Boletín de Alerta Bibliográfica - Unidad de Desarrollo de la Investigación, Tecnologías y Docencia - Acceso a la Biblioteca Virtual ...
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
2021
9(38):1-46
Boletín
de Alerta
Bibliográfica
Unidad de Desarrollo de la Investigación,
Tecnologías y Docencia
ÍNDICE TEMÁTICO CARDIOLOGÍA CIRUGÍA (CIRUGÍA CARDIOVASCULAR / NEUROCIRUGÍA / OTROS) DIAGNÓSTICO / TRATAMIENTO EPIDEMIOLOGÍA FISIOTERAPIA NEONATOS / MADRE E HIJO NEUMOLOGÍA NEUROLOGÍA NUTRICIÓN OFTALMOLOGÍA OTORRINOLARINGOLOGÍA PROFESIONALES DE LA SALUD RADIOLOGÍA SALUD MENTAL SALUD PÚBLICA / POLÍTICAS EN SALUD / GESTIÓN EN SALUD SÍNDROME INFLAMATORIO MULTISISTÉMICO (MIS-C) TELESALUD VACUNAS Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2021;9(38):1-46
CARDIOLOGÍA
Publicaciones
Fabi M, Filice E, Andreozzi L, Conti F, Gabrielli L, Balducci A, et al. Spectrum of cardio-
vascular diseases in children during high peak COVID-19 period infection in Northern
Italy: is there a link? J Pediatric Infect Dis Soc. 2020 Dec 6.
Doi: 10.1093/jpids/piaa162
Abstract
Background: Children with COVID-19 have a milder clinical course than adults. We describe the spectrum
of cardiovascular manifestations during a COVID-19 outbreak in Emilia-Romagna, Italy.
Methods: Cross-sectional multicenter study including all diagnosis of KD, myocarditis and multisystem in-
flammatory syndrome in children (MIS-C) from February to April,2020. KD patients were compared to tho-
se diagnosed before the epidemic.
Results: KD: 8 patients (6/8 boys, all negative for SARS-CoV-2); complete presentation in 5/8; 7/8 IVIG-
responders; 3/8 showed transient coronary lesions (CALs).
Myocarditis: one 5-year-old girl negative for SARS-CoV-2, positive for Parvovirus B19. She responded to
IVIG.
Mis-c: 4 SARS-CoV-2 positive boys (3 patients with positive swab and serology, 1 patient with negative
swab and positive serology). Three presented myocardial dysfunction and pericardial effusion, one develo-
ped multicoronary aneurysms and hyperinflammation; all responded to treatment. The fourth boy had mi-
tral and aortic regurgitation that rapidly regressed after steroids.
Conclusions: KD, myocarditis and MIS-C were distinguishable cardiovascular manifestations. KD did not
show a more aggressive form compared to previous years: coronary involvement was frequent, but always
transient. MIS-C and myocarditis rapidly responded to treatment without cardiac sequelae despite high
markers of myocardial injury at onset suggesting a myocardial depression due to systemic inflammation
rather than focal necrosis. Evidence of actual or previous SARS-CoV-2 infection was documented only in
patients with MIS-C.
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2021;9(38):1-46
Sendzikaite S, Heying R, Milanesi O, Hanseus K, Michel-Behnke I. Covid-19 FAQ’s in
Paediatric and Congenital Cardiology - AEPC position paper. Cardiol Young. 2021 Jan
7;1–21.
Doi: 10.1017/s1047951120005028
Abstract
The Covid-19 pandemic has had a huge influence in almost all areas of life, affecting societies, economics
and health care systems worldwide. The paediatric cardiology community is no exception. As the challen-
ging battle with Covid-19 continues, professionals from the Association for the European Paediatric and
Congenital Cardiology (AEPC) receive many questions regarding Covid-19 in a Paediatric and Congenital
Cardiology setting. The aim of this paper is to present the AEPC position on frequently asked questions ba-
sed on the most recent scientific data, as well as to frame a discussion on how to take care of our patients
during this unprecedented crisis. As the times are changing quickly and information regarding Covid-19 is
very dynamic, continuous collection of evidence will help guide constructive decision-making.
Gokalp S, Çilsal E, Yukcu B, Yolcu C, Akkoc G, Guzeltas A. A case of a very large haemo-
rrhagic pericardial effusion in an adolescent patient with COVID-19 infection. Cardiol
Young. 2021 Jan 7;1–3.
Doi: 10.1017/s1047951120004850
Abstract
An otherwise healthy 17-year-old adolescent boy presented with upper respiratory tract symptoms and
was diagnosed with coronavirus disease 2019 infection. A haemorrhagic pericardial effusion was found in
the transthoracic echocardiography. He was treated with pericardiocentesis, ibuprofen, and hydroxychlo-
roquine. A large pericardial effusion may complicate COVID-19 in children and should be considered in acu-
te decompensation.
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2021;9(38):1-46
Dayton JD, Ford K, Carroll SJ, Flynn PA, Kourtidou S, Holzer RJ. The Deconditioning
Effect of the COVID-19 Pandemic on Unaffected Healthy Children. Pediatr Cardiol.
2021 Jan 4.
Doi: 10.1007/s00246-020-02513-w
Abstract
The COVID-19 pandemic has had devastating direct consequences on the health of affected patients. It has
also had a significant impact on the ability of unaffected children to be physically active. We evaluated the
effect of deconditioning from social distancing and school shutdowns implemented during the COVID-19
pandemic on the cardiovascular fitness of healthy unaffected children. This is a single-center, retrospective
case-control study performed in an urban tertiary referral center. A cohort of 10 healthy children that un-
derwent cardiopulmonary exercise testing after COVID-19 hospital restrictions were lifted was compared
to a matched cohort before COVID-19-related shutdowns on school and after-school activities. Compari-
sons of oxygen uptake (VO2) max and VO2 at anaerobic threshold between the pre- and post-COVID-19
cohorts were done. The VO2 max in the post-COVID cohort was significantly lower than in the pre-COVID
cohort (39.1 vs. 44.7, p = 0.031). Only one out of ten patients had a higher VO2 max when compared to
their matched pre-COVID control and was also the only patient with a documented history of participation
in varsity-type athletics. The percentile of predicted VO2 was significantly lower in the post-COVID cohort
(95% vs. 105%, p = 0.042). This study for the first time documented a significant measurable decline in phy-
sical fitness of healthy children as a result of the COVID-19 pandemic and its associated restrictions.
Measures need to be identified that encourage and facilitate regular exercise in children in a way that are
not solely dependent on school and organized after-school activities.
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2021;9(38):1-46
CIRUGÍA
Publicaciones
Rajput VK, Tuvar S, Bhalsing S, Bhalsing S. Resurgence of combined intravenous Keta-
mine and regional anesthesia in pediatric ocular surgery in COVID-19 pandemic. In-
dian J Ophthalmol. 2021 Feb;69(2):395-9.
