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Wongwathanavikrom NB, Tovichien P, Udomittipong K, Palamit A, Tiamduangtawan P, Mahoran K, Charoensittisup P. Incidence and risk factors for long COVID in children with COVID-19 pneumonia. Pediatr Pulmonol 2024; 59:1330-1338. [PMID: 38353350 DOI: 10.1002/ppul.26910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 01/06/2024] [Accepted: 01/31/2024] [Indexed: 04/30/2024]
Abstract
BACKGROUND AND OBJECTIVE There are only a few reports of long COVID including pulmonary function in children after COVID-19 pneumonia. We determined the incidence of long COVID and abnormal pulmonary function in those children and identify risk factors. METHODS This cohort study enrolled children admitted with COVID-19 pneumonia during 2021-2022. We gathered clinical characteristics during admission and at follow-up 3 months after. RESULTS We determined the incidence of long COVID at 39.7% (95% confidence interval [CI]: 30.7%-49.1%). All severe pneumonia cases consistently reported persistent symptoms. Exercise intolerance, cough, and fatigue were the three most common persistent symptoms in 26 (22.4%), 21 (18.1%), and 18 (15.5%) of the patients, respectively. At the follow-up, 21 cases (18.1%) demonstrated persistent abnormal chest radiographs. Three cases (6.9%) demonstrated restrictive ventilatory defects. Among those, one case (2.3%) demonstrated concomitant diffusion defect. Three cases (6.0%) demonstrated exercise-induced hypoxemia after the 6-minute walk test. Comparing spirometry variables between children with long COVID and without revealed significant difference of FEF25-75 (z score) between two groups. Age [adjusted OR (95% CI): 1.13 (1.05-1.22), p value 0.002], allergic diseases [adjusted OR (95% CI): 4.05 (1.36-12.06), p value 0.012], and living in polluted areas [adjusted OR (95% CI): 2.73 (1.18-6.33), p value 0.019] were significantly associated with long COVID. CONCLUSION A significant percentage of children developed long COVID after COVID-19 pneumonia. We should give additional attention to those who have exercise intolerance, chronic cough, or fatigue, especially older children, severe cases, children with allergic diseases, and those living in polluted areas.
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Affiliation(s)
- Na-Bhadhra Wongwathanavikrom
- Department of Pediatrics, Division of Pulmonology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Prakarn Tovichien
- Department of Pediatrics, Division of Pulmonology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Kanokporn Udomittipong
- Department of Pediatrics, Division of Pulmonology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Apinya Palamit
- Department of Pediatrics, Division of Pulmonology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Pinyapach Tiamduangtawan
- Department of Pediatrics, Division of Pulmonology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Khunphon Mahoran
- Department of Pediatrics, Division of Pulmonology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Pawinee Charoensittisup
- Department of Pediatrics, Division of Pulmonology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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2
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Stroz S, Kosiorek P, Zbroch E, Mikoluc B, Stasiak-Barmuta A. Immune response variation in mild and severe COVID-19 patients. Qatar Med J 2024; 2024:11. [PMID: 38468605 PMCID: PMC10925834 DOI: 10.5339/qmj.2024.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 02/04/2024] [Indexed: 03/13/2024] Open
Abstract
Sixty patients with COVID-19 infection were categorized into mild and severe groups, and their immune response was analyzed using flow cytometry and complete blood count. An observed increase in immune activation parameters, notably a higher percentage of CD4 lymphocytes co-expressing CD69 and CD25 molecules, and enhanced activity of the macrophage-monocyte cell line was noted in the mild group. Although Group 2 (severe COVID) had fewer CD4 cells, significant migration and proliferation were evident, with increased CD4CD69, CD8 HLA-DR+, and CD8CD69 lymphocytes. The CD4 to CD8 ratio in Group 1 suggested potential autoimmune reactions, while Group 2 indicated potential immunosuppression from severe infection and employing immunosuppressive drugs. Additionally, Group 2 exhibited an increased neutrophil count, hinting at possible bacterial co-infection. Group 1 showed differences in CD4RO and CD8RA lymphocyte populations, implying that cellular immunity plays a role in developing efficient postinfectious immunity. This intimation suggests that vaccination might mitigate the severity of the coronavirus infection and prevent complications, including long-term COVID-19.
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Affiliation(s)
- Samuel Stroz
- Department of Clinical Immunology, Medical University of Bialystok, Bialystok, Poland
| | - Piotr Kosiorek
- Department of Clinical Immunology, Medical University of Bialystok, Bialystok, Poland
| | - Edyta Zbroch
- Department of Internal Medicine and Hypertension, Medical University of Bialystok, Bialystok, Poland
| | - Bozena Mikoluc
- Department of Pediatrics, Rheumatology, Immunology and Metabolic Bone Diseases, Medical University of Bialystok, Bialystok, Poland
| | - Anna Stasiak-Barmuta
- Department of Clinical Immunology, Medical University of Bialystok, Bialystok, Poland
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3
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Hernández-García M, Solito C, Pavón Ortiz A, Arguedas Casamayor N, Melé-Casas M, Pons-Tomàs G, F. de Sevilla M, Pino R, Launes C, Guitart C, Girona-Alarcón M, Jordan I, García-García JJ. Characteristics and Risk Factors Associated with SARS-CoV-2 Pneumonias in Hospitalized Pediatric Patients: A Pilot Study. Children (Basel) 2023; 10:1703. [PMID: 37892366 PMCID: PMC10605629 DOI: 10.3390/children10101703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 10/11/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023]
Abstract
SARS-CoV-2 pneumonia in children has a lower incidence and severity compared to adults. Risk factors are adolescence and comorbidities. Our aims were to describe the characteristics of children admitted with SARS-CoV-2 pneumonia, identify risk factors associated with severity and compare the cases according to the variant of SARS-CoV-2. This was a descriptive and retrospective study, including patients aged 0-18 years hospitalized in a tertiary-care hospital between 1 March 2020 and 1 March 2022. Epidemiological, clinical, diagnostic and therapeutic data were analyzed. Forty-four patients were admitted; twenty-six (59%) were male and twenty-seven (61%) were older than 12 years. Thirty-six (82%) had comorbidities, the most frequent of which were obesity and asthma. Seven (15.9%) patients required high-flow oxygen, eleven (25%) non-invasive ventilation and four (9.1%) conventional mechanical ventilation. In critically ill patients, higher levels of anemia, lymphopenia, procalcitonin, lactate dehydrogenase (LDH) and hypoalbuminemia and lower levels of HDL-cholesterol were detected (all p < 0.05). Prematurity (p = 0.022) was associated with intensive care unit admission. Patients were younger during the Omicron wave (p < 0.01); no variant was associated with greater severity. In conclusion, pediatric patients with a history of prematurity or with anemia, lymphopenia, elevated procalcitonin, elevated LDH levels, hypoalbuminemia and low HDL-cholesterol levels may require admission and present more severe forms. Apart from age, no notable differences between SARS-CoV-2 variant periods were found.
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Affiliation(s)
- María Hernández-García
- Paediatrics Department, Hospital Sant Joan de Déu Barcelona, 08950 Barcelona, Spain; (M.H.-G.); (C.S.); (A.P.O.); (N.A.C.); (M.M.-C.); (G.P.-T.); (M.F.d.S.); (R.P.); (C.L.); (J.J.G.-G.)
