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Jamali Z, Mohammadpour N, Sinaei R, Jafari M, Sabzevari F, Hasannejad M. The footprint of SARS-COV-2 infection in neonatal late sepsis. BMC Pediatr 2024; 24:184. [PMID: 38491449 PMCID: PMC10943770 DOI: 10.1186/s12887-024-04665-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 02/22/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Predicting and finding the viral agents responsible for neonatal late-sepsis has always been challenging. METHOD In this cross-sectional study, which has been done from September 2020 to December 2022, 145 hospitalized neonates suspected to late-onset sepsis alongside routine sepsis workup, were also evaluated for severe acute respiratory syndrome-coronavirus-2 (SARS-COV-2) infection, by nasopharyngeal real-time polymerase chain reaction (RT-PCR) or serological tests. RESULT 145 neonates including 81 girls and 64 boys with a mean age of 12.3 ± 5.9 days and an average hospitalization stay of 23.1 ± 15.4 days were enrolled in the study. While 76.6% of them had negative bacterial culture, 63 patients (43.4%) showed evidence of SARS-COV-2 infection in RT-PCR or serology tests. None of the underlying factors including gender, age, and laboratory investigation had a significant relationship with SARS-COV-2 infection. Similarly, the outcomes of death and length of hospitalization were not different between the two groups with positive and negative SARS-COV-2 RT-PCR (P < 0.05). There was only a significant relationship between radiological changes including reticulonodular pattern, consolidation, pleural effusion, and different types of infiltrations and SARS-COV2 infection. CONCLUSION Considering the widespread of coronavirus disease 2019 (COVID-19) in newborns, it seems logical to investigate the SARS-COV-2 infection in late-sepsis.
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Affiliation(s)
- Zahra Jamali
- Department of Pediatrics, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Najmeh Mohammadpour
- Clinical Research Development Unit, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Reza Sinaei
- Department of Pediatrics, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran.
- Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran.
| | - Maedeh Jafari
- Department of Pediatrics, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Fatemeh Sabzevari
- Department of Pediatrics, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Hasannejad
- Department of Laboratory Sciences, School of Medicine, Bam University of Medical Sciences, Bam, Iran
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Kaveh M, Sadatinejad SM. Management of neonatal sepsis with COVID-19 infection in a premature newborn - A case report. JOURNAL OF NEONATAL NURSING : JNN 2023; 29:409-412. [PMID: 35935164 PMCID: PMC9343744 DOI: 10.1016/j.jnn.2022.07.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 07/25/2022] [Accepted: 07/28/2022] [Indexed: 11/20/2022]
Abstract
Introduction Neonates appear to be less affected by COVID-19 than adults, yet COVID-19 has been a challenge for all medical specialties, including neonatal intensive care unit (NICU) specialists. Unfortunately, current knowledge about the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is limited. This case report explains how COVID-19 neonatal sepsis was treated with immunomodulatory agents. Case presentation In this case, we present a premature male newborn who was ill. He was born to a mother with a negative nasopharyngeal swab test for SARS-CoV-2. On the fifth day of life, the baby developed respiratory distress, and a nasopharyngeal swab test for SARS-CoV-2 tested positive. The baby was Intubated, and intratracheal surfactant was administered. The infant was treated with intravenous immunoglobulin (IVIg) and corticosteroids for 14 days. Patient's demographics Age: under 1 month, Sex: Male, Ethnicity: Iranian. Conclusion The basics of treatment for neonatal COVID-19 is supportive care. Some studies have treated infants with various drugs such as Hydroxychloroquine, Favipiravir, and Remedsivir; however, in our case, a 5-day-old baby boy was treated with corticosteroids and IVIg. We achieved good outcomes after 2 weeks of treatment with dexamethasone 0.3 mg/kg per day and IVIg 2 g/kg/day (for 3 days). It appears that these treatments, along with adjuvant ventilation and the administration of endotracheal surfactant, can improve a patient's general condition.
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Affiliation(s)
- Mahbod Kaveh
- Bahrami Children Hospital, Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyyed Mohsen Sadatinejad
- Bahrami Children Hospital, Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran
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Kuznetsov KO, Tukbaeva LR, Kazakova VV, Mirzoeva KR, Bogomolova EA, Salakhutdinova AI, Ponomareva DY, Garipova AR, Mutsolgova MSM, Galimkhanov AG, Sakhibgareev MI, Guzhvieva ER. The Role of COVID-19 in Antibiotic Resistance in Pediatric Population. PEDIATRIC PHARMACOLOGY 2023. [DOI: 10.15690/pf.v19i6.2465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
There is data on the irrational use of antimicrobial drugs in pediatric population during the COVID-19 pandemic. This could lead to potential development of antibiotic resistance and increased morbidity and mortality among this vulnerable population group. The aim of this review is to study the role of COVID-19 in antimicrobial drugs administration and antibiotic resistance development, as well as to determine a set of measures for its prevention. Recent studies results have shown that COVID-19 pandemic had both direct and indirect impact on antibiotic resistance development in pediatric population. The COVID-19 outbreak has revealed weaknesses in health systems around the world. Antibiotics administration in patients with coronavirus infection during this period exceeded the number of cases with bacterial co-infection or other diseases. Thus, it indicates irrational antibiotic treatment. There were cases of inappropriate antibiotics administration during the crisis caused by the COVID-19 pandemic even in regions with long-term rational antibiotic treatment programs. One of the most viable methods to combat antibiotic resistance is to improve approaches in health care and to increase preparedness to infectious outbreaks. Increasing clinical competence of medical workers, accessibility of medical facilities, permanent supply of high-quality and cheap antibiotics, vaccines, reducing COVID-19 testing time, and adequate administration of antibacterial agents are the measures that can prevent diseases caused by drug resistance. All stakeholders (health authorities, regulating authorities, politicians, scientific community, pharmaceutical companies) have to collaborate and achieve results to implement all the mentioned above protection measures.
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Tunçel D, Bilgin LK, İnce Z, Çoban A. Apnea as an isolated finding in neonatal COVID-19. Proc AMIA Symp 2022; 36:73-74. [PMID: 36578617 PMCID: PMC9762778 DOI: 10.1080/08998280.2022.2131184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
COVID-19 continues to mutate and spread rapidly. However, case reports about newborns remain rare. A male baby, born at 840 g at gestational week 28, was diagnosed with respiratory distress syndrome, sepsis, patent ductus arteriosus, and bronchopulmonary dysplasia in the neonatal intensive care unit. Refractory apnea developed on postnatal day 58, and an upper respiratory tract SARS-nCoV-2 polymerase chain reaction test was positive. A COVID test was also positive in an asymptomatic nurse who cared for the baby. This case shows that SARS-CoV-2 can cause symptoms of only apnea in newborns and that those who care for newborns should strictly comply with hygiene rules.
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Affiliation(s)
- Duygu Tunçel
- Department of Neonatology, University of Health Sciences Diyarbakır Gazi Yasargil Training and Research Hospital, Diyarbakır, Turkey,Corresponding author: Duygu Tunçel, Department of Neonatology, Istanbul Faculty of Medicine, Istanbul University, Talaytepe District, Urfa Road, 21090Diyarbakır, Turkey (e-mail: )
| | - Leyla Karadeniz Bilgin
- Department of Neonatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Zeynep İnce
- Department of Neonatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Asuman Çoban
- Department of Neonatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Cao H, Gao Y, Jia H, Zhang L, Liu J, Mu G, Gui H, Wang Y, Yang C, Liu J. Macrophage-Membrane-Camouflaged Nonviral Gene Vectors for the Treatment of Multidrug-Resistant Bacterial Sepsis. NANO LETTERS 2022; 22:7882-7891. [PMID: 36169350 DOI: 10.1021/acs.nanolett.2c02560] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Sepsis is a life-threatening disease caused by systemic bacterial infections, with high morbidity and mortality worldwide. As the standard treatment for sepsis, antibiotic therapy faces the challenge of impaired macrophages and drug-resistant bacteria. In this study, we developed a membrane-camouflaged metal-organic framework (MOF) system for plasmid DNA (pDNA) delivery to combat sepsis. The antimicrobial gene LL37 was efficiently encapsulated in the pH-sensitive MOF, and the nanoparticles were decorated with macrophage membranes in a compatible manner. Macrophage membrane coating allows targeted delivery of LL37 to macrophages and creates macrophage factories for the continuous generation of antimicrobial peptides. Compared to naked nanoparticles, primary bone marrow mesenchymal macrophage membrane-modified nanoparticles greatly improved the survival rate of immunodeficient septic mice through the synergistic effect of efficient gene therapy and inflammatory cytokine sequestration. This study demonstrates an effective membrane biomimetic strategy for efficiently delivering pDNA, offering an excellent option for overcoming sepsis.
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Affiliation(s)
- Hongmei Cao
- Key Laboratory of Radiopharmacokinetics for Innovative Drugs, Chinese Academy of Medical Sciences, and Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300192, P.R. of China
| | - Yang Gao
- Key Laboratory of Radiopharmacokinetics for Innovative Drugs, Chinese Academy of Medical Sciences, and Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300192, P.R. of China
| | - Haixue Jia
- Key Laboratory of Radiopharmacokinetics for Innovative Drugs, Chinese Academy of Medical Sciences, and Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300192, P.R. of China
| | - Liping Zhang
- Key Laboratory of Radiopharmacokinetics for Innovative Drugs, Chinese Academy of Medical Sciences, and Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300192, P.R. of China
| | - Jinjian Liu
- Key Laboratory of Radiopharmacokinetics for Innovative Drugs, Chinese Academy of Medical Sciences, and Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300192, P.R. of China
| | - Ganen Mu
- Key Laboratory of Radiopharmacokinetics for Innovative Drugs, Chinese Academy of Medical Sciences, and Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300192, P.R. of China
| | - Han Gui
- Key Laboratory of Radiopharmacokinetics for Innovative Drugs, Chinese Academy of Medical Sciences, and Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300192, P.R. of China
| | - Yuebing Wang
- School of Medicine, Nankai University, Tianjin 300071, China
| | - Cuihong Yang
- Key Laboratory of Radiopharmacokinetics for Innovative Drugs, Chinese Academy of Medical Sciences, and Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300192, P.R. of China
| | - Jianfeng Liu
- Key Laboratory of Radiopharmacokinetics for Innovative Drugs, Chinese Academy of Medical Sciences, and Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300192, P.R. of China
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Kabeerdass N, Thangaswamy S, Mohanasrinivasan V, Rajasekaran C, Sundaram S, Nooruddin T, Mathanmohun M. Green Synthesis–Mediated Nanoparticles and Their Curative Character Against Post COVID-19 Skin Diseases. CURRENT PHARMACOLOGY REPORTS 2022; 8:409-417. [PMID: 36105411 PMCID: PMC9461414 DOI: 10.1007/s40495-022-00303-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/18/2022] [Indexed: 01/08/2023]
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Sarfraz M, Sarfraz A, Sarfraz Z, Nadeem Z, Khalid J, Butt SZ, Thevuthasan S, Felix M, Cherrez-Ojeda I. Contributing factors to pediatric COVID-19 and MIS-C during the initial waves: A systematic review of 92 case reports. Ann Med Surg (Lond) 2022; 81:104227. [PMID: 35937636 PMCID: PMC9339082 DOI: 10.1016/j.amsu.2022.104227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 07/19/2022] [Accepted: 07/20/2022] [Indexed: 11/25/2022] Open
Abstract
Background As the coronavirus disease 2019 (COVID-19) pandemic continues to sweep the world with unprecedented speed and devastation, data has shown that cases in the pediatric population have been significantly lower than in the adult population. We conducted a systematic review of case reports to identify the contributing factors of confirmed pediatric COVID-19 patients. Methods Using the PubMed platform, and Cochrane Central, we searched for primary studies alone. All database searches were performed between December 2019 and December 2020. We incorporated keywords including “pediatrics,” “Case reports,” “Cases,” “Covid-19″ into all searches. Results A total of 92 records were included in this novel review. Of all patients, 58% were male and the mean age of the patients was 6.2 years (SD: 5.9). Contributing factors to MIS-C infections were G6PD deficiency (17.6%), Group A streptococcus co-infection (17.6%), infancy (11.8%), whereas those in COVID-19 pediatric patients included congenital (18.5%), and genetic defects (13.8%), in addition to vertical transmission or during infancy (16.9%). Data of baseline demographic characteristics and clinical sequelae of included COVID-19 pediatric and MIS-C patients is presented. Conclusion With schools reopening and closing, the pediatric age group is susceptible to high rates of COVID-19 community transmission. We provide insights into potential contributing factors to pediatric COVID-19 and MIS-C patients. These insights are critical to guide future guidelines on the management and potential vaccination efforts. COVID-19 continues to devastate communities worldwide. The pediatric population has faced the ups and downs of the many variants of disease. This systematic review includes a total of 92 studies and identifies key contributing factors from developmental, maternal and pediatric. We provide insights into potential contributing factors to pediatric COVID-19 and MIS-C patients. These insights are critical to guide future guidelines on the management and potential vaccination efforts.