Doi: 10.4103/ijo.ijo_2839_20
Abstract
Purpose: The current pandemic of COVID-19 has made airway procedures like intubation and extubation,
potential sources of virus transmission among health care workers. The aim of this work was to study the
safety profile of combined ketamine and regional anesthesia in pediatric ocular surgeries during the COVID
-19 pandemic.
Methods: This prospective study included pediatric patients undergoing ocular surgery under general
anesthesia from April to October 2020. Children were premedicated with oral midazolam (0.25-0.50 mg/
kg) or intramuscular ketamine (7-10 mg/kg), ondensetron (0.1 mg/kg) and atropine (0.02 mg/kg). Anesthe-
sia was achieved with intravenous ketamine (4-5 mg/kg) and local anesthesia (peribulbar block or local in-
filtration). The patient's vital signs were monitored. Serious complications and postoperative adverse reac-
tions related to anesthesia were documented.
Results: A total of 55 children (62 eyes) were operated. Lid tear was the most common surgical procedure
performed [n = 18 (32.7%)]. Dose of ketamine needed ranged from 30 to 120 mg (66.67 ± 30.45). No intu-
bation or resuscitation was needed. Four children complained of nausea and two needed an additional do-
se of intravenous ondansetron due to vomiting in the post-operative period. Incidence of postoperative
nausea and vomiting was not affected by age, duration of surgery or dose of ketamine used (P > 0.05). The-
re was no correlation between increase in pulse and dose of ketamine.
Conclusion: Combined ketamine and regional anesthesia is a safe and effective alternative to administer
anesthesia in a child during ocular surgeries.
Liang ZC, Chong MSY, Liu GKP, Valle AGD, Wang D, Lyu X, et al. COVID-19 and Elective
Surgery: 7 Practical Tips for a Safe, Successful, and Sustainable Reboot. Ann Surg. 2021
Feb 1;273(2):e39–40.
Doi: 10.1097/sla.0000000000004091
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2021;9(38):1-46
Lakshin G, Banek S, Keese D, Rolle U, Schmedding A. Telemedicine in the pediatric surgery in
Germany during the COVID-19 pandemic. Pediatr Surg Int. 2021 Jan 2.
Doi: 10.1007/s00383-020-04822-w
Resumen
Purpose: The COVID-19 pandemic has led to an unprecedented expansion of telemedicine services worldwide.
This study aimed to explore the practice of telemedicine in Pediatric Surgery in Germany, the impact of the pan-
demic on its development and parents' and surgeons' experiences with telemedicine.
Methods: The study is a cross-sectional analysis using three surveys between 6/2020 and 10/2020: (1) all Pedia-
tric Surgery departments of Germany reported whether they provide telemedicine services. (2) Members of the
German Society of Pediatric Surgery and (3) families who participated in an outpatient visit by telephone or vi-
deo with the Department of Pediatric Surgery and Pediatric Urology of the University Hospital Frankfurt comple-
ted an anonymous survey on their experience with telemedicine.
Results: 21% of the Pediatric Surgery departments in Germany provided telemedicine, of which 57% started due
to the pandemic. The lack of physical examination and face-to-face contact seem to be the major limitations to
surgeons and parents. 48% of the parents answered that telemedicine is equal to or better than traditional ap-
pointments, while 33% thought that telemedicine is worse.
Conclusions: This study shows that families and doctors alike have had positive experiences with telemedicine
and most will continue to use this format after the pandemic.
Malhotra A, Sturgill M, Whitley-Williams P, Lee YH, Esochaghi C, Rajasekhar H, Olson B,
Gaur S. Pediatric COVID-19 and Appendicitis: A Gut Reaction to SARS-CoV-2? Pediatr Infect
Dis J. 2021 Feb 1;40(2):e49-e55.
Doi: 10.1097/INF.0000000000002998
Abstract
Background: We describe the temporal pattern of COVID-19 admissions to a tertiary care children's hospital in
central New Jersey during the SARS-CoV-2 surge, covering the time period from March 29 to July 26, 2020.
Methods: Medical charts were reviewed for the date of admission, past medical history, and demographic varia-
bles, presenting signs and symptoms, admitting laboratory values, diagnostic imaging, diagnosis, treatment mo-
dalities, and outcomes including length of stay and disease severity.
Results: Patients with symptomatic SARS-CoV-2 infection tended to present with pneumonia early during the
study period, which coincided with the early surge in New Jersey cases. Approximately 2 weeks after the peak in
reported SARS-CoV-2 cases in New Jersey, we began to see fewer pneumonia cases and an increase in admis-
sions for Multi-Inflammatory Syndrome in Children and cases of acute appendicitis in association with a diagno-
sis of SARS-CoV-2 infection.
Conclusions: We present a novel association of acute appendicitis in children infected with SARS-CoV-2 and
postulate that it may represent a postinfectious hyperinflammatory complication of SARS-CoV-2 infection
occurring 2 weeks after the early manifestation of acute pneumonia disease in children.
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2021;9(38):1-46
DIAGNÓSTICO Y TRATAMIENTO
Publicaciones
Fanos V, Bardanzellu F, Marcialis MA. Why Is Antibiotic Treatment Rarely Performed
in COVID-19-Positive Children Admitted in Pediatric Intensive Care Units? JAMA Pe-
diatr. 2021 Jan 11.
Comment & Response
Doi: 10.1001/jamapediatrics.2020.5360
Arslan G, Aktürk H, Duman M. Clinical Characteristics of Pediatric COVID-19 and Pre-
dictors of PCR Positivity. Pediatr Int. 2021 Jan 10.
Doi: 10.1111/ped.14602
Abstract
Background: To identify the clinical findings and outcomes of children with COVID-19 and factors predic-
ting RT-PCR positivity.
Methods: The data retrospectively analyzed for suspected and confirmed pediatric COVID-19 patients bet-
ween March 20 and May 31, 2020.
Results: There were 404 children, of them, 176 (43.6%) patients were confirmed to have COVID-19 which
were less symptomatic on admission (67.6% to 95.6%). Cough (44.9%), fever (38.1%), sore throat (18.5%),
and smell-taste loss (12.7%) were the most common symptoms. Confirmed cases had 92.6% identified his-
tory of contact with COVID-19. Close contact with COVID-19 positive family members and coughs increased
the RT-PCR positivity 23.8 and 5.0 times, respectively; while positivity decreased by 0.4 times if fever was
over 38°C. Asymptomatic and mild cases were categorized as 'group 1' (n=153), moderate, severe and criti-
cal cases as 'group 2' (n=23) in terms of disease severity. Group 2 cases had higher C-reactive protein
(40.9% to 15.9%) and procalcitonin (22.7% to 4.9%) levels and had more frequent lymphopenia (45.5% to
13.1%). Out of 23 cases, 19 had abnormal chest x-ray findings; of them, 15 patients underwent chest CTs,
and all had abnormal findings. However, 26.0% of them needed respiratory support, and no patient requi-
red invasive ventilation.
