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Ho JSY, Tambyah PA, Ho AFW, Chan MYY, Sia CH. Effect of coronavirus infection on the human heart: A scoping review. Eur J Prev Cardiol 2020; 27:1136-1148. [PMID: 32423250 PMCID: PMC7717245 DOI: 10.1177/2047487320925965] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 04/22/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND The global coronavirus disease 2019 pandemic has highlighted the importance of understanding the cardiovascular implications of coronavirus infections, with more severe disease in those with cardiovascular co-morbidities, and resulting cardiac manifestations such as myocardial injury, arrhythmias, and heart failure. DESIGN A systematic review of the current knowledge on the effects of coronavirus infection on the cardiovascular system in humans was performed and results were summarized. METHODS Databases such as MEDLINE, EMBASE, CENTRAL, Scopus, Web of Science, ClinicalTrials.gov, Chinese Knowledge Resource Integrated Database and Chinese Clinical Trial Registry were searched on 20 March 2020. RESULTS In total, 135 studies were included, involving severe acute respiratory syndrome, Middle East respiratory syndrome, coronavirus disease 2019 and other coronaviruses. Most were case reports, case series and cohort studies of poor to fair quality. In post-mortem examinations of subjects who died from infection, around half had virus identified in heart tissues in severe acute respiratory syndrome, but none in Middle East respiratory syndrome and coronavirus disease 2019. Cardiac manifestations reported include tachycardia, bradycardia, arrhythmias, and myocardial injury, secondary to both systemic infection and treatment. Cardiac injury and arrhythmias are more prevalent in coronavirus disease 2019, and elevated cardiac markers are associated with intensive care unit admission and death. In severe acute respiratory syndrome, Middle East respiratory syndrome, and coronavirus disease 2019, comorbidities such as hypertension, diabetes mellitus, and heart disease are associated with intensive care unit admission, mechanical ventilation, and mortality. There were cases of misdiagnosis due to overlapping presentations of cardiovascular diseases and coronavirus infections, leading to hospital spread and delayed management of life-threatening conditions. CONCLUSION This review highlighted the ways in which coronaviruses affect cardiovascular function and interacts with pre-existing cardiovascular diseases.
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Affiliation(s)
- Jamie SY Ho
- />School of Clinical Medicine, University of Cambridge, UK
| | - Paul A Tambyah
- />Division of Infectious Diseases, National University Hospital, Singapore
- />Department of Medicine, National University of Singapore, Singapore
| | - Andrew FW Ho
- />SingHealth Duke-NUS Emergency Medicine Academic Clinical Programme, Singapore
- />Cardiovascular and Metabolic Disorders Program, Duke-NUS Medical School, Singapore
- />National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore
| | - Mark YY Chan
- />Department of Medicine, National University of Singapore, Singapore
- />Department of Cardiology, National University Heart Centre, Singapore
| | - Ching-Hui Sia
- />Department of Medicine, National University of Singapore, Singapore
- />Department of Cardiology, National University Heart Centre, Singapore
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Sia CH, Ngiam JN, Chew N, Beh DLL, Poh KK. Educational case series of electrocardiographs during the COVID-19 pandemic and the implications for therapy. Singapore Med J 2020; 61:406-412. [PMID: 32480434 DOI: 10.11622/smedj.2020087] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Ching-Hui Sia
- Department of Cardiology, National University Heart Centre Singapore, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Nicholas Chew
- University Medicine Cluster, National University Health System, Singapore
| | - Darius Lian Lian Beh
- Division of Infectious Disease, University Medicine Cluster, National University Health System, Singapore
| | - Kian Keong Poh
