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  1. Article ; Online: SARS-CoV-2 and rhinovirus infections: are there differences in clinical presentation, laboratory abnormalities, and outcomes in the pediatric population?

    Pereira, Maria Fernanda Bádue / Suguita, Priscila / Litvinov, Nadia / Farhat, Sylvia Costa Lima / Paula, Camila Sanson Yoshino de / Lázari, Carolina Dos Santos / Bedê, Pedro Vale / Framil, Juliana Valeria de Souza / Bueno, Catarina / Branas, Priscila Cristina Abduch Adas / Guimarães, Irina Monteiro da Costa / Leite, Marcia Marques / Navega, Ana Carolina Barsaglini / Nanbu, Danilo Yamamoto / Schvartsman, Claudio / Pinho, João Renato Rebello / Silva, Clovis Artur Almeida / Marques, Heloisa Helena de Sousa / Eisencraft, Adriana Pasmanik /
    Rossi, Alfio / Delgado, Artur Figueiredo / Leal, Gabriela Nunes / Gibelli, Maria Augusta Cicaroni / Palmeira, Patricia / Sakita, Neusa Keico / Santos, Emilly Henrique Dos / Rocha, Mussya Cisotto / Kanunfre, Kelly Aparecida / Okay, Thelma Suely / Carneiro-Sampaio, Magda / Carvalho, Werther Brunow de

    Revista do Instituto de Medicina Tropical de Sao Paulo

    2022  Volume 64, Page(s) e34

    Abstract: This study aims to assess COVID-19 and other respiratory viruses in pediatric patients. Between April 17 and September 30, 2020, we collected 1,566 respiratory samples from 1,044 symptomatic patients who were younger than 18 years old to assess SARS-CoV- ... ...

    Abstract This study aims to assess COVID-19 and other respiratory viruses in pediatric patients. Between April 17 and September 30, 2020, we collected 1,566 respiratory samples from 1,044 symptomatic patients who were younger than 18 years old to assess SARS-CoV-2 infection. Of these, 919 were analyzed for other respiratory pathogens (ORP). Patients with laboratory-confirmed COVID-19 or ORP were included. We evaluated 76 pediatric COVID-19 infections and 157 other respiratory virus infections. Rhinovirus occurred in 132/157 (84%). COVID-19 patients who were significantly older, had more fevers, headaches and pneumonia than those with ORP. The median white blood cell count was lower in patients with SARS-CoV-2 than in those with ORP (6,470 versus 8,170; p=0.02). COVID-19 patients had significantly worse symptoms than those with ORP.
    MeSH term(s) Adolescent ; COVID-19/diagnosis ; Child ; Communicable Diseases ; Humans ; Rhinovirus ; SARS-CoV-2
    Language English
    Publishing date 2022-05-25
    Publishing country Brazil
    Document type Journal Article
    ZDB-ID 128928-7
    ISSN 1678-9946 ; 0036-4665
    ISSN (online) 1678-9946
    ISSN 0036-4665
    DOI 10.1590/S1678-9946202264034
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  2. Article ; Online: Severe clinical spectrum with high mortality in pediatric patients with COVID-19 and multisystem inflammatory syndrome.

    Pereira, Maria Fernanda Badue / Litvinov, Nadia / Farhat, Sylvia Costa Lima / Eisencraft, Adriana Pasmanik / Gibelli, Maria Augusta Bento Cicaroni / Carvalho, Werther Brunow de / Fernandes, Vinicius Rodrigues / Fink, Thais de Toledo / Framil, Juliana Valéria de Souza / Galleti, Karine Vusberg / Fante, Alice Lima / Fonseca, Maria Fernanda Mota / Watanabe, Andreia / Paula, Camila Sanson Yoshino de / Palandri, Giovanna Gavros / Leal, Gabriela Nunes / Diniz, Maria de Fatima Rodrigues / Pinho, João Renato Rebello / Silva, Clovis Artur /
    Marques, Heloisa Helena de Sousa / Rossi Junior, Alfio / Delgado, Artur Figueiredo / Andrade, Anarella Penha Meirelles de / Schvartsman, Claudio / Sabino, Ester Cerdeira / Rocha, Mussya Cisotto / Kanunfre, Kelly Aparecida / Okay, Thelma Suely / Carneiro-Sampaio, Magda Maria Sales / Jorge, Patricia Palmeira Daenekas