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Dandachi I, Aljabr W. Prognosis of COVID-19 in the middle eastern population, knowns and unknowns. Front Microbiol 2022; 13:974205. [PMID: 36118201 PMCID: PMC9471247 DOI: 10.3389/fmicb.2022.974205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 08/09/2022] [Indexed: 01/08/2023] Open
Abstract
Since its emergence in China in 2019, the SARS-CoV-2 virus has affected all countries worldwide. The virus is easily transmitted from one person to another via infected aerosols or contaminated surfaces. Unlike its counterparts, the prognosis of COVID-19 ranges from asymptomatic to critical disease or death. Several factors play a role in determining the severity of the disease in infected patients. Among others, is the pre-existence of an underlying medical condition such as diabetes, cancer, and others. Furthermore, although children are less prone to the severe form of the COVID-19 disease, they require attention due to the report of many atypical presentations of the infection, post-asymptomatic exposure. In the Middle East, little is known about the prognosis of the SARS-CoV-2 infection in high-risk categories, notably patients with diabetes, cancer, and pregnant women. The aim of this review is to summarize the current knowledge about this group of population in the middle eastern region as well as to highlight the gap in the literature. We have found that the majority of the papers were from the Gulf countries. Although, few studies were conducted; high-risk patients appear to have an increased risk of morbidity and mortality from COVID-19 compared to their counterparts. Higher levels of inflammatory markers, C-reactive protein, erythrocyte sedimentation rate, D-dimer, and ferritin levels were also observed. Children are often asymptomatic or present with atypical presentations. More studies should be conducted to determine the clinical biomarkers of COVID-19 in high-risk categories to help in patient risk stratification and management in the middle eastern population.
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Karun A, Kaur RJ, Charan J, Murti K, Ramesh M, Ravichandiran V, Dhingra S. Impact of COVID-19 on Antimicrobial Resistance in Paediatric Population: a Narrative Review. CURRENT PHARMACOLOGY REPORTS 2022; 8:365-375. [PMID: 35789932 PMCID: PMC9244284 DOI: 10.1007/s40495-022-00298-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 06/15/2022] [Indexed: 01/08/2023]
Abstract
Purpose of Review Irrational use of antimicrobials has been reported in paediatric population during the COVID-19 time period. This may lead to potential development of antimicrobial resistance and increased morbidity and mortality among this vulnerable population. The purpose of this review is to ascertain the impact of COVID-19 pandemic on antimicrobial resistance among paediatrics and the possible strategies to minimize the menace of antimicrobial resistance. Recent Findings Recent findings indicate that the COVID-19 pandemic has direct as well as indirect impact on the development of antimicrobial resistance among paediatric population. Summary This review article shows the impact of COVID-19 on the development of antimicrobial resistance and strategies to prevent it with special reference to antimicrobial stewardship programmes among paediatric population.
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Bastoni D, Borio G, Rienzo P, Magnacavallo A, Vercelli A, Poggiali E. COVID-19 and cutaneous manifestations: Two cases and a review of the literature. EMERGENCY CARE JOURNAL 2022. [DOI: 10.4081/ecj.2022.10468] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
COVID-19 can affect multiple organs, including skin. A wide range of skin manifestations have been reported in literature. Six main phenotypes have been identified: i) urticarial rash, ii) confluent erythematous/maculopapular/morbilliform rash, iii) papulovesicular exanthem, iv) a chilblain-like acral pattern, v) a livedo reticularis/racemosa-like pattern, and vi) a purpuric vasculitic pattern. The pathogenetic mechanism is still not completely clear, but a role of hyperactive immune response, complement activation and microvascular injury have been postulated. The only correlation between the cutaneous phenotype and the severity of COVID-19 has been observed in the case of chilblain-like acral lesions, that is generally associated with the benign/subclinical course of COVID-19. Herein, we report two cases of SARS-CoV- 2 infection in patients who developed cutaneous manifestations that completely solved with systemic steroids and antihistamines. The first case is a female patient not vaccinated for SARS-CoV-2 with COVID-19 associated pneumonia, while the second case is a vaccinated female patient with only skin manifestations.
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de Moraes FM, de Souza JWPS, Alves LP, de Siqueira MFR, dos Santos APA, de Carvalho Berardo MM, Granja MG, de Castro-Faria-Neto HC. SARS-CoV-2 Infection and Possible Neonatal Neurological Outcomes: A Literature Review. Viruses 2022; 14:1037. [PMID: 35632778 PMCID: PMC9143946 DOI: 10.3390/v14051037] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 05/10/2022] [Accepted: 05/12/2022] [Indexed: 11/16/2022] Open
Abstract
The virus responsible for COVID-19 is designated "severe acute respiratory syndrome coronavirus 2" (SARS-CoV-2), a highly transmissible and pathogenic coronavirus. Although people of all ages are susceptible to SARS-CoV-2 infection, clinical manifestations may vary with age. The response of neonates to SARS-CoV-2 infection or exposure differs from that of children and adults. Encephalitis due to viral infections in the central nervous system (CNS) and childhood multisystem inflammatory syndrome (MIS-C) are some of the possible neonatal consequences of SARS-CoV-2 infection. This review aims to verify possible neonatal neurological outcomes after SARS-CoV-2 infection. Overall, the cellular and molecular basis of the neurological sequelae of SARS-CoV-2 in neonates remains unclear, and attempts to elucidate the pathophysiology of COVID-19 involve a comparison with the mechanism of other viral diseases. There are a considerable number of case reports in the literature exploring neurological outcomes in the neonatal period. In this review, we present possible effects of SARS-CoV-2 in neonates, emphasizing the importance of monitoring this group. The mechanisms of SARS-CoV-2 entry into the CNS have not yet been fully elucidated, and the potential severity of SARS-CoV-2 infection in neonates, as well as the possible short- and long-term neurological sequelae, remain unclear.
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Affiliation(s)
- Flávia Maciel de Moraes
- Programa de Pós-Graduação em Biologia Molecular e Celular, Universidade Federal do Estado do Rio de Janeiro—UNIRIO, Rua Frei Caneca, 94-Centro, Rio de Janeiro 20211-010, Brazil; (F.M.d.M.); (L.P.A.)
| | - Julia Werneck Paulino Soares de Souza
- Instituto de Educação Médica—IDOMED, Escola de Medicina, Universidade Estácio de Sá, Avenida Presidente Vargas, 1121-Centro, Rio de Janeiro 20071-004, Brazil; (J.W.P.S.d.S.); (M.M.d.C.B.)
| | - Letícia Pires Alves
- Programa de Pós-Graduação em Biologia Molecular e Celular, Universidade Federal do Estado do Rio de Janeiro—UNIRIO, Rua Frei Caneca, 94-Centro, Rio de Janeiro 20211-010, Brazil; (F.M.d.M.); (L.P.A.)
| | - Milena Ferreira Ribeiro de Siqueira
- Faculdade de Biomedicina, Instituto Biomédico, Universidade Federal Fluminense, Rua Ernani Melo, 101-São Domingos, Niterói 24210-130, Brazil;
| | - Ana Paula Aguiar dos Santos
- Escola de Medicina, Fundação Técnico-Educacional Souza Marques, Avenida Ernani Cardoso, 335-Cascadura, Rio de Janeiro 20020-080, Brazil;
| | - Mariana Monteiro de Carvalho Berardo
- Instituto de Educação Médica—IDOMED, Escola de Medicina, Universidade Estácio de Sá, Avenida Presidente Vargas, 1121-Centro, Rio de Janeiro 20071-004, Brazil; (J.W.P.S.d.S.); (M.M.d.C.B.)
| | - Marcelo Gomes Granja
- Laboratório de Imunofarmacologia, Fundação Oswaldo Cruz-Fiocruz, Avenida Brasil, 4365-Manguinhos, Rio de Janeiro 21045-900, Brazil;
| | - Hugo Caire de Castro-Faria-Neto
- Laboratório de Imunofarmacologia, Fundação Oswaldo Cruz-Fiocruz, Avenida Brasil, 4365-Manguinhos, Rio de Janeiro 21045-900, Brazil;
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COVID-19 in Neonates with Positive RT–PCR Test. Systematic Review. Arch Med Res 2022; 53:252-262. [PMID: 35321802 PMCID: PMC8919773 DOI: 10.1016/j.arcmed.2022.03.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 02/18/2022] [Accepted: 03/04/2022] [Indexed: 12/24/2022]
Abstract
Background Objective Methods Results Conclusion
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Banerjee M, Pal J, Mondal T, Ghosh T, Nayek K. Clinical Profile and Short-Term Outcome of SARS-CoV-2-Infected Neonates from a Government Medical College in West Bengal, India. J Trop Pediatr 2022; 68:6511771. [PMID: 35045183 PMCID: PMC8822412 DOI: 10.1093/tropej/fmac002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) has led to a terrifying global pandemic. The presentations in neonates are varied with less case severity compared to adults. AIM To describe the clinical and laboratory features and outcomes of neonates admitted with SARS-CoV-2 infection during the second surge of COVID-19 pandemic in a Government Medical College, West Bengal, India. MATERIALS AND METHODS It is a hospital-based observational cross-sectional study conducted in the newborn unit of Burdwan Medical College and Hospital between 1 April 2021 and 31 July 2021 including all SARS-CoV-2 Real time RT-PCR (Reverse transcriptase polymerase chain reaction) positive neonates. The demographic, clinical and laboratory characteristics of all the neonates and their outcomes were documented and analysed. RESULTS Twenty-two neonates were found to be SARS-CoV-2 RT-PCR positive out of which 9 (40.9%) were found to be asymptomatic and 6 (27.27%) required neonatal intensive care unit admissions. Among the symptomatic neonates, most common presentations were respiratory distress (40.9%) and gastrointestinal manifestations (40.9%). Eight (36.36%) neonates required respiratory support. Three (13.6%) neonates had pneumonia of which one had right middle lobe collapse. Laboratory parameters were nonspecific except for the two (9%) cases of multisystem inflammatory syndrome in neonates. High-resolution computed tomography findings in two cases were suggestive of SARS-CoV-2 infection-induced changes. Two (9%) neonates died of which one was likely due to SARS-CoV-2 infection. CONCLUSION Neonates with SARS-CoV-2 infection are mostly asymptomatic. However, clinicians must be vigilant as atypical presentations such as consolidation, collapse, meningitis or multisystem inflammatory syndrome may occur.
