Some clusters of children with a multisystem inflammatory syndrome associated with SARS-CoV-2 infection (MIS-C) have been reported. We describe the epidemiological and clinical features of children ...with MIS-C in Spain. MIS-C is a potentially severe condition that presents in children with recent SARS-CoV-2 infection.
•COVID-19 clinical manifestations and radiological findings are milder and less specific in children.•The presence of fever, and fever duration are clinical findings associated with pathological ...chest imaging.•The most common pattern seen in pathological chest X ray were bilateral diffuse interstitial pattern followed by perihilar bronchial wall thickening.•Consensual specific age-adjusted protocols regarding chest imaging indications in pediatric COVID-19, as the one developed, are needed.•Imaging should not be used as a screening tool or a routine complementary test in pediatric hospitalized patients with COVID-19.
Many articles have been published regarding chest-imaging in COVID-19, but fewer studies have been published in pediatric populations. COVID-19 symptoms in children are generally milder and radiological tests have fewer positive findings. Indications for chest imaging in pediatric COVID-19 patients remain unclear. This study aims to describe the chest radiographs performed in COVID-19 patients in a pediatric hospital, to review the current chest X-ray indications and to develop an specific age-adjusted protocol for chest-imaging in children with COVID-19.
Retrospective study in hospitalized pediatric COVID-19 patients in Navarre, Spain. Between March and December 2020, 44 children were included (mean age 3.8-year-old, 50 % males). Demographic information, cause of admission, symptoms, and clinical evolution were described. Chest imaging technique performed, indications and findings were analyzed. A literature review was performed searching for current COVID-19 pediatric chest-imaging indications.
Chest X-rays were performed in 35 patients (80 % of admissions) and most common indications were fever and respiratory symptoms. 53 % of the chest X-rays were considered “normal” and the classical bilateral diffuse interstitial pattern, described in adults, was only present in 22 %. All patients with pathological chest X-rays were symptomatic and reported fever (100 %) and fever tended to be longer (fever duration: 4.25 vs. 2.46 days p:0.048) in patients with pathological radiographs. We present a specific protocol for chest-imaging in pediatric COVID-19 cases.
COVID-19 clinical manifestations and radiological findings are milder and less specific in children. Imaging should not be used as a screening tool or a routine complementary test in pediatric COVID-19 patients, not even in hospitalized cases.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Introducción: desde el inicio de la epidemia de COVID-19, se han publicado numerosos estudios, pero la información sobre el impacto de la infección por SARS-CoV-2 en población pediátrica es todavía ...limitada. La incidencia y características en población pediátrica siguen siendo inciertas, por lo que se necesitan más estudios para entender el COVID-19 pediátrico. Material y métodos: estudio multicéntrico retrospectivo en el que se describen la incidencia y características clínicas de los niños con COVID-19 confirmada en Navarra (España) durante la primera ola epidémica (28 de febrero-31 de mayo de 2020). Resultados: la incidencia acumulada de COVID-19 pediátrico en Navarra en tres meses fue de tres casos por 1000 niños. De los 309 casos confirmados, el 85,7% tenían contacto domiciliario positivo; el 32,1% fueron asintomáticos; los síntomas fueron variados y solo el 15,8% tenían presentación “típica” de fiebre y síntomas respiratorios; 49% recibió atención telefónica y solo 11,6% requirió estudio complementario. Trece pacientes ingresaron en hospital (4,2%), dos fueron casos moderados (un cuadro respiratorio que requirió oxigenoterapia y un cuadro convulsivo tratado con antiepilépticos) y uno grave con el síndrome inflamatorio multisistémico pediátrico vinculado a SARS-CoV-2 que ingresó en la unidad de cuidados intensivos (UCIP). Evolución favorable en todos los casos sin secuelas. Un 45,2% no necesitó tratamiento, el resto tratados con analgésicos, inhaladores o antibióticos en caso de sobreinfección; 2,3% recibió hidroxicloroquina. Conclusiones: los reportes epidemiológicos son importantes para mejorar el conocimiento sobre COVID-19 en niños, ayudando a los pediatras a reconocer y tratar mejor la enfermedad.
Obesity is associated with vitamin D deficiency. The aim of this work is to analyze the changes in vitamin D status and PTH levels in a group of children with obesity receiving combined intervention ...program in order to get BMI status reduction.