    Clinics (Sao Paulo, Brazil)

    2020  Volume 75, Page(s) e2209

    Abstract: Objectives: To assess the outcomes of pediatric patients with laboratory-confirmed coronavirus disease (COVID-19) with or without multisystem inflammatory syndrome in children (MIS-C).: Methods: This cross-sectional study included 471 samples ... ...

    Abstract Objectives: To assess the outcomes of pediatric patients with laboratory-confirmed coronavirus disease (COVID-19) with or without multisystem inflammatory syndrome in children (MIS-C).
    Methods: This cross-sectional study included 471 samples collected from 371 patients (age<18 years) suspected of having severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The study group comprised 66/371 (18%) laboratory-confirmed pediatric COVID-19 patients: 61 (92.5%) patients tested positive on real-time reverse transcription-polymerase chain reaction tests for SARS-CoV-2, and 5 (7.5%) patients tested positive on serological tests. MIS-C was diagnosed according to the criteria of the Center for Disease Control.
    Results: MIS-C was diagnosed in 6/66 (9%) patients. The frequencies of diarrhea, vomiting, and/or abdominal pain (67% vs. 22%, p=0.034); pediatric SARS (67% vs. 13%, p=0.008); hypoxemia (83% vs. 23%, p=0.006); and arterial hypotension (50% vs. 3%, p=0.004) were significantly higher in patients with MIS-C than in those without MIS-C. The frequencies of C-reactive protein levels >50 mg/L (83% vs. 25%, p=0.008) and D-dimer levels >1000 ng/mL (100% vs. 40%, p=0.007) and the median D-dimer, troponin T, and ferritin levels (p<0.05) were significantly higher in patients with MIS-C. The frequencies of pediatric intensive care unit admission (100% vs. 60%, p=0.003), mechanical ventilation (83% vs. 7%, p<0.001), vasoactive agent use (83% vs. 3%, p<0.001), shock (83% vs. 5%, p<0.001), cardiac abnormalities (100% vs. 2%, p<0.001), and death (67% vs. 3%, p<0.001) were also significantly higher in patients with MIS-C. Similarly, the frequencies of oxygen therapy (100% vs. 33%, p=0.003), intravenous immunoglobulin therapy (67% vs. 2%, p<0.001), aspirin therapy (50% vs. 0%, p<0.001), and current acute renal replacement therapy (50% vs. 2%, p=0.002) were also significantly higher in patients with MIS-C. Logistic regression analysis showed that the presence of MIS-C was significantly associated with gastrointestinal manifestations [odds ratio (OR)=10.98; 95%CI (95% confidence interval)=1.20-100.86; p=0.034] and hypoxemia [OR=16.85; 95%CI=1.34-211.80; p=0.029]. Further univariate analysis showed a positive association between MIS-C and death [OR=58.00; 95%CI=6.39-526.79; p<0.0001].
    Conclusions: Pediatric patients with laboratory-confirmed COVID-19 with MIS-C had a severe clinical spectrum with a high mortality rate. Our study emphasizes the importance of investigating MIS-C in pediatric patients with COVID-19 presenting with gastrointestinal involvement and hypoxemia.
    MeSH term(s) Abdominal Pain/etiology ; Betacoronavirus ; COVID-19 ; Child ; Coronavirus ; Coronavirus Infections/complications ; Coronavirus Infections/diagnosis ; Coronavirus Infections/mortality ; Coronavirus Infections/therapy ; Cross-Sectional Studies ; Diarrhea/etiology ; Fever/etiology ; Glucocorticoids/therapeutic use ; Humans ; Immunoglobulins, Intravenous/therapeutic use ; Male ; Mucocutaneous Lymph Node Syndrome/epidemiology ; Mucocutaneous Lymph Node Syndrome/therapy ; Mucocutaneous Lymph Node Syndrome/virology ; Pandemics ; Pneumonia, Viral/complications ; Pneumonia, Viral/diagnosis ; Pneumonia, Viral/mortality ; Pneumonia, Viral/therapy ; Respiration, Artificial ; SARS-CoV-2 ; Severity of Illness Index ; Systemic Inflammatory Response Syndrome/epidemiology ; Systemic Inflammatory Response Syndrome/therapy ; Systemic Inflammatory Response Syndrome/virology ; Vomiting/etiology
    Chemical Substances Glucocorticoids ; Immunoglobulins, Intravenous
    Keywords covid19
    Language English
    Publishing date 2020-08-19
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2182801-5
    ISSN 1980-5322 ; 1807-5932
    ISSN (online) 1980-5322
    ISSN 1807-5932
    DOI 10.6061/clinics/2020/e2209
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Severe clinical spectrum with high mortality in pediatric patients with COVID-19 and multisystem inflammatory syndrome

