1) Pneumonia was significantly associated with confirmed COVID-19 cases. Patients with confirmed COVID-19 presented with longer fever duration (over 7 days), lower oxygen saturation, and higher rates of lung rhonchi on examination.
2) Chest X-rays of confirmed COVID-19 patients showed higher rates of opacity and consolidation, particularly in school-aged children.
3) Laboratory findings in confirmed COVID-19 cases included significantly lower white blood cell counts and higher C-reactive protein levels compared to suspected cases.
1) Pneumonia was significantly associated with confirmed COVID-19 cases. Patients with confirmed COVID-19 presented with longer lasting fever, lower oxygen saturation, and signs of lung rhonchi on physical exam.
2) Chest x-rays of confirmed COVID-19 patients showed lung opacity and consolidation. Blood tests found lower white blood cell counts and higher C-reactive protein levels in confirmed COVID-19 patients compared to suspected cases.
3) Characteristics that differentiated confirmed COVID-19 pneumonia from suspected cases included prolonged fever lasting over 7 days, lower oxygen saturation levels, presence of lung rhonchi on exam, chest x-ray findings of lung opacity, as well as lower white blood cell counts and higher
Covid 19 in children consensus statementgisa_legal
This document presents an experts' consensus statement on the diagnosis, treatment, and prevention of 2019 novel coronavirus (2019-nCoV) infection in children. It summarizes the current strategies based on previous diagnosis and treatment of pediatric virus infections. The key points are: 1) 2019-nCoV infections in children can range from asymptomatic to mild or severe pneumonia, with most cases being mild; 2) Diagnosis is based on epidemiological history, clinical manifestations, and laboratory tests detecting 2019-nCoV nucleic acid; 3) Treatment involves supportive care, symptom relief, oxygen therapy, and antiviral drugs like interferon-α; 4) Prevention focuses on isolation of suspected cases and treatment of confirmed cases.
Characteristics of COVID-19 and Tuberculosis Co-Infection: A Cross-Sectional ...semualkaira
Coronavirus disease 2019 (COVID-19) and Tuberculosis (TB) are two major infectious diseases posing significant
public health threats. This study aimed to investigate the clinical
features of COVID-19 and TB co-infected patients.
CLINICAL FEATURES, DIFFERENCES IN COVID FIRST, SECOND, THIRD WAVES- A DATA BA...DrHeena tiwari
This study compared the clinical features of COVID-19 in children and youth across the first three waves in multiple countries. A total of 397 patients aged 18 or younger were included. More patients were asymptomatic in the second and third waves compared to the first wave. Most illnesses were mild in all waves. A few patients presented with unusual manifestations like chilblains or multisystem inflammatory syndrome. The study found differences in symptoms and hospital length of stay across the three waves.
Clinical spectrum of COVID- 9 and risk factors associated with severity in Sp...Javier González de Dios
Solo de la suma de un gran número de pacientes recogidos en un estudio multicéntrico como EPICO-AEP es posible disponer de un tamaño muestral que nos devuelve resultados válidos desde el punto de vista de la investigación y relevantes en relación a su importancia clínica.
Y en este estudio sobre los factores de riesgo de gravedad de la COVID-19 en la edad pediátrica cabe concluir: Hospitalised children with COVID-19 usually present as one of fve major clinical phenotypes of decreasing severity. Risk factors for PICU include MIS-C, elevation of infammation biomarkers, asthma, moderate or severe live disease and cardiac disease.
What is Known:
• All studies suggest that children are less susceptible to serious SARS-CoV-2 infection when compared to adults. Most studies describe symptoms at presentation. However, it remains unclear how these symptoms group together into clinically identifable syndromes and the severity
associated with them.
What is New:
• We have gathered the primary diagnoses into fve major syndromes of decreasing severity: MIS-C, bronchopulmonary syndrome, gastrointestinal syndrome, fever without a source and mild syndrome. Classifcation of the children in one of the syndromes is unique and helps to
assess the risk of critical illness and to defne the spectrum of the disease instead of just describing symptoms and signs.
This study analyzed clinical data from 101 COVID-19 patients hospitalized in Wuhan, China between February and April 2020. The patients were classified as having moderate (n=47), severe (n=36), or critical (n=18) illness. Older age, pre-existing conditions like diabetes and hypertension, and higher blood levels of inflammatory markers were associated with more severe illness. Multivariate analysis identified older age, diabetes, chronic liver disease, and elevated neutrophil, C-reactive protein, D-dimer, and interleukin levels as independent risk factors for severe COVID-19.
1) Pneumonia was significantly associated with confirmed COVID-19 cases. Patients with confirmed COVID-19 presented with longer lasting fever, lower oxygen saturation, and signs of lung rhonchi on physical exam.
2) Chest x-rays of confirmed COVID-19 patients showed lung opacity and consolidation. Blood tests found lower white blood cell counts and higher C-reactive protein levels in confirmed COVID-19 patients compared to suspected cases.
3) Characteristics that differentiated confirmed COVID-19 pneumonia from suspected cases included prolonged fever lasting over 7 days, lower oxygen saturation levels, presence of lung rhonchi on exam, chest x-ray findings of lung opacity, as well as lower white blood cell counts and higher
Covid 19 in children consensus statementgisa_legal
This document presents an experts' consensus statement on the diagnosis, treatment, and prevention of 2019 novel coronavirus (2019-nCoV) infection in children. It summarizes the current strategies based on previous diagnosis and treatment of pediatric virus infections. The key points are: 1) 2019-nCoV infections in children can range from asymptomatic to mild or severe pneumonia, with most cases being mild; 2) Diagnosis is based on epidemiological history, clinical manifestations, and laboratory tests detecting 2019-nCoV nucleic acid; 3) Treatment involves supportive care, symptom relief, oxygen therapy, and antiviral drugs like interferon-α; 4) Prevention focuses on isolation of suspected cases and treatment of confirmed cases.
Characteristics of COVID-19 and Tuberculosis Co-Infection: A Cross-Sectional ...semualkaira
Coronavirus disease 2019 (COVID-19) and Tuberculosis (TB) are two major infectious diseases posing significant
public health threats. This study aimed to investigate the clinical
features of COVID-19 and TB co-infected patients.
CLINICAL FEATURES, DIFFERENCES IN COVID FIRST, SECOND, THIRD WAVES- A DATA BA...DrHeena tiwari
This study compared the clinical features of COVID-19 in children and youth across the first three waves in multiple countries. A total of 397 patients aged 18 or younger were included. More patients were asymptomatic in the second and third waves compared to the first wave. Most illnesses were mild in all waves. A few patients presented with unusual manifestations like chilblains or multisystem inflammatory syndrome. The study found differences in symptoms and hospital length of stay across the three waves.
