COVID-19: What Happens in Pediatric Research in the Era of Pandemic

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Unità Operativa Complessa Pediatria Medica, Azienda Sanitaria Locale di Pescara, 65124 Pescara, Italy
Interests: antineoplastic combined chemotherapy protocols; precursor cell lymphoblastic leukemia–lymphoma; DNA mutational analysis; Down syndrome; survival analysis; combined modality therapy; histiocytosis; Langerhans cell; cellular cytotoxicity; acute lymphoblastic leukemia; rare diseases
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Dear Colleagues,

The COVID-19 pandemic is having a severe impact on healthcare systems around the world, with most hospitals being forced to rewrite their rules and change their structure to meet the new challenges presented. In fact, our entire social environment has been thoroughly modified and re-thought.

While this has had devastating consequences in many ways, leading both to loss of life and extraordinary disruptions, it has also served as a form of “experimentum naturae”, forcing us into situations we never could have imagined having to live in. A big challenge for clinicians and researchers now is to find ways to make the most of, and potentially profit from, this unexpected and new context.

Clinical observation, epidemiology, and basic research, including but not limited to the field of infectious diseases, may represent a huge mine for lessons learned.

We would like to invite you to share with our medical and pediatric community your findings and interpretations stemming from the world that COVID-19 has plunged us into.

Papers focused on how pediatric practice has been changed by the pandemic, what we have “discovered” may be further changed, what we realize we may consider no more a “must” and comparisons thereof are invited, as well as papers on how technology has helped us to deal with patients with rare diseases or complex care needs. Extraordinary times lead to extraordinary measures, and bright minds discover new ways to achieve what can no longer be achieved through established means. It is our pleasure to invite you to share all your new discoveries of “untrodden paths” in the field of healthcare with our readers.

Dr. Maurizio Aricò
Collection Editor

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Published Papers (17 papers)

2024

Jump to: 2023, 2022, 2021, 2020

10 pages, 445 KiB  
Article
Impact of COVID-19 Pandemic on the Clinical Course and Complications of Varicella—A Retrospective Cohort Study
by Maja Pietrzak and Maria Pokorska-Śpiewak
Pediatr. Rep. 2024, 16(2), 451-460; https://doi.org/10.3390/pediatric16020039 - 4 Jun 2024
Cited by 1 | Viewed by 957
Abstract
In this study, we aimed to characterize a cohort of children hospitalized due to varicella before and after the outbreak of the COVID-19 pandemic. Medical charts of all children hospitalized in the Regional Hospital of Infectious Diseases in Warsaw due to varicella in [...] Read more.
In this study, we aimed to characterize a cohort of children hospitalized due to varicella before and after the outbreak of the COVID-19 pandemic. Medical charts of all children hospitalized in the Regional Hospital of Infectious Diseases in Warsaw due to varicella in the years 2019 and 2022 were retrospectively analyzed and compared. In total, 221 children were included in the analysis; 59 of them were hospitalized in 2019, whereas 162 were hospitalized in 2022. Children hospitalized in 2022 were older than those reported in 2019 (median 4.0 vs. 3.0 years, p = 0.02). None of the hospitalized children received complete varicella vaccination. The most common complication in both years was bacterial superinfection of skin lesions, found in 156/221 (70.6%) of patients. This complication rate was higher in 2022 (50.8% in 2019 vs. 77.8% in 2022, p = 0.0001), OR = 3.38, 95% CI: 1.80–6.35. Moreover, skin infections in 2022 more often manifested with cellulitis (in 2022 13.6% vs. 3.4% in 2019, p = 0.03), OR = 4.40, 95% CI: 1.00–19.33. Sepsis as a complication of varicella was almost five-fold more prevalent in 2022 than in 2019 (p = 0.009), OR = 5.70, 95% CI: 1.31–24.77. Antibiotic use increased between 2019 and 2022 (71.2% vs. 85.2%, p = 0.01). Furthermore, patients were treated more frequently with the combination of two different antibiotics simultaneously (only 3.4% of patients in 2019 compared to 15.4% in 2022, p = 0.01). Primary infections with varicella zoster virus in 2022 led to a more severe course of the disease. Full article
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2023

