We passionately know that reality is not reduced to what exists and that most of what does not exist could and deserves to exist (Santos 2014: 8)

61.
Postdigital Science and Education ; 2020.
Article | WHO COVID | ID: covidwho-671889
62.
Acta Med Port ; 2020.
Article | WHO COVID | ID: covidwho-770038

ABSTRACT

INTRODUCTION: The North Lisbon University Hospital Center was activated for referral of SARS-CoV-2 infected patients on the 11th March 2020 The aim of this study is to describe the experience at the Department of Pediatrics in the approach and the clinical outcomes of infected children MATERIAL AND METHODS: A descriptive observational study was performed Children and adolescents (0 to 18 years) with SARS-CoV-2 infection, diagnosed in the emergency room or admitted to the Department of Pediatrics between March 11th and June 18th, were included Hospital records and Trace COVID-19 platform were reviewed and patient caregivers were interviewed to assess follow up RESULTS: Among 103 diagnosed children, 83% had a known previous contact with an infected patient, 43% presented fever and 42% presented respiratory symptoms Ten percent had risk factors and 21% were aged under one year old Ten percent were hospitalised, one needing intensive care, with paediatric inflammatory multisystem syndrome Blood tests were performed in 9% and chest radiograph in 7% No children required ventilation, antiviral therapy or underwent thoracic computed tomography scan Eight percent of children returned to the emergency room and one child was hospitalised The clinical outcome is known in 101 patients and is favourable in all DISCUSSION: Most children had an epidemiological link and little clinical repercussion, even during the first year of life The expected mild severity in children justified the use of established clinical criteria and recommendations for similar conditions, regarding tests and hospitalizations No antiviral treatments were given due to lack of evidence of its benefits CONCLUSION: This strategy contributed to a low consumption of hospital resources and proved safe in this series

63.
Acta Medica Mediterranea ; 36(4):2427-2432, 2020.
Article | WHO COVID | ID: covidwho-770033

ABSTRACT

Objective: To evaluate the behaviors and attitudes of healthcare workers toward COVID-19 Methods: A total of 280 healthcare workers (172 females and 108 males) answered an online questionnaire about the biosafety procedures for and their attitudes about COVID-19 The average age of participants was 33 57 ± 7 78 The data were analyzed using descriptive statistical methods and the chi-square test Results: The study sample consisted of 39 5% medical doctors, 32 1% dentists, 14 3% nurses, 4 6% technicians, 2 9% physiotherapists, 3 6% secretaries, and 3 2% auxiliary staff Of these healthcare workers, 151 (53 9%) had children A great majority of the participants (91 8%) stated that they were afraid of being infected with the COVID-19 virus There was no significant difference by gender, but the difference between having a child (95 4%) and not having a child (87 6%) was statistically significant (p=0 042) A little more than half (54 3%) of the participants answered yes to the question of whether they quarantined themselves, and this was found to be significantly higher in those who had children (42 4%) than those who did not (33 3%)(p=0 001) The precautions worn by healthcare workers while working were as follows: masks (89 3%), gloves (80 1%), N95/FFP2 masks (17 4%), face protective shields (39 1%), glasses (28 5%), and bonnets (33 1%) Sources of information for health workers about COVID-19 included the websites or social media accounts of professional organizations such as the Ministry of Health, the Association of Dentists, and the World Health Organization (82 2%);published scientific articles (47 3%);and social media accounts like Instagram and Twitter (48%) Conclusions: While healthcare workers responded well to the standard measures and attitudes they have to protect themselves against COVID-19 contamination, their practice on the extra measures they can take should be improved In addition to personal protective equipment, efforts should be made to protect the immunity and mental health of healthcare workers

64.
Pediatricheskaya Farmakologiya ; 17(2):119-122, 2020.
Article | WHO COVID | ID: covidwho-769990

ABSTRACT

The COVID-19 infection caused by the new coronavirus SARS-CoV-2 has become the real pandemic Children account for 1-6% of all diagnosed COVID-19 cases Generally, children have mild disease in comparison to adults, and their mortality rates are extremely low Despite the fact that all the main efforts of the medical and political community are now focused on preventing the pandemic spread and organizing medical care for patients with moderate and severe COVID-19 course, we still have to remember to implement adequate help for patients with chronic diseases, especially for children with allergic diseases The pandemic period coincided with natural weather period of dusting of causative plants, that led to annual escalation of both allergic rhinitis and asthma in patient group with specific sensitization to tree pollen Leading experts of allergology (adapting to modern conditions) have created key guidelines on management of children with allergic diseases during the COVID-19 pandemic These guidelines are based on the data and results from the Union of Pediatricians of Russia, Russian Association of Allergologists and Clinical Immunologists, European Academy of Allergy and Clinical Immunology (EAACI), European Respiratory Society (ERS), American Thoracic Society (ATS), Global Strategy for Asthma Management (GINA), Initiative on Allergic Rhinitis and its Impact on Asthma (ARIA/MACVIA)