Clinical spectrum of COVID- 9 and risk factors associated with severity in Sp...Javier González de Dios
Solo de la suma de un gran número de pacientes recogidos en un estudio multicéntrico como EPICO-AEP es posible disponer de un tamaño muestral que nos devuelve resultados válidos desde el punto de vista de la investigación y relevantes en relación a su importancia clínica.
Y en este estudio sobre los factores de riesgo de gravedad de la COVID-19 en la edad pediátrica cabe concluir: Hospitalised children with COVID-19 usually present as one of fve major clinical phenotypes of decreasing severity. Risk factors for PICU include MIS-C, elevation of infammation biomarkers, asthma, moderate or severe live disease and cardiac disease.
What is Known:
• All studies suggest that children are less susceptible to serious SARS-CoV-2 infection when compared to adults. Most studies describe symptoms at presentation. However, it remains unclear how these symptoms group together into clinically identifable syndromes and the severity
associated with them.
What is New:
• We have gathered the primary diagnoses into fve major syndromes of decreasing severity: MIS-C, bronchopulmonary syndrome, gastrointestinal syndrome, fever without a source and mild syndrome. Classifcation of the children in one of the syndromes is unique and helps to
assess the risk of critical illness and to defne the spectrum of the disease instead of just describing symptoms and signs.
This study analyzed clinical data from 101 COVID-19 patients hospitalized in Wuhan, China between February and April 2020. The patients were classified as having moderate (n=47), severe (n=36), or critical (n=18) illness. Older age, pre-existing conditions like diabetes and hypertension, and higher blood levels of inflammatory markers were associated with more severe illness. Multivariate analysis identified older age, diabetes, chronic liver disease, and elevated neutrophil, C-reactive protein, D-dimer, and interleukin levels as independent risk factors for severe COVID-19.
- 84 of the 201 patients with COVID-19 pneumonia (41.8%) developed acute respiratory distress syndrome (ARDS), and of those 84 patients, 44 (52.4%) died.
- Risk factors for developing ARDS included older age, pre-existing comorbidities like hypertension and diabetes, and signs of disease severity like dyspnea.
- Risk factors for progression from ARDS to death included older age, signs of immune system overactivation and organ dysfunction like neutrophilia and elevated lactate dehydrogenase and D-dimer levels.
- Treatment with the corticosteroid methylprednisolone was associated with decreased risk of death among patients with ARDS.
This study evaluated 171 children with confirmed SARS-CoV-2 infection treated at Wuhan Children's Hospital in China. The median age was 6.7 years and most cases were mild, with 15.8% being asymptomatic. Common symptoms in symptomatic children included fever (41.5%), cough (48.5%), and pharyngeal erythema (46.2%). Radiologic findings most often showed bilateral ground-glass opacity (32.7%). The majority had known family contact with the virus and most cases were treated as outpatients, with only 3 requiring intensive care support. This suggests that while children can be infected, they generally present with milder symptoms than adults.
To Assess the Severity and Mortality among Covid 19 Patients after Having Vac...YogeshIJTSRD
The severity and mortality of COVID 19 cases has been associated with the Three category such as vaccination status, severity of disease and outcome. Objective presently study was aimed to assess the severity and mortality among covid 19 patients. Methods Using simple lottery random method 100 samples were selected. From these 100 patients, 50 patients were randomly assigned to case group and 50 patients in control group after informed consents of relative obtained. Patients in the case group who being died after got COVID 19 whereas 50 patients in the control group participated who were survive after got infected from COVID 19 patients. Result It has three categories such as a Vaccination status For the vaccination status we have seen 59 patients were not vaccinated and 41 patients was vaccinated out of 100. b Incidence There were 41 patients were vaccinated whereas 59 patients were not vaccinated. c Severity In the case of mortality we selected 50 patients who were died from the Corona and I got to know that out of 50 patients there were 12 24 patients were vaccinated whereas 38 76 patients were non vaccinated. Although for the 50 control survival group total 29 58 patients were vaccinated and 21 42 patients was not vaccinated all graph start. Conclusion we have find out that those people who got vaccinated were less infected and mortality rate very low. Prof. (Dr) Binod Kumar Singh | Dr. Saroj Kumar | Ms. Anuradha Sharma "To Assess the Severity and Mortality among Covid-19 Patients after Having Vaccinated: A Retrospective Study" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45065.pdf Paper URL: https://www.ijtsrd.com/other-scientific-research-area/other/45065/to-assess-the-severity-and-mortality-among-covid19-patients-after-having-vaccinated-a-retrospective-study/prof-dr-binod-kumar-singh
1. This document provides recommendations for the diagnosis and treatment of respiratory infections caused by the 2019 novel coronavirus (2019-nCoV) in children based on the latest national guidelines and current clinical practices in Zhejiang Province, China.
2. It summarizes the key details of 2019-nCoV including its etiology, epidemiology, clinical characteristics, diagnostic criteria, clinical classifications, differential diagnosis and imaging features to aid in the diagnosis and management of pediatric cases.
3. The recommendations aim to standardize the protocols for diagnosing and treating respiratory infections in children caused by 2019-nCoV, with the overall goal of identifying and managing cases early while differentiating them from other viral or bacterial infections.
Thank you for the detailed summary and critical appraisal of the document. This will help provide important context and evaluation of the information presented.
RSV Versus Non-RSV Bronchiolitis at Haykal Hospital between January 2016 and ...asclepiuspdfs
Introduction: Bronchiolitis is a clinical syndrome that occurs in children <2 years, characterized by upper respiratory symptoms followed by lower respiratory tract infection that results in wheezing and/or crackles and other complications. Its typically caused by a viral infection, among which, respiratory syncytial virus (RSV) is the most common cause. Objective: The aim of this study is to determine whether RSV is the most common cause of acute bronchiolitis in North Lebanon and to determine the most common age, season for RSV bronchiolitis, whether it is more prevalent in preterm patients and whether it is a more serious infection. Our study is the first one conducted in North Lebanon that provides information related to RSV versus non-RSV bronchiolitis.
This document provides information on COVID-19. It describes COVID-19 as an infectious disease caused by SARS-CoV-2. The first cases were seen in Wuhan, China in December 2019. Most people experience mild to moderate symptoms, but older people and those with pre-existing medical conditions are more likely to develop serious illness. Diagnosis is made through PCR testing of respiratory samples. Common CT findings include ground glass opacities and consolidation.
This document summarizes a study of 11 preterm infants with severe human rhinovirus (HRV) infections. Key findings include:
1) Nine of the 11 infants were preterm (median gestational age of 30 weeks) and 7 of the 9 preterm infants acquired HRV during their stay in the neonatal intensive care unit (NICU).
2) All infants presented with respiratory distress and required respiratory support like mechanical ventilation for a median of 6 days. Chest x-rays showed findings like perihilar streakiness and atelectasis.
