Comparisons of Clinical Features and Outcomes of COVID-19 between Patients with Pediatric Onset Inflammatory Rheumatic Diseases and Healthy Children.

(1) Background: We aimed to describe the clinical features and outcomes of coronavirus disease-2019 (COVID-19) in children and late adolescents with inflammatory rheumatic diseases (IRD) and to measure their severity risks by comparing them with healthy children. (2) Methods: Among children and late adolescents found to be severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) positive via polymerase chain reaction (PCR) test, IRD patients with an at least six-months follow-up duration, and healthy children were included in the study. Data were obtained retrospectively. (3) Results: A total of 658 (339 (51.5%) females) (healthy children: 506, IRD patients: 152) subjects were included in the study. While 570 of 658 (86.6%) experienced COVID-19-related symptoms, only 21 (3.19%) required hospitalization with a median duration of 5 (1-30) days. Fever, dry cough, and fatigue were the most common symptoms. None of evaluated subjects died, and all recovered without any significant sequelae. The presence of any IRD was found to increase the risk of both hospitalization (OR: 5.205; 95% CI: 2.003-13.524) and symptomatic infection (OR: 2.579; 95% CI: 1.068-6.228). Furthermore, increasing age was significantly associated with symptomatic infection (OR: 1.051; 95% CI: 1.009-1.095). (4) Conclusions: Our study emphasizes that pediatric rheumatologists should monitor their patients closely for relatively poor COVID-19 outcomes.

Prevalence of Anosmia in 10.157 Pediatric COVID-19 Cases: Multicenter Study from Turkey.

INTRODUCTION: COVID-19-related anosmia is a remarkable and disease-specific finding. With this multicenter cohort study, we aimed to determine the prevalence of anosmia in pediatric cases with COVID-19 from Turkey and make an objective assessment with a smell awareness questionnaire. MATERIAL AND METHODS: This multicenter prospective cohort study was conducted with pediatric infection clinics in 37 centers in 19 different cities of Turkey between October 2020 and March 2021. The symptoms of 10.157 COVID-19 cases 10-18 years old were examined. Age, gender, other accompanying symptoms, and clinical severity of the disease of cases with anosmia and ageusia included in the study were recorded. The cases were interviewed for the smell awareness questionnaire at admission and one month after the illness. RESULTS: Anosmia was present in 12.5% (1.266/10.157) of COVID-19 cases 10-18 years of age. The complete records of 1053 patients followed during the study period were analyzed. The most common symptoms accompanying symptoms with anosmia were ageusia in 885 (84%) cases, fatigue in 534 cases (50.7%), and cough in 466 cases (44.3%). Anosmia was recorded as the only symptom in 84 (8%) of the cases. One month later, it was determined that anosmia persisted in 88 (8.4%) cases. In the smell awareness questionnaire, the score at admission was higher than the score one month later (P < 0.001). DISCUSSION: With this study, we have provided the examination of a large case series across Turkey. Anosmia and ageusia are specific symptoms seen in cases of COVID-19. With the detection of these symptoms, it should be aimed to isolate COVID-19 cases in the early period and reduce the spread of the infection. Such studies are important because the course of COVID-19 in children differs from adults and there is limited data on the prevalence of anosmia.

Prevalence of COVID-19 in 10,000 samples from 7853 patients in Eastern Turkey by positive real-time PCR.

Aim: COVID-19, caused by SARS-CoV-2, started in December 2019 and has spread across the world. Materials & methods: We analyzed real-time PCR results of 10,000 samples from 2 April to 30 May 2020 in three neighbor cities located in the East of Turkey. The final study population was 7853 cases, after excluding screening tests. Results: Real-time PCR was performed to detect the SARS-CoV-2-specific RNA-dependent-RNA-polymerase gene fragment. The number of total positive samples out of 7853 were 487; however, the number of nonrepeating positive patient was 373 (4.8%). Cough and fever were the most common symptoms in positive cases. Conclusion: Epidemiologic studies should be performed about the prevalence of SARS-CoV-2 infection to better understand the effect of the virus across the world.

Coronavirus infections in childhood and vaccine studies.