65.
Biomedical and Pharmacology Journal ; 13(2):711-715, 2020.
Article | WHO COVID | ID: covidwho-769942

ABSTRACT

The aim was to describe the clinical data from patients with confirmed cases of COVID-19 and clinical data of patients with pneumonia by the same virus It was selected articles on clinical data from patients with COVID-19 and pneumonia by SARS-CoV-2 in pubmed, embase and google schoolar It was described the clinical data of patients with COVID-19 from 3 studies with 1,078 patients The main clinical data for COVID-19 were cough 60 4%, fever 40 9%, and production of sputum 26 0% For pneumonia by SARS-CoV-2, was described clinical data from 495 patients from 5 studies, were fever 77 4%, cough 68 9%, and myoarthralgia 49 9% In children with COVID-19 was reported cough 48 5%, pharyngeal erythema 46,2%, and fever 41 5% To use only clinical data to submit patients to RT-PCR test is not good, because many infected patients have not clinical data (asymptomatic carriers) or they did not reported the main clinical data as fever, cough or myoarthralgia

66.
Drugs in Context ; 9, 2020.
Article | WHO COVID | ID: covidwho-769807

ABSTRACT

Hydroxychloroquine (HCQ)-induced hyperpigmentation is uncommon but is increasingly recognized To our knowledge, HCQ-induced hyperpigmentation has not been reported in the pediatric age group Herein, we present the case of a 14-yearold girl with systemic lupus erythematosus, who developed hyperpigmentation on her shins and dorsum of the left foot, approximately 3 years after initiating treatment with HCQ Physicians who treat children with HCQ for reasons such as rheumatologic disorders, dermatologic disorders and, more recently, coronavirus disease-19 should be aware of this less-known side effect of HCQ

67.
Children (Basel) ; 7(9), 2020.
Article | WHO COVID | ID: covidwho-769308

ABSTRACT

The ongoing worldwide pandemic of the novel human coronavirus SARS-CoV-2 and the ensuing disease, COVID-19, has presented enormous and unprecedented challenges for all medical specialists However, to date, children, especially neonates, have been relatively spared from the devastating consequences of this infection Neurologic involvement is being increasingly recognized among adults with COVID-19, who can develop sensory deficits in smell and taste, delirium, encephalopathy, headaches, strokes, and peripheral nervous system disorders Among neonates and children, COVID-19-associated neurological manifestations have been relatively rare, yet reports involving neurologic dysfunction in this age range are increasing As discussed in this review, pediatric neurologists and other pediatric specialists should be alert to potential neurological involvement by this virus, which might have neuroinvasive capability and carry long-term neuropsychiatric and medical consequences

68.
Frontiers in Pharmacology ; 11, 2020.
Article | WHO COVID | ID: covidwho-769284

ABSTRACT

As the COVID-19 is still growing throughout the globe, a thorough investigation into the specific immunopathology of SARS-CoV-2, its interaction with the host immune system and pathogen evasion mechanism may provide a clear picture of how the pathogen can breach the host immune defenses in elderly patients and patients with comorbid conditions Such studies will also reveal the underlying mechanism of how children and young patients can withstand the disease better The study of the immune defense mechanisms and the prolonged immune memory from patients population with convalescent plasma may help in designing a suitable vaccine candidate not only for the current outbreak but also for similar outbreaks in the future The vital drug candidates, which are being tested as potential vaccines or therapeutics against COVID-19, include live attenuated vaccine, inactivated or killed vaccine, subunit vaccine, antibodies, interferon treatment, repurposing existing drugs, and nucleic acid-based vaccines Several organizations around the world have fast-tracked the development of a COVID-19 vaccine, and some drugs already went to phase III of clinical trials Hence, here, we have tried to take a quick glimpse of the development stages of vaccines or therapeutic approaches to treat this deadly disease

69.
Frontiers in Pediatrics ; 8, 2020.
Article | WHO COVID | ID: covidwho-769272

ABSTRACT

Introduction: The COVID-19 outbreak has become a worldwide public health emergency The renal histopathological features of acute tubular necrosis or thrombotic microangiopathy have been previously reported in adults with severe COVID-19 infections In children, the renal manifestations associated with COVID-19 disease are not widely reported Here we describe a case report of a child with new-onset nephrotic syndrome associated with COVID-19 infection Case Presentation: An 8-year-old boy with no previous significant medical history presented with bilateral eyelid and facial swelling soon after his parents were diagnosed with COVID-19 infection He had diarrhea but no fever or shortness of breath At 1 week after the onset of swelling, the boy tested positive for the COVID-19 virus Based on clinical findings of significant proteinuria (urine protein and creatinine ratio of 11 4), hypoalbuminemia (serum albumin of 2 g/dl), and hypercholesterolemia (total cholesterol of 384 mg/dl), he was diagnosed with nephrotic syndrome He responded well to standard-dose prednisone treatment for nephrotic syndrome At 1 week after starting the prednisone treatment, he went into clinical remission Lymphopenia continued to be present for 4 weeks after the onset of symptoms There were no complications related to clot formation or secondary infections with this presentation Conclusion: COVID-19 can be associated with new-onset nephrotic syndrome in children The patient responded well to the standard-dose prednisone treatment that is typically used for new-onset nephrotic syndrome Summary: We describe the unique presentation of COVID-19 in a child as new-onset nephrotic syndrome We offer insight on the success of standard treatment of nephrotic syndrome with COVID-19