3) HRV infection was diagnosed using real-time polymerase chain reaction testing of nasopharyngeal aspirates which showed high viral loads. All infants
Clinical characteristics of children with COVID-19 pneumoniaAI Publications
For this purpose, 75 children under the age of 18 were included in the study. The test for SARS-CoV-2 virus RNA was positive in the pathological material from the nasopharynx in all examined patients. The control group consisted of 15 healthy children. The patients included in the study were divided into 2 groups according to severity of disease: 49 (65.3%) patients with moderate COVID-19 were included in group I, 26 (34.7%) patients with severe COVID-19 - in group 2. Examination methods included anamnestic, clinical, instrumental and laboratory studies. The most common symptoms among children examined were fever (66 (88.0%)) and cough (74 (98.7%)). Rarely, muscle pains, loss of sense of smell and taste, headaches have been observed in older children. Intergroup comparison revealed higher levels of ferritin, D-dimer and fibrinogen in group II compared with group I. According to the results obtained, the course of the disease in children, in contrast to adults, is more favorable.
This document discusses a study investigating hospital-acquired pneumonia (HAP) and the association between HAP and chronic comorbidities. The study included 213 HAP patients and found the most common pathogens were Streptococcus spp. for early-onset pneumonia and Acinetobacter spp. for late-onset pneumonia. Antibiotics like quinolones, cephalosporins and carbapenems were most commonly used but showed high resistance rates. Higher Chronic Disease Scores, older age, cancer, and mechanical ventilation were associated with worse treatment outcomes.
paper 2 seroprevalencia en individuos sin sintomas.pdfssuser5aa5ba
This study aimed to estimate the seroprevalence of COVID-19 among individuals in Daegu, South Korea who had never been diagnosed with COVID-19. The study tested 198 patients and guardians for COVID-19 antibodies. It found an estimated seroprevalence of 7.6%, with 15 positive cases. Most positive cases did not experience COVID-19 symptoms. Based on this rate, the estimated number of undiagnosed COVID-19 cases in Daegu was about 12 times the number of confirmed cases. Seroprevalence was higher among smokers and diabetics. This suggests the number of undiagnosed cases was substantial even with South Korea's aggressive testing and contact tracing strategy.
Clinical features of patients infected with 2019 novel copyMadhumitaSingh23
- The document reports on 41 early patients in Wuhan, China who were infected with the 2019 novel coronavirus. It found that most patients were men under the age of 65, with common symptoms being fever, cough, and fatigue. All patients had pneumonia seen on chest CT scans. About 15% of patients died, with ICU patients having more severe illness and higher mortality. The study helps characterize the clinical features and severity of the new coronavirus.
90222 texto del artículo-506762-4-10-20210316Santiago Vasco
This document presents a living systematic review of clinical, radiological, and laboratory characteristics of pediatric patients with COVID-19. Thirteen studies including a total of 9,152 patients were analyzed. Bayesian meta-analysis found that males were more affected with an odds ratio of 1.24. Frequentist meta-analysis estimated cough in 52% of patients, no reported deaths, elevated aspartate aminotransferase levels in 16%, and lung changes on imaging in 60%. While an accurate clinical profile cannot yet be determined, evidence suggests males are more affected and lung abnormalities are more common than symptoms like cough and fever. Laboratory results were inconclusive and multiple organ systems can be impacted.
IPD and pneumonia are important causes of disease in children in Bangalore, India. A study found the highest incidence of IPD was 46.01 per 100,000 in children 6-12 months. Pneumonia was the most common presentation of IPD. The incidence of clinical and radiological pneumonia was highest in children under 6 months at 4,800.88 and 1,771.32 per 100,000 respectively. Salmonella was the most common pathogen isolated. S. pneumoniae serotype distribution and antibiotic resistance was also examined.
The document discusses the risks of COVID-19 infection in pregnant women based on a study of nine cases in China. It finds that the clinical characteristics and outcomes for pregnant women with COVID-19 were less severe than those seen in pregnant women with SARS. However, more research is still needed given the small number of cases. It recommends pregnant women and newborns be considered at-risk populations and that prevention and management strategies be strengthened.
A systematic review on COVID-1: urological manifestations...Valentina Corona
1) Acute kidney injury leading to mortality is common amongst COVID-19 patients, occurring in 7.58% of patients with a mortality rate of 93.27% amongst those developing acute kidney injury. This is likely due to direct viral toxicity as the virus interacts with receptors in the kidneys.
2) While urinary symptoms are not a presenting symptom of COVID-19, 5.74% of COVID-19 patients had positive viral RNA detected in urine samples.
3) Viral RNA was also detected in stool samples of 65.82% of COVID-19 patients, detected from 2 to 47 days from symptom onset. This suggests precautions are needed when performing transurethral or transrectal
- The document summarizes a study on COVID-19 patients hospitalized in Malaysia from February 1-21, 2022 when the Omicron variant was predominant.
- The study found that 2,279 patients were included with a mean age of 41.8, most were female (58.6%) and had no underlying medical conditions (67.4%).
- The risk of disease progression was significantly lower in patients under 50, female, with no comorbidities, and those who had received two doses of vaccination with or without a booster.
COVID-19 (coronavirus disease 2019) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), previously known as 2019 novel coronavirus (2019-nCoV), a strain of coronavirus. The first cases were seen in Wuhan, China in December 2019 before spreading globally. The current outbreak was recognized as a pandemic on 11 March 2020.
The non-specific imaging findings are most commonly of atypical or organizing pneumonia, often with a bilateral, peripheral, and basal predominant distribution. No effective treatment or vaccine exists currently (March 2020).
1) Men with COVID-19 are more at risk for worse outcomes and death compared to women, independent of age. In a case series and public data set of COVID-19 patients, men represented a higher percentage of severe and critical cases as well as deaths.
2) Older age and pre-existing medical conditions were associated with higher severity and mortality for both COVID-19 and SARS patients. However, even after accounting for age and health status, men still had poorer outcomes for both diseases.
3) While men and women were equally likely to be infected with COVID-19 or SARS, male patients experienced higher mortality rates for both viruses.
Covid19 peds case summaries pediatrics peds.2020 0702gisa_legal
This study examined the epidemiological characteristics of 2143 pediatric patients with COVID-19 in China. The key findings were:
1) Children of all ages were susceptible to COVID-19, with no significant gender difference found.
2) Most pediatric cases (over 90%) were asymptomatic, mild, or moderate in severity.
3) The median time from illness onset to diagnosis was 2 days.
4) There was a rapid initial increase then gradual decrease in cases over time, and most cases were concentrated in Hubei Province and surrounding areas, indicating human-to-human transmission.
