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Botan E, Uyar E, Öztürk Z, Şevketoğlu E, Sarı Y, Dursun O, Sincar Ş, Duyu M, Oto A, Celegen M, Özçiftçi G, Havan M, Nilüfer Öztürk M, Ağın H, Yener N, Yaman A, Gün E, Yılmaz M, Şimşek N, Özdemir H, Yıldızdaş D, Kendirli T. COVID-19 Transmission and Clinical Features in Pediatric Intensive Care Health Care Workers. Turk Arch Pediatr 2022; 57. [PMID: 35110085 PMCID: PMC8867499 DOI: 10.5152/turkarchpediatr.2021.21205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
OBJECTIVE This study aims to investigate modes of transmission and clinical features of coronavirus disease 2019 in healthcare workers in pediatric intensive care units. MATERIALS AND METHODS This multicenter descriptive study was conducted between March and November 2020. Patient demographics, clinical characteristics, origin of coronavirus disease 2019, treatment modalities, and loss of workdays were recorded. RESULTS Seven hundred and sixty-eight healthcare workers from 16 pediatric intensive care units were enrolled and 114 (14.8%) healthcare workers with a mean age of 29.7 ± 6.7 years became coronavirus disease 2019 patients. Seventy-six (66.7%) patients were female. Approximately half (54.3%) of the patients were physicians, 34.2% were nurses, and 11.4% were ancillary staff. Transmission was deemed to occur through patient contact in 54.3% of the patients. Comorbid illness was present 10.5% of the patients. Transmission occurred during endotracheal intubation in 21%, cardiopulmonary resuscitation in 9.6%, and non-invasive ventilation in 12.2% of patients, while transmission was a result of multiple possible procedures in 43.8%. Intensive care admission was needed for 13.1% of the patients. Five patients needed oxygen by cannula, 7 needed oxygen with a non-rebreathing mask, 5 needed high-flow nasal cannula support, 5 needed non-invasive ventilation, and 3 needed invasive mechanical ventilation. Fortunately, no infected healthcare workers died. CONCLUSION Coronavirus disease 2019 in healthcare workers is a significant problem in pediatric intensive care units. Transmission seems to occur particularly frequently during patient care procedures such as intubation, ventilation and aerosol therapy, which highlights the importance of proper use of full sets of personal protective equipment during all procedures during care of coronavirus disease 2019 patients.
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Affiliation(s)
- Edin Botan
- Department of Pediatric Critical Care Medicine, Ankara University Faculty of Medicine, Ankara, Turkey,Corresponding author:Edin Botan✉
| | - Emel Uyar
- Department of Pediatric Critical Care Medicine, Ankara City Hospital, Ankara, Turkey
| | - Zeynelabidin Öztürk
- Department of Pediatric Critical Care Medicine, Health Sciences University, Ankara Dr. Sami Ulus Women, Children’s Health and Diseases Education And Research Hospital, Ankara, Turkey
| | - Esra Şevketoğlu
- Department of Pediatric Critical Care Medicine, Health Sciences University Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| | - Yusuf Sarı
- Department of Pediatric Critical Care Medicine, Fırat University Faculty of Medicine, Elazığ, Turkey
| | - Oğuz Dursun
- Department of Pediatric Critical Care Medicine, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Şahin Sincar
- Department of Pediatric Critical Care Medicine, Elazığ Fethi Sekin City Hospital, Elazığ, Turkey
| | - Muhterem Duyu
- Department of Pediatric Critical Care Medicine, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, İstanbul, Turkey
| | - Arzu Oto
- Department of Pediatric Critical Care Medicine, University of Health Sciences Bursa Highly Specialized Training and Research Hospital, Bursa, Turkey
| | - Mehmet Celegen
- Department of Pediatric Critical Care Medicine, Afyonkarahisar University of Health Sciences, Afyon, Turkey
| | - Gökçen Özçiftçi
- Department of Pediatric Critical Care Medicine, Health Sciences University Van Training and Research Hospital, Van, Turkey
| | - Merve Havan
- Department of Pediatric Critical Care Medicine, Mersin City Education and Research Hospital, Mersin, Turkey
| | - Makbule Nilüfer Öztürk
- Department of Pediatric Critical Care Medicine, Marmara University Faculty of Medicine, İstanbul, Turkey
| | - Hasan Ağın
- Department of Pediatric Intensive Care, University of Health Sciences Dr. Behçet Uz Pediatric Diseases and Surgery Training and Research Hospital, İzmir, Turkey
| | - Nazik Yener
- Department of Pediatric Intensive Care, Samsun Ondokuz Mayıs University Faculty of Medicine, Turkey
| | - Ayhan Yaman
- Department of Pediatric Intensive Care, Istinye University Liv Hospital, İstanbul, Turkey
| | - Emrah Gün
- Department of Pediatric Critical Care Medicine, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Merve Yılmaz
- Department of Pediatric Critical Care Medicine, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Naile Şimşek
- Department of Pediatric Critical Care Medicine, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Halil Özdemir
- Department of Pediatric Infectious Diseases, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Dinçer Yıldızdaş
- Department of Pediatric Intensive Care, Çukurova University Faculty of Medicine, Adana, Turkey
| | - Tanıl Kendirli
- Department of Pediatric Critical Care Medicine, Ankara University Faculty of Medicine, Ankara, Turkey
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Allaerts W. How Could This Happen? : Narrowing Down the Contagion of COVID-19 and Preventing Acute Respiratory Distress Syndrome (ARDS). Acta Biotheor 2020; 68:441-452. [PMID: 32335749 PMCID: PMC7183256 DOI: 10.1007/s10441-020-09382-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 04/10/2020] [Indexed: 12/26/2022]
Abstract
In this rapid commentary, a mini-review is given of the present state-of-knowledge regarding the etiology and epidemiology of the new coronavirus 2019-nCoV and the risks for developing Acute respiratory distress syndrome (ARDS). The available knowledge on the viral genomics, molecular biology and pathogenicity of viruses of the Coronaviridae family and other Nidovirales, forms a helpful template for understanding the present pandemic outbreak. However, important questions remain unanswered about the underlying mechanism causing the very high case fatality ratios (CFR) and mechanisms regarding severe reactions like ARDS, fatal cardiac and renal failures, associated with a number of important comorbidity factors. Immunological reactions to lung alveoles in particular (involving lung macrophages and alveolar epithelial cell damage) in late phase ARDS in SARS-like CoV diseases, so far may not have received enough attention. Finally a shortlist of questions for high priority further research is suggested.
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Affiliation(s)
- Wilfried Allaerts
- Biological Publishing A&O and Immunology Department, Erasmus MC, Rotterdam, The Netherlands.
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