70.
Bulletin of the World Health Organization ; 98(9):583-583A, 2020.
Article | WHO COVID | ID: covidwho-769115
71.
PLoS One ; 15(9):e0239234, 2020.
Article | WHO COVID | ID: covidwho-768841

ABSTRACT

Effective and culturally appropriate hand-hygiene education is essential to promote health-related practices to control and prevent diseases such as Diarrhoea, Ebola and COVID-19 In this paper we outline and evaluate the Co-Creation processes underpinning a handwashing intervention for young children (A Germ's Journey) developed and delivered in India, Sierra Leone and the UK, and consider the implications surrounding Imperialist/Colonial discourse and the White Saviour Complex The paper focuses both on the ways Co-Creation was conceptualised by our collaborators in all three countries and the catalysts and challenges encountered Qualitative data have been drawn from in-depth interviews with five key stakeholders, focus group data from 37 teachers in Sierra Leone and responses to open-ended questionnaires completed by teachers in India (N = 66) and UK (N = 63) Data were analysed using thematic analysis and three themes, each with three constituent subthemes are presented In the theme 'Representations of and Unique Approaches to Co-Creation' we explore the ways in which Co-Creation was constructed in relation to teamwork, innovative practice and more continuous models of evaluation In 'Advantages of Co-Creation' we consider issues around shared ownership, improved outcomes and more meaningful insights alongside the mitigation of risks and short-circuiting of problems In 'Challenges of Co-Creation' we discuss issues around timing and organisation, attracting and working with appropriate partners and understanding the importance of local context with inherent social, economic and structural barriers, especially in low-and-middle-income countries We consider how theoretical elements of Co-Creation can inform effective international public health interventions;crucial during a global pandemic in which handwashing is the most effective method to control the transmission of COVID-19 Finally we reflect on some of the methodological challenges of our own work and in managing the potentially conflicting goals of the ethical and participatory values of Co-Creation with pragmatic considerations about ensuring an effective final 'product'

72.
Italian Journal of Pediatrics ; 46(1):133-133, 2020.
Article | WHO COVID | ID: covidwho-768533

ABSTRACT

Pediatricians have observed a significant decrease in in-person child health visits during the COVID-19 pandemic In the post lockdown period, the coronavirus trend remains positive in Italy but fears of a second wave have recently grown in Italy due to active hotbeds of contagion The pandemic may negatively affect the care of pediatric patients and overall children welfare as it may present with severe signs and symptoms or it may complicate The Italian Pediatric Society recommend to separate well visits from sick ones, to educate families and to promote hygienic strategies to provide an adequate pediatric assistance in case of a second pandemic wave

73.
BMJ Paediatrics Open ; 4(1), 2020.
Article | WHO COVID | ID: covidwho-767946

ABSTRACT

We aimed to investigate the out-of-hospital mortality, and the actual prevalence of COVID-19 in children requiring paediatric emergency department (ED) care for infectious symptoms There were four emergency medical services (EMS) responses concerning children (age 0-15 years) leading to death on-scene in 2 months during the pandemic, and eight during the previous 12 months in the Helsinki University Hospital area, although the number of EMS missions decreased by 18% The prevalence of COVID-19 in children contacting a paediatric ED for any infectious symptoms during the epidemic peak was only 2 7%

74.
Pediatr Infect Dis J ; 39(10):e297-e302, 2020.
Article | WHO COVID | ID: covidwho-766882

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) primarily affects adults and spares children, whereas very little is known about neonates We tried to define the clinical characteristics, risk factors, laboratory, and imagining results of neonates with community-acquired COVID-19 METHODS: This prospective multicentered cohort study included 24 neonatal intensive care units around Turkey, wherein outpatient neonates with COVID-19 were registered in an online national database Full-term and premature neonates diagnosed with COVID-19 were included in the study, whether hospitalized or followed up as ambulatory patients Neonates without severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) via reverse transcriptase-polymerase chain reaction testing or whose mothers had been diagnosed with COVID-19 during pregnancy were excluded RESULTS: Thirty-seven symptomatic neonates were included The most frequent findings were fever, hypoxemia, and cough (49%, 41%, 27%, respectively) Oxygen administration (41%) and noninvasive ventilation (16%) were frequently required;however, mechanical ventilation (3%) was rarely needed Median hospitalization was 11 days (1-35 days) One patient with Down syndrome and congenital cardiovascular disorders died in the study period C-reactive protein (CRP) and prothrombin time (PT) levels were found to be higher in patients who needed supplemental oxygen (0 9 [0 1-8 6] vs 5 8 [0 3-69 2] p = 0 002, 11 9 [10 1-17 2] vs 15 2 [11 7-18 0] p = 0 01, respectively) or who were severe/critical (1 0 [0 01-8 6] vs 4 5 [0 1-69 2] p = 0 01, 11 7 [10 1-13 9] vs 15 0 [11 7-18 0] p = 0 001, respectively) CONCLUSIONS: Symptomatic neonates with COVID-19 had high rates of respiratory support requirements High CRP levels or a greater PT should alert the physician to more severe disease