Monitoring Health for the SDGs - Global Health Statistics 2024 - WHOChristina Parmionova
The 2024 World Health Statistics edition reviews more than 50 health-related indicators from the Sustainable Development Goals and WHO’s Thirteenth General Programme of Work. It also highlights the findings from the Global health estimates 2021, notably the impact of the COVID-19 pandemic on life expectancy and healthy life expectancy.
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- 84 of the 201 patients with COVID-19 pneumonia (41.8%) developed acute respiratory distress syndrome (ARDS), and of those 84 patients, 44 (52.4%) died.
- Risk factors for developing ARDS included older age, pre-existing comorbidities like hypertension and diabetes, and signs of disease severity like dyspnea.
- Risk factors for progression from ARDS to death included older age, signs of immune system overactivation and organ dysfunction like neutrophilia and elevated lactate dehydrogenase and D-dimer levels.
- Treatment with the corticosteroid methylprednisolone was associated with decreased risk of death among patients with ARDS.
This study evaluated 171 children with confirmed SARS-CoV-2 infection treated at Wuhan Children's Hospital in China. The median age was 6.7 years and most cases were mild, with 15.8% being asymptomatic. Common symptoms in symptomatic children included fever (41.5%), cough (48.5%), and pharyngeal erythema (46.2%). Radiologic findings most often showed bilateral ground-glass opacity (32.7%). The majority had known family contact with the virus and most cases were treated as outpatients, with only 3 requiring intensive care support. This suggests that while children can be infected, they generally present with milder symptoms than adults.
To Assess the Severity and Mortality among Covid 19 Patients after Having Vac...YogeshIJTSRD
The severity and mortality of COVID 19 cases has been associated with the Three category such as vaccination status, severity of disease and outcome. Objective presently study was aimed to assess the severity and mortality among covid 19 patients. Methods Using simple lottery random method 100 samples were selected. From these 100 patients, 50 patients were randomly assigned to case group and 50 patients in control group after informed consents of relative obtained. Patients in the case group who being died after got COVID 19 whereas 50 patients in the control group participated who were survive after got infected from COVID 19 patients. Result It has three categories such as a Vaccination status For the vaccination status we have seen 59 patients were not vaccinated and 41 patients was vaccinated out of 100. b Incidence There were 41 patients were vaccinated whereas 59 patients were not vaccinated. c Severity In the case of mortality we selected 50 patients who were died from the Corona and I got to know that out of 50 patients there were 12 24 patients were vaccinated whereas 38 76 patients were non vaccinated. Although for the 50 control survival group total 29 58 patients were vaccinated and 21 42 patients was not vaccinated all graph start. Conclusion we have find out that those people who got vaccinated were less infected and mortality rate very low. Prof. (Dr) Binod Kumar Singh | Dr. Saroj Kumar | Ms. Anuradha Sharma "To Assess the Severity and Mortality among Covid-19 Patients after Having Vaccinated: A Retrospective Study" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45065.pdf Paper URL: https://www.ijtsrd.com/other-scientific-research-area/other/45065/to-assess-the-severity-and-mortality-among-covid19-patients-after-having-vaccinated-a-retrospective-study/prof-dr-binod-kumar-singh
1. This document provides recommendations for the diagnosis and treatment of respiratory infections caused by the 2019 novel coronavirus (2019-nCoV) in children based on the latest national guidelines and current clinical practices in Zhejiang Province, China.
2. It summarizes the key details of 2019-nCoV including its etiology, epidemiology, clinical characteristics, diagnostic criteria, clinical classifications, differential diagnosis and imaging features to aid in the diagnosis and management of pediatric cases.
3. The recommendations aim to standardize the protocols for diagnosing and treating respiratory infections in children caused by 2019-nCoV, with the overall goal of identifying and managing cases early while differentiating them from other viral or bacterial infections.
Thank you for the detailed summary and critical appraisal of the document. This will help provide important context and evaluation of the information presented.
RSV Versus Non-RSV Bronchiolitis at Haykal Hospital between January 2016 and ...asclepiuspdfs
Introduction: Bronchiolitis is a clinical syndrome that occurs in children <2 years, characterized by upper respiratory symptoms followed by lower respiratory tract infection that results in wheezing and/or crackles and other complications. Its typically caused by a viral infection, among which, respiratory syncytial virus (RSV) is the most common cause. Objective: The aim of this study is to determine whether RSV is the most common cause of acute bronchiolitis in North Lebanon and to determine the most common age, season for RSV bronchiolitis, whether it is more prevalent in preterm patients and whether it is a more serious infection. Our study is the first one conducted in North Lebanon that provides information related to RSV versus non-RSV bronchiolitis.
This document provides information on COVID-19. It describes COVID-19 as an infectious disease caused by SARS-CoV-2. The first cases were seen in Wuhan, China in December 2019. Most people experience mild to moderate symptoms, but older people and those with pre-existing medical conditions are more likely to develop serious illness. Diagnosis is made through PCR testing of respiratory samples. Common CT findings include ground glass opacities and consolidation.
This document summarizes a study of 11 preterm infants with severe human rhinovirus (HRV) infections. Key findings include:
1) Nine of the 11 infants were preterm (median gestational age of 30 weeks) and 7 of the 9 preterm infants acquired HRV during their stay in the neonatal intensive care unit (NICU).
2) All infants presented with respiratory distress and required respiratory support like mechanical ventilation for a median of 6 days. Chest x-rays showed findings like perihilar streakiness and atelectasis.
3) HRV infection was diagnosed using real-time polymerase chain reaction testing of nasopharyngeal aspirates which showed high viral loads. All infants
Clinical characteristics of children with COVID-19 pneumoniaAI Publications
For this purpose, 75 children under the age of 18 were included in the study. The test for SARS-CoV-2 virus RNA was positive in the pathological material from the nasopharynx in all examined patients. The control group consisted of 15 healthy children. The patients included in the study were divided into 2 groups according to severity of disease: 49 (65.3%) patients with moderate COVID-19 were included in group I, 26 (34.7%) patients with severe COVID-19 - in group 2. Examination methods included anamnestic, clinical, instrumental and laboratory studies. The most common symptoms among children examined were fever (66 (88.0%)) and cough (74 (98.7%)). Rarely, muscle pains, loss of sense of smell and taste, headaches have been observed in older children. Intergroup comparison revealed higher levels of ferritin, D-dimer and fibrinogen in group II compared with group I. According to the results obtained, the course of the disease in children, in contrast to adults, is more favorable.