In late December 2019, a new coronavirus (CoV) called the severe acute respiratory syndrome CoV 2 (SARS-CoV-2), which had not been detected in humans before, caused a worldwide pandemic. Owing to the highly infectious nature of this virus, it spread rapidly from person to person despite the warnings of the World Health Organization and all the measures taken by the governments. Although it has been reported that SARS-CoV-2 is more likely to infect the elderly, all age groups are susceptible to this virus, including newborns. CoV disease 2019 (COVID-19) symptoms seem to be less severe in children than in adults, but similar to the 2003 severe acute respiratory syndrome epidemic, in the COVID-19 pandemic, the number of cases and the risk of serious diseases increase as age increases. The treatment of COVID-19 is still challenging, especially in children, and the virus continues to cause death worldwide. The safest and most controlled way to effectively and sustainably prevent COVID-19 in a society is to have an effective and safe vaccine and to successfully vaccinate the majority of the population. It is possible that vaccines with safety and efficacy that have been proven in phase III trials will be effective in handling COVID-19.

Iodine status of Turkish pregnant women and their offspring: A national cross-sectional survey.

BACKGROUND: This national cross-sectional survey aimed to assess the iodine status in pregnant women and their offspring, and also to demonstrate regional differences by measuring urinary iodine concentration (UIC). For each woman and her newborn a questionnaire was prepared with basic facts as age, parity number or birth weight and additional information regarding thyroid diseases, use of iodized salt in the household, extra iodine supplementation during pregnancy, education level and wage income. METHODS: The target population represented 1444 pregnant women who gave birth between January 1 st, 2018 and 2019, and their offspring. Iodine deficiency for pregnant women and their offspring were defined as urine iodine level <150 µg/L and <100 µg/L, respectively. Results are given as median (25th-75th percentile). RESULTS: The median UIC in the group of pregnant woman was 94 (52-153) µg/L. Within the sample of 1444 pregnant women, UIC indicative of mild iodine deficiency (100-149 µg/L) was present in 21 % (n = 306), moderate deficiency (50-99 µg/L) in 30 % (n = 430), and severe deficiency (<50 µg/L) in 23 % (n = 337). This study showed a prevalence of 74 % of iodine deficiency in Turkish pregnant woman. The median UIC in the group of offspring was 96 (41-191) µg/L. Within the new-borns, UIC indicative of mild iodine deficiency (50-99 µg/L) was present in 22 % (n = 323), moderate deficiency (20-49 µg/L) in 15 % (n = 222), and severe deficiency (<20 µg/L) in 13 % (n = 192). This survey showed a prevalence of 51 % of iodine deficiency in Turkish new-borns. Pregnant women with lower socioeconomic and education level, lower access to household iodized salt, lower rates of exposure to povidone-iodine containing skin disinfectant, higher parity and higher iodine deficiency had higher rates of iodine deficiency in their offspring. Regional differences were observed both in mothers and their offspring concerning their iodine status. CONCLUSIONS: Our findings suggest that iodine deficiency is still an important public health problem in Turkey. More drastic measures should be taken to decrease these important iodine deficiencies, both in pregnant women and in their offspring.

Quantitative Assessment of Thyroid, Submandibular, and Parotid Glands Elasticity With Shear-Wave Elastography in Children.

Tissue elasticity is becoming a more commonly used parameter in evaluation of parenchyma in inflammatory diseases. Considering the changes in the thyroid and salivary glands with adolescence, determination of mean elasticity ranges with a function of age is necessary to apply ultrasound elastography more widely in the pediatric population.The thyroid, submandibular, and parotid glands of 127 healthy volunteers (66 males, 61 females; mean age = 10.3 ± 3.9 years; range = 3-17 years) were evaluated with shear-wave elastography.The mean elasticity values for the thyroid, submandibular, and parotid glands were 14.6 ± 3.3, 11.8 ± 2.2, and 11.8 ± 2.6 kPa, respectively. There was a significant positive correlation between age and elasticity of the thyroid, submandibular, and parotid glands. There was a significant correlation between age and elasticity value of the thyroid gland adjusted for weight and height.This study provided the baseline quantitative elasticity measures of thyroid, submandibular, and parotid glands, which would be a reference for upcoming studies. In addition, an increase in elasticity value in thyroid gland as a function of age independent of change in weight and height was demonstrated.