- Infectious Diseases and Microbiome, Institut de Recerca Sant Joan de Déu (IRSJD), 08950 Barcelona, Spain; (C.G.); (M.G.-A.)
| | - Claudia Solito
- Paediatrics Department, Hospital Sant Joan de Déu Barcelona, 08950 Barcelona, Spain; (M.H.-G.); (C.S.); (A.P.O.); (N.A.C.); (M.M.-C.); (G.P.-T.); (M.F.d.S.); (R.P.); (C.L.); (J.J.G.-G.)
| | - Alba Pavón Ortiz
- Paediatrics Department, Hospital Sant Joan de Déu Barcelona, 08950 Barcelona, Spain; (M.H.-G.); (C.S.); (A.P.O.); (N.A.C.); (M.M.-C.); (G.P.-T.); (M.F.d.S.); (R.P.); (C.L.); (J.J.G.-G.)
| | - Noelia Arguedas Casamayor
- Paediatrics Department, Hospital Sant Joan de Déu Barcelona, 08950 Barcelona, Spain; (M.H.-G.); (C.S.); (A.P.O.); (N.A.C.); (M.M.-C.); (G.P.-T.); (M.F.d.S.); (R.P.); (C.L.); (J.J.G.-G.)
| | - Maria Melé-Casas
- Paediatrics Department, Hospital Sant Joan de Déu Barcelona, 08950 Barcelona, Spain; (M.H.-G.); (C.S.); (A.P.O.); (N.A.C.); (M.M.-C.); (G.P.-T.); (M.F.d.S.); (R.P.); (C.L.); (J.J.G.-G.)
- Infectious Diseases and Microbiome, Institut de Recerca Sant Joan de Déu (IRSJD), 08950 Barcelona, Spain; (C.G.); (M.G.-A.)
| | - Gemma Pons-Tomàs
- Paediatrics Department, Hospital Sant Joan de Déu Barcelona, 08950 Barcelona, Spain; (M.H.-G.); (C.S.); (A.P.O.); (N.A.C.); (M.M.-C.); (G.P.-T.); (M.F.d.S.); (R.P.); (C.L.); (J.J.G.-G.)
- Infectious Diseases and Microbiome, Institut de Recerca Sant Joan de Déu (IRSJD), 08950 Barcelona, Spain; (C.G.); (M.G.-A.)
| | - Mariona F. de Sevilla
- Paediatrics Department, Hospital Sant Joan de Déu Barcelona, 08950 Barcelona, Spain; (M.H.-G.); (C.S.); (A.P.O.); (N.A.C.); (M.M.-C.); (G.P.-T.); (M.F.d.S.); (R.P.); (C.L.); (J.J.G.-G.)
- Infectious Diseases and Microbiome, Institut de Recerca Sant Joan de Déu (IRSJD), 08950 Barcelona, Spain; (C.G.); (M.G.-A.)
- Faculty of Medicine and Health Sciences, Universitat de Barcelona, 08036 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBER-ESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Rosa Pino
- Paediatrics Department, Hospital Sant Joan de Déu Barcelona, 08950 Barcelona, Spain; (M.H.-G.); (C.S.); (A.P.O.); (N.A.C.); (M.M.-C.); (G.P.-T.); (M.F.d.S.); (R.P.); (C.L.); (J.J.G.-G.)
| | - Cristian Launes
- Paediatrics Department, Hospital Sant Joan de Déu Barcelona, 08950 Barcelona, Spain; (M.H.-G.); (C.S.); (A.P.O.); (N.A.C.); (M.M.-C.); (G.P.-T.); (M.F.d.S.); (R.P.); (C.L.); (J.J.G.-G.)
- Infectious Diseases and Microbiome, Institut de Recerca Sant Joan de Déu (IRSJD), 08950 Barcelona, Spain; (C.G.); (M.G.-A.)
- Faculty of Medicine and Health Sciences, Universitat de Barcelona, 08036 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBER-ESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Carmina Guitart
- Infectious Diseases and Microbiome, Institut de Recerca Sant Joan de Déu (IRSJD), 08950 Barcelona, Spain; (C.G.); (M.G.-A.)
- Paediatric Intensive Care Unit, Hospital Sant Joan de Déu Barcelona, 08950 Barcelona, Spain
| | - Mònica Girona-Alarcón
- Infectious Diseases and Microbiome, Institut de Recerca Sant Joan de Déu (IRSJD), 08950 Barcelona, Spain; (C.G.); (M.G.-A.)
- Paediatric Intensive Care Unit, Hospital Sant Joan de Déu Barcelona, 08950 Barcelona, Spain
| | - Iolanda Jordan
- Infectious Diseases and Microbiome, Institut de Recerca Sant Joan de Déu (IRSJD), 08950 Barcelona, Spain; (C.G.); (M.G.-A.)
- Faculty of Medicine and Health Sciences, Universitat de Barcelona, 08036 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBER-ESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Paediatric Intensive Care Unit, Hospital Sant Joan de Déu Barcelona, 08950 Barcelona, Spain
| | - Juan José García-García
- Paediatrics Department, Hospital Sant Joan de Déu Barcelona, 08950 Barcelona, Spain; (M.H.-G.); (C.S.); (A.P.O.); (N.A.C.); (M.M.-C.); (G.P.-T.); (M.F.d.S.); (R.P.); (C.L.); (J.J.G.-G.)
- Infectious Diseases and Microbiome, Institut de Recerca Sant Joan de Déu (IRSJD), 08950 Barcelona, Spain; (C.G.); (M.G.-A.)
- Faculty of Medicine and Health Sciences, Universitat de Barcelona, 08036 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBER-ESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
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Miraglia Del Giudice M, Klain A, Dinardo G, D'Addio E, Bencivenga CL, Fontanella C, Decimo F, Umano GR, Siciliano M, Carotenuto M, Indolfi C. Behavioral and Sleep Disorders in Children and Adolescents following COVID-19 Disease: A Case-Control Study. Children (Basel) 2023; 10:1189. [PMID: 37508686 PMCID: PMC10378309 DOI: 10.3390/children10071189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/04/2023] [Accepted: 07/07/2023] [Indexed: 07/30/2023]
Abstract
INTRODUCTION Recent studies show that neuropsychiatric disorders are the most frequent sequelae of COVID-19 in children. PURPOSE Our work aimed to evaluate the impact of SARS-CoV-2 infection on behavior and sleep in children and adolescents. MATERIALS AND METHODS We enrolled 107 patients aged 1.5-18 years who contracted COVID-19 between one year and one month prior to data collection, referred to the University of Campania Luigi Vanvitelli in Italy. We asked their parents to complete two standardized questionnaires for the assessment of behavior (Child Behavior CheckList (CBCL)) and sleep (Sleep Disturbance Scale for Children (SLDS)). We analysed and compared the results with a control group (pre-COVID-19 pandemic). RESULTS In the COVID-19 group, the major results were found for sleep breathing disorders, sleep-wake transition disorders and disorders of initiating and maintaining sleep for the SDSC questionnaire, and internalizing scale, total scale and anxiety/depression for the CBCL questionnaire. The comparison of the CBCL results of the cases with the controls revealed statistically significant differences for the following items: internalizing scale, externalizing scale, somatic complaints, total score, thought problems [(p < 0.01)], anxious/depressed problems and withdrawn [(p < 0.001)]. CONCLUSIONS COVID-19 has impacted children's and adolescents' mental health. Adolescents were the most affected patient group for internalizing problems, including anxiety and depression.