This document discusses a study investigating hospital-acquired pneumonia (HAP) and the association between HAP and chronic comorbidities. The study included 213 HAP patients and found the most common pathogens were Streptococcus spp. for early-onset pneumonia and Acinetobacter spp. for late-onset pneumonia. Antibiotics like quinolones, cephalosporins and carbapenems were most commonly used but showed high resistance rates. Higher Chronic Disease Scores, older age, cancer, and mechanical ventilation were associated with worse treatment outcomes.
paper 2 seroprevalencia en individuos sin sintomas.pdfssuser5aa5ba
This study aimed to estimate the seroprevalence of COVID-19 among individuals in Daegu, South Korea who had never been diagnosed with COVID-19. The study tested 198 patients and guardians for COVID-19 antibodies. It found an estimated seroprevalence of 7.6%, with 15 positive cases. Most positive cases did not experience COVID-19 symptoms. Based on this rate, the estimated number of undiagnosed COVID-19 cases in Daegu was about 12 times the number of confirmed cases. Seroprevalence was higher among smokers and diabetics. This suggests the number of undiagnosed cases was substantial even with South Korea's aggressive testing and contact tracing strategy.
Clinical features of patients infected with 2019 novel copyMadhumitaSingh23
- The document reports on 41 early patients in Wuhan, China who were infected with the 2019 novel coronavirus. It found that most patients were men under the age of 65, with common symptoms being fever, cough, and fatigue. All patients had pneumonia seen on chest CT scans. About 15% of patients died, with ICU patients having more severe illness and higher mortality. The study helps characterize the clinical features and severity of the new coronavirus.
90222 texto del artículo-506762-4-10-20210316Santiago Vasco
This document presents a living systematic review of clinical, radiological, and laboratory characteristics of pediatric patients with COVID-19. Thirteen studies including a total of 9,152 patients were analyzed. Bayesian meta-analysis found that males were more affected with an odds ratio of 1.24. Frequentist meta-analysis estimated cough in 52% of patients, no reported deaths, elevated aspartate aminotransferase levels in 16%, and lung changes on imaging in 60%. While an accurate clinical profile cannot yet be determined, evidence suggests males are more affected and lung abnormalities are more common than symptoms like cough and fever. Laboratory results were inconclusive and multiple organ systems can be impacted.
IPD and pneumonia are important causes of disease in children in Bangalore, India. A study found the highest incidence of IPD was 46.01 per 100,000 in children 6-12 months. Pneumonia was the most common presentation of IPD. The incidence of clinical and radiological pneumonia was highest in children under 6 months at 4,800.88 and 1,771.32 per 100,000 respectively. Salmonella was the most common pathogen isolated. S. pneumoniae serotype distribution and antibiotic resistance was also examined.
The document discusses the risks of COVID-19 infection in pregnant women based on a study of nine cases in China. It finds that the clinical characteristics and outcomes for pregnant women with COVID-19 were less severe than those seen in pregnant women with SARS. However, more research is still needed given the small number of cases. It recommends pregnant women and newborns be considered at-risk populations and that prevention and management strategies be strengthened.
A systematic review on COVID-1: urological manifestations...Valentina Corona
1) Acute kidney injury leading to mortality is common amongst COVID-19 patients, occurring in 7.58% of patients with a mortality rate of 93.27% amongst those developing acute kidney injury. This is likely due to direct viral toxicity as the virus interacts with receptors in the kidneys.
2) While urinary symptoms are not a presenting symptom of COVID-19, 5.74% of COVID-19 patients had positive viral RNA detected in urine samples.
3) Viral RNA was also detected in stool samples of 65.82% of COVID-19 patients, detected from 2 to 47 days from symptom onset. This suggests precautions are needed when performing transurethral or transrectal
- The document summarizes a study on COVID-19 patients hospitalized in Malaysia from February 1-21, 2022 when the Omicron variant was predominant.
- The study found that 2,279 patients were included with a mean age of 41.8, most were female (58.6%) and had no underlying medical conditions (67.4%).
- The risk of disease progression was significantly lower in patients under 50, female, with no comorbidities, and those who had received two doses of vaccination with or without a booster.
COVID-19 (coronavirus disease 2019) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), previously known as 2019 novel coronavirus (2019-nCoV), a strain of coronavirus. The first cases were seen in Wuhan, China in December 2019 before spreading globally. The current outbreak was recognized as a pandemic on 11 March 2020.
The non-specific imaging findings are most commonly of atypical or organizing pneumonia, often with a bilateral, peripheral, and basal predominant distribution. No effective treatment or vaccine exists currently (March 2020).
1) Men with COVID-19 are more at risk for worse outcomes and death compared to women, independent of age. In a case series and public data set of COVID-19 patients, men represented a higher percentage of severe and critical cases as well as deaths.
2) Older age and pre-existing medical conditions were associated with higher severity and mortality for both COVID-19 and SARS patients. However, even after accounting for age and health status, men still had poorer outcomes for both diseases.
3) While men and women were equally likely to be infected with COVID-19 or SARS, male patients experienced higher mortality rates for both viruses.
Covid19 peds case summaries pediatrics peds.2020 0702gisa_legal
This study examined the epidemiological characteristics of 2143 pediatric patients with COVID-19 in China. The key findings were:
1) Children of all ages were susceptible to COVID-19, with no significant gender difference found.
2) Most pediatric cases (over 90%) were asymptomatic, mild, or moderate in severity.
3) The median time from illness onset to diagnosis was 2 days.
4) There was a rapid initial increase then gradual decrease in cases over time, and most cases were concentrated in Hubei Province and surrounding areas, indicating human-to-human transmission.
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2854-Article Text-12962-1-18-20230410.doc
1. 1
Characteristics of pneumonia in children with suspected/confirmed COVID-19
Rizal Marubob Silalahi, Wisman Dalimunthe, Rita Evalina, Juliandi Harahap,
Bidasari Lubis, Inke Nadia D. Lubis
Abstract
Background The most common COVID-19 infection clinical features in pediatric patients are
similar to those of other pulmonary diseases, i.e., fever, cough, and shortness of breath.
Information about the characteristics of coinfection and superinfection in COVID-19 cases
can reduce misdiagnosis and differentiate COVID-19 from other pulmonary infections.
Objective To observe the characteristics of pneumonia in children with
suspected/confirmed COVID-19.
Methods This descriptive study used medical record data of children hospitalized from 1
January 2020 – 31 January 2021 to describe the characteristics of pneumonia in suspected and
confirmed COVID-19 cases in Haji Adam Malik Hospital, Medan, North Sumatra.
Pneumonia-related findings, such as clinical symptoms, chest X-ray, and blood test
results,were collected.
Results There were 27 confirmed and 34 suspected COVID-19 children. Most of them were
aged 6 to 8 years. Pneumonia was significantly associated with COVID-19. In confirmed
COVID-19 cases, fever persisted after 3 days, with cough and shortness of breath. Patients
did not have flu symptoms, but had below normal SpO2 (81-90%). The occurrence of lung
rhonchi was significant in confirmed COVID-19 group. Chest X-ray results showed lung
opacity in all confirmed COVID-19 patients. Mean white blood cell (WBC) count was
significantly lower in COVID-19 confirmed (3.49x103/µL) vs. suspected group (17.9 x103/µL)
(P=0.011). Mean CRP was significantly higher in COVID-19 confirmed (26.5 mg/L) vs.
suspected group (4 mg/L).