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Affiliation(s)
- Mukut Banerjee
- Department of Pediatric Medicine, Burdwan Medical College and Hospital, Bardhaman, West Bengal 713104, India
| | - Jonaki Pal
- Department of Pediatric Medicine, Burdwan Medical College and Hospital, Bardhaman, West Bengal 713104, India,Correspondence: Jonaki Pal, Department of Pediatric Medicine, Burdwan Medical College and Hospital, Bardhaman, West Bengal 713104, India. Tel: +91 8017750670. E-mail <>
| | - Tanushree Mondal
- Department of Community Medicine, Medical College Kolkata, Kolkata, West Bengal 700073, India
| | - Taraknath Ghosh
- Department of Pediatric Medicine, Burdwan Medical College and Hospital, Bardhaman, West Bengal 713104, India
| | - Kaustav Nayek
- Department of Pediatric Medicine, Burdwan Medical College and Hospital, Bardhaman, West Bengal 713104, India
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An observational study for appraisal of clinical outcome and risk of mother-to-child SARS-CoV-2 transmission in neonates provided the benefits of mothers' own milk. Eur J Pediatr 2022; 181:513-527. [PMID: 34379196 PMCID: PMC8355567 DOI: 10.1007/s00431-021-04206-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 07/06/2021] [Accepted: 07/09/2021] [Indexed: 10/25/2022]
Abstract
This observational study done during April-December 2020 at a tertiary-care hospital in Haryana (India) enrolled 152 SARS-CoV-2-exposed neonates. Among them, 150 neonates had perinatal SARS-CoV-2 exposure and 2 neonates had late postnatal exposure. Stable infant-mother dyads were roomed-in with precautions to support breastfeeding. Nasopharyngeal swabs collected from neonates were tested for SARS-CoV-2 by reverse transcriptase-polymerase chain reaction (RT-PCR) test. There was a high incidence of prematurity (23%), low birth weight (31%), intrauterine fetal distress (16%), perinatal asphyxia (6%), admission to neonatal intensive care unit (24%), and mortality (1.3%) among neonates with perinatal SARS-CoV-2 exposure. In this sub-group, 20 neonates tested positive for SARS-CoV-2 in nasopharyngeal swab sample(s). A recent official publication by the World Health Organization emphasizes that the perinatal SARS-CoV-2-exposed neonates found RT-PCR positive once in upper respiratory (non-sterile) sample must document viral persistence in another non-sterile sample for confirmation of mother-to-child virus transmission. With this approach, only one neonate was confirmed intrapartum transmission. A telephonic follow-up in discharged neonates at 1 month of age or 1 month postexposure recorded them all to be asymptomatic and doing well.Conclusion: Neonates with perinatal SARS-CoV-2 exposure constitute a high-risk group and it is not uncommon to get a positive RT-PCR report in upper respiratory sample(s) from these babies. Majority of them do not demonstrate viral persistence. Clinical outcomes are favorable in breastfed infants roomed-in with their asymptomatic-mild symptomatic SARS-CoV-2-infected mothers following appropriate safety protocols. What is Known: •Neonates with perinatal exposure suffer a high burden of morbidities and mortality. •Still, an uncertainty exists about rooming-in and breastfeeding among neonates born to SARS-CoV-2 positive mothers. What is New: •With the policy of mother-infant rooming-in and supporting breastfeeding, none of the neonate suffered clinical illness compatible with postnatal SARS-CoV-2 transmission and infection. •Around 13% perinatal exposed neonates demonstrated SARS-CoV-2 RNA in nasopharyngeal swab samples but the majority of them did not demonstrate viral persistence.
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15
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Jenabi E, Eghbalian F, Bashirian S, Khazaei S, Shokouhi M, Basiri B, Sabzehei M, Sheikhahmadi S, Babaei H, Vakiliamini M, Jafari N, Jafari M. The clinical manifestations and outcomes in neonates infected with COVID-19 in the West of Iran. ADVANCES IN HUMAN BIOLOGY 2022. [DOI: 10.4103/aihb.aihb_4_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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16
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Hussein Alsharbaty MH, Shirazi M, Mohammed N, Akbari F. Lessons Learned from the COVID-19 Pandemic in Implant Dentistry Settings. DENTAL HYPOTHESES 2022. [DOI: 10.4103/denthyp.denthyp_119_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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17
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Al-Hadidi SH, Alhussain H, Abdel Hadi H, Johar A, Yassine HM, Al Thani AA, Eltai NO. The Spectrum of Antibiotic Prescribing During COVID-19 Pandemic: A Systematic Literature Review. Microb Drug Resist 2021; 27:1705-1725. [PMID: 34077290 PMCID: PMC8713256 DOI: 10.1089/mdr.2020.0619] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Objectives: Over the last decades, there has been a significant increase in antimicrobial prescribing and consumption associated with the development of patients' adverse events and antimicrobial resistance (AMR) to the point of becoming a global priority. This study aims at evaluating antibiotic prescribing during COVID-19 pandemic from November 2019 to December 2020. Materials and Methods: A systematic review was conducted primarily through the NCBI database, using PRISMA guidelines to identify relevant literature for the period between November 1, 2019 and December 19, 2020, using the keywords: COVID-19 OR SARS-Cov-2 AND antibiotics restricted to the English language excluding nonclinical articles. Five hundred twenty-seven titles were identified; all articles fulfilling the study criteria were included, 133 through the NCBI, and 8 through Google Scholar with a combined total of 141 studies. The patient's spectrum included all ages from neonates to elderly with all associated comorbidities, including immune suppression. Results: Of 28,093 patients included in the combined studies, 58.7% received antibiotics (16,490/28,093), ranging from 1.3% to 100% coverage. Antibiotics coverage was less in children (57%) than in adults with comorbidities (75%). Broad-spectrum antibiotics were prescribed presumptively without pathogen identifications, which might contribute to adverse outcomes. Conclusions: During the COVID-19 pandemic, there has been a significant and wide range of antibiotic prescribing in patients affected by the disease, particularly in adults with underlying comorbidities, despite the paucity of evidence of associated bacterial infections. The current practice might increase patients' immediate and long-term risks of adverse events, susceptibility to secondary infections as well as aggravating AMR.
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Affiliation(s)
| | | | - Hamad Abdel Hadi
- Infectious Disease Division, Communicable Diseases Centre, Hamad Medical Corporation, Doha, Qatar
| | | | | | | | - Nahla O. Eltai
- Biomedical Research Center, Qatar University, Doha, Qatar
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18
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Doctor PN, Kamat D, Sood BG. Changes in Clinical Care of the Newborn During COVID-19 Pandemic: From the Womb to First Newborn Visit. Pediatr Clin North Am 2021; 68:1055-1070. [PMID: 34538298 PMCID: PMC8133491 DOI: 10.1016/j.pcl.2021.05.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
COVID-19 has afflicted the health of children and women across all age groups. Since the outbreak of the pandemic in December 2019, various epidemiologic, immunologic, clinical, and pharmaceutical studies have been conducted to understand its infectious characteristics, pathogenesis, and clinical profile. COVID-19 affects pregnant women more seriously than nonpregnant women, endangering the health of the newborn. Changes have been implemented to guidelines for antenatal care of pregnant women, delivery, and newborn care. We highlight the current trends of clinical care in pregnant women and newborns during the COVID-19 pandemic.
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Affiliation(s)
- Pezad N. Doctor
- Department of Pediatrics, Children’s Hospital of Michigan, 3901, Beaubien Boulevard, Detroit, MI 48201, USA,Corresponding author. Office of Pediatric education, 3901 Beaubien, Detroit, MI 48201
| | - Deepak Kamat
- Department of Pediatrics, UT Health Science Center, UT Health San Antonio, San Antonio, TX 78229, USA
| | - Beena G. Sood
- Department of Pediatrics, Wayne State University School of Medicine, 540E Canfield Street, Detroit, Michigan 48201, USA
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19
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Mohseni Afshar Z, Babazadeh A, Hasanpour A, Barary M, Sayad B, Janbakhsh A, Aryanian Z, Ebrahimpour S. Dermatological manifestations associated with COVID-19: A comprehensive review of the current knowledge. J Med Virol 2021; 93:5756-5767. [PMID: 34241899 PMCID: PMC8427109 DOI: 10.1002/jmv.27187] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 07/06/2021] [Indexed: 02/06/2023]
Abstract
Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has become a significant health problem globally. The virus has spread widely and become a global pandemic. The pathophysiology for SARS-CoV-2 has not been explained clearly. It has been associated with several multiorgan symptoms, among which its dermatological manifestations are of great interest. Primarily, there has been no report of skin features among COVID-19 patients. Nevertheless, recently there have been several reports regarding COVID-19 patients who presented with cutaneous manifestations. In the current review, we focus on the various cutaneous manifestations of COVID-19 infection.
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Affiliation(s)
- Zeinab Mohseni Afshar
- Clinical Research Development Center, Imam Reza HospitalKermanshah University of Medical SciencesKermanshahIran
| | - Arefeh Babazadeh
- Infectious Diseases and Tropical Medicine Research Center, Health Research InstituteBabol University of Medical SciencesBabolIran
| | | | - Mohammad Barary
- Student Research CommitteeBabol University of Medical SciencesBabolIran
| | - Babak Sayad
- Clinical Research Development Center, Imam Reza HospitalKermanshah University of Medical SciencesKermanshahIran
| | - Alireza Janbakhsh
- Clinical Research Development Center, Imam Reza HospitalKermanshah University of Medical SciencesKermanshahIran
| | - Zeinab Aryanian
- Autoimmune Bullous Diseases Research CenterTehran University of Medical SciencesTehranIran
- Department of Dermatology, School of MedicineBabol University of Medical SciencesBabolIran
| | - Soheil Ebrahimpour
- Infectious Diseases and Tropical Medicine Research Center, Health Research InstituteBabol University of Medical SciencesBabolIran
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20
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Sadeghzadeh‐Bazargan A, Rezai M, Najar Nobari N, Mozafarpoor S, Goodarzi A. Skin manifestations as potential symptoms of diffuse vascular injury in critical COVID-19 patients. J Cutan Pathol 2021; 48:1266-1276. [PMID: 33978234 PMCID: PMC8239514 DOI: 10.1111/cup.14059] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 05/03/2021] [Accepted: 05/06/2021] [Indexed: 01/08/2023]
Abstract
As a respiratory viral infection caused by a novel coronavirus, COVID-19 became rapidly pandemic within a few months. Despite the wide range of manifestations and organ involvement in COVID-19 patients, the exact pathogenesis of severe and fatal types of COVID-19 and causes involved with the individual base of the disease is not yet understood. Several studies have reported clinical, laboratory, and histopathological data in favor of vascular injury in multiple organs of critically ill patients with COVID-19 as a result of hyperactive immune response, inflammation, and cytokine storm. Also, both clinical and histopathological evidence points to such vascular involvements in the skin. Given the ease of clinical examinations and skin biopsy and the lower risks of transmission of COVID-19 to healthcare workers, the present review article was conducted to investigate the vascular skin manifestations of COVID-19 patients clinically and/or histopathologically as helpful clues for better understanding the pathogenesis and predicting the prognosis of the disease, especially in severe cases.
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Affiliation(s)
| | - Mahdi Rezai
- Department of Emergency Medicine Management Research Center, Rasool Akram Medical ComplexIran University of Medical Sciences (IUMS)TehranIran
| | - Niloufar Najar Nobari
- Department of Dermatology, Rasool Akram Medical ComplexIran University of Medical Sciences (IUMS)TehranIran
| | - Samaneh Mozafarpoor
- Dermatologist, Skin Disease and Leishmaniasis Research Center, Department of DermatologyIsfahan University of Medical SciencesIsfahanIran
| | - Azadeh Goodarzi
- Department of Dermatology, Rasool Akram Medical ComplexIran University of Medical Sciences (IUMS)TehranIran
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21
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Abstract
Coronavirus disease 2019 (COVID-19), an emergent disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has rapidly spread throughout the globe since its discovery in December 2019. Although first appreciated to cause pneumonia, numerous organ systems are now known to be involved. The objective of this article is to review the broad spectrum of cutaneous manifestations reported in association with SARS-CoV-2 infection. The most commonly reported cutaneous manifestations associated with COVID-19 infection include pernio (chilblain)-like acral lesions, morbilliform (exanthematous) rash, urticaria, vesicular (varicella-like) eruptions, and vaso-occlusive lesions (livedo racemosa, retiform purpura). It is important to consider SARS-CoV-2 infection in the differential diagnosis of a patient presenting with these lesions in the appropriate clinical context, as cutaneous manifestations may be present in otherwise asymptomatic individuals, or present before developing other symptoms of infection. With increased access to diagnostic testing, we are beginning to understand the utility and limitations of currently available assays.
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Affiliation(s)
- Ritesh Agnihothri
- Department of Dermatology, University of California San Francisco, 1701 Divisadero Street, 3rd Floor, San Francisco, CA 94115, USA
| | - Lindy P Fox
- Department of Dermatology, University of California San Francisco, 1701 Divisadero Street, 3rd Floor, San Francisco, CA 94115, USA.