Jump to: 2024, 2022, 2021, 2020

9 pages, 1523 KiB  
Case Report
SARS-CoV-2-Associated Multisystem Inflammatory Syndrome in Children (MIS-C): A Case Report from Iraq
by Ruwaid Behnam Y. Al-Simaani, Lika’a Fasih Y. Al-Kzayer, Kenan Hussien Ali, Mouroge H. Al-Ani and Yozo Nakazawa
Pediatr. Rep. 2023, 15(3), 532-540; https://doi.org/10.3390/pediatric15030048 - 4 Sep 2023
Viewed by 1840
Abstract
The novel coronavirus disease (COVID-19) continues to evolve. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)-associated multisystem inflammatory syndrome in children (MIS-C) is a rare post-COVID-19 complication that affects children with critical outcomes. Few MIS-C reports were available from Arab-Asian ethnicities. We here describe a [...] Read more.
The novel coronavirus disease (COVID-19) continues to evolve. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)-associated multisystem inflammatory syndrome in children (MIS-C) is a rare post-COVID-19 complication that affects children with critical outcomes. Few MIS-C reports were available from Arab-Asian ethnicities. We here describe a presentation mimicking a head injury overlapping the manifestations of MIS-C in a child from Iraq. A 10-year-old boy presented with blunt trauma in a shock-like status, and a head injury was suspected. Since he was febrile two days before the trauma, another pathology was assumed. Imaging and laboratory evaluations were performed, and after excluding gross neurosurgical etiology, he was initially treated as a toxic shock syndrome. Meanwhile, he was deteriorating with continuous fever, impaired consciousness, and seizure on the following day. Although not considered initially, close monitoring with a multidisciplinary approach and serial investigations revealed that the child met the criteria of MIS-C. SARS-CoV-2 IgG was shown to be high, while the RT-PCR of COVID-19 was negative. Once he received immunoglobulin and methylprednisolone, he improved dramatically. In conclusion, this report aimed to increase awareness about MIS-C among health workers and emphasized the need for a multidisciplinary team approach in Iraq due to the importance of timely treatment. Full article
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9 pages, 244 KiB  
Article
COVID-19 Maternal Prevention Behavior and Future Intention to Vaccinate for Children
by Marjan Zakeri, Ekere J. Essien and Sujit S. Sansgiry
Pediatr. Rep. 2023, 15(2), 263-271; https://doi.org/10.3390/pediatric15020022 - 3 Apr 2023
Viewed by 1716
Abstract
Background: During the COVID-19 pandemic, this study aimed to understand how a mother’s current COVID-19 prevention behaviors were associated with the mother’s future intention to vaccinate their children against COVID-19. Methods: Using a cross-sectional online survey, mothers who had at least one child [...] Read more.
Background: During the COVID-19 pandemic, this study aimed to understand how a mother’s current COVID-19 prevention behaviors were associated with the mother’s future intention to vaccinate their children against COVID-19. Methods: Using a cross-sectional online survey, mothers who had at least one child between 3 and 15 years old were recruited. COVID-19 prevention behaviors evaluated were wearing a mask, appropriate coughing/sneezing, social distancing, staying home, and handwashing. Participants’ age, marital status, race, educational level, incidence of COVID-19 infection in the household, healthcare worker in the household, and future intention to vaccinate children were obtained. Results: Among the 595 participants, 38.3% indicated they did not intend to use the COVID-19 vaccine for their children. Participants with no intention for vaccination had lower mean scores on wearing masks (p < 0.0001), social distancing (p < 0.0001), staying home (p < 0.0001), and handwashing (p < 0.05). The incidence of COVID-19 infection in the household was associated with a lower mean score of staying home (p < 0.01). Conclusion: Our findings indicate that most mothers were compliant with the CDC recommended guidelines at the time of the survey. Mothers who indicated high adherence to prevention behaviors had a higher likelihood to consider vaccination for their children. Now that the COVID-19 vaccine is available for children as young as six months, healthcare providers need to be aware of the relationship between current prevention behaviors and future intention to vaccinate. They need to counsel parents appropriately with recommendations for children to keep practicing prevention behaviors. Full article

