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Fever without source as the first manifestation of SARS-CoV-2 infection in infants less than 90 days old.
Blázquez-Gamero, Daniel; Epalza, Cristina; Cadenas, José Antonio Alonso; Gero, Lourdes Calleja; Calvo, Cristina; Rodríguez-Molino, Paula; Méndez, María; Santos, Maria Del Mar; Fumadó, Victoria; Guzmán, María Fernanda; Soriano-Arandes, Antoni; Jiménez, Ana B; Penin, Maria; Cobo-Vazquez, Elvira; Pareja, Marta; Lobato, Zulema; Serna, Miquel; Delgado, Rafael; Moraleda, Cinta; Tagarro, Alfredo.
  • Blázquez-Gamero D; Pediatric Infectious Diseases Unit, Pediatric Research and Clinical Trials Unit (UPIC), Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Hospital Universitario 12 de Octubre, Universidad Complutense, Madrid, Spain. danielblazquezgamero@gmail.com.
  • Epalza C; Red de Investigación Translacional en Infectología Pediátrica (RITIP), Madrid, Spain. danielblazquezgamero@gmail.com.
  • Cadenas JAA; Pediatric Infectious Diseases Unit, Pediatric Research and Clinical Trials Unit (UPIC), Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Hospital Universitario 12 de Octubre, Universidad Complutense, Madrid, Spain.
  • Gero LC; Red de Investigación Translacional en Infectología Pediátrica (RITIP), Madrid, Spain.
  • Calvo C; Pediatrics Department, Hospital Universitario Niño Jesús, Madrid, Spain.
  • Rodríguez-Molino P; Pediatrics Department, Hospital Universitario Niño Jesús, Madrid, Spain.
  • Méndez M; Red de Investigación Translacional en Infectología Pediátrica (RITIP), Madrid, Spain.
  • Santos MDM; Pediatric and Infectious Diseases Department, Hospital Universitario La Paz, Fundación IdiPaz, Madrid, Spain.
  • Fumadó V; Pediatric and Infectious Diseases Department, Hospital Universitario La Paz, Fundación IdiPaz, Madrid, Spain.
  • Guzmán MF; Pediatric Infectious Diseases Unit, Department of Pediatrics, Hospital Universitari Germans Trias i Pujol de Badalona, Badalona, Spain.
  • Soriano-Arandes A; Red de Investigación Translacional en Infectología Pediátrica (RITIP), Madrid, Spain.
  • Jiménez AB; Hospital General Universitario Gregorio Marañón, Madrid, Spain.
  • Penin M; Pediatric Infectious Diseases Unit, Department of Pediatrics, Hospital Sant Joan de Déu, Barcelona, Spain.
  • Cobo-Vazquez E; Grupo HM Hospitales, Madrid, Spain.
  • Pareja M; Red de Investigación Translacional en Infectología Pediátrica (RITIP), Madrid, Spain.
  • Lobato Z; Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Barcelona Hospital Campus, Barcelona, Spain.
  • Serna M; Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.
  • Delgado R; Hospital Príncipe de Asturias, Alcalá de Henares, Spain.
  • Moraleda C; Hospital Universitario Fundación de Alcorcón, Alcorcón, Spain.
  • Tagarro A; Complejo Hospitalario Universitario de Albacete, Albacete, Spain.
Eur J Pediatr ; 180(7): 2099-2106, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1092067
Semantic information from SemMedBD (by NLM)
1. COVID-19 PROCESS_OF Infant
Subject
COVID-19
Predicate
PROCESS_OF
Object
Infant
2. Accident and Emergency department LOCATION_OF Polymerase Chain Reaction
Subject
Accident and Emergency department
Predicate
LOCATION_OF
Object
Polymerase Chain Reaction
3. COVID-19 PROCESS_OF Child
Subject
COVID-19
Predicate
PROCESS_OF
Object
Child
4. Coinfection PROCESS_OF Child
Subject
Coinfection
Predicate
PROCESS_OF
Object
Child
5. Child LOCATION_OF C-reactive protein
Subject
Child
Predicate
LOCATION_OF
Object
C-reactive protein
6. American College of Cardiology/American Heart Association Lesion Complexity Score C PROCESS_OF Infant
Subject
American College of Cardiology/American Heart Association Lesion Complexity Score C
Predicate
PROCESS_OF
Object
Infant
7. Coinfection PROCESS_OF Infant
Subject
Coinfection
Predicate
PROCESS_OF
Object
Infant
8. COVID-19 PROCESS_OF Infant
Subject
COVID-19
Predicate
PROCESS_OF
Object
Infant
9. Accident and Emergency department LOCATION_OF Polymerase Chain Reaction
Subject
Accident and Emergency department
Predicate
LOCATION_OF
Object
Polymerase Chain Reaction
10. COVID-19 PROCESS_OF Child
Subject
COVID-19
Predicate
PROCESS_OF
Object
Child
11. Coinfection PROCESS_OF Child
Subject
Coinfection
Predicate
PROCESS_OF
Object
Child
12. Child LOCATION_OF C-reactive protein
Subject
Child
Predicate
LOCATION_OF
Object
C-reactive protein
13. American College of Cardiology/American Heart Association Lesion Complexity Score C PROCESS_OF Infant
Subject
American College of Cardiology/American Heart Association Lesion Complexity Score C
Predicate
PROCESS_OF
Object
Infant
14. Coinfection PROCESS_OF Infant
Subject
Coinfection
Predicate
PROCESS_OF
Object
Infant
ABSTRACT
Fever without source (FWS) in infants is a frequent cause of consultation at the emergency department, and the emergence of SARS-CoV-2 could affect the approach to those infants. The aim of this study is to define the clinical characteristics and rates of bacterial coinfections of infants < 90 days with FWS as the first manifestation of SARS-CoV-2 infection. This is a cross-sectional study of infants under 90 days of age with FWS and positive SARS-CoV2 PCR in nasopharyngeal swab/aspirate, attended at the emergency departments of 49 Spanish hospitals (EPICO-AEP cohort) from March 1 to June 26, 2020. Three hundred and thirty-three children with COVID-19 were included in EPICO-AEP. A total of 67/336 (20%) were infants less than 90 days old, and 27/67(40%) presented with FWS. Blood cultures were performed in 24/27(89%) and were negative in all but one (4%) who presented a Streptococcus mitis bacteremia. Urine culture was performed in 26/27(97%) children and was negative in all, except in two (7%) patients. Lumbar puncture was performed in 6/27(22%) cases, with no growth of bacteria. Two children had bacterial coinfections 1 had UTI and bacteremia, and 1 had UTI. C-reactive was protein over 20 mg/L in two children (one with bacterial coinfection), and procalcitonin was normal in all. One child was admitted to the pediatric intensive care unit because of apnea episodes. No patients died.

