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COVID-19 in Children's ORL
Published in Raymond W Clarke, Diseases of the Ear, Nose & Throat in Children, 2023
COVID-19 developed a serious and life-threatening illness characterised by multisystem inflammation – multisystem inflammatory syndrome in children-(MIS-C). The clinical and laboratory features were not dissimilar to the findings in other multisystem inflammatory disorders in children (e.g. Kawasaki disease).
COVID-19 and MIS-C
Published in Jason Liebowitz, Philip Seo, David Hellmann, Michael Zeide, Clinical Innovation in Rheumatology, 2023
Jordan E. Roberts, Mary Beth Son
Initially, children appeared to be spared from severe COVID-19, with relatively few hospitalizations and deaths reported worldwide in the first months of the pandemic despite a quickly escalating global death toll. However, several weeks after the peak of COVID-19 outbreaks in the United Kingdom and northern Italy, an unexpected syndrome with parallels to Kawasaki disease and toxic shock syndrome was reported. This would ultimately come to be recognized as multisystem inflammatory syndrome in children (MIS-C) associated with SARS-CoV-2.
Viral Infections
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Pernio-like red-purple macules/papules (i.e., “COVID toes”) have been seen in young, healthy asymptomatic individuals and can present with pain/burning and/or pruritis (Figure 7.21). An erythema multiforme-like eruption can be seen in children with a milder course. In contrast, some children have presented with the serious multisystem inflammatory syndrome in children (MIS-C). MIS-C can resemble Kawasaki disease clinically with the main features of a viral exanthem and/or mucocutaneous involvement, myocardial dysfunction, hypotension, coagulopathy, and gastrointestinal upset. Other cutaneous COVID-19 presentations include a morbilliform, urticarial, petechial, vesicular eruption on the trunk and extremities and livedo reticularis. These often occur after the onset of COVID-19 findings and are generally seen in moderately sick patients. Retiform (angulated) purpura on the extremities and buttocks at pressure sites and acro-ischemia have been seen in critically ill hospitalized patients. The retiform purpura and acro-ischemia mostly occur after other COVID-19 findings and are likely due to thrombotic disease/vasculopathy via activation of the complement pathway.
Impact of socio-behavioral measures implemented during the SARS-CoV-2 pandemic on the outcomes of febrile neutropenia episodes in pediatric cancer patients: a single center quasi-experimental pre-post study
Published in Pediatric Hematology and Oncology, 2023
Charles Nathaniel Nessle, Tom Braun, Vineet Chopra, Sung Won Choi, Rajen Mody
Ongoing efforts to improve healthcare delivery during FN episodes remain, focusing on risk stratification and antimicrobial stewardship.6,26,27 In this study, our findings support the hypothesis that fewer viral upper respiratory infections were identified in FN episodes during the COVID-era. Similar to prior studies evaluating the frequency of URIs in the COVID-era, we observed a decreased frequency of URIs in patients admitted with FN.15,16 There have been no cases of Influenza in our FN population during the current 2020–2021 respiratory season, and unpublished internal data from our institution shows a decrease in URI cases between respiratory seasons similar to the US and other nations.15,16 Thus, measures to curtail the spread of COVID-19 lowered the prevalence of URIs in our FN population and subsequently affected the number of low and high-risk episodes treated at our institution. Although the majority of pediatric COVID-19 cases were asymptomatic or had mild symptoms, children who developed multisystem inflammatory syndrome in children (MIS-C) or severe acute COVID-19 infection were at increased risk of organ failure and poor outcomes.28–30 The successful implications of nationwide public health measures cannot be understated as important mitigation measures in preventing disease transmission, especially since vaccine trials have not completed recruitment of pediatric patients of all ages.31
Smart and connected devices in point-of-care molecular diagnostics: what role can they play in the response to COVID-19?
Published in Expert Review of Molecular Diagnostics, 2022
Ashlesha Kaushik, Sandeep Gupta, Mangla Sood, Bryan W. Steussy, Bryce W. Noll
A rapid diagnosis is also crucial in ensuring initiation of outpatient preventive therapies in patients with chronic medical conditions in whom COVID-19 infection can cause high morbidity and mortality. The U.S. National Institutes of Health (NIH) guidelines recommend initiating anti-SARS-CoV-2 monoclonal antibodies to prevent progression-to-severe COVID-19 disease for patients over 12 years of age with underlying comorbidities like diabetes, cancer, or immunocompromise, testing positive for COVID-19, in whom COVID-19 could quickly progress to severe illness leading to increased need for intensive care and high fatality [39]. A rapid and accurate detection of infection would be especially valuable as therapeutic interventions as outpatients could prevent hospitalizations and deaths [39], and also prevent overwhelming of already burdened healthcare systems. Prompt diagnosis and treatment can be lifesaving in children with symptoms of multisystem inflammatory syndrome in children (MIS-C) that can cause cardiovascular dysfunction and high rates of need for intensive care [40–43].
Current status of COVID-19 vaccination: safety and liability concern for children, pregnant and lactating women
Published in Expert Review of Vaccines, 2022
Swagat Kumar Das, Manish Paul, Bikash Chandra Behera, Hrudayanath Thatoi
Equitable access to safe and effective vaccines is critical to ending the COVID-19 pandemic. In most countries, children and pregnant women are still not vaccinated; therefore, efforts must be made to reach these groups. Because the bulk of the youngsters are too young to receive vaccines, suitable immunization guidelines should be prepared. Though the severity of COVID-19 is less in the case of children, they may develop post-SARS CoV-2 complication known as a multisystem inflammatory syndrome in children (MIS-C), which is mainly associated with multi-organ failure of children. The early detection of this disease in children can be managed with aggressive fluid resuscitation that can push the starling curve to a fulminant heart failure. Also, the SARS-CoV-2 infection has been frequently found as maternal, neonatal, and obstetrical risk during pregnancy. COVID-19 vaccines elicited strong humoral immunity in pregnant and lactating women, with immunogenicity and reactogenicity in a similar manner as observed in non-pregnant women. Protective immunoglobulins were passed down through the placenta and breast milk to neonates, giving additional protection against COVID-19. Although miscarriage and abortion were documented after some vaccine trials, there is no direct evidence that intact vaccination particles enter the fetus’s cells and possess any significant risk to the fetus or breastfeeding infant. No such evidence of COVID-19 vaccines was also observed of affecting the fertility of women or men.