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22
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Neale H, Hawryluk EB. COVID-19 Pediatric Dermatology. Dermatol Clin 2021; 39:505-519. [PMID: 34556241 PMCID: PMC8165089 DOI: 10.1016/j.det.2021.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Holly Neale
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA; University of Massachusetts Medical School, Worcester, MA, USA
| | - Elena B Hawryluk
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Boston Children's Hospital, Boston, MA, USA.
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23
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Polemis M, Mandilara G, Pappa O, Argyropoulou A, Perivolioti E, Koudoumnakis N, Pournaras S, Vasilakopoulou A, Vourli S, Katsifa H, Karampatakis T, Papavasiliou A, Petinaki E, Xitsas S, Skoura L, Protonotariou E, Mantzana P, Gartzonika K, Priavali E, Kallinteri A, Giannopoulou P, Charalampaki N, Memezas M, Calina Oana Z, Papadogianni M, Panopoulou M, Koutsidou A, Vatopoulos A, Tryfinopoulou K. COVID-19 and Antimicrobial Resistance: Data from the Greek Electronic System for the Surveillance of Antimicrobial Resistance-WHONET-Greece (January 2018-March 2021). Life (Basel) 2021; 11:996. [PMID: 34685368 PMCID: PMC8538738 DOI: 10.3390/life11100996] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/31/2021] [Accepted: 09/08/2021] [Indexed: 12/15/2022] Open
Abstract
Changes in hospitals' daily practice due to COVID-19 pandemic may have an impact on antimicrobial resistance (AMR). We aimed to assess this possible impact as captured by the Greek Electronic System for the Surveillance of Antimicrobial Resistance (WHONET-Greece). Routine susceptibility data of 17,837 Gram-negative and Gram-positive bacterial isolates from blood and respiratory specimens of hospitalized patients in nine COVID-19 tertiary hospitals were used in order to identify potential differences in AMR trends in the last three years, divided into two periods, January 2018-March 2020 and April 2020-March 2021. Interrupted time-series analysis was used to evaluate differences in the trends of non-susceptibility before and after the changes due to COVID-19. We found significant differences in the slope of non-susceptibility trends of Acinetobacter baumannii blood and respiratory isolates to amikacin, tigecycline and colistin; of Klebsiella pneumoniae blood and respiratory isolates to meropenem and tigecycline; and of Pseudomonas aeruginosa respiratory isolates to imipenem, meropenem and levofloxacin. Additionally, we found significant differences in the slope of non-susceptibility trends of Staphylococcus aureus isolates to oxacillin and of Enterococcus faecium isolates to glycopeptides. Assessing in this early stage, through surveillance of routine laboratory data, the way a new global threat like COVID-19 could affect an already ongoing pandemic like AMR provides useful information for prompt action.
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Affiliation(s)
- Michalis Polemis
- Central Public Health Laboratory, National Public Health Organization, 16672 Vari, Greece; (O.P.); (K.T.)
| | - Georgia Mandilara
- School of Public Health, University of West Attica, 11521 Athens, Greece; (G.M.); (A.V.)
| | - Olga Pappa
- Central Public Health Laboratory, National Public Health Organization, 16672 Vari, Greece; (O.P.); (K.T.)
| | - Athina Argyropoulou
- “Evaggelismos” General Hospital, 10676 Athens, Greece; (A.A.); (E.P.); (N.K.)
| | | | | | - Spyros Pournaras
- “Attikon” University Hospital, 12462 Athens, Greece; (S.P.); (A.V.); (S.V.)
| | | | - Sophia Vourli
- “Attikon” University Hospital, 12462 Athens, Greece; (S.P.); (A.V.); (S.V.)
| | - Helen Katsifa
- General Hospital “George Papanikolaou”, 57010 Thessaloniki, Greece; (H.K.); (T.K.); (A.P.)
| | - Theodoros Karampatakis
- General Hospital “George Papanikolaou”, 57010 Thessaloniki, Greece; (H.K.); (T.K.); (A.P.)
| | - Anastasia Papavasiliou
- General Hospital “George Papanikolaou”, 57010 Thessaloniki, Greece; (H.K.); (T.K.); (A.P.)
| | - Efthymia Petinaki
- University Hospital of Larissa, 41110 Larissa, Greece; (E.P.); (S.X.)
| | - Stylianos Xitsas
- University Hospital of Larissa, 41110 Larissa, Greece; (E.P.); (S.X.)
| | - Lemonia Skoura
- “Axepa” University Hospital, 54636 Thessaloniki, Greece; (L.S.); (E.P.); (P.M.)
| | | | - Paraskevi Mantzana
- “Axepa” University Hospital, 54636 Thessaloniki, Greece; (L.S.); (E.P.); (P.M.)
| | | | - Efthalia Priavali
- University Hospital of Ioannina, 45500 Ioannina, Greece; (K.G.); (E.P.); (A.K.)
| | - Amalia Kallinteri
- University Hospital of Ioannina, 45500 Ioannina, Greece; (K.G.); (E.P.); (A.K.)
| | | | | | - Meletis Memezas
- “Thriasio” General Hospital of Elefsina, 19600 Athens, Greece; (P.G.); (N.C.); (M.M.)
| | - Zervaki Calina Oana
- “St. George” General Hospital, 73300 Crete (Chania), Greece; (Z.C.O.); (M.P.)
| | - Marina Papadogianni
- “St. George” General Hospital, 73300 Crete (Chania), Greece; (Z.C.O.); (M.P.)
| | - Maria Panopoulou
- University Hospital of Alexandroupolis, 68100 Alexandroupoli, Greece; (M.P.); (A.K.)
| | - Athanasia Koutsidou
- University Hospital of Alexandroupolis, 68100 Alexandroupoli, Greece; (M.P.); (A.K.)
| | - Alkiviadis Vatopoulos
- School of Public Health, University of West Attica, 11521 Athens, Greece; (G.M.); (A.V.)
| | - Kyriaki Tryfinopoulou
- Central Public Health Laboratory, National Public Health Organization, 16672 Vari, Greece; (O.P.); (K.T.)
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24
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Martins LA, Santos DVD, Marques PF, Silva EAL, Castro CTD, Santos DBD, Camargo CLD. Clinical overview for pediatric population with SARS-CoV-2 and care: review. ACTA ACUST UNITED AC 2021; 42:e20200162. [PMID: 34524352 DOI: 10.1590/1983-1447.2021.20200162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 02/26/2021] [Indexed: 08/30/2023]
Abstract
OBJECTIVE To identify in the scientific literature the clinical overview of the pediatric population that tested positive for SARS-CoV-2 and care recommendations and recommendations among children who tested positive for SARS-CoV-2 in the scientific literature. METHOD Rapid review based on the guidelines of the Joana Briggs Institute: elaboration of the research question, structured search of the literature in April 2020, in nine databases, selection and critical analysis of the eighteen primary studies (using two instruments to assess methodological quality), elaboration of the synthesis, incorporation of suggestions and dissemination. RESULT The most frequent clinical overview was respiratory, gastrointestinal symptoms and fever. The images showed irregular frosted glass opacification. It is recommended to screen the pediatric population and family members who show signs and symptoms and to adopt isolation for more than fourteen days. CONCLUSION The clinical overview in pediatric population is varied, not exclusively with respiratory symptoms, and a significant number of asymptomatic patients. The importance of new investigations is highlighted, such as randomized clinical trial or cohort studies, identifying their participation in the transmission of COVID-19.
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Affiliation(s)
- Lucas Amaral Martins
- Universidade Federal do Recôncavo da Bahia (UFRB), Centro de Ciências da Saúde, Colegiado de Enfermagem. Santo Antônio de Jesus, Bahia, Brasil.,Universidade Federal da Bahia (UFBA), Escola de Enfermagem, Programa de Pós-Graduação. Salvador, Bahia, Brasil
| | - Deisy Vital Dos Santos
- Universidade Federal do Recôncavo da Bahia (UFRB), Centro de Ciências da Saúde, Colegiado de Enfermagem. Santo Antônio de Jesus, Bahia, Brasil
| | - Patrícia Figueiredo Marques
- Universidade Federal do Recôncavo da Bahia (UFRB), Centro de Ciências da Saúde, Colegiado de Enfermagem. Santo Antônio de Jesus, Bahia, Brasil
| | - Elaine Andrade Leal Silva
- Universidade Federal do Recôncavo da Bahia (UFRB), Centro de Ciências da Saúde, Colegiado de Enfermagem. Santo Antônio de Jesus, Bahia, Brasil.,Universidade Federal da Bahia (UFBA), Escola de Enfermagem, Programa de Pós-Graduação. Salvador, Bahia, Brasil
| | - Caroline Tianeze de Castro
- Universidade Federal da Bahia (UFBA), Instituto Multidisciplinar em Saúde. Vitória da Conquista, Bahia, Brasil
| | - Djanilson Barbosa Dos Santos
- Universidade Federal da Bahia (UFBA), Instituto Multidisciplinar em Saúde. Vitória da Conquista, Bahia, Brasil.,Universidade Federal do Recôncavo da Bahia (UFRB), Centro de Ciências da Saúde, Colegiado do Bacharelado Interdisciplinar em Saúde. Santo Antônio de Jesus, Bahia, Brasil
| | - Climene Laura de Camargo
- Universidade Federal da Bahia (UFBA), Instituto Multidisciplinar em Saúde. Vitória da Conquista, Bahia, Brasil
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25
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Cakir U, Demirel MA, Kanik Yuksek S, Tugcu AU, Tufan N, Tayman C. Case Report of Severe COVID-19 Pneumonia in a Term Newborn. J Trop Pediatr 2021; 67:6362433. [PMID: 34471924 PMCID: PMC8499898 DOI: 10.1093/tropej/fmab023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Coronavirus disease (COVID-19) has been shown to affect all age groups. The data in the literature usually admit a milder form of disease in infants and newborns than adults. COVID-19 is rarely seen in newborns and an urgent diagnosis should be made in any suspicious situation. A 6-day-old female newborn was admitted to our hospital with fever and dyspnea without cough. A rapid reverse-transcription polymerase chain reaction COVID-19 showed a positive result. Chest computed tomography revealed bilateral and widespread pulmonary involvement. After support therapy, the newborn was successfully discharged. We should carefully consider the new type of coronavirus as an agent for pneumonia in newborns with fever and dyspnea together with non-symptomatic family history. Our case was one of the interesting reported cases of severe pneumonia presenting in the perinatal period.
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Affiliation(s)
- Ufuk Cakir
- Division of Neonatology, Department of Pediatrics, Health Sciences University, Ankara City Hospital, Ankara, Turkey,Correspondence: Ufuk Cakir, Division of Neonatology, Department of Pediatrics, Health Sciences University, Ankara Bilkent City Hospital, 9. Cankaya, Ankara, 06800, Turkey. Tel: +90 505 8581781. Fax: +90 312 306 52 71. E-mail: <>
| | - Merve Akin Demirel
- Department of Pediatrics, Health Sciences University, Ankara City Hospital, Ankara, Turkey
| | - Saliha Kanik Yuksek
- Department of Pediatric Infectious Diseases, Health Sciences University, Ankara City Hospital, Ankara, Turkey
| | - Ali Ulas Tugcu
- Division of Neonatology, Department of Pediatrics, Health Sciences University, Ankara City Hospital, Ankara, Turkey
| | - Nihan Tufan
- Division of Neonatology, Department of Pediatrics, Health Sciences University, Ankara City Hospital, Ankara, Turkey
| | - Cuneyt Tayman
- Division of Neonatology, Department of Pediatrics, Health Sciences University, Ankara City Hospital, Ankara, Turkey
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26
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Gonçalves LF, Cipriano GDS, Paiva KM, Gonzales AI, Haas P. Effectiveness of early therapeutic intervention in phases one and two after COVID-19 infection: systematic review. ACTA ACUST UNITED AC 2021; 67:302-312. [PMID: 34406258 DOI: 10.1590/1806-9282.67.02.20200594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 12/10/2020] [Indexed: 02/08/2023]
Abstract
OBJECTIVES Although research in relation to new vaccines for the coronavirus, SARS-CoV-2 (COVID-19), is ongoing, it has been reported that medical teams are also considering the use of antiviral drugs in patients in order to verify their effectiveness when infection signs and symptoms present, mainly in stages one and two of the disease. METHODS For the selection of studies, the combination based on the Medical Subject Heading Terms (MeSH) was used, and the databases Medline (Pubmed), LILACS, SciELO, SCOPUS, Web of Science, and BIREME were searched. The search period for articles consisted of manuscripts published between January 2010 and July 2020 without language and localization restrictions. RESULTS Initially, 20 articles were selected and then reduced to 19 after exclusion based on repetititve articles. Titles and abstracts were analyzed, and 14 articles were excluded because they did not meet the inclusion criteria and did not answer the guiding question. Studies show that patients receiving certain medications in the initial stages (one and two) indicate a reversal of complications during hospitalization or often do not require hospitalization in addition to being discharged in a shorter period of time. CONCLUSION Studies have reported that effective drugs for treating COVID-19 exist. In addition, this study emphasizes the importance of performing therapeutic interventions in the initial stages of infection aimed at reversing the disease and minimizing public health costs.