75.
Pediatr Infect Dis J ; 39(10):e314-e315, 2020.
Article | WHO COVID | ID: covidwho-766880

ABSTRACT

Severe acute respiratory syndrome coronavirus 2, the virus responsible of the current COVID-19 pandemic, has limited impact in the pediatric population Children are often asymptomatic or present mild flu-like symptoms We report the case of a COVID-19-infected adolescent presenting severe rhabdomyolysis and acute kidney injury without any fever or respiratory symptoms

76.
Pediatr Infect Dis J ; 39(10):e317-e320, 2020.
Article | WHO COVID | ID: covidwho-766879

ABSTRACT

There are growing evidence of clinical manifestations other than acute respiratory syndrome in severe acute respiratory syndrome associated with coronavirus 2-infected children In our multicenter retrospective analysis, we observed among 127 severe acute respiratory syndrome associated with coronavirus 2 positive children that the presence of gastrointestinal symptoms was more frequently associated with severe and critical phenotype (P = 0 029) Moreover, having gastrointestinal symptoms was more frequently reported in patients who developed cardiac impairment

77.
Pediatr Infect Dis J ; 39(10):e315-e317, 2020.
Article | WHO COVID | ID: covidwho-766878

ABSTRACT

In the current study, we report on 4 children with confirmed SARS-CoV-2 infection, of which 3 of them were asymptomatic These patients had both pharyngeal swabs and anal swabs testing during hospital or after discharge All the 4 children showed long-time positive viral RNA in the stool specimens after pharyngeal swabs turned negative during the follow-up stage, especially in the asymptomatic children The positive RNA in stool specimens of asymptomatic children last for more than 54 days after admission or 30 days after discharge

78.
Pediatr Infect Dis J ; 39(10):e321-e324, 2020.
Article | WHO COVID | ID: covidwho-766876

ABSTRACT

Although first considered a benign infection, recent studies have disclosed severe and potentially lethal inflammatory manifestations of COVID-19 in children We report the case of a 4-year-old child with a post-infectious multisystem inflammatory syndrome associated with COVID-19, with a Kawasaki-like shock and prominent neurologic features, for whom a cytokine storm and reduced brain-derived neurotrophic factor were well documented

79.
Journal of Pediatric Orthopaedics ; 2020.
Article | WHO COVID | ID: covidwho-766811

ABSTRACT

Background: The COVID-19 pandemic has substantially altered the typical process around performing surgery to ensure protection of health care workers, patients, and their families One safety precaution has been the implementation of universal preoperative screening for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) This study examines the results of universal screening on children undergoing orthopaedic surgery Methods: This is a retrospective cohort study evaluating the incidence and symptomatology of COVID-19 in all patients presenting for orthopaedic surgery at 3 pediatric tertiary care children's hospitals during the COVID-19 pandemic (March to June 2020) All patients underwent universal screening with a nasopharyngeal swab to detect presence of SARS-CoV-2 Bivariate and multivariate logistic regression analysis was performed to identify risk factors for positive COVID-19 screening Results: In total, 1198 patients underwent preoperative screening across all 3 institutions and 7 (0 58%) had detection of SARS-CoV-2 The majority of patients (1/7, 86%) were asymptomatic Patients that tested positive were significantly more likely to be Hispanic (P=0 046) and had greater number of medical comorbidities (P=0 013), as scored on the American Society of Anesthesiologists (ASA) physical status score A known COVID-19 positive contact was found to be a significant risk factor in the multivariate analysis (P=0 004) Conclusions: Early results of universal preoperative screening for COVID-19 demonstrates a low incidence and high rate of asymptomatic patients Health care professionals, especially those at higher risk for the virus, should be aware of the challenges related to screening based solely on symptoms or travel history and consider universal screening for patients undergoing elective surgery Level of Evidence: Level II

80.
Journal of Child Science ; 10(1):E53-E62, 2020.
Article | WHO COVID | ID: covidwho-766217

ABSTRACT

Coronavirus disease 2019 (COVID-19) pandemic has affected millions of people worldwide However, the mechanism by which the pathogen affects children is not understood completely Children so far accounted for only1 to 6 4% of diagnosed cases and the mortality rate is also less Though clinical findings are similar to adults, with fever and respiratory symptoms being prevalent, fewer numbers of children appear to develop severe pneumonia Observed attenuated response to the virus may possibly be due to decrease in the expression of the angiotensin-converting enzyme 2 receptor in lungs, repeated viral exposure, and not having any underlying chronic diseases or immunosuppression Suggested treatment included oxygen supplementation, mechanical ventilation in severe cases, nutritional support, and maintaining fluids and electrolyte balances Although, no definitive pharmacological therapy is available, various combination of drugs like hydroxychloroquine, lopinavir/ritonavir, remdesivir, tocilizumab, and convalescent serum show promising result to an extent As there is no specific therapeutic measure for this ailment, aggressive efforts are being made to develop a potential vaccine against the disease Although few reports on epidemiology of COVID-19 in children have been published, comprehensive reports are lacking The present article reviews on important issues such as epidemiological characteristics, postulations of milder disease, therapeutic aspect, and recent development of vaccination against COVID-19 in children