Conclusion Pneumonia with confirmed COVID-19 cases present with longer fever and lower
SpO2. Patients are presented with lung ronchi, had lower WBC count, and higher CRP. Chest
X-ray shows opacity and consolidation.
Keywords: COVID-19; pediatric pneumonia; characteristics of pneumonia
From the Department of Child Health, Universitas Sumatera Utara Medical School, Medan,
North Sumatra, Indonesia.
2. 2
Corresponding author: Rizal Marubob Silalahi. Department of Child Health, Universitas
Sumatera Utara Medical School. Jalan Paya Bakung No. 19 C Sumber Melati Diski, Medan,
North Sumatra 20351, Indonesia. Phone +62 812 6395 940; Email: dr_rizalms@yahoo.com
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the novel coronavirus first
detected at the end of 2019 in Wuhan (Hubei province), China.1-3 In reports released from
countries severely impacted in the early course of the pandemic in 2020, children below 18
years (median age 11-year-old) contributed to 1.8% of total infections (216,305 cases), with
the main route of transmission was through household contact (82%). Around ten percent of
the cases were asymptomatic, while the most common symptom reported was fever (44–
50%).4-6
A literature review reported the characteristics of respiratory clinical symptoms in
COVID-19 from 5 earlier studies in Wuhan, China. Common symptoms of pulmonary
infection in COVID-19 cases were constitutional symptoms, such as fever (77 - 94%), myalgia
(12-15%), and headache (6-34%). Upper respiratory tract infection symptoms were
rhinorrhea (4.8-24%) and sore throat (13.9%), whereas lower respiratory tract infection
symptoms were dyspnea (18.7-64%), shortness of breath (24%), cough (67.8-81%), sputum
(23-56%), and hemoptysis (0.9-3%).7
The most common clinical symptoms reported in pediatric patients with confirmed
COVID-19 were fever, cough, and shortness of breath.2,7,8 However, these symptoms are also
the most common in other pulmonary diseases. Cough usually occurs in patients with upper
and lower respiratory tract infections.8 COVID-19 infection symptoms are similar to
symptoms of flu and other common cold viruses. Therefore, when screening for suspected
COVID-19 infection, other criteria that meet the additional risk factors may be added,
including travel history to pandemic areas or exposure to individuals with COVID-19
infections. Nasopharyngeal swab can help to detect the presence of the virus in the
respiratory tract. Multiplex nucleic acid PCR testing in suspected COVID-19 cases revealed
other infectious agents, including influenza A (2.8%), influenza B (4.4%), adenovirus (2.8%),
Chlamydia pneumoniae (2.8%), and Mycoplasma pneumoniae (10.3%).9 Pneumonia is the most
common respiratory disease in children, with symptoms similar to COVID-19 infection
symptoms.10 In a study of 416 children (<10 years of age) with COVID-19 infection in China,
70.4% of the patients showed chest imaging of pneumonia viral infections.11
COVID-19 patients often suffer from complications of bacterial infections.12 Children
with suspected COVID-19 should undergo comprehensive clinical examinations, including
3. 3
epidemiological history, clinical characteristics, hematologic examinations, and imaging to
reduce the risk of misdiagnosis and differentiate COVID-19 infection from other respiratory
infections and coinfections.13 However, information about coinfections and superinfections
of lung patients with COVID-19 is still limited. As such, we aimed to assess the
characteristics of pneumonia in children with suspected or confirmed COVID-19.
Methods
This descriptive study was done with medical record data from children with suspected or
confirmed COVID-19 admitted in Haji Adam Malik Hospital, Medan, North Sumatera, from
1 January 2020 to 31 January 2021.
Subjects were pneumonia patients with clinically suspected COVID-19 or confirmed
COVID-19 infection based on RT-PCR results. Sample size was estimated based on a formula
for a cross-sectional study; the population proportion formula, to be a minimum of 57
subjects. Subjects were selected by consecutive sampling. Exclusion criteria were patients
with suspected or confirmed COVID-19 who had underlying conditions other than lung
diseases, patients who conducted self-quarantine, and patients with suspected or confirmed
COVID-19 who only underwent an antigen test for SARS-CoV-2.
The variables analyzed were age, gender, physical examination results (pulse and
respiratory rate, chest retraction, rhonchi, wheezing, and body temperature), chest X-ray,
and blood test results, such as arterial blood gas analysis, CRP, procalcitonin (PCT), white
blood cell count, neutrophils, and lymphocytes. Complaints presented in patients, such as
fever (body temperature above 38ºC), cough (wet or dry cough), flu symptoms (sniffles or
allergy), and shortness of breath (abnormal breath frequency unrelated to the weather or
physical activities), were recorded based on the duration when the condition occurred.
Data were processed and analyzed by Statistical Package for the Social Sciences (SPSS)
version 22 software. Univariate analysis (descriptive analysis) was used to describe the
characteristics of all study variables to get distribution frequencies. Categorical variables
were presented as frequency (n) and percentage (%), while numeric variables were
presented as mean and standard deviation (SD) for normally distributed data, otherwise,
median values were presented. This study was approved by Health Research Ethics
Committee, Medical Faculty of Universitas Sumatera Utara.
4. 4
Results
There was a total of 61 patients reviewed in this study, where 27 (44.3%) was confirmed and
34 (55.7%) was suspected COVID-19 cases with pneumonia. Table 1 shows the basic
demographics of subjects. Of 26 male patients, 11/26 were confirmed with COVID-19
infection, while of 35 female subjects, 16/35 were confirmed with COVID-19. Over half
subjects, such as 19/37, with confirmed COVID-19 were in the school age group (6-18 years),
while only a small proportion of neonates and pre-schoolers were COVID-19 positive, such
as 2/10 were infants between 1 month and 1 year old, 4/10 were between 1 and 3-year-old,
and 2/4 were between 3 and 6-year-old.
Among 17 patients with severe degree of pneumonia, 12/17 had confirmed COVID-
19, whereas among 35 patients with mild degree of pneumonia, 23/35 subjects were
suspected with COVID-19. Chi-square test revealed that a severe degree of pneumonia was
significantly associated with COVID-19 infection (P=0.036). In both confirmed and suspected
COVID-19 groups, most subjects, 37/61 (60.7%), had good nutritional status. Nutritional
status had no significant relationship with COVID-19 infection (P=0.216).
Among the 27 confirmed COVID-19 patients, 2 (2/27) died. Of the 34 patients with
suspected COVID-19, 10/34 died. Disease outcome, such as the proportion of death, was
significantly associated with COVID-19 infections in patients with pneumonia (P=0.032).
