A systematic review of clinical characteristics, co-morbidities and outcomes of COVID-19 in children and adolescents

Background: COVID-19 is a major global health challenge that has affected all age groups and gender, with over 5 million deaths reported worldwide to date. The objective of this study is to assess available information on COVID-19 in children and adolescents with respect to clinical characteristics, co-morbidities, and outcomes, and identify gaps in the literatures for appropriate actions. Methodology: Electronic databases including Web of Science, PubMed, Scopus, and Google Scholar were searched for observational studies such as case series, cross-sectional and cohort studies published from December 2019 to September 2021, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guide. Data extracted included (i) patient demography (age and gender), (ii) clinical characteristics including vaccination status and presence of co-morbidities, (iii) clinical management including the use of sequential organ failure assessment (SOFA) scores, oxygen requirement, use of mechanical ventilation, and (iv) disease outcomes including length of hospital and intensive care unit (ICU) admission, recovery, complications with sequelae, or death. Data were analyzed using descriptive statistics. Results: A total of 11 eligible studies were included with a total of 266 children and adolescents; 137 (51.5%) females and 129 (48.5%) males. The mean age of the children was 9.8 years (range of 0 ­ 19 years), and children ≥ 6 years were more affected (40.7%) than age groups 1 ­ 5 years (31.9%) and < 1 year (27.4%). The major co-morbidities were respiratory diseases including pre-existing asthma (3.4%), neurologic conditions (3.4%) and cardiac pathology (2.3%). Majority (74.8%, 199/266) of the patients were discharged without sequelae, 0.8% (2/266) were discharged with sequalae from one study, and mortality of 1.9% (5/266) was reported, also from one study. SOFA scores of patients at admission were not stated in any of the study, while only one study reported patient vaccination status. Conclusion: It is recommended that safe vaccines for children < 1 year of age should be developed in addition to other preventive measures currently in place. SOFA scores should be used to assess risk of COVID-19 severity and monitor prognosis of the disease, and vaccination status of children should be documented as this may impact the management and prognosis of the disease.

Antibacterial activities of triterpenoidal compounds isolated from Calothamnus quadrifidus leaves.

BACKGROUND: Calothamnus quadrifidus R.Br has many traditional uses and there are few reports about its chemical and biological activities. So our aim is to isolate the triterpenoidal compounds from dichloromethane fraction (DCMF) of Calothamnus quadrifidus R.Br leaves and in addition to evaluate the antibacterial activity of the isolated compounds. METHODS: DCMF of C. quadrifidus leaves was subjected to different chromatographic techniques to isolate pure triterpenoidal compounds which were identified using different chemical and spectroscopic techniques. Antibacterial activities of the isolated compounds were evaluated using agar well diffusion method while minimum inhibitory concentration was assessed by microtiter plate assay method. RESULTS: Five compounds were isolated and they were betulinic acid (1), ursolic acid (2), 3-acetyl-23-hydroxy betulinic acid (3), 2,23-dihydroxy betulinic acid (4) and 2,21,23-trihydroxy betulinic acid (5) were isolated from DCMF of C. quadrifidus leaves for the first time. Compounds 4 and 5 showed strong antibacterial activity against S. typhimurium while compound 4, 5 and 3, 4 exhibits moderate effect against E.coli and S. aureus respectively. CONCLUSION: Pure triterpenoidal compounds isolated from C. quadrifidus leaves showed antibacterial activities in different strengths.