Seroprevalence of SARS-CoV-2 antibodies in pediatric hospital surgical unit: a lower-middle-income country perspective.

BACKGROUND: The objective of our study was to measure and give insight into the seropositivity of anti-SARS-CoV-2 antibodies in the patients in our pediatric hospital surgical unit in Pakistan. METHODS: A prospective cohort study was conducted at a tertiary care pediatric hospital surgical unit in Pakistan between 1 January 2021 and 1 June 2021 on the enrolled neonates and children aged 1 day to 13 years. All patients from three different pediatric strata [neonates (<1 month), infants (1 to 12 months) and children (>1 year)] were enrolled in the study. RESULTS: Six-hundred patients were enrolled, and 426 patients were included in the study. Among 426 patients, 234 (54.9%) were male, and 192 (45.1%) were female. Overall only 118 (27.7%) patients developed symptoms. The other 308 (72.3%) were asymptomatic of which 28 (9.1%) had fever, 28 (9.1%) had cough, 38 (12.33%) had body aches, 292 (94.8%) had vomiting/diarrhea, and only 28 (9.1%) developed loss of smell and taste. Our results showed seropositivity of 27.7% (n = 118), while 72.3% (n = 308) had negative antibody titers. CONCLUSION: A much higher pediatric SARS-CoV-2 burden of 27.7% was found in our pediatric surgical unit than has previously been reported in the literature of 6.8% for children in pediatric hospitals or pediatric surgical units. Contrary to reporting early in the COVID-19 pandemic, this study determined that children experience a significant burden of COVID-19 infection. Thus, children appear very important in SARS-CoV-2 pandemic, from harboring the virus and further studies need to be done to find if they are transmitting the disease silently.

Determinants Of Bowel Resection In Childhood Intussusception.

BACKGROUND: Intussusception is an acute surgical emergency and one of the most common causes of acute abdomen in early paediatric age group with peak incidence between 3 months to 3 years. It is considered the most common cause of intestinal obstruction in first two years of life. Early diagnosis and management may prevent major complications of bowel ischemia and necrosis thus avoiding morbidity and mortality. Our objective was to evaluate the risk factors or determinants of bowel resection in childhood intussusception. METHODS: It is a prospective, descriptive and cross-sectional study in which 102 consecutive cases of intussusception presenting to The Children's Hospital PIMS, from January 2018 to May 2019, were included. RESULTS: Total 102 patients were included in the study. Seventy-three (71.6%) were male and 29 (28.4%) were female. Mean age at presentation was 16.30 months (ranged from 1 day to 9 years). Mean duration of symptoms was 3.1 days. 52.9% (53/102) patients had mass palpable on abdominal examination while 22.5% (23/102) had palpable mass on digital rectal examination (DRE). Mean haemoglobin at presentation was 10.2 g/dL (min 4g/dL, max 26g/dL) and mean haematocrit was 32.6%. The most common type of intussusception was ileo-colic (57.8%) followed by ileo-ileal (21.6%). 36.3% (37/102) patients had to undergo bowel resection due to bowel gangrene/necrosis while in 66 (64.7%) patients had manual reduction. Statistically significant relationship was found between resection and duration of symptoms more than 24 hours (p=0.01, CI=95% OR= 6.24), haemoglobin less than 10g/dL (p=0.022, CI=95% OR=2.78) and haematocrit less than 30% (p=0.028, CI=95% OR=2.63). CONCLUSIONS: Prevention of anaemia and early presentation to a facility where trained paediatric surgeons are available can reduce the chances of bowel resection in childhood intussusception.