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Affiliation(s)
- Laura Faustino Gonçalves
- Universidade Federal de Santa Catarina, Faculdade de Fonoaudiologia - Florianópolis (SC), Brazil
| | | | - Karina Mary Paiva
- Universidade Federal de Santa Catarina, Faculdade de Fonoaudiologia - Florianópolis (SC), Brazil
| | - Ana Inês Gonzales
- Universidade do Estado de Santa Catarina, Centro de Ciências da Saúde e do Esporte - Florianópolis (SC), Brazil
| | - Patrícia Haas
- Universidade Federal de Santa Catarina, Faculdade de Fonoaudiologia - Florianópolis (SC), Brazil
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27
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Abstract
OBJECTIVE The objective of this study is to systematically synthesize the currently available literature on various modes of transmission (congenital, intrapartum, and postpartum), clinical features and outcomes of SARS-CoV-2 infection in neonates. METHODS We conducted a comprehensive literature search using PubMed, EMBASE, and Web of Science until 9 June 2020. A combination of keywords and MeSH terms, such as COVID-19, coronavirus, SARS-CoV-2, 2019-nCoV, severe acute respiratory syndrome coronavirus 2, neonates, newborn, infant, pregnancy, obstetrics, vertical transmission, maternal-foetal transmission and intrauterine transmission, were used in the search strategy. We included studies reporting neonatal outcomes of SARS-CoV-2 proven pregnancies or neonatal cases diagnosed with SARS-CoV-2 infection. RESULTS Eighty-six publications (45 case series and 41 case reports) were included in this review. Forty-five case series reported 1992 pregnant women, of which 1125 (56.5%) gave birth to 1141 neonates. A total of 281 (25%) neonates were preterm, and caesarean section (66%) was the preferred mode of delivery. Forty-one case reports describe 43 mother-baby dyads of which 16 were preterm, 9 were low birth weight and 27 were born by caesarean section. Overall, 58 neonates were reported with SARS-CoV-2 infection (4 had a congenital infection), of which 29 (50%) were symptomatic (23 required ICU) with respiratory symptoms being the predominant manifestation (70%). No mortality was reported in SARS-CoV-2-positive neonates. CONCLUSION The limited low-quality evidence suggests that the risk of SARS-CoV-2 infections in neonates is extremely low. Unlike children, most COVID-positive neonates were symptomatic and required intensive care. Postpartum acquisition was the commonest mode of infection in neonates, although a few cases of congenital infection have also been reported.
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Affiliation(s)
- Shashi Kant Dhir
- Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Jogender Kumar
- Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Jitendra Meena
- Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Praveen Kumar
- Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
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Taheri L, Gheiasi SF, Taher M, Basirinezhad MH, Shaikh ZA, Dehghan Nayeri N. Clinical Features of COVID-19 in Newborns, Infants, and Children: A Systematic Review and Meta-analysis. Compr Child Adolesc Nurs 2021:1-19. [PMID: 34125643 DOI: 10.1080/24694193.2021.1930288] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 05/07/2021] [Indexed: 12/17/2022]
Abstract
Although it was thought that children were not susceptible to 2019-nCoV in the early days of the COVID-19 infection outbreak, there are currently reports of children and even one-day-old newborns being infected by the virus and hospitalized around the world. Recognizing the symptoms of the infection in children is of great value since a large number of children are asymptomatic or have mild symptoms, which may act as facilitators of the virus transmission. This review aimed to identify and summarize the existing evidence on clinical characteristics of COVID-19 in pediatric patients. A systematic search was conducted in the PubMed, Web of Science, Scopus, Google Scholar, and WHO database for eligible publications. The review proposal was registered with the PROSPERO. The quality assessment was done based on JBI Critical appraisal tools. The random-effects model was used to pool clinical features in the meta-analysis. From the identified 256 potentially relevant studies, 32 articles met the predetermined inclusion and exclusion criteria. Twenty-one studies fulfilled the criteria for this meta-analysis. Fever (58%) and cough (48%) were reported as the most common symptoms of infected children. Disease severity was mild in 51% and moderate in 39% of cases. A total of 63% of cases had respiratory and 25% of children had gastrointestinal symptoms, particularly diarrhea and nausea/vomiting. Approximately 24% of patients were asymptomatic. Results demonstrated that fever and cough were the most common symptoms of COVID-19-infected children and the majority of cases had mild-to-moderate disease severity.
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Affiliation(s)
- Leila Taheri
- Department of Pediatric and NICU, School of Nursing & Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyede Fatemeh Gheiasi
- Department of Critical Care and Management, School of Nursing & Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Taher
- Nursing Education Department of Intensive Care and Management, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hasan Basirinezhad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Nahid Dehghan Nayeri
- Management Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
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29
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Kamali Aghdam M, Bakhtiari H, Diaz DN, Eftekhari K. Neurological Manifestations of Novel Coronavirus Disease in a 2-Month-Old Infant: A Case Report. JOURNAL OF PEDIATRIC NEUROLOGY 2021. [DOI: 10.1055/s-0040-1716393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
AbstractThe main manifestations of novel coronavirus usually include fever and cough. Neurological manifestations have not been properly identified in children. A 65-day-old infant was hospitalized due to poor feeding, weakness, lethargy, and occasional cough. She suffered several seizures during her hospitalization. The brain computed tomography scan depicted a minor hemorrhage. Due to the exacerbation of her condition during hospital stay and the presence of respiratory symptoms in her parents, coronavirus disease was suspected. Reverse transcription–polymerase chain reaction (PCR) of coronavirus was positive for both: child and parents. In children with neurological manifestations such as lethargy, recurrent seizures, cerebral hemorrhage, and clinical evidence of respiratory symptoms in his/her relatives, PCR testing for coronavirus is recommended.
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Affiliation(s)
- Mojtaba Kamali Aghdam
- Pediatrics Department, Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Hassan Bakhtiari
- Pediatrics Department, Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Diana Noemi Diaz
- Pediatrics Department, Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Kambiz Eftekhari
- Department of Pediatrics, Pediatric Gastroenterology and Hepatology Research Center, Tehran University of Medical Sciences, Bahrami Children's Hospital, Tehran, Iran
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30
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Karimi Alavije M, Karbalaie Niya MH, Sadeghzadeh-Bazargan A, Nikkhah M, Faraji A, Motamed N, Safarnezhad Tameshkel F, Zamani F. Cutaneous hemorrhagic bullae in a patient with COVID-19: A case report. Med J Islam Repub Iran 2021; 35:15. [PMID: 33996666 PMCID: PMC8111639 DOI: 10.47176/mjiri.35.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Indexed: 11/09/2022] Open
Abstract
COVID-19 was first discovered in Wuhan, China, and has spread rapidly around the world. The most important manifestation of COVID-19 was ARDS-like lung injury at first, but the involvement of other organs, such as kidney, heart, liver, and skin, was gradually reported. It is important to report and share all atypical manifestations of this disease to help other physicians to gain more knowledge about this new viral disease. As mentioned, there are also studies that show different types of cutaneous involvement in these patients, but due to the lack of more detailed studies in this field, and on the other hand, the possible usefulness of skin lesions as a diagnostic or alarming sign in the COVID-19 era, in this study we report a COVID-19 patient with a large hemorrhagic blister similar to sepsis-induced skin lesion. Despite the lack of common symptoms of the disease, the lung scan of the patient was positive for COVID-19.
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Affiliation(s)
| | - Mohammad Hadi Karbalaie Niya
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran.,Department of Virology, Iran University of Medical Sciences, Tehran, Iran
| | | | - Mehdi Nikkhah
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Amirhossein Faraji
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Nima Motamed
- Department of Social Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | | | - Farhad Zamani
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
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31
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Perna A, Passiatore M, Massaro A, Terrinoni A, Bianchi L, Cilli V, D’Orio M, Proietti L, Taccardo G, De Vitis R. Skin manifestations in COVID-19 patients, state of the art. A systematic review. Int J Dermatol 2021; 60:547-553. [PMID: 33533036 PMCID: PMC8014166 DOI: 10.1111/ijd.15414] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 12/10/2020] [Accepted: 12/15/2020] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Since COVID-19 has become a pandemic, extensive literature has been produced. The commonest symptoms of COVID-19 disease are fever, cough, anosmia, and lymphocytopenia. However, other apparently less common clinical symptoms have been described, including skin lesions. We conducted a systematic review to evaluate skin involvement in COVID-19. METHODS The authors performed a systematic review of literature, in accordance with the Preferred Reporting Items for Systematic and Meta-Analysis (PRISMA). The search was reiterated until May 06, 2020. RESULTS Overall, 1593 patients (M/F ratio: 1 : 9) with suspect of COVID-19 were examined. The mean age was 37.8 (range 0-91) years. Among the analyzed patients, 84 (5.3%) were pediatrics (<18 years). Chilblains are very common among skin lesions and represent almost half of all skin lesions reported (46%); in 75% of patients with cutaneous manifestation, the latter presented before other typical clinical manifestation of COVID-19. Vasculitis or thrombosis was identified in almost 70% of patients who suffered from skin manifestations. CONCLUSION The present study highlights the importance of skin involvement in COVID-19. Limbs should be examined to eventually foresee the onset of further typical symptoms. Chilblains can be considered typical features. Studies with higher scientific evidence are required.
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Affiliation(s)
- Andrea Perna
- Istituto di Clinica OrtopedicaFondazione Policlinico Universitario A. Gemelli IRCCSRomaItalia
| | - Marco Passiatore
- Istituto di Clinica OrtopedicaFondazione Policlinico Universitario A. Gemelli IRCCSRomaItalia
| | - Antonio Massaro
- Unità Operativa di DermatologiaDipartimento di Medicina dei SistemiUniversità di Roma Tor VergataRomaItalia
| | | | - Luca Bianchi
- Unità Operativa di DermatologiaDipartimento di Medicina dei SistemiUniversità di Roma Tor VergataRomaItalia
| | - Vitale Cilli
- Chirurgie de la MainCHIREC site DeltaBruxellesBelgique
| | - Marco D’Orio
- Istituto di Clinica OrtopedicaFondazione Policlinico Universitario A. Gemelli IRCCSRomaItalia
| | - Luca Proietti
- Istituto di Clinica OrtopedicaFondazione Policlinico Universitario A. Gemelli IRCCSRomaItalia,Università Cattolica del Sacro CuoreRomaItalia
| | - Giuseppe Taccardo
- Istituto di Clinica OrtopedicaFondazione Policlinico Universitario A. Gemelli IRCCSRomaItalia,Università Cattolica del Sacro CuoreRomaItalia
| | - Rocco De Vitis
- Istituto di Clinica OrtopedicaFondazione Policlinico Universitario A. Gemelli IRCCSRomaItalia,Università Cattolica del Sacro CuoreRomaItalia
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32
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Sharma S, Raby E, Prasad Kumarasinghe S. Cutaneous manifestations and dermatological sequelae of Covid-19 infection compared to those from other viruses. Australas J Dermatol 2021; 62:141-150. [PMID: 33595840 PMCID: PMC8014733 DOI: 10.1111/ajd.13561] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 11/21/2020] [Accepted: 01/02/2021] [Indexed: 01/07/2023]
Abstract
In the last few months, there have been numerous reports describing a variety of cutaneous signs associated with COVID-19. Clinicians from Italy were the first to describe the cutaneous manifestations of COVID-19, which were later observed in other parts of the globe. In some cases, cutaneous signs were the only manifestation of COVID-19 rather than the typical syndrome of fever and upper respiratory tract symptoms. However, there is considerable heterogeneity amongst the cutaneous signs described so far, which has been published extensively. Our aim is to summarise the latest studies that have reported the early and late cutaneous signs of COVID-19 and compare them to the most common established viral exanthems.