Conclusion: Children with COVID-19 have milder clinical course and SARS-CoV-2 rarely causes severe disea-
se in children. Contact history with COVID-19 and sore throat are the most important predictors for RT-PCR
positivity. Consequently, the role of asymptomatic children in the contamination chain must be fully esta-
blished and considered for the control of pandemic.
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2021;9(38):1-46 Crawford RL, Bolin EH, Prodhan P, Renno MS, Knecht KR. Variable Presentation of CO-
VID-19 in Pediatric Patients. Pediatr Infect Dis J. 2021 Feb 1;40(2):e88–9.
Doi: 10.1097/inf.0000000000002974
Abstract
Infection by SARS-CoV-2 has led to disease referred to as coronavirus disease 2019 which, in children has
been described as of multisystem inflammatory syndrome in children. Our experience demonstrates 2 dis-
tinct presentations of this syndrome which have different clinical courses and may have differing long-term
outcomes.
Di Pietro GM, Capecchi E, Luconi E, Lunghi G, Bosis S, Bertolozzi G, et al. Diagnosis of
SARS-CoV-2 in children: accuracy of nasopharyngeal swab compared to nasopharyn-
geal aspirate. Eur J Clin Microbiol Infect Dis. 2021 Jan 7.
Doi: 10.1007/s10096-020-04131-z
Abstract
The tests currently used for the identification of SARS-CoV-2 include specimens taken from the upper and
lower respiratory tract. Although recommendations from the World Health Organization prioritise the usa-
ge of a nasopharyngeal swab (NS), nasopharyngeal aspirates (NPA) are thought to be superior in identifying
SARS-CoV-2 in children. To our knowledge, however, no paediatric study has been published on the sub-
ject. The aim of this study is to evaluate the diagnostic performances of NS referred to NPA for SARS-CoV-2
in children. We calculated the sensitivity and specificity of the NS referred to the NPA of the whole sample
and considered both age and collection period as covariates in different analyses. We collected 300 paired
samples. The NS had a specificity of 97.7% and a sensitivity of 58.1%. We found similar results for the
group of subjects ≥ 6 years old, while for subjects < 6 years old, the sensitivity was 66.7% and the specificity
97.8%. Considering period as a covariate, the sensitivity and specificity for patients hospitalised in March
(31 patients, 52 records) were 70.0% and 97.6%, while for patients involved in the follow-up (16 patients,
57 records), they were 57.2% and 89.7%. The NS has a low sensitivity in detecting SARS-CoV-2 in children
when referred to the NPA, whereas its specificity is high. Our results suggest that in children under 6 years
of age, NSs should be preferred whenever possible. Though statistically not significant, the sensitivity of
the NS rises when performed before the NPA .
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2021;9(38):1-46 Patwardhan A, Ohler A. The Flu Vaccination May Have a Protective Effect on the Cour-
se of COVID-19 in the Pediatric Population: When Does Severe Acute Respiratory Syn-
drome Coronavirus 2 (SARS-CoV-2) Meet Influenza? Cureus. 2021 Jan 6;13(1):e12533.
Doi: 10.7759/cureus.12533
Abstract
Background In the midst of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, a
lot more chaos could be anticipated in the flu season due to the coexistence of SARS-CoV-2 and influenza
with almost similar epidemiologic and clinical features. Could this become a "twindemic" or "syndemic" if
there is any viral interference occurs? We investigated the effect of influenza and pneumococcal vaccines
on the disease course of SARS-CoV-2 in the pediatric population and the possibility of viral interference.
Material and methods After approval from Institutional Review Board, a retrospective electronic chart re-
view on 20 years and younger SARS-CoV-2 polymerase chain reaction (PCR) positive patients who visited
Arkansas Children's Hospital System between February 1 to August 30, 2020, was performed. The clinical
data was collected along with influenza and pneumococcal vaccination status of these patients. Results The
results showed that viral interference may have played a role in the current flu and coronavirus disease
2019 (COVID-19) twindemic. SARS-CoV-2 and influenza may have significantly affected each other's epide-
miological features. Conclusion Understanding the relationship and co-existence of other viruses alongside
SARS-CoV-2 and knowing the vaccination status of the host population may help in deploying the right stra-
tegies to get the best outcomes.
Saeed A, Shorafa E, Seratishirazi Z, Abootalebi S. COVID-19 in Pediatric Granulomato-
sis with Polyangiitis. Pediatr Rep. 2021 Jan 4;13(1):31–4.
Doi: 10.3390/pediatric13010004
Abstract
The confirmed cases with COVID-19 in children account for just 1% of the overall confirmed cases. Severe
COVID-19 in children is rare. Case Presentation: Our patient was 16 years old with a severe case of COVID-
19 and did not survive due to the presence of Granulomatosis with polyangiitis and being treated with im-
munosuppressive drugs. We used lopinavir, ritonavir, hydroxy chloroquine, intravenous immunoglobulin
and continuous veno-venous hemodialysis for treatment. Conclusion: In this patient, an underlying disease
and delayed admission to the hospital were two factors complicating his condition.
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2021;9(38):1-46 Pérez-Gaxiola G, Verdugo-Paiva F, Rada G, Flórez ID. Assessment of Duplicate Eviden-
ce in Systematic Reviews of Imaging Findings of Children With COVID-19. JAMA Netw
Open. 2021 Jan 4;4(1):e2032690.
Doi: 10.1001/jamanetworkopen.2020.32690
Abstract
This cross-sectional study maps a coronavirus research question to illustrate the overlap and shortcomings
of the evidence syntheses in this área.
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2021;9(38):1-46EPIDEMIOLOGÍA
Publicaciones
Rytter MJH, Nygaard U, Mandic IN, Glenthøj JP, Schmidt LS, Cortes D, et al. Prevalence
of sars-cov-2-antibodies in danish children and adults. Pediatr Infect Dis J. 2021 Jan 7.
Doi: 10.1097/inf.0000000000003048
Abstract
In Denmark, severe acute respiratory syndrome coronavirus 2 antibodies were assessed in a cross-sectional
study among 1033 children visiting pediatric departments and 750 blood donors in June 2020, using a point
-of-care test. Antibodies were detected in 17 children (1.6%) and 15 blood donors (2.0%) (P = 0.58). In con-
clusion, children and adults were infected to a similar low degree.
Weisberg SP, Connors TJ, Zhu Y, Baldwin MR, Lin W-H, Wontakal S, et al. Distinct anti-
body responses to SARS-CoV-2 in children and adults across the COVID-19 clinical
spectrum. Nature Immunology. 2021 Jan;22(1):25–31.
Doi: 10.1038/s41590-020-00826-9
Abstract
Clinical manifestations of COVID-19 caused by the new coronavirus SARS-CoV-2 are associated with age1,2.
