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  1. Article: Critical Care Course of Pediatric Inflammatory Multisystem Syndrome Temporally Associated with SARS-CoV-2 and Response to Immunomodulation.

    Richens, Nicholas / Kanthimathinathan, Hari Krishnan / Sontakke, Sanket / Chikermane, Ashish / Jyothish, Deepthi / Hackett, Scott / Welch, Steven B / Al-Abadi, Eslam / Duncan, Heather P / Richter, Alex G / Scholefield, Barnaby R

    Journal of pediatric intensive care

    2020  Volume 11, Issue 2, Page(s) 124–129

    Abstract: We describe the critical care course of children with a novel hyperinflammatory syndrome associated with coronavirus disease 2019 (COVID-19) pediatric inflammatory multisystem syndrome temporally associated with severe acute respiratory syndrome ... ...

    Abstract We describe the critical care course of children with a novel hyperinflammatory syndrome associated with coronavirus disease 2019 (COVID-19) pediatric inflammatory multisystem syndrome temporally associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), with focus on trajectory before and after immunomodulation. Overall, 10 patients who met the U.K. Royal College of Pediatrics and Child Health case definition during a 2-month study period were analyzed. All tested positive for SARS-CoV-2 IgG antibody. Although only 20% were ventilated, 100% required inotropic or vasopressor support. All children had significantly raised inflammatory markers with a median C-reactive protein of 248 (175-263) mg/L, ferritin of 1,561 (726-2,255) µg/L, and troponin-I of 723 (351-2,235) ng/L. Six patients had moderately impaired myocardial function and two had severe impairment. None needed extracorporeal membrane oxygenation. Despite severe illness only a brief period of critical care support of 3 to 5 days was required. Eight received at least one dose of intravenous immunoglobulin. Six received high-dose steroids. Clinical improvement including cardiovascular stability and reduction in inflammatory markers may have occurred with and without immunomodulation.
    Language English
    Publishing date 2020-12-04
    Publishing country Germany
    Document type Journal Article
    ISSN 2146-4618
    ISSN 2146-4618
    DOI 10.1055/s-0040-1721456
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Changes in paediatric respiratory infections at a UK teaching hospital 2016-2021; impact of the SARS-CoV-2 pandemic.

    Lumley, Sheila F / Richens, Nicholas / Lees, Emily / Cregan, Jack / Kalimeris, Elizabeth / Oakley, Sarah / Morgan, Marcus / Segal, Shelley / Dawson, Moya / Walker, A Sarah / Eyre, David W / Crook, Derrick W / Beer, Sally / Novak, Alex / Stoesser, Nicole E / Matthews, Philippa C

    The Journal of infection

    2021  Volume 84, Issue 1, Page(s) 40–47

    Abstract: Objective To describe the impact of the SARS-CoV-2 pandemic on the incidence of paediatric viral respiratory tract infection in Oxfordshire, UK. Methods Data on paediatric Emergency Department (ED) attendances (0-15 years inclusive), respiratory virus ... ...

    Abstract Objective To describe the impact of the SARS-CoV-2 pandemic on the incidence of paediatric viral respiratory tract infection in Oxfordshire, UK. Methods Data on paediatric Emergency Department (ED) attendances (0-15 years inclusive), respiratory virus testing, vital signs and mortality at Oxford University Hospitals were summarised using descriptive statistics. Results Between 1-March-2016 and 30-July-2021, 155,056 ED attendances occurred and 7,195 respiratory virus PCRs were performed. Detection of all pathogens was suppressed during the first national lockdown. Rhinovirus and adenovirus rates increased when schools reopened September-December 2020, then fell, before rising in March-May 2021. The usual winter RSV peak did not occur in 2020/21, with an inter-seasonal rise (32/1,000 attendances in 0-3 yr olds) in July 2021. Influenza remained suppressed throughout. A higher paediatric early warning score (PEWS) was seen for attendees with adenovirus during the pandemic compared to pre-pandemic (p = 0.04, Mann-Witney U test), no other differences in PEWS were seen. Conclusions SARS-CoV-2 caused major changes in the incidence of paediatric respiratory viral infection in Oxfordshire, with implications for clinical service demand, testing strategies, timing of palivizumab RSV prophylaxis, and highlighting the need to understand which public health interventions are most effective for preventing respiratory virus infections.
    MeSH term(s) COVID-19 ; Child ; Communicable Disease Control ; Hospitals, Teaching ; Humans ; Pandemics ; Respiratory Syncytial Virus Infections/epidemiology ; Respiratory Tract Infections/epidemiology ; SARS-CoV-2 ; United Kingdom
    Language English
    Publishing date 2021-10-29
    Publishing country England
    Document type Journal Article
    ZDB-ID 424417-5
    ISSN 1532-2742 ; 0163-4453
    ISSN (online) 1532-2742
    ISSN 0163-4453
    DOI 10.1016/j.jinf.2021.10.022
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Critical Care Course of Pediatric Inflammatory Multisystem Syndrome Temporally Associated with SARS-CoV-2 and Response to Immunomodulation

    Richens, Nicholas / Kanthimathinathan, Hari Krishnan / Sontakke, Sanket / Chikermane, Ashish / Jyothish, Deepthi / Hackett, Scott / Welch, Steven B. / Al-Abadi, Eslam / Duncan, Heather P. / Richter, Alex G. / Scholefield, Barnaby R.