- Department of Cardiology, National University Heart Centre Singapore, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Gagneur A, Vallet S, Talbot PJ, Legrand-Quillien MC, Picard B, Payan C, Sizun J. Outbreaks of human coronavirus in a pediatric and neonatal intensive care unit. Eur J Pediatr 2008; 167:1427-34. [PMID: 18335238 PMCID: PMC7087120 DOI: 10.1007/s00431-008-0687-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2007] [Accepted: 02/06/2008] [Indexed: 01/17/2023]
Abstract
Human coronavirus 229E (HCoV) has been recently recognized as a potential agent of nosocomial viral respiratory infections (NRVI) in high-risk infants. We have confirmed this as fact through the study of a 1-year period of HCoV outbreaks occurring during a prospective survey of NRVI in a paediatric and neonatal intensive care unit (PNICU) using new molecular techniques for HCoV detection. Nasal samples obtained at admission and weekly thereafter for all hospitalised children, as well as monthly nasal samples from staff, were analysed using immunofluorescence for respiratory syncytial virus (RSV), influenza viruses A and B, paramyxoviruses 1, 2, 3 and adenoviruses. RT-PCR was used for HCoV detection. During the year 1998, 43 HCoV-related NRVI were detected in 152 neonates (incidence 28.3%), and 7 HCoV-related NRVI were found in 92 children (incidence 7.6%). Three HCoV-related outbreaks were observed (February, August and December), associated with a high prevalence of HCoV infection in the staff. During the August outbreak, 50% to 78% of hospitalised neonates and children were infected. Seventy-five percent of hospitalised preterm neonates with a gestational age less than 32 weeks and 52.4% of staff members were infected. Risk factors for NRVI in neonates were birth weight, gestational age, ventilation, oxygenation and hospitalisation length. Ninety-two percent of infected preterm neonates were symptomatic, mainly with bradycardia and respiratory worsening. These data provide additional evidence for a possibly significant role of HCoV in NRVI in a PNICU. The role of staff or hospitalised children in spreading HCoV is hypothesised.
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Affiliation(s)
- Arnaud Gagneur
- Department of Paediatrics, EA 3882 Laboratory of Biodiversity and Microbial Ecology, University Hospital, Brest, France.
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Gagneur A, Dirson E, Audebert S, Vallet S, Quillien MCL, Baron R, Laurent Y, Collet M, Sizun J, Oger E, Payan C. [Vertical transmission of human coronavirus. Prospective pilot study]. ACTA ACUST UNITED AC 2007; 55:525-30. [PMID: 17889450 PMCID: PMC7119136 DOI: 10.1016/j.patbio.2007.07.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2007] [Accepted: 07/05/2007] [Indexed: 11/30/2022]
Abstract
Les coronavirus humains (HCoV) ont été impliqués dans la survenue d'infections respiratoires nosocomiales chez les nouveau-nés. Plusieurs cas d'infections néonatales ont été mis en évidence. Cette étude pilote recherche l'existence d'une éventuelle transmission maternofœtale des HCoV pouvant expliquer les cas infections néonatales observées dans les premières 24 heures de vie. Matériel et méthode Étude monocentrique prospective pilote. Étude des couples mère–enfant par la réalisation de trois prélèvements : vaginal et respiratoire chez la mère (VM et RM) lors du travail, gastrique chez le nouveau-né (GNN). Suivi clinique des nouveau-nés et des mères jusqu'à j3. Analyse virologique des échantillons par reverse transcription-polymerase chain reaction (RT-PCR) en temps réel pour la recherche des HCoV 229-E et OC43. Résultats Cent cinquante-neuf couples mère–enfant ont été inclus de juillet 2003 à août 2005. Seul HCoV 229-E a été détecté dans 11 échantillons chez six couples mère–enfant. Pour deux couples, les trois prélèvements (VM, RM et GNN) étaient positifs (cas 1 et 2). Pour le cas 3, seuls le VM et GNN étaient positifs. Pour deux couples, seuls les RM étaient positifs (cas 4 et 5). Pour le cas 6, seul le VM était positif. Pour les trois GNN positifs, aucun enfant n'était symptomatique. Conclusion Une possible transmission verticale des HCoV est mise en évidence dans cette étude pilote qui nécessite désormais d'être poursuivie à plus large échelle. Il convient également d'inclure la recherche des coronavirus humains identifiés récemment, HCoV NL63 et HKU1, et d'analyser le profil génomique des HCoV détectés chez les trois couples mère–enfant positifs.
