Evaluation of ischemia-modified albumin in the diagnosis and the clinical severity of COVID-19 in children.

BACKGROUND: There is no specific biomarker used in the diagnosis of COVID-19 and predicting its clinical severity. This study aimed to investigate the utility of ischemia-modified albumin (IMA) in diagnosing and predicting clinical severity in children with COVID-19. METHODS: Between October 2020 and March 2021, 41 cases constituted the COVID-19 group and 41 cases constituted the healthy control group. IMA levels were measured at admission (IMA-1) and 48-72 hours (IMA- 2) in the COVID-19 group. In the control group, it was measured at admission. COVID-19 clinical severity was classified as asymptomatic infection, mild, moderate, severe, or critical disease. Patients were divided into two groups (asymptomatic/mild and moderate/severe) to evaluate IMA levels in terms of clinical severity. RESULTS: In the COVID-19 group, the mean IMA-1 level was 0.901±0.099, and the mean IMA-2 level was 0.866±0.090. The mean level of IMA-1 in the control group was 0.787±0.051. When IMA-1 levels of COVID-19 and control cases were compared, the difference was statistically significant (p < 0.001). When clinical severity and laboratory data are compared, C-reactive protein, ferritin and ischemia-modified albumin ratio (IMAR) were statistically significantly higher in moderate-severe clinical cases (p=0.034, p=0.034, p=0.037 respectively). However, IMA-1 and IMA-2 levels were similar between the groups (p=0.134, p=0.922, respectively). CONCLUSIONS: To date, no study has been conducted on IMA levels in children with COVID-19. The IMA level may be a new marker for the diagnosis of COVID-19 in children. Studies with a larger number of cases are needed to predict clinical severity.

Attitudes of parents with children aged 12-18 to COVID-19 vaccines for themselves and their children.

BACKGROUND: The incidence of vaccine hesitancy is increasing in many countries. This study aims to determine parents` attitudes and related factors regarding COVID-19 vaccine acceptance for themselves and their children aged 12-18. METHODS: A cross-sectional survey was conducted on parents between 16th November and 31st December 2021, after COVID-19 vaccines were initiated for children in Türkiye. In the survey, the sociodemographic characteristics of the parents, whether they and their children were vaccinated against COVID-19, and if not, the reasons for this were asked. Multivariate binary logistic regression analysis was used to evaluate the factors affecting parents` refusal to vaccinate their children for COVID-19. RESULTS: Three hundred and ninety-six mothers and fathers were included in the final analysis. Overall, 41.7% of parents reported vaccine refusal for their children. COVID-19 vaccine refusal was higher in mothers younger than 35 (ß = 6.5, p = 0.002, 95% CI: 2.0-23.1), children aged 15 and younger (ß = 2.3, p = 0.001, 95% CI: 1.4-3.7). Concerns about the side effects of the COVID-19 vaccine (29.7%) and their children not wanting to be vaccinated (29.0%) were the most common causes of COVID-19 vaccine refusal. CONCLUSIONS: In the present study, the rate of children not vaccinated due to COVID-19 vaccine refusal was relatively high. Parents` concerns about vaccine side effects, as well as their children`s unwillingness to be vaccinated, suggest that both parents and adolescents should be informed about the importance of COVID-19 vaccines.

Colistin Treatment for Multidrug-Resistant Gram-Negative Infections in Children: Caution Required for Nephrotoxicity.

Objectives: Colistin has come to the fore as a treatment option, especially with the occurrence of multidrug-resistant Gram-negative infections across the world. However, the high nephrotoxic effects of colistin should be taken into consideration in children. The study's primary outcome was to determine the clinical success of the colistin treatment, and the secondary outcome was to detect the side effects related to colistin. Methods: The patients who received intravenous colistin in our hospital's last 5 years were included in the study. In addition to the patients' demographic and clinical characteristics, the clinical success of the colistin treatment, 28-day infection-related mortality of the patients, and side effects of colistin were recorded. Results: A total of 37 patients received colistin therapy during 2015-2019. Four of these patients had colistin treatment twice a year, so we accepted them as separate cases in each infection attack. Therefore, 41 cases were included in the study. The median age of the cases was 26 months (IQR: 4.50-144.50) and 27 (65.9%) were male. Twenty-seven cases (65.9%) had sepsis. The median dose of colistin was 4.2 (IQR: 3-5) mg/kg/day. Among 44 cultures obtained from the patients, the most common microorganism was Acinetobacter baumannii, with 58.5%. The clinical success was detected in 18 patients (43.9%). While overall nephrotoxicity developed in 14 (34.1%) patients, only two of them needed dialysis. Conclusion: Colistin should not be considered the first choice in treating Gram-negative infections but should be kept as salvage therapy in multidrug-resistant Gram-negative infections across the world. During the treatment process, close monitoring of renal function tests and urinary output were recommended due to the risk of developing nephrotoxicity.