    Journal of Pediatric Intensive Care

    2020  Volume 11, Issue 02, Page(s) 124–129

    Abstract: We describe the critical care course of children with a novel hyperinflammatory syndrome associated with coronavirus disease 2019 (COVID-19) pediatric inflammatory multisystem syndrome temporally associated with severe acute respiratory syndrome ... ...

    Abstract We describe the critical care course of children with a novel hyperinflammatory syndrome associated with coronavirus disease 2019 (COVID-19) pediatric inflammatory multisystem syndrome temporally associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), with focus on trajectory before and after immunomodulation. Overall, 10 patients who met the U.K. Royal College of Pediatrics and Child Health case definition during a 2-month study period were analyzed. All tested positive for SARS-CoV-2 IgG antibody. Although only 20% were ventilated, 100% required inotropic or vasopressor support. All children had significantly raised inflammatory markers with a median C-reactive protein of 248 (175–263) mg/L, ferritin of 1,561 (726–2,255) µg/L, and troponin-I of 723 (351–2,235) ng/L. Six patients had moderately impaired myocardial function and two had severe impairment. None needed extracorporeal membrane oxygenation. Despite severe illness only a brief period of critical care support of 3 to 5 days was required. Eight received at least one dose of intravenous immunoglobulin. Six received high-dose steroids. Clinical improvement including cardiovascular stability and reduction in inflammatory markers may have occurred with and without immunomodulation.
    Keywords coronavirus disease 2019 ; Kawasaki disease ; inflammation ; toxic shock syndrome ; SARS-CoV-2
    Language English
    Publishing date 2020-12-04
    Publisher Georg Thieme Verlag KG
    Publishing place Stuttgart ; New York
    Document type Article
    ISSN 2146-4626 ; 2146-4618
    ISSN (online) 2146-4626
    ISSN 2146-4618
    DOI 10.1055/s-0040-1721456
    Database Thieme publisher's database

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  4. Article ; Online: Changes in paediatric respiratory infections at a UK teaching hospital 2016-2021; impact of the SARS-CoV-2 pandemic

    Lumley, Sheila F. / Richens, Nicholas / Lees, Emily / Cregan, Jack / Kalimeris, Elizabeth / Oakley, Sarah / Morgan, Marcus / Segal, Shelley / Dawson, Moya / Walker, A. Sarah / Eyre, David W. / Crook, Derrick W. / Beer, Sally / Novak, Alex / Stoesser, Nicole E. / Matthews, Philippa C.

    medRxiv

    Abstract: Objective To describe the impact of the SARS-CoV-2 pandemic on the incidence of paediatric viral respiratory tract infection in Oxfordshire, UK. Methods Data on paediatric Emergency Department (ED) attendances (0-15 years inclusive), respiratory virus ... ...

    Abstract Objective To describe the impact of the SARS-CoV-2 pandemic on the incidence of paediatric viral respiratory tract infection in Oxfordshire, UK. Methods Data on paediatric Emergency Department (ED) attendances (0-15 years inclusive), respiratory virus testing, vital signs and mortality at Oxford University Hospitals were summarised using descriptive statistics. Results Between 1-March-2016 and 30-July-2021, 155,056 ED attendances occurred and 7,195 respiratory virus PCRs were performed. Detection of all pathogens was suppressed during the first national lockdown. Rhinovirus and adenovirus rates increased when schools reopened September-December 2020, then fell, before rising in March-May 2021. The usual winter RSV peak did not occur in 2020/21, with an inter-seasonal rise (32/1,000 attendances in 0-3yr olds) in July 2021. Influenza remained suppressed throughout. A higher Paediatric Early Warning Score (PEWS) was seen for attendees with adenovirus during the pandemic compared to pre-pandemic (p=0.04, Mann-Witney U test), no other differences in PEWS were seen. Conclusions SARS-CoV-2 caused major changes in the incidence of paediatric respiratory viral infection in Oxfordshire, with implications for clinical service demand, testing strategies, timing of palivizumab RSV prophylaxis, and highlighting the need to understand which public health interventions are most effective for preventing respiratory virus infections.
    Keywords covid19
    Language English
    Publishing date 2021-10-16
    Publisher Cold Spring Harbor Laboratory Press
    Document type Article ; Online
    DOI 10.1101/2021.10.13.21264956
    Database COVID19

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