Retrospective Analysis of Serology and Radiology Results in Patients with Suspected Cystic Echinococcosis Through 3 Years Period

OBJECTIVE: Cystic echinococcosis (CE), caused by the larval stage of Echinococcus granulosus sensu latu, is one of the neglected zoonotic infectious diseases and Türkiye is among the endemic countries. This study was designed to analyze serology results for patients who were diagnosed as CE by clinical symptoms and radiological methods over a three-year period. METHODS: Sera were analyzed for Anti-E. granulosus IgG by a chemiluminescence immunoassay (CLIA) (HYDATIDOSIS VIRCLIA® IgG MONOTEST, Vircell) using the VIRCLIA® (CLIA; Vircell, Granada, Spain) and results processed by the dedicated software. Cut-off for a positive test was ≥1.1 index value. Echinococcal cysts were detected based on ultrasonography, computed tomography, and magnetic resonance imaging. RESULTS: A total of 244 sera were analyzed from 109 patients, during three-year-period from January 2018 to December 2020. Anti-E. granulosus IgG was ordered twice in 89 patients, three times in 15 patients, four times in four patients, and five times in one patient. CLIA test was positive among 41 of 109 (37.6%) patients in whom 32 (76%) had only hepatic involvement, whereas in 5 (12%) hepatic and pulmonary involvement were coexisted. The mean age of seropositive patients was 39.8 (6-75±2.72) and 61.9% of them (n=26) were female. Time intervals between sequential test orders varied from 1 day to 33 months. Eight seropositive patients turned out to be negative, and one of 66 seronegative patients became seropositive. Positive test results were converted to negative in the case of therapy or cyst inactivity. CONCLUSION: We may conclude that CLIA could be used as a complementary tool for CE patient follow-up.

COVID-19 disease characteristics in different pediatric age groups.

INTRODUCTION: Little is known about the COVID-19 disease characteristics and differences between different pediatric age groups. This study aimed to investigate the disease characteristics according to age groups. METHODOLOGY: We conducted a retrospective, single-center study of pediatric COVID-19 in a tertiary care hospital in Turkey. The patients were divided into three groups: 15 days-24 months old (Group 1), 25-144 months old (Group 2), and 145-210 months old (Group 3) according to age. RESULTS: A total of 139 pediatric patients with COVID-19 were examined. Twenty-nine patients (20.9%) were in Group 1, 52 (37.4%) were in Group 2, 58 (41.7%) were in Group 3. Thirty-nine patients (28.1%) were hospitalized. The most common symptoms were cough (55.4%) and fever (51.8%). The median chest X-ray (CXR) score of hospitalized patients was 1 (min 0-max 7), and the median CXR score of outpatients was 1 (min 0-max 6). Fever was significantly more frequent in Group 1, and chest pain was more frequent in Group 3. Group 1 had significantly higher WBC, lymphocyte, thrombocyte counts, AST, LDH, D-dimer, and Troponin T levels but lower hemoglobin, total protein, and albumin levels. The treatment included antibiotics, oseltamivir, hydroxychloroquine, and supportive therapy. Only one patient (0.7%) received non-invasive mechanical ventilatory support. CONCLUSIONS: As we know the clinical course of COVID-19 in children is less severe than in adults. We also found significant differences in both clinical and laboratory findings between different pediatric age groups which supports the theory that disease pathogenesis is highly variable according to age.

Incidence of multisystem inflammatory syndrome in children and the comorbidity scores in pediatric coronavirus disease 2019 cases.

BACKGROUND: We aimed to determine the incidence of multisystem inflammatory syndrome in children (MIS-C) in pediatric coronavirus disease 2019 (COVID-19) cases and to define the relationships between the need for hospitalization, the development of MIS-C, and the Charlson Comorbidity Index (CCI) and Pediatric Comorbidity Index (PCI) scores. METHODS: All pediatric COVID-19 cases between March 25, 2020, and December 28, 2020, in the Marmara University Pendik Training and Research Hospital were enrolled. Patients who needed hospitalization were determined. Hospital records were re-examined to identify those diagnosed as having MIS-C. The CCI and PCI were used to validate the comorbidity status. RESULTS: Among 2,055 pediatric COVID-19 cases, 1,340 were included in the study, and 213 patients (15.9%) had at least one comorbidity. All the patients or their parents were interviewed about the need for hospitalization, except for the acute period. Six patients had MIS-C, which corresponds to a MIS-C incidence of 0.4%. The need for hospitalization increased in the patients with comorbidities (P < 0.05). No correlation was found between the comorbidity scores and the development of MIS-C. The need for hospitalization increased in the patients with CCI scores of ≥2 and PCI scores of ≥4 (P < 0.05). CONCLUSIONS: Our study is the first to examine the incidence of MIS-C, which was 0.4%, by long-term follow up of pediatric COVID-19 cases and to demonstrate that the CCI and PCI can be used to predict the need for hospitalization and prognosis of pediatric patients with COVID-19.

Comparison of SARS-COV-2 antibody assays in PCR negative and PCR positive Turkish patients.

BACKGROUND: To the Editor, Serology may offer valuable information during COVID-19 pandemic; however, published papers mainly reported the results of symptomatic patients having positive RT-PCR on upper respiratory tract specimens [1]. More studies are needed to address whether asymptomatic patients, or patients with chest imaging compatible with COVID-19 but negative RT-PCR, have different antibody response that could influence assays performances. We wanted to share our data from Turkey where 4,323,596 COVID-19 cases were detected out of 44,087,628 PCR tests by April 20, 2021 but there are only a couple of published studies about serodiagnosis of the infection. DISCUSSION: The authors have no funding source for the study. The authors have no conflicts of interest to declare.