2022

Jump to: 2024, 2023, 2021, 2020

9 pages, 625 KiB  
Article
The Impact of the COVID-19 Pandemic on Childhood Obesity and Lifestyle—A Report from Italy
by Stefano Palermi, Marco Vecchiato, Sonia Pennella, Anna Marasca, Alessandro Spinelli, Mariarosaria De Luca, Lorena De Martino, Fredrick Fernando, Felice Sirico and Alessandro Biffi
Pediatr. Rep. 2022, 14(4), 410-418; https://doi.org/10.3390/pediatric14040049 - 29 Sep 2022
Cited by 23 | Viewed by 3844
Abstract
During the COVID-19 lockdown, especially in the first wave of pandemic (March 2020), sedentary lifestyle and calorie intake increase in children became considerably more prevalent. The aim of the present paper was to evaluate changes in children’s weights and nutritional habits during the [...] Read more.
During the COVID-19 lockdown, especially in the first wave of pandemic (March 2020), sedentary lifestyle and calorie intake increase in children became considerably more prevalent. The aim of the present paper was to evaluate changes in children’s weights and nutritional habits during the COVID-19 pandemic in Italy. In this cross-sectional observational study, for 3 years, as part of the corporate wellness program (2019–2021) in Emilia Romagna region of Italy, anthropometric data of Ferrari car company employers’ children were collected, analyzed, and compared. Moreover, at the visit of November 2020, performed after the first wave of the pandemic with the most rigorous lockdown rules in Italy, a questionnaire on nutritional and lifestyle habits was administered. We evaluated 307 children (163 M, 10.1 ± 2.3 mean aged in 2019). A significant increase in BMI percentile in 2020 (65.2) compared to 2019 (49.2) was observed; it was confirmed, albeit slightly decreased, in 2021 (64.5). About one-third of participants reported an increase in consumption of fatty condiments and more than half report an increase in consumption of junk food. Levels of physical activity were still high during the COVID-19 lockdown, while sleeping time was significantly reduced. Our findings alert us to the importance of carefully monitoring eating behaviors in young to avoid the adoption of unhealthy food habits and prevent childhood obesity, especially during the period of COVID-19 lockdown. Full article
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9 pages, 2263 KiB  
Article
Activity of a Pediatric Emergency Department of a Tertiary Center in Bologna, Italy, during SARS-CoV-2 Pandemic
by Daniele Zama, Davide Leardini, Lorenzo Biscardi, Ilaria Corsini, Luca Pierantoni, Laura Andreozzi and Marcello Lanari
Pediatr. Rep. 2022, 14(3), 366-374; https://doi.org/10.3390/pediatric14030043 - 30 Aug 2022
Viewed by 2195
Abstract
During the SARS-CoV-2 pandemic, the pediatric emergency department (ED) of Bologna, Emilia-Romagna, Italy faced a reorganization to better deal with the new clinical needs. We herein describe the main changes in the organization and in the attendances to our pediatric ED. From the [...] Read more.
During the SARS-CoV-2 pandemic, the pediatric emergency department (ED) of Bologna, Emilia-Romagna, Italy faced a reorganization to better deal with the new clinical needs. We herein describe the main changes in the organization and in the attendances to our pediatric ED. From the 1 March 2020 to the 31 January 2022, 796 children positive for SARS-CoV-2 presented to our pediatric ED, but only 26 required hospitalizations, of which only 9 for COVID-19 related reasons. During this period, we also registered a temporal correlation between multisystem inflammatory syndrome in children (MIS-C) admissions and the peaks of SARS-CoV-2 infection in the Italian population. Respiratory syncytial virus (RSV) remained during last year the viral infection with the highest hospitalization rate. The analysis and description of the changes in the activity of the pediatric ED during the SARS-CoV-2 pandemic may help to better understand the routinary activity and be prepared for any possible new challenge. Full article
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2021