    Pereira, Maria Fernanda Badue / Litvinov, Nadia / Farhat, Sylvia Costa Lima / Eisencraft, Adriana Pasmanik / Gibelli, Maria Augusta Bento Cicaroni / Carvalho, Werther Brunow de / Fernandes, Vinicius Rodrigues / Fink, Thais de Toledo / Framil, Juliana Vale´ria de Souza / Galleti, Karine Vusberg / Fante, Alice Lima / Fonseca, Maria Fernanda Mota / Watanabe, Andreia / Paula, Camila Sanson Yoshino de / Palandri, Giovanna Gavros / Leal, Gabriela Nunes / Diniz, Maria de Fatima Rodrigues / Pinho, João Renato Rebello / Silva, Clovis Artur /
    Marques, Heloisa Helena de Sousa / Study Group, Pediatric COVID HC-FMUSP

    Clinics; v.; e2209 ; Clinics; Vol. 75 (2020); e2209 ; Clinics; Vol 75 (2020); e2209 ; 1980-5322 ; 1807-5932

    2020  Volume 75

    Abstract: OBJECTIVES: To assess the outcomes of pediatric patients with laboratory-confirmed coronavirus disease (COVID-19) with or without multisystem inflammatory syndrome in children (MIS-C). METHODS: This cross-sectional study included 471 samples collected ... ...

    Abstract OBJECTIVES: To assess the outcomes of pediatric patients with laboratory-confirmed coronavirus disease (COVID-19) with or without multisystem inflammatory syndrome in children (MIS-C). METHODS: This cross-sectional study included 471 samples collected from 371 patients (ageo18 years) suspected of having severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The study group comprised 66/371 (18%) laboratory-confirmed pediatric COVID-19 patients: 61 (92.5%) patients tested positive on real-time reverse transcription-polymerase chain reaction tests for SARS-CoV-2, and 5 (7.5%) patients tested positive on serological tests. MIS-C was diagnosed according to the criteria of the Center for Disease Control. RESULTS: MIS-C was diagnosed in 6/66 (9%) patients. The frequencies of diarrhea, vomiting, and/or abdominal pain (67% vs. 22%, p=0.034); pediatric SARS (67% vs. 13%, p=0.008); hypoxemia (83% vs. 23%, p=0.006); and arterial hypotension (50% vs. 3%, p=0.004) were significantly higher in patients with MIS-C than in those without MIS-C. The frequencies of C-reactive protein levels 450 mg/L (83% vs. 25%, p=0.008) and D-dimer levels 41000 ng/mL (100% vs. 40%, p=0.007) and the median D-dimer, troponin T, and ferritin levels (po0.05) were significantly higher in patients with MIS-C. The frequencies of pediatric intensive care unit admission (100% vs. 60%, p=0.003), mechanical ventilation (83% vs. 7%, po0.001), vasoactive agent use (83% vs. 3%, po0.001), shock (83% vs. 5%, po0.001), cardiac abnormalities (100% vs. 2%, po0.001), and death (67% vs. 3%, po0.001) were also significantly higher in patients with MIS-C. Similarly, the frequencies of oxygen therapy (100% vs. 33%, p=0.003), intravenous immunoglobulin therapy (67% vs. 2%, po0.001), aspirin therapy (50% vs. 0%, po0.001), and current acute renal replacement therapy (50% vs. 2%, p=0.002) were also significantly higher in patients with MIS-C. Logistic regression analysis showed that the presence of MIS-C was significantly associated with gastrointestinal manifestations [odds ratio (OR)=10.98; 95%CI (95% confidence interval)=1.20-100.86; p=0.034] and hypoxemia [OR=16.85; 95%CI=1.34-211.80; p=0.029]. Further univariate analysis showed a positive association between MIS-C and death [OR=58.00; 95%CI=6.39- 526.79; po0.0001]. CONCLUSIONS: Pediatric patients with laboratory-confirmed COVID-19 with MIS-C had a severe clinical spectrum with a high mortality rate. Our study emphasizes the importance of investigating MIS-C in pediatric patients with COVID-19 presenting with gastrointestinal involvement and hypoxemia.
    Keywords covid19
    Subject code 610 ; 616
    Language English
    Publishing date 2020-08-29
    Publisher Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo
    Publishing country br
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article: Severe clinical spectrum with high mortality in pediatric patients with COVID-19 and multisystem inflammatory syndrome