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Affiliation(s)
- A Gagneur
- Département de Pédiatrie, Inserm CIC 0502, CHU de Brest, Brest, France.
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Simon A, Völz S, Höfling K, Kehl A, Tillman R, Müller A, Kupfer B, Eis-Hübinger AM, Lentze MJ, Bode U, Schildgen O. Acute life threatening event (ALTE) in an infant with human coronavirus HCoV-229E infection. Pediatr Pulmonol 2007; 42:393-6. [PMID: 17352399 PMCID: PMC7167760 DOI: 10.1002/ppul.20595] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
In this short report we discuss the temporal association between an acute life threatening event (ALTE) and a RT-PCR confirmed coronavirus HCoV-229E infection in a 4 months old otherwise healthy infant. More detailed microbiological investigations of affected children even without apparent signs of a respiratory tract infection may help to clarify the etiology in some patients and extend our understanding of the pathogenesis. PCR-based techniques should be utilized to increase the sensitivity of detection for old and new respiratory viral pathogens in comparable cases.
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Affiliation(s)
- Arne Simon
- Children's Hospital Medical Centre, University of Bonn, Bonn, Germany.
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Williams JV. The clinical presentation and outcomes of children infected with newly identified respiratory tract viruses. Infect Dis Clin North Am 2006; 19:569-84. [PMID: 16102649 PMCID: PMC3351010 DOI: 10.1016/j.idc.2005.05.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Numerous emerging respiratory tract viruses have been identified as significant causes of acute upper and lower respiratory tract illness in children. Human metapneumovirus is a paramyxovirus discovered in 2001 in the Netherlands, with a seasonal occurrence and spectrum of clinical illness most similar to the closely related respiratory syncytial virus. Several new members of the corona-virus family have been identified, including the truly novel agent of severe acute respiratory syndrome and others that probably have been circulating undetected. Avian influenza strains have caused numerous outbreaks with high mortality, including children, and are potential causes of pandemic influenza. Several zoonotic paramyxoviruses, including Nipah and Hendra viruses, have emerged as occasional causes of sever outbreaks of respiratory tract illness in children and adults.
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Affiliation(s)
- John V Williams
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Vanderbilt University Medical Center, Nashville, TN, 37232-2581, USA.
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Vallet S, Gagneur A, Talbot PJ, Legrand MC, Sizun J, Picard B. Detection of human Coronavirus 229E in nasal specimens in large scale studies using an RT-PCR hybridization assay. Mol Cell Probes 2004; 18:75-80. [PMID: 15051115 PMCID: PMC7134763 DOI: 10.1016/j.mcp.2003.09.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2003] [Accepted: 09/18/2003] [Indexed: 11/24/2022]
Abstract
A novel human Coronavirus (HCoV) was this year recognized as the etiological agent of the Severe Acute Respiratory Syndrome. Two other HCoV (HCoV-229E and HCoV-OC43) have been known for 30 years. HCoV-229E has been recently involved in nosocomial respiratory viral infections in high-risk children. However, their diagnosis is not routinely performed. Currently, reliable immunofluorescence and cell culture methodologies are not available. As part of a four-year epidemiological study in a Pediatric and Neonatal Intensive care unit, we have performed and demonstrated the reliability of a reverse transcription-PCR-hybridization assay to detect HCoV of the 229E antigenic group in 2028 clinical respiratory specimens. In hospitalized children (children and newborns) and staff members we found a high incidence of HcoV-229E infection. This reverse transcription-PCR-hybridization assay gave a high specificity and a sensitivity of 0.5 50% Tissue Culture Infective Dose per ml. This technique is reliable and its application for screening large number of clinical samples would improve the diagnosis of HCoVs respiratory infection and our knowledge of these viruses epidemiology.
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Affiliation(s)
- Sophie Vallet
- Laboratoire de Virologie, Department of Microbiology, Centre hospitalier Universitaire Morvan, 5 avenue Foch, 29200 Brest Cedex, France.