81.
Injury ; 2020.
Article | WHO COVID | ID: covidwho-764865

ABSTRACT

Introduction : In Iran, like most other countries, COVID-19 has had a deep impact on children's lives Our hypothesis was that, a significant change in the number of pediatric injuries has happened in trauma centers In the current study, we intend to identify the possible epidemiological shift in pediatric fracture patterns, by comparing the data from ‘COVID-19 era’ and the mean data from the past 2 years To the best of our knowledge there are only few reports on epidemiology of pediatric fractures during the COVID-19 outbreak Methods : Data are reported in two sections In the descriptive section, epidemiological data regarding pediatric fractures referred to Taleghani tertiary trauma center, including demographics, distribution curves, etiologies and fracture types are presented during the ‘COVID era’, from 1 March 2020 to 15 April 2020 In the comparative section, the aforementioned data are compared with mean data from the past 2 years, the ‘non-COVID era’ Results : Altogether 117 of the 288 trauma children (40 62%) had a fractured bone (145 fractures) Patients were mostly boys, with a mean age of 9 87 years (SD=5 27) The three most common fracture types in children included distal radius, mid-forearm and humeral supracondylar fractures Compared to non-COVID era, the number of pediatric trauma admissions dropped from 589 to 288 No significant change happened in the mean age, male/female ratio and percentage of motor vehicle accidents Proportion of proximal humeral, proximal forearm, carpal, and hand fractures declined The number of open fractures significantly dropped (from 12 to 2) Conclusions : In Iran, overall trend of pediatric trauma has been decreasing during the outbreak;but the lack of reduction in proportion of accidents may pose an alarm that an effective lock-down has not been imposed This study has implications as to preparing appropriate resources particular to common “COVID era fractures”

82.
Child Abuse & Neglect ; 2020.
Article | WHO COVID | ID: covidwho-764372

ABSTRACT

Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2;COVID-19) has created an urgent need to identify child abuse and neglect (CAN) and efficiently allocate resources to improve the coordination of responses during a public health crisis Objective To provide unique insights into the spatial and temporal distribution of CAN in relation to COVID-19 outcomes and identify areas where CAN has increased or decreased during the pandemic Participants Children under 18 years old reported to the Los Angeles Police Department for CAN Setting CAN incidents in the city of Los Angeles Methods Negative binomial regression was used to explore associations between the implementation of social distancing protocols and reported CAN during COVID-19 Spatiotemporal analysis identified locations of emerging hot and cold spots during the pandemic Associations between neighborhood structural factors (e g , school absenteeism, poverty, unemployment, housing insecurity and birth assets) and hot and cold spot patterns were explored Results There was a statistically significant decline in reports of CAN during the COVID-19 pandemic but no significant trends following the implementation of social distancing measures (e g safer at home orders, school closures) Compared to consecutive cold spots, severe housing burden, the number of assets children have at birth, poverty, school absenteeism and labor force participation were significantly associated with new and intensifying hotspots of CAN during the COVID-19 pandemic Conclusions Our findings reinforce the utility of developing intervention strategies that minimize harm to children by targeting resources to specific challenges facing families enduring the COVID-19 experience

84.
Medicina ; 56(9):474, 2020.
Article | WHO COVID | ID: covidwho-762901

ABSTRACT

Background and objectives: Characterization of pediatric coronavirus disease 2019 (COVID-19) is necessary to control the pandemic, as asymptomatic or mildly infected children may act as carriers To date, there are limited reports describing differences in clinical, laboratory, and radiological characteristics between asymptomatic and symptomatic infection, and between younger and older pediatric patients The objective of this study is to compare characteristics among: (1) asymptomatic versus symptomatic and (2) less than 10 versus greater or equal to 10 years old pediatric COVID-19 patients Materials and Methods: We searched for all terms related to pediatric COVID-19 in electronic databases (Embase, Medline, PubMed, and Web of Science) for articles from January 2020 This protocol followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines Results: Eligible study designs included case reports and series, while we excluded comments/letters, reviews, and literature not written in English Initially, 817 articles were identified Forty-three articles encompassing 158 confirmed pediatric COVID-19 cases were included in the final analyses Lymphocytosis and high CRP were associated with symptomatic infection Abnormal chest CT more accurately detected asymptomatic COVID-19 in older patients than in younger ones, but clinical characteristics were similar between older and younger patients Conclusions: Chest CT scan findings are untrustworthy in younger children with COVID-19 as compared with clinical findings, or significant differences in findings between asymptomatic to symptomatic children Further studies evaluating pediatric COVID-19 could contribute to potential therapeutic interventions and preventive strategies to limit spreading