    Pereira, Maria Fernanda Badue / Litvinov, Nadia / Farhat, Sylvia Costa Lima / Eisencraft, Adriana Pasmanik / Gibelli, Maria Augusta Bento Cicaroni / Carvalho, Werther Brunow de / Fernandes, Vinicius Rodrigues / Fink, Thais de Toledo / Framil, Juliana Valéria de Souza / Galleti, Karine Vusberg / Fante, Alice Lima / Fonseca, Maria Fernanda Mota / Watanabe, Andreia / Paula, Camila Sanson Yoshino de / Palandri, Giovanna Gavros / Leal, Gabriela Nunes / Diniz, Maria de Fatima Rodrigues / Pinho, João Renato Rebello / Silva, Clovis Artur /
    Marques, Heloisa Helena de Sousa / Rossi Junior, Alfio / Delgado, Artur Figueiredo / Andrade, Anarella Penha Meirelles de / Schvartsman, Claudio / Sabino, Ester Cerdeira / Rocha, Mussya Cisotto / Kanunfre, Kelly Aparecida / Okay, Thelma Suely / Carneiro-Sampaio, Magda Maria Sales / Jorge, Patricia Palmeira Daenekas

    Clinics (Sao Paulo)

    Abstract: OBJECTIVES: To assess the outcomes of pediatric patients with laboratory-confirmed coronavirus disease (COVID-19) with or without multisystem inflammatory syndrome in children (MIS-C). METHODS: This cross-sectional study included 471 samples collected ... ...