Adults develop respiratory symptoms, which can progress to acute respiratory distress syndrome (ARDS) in
the most severe form, while children are largely spared from respiratory illness but can develop a life-
threatening multisystem inflammatory syndrome (MIS-C)3-5. Here, we show distinct antibody responses in
children and adults after SARS-CoV-2 infection. Adult COVID-19 cohorts had anti-spike (S) IgG, IgM and IgA
antibodies, as well as anti-nucleocapsid (N) IgG antibody, while children with and without MIS-C had redu-
ced breadth of anti-SARS-CoV-2-specific antibodies, predominantly generating IgG antibodies specific for
the S protein but not the N protein. Moreover, children with and without MIS-C had reduced neutralizing
activity as compared to both adult COVID-19 cohorts, indicating a reduced protective serological response.
These results suggest a distinct infection course and immune response in children independent of whether
they develop MIS-C, with implications for developing age-targeted strategies for testing and protecting the
population.
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2021;9(38):1-46FISIOTERAPIA
Publicaciones
Schaan CW, Vieira V de S, Miller C, Peiter APD, Piccoli T, Cavion G, et al. Hospital phy-
sical therapy management in pediatric patients with covid-19: case reports. Rev Paul
Pediatr. 2021;39.
Doi: 10.1590/1984-0462/2021/39/2020238
Abstract
Objective: To report the physiotherapeutic management of two pediatric cases with COVID-19 admitted in
a reference state hospital to treat the disease in Porto Alegre, Southern Brazil.
Cases description: Case 1, female, 10-month-old child, pre-existing chronic disease, hospitalized since
birth, mechanical ventilation dependency via tracheotomy, progressed with hypoxemia, requiring oxygen
therapy, and increased ventilator parameters, and a diagnosis of COVID-19 was confirmed. Airway clearan-
ce and pulmonary expansion maintenance therapies were performed. During hospitalization, the child ac-
quired cephalic control, sitting without support, rolling, holding, and reaching objects. Recommendations
were provided to a family member to maintain motor development milestones. Case 2, male, nine years
old, previous psychiatric disease and obesity, showed worsening of the sensory state, requiring intensive
care and invasive mechanical ventilation, with the diagnosis of SARS-Cov-2 infection. The physical therapy
was performed to maintain airway clearance, pulmonary expansion, and early mobilization, showing venti-
latory improvement during the intensive care hospitalization and successfully extubated after 17 days. The
physical therapy evolved from passive to resistive exercises during the hospitalization, and the patient was
able to walk without assistance at discharge, with the same previous functional status.
Comments: The COVID-19 showed different manifestations in both cases. Physical therapy treatment was
essential to maintain and to recover the functional status of the patients. Future studies are needed to im-
prove the understanding of disease course and its functional consequences to offer an efficient treatment
to pediatric patients with COVID-19
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2021;9(38):1-46NEONATOS / MADRE E HIJO
Publicaciones
Mehl SC, Whitlock RS, Marcano DC, Rialon KL, Arrington AS, Naik-Mathuria B. Necro-
tizing Enterocolitis-like Pneumatosis Intestinalis in an Infant With COVID-19. Pediatr
Infect Dis J. 2021 Feb 1;40(2):e85-6.
Doi: 10.1097/INF.0000000000002968
Abstract
We report an infant with COVID-19 who presented with bloody stools, lethargy and imaging findings signifi-
cant for pneumatosis intestinalis. The infant was treated with conservative therapy, including resuscitation,
bowel rest and intravenous antibiotics, successfully avoiding surgical intervention.
Van Oers NSC, Hanners NW, Sue P, Aquino V, Li Q-Z, Schoggins JW, et al. SARS-CoV-2
infection associated with hepatitis in an infant with X-linked severe combined im-
munodeficiency. Clin Immunol. 2021 Jan 4;224:108662 .
Doi: 10.1016/j.clim.2020.108662
Abstract
X-linked severe combined immunodeficiency (X-SCID) is a disorder of adaptive immunity caused by muta-
tions in the IL-2 receptor common gamma chain gene resulting in deficiencies of T and natural killer cells,
coupled with severe dysfunction in B cells. X-SCID is lethal without allogeneic stem cell transplant or gene
therapy due to opportunistic infections. An infant with X-SCID became infected with SARS-CoV-2 while
awaiting transplant. The patient developed severe hepatitis without the respiratory symptoms typical of
COVID-19. He was treated with convalescent plasma, and thereafter was confirmed to have SARS-CoV-2
specific antibodies, as detected with a microfluidic antigen array. After resolution of the hepatitis, he recei-
ved a haploidentical CD34 selected stem cell transplant, without conditioning, from his father who had re-
covered from COVID-19. SARS CoV-2 was detected via RT-PCR on nasopharyngeal swabs until 61 days post
transplantation. He successfully engrafted donor T and NK cells, and continues to do well clinically.
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2021;9(38):1-46NEUMOLOGÍA
Publicaciones
Patel S, Thompson MD, Slaven JE, Sanders DB, Ren CL. Reduction of pulmonary exa-
cerbations in young children with cystic fibrosis during the COVID-19 pandemic. Pe-
diatr Pulmonol. 2021 Jan 12.
Doi: 10.1002/ppul.25250
Abstract
To assess the impact of COVID-19 restrictions on cystic fibrosis (CF) pulmonary exacerbations (PEx) we per-
formed a retrospective review of PEx events at our CF Center and compared the rate of PEx in 2019 versus
2020. Restrictions on social interaction due to the COVID-19 pandemic were associated with a lower num-
ber of PEx events at our pediatric CF Center, suggesting that these restrictions also reduced exposure to
other respiratory viral infection in children with CF.
Tang Z, Li M, Chen W, Ran X, Li H, Chen Z. Clinical symptoms of COVID-19 pneumonia
in children: A protocol for systematic review and meta-analysis. Medicine (Baltimore).
2021 Jan 8;100(1):e2410.
Doi: 10.1097/md.0000000000024108
Abstract
Background: This meta-analysis aimed to compare the clinical symptoms of COVID-19 pneumonia in chil-
dren.
Methods and analysis: Electronic databases including PubMed, EMBASE, Web of Science, China National
Knowledge Infrastructure (CNKI) database, Wanfang Database, and Chinese Biomedical Literature Databa-
se (CBM) were searched from its inception to June 21, 2020. We only included studies that reported clinical
symptoms of COVID pneumonia in children. Quality of the included studies was assessed by 2 authors.
Pooled results were summarized by STATA 12.0 software.The heterogeneity was measured by I2 tests (I2 <
50 indicates little heterogeneity, I2≥50 indicates high heterogeneity). Publication bias was performed by
funnel plot and statistically assessed by Begg test (P > .05 as no publication bias).
Results: Results will be shown as figures or tables.
Conclusion: Our study aims to systematically present the clinical symptoms of COVID-19 pneumonia pa-
tients in children, so as to further provide guidance for clinical management.
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2021;9(38):1-46 Nunes MC, Cutland CL, Klugman KP, Madhi SA. Pneumococcal Conjugate Vaccine Pro-
tection against Coronavirus-Associated Pneumonia Hospitalization in Children Living
with and without HIV. mBio. 2021 Jan 8;12(1).