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Affiliation(s)
- Michele Miraglia Del Giudice
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Angela Klain
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Giulio Dinardo
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Elisabetta D'Addio
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Chiara Lucia Bencivenga
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Cristina Fontanella
- Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, University of Campania "Luigi Vanvitelli", 80138 Caserta, Italy
| | - Fabio Decimo
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Giuseppina Rosaria Umano
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Margherita Siciliano
- Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, University of Campania "Luigi Vanvitelli", 80138 Caserta, Italy
| | - Marco Carotenuto
- Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, University of Campania "Luigi Vanvitelli", 80138 Caserta, Italy
| | - Cristiana Indolfi
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
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Flaxman S, Whittaker C, Semenova E, Rashid T, Parks RM, Blenkinsop A, Unwin HJT, Mishra S, Bhatt S, Gurdasani D, Ratmann O. Assessment of COVID-19 as the Underlying Cause of Death Among Children and Young People Aged 0 to 19 Years in the US. JAMA Netw Open 2023; 6:e2253590. [PMID: 36716029 PMCID: PMC9887489 DOI: 10.1001/jamanetworkopen.2022.53590] [Citation(s) in RCA: 34] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 12/09/2022] [Indexed: 01/31/2023] Open
Abstract
Importance COVID-19 was the underlying cause of death for more than 940 000 individuals in the US, including at least 1289 children and young people (CYP) aged 0 to 19 years, with at least 821 CYP deaths occurring in the 1-year period from August 1, 2021, to July 31, 2022. Because deaths among US CYP are rare, the mortality burden of COVID-19 in CYP is best understood in the context of all other causes of CYP death. Objective To determine whether COVID-19 is a leading (top 10) cause of death in CYP in the US. Design, Setting, and Participants This national population-level cross-sectional epidemiological analysis for the years 2019 to 2022 used data from the US Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (WONDER) database on underlying cause of death in the US to identify the ranking of COVID-19 relative to other causes of death among individuals aged 0 to 19 years. COVID-19 deaths were considered in 12-month periods between April 1, 2020, and August 31, 2022, compared with deaths from leading non-COVID-19 causes in 2019, 2020, and 2021. Main Outcomes and Measures Cause of death rankings by total number of deaths, crude rates per 100 000 population, and percentage of all causes of death, using the National Center for Health Statistics 113 Selected Causes of Death, for ages 0 to 19 and by age groupings (<1 year, 1-4 years, 5-9 years, 10-14 years, 15-19 years). Results There were 821 COVID-19 deaths among individuals aged 0 to 19 years during the study period, resulting in a crude death rate of 1.0 per 100 000 population overall; 4.3 per 100 000 for those younger than 1 year; 0.6 per 100 000 for those aged 1 to 4 years; 0.4 per 100 000 for those aged 5 to 9 years; 0.5 per 100 000 for those aged 10 to 14 years; and 1.8 per 100 000 for those aged 15 to 19 years. COVID-19 mortality in the time period of August 1, 2021, to July 31, 2022, was among the 10 leading causes of death in CYP aged 0 to 19 years in the US, ranking eighth among all causes of deaths, fifth in disease-related causes of deaths (excluding unintentional injuries, assault, and suicide), and first in deaths caused by infectious or respiratory diseases when compared with 2019. COVID-19 deaths constituted 2% of all causes of death in this age group. Conclusions and Relevance The findings of this study suggest that COVID-19 was a leading cause of death in CYP. It caused substantially more deaths in CYP annually than any vaccine-preventable disease historically in the recent period before vaccines became available. Various factors, including underreporting and not accounting for COVID-19's role as a contributing cause of death from other diseases, mean that these estimates may understate the true mortality burden of COVID-19. The findings of this study underscore the public health relevance of COVID-19 to CYP. In the likely future context of sustained SARS-CoV-2 circulation, appropriate pharmaceutical and nonpharmaceutical interventions (eg, vaccines, ventilation, air cleaning) will continue to play an important role in limiting transmission of the virus and mitigating severe disease in CYP.
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Affiliation(s)
- Seth Flaxman
- Department of Computer Science, University of Oxford, Oxford, United Kingdom
| | - Charles Whittaker
- MRC Centre for Global Infectious Disease Analysis, Jameel Institute for Disease and Emergency Analytics, Imperial College London, United Kingdom
| | - Elizaveta Semenova
- Department of Computer Science, University of Oxford, Oxford, United Kingdom
| | - Theo Rashid
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, United Kingdom
| | - Robbie M. Parks
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York
| | | | - H. Juliette T. Unwin
- MRC Centre for Global Infectious Disease Analysis, Jameel Institute for Disease and Emergency Analytics, Imperial College London, United Kingdom
| | - Swapnil Mishra
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Samir Bhatt
- MRC Centre for Global Infectious Disease Analysis, Jameel Institute for Disease and Emergency Analytics, Imperial College London, United Kingdom
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | | | - Oliver Ratmann
- Department of Mathematics, Imperial College London, United Kingdom
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6
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Smith RR, Driver KC, Karber BF, Luciano AA, Berg MT, Prado IV, Teper JE. A case report: Hypoxic ischemic encephalopathy & pneumonia in a neonate after SARS-CoV-2 intrauterine transmission. J Neonatal Perinatal Med 2022; 15:851-858. [PMID: 36031910 DOI: 10.3233/npm-221026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Severe acute respiratory coronavirus 2 (SARS-CoV-2) is primarily transmitted via respiratory droplet or aerosol route. However, there is mounting evidence for intrauterine transmission. We report on a late preterm infant with suspected intrauterine acquisition of SARS-CoV-2 who experienced birth depression, hypoxic ischemic encephalopathy, multisystem organ involvement, and late onset COVID-19 pneumonia [22].