Jump to: 2024, 2023, 2022, 2020

6 pages, 370 KiB  
Case Report
SARS-CoV-2 Infection as a Cause of Acute Pancreatitis in a Child—A Case Report
by Natalia Kopiczko, Kamila Kwiatek-Średzińska, Mirosława Uścinowicz, Monika Kowalczuk-Krystoń and Dariusz Marek Lebensztejn
Pediatr. Rep. 2021, 13(4), 552-557; https://doi.org/10.3390/pediatric13040065 - 1 Oct 2021
Cited by 6 | Viewed by 2882
Abstract
The novel coronavirus disease (COVID-19) was detected for the first time in China in December 2019. Soon after it was declared a pandemic. Main symptoms include fever, dyspnea, cough, muscle pain, headache, anosmia and ageusia, however a growing body of evidence shows that [...] Read more.
The novel coronavirus disease (COVID-19) was detected for the first time in China in December 2019. Soon after it was declared a pandemic. Main symptoms include fever, dyspnea, cough, muscle pain, headache, anosmia and ageusia, however a growing body of evidence shows that other organs can be affected. Gastrointestinal manifestations have been observed in a considerable number of patients and include abdominal pain, diarrhea and vomiting. The involvement of liver as well as pancreas has been also described, however there are only a few cases of acute pancreatitis reported in patients with COVID-19. Therefore, we present a case of 6-year-old child with mild acute pancreatitis and COVID-19 pneumonia. Full article
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7 pages, 4552 KiB  
Case Report
Brugada Pattern in a Child with Severe SARS-CoV-2 Related Multisystem Inflammatory Syndrome
by Angelica De Nigris, Angela Pepe, Giangiacomo Di Nardo, Antonietta Giannattasio, Annamaria Pagano, Carolina D’Anna, Stefania Muzzica, Selvaggia Lenta, Giovanni Maria Di Marco and Vincenzo Tipo
Pediatr. Rep. 2021, 13(3), 504-510; https://doi.org/10.3390/pediatric13030058 - 1 Sep 2021
Cited by 5 | Viewed by 3370
Abstract
This report presents the first case of Brugada pattern complicated by a supraventricular arrhythmia in a child with SARS-CoV-2 related Multisystem Inflammatory Syndrome in Children (MIS-C). A 7-year-old boy came to our Emergency Department with 7 days of abdominal pain and fever. MIS-C [...] Read more.
This report presents the first case of Brugada pattern complicated by a supraventricular arrhythmia in a child with SARS-CoV-2 related Multisystem Inflammatory Syndrome in Children (MIS-C). A 7-year-old boy came to our Emergency Department with 7 days of abdominal pain and fever. MIS-C was diagnosed on the basis of the clinical, laboratory and instrumental tests. On admission, ECG showed type 1 Brugada pattern in the right precordial leads. During hospitalization the onset of supraventricular arrhythmias complicated the clinical picture. This case underlines management complexity of supraventricular arrhythmic events, different from atrial fibrillation, in patients with Brugada pattern in the context of a systemic inflammatory condition with significant cardiac involvement. All potential therapeutic choices should be considered to ensure the best outcomes. Full article
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20 pages, 653 KiB  
Review
Innate Immunity in Children and the Role of ACE2 Expression in SARS-CoV-2 Infection
by Mario Dioguardi, Angela Pia Cazzolla, Claudia Arena, Diego Sovereto, Giorgia Apollonia Caloro, Antonio Dioguardi, Vito Crincoli, Luigi Laino, Giuseppe Troiano and Lorenzo Lo Muzio
Pediatr. Rep. 2021, 13(3), 363-382; https://doi.org/10.3390/pediatric13030045 - 2 Jul 2021
Cited by 20 | Viewed by 5265
Abstract
COVID-19 (Coronavirus Disease 2019) is an emerging viral disease caused by the coronavirus SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), which leads to severe respiratory infections in humans. The first reports came in December 2019 from the city of Wuhan in the province [...] Read more.
COVID-19 (Coronavirus Disease 2019) is an emerging viral disease caused by the coronavirus SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), which leads to severe respiratory infections in humans. The first reports came in December 2019 from the city of Wuhan in the province of Hubei in China. It was immediately clear that children developed a milder disease than adults. The reasons for the milder course of the disease were attributed to several factors: innate immunity, difference in ACE2 (angiotensin-converting enzyme II) receptor expression, and previous infections with other common coronaviruses (CovH). This literature review aims to summarize aspects of innate immunity by focusing on the role of ACE2 expression and viral infections in children in modulating the antibody response to SARS-CoV-2 infection. This review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Articles deemed potentially eligible were considered, including those dealing with COVID-19 in children and providing more up-to-date and significant data in terms of epidemiology, prognosis, course, and symptoms, focusing on the etiopathogenesis of SARS-CoV-2 disease in children. The bibliographic search was conducted using the search engines PubMed and Scopus. The following search terms were entered in PubMed and Scopus: COVID-19 AND ACE2 AND Children; COVID-19 AND Immunity innate AND children. The search identified 857 records, and 18 studies were applicable based on inclusion and exclusion criteria that addressed the issues of COVID-19 concerning the role of ACE2 expression in children. The scientific literature agrees that children develop milder COVID-19 disease than adults. Milder symptomatology could be attributed to innate immunity or previous CovH virus infections, while it is not yet fully understood how the differential expression of ACE2 in children could contribute to milder disease. Full article
