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Calderwood S, Sabir A, Rao L, Baker B, Balasa V, Sathi BK. SARS-CoV-2 Infection Presenting as Acute Chest Syndrome in a Child With Hemoglobin SD-Los Angeles Disease: A Case Report and Review of Literature. J Pediatr Hematol Oncol 2023; 45:82-87. [PMID: 36162052 DOI: 10.1097/mph.0000000000002546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 07/29/2022] [Indexed: 11/26/2022]
Abstract
Hemoglobin D-Los Angeles is a variant of hemoglobin that can polymerize in the deoxygenated state. When co-inherited with Hemoglobin S (HbSD-Los Angeles disease) a severe sickling syndrome similar to HbSS can result. Corona virus infectious disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome-corona virus-2. It has been associated with acute chest syndrome (ACS) in individuals with sickle cell disease (SCD), but this complication has not previously been reported in patients with HbSD-Los Angeles. Dexamethasone has been shown to improve outcomes in non-SCD patients with severe acute respiratory syndrome-corona virus-2 pneumonia or acute respiratory distress syndrome; however, its use in SCD patients with ACS is controversial due to a reported increased risk of complications including vaso-occlusive painful episodes. Herein, we reported a patient with HbSD-Los Angeles and COVID-19-associated ACS whom we treated with dexamethasone without transfusion. The patient experienced a rapid recovery without sequelae from steroid use. To further evaluate the use of steroids, we conducted a literature review focusing on the management of pediatric SCD patients with COVID-19-associated ACS. We identified a total of 39 pediatric patients with SCD and COVID-19, of whom 21 (54%) had ACS. Packed red blood cell transfusion (n=11), exchange transfusion (n=4), or a combination of exchange transfusion and packed red blood cell transfusion (n=4) were the most frequently reported treatment, with hydroxychloroquine (n=5), remdesivir (n=1), and tocilizumab (n=1) also being reported. Three patients were treated with dexamethasone. All patients recovered and no adverse outcomes from steroid use were reported. Even though transfusion is considered the standard of care for children with ACS and steroids are not routinely recommended, our experience suggested that COVID-19-associated ACS may be an important exception, especially for patients who refuse transfusion or are in resource-poor nations where blood transfusions may not be readily available. Further studies are warranted to confirm these observations.
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Affiliation(s)
- Stanley Calderwood
- Pediatric Hospital Medicine Program, Bakersfield Memorial Hospital, Bakersfield
- Valley Children's Healthcare, Madera
| | - Aqsa Sabir
- Pediatric Hospital Medicine Program, Bakersfield Memorial Hospital, Bakersfield
- Valley Children's Healthcare, Madera
| | - Latha Rao
- Pediatric Hematology Oncology
- Valley Children's Healthcare, Madera
| | | | - Vinod Balasa
- Pediatric Hematology Oncology
- Valley Children's Healthcare, Madera
- University of San Francisco-Fresno Program, Fresno, CA
| | - Bindu K Sathi
- Pediatric Hematology Oncology
- Valley Children's Healthcare, Madera
- University of San Francisco-Fresno Program, Fresno, CA
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You Y, Yang X, Hung D, Yang Q, Wu T, Deng M. Asymptomatic COVID-19 infection: diagnosis, transmission, population characteristics. BMJ Support Palliat Care 2021:bmjspcare-2020-002813. [PMID: 34330791 DOI: 10.1136/bmjspcare-2020-002813] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 02/26/2021] [Accepted: 03/27/2021] [Indexed: 12/19/2022]
Abstract
A novel coronavirus first discovered in late December 2019 has spread to many countries around the world. An increasing number of asymptomatic patients have been reported and their ability to spread the virus has been proven. This brings major challenges to the control of the transmission. The discovery and control of asymptomatic patients with COVID-19 are the key issues in future epidemic prevention and recovery. In this narrative review, we summarise the existing knowledge about asymptomatic patients and put forward detection methods that are suitable for finding such patients. Besides, we compared the characteristics and transmissibility of asymptomatic patients in different populations in order to find the best screening, diagnosis and control measures for different populations. Comprehensive preventive advice is also provided to prevent the spread of infection from asymptomatic patients.