Conclusion:

FWS was frequent in infants under 90 days of age with SARS-CoV-2 infection. Standardized markers to rule out bacterial infections remain useful in this population, and the outcome is generally good. What is Known • Fever without source (FWS) in infants is a common cause of consultation at the emergency department, and young infants have a higher risk of serious bacterial infections (SBI). • The emergence of the new coronavirus SARS-CoV-2 could affect the approach to young infants with FWS in the emergency department. management of those children is a challenge because information about bacterial coinfection and prognosis is scarce. What is New • SARS-CoV-2 infection should be ruled out in young infants (< 90 days of age) with FWS in areas with community transmission. • Bacterial coinfection rarely coexists in those infants. • Inflammatory markers were not increased in children without bacterial coinfection. • Outcome is good in most patients.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: SARS-CoV-2 / COVID-19 Subject: SARS-CoV-2 / COVID-19 Type of study: Etiology study / Prevalence study / Prognostic study / Risk factors Language: English Journal: Eur J Pediatr Clinical aspect: Etiology / Prognosis Year: 2021

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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: SARS-CoV-2 / COVID-19 Subject: SARS-CoV-2 / COVID-19 Type of study: Etiology study / Prevalence study / Prognostic study / Risk factors Language: English Journal: Eur J Pediatr Clinical aspect: Etiology / Prognosis Year: 2021
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