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6 pages, 220 KiB  
Case Report
The Deleterious Effects of COVID-19 in the Peripartum Period: A Case Report
by Alixandria F. Pfeiffer, Rosylyn James, Barbara K. Neuhoff, Wilson B. Pfeiffer, David R. Lowery and Syed A. A. Rizvi
Pediatr. Rep. 2021, 13(2), 334-339; https://doi.org/10.3390/pediatric13020041 - 16 Jun 2021
Viewed by 2634
Abstract
While the Coronavirus Disease 2019 (COVID-19) pandemic continues to wreak havoc across the nation and the globe as one of the most significant global health crises of our time, recent attention has been turned to the effects of COVID-19 on pregnancy and the [...] Read more.
While the Coronavirus Disease 2019 (COVID-19) pandemic continues to wreak havoc across the nation and the globe as one of the most significant global health crises of our time, recent attention has been turned to the effects of COVID-19 on pregnancy and the puerperium. Although most cases have been asymptomatic, for some patients, the disease may be accompanied by serious complications such as pneumonia, acute respiratory distress, multi organ failure, and death. Several case studies have noted that patients with co-morbidities are at a significant risk of these complications. In a recent systematic review and meta-analysis, authors conclude that cardiovascular disease was associated with increased composite poor outcome in patients with COVID-19. The following case report highlights the multi-system complications and severity of symptoms that can take place after childbirth in a patient with co-morbid obstetric and prenatal conditions and an initially asymptomatic COVID-19 infection. Full article
22 pages, 313 KiB  
Review
COVID-19 and School: To Open or Not to Open, That Is the Question. The First Review on Current Knowledge
by Francesco Busa, Flaminia Bardanzellu, Maria Cristina Pintus, Vassilios Fanos and Maria Antonietta Marcialis
Pediatr. Rep. 2021, 13(2), 257-278; https://doi.org/10.3390/pediatric13020035 - 1 Jun 2021
Cited by 10 | Viewed by 4691
Abstract
The COVID-19 pandemic has led to an unprecedented closure of schools in terms of duration. The option of school closure, SARS-CoV-2 initially being poorly known, was influenced by the epidemiological aspects of the influenza virus. However, school closure is still under debate and [...] Read more.
The COVID-19 pandemic has led to an unprecedented closure of schools in terms of duration. The option of school closure, SARS-CoV-2 initially being poorly known, was influenced by the epidemiological aspects of the influenza virus. However, school closure is still under debate and seems unsupported by sure evidence of efficacy in the COVID-19 era. The aim of our narrative review is to discuss the available literature on SARS-CoV-2 spread among children and adolescents, in the school setting, trying to explain why children appear less susceptible to severe disease and less involved in viral spreading. We also tried to define the efficacy of school closure, through an overview of the effects of the choices made by the various countries, trying to identify which preventive measures could be effective for a safe reopening. Finally, we focused on the psychological aspects of such a prolonged closure for children and adolescents. SARS-CoV-2, children, COVID-19, influenza, and school were used as key words in our literature research, updated to 29 March 2021. To our knowledge, this is the first review summarizing the whole current knowledge on SARS-CoV-2 spreading among children and adolescents in the school setting, providing a worldwide overview in such a pandemic context. Full article
8 pages, 4390 KiB  
Article
Inflammatory Skin Lesions in Three SARS-CoV-2 Swab-Negative Adolescents: A Possible COVID-19 Sneaky Manifestation?
by Giuseppe Ingravallo, Francesco Mazzotta, Leonardo Resta, Sara Sablone, Gerardo Cazzato, Antonietta Cimmino, Roberta Rossi, Anna Colagrande, Beniamino Ferrante, Teresa Troccoli and Ernesto Bonifazi
Pediatr. Rep. 2021, 13(2), 181-188; https://doi.org/10.3390/pediatric13020025 - 9 Apr 2021
Cited by 9 | Viewed by 3639
Abstract
Coronavirus disease 19 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is associated with various clinical manifestations, including skin lesions. In particular, during the COVID-19 pandemic lock-down period numerous chilblain-like lesions, mainly located on the feet, were observed in adolescents. The [...] Read more.
