A Snapshot of Pediatric Patients with COVID-19 in a Pandemic Hospital.

AIM: Reports describing coronavirus disease 2019 (Covid-19) in children are fewer than adult studies due to milder clinical picture. We aimed to share our experience at a single center with an emphasis on collective decision making. MATERIALS AND METHODS: A suspected case was defined as the presence of symptoms suggestive of COVID-19 and/or positive contact history. SARS-CoV-2 PCR positive patients were defined as confirmed COVID-19. Between March 12, 2020, and May 15, 2020, all children presenting with fever, cough, or respiratory difficulty were investigated for COVID-19. A total of 719 children were examined at outpatient clinics, and 495 were tested with polymerase chain reaction (PCR) for suspicion of COVID-19. A team was organized for monitoring and treating patients either as outpatients or hospitalization. Patients were evaluated in terms of age, gender, travel history, epidemiological history, clinical symptoms and signs, laboratory and radiological findings, treatment, and outcome. RESULTS: Sixty patients were hospitalized for suspicion of COVID-19. Forty-three patients were diagnosed as probable or confirmed COVID-19. 21 of 43 patients (48.8%) were PCR confirmed. The remaining 22 were diagnosed by epidemiologic history, clinical assessment, and computerized thorax tomography (CT) findings. The median age was 126 and 78.5 months in PCR positives and PCR negatives, respectively and the youngest patient was a 28 days old baby. Nineteen of the patients had an upper respiratory infection (44.1%). Although five patients had no clinical signs, chest X-ray, or CT revealed pneumonia. CONCLUSIONS: As previously reported, the clinical manifestations of COVID-19 in children are mostly mild. Even very young kids can become infected following exposure to sick family members. International and local guidelines are valuable for decision making since it is a new disease. A combination of chest disease, infectious diseases, and emergency care physicians approach will aid the appropriate management of cases.

Potential risk factors for patient mortality during admission to the intensive care units.

OBJECTIVE: To determine the prognostic importance of admission time, admission day, admission source, and route of admission, attached devices before admission, diagnosis of patients, and total Simplified Acute Physiology Score (SAPS) II score during admission on intensive care unit mortality rates. METHODS: This retrospective study was carried out with 545 patients admitted to adult intensive care units between January 2006 and January 2011 at Zonguldak, Turkey. Computerised database and patient records were used for data collection. Data from the patient records was collected by a constructed survey form and SAPS II scale. The data was evaluated by numeric values and percentages, Pearson correlation analysis, logistic regression analysis, Chi-square, and student t-tests. RESULTS: The mortality rate was 60.4%. The patients who died had a higher SAPS II score. The mortality rate was higher in admissions from the emergency department (p=0.000), admissions of patients on a stretcher (p=0.000), the existence of an intubation tube (p=0.000) and monitor (p=0.001), and in patients with respiratory tract illness (p=0.000), and infection (p=0.000). A significant difference was not found between the admission day (p=0.761), and time (p=0.063). CONCLUSION: The SAPS II scores of the patients, the route of admission and admission source, being intubated and connected to a monitor, admission diagnosis, and length of stay in intensive care units was increased to mortality rate. However, the days and hours of admission did not significantly affect mortality.