Longitudinal study in 119 children with obesity, aged 9.1-13.9 years, included in a 1-year combined dietary-behavioral-physical activity intervention. Anthropometric measurements (weight, height, BMI and fat mass index) were registered every 3 months and blood testing (calcium, phosphorous, 25(OH)D and PTH) were collected at the beginning and after 12 months of follow-up. A control group was recruited (300 healthy children, aged 8.1-13.9 years). The criteria of the US Endocrine Society were used for the definition of hypovitaminosis D.
Vitamin D deficiency was significantly higher in obesity group (31.1 vs. 14%). There was negative correlation between 25(OH)D and fat mass index (r = -0.361, p = 0.001). Patients with BMI reduction throughout combined intervention were 52 (43.7%). There was a significant increase in the prevalence of hypovitaminosis D in patients without BMI reduction at the end of follow-up, but in those patients with BMI reduction there was no changes of vitamin D status.
Obesity increases the prevalence of suboptimal vitamin D status, and a BMI status reduction in children with obesity may be required to at least stabilize vitamin D status.
Abstract
The SARS-CoV-2 pandemic has caused an increase in antibiotic use in different settings. We describe the antibiotic prescribing prevalence, associated factors and trends, as well as ...concomitant bacterial infections in children hospitalized with COVID-19 or multisystemic inflammatory syndrome related to SARS-CoV-2 in Spain.
Background: Insulin deficiency inhibits protein synthesis and stimulates protein degradation, and
therefore amino acid metabolism could be altered in diabetes mellitus.
Objective: To analyze amino ...acid plasma profile in a group of children with type 1 diabetes, and to
evaluate its potential application as a marker of metabolic control for the disease.
Methods: A clinical assessment and metabolic study (amino acid plasma concentrations) was performed
in a group of 49 children diagnosed with type 1 diabetes, aged 8.6 to 14.3 years, and a group of 48 healthy
children (control group), aged 7.4 to 14.8 years.
Results: Plasma concentrations of ARG, GLN, ILE, PHE, THR, TYR, VAL and TAU were significantly
higher (p<0.05) within the diabetic group with respect to the control group. Likewise, plasma
concentrations of branched-chain (347.65±58.76 vs. 285.20±45.20 nmol/ml), glucogenic
(1252.74±236.82 vs. 1053.69±211.19 nmol/ml) and ketogenic amino acids (441.62±57.09 vs.
354.13±53.45 nmol/ml) were significantly higher (p< 0.05) in the diabetic group with respect to the
control group. There was no correlation between the single amino acid (or amino acid groups) plasma
levels and the evolution of the disease (years) or HbA1c levels.
Conclusion: The study of changes in amino acid plasma profile in the young diabetic, probably as a
consequence of insulinopenia, could have interest as a marker of metabolic control for the disease
Alterations in cognitive performance have been described in patients with major depressive disorder (MDD). However, the specific risk factors of these changes are not yet known. This study aimed to ...explore whether inmunometabolic parameters are related to cognitive performance in MDD in comparison to healthy controls (HC)
Sample consisted of 84 MDD patients and 78 HC. Both groups were compared on the results of cognitive performance measured with the Cambridge Neuropsychological Test Automated Battery (CANTAB), the presence of metabolic syndrome (MetS) and an inflammatory/oxidative index calculated by a principal component analysis of peripheral biomarkers (tumor necrosis factor, C-reactive protein and 4-hydroxynonenal). A multiple linear regression was carried out, to study the relationship between inmunometabolic variables and the global cognitive performance, being the latter the dependent variable.
Significant differences were obtained in the inflammatory/oxidative index between both groups (F(1157)= 12.93; p < .001), also in cognitive performance (F(1157)= 56.75; p < .001). The inmunometabolic covariate regression model (i.e., condition (HC/MDD), sex, age and medication loading, MetS, inflammatory/oxidative index and the interaction between MetS and inflammatory/oxidative index) was statistically significant (F(7157)= 11.24; p < .01) and explained 31% of variance. The condition, being either MDD or HD, (B=˗0.97; p < .001), age (B=˗0.28; p < .001) and the interaction between inflammatory/oxidative index and MetS (B=˗0.38; p = .02) were factors associated to cognitive performance.
Sample size was relatively small. The cross-sectional design of the study limits the possibilities of analysis.
Our results provide evidence on the conjoint influence of metabolic and inflammatory dysregulation on cognitive dysfunction in MDD patients. In this way, our study opens a line of research in immunometabolic agents to deal with cognitive decline associated with MDD.
•MDD patients show dysregulation in an inflammatory index obtained from peripheral biomarkers.•Suffering from MDD, being older and having MetS with high inflammatory index are related to poorer cognitive performance.•Cognitive impairment in MDD is increased in patients in which metabolic and inflammatory dysregulation coexist.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
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