    Abstract OBJECTIVES: To assess the outcomes of pediatric patients with laboratory-confirmed coronavirus disease (COVID-19) with or without multisystem inflammatory syndrome in children (MIS-C). METHODS: This cross-sectional study included 471 samples collected from 371 patients (age<18 years) suspected of having severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The study group comprised 66/371 (18%) laboratory-confirmed pediatric COVID-19 patients: 61 (92.5%) patients tested positive on real-time reverse transcription-polymerase chain reaction tests for SARS-CoV-2, and 5 (7.5%) patients tested positive on serological tests. MIS-C was diagnosed according to the criteria of the Center for Disease Control. RESULTS: MIS-C was diagnosed in 6/66 (9%) patients. The frequencies of diarrhea, vomiting, and/or abdominal pain (67% vs. 22%, p=0.034); pediatric SARS (67% vs. 13%, p=0.008); hypoxemia (83% vs. 23%, p=0.006); and arterial hypotension (50% vs. 3%, p=0.004) were significantly higher in patients with MIS-C than in those without MIS-C. The frequencies of C-reactive protein levels >50 mg/L (83% vs. 25%, p=0.008) and D-dimer levels >1000 ng/mL (100% vs. 40%, p=0.007) and the median D-dimer, troponin T, and ferritin levels (p<0.05) were significantly higher in patients with MIS-C. The frequencies of pediatric intensive care unit admission (100% vs. 60%, p=0.003), mechanical ventilation (83% vs. 7%, p<0.001), vasoactive agent use (83% vs. 3%, p<0.001), shock (83% vs. 5%, p<0.001), cardiac abnormalities (100% vs. 2%, p<0.001), and death (67% vs. 3%, p<0.001) were also significantly higher in patients with MIS-C. Similarly, the frequencies of oxygen therapy (100% vs. 33%, p=0.003), intravenous immunoglobulin therapy (67% vs. 2%, p<0.001), aspirin therapy (50% vs. 0%, p<0.001), and current acute renal replacement therapy (50% vs. 2%, p=0.002) were also significantly higher in patients with MIS-C. Logistic regression analysis showed that the presence of MIS-C was significantly associated with gastrointestinal manifestations [odds ratio (OR)=10.98; 95%CI (95% confidence interval)=1.20-100.86; p=0.034] and hypoxemia [OR=16.85; 95%CI=1.34-211.80; p=0.029]. Further univariate analysis showed a positive association between MIS-C and death [OR=58.00; 95%CI=6.39-526.79; p<0.0001]. CONCLUSIONS: Pediatric patients with laboratory-confirmed COVID-19 with MIS-C had a severe clinical spectrum with a high mortality rate. Our study emphasizes the importance of investigating MIS-C in pediatric patients with COVID-19 presenting with gastrointestinal involvement and hypoxemia.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #749235
    Database COVID19

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  5. Article ; Online: Differences in children and adolescents with SARS-CoV-2 infection: a cohort study in a Brazilian tertiary referral hospital.

    Marques, Heloisa Helena de Sousa / Pereira, Maria Fernanda Badue / Santos, Angélica Carreira Dos / Fink, Thais Toledo / Paula, Camila Sanson Yoshino de / Litvinov, Nadia / Schvartsman, Claudio / Delgado, Artur Figueiredo / Gibelli, Maria Augusta Bento Cicaroni / Carvalho, Werther Brunow de / Odone Filho, Vicente / Tannuri, Uenis / Carneiro-Sampaio, Magda / Grisi, Sandra / Duarte, Alberto José da Silva / Antonangelo, Leila / Francisco, Rossana Pucineli Vieira / Okay, Thelma Suely / Batisttella, Linamara Rizzo /
    Carvalho, Carlos Roberto Ribeiro de / Brentani, Alexandra Valéria Maria / Silva, Clovis Artur / Eisencraft, Adriana Pasmanik / Rossi Junior, Alfio / Fante, Alice Lima / Cora, Aline Pivetta / Reis, Amelia Gorete A de Costa / Ferrer, Ana Paula Scoleze / Andrade, Anarella Penha Meirelles de / Watanabe, Andreia / Gonçalves, Angelina Maria Freire / Waetge, Aurora Rosaria Pagliara / Silva, Camila Altenfelder / Ceneviva, Carina / Lazari, Carolina Dos Santos / Abellan, Deipara Monteiro / Santos, Emilly Henrique Dos / Sabino, Ester Cerdeira / Bianchini, Fabíola Roberta Marim / Alcantara, Flávio Ferraz de Paes / Ramos, Gabriel Frizzo / Leal, Gabriela Nunes / Rodriguez, Isadora Souza / Pinho, João Renato Rebello / Carneiro, Jorge David Avaizoglou / Paz, Jose Albino / Ferreira, Juliana Carvalho / Ferranti, Juliana Ferreira / Ferreira, Juliana de Oliveira Achili / Framil, Juliana Valéria de Souza / Silva, Katia Regina da / Kanunfre, Kelly Aparecida / Bastos, Karina Lucio de Medeiros / Galleti, Karine Vusberg / Cristofani, Lilian Maria / Suzuki, Lisa / Campos, Lucia Maria Arruda / Perondi, Maria Beatriz de Moliterno / Diniz, Maria de Fatima Rodrigues / Fonseca, Maria Fernanda Mota / Cordon, Mariana Nutti de Almeida / Pissolato, Mariana / Peres, Marina Silva / Garanito, Marlene Pereira / Imamura, Marta / Dorna, Mayra de Barros / Luglio, Michele / Rocha, Mussya Cisotto / Aikawa, Nadia Emi / Degaspare, Natalia Viu / Sakita, Neusa Keico / Udsen, Nicole Lee / Scudeller, Paula Gobi / Gaiolla, Paula Vieira de Vincenzi / Severini, Rafael da Silva Giannasi / Rodrigues, Regina Maria / Toma, Ricardo Katsuya / Paula, Ricardo Iunis Citrangulo de / Palmeira, Patricia / Forsait, Silvana / Farhat, Sylvia Costa Lima / Sakano, Tânia Miyuki Shimoda / Koch, Vera Hermina Kalika / Cobello Junior, Vilson