Doi: 10.1128/mbio.02347-20
Abstract
In December 2019 a new coronavirus (CoV) emerged as a human pathogen, SARS-CoV-2. There are few
data on human coronavirus infections among individuals living with HIV. In this study we probed the role of
pneumococcal coinfections with seasonal CoVs among children living with and without HIV hospitalized for
pneumonia. We also described the prevalence and clinical manifestations of these infections. A total of
39,836 children who participated in a randomized, double-blind, placebo-controlled clinical trial on the effi-
cacy of a 9-valent pneumococcal conjugate vaccine (PCV9) were followed for lower respiratory tract infec-
tion hospitalizations until 2 years of age. Nasopharyngeal aspirates were collected at the time of hospitali-
zation and were screened by PCR for four seasonal CoVs. The frequency of CoV-associated pneumonia was
higher in children living with HIV (19.9%) than in those without HIV (7.6%, P < 0.001). Serial CoV infections
were detected in children living with HIV. The case fatality risk among children with CoV-associated pneu-
monia was higher in those living with HIV (30.4%) than without HIV (2.9%, P = 0.001). C-reactive protein
and procalcitonin levels were elevated in 36.8% (≥40 mg/liter) and 64.7% (≥0.5 ng/ml), respectively, of the
fatal cases living with HIV. Among children without HIV, there was a 64.0% (95% CI: 22.9% to 83.2%) lower
incidence of CoV-associated pneumonia hospitalizations among PCV9 recipients compared to placebo reci-
pients. These data suggest that Streptococcus pneumoniae infections might have a role in the development
of pneumonia associated with endemic CoVs, that PCV may prevent pediatric CoV-associated hospitalizati-
on, and that children living with HIV with CoV infections develop more severe outcomes.
IMPORTANCE SARS-CoV-2 may cause severe hospitalization, but little is known about the role of secondary
bacterial infection in these severe cases, beyond the observation of high levels of reported inflammatory
markers, associated with bacterial infection, such as procalcitonin. We did a secondary analysis of a double
-blind randomized trial of PCV to examine its impact on human CoV infections before the pandemic. We
found that both children living with and without HIV randomized to receive PCV had evidence of less hospi-
talization due to seasonal CoV, suggesting that pneumococcal coinfection may play a role in severe hospita-
lized CoV infections.
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2021;9(38):1-46 Frenkel LD, Gomez F, Bellanti JA. COVID-19 in children: Pathogenesis and current sta-
tus. Allergy Asthma Proc. 2021 Jan 3;42(1):8–15.
Doi: 10.1128/mbio.02347-20
Abstract
Background: Since its initial description in December 2019 in Wuhan, China, coronavirus disease 2019
(COVID-19) has rapidly progressed into a worldwide pandemic, which has affected millions of lives. Unlike
the disease in adults, the vast majority of children with COVID-19 have mild symptoms and are largely spa-
red from severe respiratory disease. However, thereare children who have significant respiratory disease,
and some may develop a hyperinflammatory response similar to thatseen in adults with COVID-19 and in
children with Kawasaki disease (KD), which has been termed multisystem inflammatory syndrome in chil-
dren (MIS-C).
Objective: The purpose of this report was to examine the current evidence that supports the etiopathoge-
nesis of COVID-19 in children and the relationship of COVID-19 with KD and MIS-C as a basis for a better
understanding of the clinical course, diagnosis, and management of these clinically perplexing conditions.
Results: The pathogenesis of COVID-19 is carried out in two distinct but overlapping phases of COVID-19:
the first triggered by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) itself and the se-
cond by the host immune response. Children with KD have fewer of the previously described COVID-19-
associated KD features with less prominent acute respiratory distress syndrome and shock than children
with MIS-C.
Conclusion: COVID-19 in adults usually includes severe respiratory symptoms and pathology, with a high
mortality. Ithas become apparent that children are infected as easily as adults but are more often asympto-
matic and have milder diseasebecause of their immature immune systems. Although children are largely
spared from severe respiratory disease, they canpresent with a SARS-CoV-2-associated MIS-C similar to
KD.
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2021;9(38):1-46NEUROLOGÍA
Publicaciones
Orman G, Desai NK, Kralik SF, Meoded A, Seghers VJ, Annapragada AV, et al. Neuro-
imaging Offers Low Yield in Children Positive for SARS-CoV-2. AJNR Am J Neuroradiol.
2021 Jan 7.
Doi: 10.3174/ajnr.a7022
Abstract
The coronavirus disease 2019 (COVID-19) pandemic caused by Severe Acute Respiratory Syndrome corona-
virus disease 2 (SARS CoV-2) most commonly presents with respiratory disease, but neurologic complica-
tions are being reported. We aimed to investigate the rate of positive neuroimaging findings in children
positive for SARS-CoV-2 referred for neuroimaging between March 18 and September 30, 2020. We found
that 10% (n = 2) had acute findings. Our results may suggest that in children, neurologic involvement in CO-
VID-19 is rare, neuroimaging has a low yield in diagnosis, and acute neuroimaging should involve careful
risk-benefit analysis.
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2021;9(38):1-46NUTRICIÓN
Publicaciones
Haiek LN, LeDrew M, Charette C, Bartick M. Shared decision-making for infant feeding
and care during the coronavirus disease 2019 pandemic. Matern Child Nutr. 2021 Jan
6;e13129.
Doi: 10.1111/mcn.13129
Abstract
Despite decades of research establishing the importance of breastfeeding, skin-to-skin contact and mother-
infant closeness, the response to the coronavirus disease 2019 (COVID-19) pandemic has underscored the
hidden assumption that these practices can be dispensed with no consequences to mother or child. This
article aims to support shared decision-making process for infant feeding and care with parents and health
care providers during the unprecedented times of the pandemic. It proposes a structure and rationale to
guide the process that includes (1) discussing with parents evidence-based information and the different
options to feed and care for an infant and young child in the context of the pandemic as well as their po-
tential benefits, risks and scientific uncertainties; (2) helping parents to recognize the sensitive nature of
the decisions and to clarify the value they place on the different options to feed and care for their infant or
young child; and (3) providing guidance and support needed to make and implement their decisions. A sha-
red decision-making process will help parents navigate complex feeding and care decisions for their child as
we face the different stages of the COVID-19 pandemic.
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2021;9(38):1-46OFTALMOLOGÍA
Publicaciones
Wang J, Li Y, Musch DC, Wei N, Qi X, Ding G, et al. Progression of Myopia in School-
Aged Children After COVID-19 Home Confinement. JAMA Ophthalmol. 2021 Jan 14.
Doi: 10.1001/jamaophthalmol.2020.6239
Abstract
Importance: Time spent in outdoor activities has decreased owing to home confinement for the coronavi-
rus disease 2019 (COVID-19) pandemic. Concerns have been raised about whether home confinement may
have worsened the burden of myopia owing to substantially decreased time spent outdoors and increased
screen time at home.