Coronavirus disease 19 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is associated with various clinical manifestations, including skin lesions. In particular, during the COVID-19 pandemic lock-down period numerous chilblain-like lesions, mainly located on the feet, were observed in adolescents. The latter were often asymptomatic or associated with very mild respiratory symptoms. Here, we report three cases of acral nodular lesions in SARS-CoV-2 swab-negative adolescents with histological findings of chronic immune-mediated inflammation and immunohistochemical evidence of SARS-CoV-2 spike glycoproteins in endothelial cells and eccrine sweat glands. In one of these cases, the virus presence was confirmed by electron microscopy. Full article
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9 pages, 843 KiB  
Article
Neonatal and Pediatric Emergency Room Visits in a Tertiary Center during the COVID-19 Pandemic in Italy
by Davide Silvagni, Laura Baggio, Patrizia Lo Tartaro Meragliotta, Pietro Soloni, Giovanna La Fauci, Chiara Bovo, Stefania Ielo and Paolo Biban
Pediatr. Rep. 2021, 13(2), 168-176; https://doi.org/10.3390/pediatric13020023 - 7 Apr 2021
Cited by 19 | Viewed by 3068
Abstract
The COVID-19 pandemic is affecting healthcare services worldwide. We investigated the impact of a strict lockdown policy on the characteristics of neonatal and pediatric attendances to our pediatric emergency department (PED). The clinical features of PED visits in March–April 2020 (COVID-19) and March–April [...] Read more.
The COVID-19 pandemic is affecting healthcare services worldwide. We investigated the impact of a strict lockdown policy on the characteristics of neonatal and pediatric attendances to our pediatric emergency department (PED). The clinical features of PED visits in March–April 2020 (COVID-19) and March–April 2019 (non-COVID-19) were analyzed. During the COVID-19 lockdown period, visits reduced by 67%, from 3159 to 1039. Neonatal access decreased from 78 to 59, mainly due to fewer pathological conditions, with a complete disappearance of respiratory infections. On the other hand, minor neonatal clinical conditions rose from 44 (56.4%) to 48 (81.4%), mostly due to feeding-related issues. Communicable diseases, particularly respiratory infections and gastroenteritis, dropped from 1552 (49.1%) to 288 (27.7%). Accident-related visits also decreased during COVID-19, from 535 (16.9%) to 309 (29.7%), becoming the most common cause of PED access. Hospital admissions reduced from 266 to 109, while PICU (pediatric intensive care unit) admissions decreased from 27 to 11, with a comparable rate of 10.1% in both periods. The lockdown due to COVID-19 had a substantial impact on our PED visits, which markedly decreased, mainly due to fewer respiratory infections. Unexpectedly, neonatal visits for minor conditions did not decline, but rather slightly increased. Among the children admitted to the PICU, none had respiratory disease. Full article
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7 pages, 249 KiB  
Article
Effectiveness of Preventive Measures in Keeping Low Prevalence of SARS-CoV-2 Infection in Health Care Workers in a Referral Children’s Hospital in Southern Italy
by Désirée Caselli, Daniela Loconsole, Rita Dario, Maria Chironna and Maurizio Aricò
Pediatr. Rep. 2021, 13(1), 118-124; https://doi.org/10.3390/pediatric13010017 - 4 Mar 2021
Cited by 4 | Viewed by 2469
Abstract
The coronavirus disease 2019 (COVID-19) pandemic now represents a major threat to public health. Health care workers (HCW) are exposed to biological risk. Little is currently known about the risk of HCW operating in pediatric wards for SARS-CoV-2 infection. The aim is to [...] Read more.
The coronavirus disease 2019 (COVID-19) pandemic now represents a major threat to public health. Health care workers (HCW) are exposed to biological risk. Little is currently known about the risk of HCW operating in pediatric wards for SARS-CoV-2 infection. The aim is to assess the prevalence of SARS-CoV-2 infection in HCW in a third-level children’s hospital in Southern Italy. An observational cohort study of all asymptomatic HCW (physician, technicians, nurses, and logistic and support operators) was conducted. HCW were screened, on a voluntary basis, for SARS-CoV-2 by RT-PCR on nasopharyngeal swab performed during the first wave of COVID-19. The study was then repeated, with the same modalities, at a 7-month interval, during the “second wave” of the COVID-19 pandemic. At the initial screening between 7 and 24 April 2020, 525 HCW were tested. None of them tested positive. At the repeated screening, conducted between 9 and 20 November 2020, 627 HCW were tested, including 61 additional ones resulting from COVID-emergency recruitment. At this second screening, eight subjects (1.3%) tested positive, thus being diagnosed as asymptomatic carriers of SARS-CoV-2. They were one physician, five nurses, and two HCW from the logistic/support services. They were employed in eight different wards/services. In all cases, the epidemiological investigation showed convincing evidence that the infection was acquired through social contacts. The study revealed a very low circulation of SARS-CoV-2 infection in HCW tested with RT-PCR. All the infections documented in the second wave of epidemic of SARS-CoV-2 were acquired outside of the workplace, confirming that in a pediatric hospital setting, HCW education, correct use of personal protective equipment, and separation of the COVID-patient pathway and staff flow may minimize the risk derived from occupational exposure. Full article