    Clinics (Sao Paulo, Brazil)

    2021  Volume 76, Page(s) e3488

    Abstract: Objectives: To compare demographic/clinical/laboratory/treatments and outcomes among children and adolescents with laboratory-confirmed coronavirus disease 2019 (COVID-19).: Methods: This was a cross-sectional study that included patients diagnosed ... ...

    Abstract Objectives: To compare demographic/clinical/laboratory/treatments and outcomes among children and adolescents with laboratory-confirmed coronavirus disease 2019 (COVID-19).
    Methods: This was a cross-sectional study that included patients diagnosed with pediatric COVID-19 (aged <18 years) between April 11, 2020 and April 22, 2021. During this period, 102/5,951 (1.7%) of all admissions occurred in neonates, children, and adolescents. Furthermore, 3,962 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection samples were processed in patients aged <18 years, and laboratory-confirmed COVID-19 occurred in 155 (4%) inpatients and outpatients. Six/155 pediatric patients were excluded from the study. Therefore, the final group included 149 children and adolescents (n=97 inpatients and 52 outpatients) with positive SARS-CoV-2 results.
    Results: The frequencies of sore throat, anosmia, dysgeusia, headache, myalgia, nausea, lymphopenia, pre-existing chronic conditions, immunosuppressive conditions, and autoimmune diseases were significantly reduced in children and adolescents (p<0.05). Likewise, the frequencies of enoxaparin use (p=0.037), current immunosuppressant use (p=0.008), vasoactive agents (p=0.045), arterial hypotension (p<0.001), and shock (p=0.024) were significantly lower in children than in adolescents. Logistic regression analysis showed that adolescents with laboratory-confirmed COVID-19 had increased odds ratios (ORs) for sore throat (OR 13.054; 95% confidence interval [CI] 2.750-61.977; p=0.001), nausea (OR 8.875; 95% CI 1.660-47.446; p=0.011), and lymphopenia (OR 3.575; 95% CI 1.355-9.430; p=0.010), but also had less hospitalizations (OR 0.355; 95% CI 0.138-0.916; p=0.032). The additional logistic regression analysis on patients with preexisting chronic conditions (n=108) showed that death as an outcome was significantly associated with pediatric severe acute respiratory syndrome (SARS) (OR 22.300; 95% CI 2.341-212.421; p=0.007) and multisystem inflammatory syndrome in children (MIS-C) (OR 11.261; 95% CI 1.189-106. 581; p=0.035).
    Conclusions: Half of the laboratory-confirmed COVID-19 cases occurred in adolescents. Individuals belonging to this age group had an acute systemic involvement of SARS-CoV-2 infection. Pediatric SARS and MIS-C were the most important factors associated with the mortality rate in pediatric chronic conditions with COVID-19.
    MeSH term(s) Adolescent ; COVID-19/complications ; Child ; Cohort Studies ; Cross-Sectional Studies ; Humans ; Infant, Newborn ; SARS-CoV-2 ; Systemic Inflammatory Response Syndrome ; Tertiary Care Centers
    Language English
    Publishing date 2021-11-26
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2182801-5
    ISSN 1980-5322 ; 1807-5932
    ISSN (online) 1980-5322
    ISSN 1807-5932
    DOI 10.6061/clinics/2021/e3488
    Database MEDical Literature Analysis and Retrieval System OnLINE

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