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Affiliation(s)
- Surabhi Sharma
- Willetton Medical CentreWillettonWestern AustraliaAustralia
| | - Edward Raby
- Fiona Stanley HospitalMurdochWestern AustraliaAustralia
| | - Sujith Prasad Kumarasinghe
- Fiona Stanley HospitalMurdochWestern AustraliaAustralia,Faculty of Health and Medical SciencesSchool of MedicineUniversity of Western AustraliaPerthWestern AustraliaAustralia
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33
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Trevisanuto D, Cavallin F, Cavicchiolo ME, Borellini M, Calgaro S, Baraldi E. Coronavirus infection in neonates: a systematic review. Arch Dis Child Fetal Neonatal Ed 2021; 106:330-335. [PMID: 32943533 DOI: 10.1136/archdischild-2020-319837] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 08/19/2020] [Accepted: 08/21/2020] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To summarise currently reported neonatal cases of SARS-CoV-2 infection. METHODS A search strategy was designed to retrieve all articles published from 1 December 2019 to 12 May 2020, by combining the terms 'coronavirus' OR 'covid' OR 'SARS-CoV-2') AND ('neonat*' OR 'newborn') in the following electronic databases: MEDLINE/Pubmed, Scopus, Web of Science, MedRxiv, the Cochrane Database of Systematic Review and the WHO COVID-19 database, with no language restrictions. Quality of studies was evaluated by using a specific tool for assessment of case reports and/or case series. RESULTS Twenty-six observational studies (18 case reports and 8 case series) with 44 newborns with confirmed SARS-CoV-2 infection were included in the final analysis. Studies were mainly from China and Italy. Half of neonates had a documented contact with the infected mother and one out of three infected neonates was admitted from home. Median age at diagnosis was 5 days. One out of four neonates was asymptomatic, and the remaining showed mild symptoms typical of acute respiratory infections and/or gastrointestinal symptoms. The majority of neonates were left in spontaneous breathing (room air) and had good prognosis after a median duration of hospitalisation of 10 days. CONCLUSIONS Most neonates with SARS-CoV-2 infection were asymptomatic or presented mild symptoms, generally were left in spontaneous breathing and had a good prognosis after median 10 days of hospitalisation. Large epidemiological and clinical cohort studies, as well as the implementation of collaborative networks, are needed to improve the understanding of the impact of SARS-CoV-2 infection in neonates.
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Affiliation(s)
- Daniele Trevisanuto
- Department of Women's and Children's Health, University of Padova, Padova, Italy
| | | | | | - Martina Borellini
- Department of Women's and Children's Health, University of Padova, Padova, Italy
| | - Serena Calgaro
- Department of Women's and Children's Health, University of Padova, Padova, Italy
| | - Eugenio Baraldi
- Department of Women's and Children's Health, University of Padova, Padova, Italy
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34
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Shahbaznejad L, Rouhanizadeh H, Navaeifar MR, Hosseinzadeh F, Movahedi FS, Rezai MS. Clinical Characteristics and Outcomes of COVID-19 in Children in Northern Iran. Int J Pediatr 2021; 2021:5558287. [PMID: 34007286 PMCID: PMC8099525 DOI: 10.1155/2021/5558287] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/18/2021] [Accepted: 04/03/2021] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE Since December 2019, the coronavirus disease 2019 (COVID-19) has been spread rapidly all over the world, infecting all age groups with this novel virus. In this manuscript, we report characteristics of children with COVID-19 in Mazandaran province, northern Iran. METHOD From 12 February to 28 July 2020, medical records of 100 children diagnosed with COVID-19 admitted to the hospitals of Mazandaran province were collected. Patients' age, gender, clinical symptoms, and signs, in addition to therapeutic management and outcomes, were reported. RESULTS 57 (57%) boys and 43 girls with the mean age of 104.63 ± 79.14 months were evaluated. 20 patients (20%) were transferred to the PICU (pediatric intensive care unit), and 13 children experienced a severe form of the disease, pediatric inflammatory multisystem syndrome (PIMS). The mean duration of hospitalization was 5.3 ± 4.7 days. Fever (81%), respiratory (79%), gastrointestinal (47%), and neurologic complaints (29%) were experienced by the patients in addition to skin rash (14%). Sixty-two patients needed supplemental oxygen, and 6 of them underwent endotracheal intubation. Leukopenia was reported in 7, anemia in 24, and thrombocytopenia in 12 patients. 4 patients with underlying diseases including chronic renal failure, Down syndrome with cerebral palsy, and morbid obesity died. CONCLUSION COVID-19 can cause symptoms in children in two stages. In the first week, upper and lower respiratory symptoms can occur which has lower severity and prevalence compared to adults. But after 2-3 weeks following infection, symptoms of MIS-C or multisystem involvement can occur and COVID-19 should be considered. The most common indication for admission is fever, rash, and respiratory problems.
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Affiliation(s)
- Leila Shahbaznejad
- Pediatric Infectious Diseases Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hamed Rouhanizadeh
- Pediatric Infectious Diseases Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad Reza Navaeifar
- Pediatric Infectious Diseases Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Fatemeh Hosseinzadeh
- Pediatric Infectious Diseases Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Faeze Sadat Movahedi
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad Sadegh Rezai
- Pediatric Infectious Diseases Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
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35
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Zhang C, Chu H, Pei YV, Zhang J. Laboratory Effects of COVID-19 Infection in Pregnant Women and Their Newborns: A Systematic Review and Meta-Analysis. Front Glob Womens Health 2021; 2:647072. [PMID: 34816200 PMCID: PMC8594029 DOI: 10.3389/fgwh.2021.647072] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 03/09/2021] [Indexed: 12/21/2022] Open
Abstract
Amidst the COVID-19 pandemic, there is a need for further research on its manifestation in pregnant women, since they are particularly prone to respiratory pathogens, like severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), due to physiological changes during pregnancy. Its effects on infants born to mothers with COVID-19 are also not well-studied, and more evidence is needed on vertical transmission of the disease from mother to infant and on the transmission of IgG/IgM antibodies between mother and infant. We aim to systematically review and evaluate the effects of COVID-19 among SARS-CoV-2-positive pregnant women in late pregnancy and neonates with SARS-CoV-2-positive pregnant mothers using blood assays to find indicators of maternal and neonatal complications. We searched for original published articles in Google Scholar, Medline (PubMed), and Embase databases to identify articles in the English language from December 2019 to July 20, 2020. Duplicate entries were searched by their titles, authors, date of publication, and Digital Object Identifier. The selected studies were included based on patient pregnancy on admission, pregnant mothers with laboratory-confirmed COVID-19 virus, maternal/neonatal complications, and blood test results. We excluded duplicate studies, articles where full text was not available, other languages than English, opinions, and perspectives. The meta-analysis using the Generalized Linear Mixed model was conducted using the "meta" and "metaprop" packages in R code. Of the 1,642 studies assessed for eligibility, 29 studies (375 mothers and neonates) were included. Preterm birth rate was 34.2%, and cesarean section rate was 82.7%. Maternal laboratory findings found elevated neutrophils (71.4%; 95% CI: 38.5-90.9), elevated CRP (67.7%; 95%: 50.6-81.1), and low hemoglobin (57.3%; 95% CI: 26.0-87.8). We found platelet count, lactate dehydrogenase, and procalcitonin to be less strongly correlated with preterm birth than between high neutrophil counts (P = 0.0007), low hemoglobin (P = 0.0188), and risk of preterm birth. There is little evidence for vertical transmission. Elevated procalcitonin levels (23.2%; 95% CI: 8.4-49.8) are observed in infants born to mothers with COVID-19, which could indicate risk for neonatal sepsis. These infants may gain passive immunity to COVID-19 through antibody transfer via placenta. These results can guide current obstetrical care during the current SARS-CoV-2 pandemic.
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Affiliation(s)
- Clark Zhang
- Division of Biostatistics, University of Minnesota, Minneapolis, MN, United States
| | - Haitao Chu
- Division of Biostatistics, University of Minnesota, Minneapolis, MN, United States
| | - Y. Veronica Pei
- Department of Emergency Medicine, University of Maryland, Baltimore, MD, United States
| | - Jason Zhang
- Division of Biostatistics, University of Minnesota, Minneapolis, MN, United States
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36
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Bhatta S, Sayed A, Bhatta RK, Acharya Y. Rapid Clinical Deterioration With Sepsis and Persistent Hypertension in a Pediatric Patient During Recent COVID-19 Crisis. Cureus 2021; 13:e14281. [PMID: 33959459 PMCID: PMC8092993 DOI: 10.7759/cureus.14281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
We present a child with a clear and classic COVID-19 symptomatic picture that rapidly progressed to sepsis with persistent hypertension. This patient, a five-year-old Hispanic female child was brought to our emergency department on March 21, 2020, with fever, productive cough, shortness of breath with chest tightness, abdominal pain, and diarrhea for a week. Her condition deteriorated rapidly, and she developed sepsis within 24 hours, needing intensive care unit admission and ventilator support. She tested negative for COVID-19 Biofire ® nucleic acid tests (BioFire Diagnostics, Salt Lake City, Utah 84108 USA); however, she was recently exposed to COVID-19 cases at her school. This case highlights the importance of a high index of COVID-19 suspicion in children in the endemic areas despite negative COVID-19 tests for keeping a watchful eye to prevent sudden deterioration and unexpected complications.
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Affiliation(s)
| | - Abida Sayed
- Medicine and Research, Avalon University School of Medicine, Willemstad, CUW
| | - Raj Kumar Bhatta
- Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, IND
| | - Yogesh Acharya
- Vascular and Endovascular Surgery, Western Vascular Institute, Galway, IRL
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37
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Kim DH. Clinical implications of coronavirus disease 2019 in neonates. Clin Exp Pediatr 2021; 64:157-164. [PMID: 33539697 PMCID: PMC8024123 DOI: 10.3345/cep.2020.01795] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 01/19/2021] [Indexed: 12/30/2022] Open
Abstract
Since the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in December 2019, a small number of coronavirus disease 2019 (COVID-19) cases in neonates have been reported worldwide. Neonates currently account for only a minor proportion of the pediatric population affected by COVID-19. Thus, data on the epidemiological and clinical features of COVID-19 in neonates are limited. Approximately 3% of neonates born to mothers with COVID-19 reportedly tested positive for SARS-CoV-2. Current limited data on neonates with COVID-19 suggest that neonatal COVID-19 shows a relatively benign course despite a high requirement for mechanical ventilation. However, neonates with pre-existing medical conditions and preterm infants appear to be at a higher risk of developing severe COVID-19. The greatest perinatal concern of the COVID-19 pandemic is the possibility of vertical transmission, especially transplacental transmission of SARS-CoV-2. Although direct evidence of the vertical transmission of SARS-CoV-2 is lacking, its possibility during late pregnancy cannot be ruled out. This review summarizes available case studies on COVID-19 in neonates and introduces what is currently known about neonatal COVID-19 with focus on its vertical transmission.
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Affiliation(s)
- Do-Hyun Kim
- Department of Pediatrics, Dongguk University Ilsan Hospital, Goyang, Korea
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38
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Li X, Sun L, Li T. Updates in neonatal coronavirus disease 2019: What can we learn from detailed case reports? (Review). Mol Med Rep 2021; 23:351. [PMID: 33760212 PMCID: PMC7974256 DOI: 10.3892/mmr.2021.11990] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 02/04/2021] [Indexed: 12/31/2022] Open
Abstract
Although the COVID-19 epidemic has lasted for months, it has not yet been successfully controlled, and little is known about neonatal COVID-19. Therefore, literature search was conducted for references in PubMed, Science Direct, ProQuest, Web of Science and China National Knowledge Infrastructure for detailed case reports on neonatal COVID-19 published as of July 15, 2020, to facilitate the clinical treatment, epidemic prevention and control of neonatal COVID-19. Forty nonoverlapping case reports focusing mainly on the demographic characteristics, transmission modes, clinical features, treatments and prognosis of neonatal COVID-19, including 3 in Chinese and 37 in English, were available.