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Affiliation(s)
- R R Smith
- HCA Florida Brandon Hospital, Brandon, Florida.,Johns Hopkins All Children's Hospital, Maternal Fetal & Neonatal Institute St. Petersburg, Florida
| | - K C Driver
- HCA Florida Brandon Hospital, Brandon, Florida.,Johns Hopkins All Children's Hospital, Maternal Fetal & Neonatal Institute St. Petersburg, Florida
| | - B F Karber
- HCA Florida Brandon Hospital, Brandon, Florida.,Johns Hopkins All Children's Hospital, Maternal Fetal & Neonatal Institute St. Petersburg, Florida
| | - A A Luciano
- HCA Florida Brandon Hospital, Brandon, Florida.,Johns Hopkins All Children's Hospital, Maternal Fetal & Neonatal Institute St. Petersburg, Florida
| | - M T Berg
- HCA Florida Brandon Hospital, Brandon, Florida.,Johns Hopkins All Children's Hospital, Maternal Fetal & Neonatal Institute St. Petersburg, Florida
| | - I V Prado
- HCA Florida Brandon Hospital, Brandon, Florida
| | - J E Teper
- HCA Florida Brandon Hospital, Brandon, Florida.,Johns Hopkins All Children's Hospital, Maternal Fetal & Neonatal Institute St. Petersburg, Florida
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7
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Asseri AA, Al-Qahtani SM, Algathradi MA, Alzaydani IA, Al-Jarie AA, Al-Benhassan IA, AlHelali IA, Alassiri MS, Alrmelawi AA, Ali AS. Clinical, laboratory, and chest radiographic characteristics of COVID-19 associated severe pediatric pneumonia. A retrospective study. Saudi Med J 2022; 43:1390-1396. [PMID: 36517065 PMCID: PMC9994509 DOI: 10.15537/smj.2022.43.12.20220420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 10/13/2022] [Indexed: 12/17/2023] Open
Abstract
OBJECTIVES To evaluate the demographics, clinical presentation, laboratory data, chest radiographs, and outcomes of pediatric patients with critical coronavirus disease 2019 (COVID-19). METHODS This retrospective study included 34 children who were diagnosed with severe COVID-19 pneumonia between August 2020 and July 2021. Severe pneumonia was defined as fever, respiratory distress (tachypnea, chest retractions, and hypoxia [oxygen saturation <90% in room air]), and obvious infiltrations on chest radiography. RESULTS Ages of the patients ranged from newborns to 12 years old, with a median of 24 months (interquartile range: 12-72 months). Preschool-aged children were the most common age group (44%). Levels of inflammatory markers (C-reactive protein, ferritin, and procalcitonin) were elevated in most patients. A total of 13 patients developed severe acute respiratory distress syndrome (ARDS), while 4 developed multiorgan failure. Despite receiving supportive therapy, 2 (5.9%) patients died due to severe septic shock and multiorgan failure. One deceased patient was born prematurely at 30 weeks, while the other had chronic granulomatous disease. CONCLUSION This study described a single-center cohort of pediatric patients with severe COVID-19 pneumonia. In this cohort, children with cardiopulmonary comorbidities and ARDS had a high mortality and long-term morbidity, as observed in other pediatric studies.
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Affiliation(s)
- Ali A. Asseri
- From the Department of Child Health (Asseri, Al-Qahtani); from the Department of Radiology (Algathradi); from the Department of Microbiology and Clinical Parasitology (Ali), College of Medicine, King Khalid University, from the Department of Pediatrics (Alzaydani, Al-Jarie, Alassiri); from the Department of Pediatric Critical Care Unit (Al-Benhassan, AlHelali); and from the Department of Microbiology (Alrmelawi), Abha Maternity and Children Hospital, Abha, Kingdom of Saudi Arabia.
| | - Saleh M. Al-Qahtani
- From the Department of Child Health (Asseri, Al-Qahtani); from the Department of Radiology (Algathradi); from the Department of Microbiology and Clinical Parasitology (Ali), College of Medicine, King Khalid University, from the Department of Pediatrics (Alzaydani, Al-Jarie, Alassiri); from the Department of Pediatric Critical Care Unit (Al-Benhassan, AlHelali); and from the Department of Microbiology (Alrmelawi), Abha Maternity and Children Hospital, Abha, Kingdom of Saudi Arabia.
| | - Mohammed A. Algathradi
- From the Department of Child Health (Asseri, Al-Qahtani); from the Department of Radiology (Algathradi); from the Department of Microbiology and Clinical Parasitology (Ali), College of Medicine, King Khalid University, from the Department of Pediatrics (Alzaydani, Al-Jarie, Alassiri); from the Department of Pediatric Critical Care Unit (Al-Benhassan, AlHelali); and from the Department of Microbiology (Alrmelawi), Abha Maternity and Children Hospital, Abha, Kingdom of Saudi Arabia.
| | - Ibrahim A. Alzaydani
- From the Department of Child Health (Asseri, Al-Qahtani); from the Department of Radiology (Algathradi); from the Department of Microbiology and Clinical Parasitology (Ali), College of Medicine, King Khalid University, from the Department of Pediatrics (Alzaydani, Al-Jarie, Alassiri); from the Department of Pediatric Critical Care Unit (Al-Benhassan, AlHelali); and from the Department of Microbiology (Alrmelawi), Abha Maternity and Children Hospital, Abha, Kingdom of Saudi Arabia.
| | - Ahmed A. Al-Jarie
- From the Department of Child Health (Asseri, Al-Qahtani); from the Department of Radiology (Algathradi); from the Department of Microbiology and Clinical Parasitology (Ali), College of Medicine, King Khalid University, from the Department of Pediatrics (Alzaydani, Al-Jarie, Alassiri); from the Department of Pediatric Critical Care Unit (Al-Benhassan, AlHelali); and from the Department of Microbiology (Alrmelawi), Abha Maternity and Children Hospital, Abha, Kingdom of Saudi Arabia.
| | - Ibrahim A. Al-Benhassan
- From the Department of Child Health (Asseri, Al-Qahtani); from the Department of Radiology (Algathradi); from the Department of Microbiology and Clinical Parasitology (Ali), College of Medicine, King Khalid University, from the Department of Pediatrics (Alzaydani, Al-Jarie, Alassiri); from the Department of Pediatric Critical Care Unit (Al-Benhassan, AlHelali); and from the Department of Microbiology (Alrmelawi), Abha Maternity and Children Hospital, Abha, Kingdom of Saudi Arabia.
| | - Ibrahim A. AlHelali
- From the Department of Child Health (Asseri, Al-Qahtani); from the Department of Radiology (Algathradi); from the Department of Microbiology and Clinical Parasitology (Ali), College of Medicine, King Khalid University, from the Department of Pediatrics (Alzaydani, Al-Jarie, Alassiri); from the Department of Pediatric Critical Care Unit (Al-Benhassan, AlHelali); and from the Department of Microbiology (Alrmelawi), Abha Maternity and Children Hospital, Abha, Kingdom of Saudi Arabia.
| | - Mona S. Alassiri
- From the Department of Child Health (Asseri, Al-Qahtani); from the Department of Radiology (Algathradi); from the Department of Microbiology and Clinical Parasitology (Ali), College of Medicine, King Khalid University, from the Department of Pediatrics (Alzaydani, Al-Jarie, Alassiri); from the Department of Pediatric Critical Care Unit (Al-Benhassan, AlHelali); and from the Department of Microbiology (Alrmelawi), Abha Maternity and Children Hospital, Abha, Kingdom of Saudi Arabia.
| | - Ali A. Alrmelawi
- From the Department of Child Health (Asseri, Al-Qahtani); from the Department of Radiology (Algathradi); from the Department of Microbiology and Clinical Parasitology (Ali), College of Medicine, King Khalid University, from the Department of Pediatrics (Alzaydani, Al-Jarie, Alassiri); from the Department of Pediatric Critical Care Unit (Al-Benhassan, AlHelali); and from the Department of Microbiology (Alrmelawi), Abha Maternity and Children Hospital, Abha, Kingdom of Saudi Arabia.
| | - Abdelwahid S. Ali
- From the Department of Child Health (Asseri, Al-Qahtani); from the Department of Radiology (Algathradi); from the Department of Microbiology and Clinical Parasitology (Ali), College of Medicine, King Khalid University, from the Department of Pediatrics (Alzaydani, Al-Jarie, Alassiri); from the Department of Pediatric Critical Care Unit (Al-Benhassan, AlHelali); and from the Department of Microbiology (Alrmelawi), Abha Maternity and Children Hospital, Abha, Kingdom of Saudi Arabia.