86.
Journal of Clinical Medicine ; 9(9):2950, 2020.
Article | WHO COVID | ID: covidwho-762738

ABSTRACT

Background: Ten months after its appearance in December 2019, SARS-CoV-2 has infected more than 25 million patients worldwide Because children were first identified as potential spreaders of the virus, schools were closed in several countries However, it rapidly became evident that the number of hospitalized children infected by SARS-CoV-2 was dramatically lower than that of adults To date, only hypotheses have been raised to explain this difference, so it is of great importance to describe the presentation of this disease among children Here, we describe a wide spectrum of COVID-19 manifestation in children in a dedicated pediatric unit in France Methods: Patients hospitalized with COVID-19 who were diagnosed on the basis of either positive SARS-CoV-2 RT-PCR in nasopharyngeal swabs and/or typical aspects in chest-computed tomography (CT) were included between March and May 2020 in Paris Results: Twenty-three patients were included on the basis of positive RT-PCR (n = 20) and/or typical aspects in CT (n = 4) The median age was 4 9 years [0 1–17 6] Patients were grouped by age (<2 years old: n = 14, 61%;2–10 years old: n = 2, 9%;>10 years old: n = 7, 30%) Overweight or obesity was reported in only three patients At presentation, the most frequent symptom in the overall cohort was fever (n = 18, 78%), followed by acute rhinitis (n = 9, 64%) and cough (n = 7, 50%) in the under 2-year-old group and cough (n = 4, 57%), fatigue, dyspnea and abdominal pain (n = 3, 43% each) in the over 10-year-old group Five patients required ICU treatment, four of whom were aged >10 years, two presented with acute myocarditis, and two were sickle cell disease patients who presented with acute chest syndrome Discussion and conclusion: The youngest patients seem to present milder forms of COVID-19 without the need for ICU treatment and with a shorter length of hospitalization More severe evolutions were observed in teenagers, with, however, favorable outcomes Given the context of closed schools and confinement, the infection of these children suggests intra-familial transmission that needs to be further assessed This description might help to understand the intriguing differences in COVID-19 severity across age-classes

87.
Children ; 7(9):138, 2020.
Article | WHO COVID | ID: covidwho-762470

ABSTRACT

In the wake of the COVID-19 pandemic, social restrictions to contain the spread of the virus have disrupted behaviors across the 24-h day including physical activity, sedentary behavior, and sleep among children (5–12 years old) and adolescents (13–17 years old) Preliminary evidence reports significant decreases in physical activity, increases in sedentary behavior, and disrupted sleep schedules/sleep quality in children and adolescents This commentary discusses the impact of COVID-19-related restrictions on behaviors across the 24-h day in children and adolescents Furthermore, we suggest recommendations through the lens of a socio-ecological model to provide strategies for lasting behavior change to insure the health and well-being of children and adolescents during the COVID-19 pandemic

89.
F1000Res ; 9: 352, 2020.
Article in English | MEDLINE | ID: covidwho-769911

ABSTRACT

Background: School closures have been a recommended non-pharmaceutical intervention in pandemic response owing to the potential to reduce transmission of infection between children, school staff and those that they contact. However, given the many roles that schools play in society, closure for any extended period is likely to have additional impacts. Literature reviews of research exploring school closure to date have focused upon epidemiological effects; there is an unmet need for research that considers the multiplicity of potential impacts of school closures. Methods: We used systematic searching, coding and synthesis techniques to develop a systems-based logic model. We included literature related to school closure planned in response to epidemics large and small, spanning the 1918-19 'flu pandemic through to the emerging literature on the 2019 novel coronavirus. We used over 170 research studies and a number of policy documents to inform our model. Results: The model organises the concepts used by authors into seven higher level domains: children's health and wellbeing, children's education, impacts on teachers and other school staff, the school organisation, considerations for parents and families, public health considerations, and broader economic impacts. The model also collates ideas about potential moderating factors and ethical considerations. While dependent upon the nature of epidemics experienced to date, we aim for the model to provide a starting point for theorising about school closures in general, and as part of a wider system that is influenced by contextual and population factors. Conclusions: The model highlights that the impacts of school closures are much broader than those related solely to health, and demonstrates that there is a need for further concerted work in this area. The publication of this logic model should help to frame future research in this area and aid decision-makers when considering future school closure policy and possible mitigation strategies.


Subject(s)
Communicable Disease Control/methods , Coronavirus Infections/prevention & control , Influenza, Human/prevention & control , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Schools , Betacoronavirus , Disease Outbreaks/prevention & control , Humans , Models, Theoretical
90.
Pediatr Ann ; 49(9): e403-e404, 2020 Sep 01.
Article in English | MEDLINE | ID: covidwho-769510

ABSTRACT

Two pediatricians share perspectives on patient experience and delivery, future health care encounters, and social implications during the coronavirus 2019 pandemic. Collateral effects may comprise the most significant impacts on children, from limitations on hospital visitors, to closures of child-friendly hospital playrooms during this pandemic, to an alarming decrease in vaccination rates. Educational disparities will also likely widen, especially among those with limited access to technology at home. [Pediatr Ann. 2020;49(9):e403-e404.].