Objective: To investigate the refractive changes and prevalence of myopia in school-aged children during
the COVID-19 home confinement.
Design, setting, and participants: A prospective cross-sectional study using school-based photoscreenings
in 123 535 children aged 6 to 13 years from 10 elementary schools in Feicheng, China, was conducted. The
study was performed during 6 consecutive years (2015-2020). Data were analyzed in July 2020.
Exposures: Noncycloplegic photorefraction was examined using a photoscreener device.
Main outcomes and measures: The spherical equivalent refraction was recorded for each child and the
prevalence of myopia for each age group during each year was calculated. The mean spherical equivalent
refraction and prevalence of myopia were compared between 2020 (after home confinement) and the pre-
vious 5 years for each age group.
Results: Of the 123 535 children included in the study, 64 335 (52.1%) were boys. A total of 194 904 test
results (389 808 eyes) were included in the analysis. A substantial myopic shift (approximately -0.3 diopters
[D]) was found in the 2020 school-based photoscreenings compared with previous years (2015-2019) for
younger children aged 6 (-0.32 D), 7 (-0.28 D), and 8 (-0.29 D) years. The prevalence of myopia in the 2020
photoscreenings was higher than the highest prevalence of myopia within 2015-2019 for children aged 6
(21.5% vs 5.7%), 7 (26.2% vs 16.2%), and 8 (37.2% vs 27.7%) years. The differences in spherical equivalent
refraction and the prevalence of myopia between 2020 and previous years were minimal in children aged 9
to 13 years.
Conclusions and relevance: Home confinement during the COVID-19 pandemic appeared to be associated
with a significant myopic shift for children aged 6 to 8 years according to 2020 school-based photoscree-
nings. However, numerous limitations warrant caution in the interpretation of these associations, including
use of noncycloplegic refractions and lack of orthokeratology history or ocular biometry data. Younger chil-
dren's refractive status may be more sensitive to environmental changes than older ages, given the youn-
ger children are in a critical period for the development of myopia.
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2021;9(38):1-46OTORRINOLARINGOLOGÍA
Publicaciones
Rusetsky Y, Meytel I, Mokoyan Z, Fisenko A, Babayan A, Malyavina U. Smell status in
children infected with SARS-CoV-2. Laryngoscope. 2021 Jan 14.
Doi: 10.1002/lary.29403
Abstract
Objectives/hypothesis: This study aimed to evaluate the olfactory status in children with laboratory confir-
med SARS-CoV-2 using subjective and psychophysical methods.
Study design: Prospective clinical cross-sectional study.
Methods: This is a prospective clinical cross-sectional study of 79 children with COVID-19. The 21st item of
SNOT-22 questionnaire and odor identification test were used for smell assessment. Children were exami-
ned twice during the hospitalization, and a telephone survey was conducted 60 days after hospital dischar-
ge.
Results: Immediately after confirmation of COVID-19, smell impairment was detected in 86.1% of children
by means of the Identification test and in 68.4% of children by means of the survey (P = .010). After 5 days
survey revealed a statistically significant decrease in the number of patients with hyposmia (41 out of 79,
51.9%). On the first visit, the mean Identification test score corresponded to "hyposmia" (9.5 ± 2.7), while
on the second visit, the average value was 13.1 ± 1.9, which corresponded to "normosmia." According to
the telephone survey, recovery of the olfactory function occurred within 10 days in 37 of 52 patients
(71.2%), 11 to 29 days - in 12 children (23.1%), and later than 30 days - in three cases (5.7%).
Conclusions: In the pediatric population, olfactory dysfunction is an early and common symptom of COVID-
19. There is a trend to quick recovery of olfactory function in children with COVID-19. The overwhelming
majority of patients (94.3%) had no subjective olfactory complaints by the end of the first month.
Level of evidence: 4 Laryngoscope, 2021.
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2021;9(38):1-46 Kumar L, Kahlon N, Jain A, Kaur J, Singh M, Pandey AK. Loss of smell and taste in CO-
VID-19 infection in adolescents. Int J Pediatr Otorhinolaryngol. 2021 Jan 13.
Doi: 10.1016/j.ijporl.2021.110626
Objectives
To study the prevalence, clinical course and outcomes of olfactory and taste dysfunction in COVID-19 posi-
tive adolescents.
Methods
This prospective study was carried out from May to August 2020. The adolescents, aged 10–19 years, who
were detected COVID-19 positive by RT-PCR with mild to moderate disease were included in the study. The
following epidemiological and clinical outcomes were studied: age, sex, general symptoms, olfactory and
taste dysfunction.
Results
Out of 141 patients included in the study, there were 83 males (58.9%) and 58 females (41.1%). The age
varied from 10 to 19 years with an average of 15.2 years. Forty patients (28.4%) had olfactory or taste dys-
function. Out of these 40 patients, 28 patients (19.8%) had both olfactory and taste dysfunction. Of the 34
patients (24.1%) who complained of olfactory dysfunction, 16 patients complained of hyposmia and 18 pa-
tients complained of anosmia. Dysgeusia was reported by 34 patients (24.1%). The duration of OTD varied
from 2 to 15 days with an average of 5.7 days.
Conclusion
Loss of smell and taste are common symptoms in COVID-19 positive adolescents. It recovers spontaneously
within a few weeks, along with the resolution of other symptoms.
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2021;9(38):1-46 Palas A, Raval J, Aiyer RG, Arunlal B. Pediatric E.N.T. emergencies during COVID-19
pandemic: our experience. Indian J Otolaryngol Head Neck Surg. 2021 Jan 4;1–5.
Doi: 10.1007/s12070-020-02357-z
Abstract
Our aim is to analyze effect of covid-19 pandemic in management of pediatric emergencies in E.N.T. and to
provide recommendations for management of pediatric emergencies in E.N.T. during pandemic. In this re-
trospective study we included emergency pediatric cases required early intervention during covid-19 pan-
demic. Pre operative radiological investigation x-ray was done in all aero digestive foreign body patients.
Pre operative HRCT neck and chest with virtual bronchoscopy in foreign body inhalation & compromised
airway patients was done only in cases where patient's clinical condition was stable. Similarly RT PCR for
covid-19 screening done only in cases where patient's clinical condition was stable. Adequate personal pro-
tective equipment was used during all the procedures. Total 29 Pediatric patients age ranging from 1 day to
13 years underwent procedures due to history of foreign body inhalation; ingestion, insertion and compro-
mised airway in form of immediate endotracheal intubation were included. Comprehensively we recom-
mend intervention only in emergency procedures during pandemic, use of personal protective equipment
during all procedures, preoperative investigations for diagnosis and modifications in operation theatre,
anesthesia and surgical techniques to reduce aerosols generation will minimize risk of infection transmis-
sion to health care workers.
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2021;9(38):1-46PROFESIONALES DE LA SALUD
Publicaciones
Treluyer L, Tourneux P. Burnout among paediatric residents during the COVID-19 out-
break in France. Eur J Pediatr. 2021 Jan 7.