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Affiliation(s)
- Yaxian You
- Department of Biochemistry and Molecular Biology & Hunan Province Key Laboratory of Basic and Applied Hematology, School of Life Sciences, Central South University, Changsha, Hunan, China
- Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Xinyuan Yang
- Department of Biochemistry and Molecular Biology & Hunan Province Key Laboratory of Basic and Applied Hematology, School of Life Sciences, Central South University, Changsha, Hunan, China
- Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Dongni Hung
- Department of Biochemistry and Molecular Biology & Hunan Province Key Laboratory of Basic and Applied Hematology, School of Life Sciences, Central South University, Changsha, Hunan, China
- Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Qianxi Yang
- Department of Biochemistry and Molecular Biology & Hunan Province Key Laboratory of Basic and Applied Hematology, School of Life Sciences, Central South University, Changsha, Hunan, China
- Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Ting Wu
- Department of Biochemistry and Molecular Biology & Hunan Province Key Laboratory of Basic and Applied Hematology, School of Life Sciences, Central South University, Changsha, Hunan, China
- Department of Cardiovascular Medicine, The Third Xiangya Hospita, Central South University, Changsha, Hunan, China
| | - Meichun Deng
- Department of Biochemistry and Molecular Biology & Hunan Province Key Laboratory of Basic and Applied Hematology, School of Life Sciences, Central South University, Changsha, Hunan, China
- Xiangya School of Medicine, Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Animal Models for Human Diseases, Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, Hunan, China
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Katayama Y, Zha L, Kitamura T, Hirayama A, Takeuchi T, Tanaka K, Komukai S, Shimazu T, Sobue T. Characteristics and Outcomes of Pediatric COVID-19 Patients in Osaka, Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115911. [PMID: 34072919 PMCID: PMC8198974 DOI: 10.3390/ijerph18115911] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 05/18/2021] [Accepted: 05/28/2021] [Indexed: 12/23/2022]
Abstract
The epidemiological information on characteristics, in-hospital treatments, and outcomes of the coronavirus disease 2019 (COVID-19) among pediatric patients has not been fully evaluated in Japan. This was a retrospective observational study conducted in the Osaka Prefecture, Japan, and we enrolled laboratory-confirmed COVID-19 patients aged ≤19 years old from January to November in 2020. Of 14,846 COVID-19 eligible patients, 1240 pediatric patients (8.4%) were registered during the study period; 329 were children aged 0–9 years (26.5%) and 911 were adolescents aged 10–19 years (73.5%). The majority of the patients exhibited mild symptoms at diagnosis (872, 70.3%), some were asymptomatic (296, 23.9%). Cluster infections occurred in child-care facilities (26, 7.9%) among children and in universities (27, 3.0%) and schools (18, 2.0%) among adolescents. The number of close-contact cases was 260 (69.0%) in children and 459 (50.4%) in adolescents. Sixty of the children (18.2%) and 90 of the adolescents (9.9%) were hospitalized. One patient received mechanical ventilation, and none underwent extracorporeal membrane oxygenation. One patient was admitted to the intensive care unit; there were no deaths. These results are useful for recognizing the clinical course from transmission route to outcomes of this infection in pediatric patients.
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Affiliation(s)
- Yusuke Katayama
- Department of Traumatology and Acute Critical Medicine, Graduate School of Medicine, Osaka University, Suita, Osaka 565-0871, Japan; (Y.K.); (T.S.)
| | - Ling Zha
- Department of Social and Environmental Medicine, Division of Environmental Medicine and Population Sciences, Graduate School of Medicine, Osaka University, Suita 565-0871, Japan; (L.Z.); (T.T.); (K.T.); (T.S.)
| | - Tetsuhisa Kitamura
- Department of Social and Environmental Medicine, Division of Environmental Medicine and Population Sciences, Graduate School of Medicine, Osaka University, Suita 565-0871, Japan; (L.Z.); (T.T.); (K.T.); (T.S.)
- Correspondence: ; Tel.: +81-6-6879-3922
| | - Atsushi Hirayama
- Department of Social Medicine, Division of Public Health, Graduate School of Medicine, Osaka University, Suita, Osaka 565-0871, Japan;
| | - Taro Takeuchi
- Department of Social and Environmental Medicine, Division of Environmental Medicine and Population Sciences, Graduate School of Medicine, Osaka University, Suita 565-0871, Japan; (L.Z.); (T.T.); (K.T.); (T.S.)
| | - Kenta Tanaka
- Department of Social and Environmental Medicine, Division of Environmental Medicine and Population Sciences, Graduate School of Medicine, Osaka University, Suita 565-0871, Japan; (L.Z.); (T.T.); (K.T.); (T.S.)
| | - Sho Komukai
- Department of Integrated Medicine, Division of Biomedical Statistics, Graduate School of Medicine, Osaka University, Suita, Osaka 565-0871, Japan;
| | - Takeshi Shimazu
- Department of Traumatology and Acute Critical Medicine, Graduate School of Medicine, Osaka University, Suita, Osaka 565-0871, Japan; (Y.K.); (T.S.)
| | - Tomotaka Sobue
- Department of Social and Environmental Medicine, Division of Environmental Medicine and Population Sciences, Graduate School of Medicine, Osaka University, Suita 565-0871, Japan; (L.Z.); (T.T.); (K.T.); (T.S.)
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