10 pages, 790 KiB  
Article
Autism, Therapy and COVID-19
by Luana Sergi, Emanuele Mingione, Maria Carla Ricci, Antonella Cavallaro, Ferdinando Russo, Giulio Corrivetti, Francesca Felicia Operto and Alessandro Frolli
Pediatr. Rep. 2021, 13(1), 35-44; https://doi.org/10.3390/pediatric13010005 - 5 Jan 2021
Cited by 9 | Viewed by 6640
Abstract
While numerous treatments for ASD are available, intervention based on the principles and procedures of Applied Behavior Analysis (ABA) has garnered substantial scientific support. In this study we evaluated the effects of the lockdown during the COVID-19 pandemic outbreak, followed by quarantine provisions [...] Read more.
While numerous treatments for ASD are available, intervention based on the principles and procedures of Applied Behavior Analysis (ABA) has garnered substantial scientific support. In this study we evaluated the effects of the lockdown during the COVID-19 pandemic outbreak, followed by quarantine provisions and during the three months after the resumption of activities. The study was conducted on a group of children taking part on a ABA-based intervention funded by the Local Health Authority (ASL) of the province of Caserta. In this study we considered a sample of 88 children who had been diagnosed with Autism Spectrum Disorder, aged between 18 and 30 months. The following inclusion criteria were observed: age at the time of diagnosis less than 30 months, absence of other neurological, genetic, or sensorineural pathologies, and severity level 1 measured by symptoms evaluation based on the ADOS 2 module T (used for diagnosis). During the lockdown children experienced improvements in communication, socialization, and personal autonomy. During the three months after the ABA treatment, the acquired skills were maintained but no significant improvement was demonstrated. In this study, we describe how parent training was significant in avoiding delays in the generalization of socially significant behaviors, following the drastic interruption of the treatment in this group of children. Full article
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4 pages, 476 KiB  
Case Report
COVID-19 in Pediatric Granulomatosis with Polyangiitis
by Amir Saeed, Eslam Shorafa, Zahra Seratishirazi and Seyedenarjes Abootalebi
Pediatr. Rep. 2021, 13(1), 31-34; https://doi.org/10.3390/pediatric13010004 - 4 Jan 2021
Cited by 1 | Viewed by 2457
Abstract
The confirmed cases with COVID-19 in children account for just 1% of the overall confirmed cases. Severe COVID-19 in children is rare. Case Presentation: Our patient was 16 years old with a severe case of COVID-19 and did not survive due to the [...] Read more.
The confirmed cases with COVID-19 in children account for just 1% of the overall confirmed cases. Severe COVID-19 in children is rare. Case Presentation: Our patient was 16 years old with a severe case of COVID-19 and did not survive due to the presence of Granulomatosis with polyangiitis and being treated with immunosuppressive drugs. We used lopinavir, ritonavir, hydroxy chloroquine, intravenous immunoglobulin and continuous veno-venous hemodialysis for treatment. Conclusion: In this patient, an underlying disease and delayed admission to the hospital were two factors complicating his condition. Full article
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16 pages, 480 KiB  
Review
Noli Timere: The Role of Reassuring Adults in Dealing with COVID-19 Anxiety in Pediatric Age
by Daniela Smirni
Pediatr. Rep. 2021, 13(1), 15-30; https://doi.org/10.3390/pediatric13010003 - 1 Jan 2021
Cited by 7 | Viewed by 3464
Abstract
Since the earliest stages of the Corona Virus Disease-19 (COVID-19) spread, the elderly has been identified as the most vulnerable and health authorities have rightly focused on that population. Minor attention was paid to pediatric populations and their emotional reactions. Actually, children and [...] Read more.
Since the earliest stages of the Corona Virus Disease-19 (COVID-19) spread, the elderly has been identified as the most vulnerable and health authorities have rightly focused on that population. Minor attention was paid to pediatric populations and their emotional reactions. Actually, children and adolescents faced severe anxiety, fear and stress conditions. An efficient management of the pandemic, therefore, must take into account the pediatric population which cannot be neglected as a minor matter compared to the elderly, the economy and health care. Since the lockdown time is over, children and adolescents must recover sociality, return to living in the open air, rediscover playing, free time, aiming for the beauty of their everyday life. In order to mitigate the long-term impact of COVID-19, the key response is the reassuring presence of the adult as ‘a secure base’. The current study aimed to collect an overview of the recent references that report evidence on the role of adults in containing pandemic anxiety COVID-19 in pediatric populations, suggesting the need to ensure a reassuring presence of the adult, an effective child-parent communication, a child-friendly day and a long-lasting shared time with parents. Full article
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2020