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Gagneur A, Sizun J, Vallet S, Legr MC, Picard B, Talbot PJ. Coronavirus-related nosocomial viral respiratory infections in a neonatal and paediatric intensive care unit: a prospective study. J Hosp Infect 2002; 51:59-64. [PMID: 12009822 PMCID: PMC7134478 DOI: 10.1053/jhin.2002.1179] [Citation(s) in RCA: 101] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The incidence of nosocomial viral respiratory infections (NVRI) in neonates and children hospitalized in paediatric and neonatal intensive care units (PNICU) is unknown. Human coronaviruses (HCoV) have been implicated in NVRI in hospitalized preterm neonates. The objectives of this study were to determine the incidence of HCoV-related NVRI in neonates and children hospitalized in a PNICU and the prevalence of viral respiratory tract infections in staff. All neonates (age< or =28 days) and children (age>28 days) hospitalized between November 1997 and April 1998 were included. Nasal samples were obtained by cytological brush at admission and weekly thereafter. Nasal samples were taken monthly from staff. Virological studies were performed, using indirect immunofluorescence, for HCoV strains 229E and OC43, respiratory syncytial virus (RSV), influenza virus types A and B, paramyxoviruses types 1, 2 and 3 and adenovirus. A total of 120 patients were enrolled (64 neonates and 56 children). Twenty-two samples from 20 patients were positive (incidence 16.7%). In neonates, seven positive samples, all for HCoV, were detected (incidence 11%). Risk factors for NVRI in neonates were: duration of hospitalization, antibiotic treatment and duration of parenteral nutrition (P<0.01). Monthly prevalence of viral infections in staff was between 0% and 10.5%, mainly with HCoV. In children, 15 samples were positive in 13 children at admission (seven RSV, five influenza and three adenovirus) but no NVRI were observed. In spite of a high rate of community-acquired infection in hospitalized children, the incidence of NVRI with common respiratory viruses appears low in neonates, HCoV being the most important pathogen of NRVI in neonates during this study period. Further research is needed to evaluate the long-term impact on pulmonary function.
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Affiliation(s)
- A Gagneur
- Pediatric Intensive Care Unit, Department of Paediatrics, University Hospital, 29609 Brest, France
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Gagneur A, Legrand M, Picard B, Baron R, Talbot P, de Parscau L, Sizun J. [Nosocomial infections due to human coronaviruses in the newborn]. Arch Pediatr 2002; 9:61-9. [PMID: 11865552 PMCID: PMC7126531 DOI: 10.1016/s0929-693x(01)00696-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2001] [Accepted: 09/10/2001] [Indexed: 10/26/2022]
Abstract
Human coronaviruses, with two known serogroups named 229-E and OC-43, are enveloped positive-stranded RNA viruses. The large RNA is surrounded by a nucleoprotein (protein N). The envelop contains 2 or 3 glycoproteins: spike protein (or protein S), matrix protein (or protein M) and a hemagglutinin (or protein HE). Their pathogen role remains unclear because their isolation is difficult. Reliable and rapid methods as immunofluorescence with monoclonal antibodies and reverse transcription-polymerase chain reaction allow new researches on epidemiology. Human coronaviruses can survive for as long as 6 days in suspension and 3 hours after drying on surfaces, suggesting that they could be a source of hospital-acquired infections. Two prospective studies conducted in a neonatal and paediatric intensive care unit demonstrated a significant association of coronavirus-positive nasopharyngal samples with respiratory illness in hospitalised preterm neonates. Positive samples from staff suggested either a patient-to-staff or a staff-to-patient transmission. No cross-infection were observed from community-acquired respiratory-syncitial virus or influenza-infected children to neonates. Universal precautions with hand washing and surface desinfection could be proposed to prevent coronavirus transmission.