Doi: 10.1007/s00431-020-03907-x
Abstract
The primary objective of the study was to assess the prevalence of burnout among paediatric residents du-
ring the coronavirus disease 2019 (COVID-19) outbreak in France. The secondary objective was to identify
risk factors associated with burnout in this population. In a nationwide, cross-sectional survey, a question-
naire was e-mailed to all paediatric residents in France in the first week of May 2020. The prevalence of
burnout was assessed with the validated French-language version of the Maslach Burnout Inventory - Hu-
man Services Survey. The questionnaire also contained items on the residents' sociodemographic characte-
ristics and professional situation. Three hundred and forty paediatric residents completed the questionnai-
re. The median age was 27 (interquartile range 25-28) and 285 (83.8%, 95% confidence interval (CI) [79.5-
87.6]) of the residents were women. The prevalence of burnout was 37.4%, 95%CI [32.2-42.7]. There was
no association between burnout and exposure to the consequences of COVID-19, which may be related to
the low incidence of severe COVID-19 among children. In contrast, the hours worked per week and the an-
xiety scores were significantly associated with burnout.Conclusion: The level of burnout among French pae-
diatric residents is a matter of concern for residents, and cannot be ascribed to the COVID-19 outbreak.
Preventive actions should be implemented, with a reduction in working hours and support programs to
help manage work-related anxiety. What is Known: • Burnout is a concern for both residents and the pa-
tients they care for. • Natural disasters disrupt the health care organizations and increase the burnout rate.
What is New: • The prevalence of burnout among paediatric residents in France is 37.4%, 95%CI [32.2-
42.7]. • COVID-19 outbreak is not associated with burnout in this population but anxiety and working hours
per week might be modifiable risk factors.
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2021;9(38):1-46RADIOLOGÍA
Publicaciones
Fenlon Iii EP, Chen S, Ruzal-Shapiro CB, Jaramillo D, Maddocks ABR. Extracardiac ima-
ging findings in COVID-19-associated multisystem inflammatory syndrome in children.
Pediatr Radiol. 2021 Jan 12.
Doi: 10.1007/s00247-020-04929-1
Abstract
Background: Coronavirus disease 2019 (COVID-19)-associated multisystem inflammatory syndrome in chil-
dren (MIS-C) is an emerging syndrome that presents with a Kawasaki-like disease and multiorgan damage
in children previously exposed to COVID-19.
Objective: To review the extracardiac radiologic findings of MIS-C in a group of children and young adults
with a confirmed diagnosis of MIS-C.
Materials and methods: In a retrospective study from April 1, 2020, to July 31, 2020, we reviewed the ima-
ging studies of 47 children and adolescents diagnosed with MIS-C, 25 females (53%) and 22 males (47%),
with an average age of 8.4 years (range 1.3-20 years). Forty-five had chest radiographs, 8 had abdominal
radiographs, 13 had abdominal US or MRI, 2 had neck US, and 4 had brain MRI.
Results: Thirty-seven of 45 (82%) patients with chest radiographs had findings, with pulmonary opacities
being the most common finding (n=27, 60%), most often bilateral and diffuse, followed by peribronchial
thickening (n=26, 58%). Eight patients had normal chest radiographs. On abdominal imaging, small-volume
ascites was the most common finding (n=7, 54%). Other findings included right lower quadrant bowel wall
thickening (n=3, 23%), gallbladder wall thickening (n=3, 23%), and cervical (n=2) or abdominal (n=2) lymp-
hadenopathy. Of the four patients with brain MRI, one had bilateral parieto-occipital abnormalities and
another papilledema.
Conclusion: The diagnosis of MIS-C and its distinction from other pathologies should be primarily based on
clinical presentation and laboratory evidence of inflammation because imaging findings are nonspecific.
However, it should be considered in the setting of bilateral diffuse pulmonary opacities, peribronchial thi-
ckening, right lower quadrant bowel inflammation or unexplained ascites in a child presenting with Kawa-
saki-like symptoms and a history of COVID-19 infection or recent COVID-19 exposure.
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2021;9(38):1-46 Rostad BS, Shah JH, Rostad CA, Jaggi P, Richer EJ, Linam LE, et al. Chest radiograph
features of multisystem inflammatory syndrome in children (MIS-C) compared to pe-
diatric COVID-19. Pediatr Radiol. 2021 Jan 6.
Doi: 10.1007/s00247-020-04921-9
Abstract
Background: Although the radiographic features of coronavirus disease 2019 (COVID-19) in children have
been described, the distinguishing features of multisystem inflammatory syndrome in children (MIS-C) as-
sociated with COVID-19 are not well characterized.
Objective: We compared the chest radiographic findings of MIS-C with those of COVID-19 and described
other distinguishing imaging features of MIS-C.
Materials and methods: We performed a retrospective case series review of children ages 0 to 18 years
who were hospitalized at Children's Healthcare of Atlanta from March to May 2020 and who either met the
Centers for Disease Control and Prevention (CDC) case definition for MIS-C (n=11) or who had symptoma-
tic, laboratory-confirmed COVID-19 (n=16). Two radiologists reviewed the most severe chest radiographs
for each patient. The type and distribution of pulmonary opacities and presence or absence of pleural effu-
sions were recorded. The chest radiographs were categorized based on potential COVID-19 imaging fin-
dings as typical, indeterminate, atypical or negative. An imaging severity score was also assigned using a
simplified version of the Radiographic Assessment of Lung Edema Score. Findings were statistically compa-
red between patients with MIS-C and those with COVID-19. Additional imaging findings of MIS-C were also
described.
Results: Radiographic features of MIS-C included pleural effusions (82% [9/11]), pulmonary consolidations
(73% [8/11]) and ground glass opacities (91% [10/11]). All of the lung opacities (100% [10/10]) were bilate-
ral, and the majority of the pleural effusions (67% [6/9]) were bilateral. Compared to children with COVID-
19, children with MIS-C were significantly more likely to develop pleural effusions on chest radiograph (82%
[9/11] vs. 0% [0/0], P-value Musolino AM, Supino MC, Buonsenso D, Papa RE, Chiurchiù S, Magistrelli A, et al.
Lung ultrasound in the diagnosis and monitoring of 30 children with coronavirus di-
sease 2019. Pediatr Pulmonol. 2021 Jan 6.
Doi: 10.1002/ppul.25255
Abstract
Background: The coronavirus disease 2019 (COVID-19) has caused a new global pandemic and is responsi-
ble for millions of infections and thousands of deaths in the world. The lung ultrasound (LUS) is a noninvasi-
ve and easily repeatable tool and can be carried out by the pediatrician at the bedside of children with a
consequent reduction in the risk of transmission of the virus.
Objective: We hypothesized that ultrasound findings in these patients would (1) be associated with their
disease severity and (2) change over time in alignment with clinical outcome.
Methods: The study was made in the emergency department (ED) in a tertiary level pediatric hospital. All
patients with swab-confirmed COVID-19 infection were subjected to a LUS within 6 h from admission and
after 96 h.