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Affiliation(s)
- Xingchao Li
- Department of Pediatrics, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei 442000, P.R. China
| | - Li Sun
- Department of Pediatrics, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei 442000, P.R. China
| | - Tao Li
- Department of Pediatrics, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei 442000, P.R. China
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39
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A Comprehensive Analysis of Maternal and Newborn Disease and Related Control for COVID-19. ACTA ACUST UNITED AC 2021; 3:1272-1294. [PMID: 33754135 PMCID: PMC7968576 DOI: 10.1007/s42399-021-00836-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2021] [Indexed: 02/07/2023]
Abstract
The maternal-fetal/newborn unit is established at risk for COVID-19 infection. This narrative review summarizes the contemporary and cumulative publications which detail maternal infection, antenatal and newborn infections, and maternal/fetal/newborn management and prevention. There is a wide spectrum of maternal disease, but the potential for severe disease albeit in a minority is confirmed. COVID-19 carries risk for preterm delivery. Pregnant females can suffer multisystem disease, and co-morbidities play a significant role in risk. Congenital infection has been supported by several anecdotal reports, but strong confirmatory data are few. No typical congenital dysmorphisms are evident. Nevertheless, placental vascular compromise must be considered a risk for the fetus during advanced maternal infections. Clinical manifestations of newborn infection have been mild to moderate and relatively uncommon. Proven antiviral therapy is of yet lacking. The mode of delivery is a medical decision that must include patient risk assessment and patient directives. Both presymptomatic and asymptomatic mothers and offspring can complicate infection control management with the potential for spread to others in several regards. In the interim, infections of the maternal-fetal-newborn unit must be taken seriously both for the disease so caused and the potential for further dissemination of disease.
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40
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Oltean I, Tran J, Lawrence S, Ruschkowski BA, Zeng N, Bardwell C, Nasr Y, de Nanassy J, El Demellawy D. Impact of SARS-CoV-2 on the clinical outcomes and placental pathology of pregnant women and their infants: A systematic review. Heliyon 2021; 7:e06393. [PMID: 33688585 PMCID: PMC7923950 DOI: 10.1016/j.heliyon.2021.e06393] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 11/18/2020] [Accepted: 02/25/2021] [Indexed: 01/08/2023] Open
Abstract
Pregnant women are susceptible to viral infections due to physiological changes such as cell-mediated immunity. No severe adverse pregnancy or neonatal outcomes have been consistently reported in 2019 novel coronavirus disease (COVID-19) positive pregnancy cases. There are controversies around the role of COVID-19 in pregnancy. A systematic review was conducted to examine clinical maternal and neonatal clinical outcomes. Studies were included if they reported SARS-CoV-2 infection among pregnant women and/or COVID-19 positive neonates as validated by positive antibody testing or viral testing using polymerase chain reaction. Case series, case reports, case-control studies, and comparative studies were included. Eight hundred and thirty-seven records were identified, resulting in 525 records for level I screening. Forty-one were included after full-text review. Results suggest elevated rates of intensive care unit (ICU) admission, gestational diabetes, preeclampsia, C-sections, pre-term birth, and C-reactive protein (CRP) in comparison to pregnant women without SARS-CoV-2. Careful monitoring of pregnancies with SARS-CoV-2 is recommended.
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Affiliation(s)
- Irina Oltean
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, K1H 8L1, Canada
| | - Jason Tran
- Department of Medicine, University of Ottawa, Ottawa, Ontario, K1H 8M5 Canada
| | - Sarah Lawrence
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, K1H 8L1, Canada
- Department of Medicine, University of Ottawa, Ottawa, Ontario, K1H 8M5 Canada
- Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, Ontario, K1H 8L1, Canada
| | | | - Na Zeng
- Department of Medicine, University of Ottawa, Ottawa, Ontario, K1H 8M5 Canada
| | - Cameron Bardwell
- Department of Medicine, University of Ottawa, Ottawa, Ontario, K1H 8M5 Canada
| | - Youssef Nasr
- Department of Medicine, University of Ottawa, Ottawa, Ontario, K1H 8M5 Canada
| | - Joseph de Nanassy
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, K1H 8L1, Canada
- Department of Medicine, University of Ottawa, Ottawa, Ontario, K1H 8M5 Canada
- Department of Pathology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, K1H 8L1, Canada
| | - Dina El Demellawy
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, K1H 8L1, Canada
- Department of Medicine, University of Ottawa, Ottawa, Ontario, K1H 8M5 Canada
- Department of Pathology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, K1H 8L1, Canada
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Pousa PA, Mendonça TSC, Oliveira EA, Simões-E-Silva AC. Extrapulmonary manifestations of COVID-19 in children: a comprehensive review and pathophysiological considerations. J Pediatr (Rio J) 2021; 97:116-139. [PMID: 32980319 PMCID: PMC7508521 DOI: 10.1016/j.jped.2020.08.007] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 08/25/2020] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE The aim of this review was to summarize the most common extrapulmonary manifestations in pediatric patients with COVID-19, as well as to discuss clinical, epidemiological, and pathophysiological aspects of these clinical presentations in children. SOURCE OF DATA An extensive search of literature was performed in order to identify pediatric cases with extrapulmonary manifestations between January 1, 2020 and June 21, 2020. Generic keywords, such as "Novel coronavirus" or "Novel coronavirus 2019" or "2019 nCoV" or "COVID-19" or "SARS-CoV-2" were searched on PubMed database, associated either with age filters or generic pediatric terms. SUMMARY OF FINDINGS A total of 28 articles, including 199 patients, were considered suitable to review and data extraction. The main findings were summarized in tables. The main non-pulmonary manifestations in pediatric patients, in decreasing order of frequency, were gastrointestinal, renal, cardiovascular, neurological, hematological and lymphatic, cutaneous, hepatic, ocular, olfactory, and gustatory. Multisystem impairment and Kawasaki-like disease were also described. CONCLUSIONS Differences in immune response of children and variations of tissue expression of angiotensin converting enzyme 2, the virus receptor, are likely to influence clinical, epidemiological, and pathophysiological patterns of the disease.
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Affiliation(s)
- Pedro A Pousa
- Universidade Federal de Minas Gerais (UFMG), Faculdade de Medicina, Laboratório Interdisciplinar de Pesquisa Médica, Belo Horizonte, MG, Brazil
| | - Tamires S C Mendonça
- Universidade Federal de Minas Gerais (UFMG), Faculdade de Medicina, Laboratório Interdisciplinar de Pesquisa Médica, Belo Horizonte, MG, Brazil
| | - Eduardo A Oliveira
- Universidade Federal de Minas Gerais (UFMG), Faculdade de Medicina, Departamento de Pediatria, Unidade de Nefrologia Pediátrica, Belo Horizonte, MG, Brazil
| | - Ana Cristina Simões-E-Silva
- Universidade Federal de Minas Gerais (UFMG), Faculdade de Medicina, Laboratório Interdisciplinar de Pesquisa Médica, Belo Horizonte, MG, Brazil; Universidade Federal de Minas Gerais (UFMG), Faculdade de Medicina, Departamento de Pediatria, Unidade de Nefrologia Pediátrica, Belo Horizonte, MG, Brazil.
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COVID-19 in Neonates, A Case Series Study From Tertiary Neonatal Centers in Iran. ARCHIVES OF PEDIATRIC INFECTIOUS DISEASES 2021. [DOI: 10.5812/pedinfect.110603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction: The Novel coronavirus, sars-cov-2, is responsible for the recent pandemic. Although it mostly affects adults, children of all ages, including neonates, can become ill with Covid-19, as well. The real prevalence rate of coronavirus disease 2019 (COVID-19) in children is unknown. However, the severity of symptoms in children and neonates is less than in adults. Regarding the new presentation of this disease, the current study has reported a case series of COVID-19 in neonates. Case Presentation: In this article, 10 neonates with COVID- 19 admitted to our neonatal intensive care units are reported. All reported neonates had general suspicious symptoms of COVID- 19 with positive results for SARS-CoV-2 assessed by polymerase chain reaction (PCR) from the nasopharynx area or nose of the patients. All neonates, except for two of them, were term neonates. One case had open-heart surgery for congenital heart disease (transposition of the great arteries (TGA)). The patients aged 22 days on admission. The most frequent symptom was fever. Severe respiratory symptoms were reported in two cases. Also, abnormal radiologic findings in the chest x-ray were detected in two cases. Regarding the lack of significant respiratory symptoms in most of the patients, the lung computed tomography (CT) scan was taken just from one neonate. Leukopenia (WBC < 5000/mm3) was detected in one case, with no lymphopenia in all neonates. The positive C-reactive protein test was not found in all cases. No patient was treated by special anti-viral agents for COVID-19, and usual antibiotic treatment for neonatal sepsis was administered for all cases. All patients, except for one, survived with no significant sequela of the disease. Conclusions: This study demonstrated that clinical manifestations, as well as laboratory and radiologic findings of COVID-19, are milder in neonates than in the older ages. Hence, it can be argued that the prognosis of COVID-19 in the neonatal period is generally good.
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Kimberlin DW, Puopolo KM. Breast Milk and COVID-19: What Do We Know? Clin Infect Dis 2021; 72:131-132. [PMID: 32566944 PMCID: PMC7337725 DOI: 10.1093/cid/ciaa800] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 06/18/2020] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - Karen M Puopolo
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Bhuiyan MU, Stiboy E, Hassan MZ, Chan M, Islam MS, Haider N, Jaffe A, Homaira N. Epidemiology of COVID-19 infection in young children under five years: A systematic review and meta-analysis. Vaccine 2021; 39:667-677. [PMID: 33342635 PMCID: PMC7833125 DOI: 10.1016/j.vaccine.2020.11.078] [Citation(s) in RCA: 117] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 11/16/2020] [Accepted: 11/30/2020] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Emerging evidence suggests young children are at greater risk of COVID-19 infection than initially predicted. However, a comprehensive understanding of epidemiology of COVID-19 infection in young children under five years, the most at-risk age-group for respiratory infections, remain unclear. We conducted a systematic review and meta-analysis of epidemiological and clinical characteristics of COVID-19 infection in children under five years. METHOD Following the Preferred Reporting Items for Systematic Reviews and Meta-analyses , we searched several electronic databases (Pubmed, EMBASE, Web of Science, and Scopus) with no language restriction for published epidemiological studies and case-reports reporting laboratory-confirmed COVID-19 infection in children under five years until June 4, 2020. We assessed pooled prevalence for key demographics and clinical characteristics using Freeman-Tukey double arcsine random-effects model for studies except case-reports. We evaluated risk of bias separately for case-reports and other studies. RESULTS We identified 1,964 articles, of which, 65 articles were eligible for systematic review that represented 1,214 children younger than five years with laboratory-confirmed COVID-19 infection. The pooled estimates showed that 50% young COVID-19 cases were infants (95% CI: 36% - 63%, 27 studies); 53% were male (95% CI: 41% - 65%, 24 studies); 43% were asymptomatic (95% CI: 15% - 73%, 9 studies) and 7% (95% CI: 0% - 30%, 5 studies) had severe disease that required intensive-care-unit admission. Of 139 newborns from COVID-19 infected mothers, five (3.6%) were COVID-19 positive. There was only one death recorded. DISCUSSION This systematic review reports the largest number of children younger than five years with COVID-19 infection till date. Our meta-analysis shows nearly half of young COVID-19 cases were asymptomatic and half were infants, highlighting the need for ongoing surveillance to better understand the epidemiology, clinical pattern, and transmission of COVID-19 to develop effective preventive strategies against COVID-19 disease in young paediatric population.