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8
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Al-Ani RM, Rashid RA. Unpredicted clinical manifestation of COVID-19: a unique case report and review of literature. Egypt J Otolaryngol 2022. [PMCID: PMC9449950 DOI: 10.1186/s43163-022-00312-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Background Cervical lymphadenopathy in children is a common problem in daily clinical practice. Many cases of cervical lymphadenopathy after the COVID-19 vaccine were reported. However, there is no yet reporting a case of supraclavicular cervical lymphadenopathy due to COVID-19. Case presentation A 12-year-old girl presented with fever, cough, fatigue, anosmia, and ageusia. COVID-19 was confirmed by real-time PCR. The symptoms were resolved within 10 days. Seven days later, she complained of supraclavicular swelling. Physical examination revealed painless, multiple, and mobile supraclavicular lymph nodes. Ultrasound and fine-needle aspiration cytology were suspicious. Therefore, an excisional biopsy of the largest node was performed. The specimen was sent for histopathology and immunohistochemistry evaluation which confirmed the benign nature of the lymph node. Conclusion To our best knowledge, this is the first case of supraclavicular lymphadenopathy in a child with COVID-19. It is essential to put COVID-19 in the differential diagnosis of cervical lymphadenopathy.
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9
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Miraglia del Giudice M, Indolfi C, Dinardo G, Decimo F, Decimo A, Klain A. Vitamin D status can affect COVID-19 outcomes also in pediatric population. PharmaNutrition 2022; 22:100319. [PMID: 36268528 PMCID: PMC9562619 DOI: 10.1016/j.phanu.2022.100319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 10/12/2022] [Accepted: 10/12/2022] [Indexed: 11/03/2022]
Abstract
Background vitamin D influences the immune system and the inflammatory response. It is known that vitamin D supplementation reduces the risk of acute respiratory tract infection. In the last two years, many researchers have investigated vitamin D's role in the pathophysiology of COVID-19 disease. Results the findings obtained from clinical trials and systematic reviews highlight that most patients with COVID-19 have decreased vitamin D levels and low levels of vitamin D increase the risk of severe disease. This evidence seems to be also confirmed in the pediatric population. Conclusions further studies (systematic review and meta-analysis) conducted on children are needed to confirm that vitamin D affects COVID-19 outcomes and to determine the effectiveness of supplementation and the appropriate dose, duration and mode of administration.
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Key Words
- , IFN-γ, reduce interferon-gamma
- , RAS, renin-angiotensin system
- ACE2, angiotensin-converting enzyme 2
- CI, confidence interval
- COVID-19
- Children
- DAMPs, damage-associated molecular patterns
- DCs, dendritic cells
- HR, Hazard Risk
- ICU, intensive care unit
- IL, interleukin
- IgE, immunoglobulin E
- Immunity
- MD, mean difference
- NK, natural killer
- OR, odds ratio
- PAMPs, pathogen-associated molecular patterns
- PRRs, pattern recognition receptors
- RCTs, randomized control trials
- RR, risk ratio
- SARS-CoV-2 infection
- TLRs, Toll-like receptors
- TNF-α, tumor necrosis factor-α
- Treg cells, CD, regulatory T cellcluster of differentiation
- VDRs, vitamin D receptors
- Vitamin D
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Affiliation(s)
- Michele Miraglia del Giudice
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy,Correspondence to: Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Via Luigi de Crecchio, 4, 80138 Naples, Italy
| | - Cristiana Indolfi
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Giulio Dinardo
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Fabio Decimo
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Alberto Decimo
- Department of Mental, Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Angela Klain
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
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10
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Pascoal LM, de Oliveira Lopes MV, da Silva VM, Diniz CM, Nunes MM, Guedes NG, de Menezes AP. Simultaneous concept analysis of nursing diagnoses related to respiratory function. Nurs Forum 2022; 57:1513-1522. [PMID: 36210479 DOI: 10.1111/nuf.12807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 08/24/2022] [Accepted: 09/16/2022] [Indexed: 06/16/2023]
Abstract
AIM To perform a simultaneous concept analysis of the concepts associated to nursing diagnoses ineffective airway clearance, ineffective breathing pattern, and impaired gas exchange. BACKGROUND Concepts about respiratory manifestations need to be well defined, especially in the current pandemic scenario. For that, the simultaneous concept analysis can help in the clarity and differentiation of similar concepts. METHODS A concept analysis using the Walker and Avant approach and an integrative review. Data were collected by a group of nurses through a literature review. The group identified 10 articles that met the inclusion criteria and complemented the understanding of the concepts analysed through the sequential description of respiratory physiology in technical books. RESULTS The final list included 28, 22, and 21 clinical indicators for ineffective breathing pattern, impaired gas exchange, and ineffective airway clearance, respectively. The former, the final proposal incorporated 13 indicators that were pointed out by the group and 15 defining characteristics of NANDA-International. For Impaired gas exchange, the indicator "decreased oxygen saturation" was included; among the defining characteristics of NANDA-International, "abnormal arterial blood gases" was excluded, and "abnormal breathing pattern" was subdivided into "alterations in respiratory depth," "bradypnea," "tachypnea," and "change in respiratory rhythm." The latter, only the "wide-eyed" was removed from the final list of clinical indicators, which subsequently consisted of nine indicators suggested by the group and 12 defining characteristics. CONCLUSION This concept analysis may aid in the process of differentiation for ineffective airway clearance, ineffective breathing pattern, and impaired gas exchange, and aid in safer diagnostic inference. This concept analysis can support the understanding of respiratory nursing diagnoses, helping nurses to identify and differentiate them more safely.
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Affiliation(s)
- Lívia M Pascoal
- Nursing Department, Center of Social Sciences, Health and Technology, Federal University of Maranhão, University Av., Dom Afonso Felipe Gregory, Imperatriz, Maranhão, Brazil
| | | | | | - Camila M Diniz
- Nursing Department, Federal University of Ceará, Ceará, Brazil
| | - Marília M Nunes
- Nursing Department, Federal University of Ceará, Ceará, Brazil
| | - Nirla G Guedes
- Nursing Department, Federal University of Ceará, Ceará, Brazil
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11
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D’Ascenzi F, Castelletti S, Adami PE, Cavarretta E, Sanz-de la Garza M, Maestrini V, Biffi A, Kantor P, Pieles G, Verhagen E, Tiberi M, Hanssen H, Papadakis M, Niebauer J, Halle M. Cardiac screening prior to return to play after SARS-CoV-2 infection: focus on the child and adolescent athlete: A Clinical Consensus Statement of the Task Force for Childhood Health of the European Association of Preventive Cardiology. Eur J Prev Cardiol 2022; 29:2120-2124. [PMID: 36059208 PMCID: PMC9494331 DOI: 10.1093/eurjpc/zwac180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 08/10/2022] [Accepted: 08/16/2022] [Indexed: 01/11/2023]
Abstract
Cardiac sequelae after COVID-19 have been described in athletes, prompting the need to establish a return-to-play (RTP) protocol to guarantee a safe return to sports practice. Sports participation is strongly associated with multiple short- and long-term health benefits in children and adolescents and plays a crucial role in counteracting the psychological and physical effects of the current pandemic. Therefore, RTP protocols should be balanced to promote safe sports practice, particularly after an asymptomatic SARS-CoV-2 infection that represents the common manifestation in children. The present consensus document aims to summarize the current evidence on the cardiac sequelae of COVID-19 in children and young athletes, providing key messages for conducting the RTP protocol in paediatric athletes to promote a safe sports practice during the COVID-19 era.