Results: Among a total of 30 children, 18 (60%) were males, 4 reported exertional dyspnea, and only 1
chest pain. The mean oxygen saturation was 98.8 ± 1.0% in ambient air in the ED and no patient needed
oxygen therapy during hospitalization. Children with moderate disease presented more B line (p = .03).
After 96 h, we had observed ultrasound abnormality only in 20% of the children. We found a statistically
significant reduction in pleural irregularities (30% vs. 16.7; p = .001) and in B lines (50% vs. 20%; p = .008).
Conclusions: The LUS is a useful, feasible, and safe tool for the clinician to complement the clinical evalua-
tion and to monitor the evolution of lung disease in children with COVID-19.
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2021;9(38):1-46SALUD MENTAL
Publicaciones
Newlove-Delgado T, McManus S, Sadler K, Thandi S, Vizard T, Cartwright C, et al. Child
mental health in England before and during the COVID-19 lockdown. Lancet Psychia-
try. 2021 Jan 11.
Comment
Doi: 10.1016/s2215-0366(20)30570-8
Waller R, Powell T, Rodriguez Y, Corbett N, Perlstein S, White LK, et al. The Impact of
the COVID-19 Pandemic on Children’s Conduct Problems and Callous-Unemotional
Traits. Child Psychiatry Hum Dev. 2021 Jan 6.
Doi: 10.1007/s10578-020-01109-y
Abstract
The COVID-19 pandemic has dramatically altered family life, but whether family exposures to and worries
about the COVID-19 pandemic has impacted child conduct problems (CP) and callous-unemotional (CU)
traits is unknown. Thus, we evaluated 303 parents (Mage = 38.04; SD = 5.21; 92.4% biological mothers) and
children (Mage = 6.43; SD = 2.13; 51.8% female) during a four-month period early in the pandemic. We
examined associations between parental exposures to COVID-19, parental worries about the pandemic,
harsh and warm parenting practices, and child CP and CU traits. Although more parental worries were not
directly related to parenting practices, more worry about COVID-19 was specifically related to higher levels
of child CP, particularly parental worries about themselves or family members contracting the virus. Our
findings add to a growing literature demonstrating the burden that the pandemic has placed on families
and its implications for children's mental health .
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2021;9(38):1-46SALUD PÚBLICA / POLÍTICAS EN SALUD / GESTIÓN EN SALUD
Publicaciones
Diskin C, Orkin J, Agarwal T, Parmar A, Friedman JN. The Secondary Consequences of
the COVID-19 Pandemic in Hospital Pediatrics. Hosp Pediatr. 2021 Jan 12.
Doi: 10.1542/hpeds.2020-002477
Abstract
Background: The coronavirus disease 2019 (COVID-19) pandemic is a once in a lifetime public health catas-
trophe that has driven the world not only into a medical crisis but has pushed to the brink of economic co-
llapse. Prevention of transmission of the replication-competent virus to the susceptible host is the key to
the control of COVID-19. The phenomenon of "sustained-positivity," "reinfections," and their role in disea-
se transmission are poorly understood in adults and not even recognized in the pediatric population yet.
This information is crucial for ascertaining the quarantine/isolation period for test-positive patients. Most
of the time, adult studies' results are extrapolated and applied to children, but severe acute respiratory
syndrome coronavirus 2 (SARS-CoV-2) has treated children differently than adults.
Material and methods: The Institutional Review Board (IRB) approval has been obtained. A retrospective
electronic chart review of 989 SARS-CoV-2 polymerase chain reaction (PCR)/reverse transcription-PCR (RT-
PCR) positive pediatric patients was performed. The aim was to look at the existence of sustained positivity
and SARS -CoV-2 reinfection in the pediatric population, as was reported in the adults. Results: We present
our retrospective observational study on 989 SARS-CoV-2 positive pediatric patients; 172 of these had re-
peated multiple testings, 68 had multiple consecutive positive tests over time, and 27 qualified for sustai-
ned-positive status. We also report on four pediatric COVID-19 reinfections.
Conclusion: This is the first report on pediatric SARS-CoV-2 reinfection, one of very few on pediatric SARS-
CoV-2 sustained positivity and reinfection. These two phenomena occur in children also as reported in
adults but have several differences. The reinfection is possible within one to three weeks of becoming ne-
gative as against adults who have been reported to become positive in a minimum of 45-90 days from be-
coming negative. More extensive reporting is essential to ascertain the accurate quarantine/isolation re-
commendation in children.
Zimmerman KO, Akinboyo IC, Brookhart MA, Boutzoukas AE, McGann K, Smith MJ, et
al. Incidence and Secondary Transmission of SARS-CoV-2 Infections in Schools. Pedia-
trics. 2021 Jan 8.
Doi: 10.1542/peds.2020-048090
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2021;9(38):1-46 Esposito S, Cotugno N, Principi N. Comprehensive and safe school strategy during CO-
VID-19 pandemic. Ital J Pediatr. 2021 Jan 9;47(1):6.
Doi: 10.1186/s13052-021-00960-6
Abstract
Background: Although several studies have tried to evaluate the real efficacy of school closure for pande-
mic control over time, no definitive answer to this question has been given. Moreover, it has not been clari-
fied whether children or teenagers could be considered a problem for SARS-CoV-2 diffusion or, on the con-
trary, whether parents and school workers play a greater role. The aims of this review are to discuss about
children's safety at school and the better strategies currently able to reduce the risk of SARS-CoV-2 infec-
tion at school.
Main aim: Compared to adults, very few cases of COVID-19 were diagnosed in children, who generally
suffered from an asymptomatic infection or a mild disease. Moreover, school closure is systematically asso-
ciated with the development of problems involving students, teachers and parents, particularly among po-
pulations with poor resources. Although several researches have tried to evaluate the real efficacy of
school closure for pandemic control over time, no definitive answer to this question has been given. Availa-
ble findings seem to confirm that to ensure adequate learning and to avoid social and economic problems,
schools must remain open, provided that the adults who follow children at home and at school absolutely
comply with recommendations for prevention measures and that school facilities can be optimized in order
to significantly reduce the spread of infection. In this regard, the universal use of face masks in addition to
hand hygiene and safe distancing in schools, at least starting from the age of 6 years, seems extremely
useful. Moreover, since the beginning of the COVID-19 outbreak the use of telemedicine to manage sus-
pected SARS-CoV-2-infected individuals in the community has appeared to be an easy and effective measu-
re to solve many paediatric problems and could represent a further support to schools .
Conclusions: We think that schools must remain open, despite COVID-19 pandemic. However, several pro-
blems strictly related to school frequency and reduction of infectious risk must be solved before school
attendance can be considered completely safe. A single more in-depth guideline agreed between countries
with the same school problems could be very useful in eliminating doubts and fostering the compliance of
students, teachers and non-teaching school staff reducing errors and misinterpretations.
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2021;9(38):1-46You can also read