91.
CMAJ ; 192(28): E814, 2020 Jul 13.
Article in English | MEDLINE | ID: covidwho-768850
92.
BMJ Case Rep ; 13(9)2020 Sep 14.
Article in English | MEDLINE | ID: covidwho-767806

ABSTRACT

The effect of COVID-19 by SARS-CoV-2 on the paediatric population remains an evolving mystery. Early reports from China stated that children seem to be unharmed by its dangerous effects, yet more recently there has been evidence of a systemic inflammatory response in a small number of children who are affected. We discuss a 5-week-old male infant who presented atypically with severe COVID-19 infection. To our knowledge, he is the youngest reported case in the UK to require mechanical ventilation and intensive care treatment as a direct result of COVID-19 following horizontal transmission. This case has generated several learning points with regard to atypical presentations of COVID-19 and identifying a potential cohort of 'at risk' infants. We also highlight a number of new challenges that have arisen for paediatricians and anaesthetists providing airway management for infants with SARS-CoV-2.

93.
J Am Geriatr Soc ; 68(8): 1657-1660, 2020 08.
Article in English | MEDLINE | ID: covidwho-767516

ABSTRACT

OBJECTIVES: Long-term care (LTC) facilities are particularly dangerous places for the spread of COVID-19 given that they house vulnerable high-risk populations. Transmission-based precautions to protect residents, employees, and families alike must account for potential risks posed by LTC workers' second jobs and unpaid care work. This observational study describes the prevalence of their (1) second jobs, and (2) unpaid care work for dependent children and/or adult relatives (double- and triple-duty caregiving) overall and by occupational group (registered nurses [RNs], licensed practical nurses [LPNs], or certified nursing assistants [CNAs]). DESIGN: A descriptive secondary analysis of data collected as part of the final wave of the Work, Family and Health Study. SETTING: Thirty nursing home facilities located throughout the northeastern United States. PARTICIPANTS: A subset of 958 essential facility-based LTC workers involved in direct patient care. MEASUREMENTS: We present information on LTC workers' demographic characteristics, health, features of their LTC occupation, additional paid work, wages, and double- or triple-duty caregiving roles. RESULTS: Most LTC workers were CNAs, followed by LPNs and RNs. Overall, more than 70% of these workers agreed or strongly agreed with this statement: "When you are sick, you still feel obligated to come into work." One-sixth had a second job, where they worked an average of 20 hours per week, and more than 60% held double- or triple-duty caregiving roles. Additional paid work and unpaid care work characteristics did not significantly differ by occupational group, although the prevalence of second jobs was highest and accompanying work hours were longest among CNAs. CONCLUSION: LTC workers commonly hold second jobs along with double- and triple-duty caregiving roles. To slow the spread of COVID-19, both the paid and unpaid activities of these employees warrant consideration in the identification of appropriate clinical, policy, and informal supports. J Am Geriatr Soc 68:1657-1660, 2020.


Subject(s)
Caregivers/statistics & numerical data , Coronavirus Infections/prevention & control , Employment/statistics & numerical data , Long-Term Care/statistics & numerical data , Occupations/statistics & numerical data , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Betacoronavirus , Female , Health Services Needs and Demand , Humans , Licensed Practical Nurses/statistics & numerical data , Male , New England , Nurses/statistics & numerical data , Nursing Assistants/statistics & numerical data , Nursing Homes , Work-Life Balance
94.
Dermatol Ther ; : e13785, 2020 Jun 08.
Article in English | MEDLINE | ID: covidwho-767358

ABSTRACT

The devastating effects of the coronavirus designated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have led to urgent attempts to find effective therapeutic agents for inpatient and outpatient treatment of COVID-19. Initial enthusiasm for the combination of hydroxychloroquine and azithromycin has abated. However, as a result of positive clinical experience with azithromycin used alone during the first few days of the flu-like illness caused by this coronavirus, we recommend formal clinical trials using azithromycin early in the course of a COVID-19 infection. There is one clinical trial initiated, the individually randomized, telemedicine-based, "Azithromycin for COVID-19 Treatment in Outpatients Nationwide" based at the University of California San Francisco. This placebo-controlled trial is designed to determine the efficacy of a single 1.2-g dose of oral azithromycin to prevent COVID-19 patient progression to hospitalization. We recommend formal clinical trials of azithromycin in its prepackaged form at the first sign of COVID-19 infection in adults and children, using an initial adult dose of 500 mg followed by 250 mg per day for 4 days, a total cumulative dose of 1.5 g, and for children 5 to 18 years of age, 10 mg/kg on the first day followed by 5 mg/kg for 4 days.