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Affiliation(s)
| | - Silvia Castelletti
- IRCCS Istituto Auxologico Italiano, Cardiomyopathy Unit and Department of Cardiovascular, Neural and Metabolic Sciences, Milan, Italy
| | - Paolo Emilio Adami
- Health and Science Department, World Athletics, Monaco, Principality of Monaco
| | - Elena Cavarretta
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy,Mediterranea Cardiocentro, Naples, Italy
| | - María Sanz-de la Garza
- Cardiovascular Institute, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Viviana Maestrini
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Alessandro Biffi
- Med-Ex, Medicine and Exercise srl, Medical Partner Scuderia Ferrari, Rome, Italy
| | - Paul Kantor
- Division of Cardiology, Department of Pediatrics, Children’s Hospital of Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Guido Pieles
- Sports Medicine Department, Aspetar, Orthopaedic and Sports Medicine Hospital, Doh, Qatar,Institute of Sport Exercise and Health (ISEH), University College London, London, UK
| | - Evert Verhagen
- Amsterdam Collaboration on Health & Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, University Medical Centers - Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Monica Tiberi
- Sport Medicine, Department of Prevention, ASUR Marche Area Vasta 1, Pesaro, Italy
| | - Henner Hanssen
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
| | - Michael Papadakis
- Cardiovascular Clinical Academic Group, St George’s, University of London, London, UK
| | - Josef Niebauer
- University Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University of Salzburg, Salzburg, Austria
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12
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Scapaticci S, Neri CR, Marseglia GL, Staiano A, Chiarelli F, Verduci E. The impact of the COVID-19 pandemic on lifestyle behaviors in children and adolescents: an international overview. Ital J Pediatr 2022; 48:22. [PMID: 35120570 DOI: 10.1186/s13052-022-01211-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 01/11/2022] [Indexed: 12/24/2022] Open
Abstract
The adverse effects of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) are not limited to the related infectious disease. In children and adolescents, serious risks due to the coronavirus disease 2019 (COVID-19) pandemic are also related to its indirect effects. These include an unbalanced diet with an increased risk of weight excess or nutritional deficiencies, increased sedentary lifestyle, lack of schooling, social isolation, and impaired mental health. Pediatricians should be aware of the side effects of the COVID-19 pandemic on children’s diet, physical mental health and advise the families according to their nutritional needs and financial resources. Moreover, the lack of a targeted therapy able to offer protection against the deleterious effects of SARS-CoV-2 infection should require a greater effort by scientific societies to find a more effective prevention strategy. In this context, much interest should be given to nutritional support, able to contrast malnutrition and to stimulate the immune system.
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13
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Kumar R, Sah RR, Gupta A, Nallasamy K, Ghosh A, Verma S. Do children with severe acute respiratory infection need cohorting & isolation before screening for COVID-19? Indian J Med Res 2022; 155:491-495. [PMID: 36348595 PMCID: PMC9807203 DOI: 10.4103/ijmr.ijmr_2557_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
This retrospective analysis was done to ascertain the SARS-CoV-2-positivity rate in children (0-12 yr) with severe acute respiratory infection (SARI) and compare it to those without SARI to determine the need for running a dedicated SARI isolation facility for paediatric COVID-19 care. The case records of 8780 children (0-12 yr) admitted and/or tested for SARS-CoV-2 between June 2020 and May 2021 at a tertiary care centre in north India were analyzed. The overall SARS-CoV-2 reverse transcription (RT)-PCR positivity rate was 3.0 per cent (262/8780). There were 1155 (13.15%) children with SARI. Fifty of these 1155 (4.3%) children with SARI, as against 212 of the 7625 (2.8%) children without SARI, tested positive for COVID-19. The absolute difference in the positivity rate among SARI and non-SARI groups was only 1.54 per cent which translates to cohorting and isolating 65 children with SARI to pick up one extra SARS-CoV-2-positive child (compared to those without SARI). The positive predictive value of SARI as a screening test was 4.3 per cent. Our findings suggest that isolation of children with SARI as a transmission-prevention strategy for COVID-19 may not be required. This is particularly relevant in resource-limited settings.
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Affiliation(s)
- Rakesh Kumar
- Department of Paediatrics, Postgraduate Institute of Medical Education & Research, Chandigarh, India,For correspondence: Dr Rakesh Kumar, Department of Paediatrics, Postgraduate Institute of Medical Education & Research, Sector 12, Chandigarh 160 012, India e-mail:
| | - Ritesh Ranjan Sah
- Department of Paediatrics, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Anju Gupta
- Department of Paediatrics, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Karthi Nallasamy
- Department of Paediatrics, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Arnab Ghosh
- Department of Virology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Sanjay Verma
- Department of Paediatrics, Postgraduate Institute of Medical Education & Research, Chandigarh, India
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14
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Parisi GF, Brindisi G, Indolfi C, Diaferio L, Marchese G, Ghiglioni DG, Zicari AM, Miraglia Del Giudice M. COVID-19, anosmia, and ageusia in atopic children. Pediatr Allergy Immunol 2022; 33 Suppl 27:99-101. [PMID: 35080301 PMCID: PMC9303964 DOI: 10.1111/pai.13644] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/28/2021] [Accepted: 08/07/2021] [Indexed: 01/05/2023]
Abstract
More than a year and a half after the beginning of the coronavirus disease 2019 (COVID-19) pandemic, symptoms, such as loss of smell and taste (anosmia and ageusia, respectively), remain difficult to characterize and quantify, especially in children, since no validated tests to assess these disorders are available. However, these symptoms can also be seen in children, although less frequently than observed in the adult population. In this article, we present the results of a national survey that collected the responses of 267 Italian pediatricians on the presence of anosmia and ageusia in children affected by COVID-19. These data were then compared with existing literature.
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Affiliation(s)
- Giuseppe Fabio Parisi
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Giulia Brindisi
- Department of Pediatrics, Allergology and Immunology Division, Sapienza University, Rome, Italy
| | - Cristiana Indolfi
- Department of Woman, Child and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Lucia Diaferio
- Department of Pediatrics, Giovanni XXIII Hospital, University of Bari, Bari, Italy
| | | | | | - Anna Maria Zicari
- Department of Pediatrics, Allergology and Immunology Division, Sapienza University, Rome, Italy
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15
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Matera MG, Imperatore F, Annibale R, Cazzola M. Advances in the Pharmacological Management of Pediatric Acute Respiratory Distress Syndrome. Expert Opin Pharmacother 2021; 23:349-360. [PMID: 34781794 DOI: 10.1080/14656566.2021.2006632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Noninvasive mechanical ventilation is the main supportive measure used in patients with pediatric ARDS (PARDS), but adjunctive pharmacological therapies (corticosteroids, inhaled nitric oxide [iNO], surfactant replacement therapy and neuromuscular blocking drugs) are also used, although limited data exists to inform of this practice. AREAS COVERED The authors review the current challenges in the pharmacological management of PARDS and highlight the few certainties currently available. EXPERT OPINION Children with PARDS must not be treated as young adults with ARDS, essentially because children's lungs differ substantially from those of adults and PARDS occurs in children differently than ARDS in adults. Pharmacological treatments available for PARDS are relatively few and, since there is great uncertainty about their effectiveness also because of the extreme heterogeneity of this syndrome, it is necessary to conduct large clinical trials using currently available definitions and considering recent pathobiological knowledge. The aim is to identify homogeneous subgroups or phenotypes of children with PARDS that may benefit from the specific pharmaceutical approach examined. It will be then necessary to link endotypes and outcomes to appropriately target therapies in future trials, but this will be possible only after it will be possible to identify the different PARDS endotypes.