Respiratory support was needed by 23/27 of patients with confirmed COVID-19 and 23/34
of patients with suspected COVID-19 (P=0.114). There were 18 subjects who had prior
contacts with COVID-19-infected individuals, where 15/18 subjects were noted in confirmed
COVID-19 cases and only 3/18 subjects in suspected COVID-19 group. There was a
correlation between having a contact history and COVID-19 diagnosis (P<0.001) (Table 1).
Table 1. Subjects’ characteristics
Demographic characteristics
Confirmed
COVID-19
(n=27)
Suspected
COVID-19
(n=34)
P value
Gender, n
Male 11 15 0.791a
Female 16 19
Age, n
Infant (1 month – 1 year) 2 8 0.360b
Early childhood (1-3 years) 4 6
Pre-school (3-6 years) 2 2
School age (6-18 years) 19 18
Mean (SD), months 115.19 (71.13) 81.09 (69.33)
Median (range), months 116.01 (2 - 215) 86.5 (1 - 196)
Degree of pneumonia, n
5. 5
Mild 12 23 0.036a
Severe 12 5
ARDS/Critical 3 6
Nutritional status, n
Malnutrition 2 7 0.216b
Poor nutrition 4 4
Good nutrition 18 19
Overweight 1 4
Obese 2 0
Disease outcome, n
Died 2 10 0.032a
Recovered 25 24
Respiratory support, n
Yes 23 23 0.114a
No 4 11
COVID-19 contact history, n
Yes 15 3 <0.001a
No 12 31
aChi-square, bKruskal Wallis
Table 2 shows the characteristics of patients’ subjective complaints There was a
significant difference between days of fever in the two groups (P<0.001), where the
confirmed COVID-19 group had significantly more subjects with persistent fever after 7
days than the suspected COVID-19 group. In both groups, over half of subjects had a cough
for ≤3 days and no significant difference was found (P=0.95). On the other hand, flu
symptoms were not a major complaint in either group, as 23/27 and 33/34 of the confirmed
and suspected groups, respectively, did not have flu. Shortness of breath was experienced by
the subjects in both groups but was found more in confirmed cases (P=0.019).
Table 2. Analysis of subjective complaints
Subjective complaint
Confirmed
COVID-19
(n=27)
Suspected
COVID-19
(n=34)
P value
Days of fever, n
≤ 3 days 0 8 <0.001a
4 – 6 days 5 18
≥ 7 days 22 8
Days of cough, n
≤ 3 days 18 18 0.095b
4 – 6 days 8 8
≥ 7 days 1 8
Flu symptoms, n
Yes, ≤ 3 days 4 1 0.161c
No flu 23 33
Shortness of breath, n
No 7 5 0.019a
≤ 3 days 20 22
4 – 6 days 0 7
6. 6
aKruskal Wallis, bChi-square, cFisher’s exact
Table 3 shows the results of subjects’ physical examinations. The majority of both
confirmed and suspected COVID-19 groups had > 38.5ºC body temperature, but was more
found in COVID-19 cases (P=0.029). Heart and respiratory rates were not significantly
different between groups (P=0.100 and P=0.789, respectively). Lower oxygen saturation
(SpO2) was significantly correlated to COVID-19 infection (P=0.03). Chest retraction was not
significantly different in between groups (P=0.381). However, lung rhonchi was significantly
found higher in the suspected group (P=0.017).
Table 3. Analysis of physical examination characteristics
Clinical physical examination
Confirmed
COVID-19
(n=27)
Suspected
COVID-19
(n=34)
P value
Body temperature, n
37.5-38.5 ºC 2 12 0.029a
38.6-39.4 ºC 11 14
39.5-40.5 ºC 10 7
> 40.5 ºC 4 1
Heart rate, n
81-120 bpm 22 19 0.100a
121-149 bpm 3 7
≥ 150 bpm 2 8
Respiratory rate, n
19-30 x/minute 9 12 0.789a
31-39 x/minute 3 4
40-60 x/minute 13 13
≥ 60 x/minute 2 5
O2 saturation (SpO2), n
71-80% 1 6 0.003a
81-90% 15 (55.6) 4 (11.8)
91-94% 3 6
≥ 95% 8 18 (52.9)
Retraction, n
Yes 6 ( 11 ( 0.381b
No 21 (77.8) 23 (67.6)
Rhonchi, n
Yes 10 (37.0) 23 (67.6) 0.017b
No 17 11
aKruskal Wallis, bChi-square
Table 4 shows the chest X-ray results according to age groups. All subjects had infiltrates,
appearance on ches X-ray. In the COVID-19 confirmed group, consolidation and opacity
were mostly observed in the school age group (6 – 18 years). There were significantly more
school aged subjects with consolidation in the confirmed COVID-19 group than in the
7. 7
suspected COVID-19 group [15/27 vs. 6/34, respectively (P=0.005)]. In addition, there were
significantly more school aged subjects with opacity in the confirmed COVID-19 group than
in the suspected COVID-19 group [16 /27 vs. 0/34, respectively (P<0.001)].
Table 4. Analysis of chest x-ray results by age group
Chest X-ray
Confirmed
COVID-19
(n=27)
Suspected
COVID-19
(n=34)
P value
Infiltrates, n
Infant (1 month – 1 year) 2 8 -
Early childhood (1-3 years) 4 6 -
Pre-school (3-6 years) 2 2 -
School age (6-18 years) 19 18 -
Consolidation, n
Infant (1 month – 1 year) 1 3 (75) 1.000a
Early childhood (1-3 years) 3 3 (50) 0.571a
Pre-school (3-6 years) 2 2 (100) -
School age (6-18 years) 15 6 (28.6) 17.6 0.005b
Opacity, n
Infant (1 month – 1 year) 1 0 0.200a
Early childhood (1-3 years) 1 0 0.400a
Pre-school (3-6 years) 2 0 0.333a
School age (6-18 years) 16 0 <0.001b
aFisher’s exact, bChi-square
Table 5 shows the blood test analysis results of all subjects. Mean WBC count was
significantly lower in the confirmed group (3.49x103/µL) than in the suspected group (17.9
x103/µL) (P=0.011). In addition, mean CRP was significantly higher in the COVID-19
confirmed group (26.5 mg/L) than in the suspected group (4 mg/L) (P=0.019). There was no
significant relationship with regards to blood gas analysis between the two groups
(P=0.125). Similarly, there were no significant differences in hemoglobin, platelets count,
neutrophil, lymphocyte, fibrinogen, or D-dimer results between the two groups (P>0.05 for
all).