96.
J Pediatr Psychol ; 45(8): 839-841, 2020 09 01.
Article in English | MEDLINE | ID: covidwho-766664

ABSTRACT

The COVID-19 (2019 novel coronavirus) pandemic has had a significant economic, social, emotional, and public health impact in the United States. A disturbing trend is that Black, Indigenous, and/or People of Color (BIPOC) are disproportionately contracting coronavirus, as well as dying from COVID-19. Objective/Methods The pandemic has the potential to entrench and magnify existing health disparities and families marginalized across multiple demographic intersections such as race/ethnicity, class, immigration status, are especially vulnerable. These inequities have been further underscored by the recent murders of Black Americans by police and a resulting spotlight on racial injustice in the United States. Results Efforts to lessen the spread of the virus, have resulted in changes in pediatric primary and subspecialty service delivery which may affect access for BIPOC communities. BIPOC trainees including those with debt or caregiving responsibilities may be faced with new barriers resulting in delays in completion of their training. Further, clinical, community-based, and translational research has been disrupted by heightened safety precautions and social distancing which may affect BIPOC representation in research downstream. Conclusion In our roles as clinicians, supervisors, trainees, and researchers in primary and subspecialty care as well as in academia, pediatric psychologists have an ethical responsibility to address the disproportionate burden of this pandemic on vulnerable communities and to allocate our time and resources to ensuring health equity now and in the aftermath of COVID-19.


Subject(s)
Coronavirus Infections , Health Status Disparities , Pandemics , Pneumonia, Viral , Psychology, Child , Racism , Child , Humans , United States
97.
Nat Rev Immunol ; 20(9): 519, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-766101
98.
J Pediatr ; 2020 Aug 07.
Article in English | MEDLINE | ID: covidwho-765223

ABSTRACT

OBJECTIVES: To determine factors associated with parents who plan to vaccinate their children against influenza next year, especially those who did not vaccinate against influenza last year using a global survey. STUDY DESIGN: A survey of caregivers accompanying their children aged 1-19 years old in 17 pediatric emergency departments in 6 countries at the peak of the coronavirus disease 2019 (COVID-19) pandemic. Anonymous online survey included caregiver and child demographic information, vaccination history and future intentions, and concern about the child and caregiver having COVID-19 at the time of emergency department visit. RESULTS: Of 2422 surveys, 1314 (54.2%) caregivers stated they plan to vaccinate their child against influenza next year, an increase of 15.8% from the previous year. Of 1459 caregivers who did not vaccinate their children last year, 418 (28.6%) plan to do so next year. Factors predicting willingness to change and vaccinate included child's up-to-date vaccination status (aOR 2.03, 95% CI 1.29-3.32, P = .003); caregivers' influenza vaccine history (aOR 3.26, 95% CI 2.41-4.40, P < .010), and level of concern their child had COVID-19 (aOR 1.09, 95% CI 1.01-1.17, P = .022). CONCLUSIONS: Changes in risk perception due to COVID-19, and previous vaccination, may serve to influence decision-making among caregivers regarding influenza vaccination in the coming season. To promote influenza vaccination among children, public health programs can leverage this information.

99.
J Pediatr ; 2020 Jul 27.
Article in English | MEDLINE | ID: covidwho-765220

ABSTRACT

We present 7 children with congenital heart disease and coronavirus disease 2019. Of these, 5 were younger than 1 year of age and 3 had atrioventricular canal defect and trisomy 21. All 7 developed acute decompensation, with 1 death in an 18-year-old with hypertrophic cardiomyopathy and other comorbidities.

100.
J Pediatr ; 2020 Jul 16.
Article in English | MEDLINE | ID: covidwho-765218

ABSTRACT

OBJECTIVES: To describe the clinical manifestations and outcomes of critically ill children with coronavirus disease-19 (COVID-19) in New York City. STUDY DESIGN: Retrospective observational study of children 1 month to 21 years admitted March 14 to May 2, 2020, to 9 New York City pediatric intensive care units (PICUs) with severe acute respiratory syndrome coronavirus 2 infection. RESULTS: Of 70 children admitted to PICUs, median age was 15 (IQR 9, 19) years; 61.4% male; 38.6% Hispanic; 32.9% black; and 74.3% with comorbidities. Fever (72.9%) and cough (71.4%) were the common presenting symptoms. Twelve patients (17%) met severe sepsis criteria; 14 (20%) required vasopressor support; 21 (30%) developed acute respiratory distress syndrome (ARDS); 9 (12.9%) met acute kidney injury criteria; 1 (1.4%) required renal-replacement therapy, and 2 (2.8%) had cardiac arrest. For treatment, 27 (38.6%) patients received hydroxychloroquine; 13 (18.6%) remdesivir; 23 (32.9%) corticosteroids; 3 (4.3%) tocilizumab; and 1 (1.4%) anakinra; no patient was given immunoglobulin or convalescent plasma. Forty-nine (70%) patients required respiratory support: 14 (20.0%) noninvasive mechanical ventilation, 20 (28.6%) invasive mechanical ventilation (IMV), 7 (10%) prone position, 2 (2.8%) inhaled nitric oxide, and 1 (1.4%) extracorporeal membrane oxygenation. Nine (45%) of the 20 patients requiring IMV were extubated by day 14 with median IMV duration of 218 (IQR 79, 310.4) hours. Presence of ARDS was significantly associated with duration of PICU and hospital stay, and lower probability of PICU and hospital discharge at hospital day 14 (P < .05 for all). CONCLUSIONS: Critically ill children with COVID-19 predominantly are adolescents, have comorbidities, and require some form of respiratory support. The presence of ARDS is significantly associated with prolonged PICU and hospital stay.

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