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Affiliation(s)
- Maria Gabriella Matera
- Unit of Pharmacology, Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Francesco Imperatore
- Unit of Anesthesia and Intensive Care, "San Giovanni Di Dio" Hospital, Naples, Italy
| | - Rosa Annibale
- Pharmacy Unit, "Luigi Vanvitelli" University Hospital, Naples, Italy
| | - Mario Cazzola
- Unit of Respiratory Medicine, Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy
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16
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Khamis Hussein S, Magdy Yousef R, Mohammed MM, Yehia Abdelwahed M, Ahmed Mohammed R. COVID-19 in Children: Clinical Presentations and Outcomes in Fayoum Governorate, Egypt. Arch Pediatr Infect Dis 2021; In Press. [DOI: 10.5812/pedinfect.112798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: The number of children with coronavirus disease 2019 (COVID-19) significantly increased with limited data available about Egyptian children infected with COVID-19. Objectives: The study was performed early in the pandemic to address and record different clinical presentations of COVID-19 in Egyptian children in Fayoum Governorate and determine the percentage of children with complicated COVID-19 infection. The present article describes some epidemiological characteristics, along with the clinical patterns, laboratory and radiological findings, and outcomes of pediatric patients with COVID-19 in Fayoum Governorate. Methods: A total of 200 Egyptian children with COVID-19 in Fayoum Governorate were included in this study. This study was conducted from the beginning of June 2020 to the end of October 2020. In this study, 192 children (96%) had a history of contact with either suspected or confirmed COVID-19 cases in relatives. The age, gender, clinical symptoms, signs, and laboratory results were estimated. Results: About a tenth of the patients (n = 19; 9.5%) were asymptomatic. Fever and diarrhea were the most common symptoms at presentation, as it was identified in 81 children (40.5%). Lymphopenia was observed in 46.5% of the patients. The majority of the patients with respiratory symptoms had normal findings in chest X-rays (92.5%). Chest opacity was reported in 11 patients (5.5%). According to chest computed tomography, bilateral ground-glass opacity was identified in 16 patients (8.0%). Five hospitalized cases (2.5%) developed severe non-respiratory complications. One death was reported in this study. Conclusions: The COVID-19 can affect children at any age with variable presentations ranging from asymptomatic to severe symptomatic phenotypes requiring intensive care interventions.
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Parisi GF, Diaferio L, Brindisi G, Indolfi C, Umano GR, Klain A, Marchese G, Ghiglioni DG, Zicari AM, Marseglia GL, Miraglia del Giudice M. Cross-Sectional Survey on Long Term Sequelae of Pediatric COVID-19 among Italian Pediatricians. Children (Basel) 2021; 8:children8090769. [PMID: 34572201 PMCID: PMC8467017 DOI: 10.3390/children8090769] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 08/28/2021] [Accepted: 08/30/2021] [Indexed: 12/17/2022]
Abstract
The persistence of symptoms after recovery from Coronavirus 2019 (COVID-19) is defined as long COVID, an entity that had occurred among adults but which is not yet well characterized in pediatric ages. The purpose of this work was to present some of the data from a survey addressed to Italian pediatricians concerning the impact of long-COVID among children who recovered from severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. The questionnaire was designed and pre-tested in February 2021 by a working group of experts from the Italian Pediatric Society for Allergy and Immunology (SIAIP). The survey was emailed once in March 2021 to a sample of Italian pediatricians. A total 267 Italian pediatricians participated in our survey. According to most pediatricians (97.3%), the persistence of symptoms is found in less than 20% of children. Specifically, with regard to the symptoms that persist even after swab negativization, fatigue was the most mentioned one (75.6%). Long-COVID would seem to be a phenomenon of limited occurrence in pediatric ages, affecting less than 20% of children. Among all of the symptoms, the one that was most prevalent was fatigue, a pathological entity that is associated with many viral diseases.
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Affiliation(s)
- Giuseppe Fabio Parisi
- Department of Clinical and Experimental Medicine, University of Catania, Via Santa Sofia 78, 95123 Catania, Italy;
| | - Lucia Diaferio
- Department of Pediatrics, Giovanni XXIII Hospital, University of Bari, 70126 Bari, Italy;
| | - Giulia Brindisi
- Department of Pediatrics, Allergology and Immunology Division, Sapienza University, Viale Regina Elena 324, 00161 Rome, Italy; (G.B.); (A.M.Z.)
| | - Cristiana Indolfi
- Department of Woman, Child and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (C.I.); (G.R.U.); (A.K.)
| | - Giuseppina Rosaria Umano
- Department of Woman, Child and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (C.I.); (G.R.U.); (A.K.)
| | - Angela Klain
- Department of Woman, Child and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (C.I.); (G.R.U.); (A.K.)
| | | | - Daniele Giovanni Ghiglioni
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano, Via Francesco Sforza, 28, 20122 Milan, Italy;
| | - Anna Maria Zicari
- Department of Pediatrics, Allergology and Immunology Division, Sapienza University, Viale Regina Elena 324, 00161 Rome, Italy; (G.B.); (A.M.Z.)
| | - Gian Luigi Marseglia
- Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, 27100 Pavia, Italy;
| | - Michele Miraglia del Giudice
- Department of Woman, Child and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (C.I.); (G.R.U.); (A.K.)
- Correspondence: ; Tel.: +39-0815-66-5922
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Shahid S, Raza M, Junejo S, Maqsood S. Clinical features and outcome of COVID-19 positive children from a tertiary healthcare hospital in Karachi. J Med Virol 2021; 93:5988-5997. [PMID: 34228363 PMCID: PMC8427002 DOI: 10.1002/jmv.27178] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 06/22/2021] [Accepted: 07/01/2021] [Indexed: 12/28/2022]
Abstract
As the coronavirus disease 2019 (COVID‐19) pandemic continues to evolve, differences in epidemiological and clinical features among pediatrics have been noticed across different countries. We describe the spectrum of COVID‐19 in pediatric patients treated in tertiary health care. We conducted a retrospective chart review of pediatric patients admitted to Indus Hospital & Health care network, Korangi campus, Karachi; from April 1st, 2020 to July 31st, 2020. A total of 141 COVID‐19 cases were reported, males were 81 (57%) and the median age was 8 (0.3–17) years. Moderate and severe infections were noted in 36(26%), and 17(12%) children respectively. Fever (50%) was the most common clinical feature. The SF ratio less than 264 was significantly associated with severe disease (p < .05). Lab investigations that differed significantly across disease severity groups included IL‐6 levels (p < .01) and Prothrombin time (p < .05). Majority of children were advised home isolation 89 (63%), 29 (20.5%) were admitted while mortality was observed in 10 (7%) children. No significant difference was observed between children with and without malignancy. Pre‐existing comorbidities are significantly associated with COVID‐19 infections among children. Reduced SF ratio, elevated Prothrombin time, and interleukin‐6 levels are associated with greater disease severity.