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Affiliation(s)
- Mejbah Uddin Bhuiyan
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Western Australia, Australia.
| | - Eunice Stiboy
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Md Zakiul Hassan
- Program for Emerging Infections, Infectious Diseases Division, icddr,b, Bangladesh
| | - Mei Chan
- School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Md Saiful Islam
- Program for Emerging Infections, Infectious Diseases Division, icddr,b, Bangladesh; School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Najmul Haider
- The Royal Veterinary College, University of London, Hatfield, Hertfordshire, AL9 7TA, UK
| | - Adam Jaffe
- School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia; Respiratory Department, Sydney Children's Hospital, Sydney, New South Wales, Australia
| | - Nusrat Homaira
- School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia; Respiratory Department, Sydney Children's Hospital, Sydney, New South Wales, Australia
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Benarroch Y, Juttukonda L, Sabharwal V, Boateng J, Khan AR, Yarrington C, Wachman EM, Taglauer E. Differential Expression of Rab5 and Rab7 Small GTPase Proteins in Placental Tissues From Pregnancies Affected by Maternal Coronavirus Disease 2019. Clin Ther 2021; 43:308-318. [PMID: 33541739 PMCID: PMC7837084 DOI: 10.1016/j.clinthera.2021.01.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 01/03/2021] [Accepted: 01/04/2021] [Indexed: 12/26/2022]
Abstract
Purpose The majority of pregnancies affected by maternal coronavirus disease 2019 (COVID-19) do not result in fetal transmission. However, several studies have identified parenchymal changes in their placental tissues, suggesting a placental response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at the maternal–fetal interface. Although many COVID-19 placental studies have focused on the expression of the canonical SARS-CoV-2 entry proteins angiotensin-converting enzyme 2 (ACE2) and transmembrane serine protease 2, further characterization of subcellular molecules involved in viral trafficking have not yet been investigated in these tissues. Of interest are Rab proteins, a family of small GTPase proteins that direct intracellular transport between different endocytic organelles. Rab5 and Rab7 in particular have previously been implicated in HIV and cytomegalovirus invasion of placental trophoblast cells in vitro; the localization of these molecules has not been fully characterized within the human maternal–fetal interface, however, or within placental tissues from SARS-CoV-2–infected pregnancies. Methods Using fluorescent immunohistochemistry, Rab5 and Rab7 placental localization and comparative fluorescence intensity were explored in a cohort of placental tissues from pregnancies affected by maternal COVID-19 disease (COVID, n = 15) compared with contemporary control subjects (Control, n = 10). Fluorescence intensity was quantified by using corrected total cell fluorescence values. Findings Within placental villi, Rab5 was consistently localized in syncytiotrophoblast and cytotrophoblast cells. Rab5 had significantly higher mean (SEM) fluorescence intensity in the COVID cohort (Control, 1.96 [0.16]; COVID, 2.62 [0.09]; P = 0.0014). In contrast, although Rab7 was also localized within placental villous syncytiotrophoblast and cytotrophoblast cells, mean (SEM) Rab7 fluorescence intensity was significantly downregulated in COVID vs Control placentas (Control, 35.9 [4.1]; COVID, 20.1 [0.52]; P = 0.0001). Implications This differential expression of Rab5 and Rab7 suggests that placental endocytic pathways may be altered at the maternal–fetal interface in pregnancies affected by maternal SARS-CoV-2 infection. As key molecules governing intracellular vesicle transport, including viral trafficking, Rab GTPase proteins may be of interest for ongoing studies examining placental responses to COVID-19 in pregnancy.
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Affiliation(s)
| | - Lillian Juttukonda
- Boston Combined Residency Program in Pediatrics, Boston Medical Center and Children's Hospital Boston, Boston, MA, USA
| | | | - Jeffery Boateng
- Department of Pediatrics, Boston Medical Center, Boston, MA, USA
| | - Amir R Khan
- Division of Newborn Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA; School of Biochemistry and Immunology, Trinity College, Dublin, Ireland
| | | | - Elisha M Wachman
- Department of Pediatrics, Boston Medical Center, Boston, MA, USA
| | - Elizabeth Taglauer
- Department of Pediatrics, Boston Medical Center, Boston, MA, USA; Division of Newborn Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA.
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46
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Zenzeri L, Giannattasio A, Zito Marinosci G, Ponticiello E, Iodice MR, Vitullo ME, Tipo V. Immunodepression COVID-19-related as a promoting factor for severe Pseudomonas sepsis in an infant with not respiratory symptoms. EMERGENCY CARE JOURNAL 2021. [DOI: 10.4081/ecj.2020.9105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The outbreak of coronavirus disease 2019 caused by severe acute respiratory syndrome coronavirus 2 is a reason of concern worldwide. While a high proportion of adult patients have been severely ill, requiring intensive care assistance and mechanical ventilation, pediatric patients seem to have a less invasive clinical expression of the disease. Reasons for a milder disease in children compared to that seen in adults are yet to be elucidated. Nonetheless, severe and fatal cases have been reported in children and are expected to continue to increase with the growing community transmission and overall current disease prevalence. We report the first case of an infant with a very mild not-respiratory COVID- 19 infection and a concomitant invasive bacterial sepsis.
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Mark EG, Golden WC, Gilmore MM, Sick-Samuels A, Curless MS, Nogee LM, Milstone AM, Johnson J. Community-Onset Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Young Infants: A Systematic Review. J Pediatr 2021; 228:94-100.e3. [PMID: 32910943 PMCID: PMC7477627 DOI: 10.1016/j.jpeds.2020.09.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 09/01/2020] [Accepted: 09/02/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To summarize and evaluate current reports on community-onset severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in young infants. STUDY DESIGN We performed a systematic review to identify reports published from November 1, 2019, until June 15, 2020, on laboratory-confirmed community-onset SARS-CoV-2 infection in infants younger than 3 months of age. We excluded studies reporting neonates with perinatal coronavirus disease 2019 (COVID-19) exposure and diagnosis before hospital discharge and hospital-onset disease, as well as clinically diagnosed cases without confirmation. Two independent reviewers performed study screening, data abstraction, and risk of bias assessment. Variables of interest included patient age, exposure to COVID-19, medical history, clinical symptoms, SARS-CoV-2 testing, laboratory findings, clinical course, and disposition. RESULTS In total, 38 publications met inclusion criteria, including 23 single case reports, 14 case series, and 1 cohort study, describing 63 infants younger than 3 months of age with laboratory-confirmed SARS-CoV-2 infection. Most cases were mild to moderate. Fever, respiratory, gastrointestinal, cardiac, and neurologic findings were reported. Laboratory abnormalities included neutropenia, lymphopenia, and elevated serum levels of inflammatory markers and aminotransferases. Fifty-eight (92%) infants were hospitalized, 13 (21%) were admitted to the intensive care unit, and 2 (3%) required mechanical ventilation. No death was reported. CONCLUSIONS Among young infants with laboratory-confirmed SARS-CoV-2 infection, most cases were mild to moderate and improved with supportive care. Our results demonstrate a need for a high index of suspicion for SARS-CoV-2 infection in young infants presenting with generalized symptoms such as fever or decreased feeding, even in the absence of respiratory symptoms.
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Affiliation(s)
- Elyse G Mark
- Division of Neonatology, Department of Pediatrics, Johns Hopkins University, Baltimore, MD
| | - W Christopher Golden
- Division of Neonatology, Department of Pediatrics, Johns Hopkins University, Baltimore, MD
| | - Maureen M Gilmore
- Division of Neonatology, Department of Pediatrics, Johns Hopkins University, Baltimore, MD
| | - Anna Sick-Samuels
- Division of Infectious Diseases, Department of Pediatrics, Johns Hopkins University, Baltimore, MD
| | - Melanie S Curless
- Department of Hospital Epidemiology and Infection Control, Johns Hopkins Hospital, Baltimore, MD
| | - Lawrence M Nogee
- Division of Neonatology, Department of Pediatrics, Johns Hopkins University, Baltimore, MD
| | - Aaron M Milstone
- Division of Infectious Diseases, Department of Pediatrics, Johns Hopkins University, Baltimore, MD
| | - Julia Johnson
- Division of Neonatology, Department of Pediatrics, Johns Hopkins University, Baltimore, MD.
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Rongioletti F, Ferreli C, Sena P, Caputo V, Atzori L. Clinicopathologic correlations of COVID-19-related cutaneous manifestations with special emphasis on histopathologic patterns. Clin Dermatol 2021; 39:149-162. [PMID: 33972045 PMCID: PMC7832768 DOI: 10.1016/j.clindermatol.2020.12.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Skin is one of target organs affected by the novel coronavirus SARS-CoV-2, and in response to the current COVID-19 pandemic, a fast body of literature has emerged on related cutaneous manifestations. Current perspective is that the skin is not only a bystander of the general cytokines storm with thrombophilic multiorgan injury, but it is directly affected by the epithelial tropism of the virus, as confirmed by the detection of SARS-CoV-2 in endothelial cells and epithelial cells of epidermis and eccrine glands. In contrast with the abundance of epidemiologic and clinical reports, histopathologic characterization of skin manifestations is limited. Without an adequate clinicopathologic correlation, nosology of clinically similar conditions is confusing, and effective association with COVID-19 remains presumptive. Several patients with different types of skin lesions, including the most specific acral chilblains-like lesions, showed negative results at SARS-CoV-2 nasopharyngeal and serologic sampling. The aim of this review is to provide an overview of what has currently been reported worldwide, with a particular emphasis on microscopic patterns of the skin manifestations in patients exposed to or affected by COVID-19. Substantial breakthroughs may occur in the near future from more skin biopsies, improvement of immunohistochemistry studies, RNA detection of SARS-CoV-2 strain by real-time polymerase chain reaction-based assay, and electron microscopic studies.
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Affiliation(s)
- Franco Rongioletti
- Unit of Dermatology, Department Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; IRCCS San Raffaele Hospital and Dental School, Vita Salute University, 20132 Milan, Italy
| | - Caterina Ferreli
- Unit of Dermatology, Department Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
| | - Paolo Sena
- Unit of Dermatology, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Valentina Caputo
- Unit of Pathology, Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Laura Atzori
- Unit of Dermatology, Department Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
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Thakur N, Rai N. An unusual case of multisystem inflammatory syndrome in children in newborn due to covid-19 – presenting with stage 11 b necrotizing enterocolitis. J Clin Neonatol 2021. [DOI: 10.4103/jcn.jcn_78_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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50
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Centeno‐Tablante E, Medina‐Rivera M, Finkelstein JL, Rayco‐Solon P, Garcia‐Casal MN, Rogers L, Ghezzi‐Kopel K, Ridwan P, Peña‐Rosas JP, Mehta S. Transmission of SARS-CoV-2 through breast milk and breastfeeding: a living systematic review. Ann N Y Acad Sci 2021; 1484:32-54. [PMID: 32860259 PMCID: PMC7970667 DOI: 10.1111/nyas.14477] [Citation(s) in RCA: 98] [Impact Index Per Article: 32.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 07/30/2020] [Accepted: 08/03/2020] [Indexed: 01/08/2023]
Abstract
The pandemic of coronavirus disease 2019 (COVID-19) is caused by infection with a novel coronavirus strain, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). At present, there is limited information on potential transmission of the infection from mother to child, particularly through breast milk and breastfeeding. Here, we provide a living systematic review to capture information that might necessitate changes in the guidance on breast milk and breastfeeding given the uncertainty in this area. Our search retrieved 19,414 total records; 605 were considered for full-text eligibility and no ongoing trials were identified. Our review includes 340 records, 37 with breast milk samples and 303 without. The 37 articles with analyzed breast milk samples reported on 77 mothers who were breastfeeding their children; among them, 19 of 77 children were confirmed COVID-19 cases based on RT-PCR assays, including 14 neonates and five older infants. Nine of the 68 analyzed breast milk samples from mothers with COVID-19 were positive for SARS-CoV-2 RNA; of the exposed infants, four were positive and two were negative for COVID-19. Currently, there is no evidence of SARS-CoV-2 transmission through breast milk. Studies are needed with longer follow-up periods that collect data on infant feeding practices and on viral presence in breast milk.
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Affiliation(s)
| | | | | | - Pura Rayco‐Solon
- Department of Maternal, Newborn,
Child and Adolescent Health and AgeingWorld Health OrganizationGenevaSwitzerland
| | | | - Lisa Rogers
- Department of Nutrition and Food
SafetyWorld Health OrganizationGenevaSwitzerland
| | | | - Pratiwi Ridwan
- Division of Nutritional
SciencesCornell UniversityIthacaNew York
| | | | - Saurabh Mehta
- Division of Nutritional
SciencesCornell UniversityIthacaNew York
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