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Affiliation(s)
- A. Gagneur
- Unité de réanimation pédiatrique, département de pédiatrie, CHU, 29609 Brest, France
| | - M.C. Legrand
- unité de virologie, département de microbiologie, CHU, 29609 Brest, France
| | - B. Picard
- unité de virologie, département de microbiologie, CHU, 29609 Brest, France
| | - R. Baron
- unité d’hygiène hospitalière, CHU, 29609 Brest, France
| | - P.J. Talbot
- laboratoire de neuro-immunovirologie, INRS-institut Armand-Frappier, université du Québec, Laval, Québec, Canada
| | - L. de Parscau
- Unité de réanimation pédiatrique, département de pédiatrie, CHU, 29609 Brest, France
| | - J. Sizun
- Unité de réanimation pédiatrique, département de pédiatrie, CHU, 29609 Brest, France
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Sizun J, Yu MW, Talbot PJ. Survival of human coronaviruses 229E and OC43 in suspension and after drying onsurfaces: a possible source ofhospital-acquired infections. J Hosp Infect 2000; 46:55-60. [PMID: 11023724 PMCID: PMC7134510 DOI: 10.1053/jhin.2000.0795] [Citation(s) in RCA: 185] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Strains OC43 and 229E of human coronaviruses (HCoV) cause one-third of common colds and hospital-acquired upper respiratory tract HCoV infections have been reported in premature newborns. To evaluate possible sources of infection, virus survival was studied in aqueous suspensions and on absorptive and non-absorptive surfaces representative of a hospital environment. Virus susceptibility to chemical disinfection with standard products was also characterized. Virus survived in saline solution for as long as six days but less in culture medium, with or without added cells. After drying, HCoV-229E infectivity was still detectable after 3h on various surfaces (aluminum, sterile latex surgical gloves, sterile sponges) but HCoV-OC43 survived 1h or less. Of the various chemical disinfectants tested, Proviodine reduced the virus infectious titre by at least 50%. This study suggests that surfaces and suspensions can be considered as possible sources of contamination that may lead to hospital-acquired infections with HCoV and should be appropriately disinfected.
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Affiliation(s)
- J Sizun
- Human Health Research Center, INRS-Institut Armand-Frappier, University of Quebec, Laboratory of Neuroimmunovirology, Laval, Québec, H7V 1B7, Canada.
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Sizun J, Soupre D, Giroux JD, Legrand MC. [Nosocomial respiratory infection due to coronavirus in neonatal intensive care units: prospective evaluation]. Arch Pediatr 1995; 2:1020-1. [PMID: 7496463 PMCID: PMC7133326 DOI: 10.1016/0929-693x(96)89905-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/1995] [Accepted: 06/14/1995] [Indexed: 01/25/2023]
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Sizun J, Soupre D, Legrand MC, Giroux JD, Rubio S, Cauvin JM, Chastel C, Alix D, de Parscau L. Neonatal nosocomial respiratory infection with coronavirus: a prospective study in a neonatal intensive care unit. Acta Paediatr 1995; 84:617-20. [PMID: 7670241 PMCID: PMC7188327 DOI: 10.1111/j.1651-2227.1995.tb13710.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The aim of this prospective study was to evaluate the incidence of viral respiratory infection in hospitalized premature newborn infants and to assess the role of coronaviruses. All hospitalized premature infants with a gestational age less than or equal to 32 weeks were included. Tracheal or nasopharyngal specimens were studied by immunofluorescence for coronaviruses, respiratory syncytial virus, adenoviruses, influenza and parainfluenza viruses. Forty premature infants were included; 13 samples were positive in 10 newborns (coronaviruses n = 10; influenza 1 n = 2; adenovirus n = 1). None was positive at admission. All premature infants infected with coronaviruses had symptoms of bradycardia, apnea, hypoxemia, fever or abdominal distension. Chest X-ray revealed diffuse infiltrates in two cases. However, no significant difference was observed between infected and non-infected premature infants for gestational age, birth weight, duration of ventilation, age at discharge, incidence of apnea or bradycardia. Nosocomial respiratory tract infection with coronaviruses appears to be frequent. The clinical consequences should be evaluated in a larger population.
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Affiliation(s)
- J Sizun
- Department of Pediatrics, University Hospital, Brest, France
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