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10 pages, 228 KiB  
Article
The Challenges of a Children’s Hospital during the COVID-19 Pandemic: The Pediatric Surgeon’s Point of View
by Gloria Pelizzo, Sara Costanzo, Luciano Maestri, Giorgio Giuseppe Orlando Selvaggio, Andrea Pansini, Gian Vincenzo Zuccotti, Elena Zoia, Giuseppe De Filippis, Alessandro Visconti and Valeria Calcaterra
Pediatr. Rep. 2020, 12(3), 114-123; https://doi.org/10.3390/pediatric12030025 - 12 Nov 2020
Cited by 8 | Viewed by 3035
Abstract
During the coronavirus disease of 2019 (COVID-19) emergency, in the pediatric surgical setting, it has been essential to avoid and contain infections as well as to protect both the patients and the surgical team. During this emergency, procedures and workflow were adapted to [...] Read more.
During the coronavirus disease of 2019 (COVID-19) emergency, in the pediatric surgical setting, it has been essential to avoid and contain infections as well as to protect both the patients and the surgical team. During this emergency, procedures and workflow were adapted to provide the safest possible environment for both the surgical team and the patients. Pediatric surgical activities were reorganized during the COVID-19 pandemic at the “Vittore Buzzi” Children’s Hospital, which is a pediatric/maternal hospital located in Milan (Lombardy Region), Italy. Resources were optimized in order to maintain high levels of care and quality of assistance. During the COVID-19 emergency, the pediatric surgical department at the “Vittore Buzzi” Children’s Hospital became an acute care surgical service. For the reorganization of surgical activities, institutional protocols were adapted in order to preserve the pediatric-specific characteristics of our service; five crucial points were specifically addressed. The pediatric surgical procedures carried out during the initial two months of the Italian lockdown are also reported. Continuity of care was maintained for children affected by severe diseases, such as tumors and neurosurgical conditions, whose treatment could not be deferred. Telemedicine and telecommunication were adopted as quick-support modalities for pre- and post-operative care. This reorganization allowed us to preserve the “pediatric specificity” and all care-related procedures offered at this high-quality/high-volume surgical care referral center. Full article
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