Table 5. Blood test result analysis
Blood test
Confirmed
COVID-19
(n=27)
Suspected
COVID-19
(n=34)
P value
Blood gas analysis
Arterial blood gas, n
Metabolic acidosis 10 21 0.125a
Metabolic alkalosis 17 13
Hemoglobin, n
8. 8
Mean (SD), g/dL 9.16 (2.11) 11.39 (1.41) 0.283b
Median (range), g/dL 9.2 (3.9-13.6) 11.5 (7.8-14.1)
Platelets count
Mean (SD), x103/µL 143.7 (782.73) 317.69 (186.79) 0.928c
Median (range), x103/µL 138 (8-385) 326.5 (24-686)
WBC
Mean (SD), x103/µL 3.49 (3.81) 17.9 (18.94) 0.011c
Median (range), x103/µL 2.8 (2-183) 12 (2-69.81)
Neutrophil
Mean (SD), % 69.81 (17.61) 61.68 (18.91) 0.964c
Median (range), % 75.2 (18.9-93.9) 64.8 (22.3-90.4)
Lymphocyte
Mean (SD), % 22.02 (15.33) 28.87 (17.61) 0.502c
Median (range), % 18 (2.6-68.6) 26.7 (3-67.8)
CRP
Mean (SD), mg/L 26.5 (36.15) 4.0 (5.84) 0.019c
Median (range), mg/L 14.5 (0.7-158.2) 1.1 (0.7-25.6)
Fibrinogen
Mean (SD), mg/dL 251.52 (96.23) 98.21 (61.04) 0.086c
Median (range), mg/L 237 (129-610) 79 (30-275)
D-dimer
Mean (SD), µg/mL 1427.48 (857.89) 475.85 (282.47) 0.114c
Median (range), µg/mL 1120 (550-4000) 401 (130-1410)
aChi-square, bT-independent, cMann-Whitney
Discussion
From January 2020 to January 2021 in Haji Adam Malik Hospital, Medan, North Sumatra,
27/61 (44%) of pneumonia patients had confirmed COVID-19 infection. While children can
become the carriers of SARS-CoV-2 virus, those with clinical symptoms of severe COVID-19,
especially those suffering from pneumonia, should be treated in hospitals like adults. Those
with mild symptoms require self-quarantine.11 Pneumonia in children is often untreated or
ignored, resulting in high morbidity and mortality rates. In most children, viral pneumonia
tends to clear up without any treatment and rarely with any long-term sequelae.14
How children contribute to SARS-CoV-2 community transmission is still difficult to
be determined, especially with the high asymptomatic infection rate in the younger age
group.5 COVID-19 clinical characteristics in children usually appear as mild (37%) or
moderate (45%) respiratory infection, such as common respiratory problems, like common
cold, pharyngitis, or allergies.15 COVID-19 symptoms, such as fever, cough, and shortness of
breath, were common in our subjects. Among 27 pediatric patients with confirmed COVID-
19, 22 (81.5%) subjects experienced fever that persisted after 7 days, while 5 (18.5%)
experienced fever shorter than 7 days. In contrast to the suspected group, 22/34 of patients
had fever, which mostly persisted for 4-6 days in 18/34 subjects. All of the patients in
confirmed COVID-19 group had cough, where 18/27 patients suffered from cough for up to
9. 9
3 days. Moreover, only 4/27 of the confirmed group had flu symptoms. But, 20/27 patients
experienced shortness of breath with low oxygen saturation rate. Cough duration was not
significantly different between groups (P=0.95). Patients with confirmed COVID-19 had
much lower O2 saturation than those in suspected COVID-19 group. A previous study
reported that 80% of pediatric COVID-19 patients had a mean body temperature of>37.3oC,
while 60% had cough, 40% had pharyngitis, and 20% had rhinorrhea and sniffles.2
Pneumonia was the most common respiratory problem in children with suspected COVID-
19.10 Viral and bacterial pneumonia are often preceded by a few days of upper respiratory
tract infections, usually accompanied by rhinitis and cough. Severe infection may be
accompanied by cyanosis and respiratory fatigue, especially in babies.16 A study reported
that two neonates with COVID-19 (<3 months old) developed bronchiolitis after a 2-to-10-
day delay of SARS‐CoV‐2 infection diagnosis without RSV coinfection.10 Another study
explained that almost 5% frequency of OC43 and 229E coronaviruses was found in infants
with acute bronchiolitis. Physical examination revealed rales (5%), retraction (5%), and
cyanosis (5%) in children with COVID-19.2 In our study, no chest wall retractions were
observed in 77.8% of the confirmed group and in 67.6% of the suspected COVID-19 group.
Chest X-ray images revealed infiltrates in all subjects. In the confirmed COVID-19
group, consolidation and opacity were mostly observed in school age children (6 to 18 years).
No opacity was observed in the suspected COVID-19 group. A study analyzed the chest
images of the lungs of children with COVID-19 infection and reported that there could be a
slight increase of ground-glass opacification or even severe pneumonia.11
Blood test results showed metabolic acidosis in 10/27 of patients with confirmed
COVID-19 and of 21/34 of the suspected group, but the difference was not statistically
significant. In confirmed COVID-19 subjects, hemoglobin, WBC, and platelets count
decreased, while CRP and D-dimer increased. The mean WBC count in the confirmed
COVID-19 group (3.49 x 103/µL) was significantly lower than that in the suspected COVID-
19 group (17.9 x 103/µL) (P=0.011). Furthermore, the mean CRP was significantly higher in
the COVID-19 confirmed group (26.5 mg/L) than that of the suspected COVID-19 group (4.0
mg/L) (P=0.019). Yasuhara et al.17 stated that patients with multisystem inflammatory
syndrome in children (MIS-C) experienced an increase in CRP by 39.5% with a median value
of 166.5 [30.2-302.5] mg/L and procalcitonin by 3.2% with a median value of 16.3 [15.1-47.5]
ng/mL. High procalcitonin (PCT) values is a marker for inflammatory.18
Inflammation markers in the form of increased procalcitonin (PCT) > 0.5 ng/ml were
found in patients infected by either virus or bacteria,19 and normal procalcitonin (PCT)
10. 10
values can be found in the majority of infection cases.20 Comprehensive tests on blood count,
heart function, kidney function, coagulation parameter (if needed), and other relevant tests
need to be considered and performed according to subjects’ clinical conditions. The increase
in liver enzymes, muscle enzymes, and myoglobin in conjunction with d-dimer levels were
reported in severe cases, alongside normal or increasing CRP values.20
In conclusion, the characteristics of pneumonia associated with COVID-19 are
significant prolonged and higher fever, less shortness of breath, less lung rhonchi , greater
opacity on chest x-ray, lower WBC count, and higher CRP compared to pneumonia in non-
COVID-19 patients.
Conflict of Interest
None declared.
Funding Acknowledgement
The authors received no specific grants from any funding agency in the public, commercial,
or not-for-profit sectors.
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