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Affiliation(s)
- Saba Shahid
- Department of Pediatrics, The Indus Hospital & Health network, Karachi, Pakistan
| | - Mohammad Raza
- Department of Pediatrics, The Indus Hospital & Health network, Karachi, Pakistan
| | - Samina Junejo
- Department of Pediatrics, The Indus Hospital & Health network, Karachi, Pakistan
| | - Sidra Maqsood
- Indus hospital Research Centre, Indus Hospital and Health network, Karachi, Pakistan
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19
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Abstract
PURPOSE OF REVIEW Pediatric coronavirus disease 2019 (COVID-19) respiratory disease is a distinct entity from adult illness, most notable in its milder phenotype. This review summarizes the current knowledge of the clinical patterns, cellular pathophysiology, and epidemiology of COVID-19 respiratory disease in children with specific attention toward factors that account for the maturation-related differences in disease severity. RECENT FINDINGS Over the past 14 months, knowledge of the clinical presentation and pathophysiology of COVID-19 pneumonia has rapidly expanded. The decreased disease severity of COVID-19 pneumonia in children was an early observation. Differences in the efficiency of viral cell entry and timing of immune recognition and response between children and adults remain at the center of ongoing research. SUMMARY The clinical spectrum of COVID-19 respiratory disease in children is well defined. The age-related differences protecting children from severe disease and death remain incompletely understood.
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Affiliation(s)
- Lea C Steffes
- Division of Pulmonary, Asthma and Sleep Medicine, Department of Pediatrics, Center for Excellence in Pulmonary Biology, Stanford University Medical School, Stanford, California, USA
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20
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Abstract
Since its appearance in Wuhan in mid-December 2019, acute respiratory syndrome coronavirus 2 (SARS-CoV-2) related 19 coronavirus disease (COVID-19) has spread dramatically worldwide. It soon became apparent that the incidence of pediatric COVID-19 was much lower than the adult form. Morbidity in children is characterized by a variable clinical presentation and course. Symptoms are similar to those of other acute respiratory viral infections, the upper airways being more affected than the lower airways. Thus far, over 90% of children who tested positive for the virus presented mild or moderate symptoms and signs. Most children were asymptomatic, and only a few cases were severe, unlike in the adult population. Deaths have been rare and occurred mainly in children with underlying morbidity. Factors as reduced angiotensin-converting enzyme receptor expression, increased activation of the interferon-related innate immune response, and trained immunity have been implicated in the relative resistance to COVID-19 in children, however the underlying pathogenesis and mechanism of action remain to be established. While at the pandemic outbreak, mild respiratory manifestations were the most frequently described symptoms in children, subsequent reports suggested that the clinical course of COVID-19 is more complex than initially thought. Thanks to the experience acquired in adults, the diagnosis of pediatric SARS-CoV-2 infection has improved with time. Data on the treatment of children are sparse, however, several antiviral trials are ongoing. The purpose of this narrative review is to summarize current understanding of pediatric SARS-CoV-2 infection and provide more accurate information for healthcare workers and improve the care of patients.
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Affiliation(s)
| | | | | | | | - Francesca Santamaria
- Section of Pediatrics, Pediatric Pulmonology Unit, Department of Translational Medical Sciences, Università di Napoli Federico II, Naples, Italy
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21
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Jurado Hernández JL, Álvarez Orozco IF. COVID-19 in Children: Respiratory Involvement and Some Differences With the Adults. Front Pediatr 2021; 9:622240. [PMID: 33855003 PMCID: PMC8039144 DOI: 10.3389/fped.2021.622240] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 01/28/2021] [Indexed: 12/15/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) represents a health problem with multidimensional impacts and heterogeneous respiratory involvement in children, probably due to the interaction between different and complex mechanisms that could explain its variable degrees of severity. Although the majority of reports reveal that children develop less severe cases, the number of patients is increasing with more morbidity. Most serious respiratory manifestations are acute respiratory distress syndrome (ARDS) and pneumonia. By understanding the key aspects that can be used to differentiate between pediatric and adult respiratory compromise by COVID-19, we can improve our knowledge, and thus decrease the negative impact of the disease in the pediatric population. In this mini review, we summarize some of the mechanisms and findings that distinguish between adult and pediatric COVID-19 and respiratory involvement, taking into account some issues related to the physiopathology, diagnosis, clinical and paraclinical presentation, severity, treatment, and control of the disease.
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22
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Parisi GF, Carota G, Castruccio Castracani C, Spampinato M, Manti S, Papale M, Di Rosa M, Barbagallo I, Leonardi S. Nutraceuticals in the Prevention of Viral Infections, including COVID-19, among the Pediatric Population: A Review of the Literature. Int J Mol Sci 2021; 22:2465. [PMID: 33671104 PMCID: PMC7957644 DOI: 10.3390/ijms22052465] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 02/24/2021] [Accepted: 02/25/2021] [Indexed: 02/06/2023] Open
Abstract
In recent years, there has been a growth in scientific interest in nutraceuticals, which are those nutrients in foods that have beneficial effects on health. Nutraceuticals can be extracted, used for food supplements, or added to foods. There has long been interest in the antiviral properties of nutraceuticals, which are especially topical in the context of the ongoing COVID-19 pandemic. Therefore, the purpose of this review is to evaluate the main nutraceuticals to which antiviral roles have been attributed (either by direct action on viruses or by modulating the immune system), with a focus on the pediatric population. Furthermore, the possible applications of these substances against SARS-CoV-2 will be considered.
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Affiliation(s)
- Giuseppe Fabio Parisi
- Pediatric Pulmonology Unit, Department of Clinical and Experimental Medicine, University of Catania, Viale A. Doria 6, 95125 Catania, Italy; (G.F.P.); (S.M.); (M.P.); (S.L.)
| | - Giuseppe Carota
- Department of Biomedical and Biotechnological Sciences, University of Catania, Via S. Sofia, 87 95125 Catania, Italy; (G.C.); (M.S.); (M.D.R.)
| | - Carlo Castruccio Castracani
- The Children’s Hospital of Philadelphia (CHOP), Department of Pediatrics, Division of Hematology Leonard and Madlyn Abramson Pediatric Research Center, Philadelphia, PA 19104, USA;
| | - Mariarita Spampinato
- Department of Biomedical and Biotechnological Sciences, University of Catania, Via S. Sofia, 87 95125 Catania, Italy; (G.C.); (M.S.); (M.D.R.)
| | - Sara Manti
- Pediatric Pulmonology Unit, Department of Clinical and Experimental Medicine, University of Catania, Viale A. Doria 6, 95125 Catania, Italy; (G.F.P.); (S.M.); (M.P.); (S.L.)
| | - Maria Papale
- Pediatric Pulmonology Unit, Department of Clinical and Experimental Medicine, University of Catania, Viale A. Doria 6, 95125 Catania, Italy; (G.F.P.); (S.M.); (M.P.); (S.L.)
| | - Michelino Di Rosa
- Department of Biomedical and Biotechnological Sciences, University of Catania, Via S. Sofia, 87 95125 Catania, Italy; (G.C.); (M.S.); (M.D.R.)
| | - Ignazio Barbagallo
- Department of Drug and Health Sciences, University of Catania, Viale A. Doria 6, 95125 Catania, Italy
| | - Salvatore Leonardi
- Pediatric Pulmonology Unit, Department of Clinical and Experimental Medicine, University of Catania, Viale A. Doria 6, 95125 Catania, Italy; (G.F.P.); (S.M.); (M.P.); (S.L.)
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