Pub Date : 2022-12-31DOI: 10.5812/pedinfect-129575
F. Bokharaei-Salim, Khadijeh Khanaliha, S. Sayyahfar, M. Sadeghi, A. Tavakoli, Borna Salemi
Background: Toxoplasma gondii is a pathogenic protozoan that causes toxoplasmosis and spreads worldwide. Objectives: This study aimed to investigate the prevalence of toxoplasmosis by serological and molecular methods in working children and a control group in Tehran. Methods: The study participants comprised 460 children aged 7 - 14 years, including 278 working children and 182 age-matched controls. Blood samples were collected, and a serological test was performed to evaluate IgM and IgG antibodies against T. gondii. Peripheral blood mononuclear cells (PBMCs) were isolated from the blood specimens by gradient centrifugation method. Real-time polymerase chain reaction (PCR) was performed using primer B1 on PBMC samples in children’s blood to determine the status of Toxoplasma infection. Results: Seroprevalence of IgG and IgM antibodies against T. gondii was 24.8% and 0.7%, respectively, in working children; however, in the control group, 12.1% and 2.2% had IgG and IgM antibodies against T. gondii, respectively. The mean IgG titer was 160 ± 86.39 IU/mL and 69.36 ± 88 IU/mL for working children and the control group, respectively (P < 0.0001); however, the mean IgM titer was 4.65 ± 3.04 IU/mL and 3.85 ± 4 IU/mL for working children and control group, respectively (P = 0.8187). Real-time PCR results indicated two (0.7%) positive cases among working children and three (1.65%) samples in the control group. The present study showed a significant difference between working children and the control group regarding the frequency of IgG antibodies (P = 0.0012). However, there was no significant difference in the frequency of IgM antibodies in the two mentioned groups. Conclusions: Seroprevalence of IgG antibody against T. gondii was more in working children than in the control group in Tehran. This investigation revealed a significant difference in frequency and titer of IgG antibodies between working children and the control group. More exposure to the soil and contaminated hands before drinking water or food may be considered factors in the development of toxoplasmosis infection in these children.
{"title":"Seroprevalence and Molecular Investigation of Toxoplasmosis among Working Children in Tehran","authors":"F. Bokharaei-Salim, Khadijeh Khanaliha, S. Sayyahfar, M. Sadeghi, A. Tavakoli, Borna Salemi","doi":"10.5812/pedinfect-129575","DOIUrl":"https://doi.org/10.5812/pedinfect-129575","url":null,"abstract":"Background: Toxoplasma gondii is a pathogenic protozoan that causes toxoplasmosis and spreads worldwide. Objectives: This study aimed to investigate the prevalence of toxoplasmosis by serological and molecular methods in working children and a control group in Tehran. Methods: The study participants comprised 460 children aged 7 - 14 years, including 278 working children and 182 age-matched controls. Blood samples were collected, and a serological test was performed to evaluate IgM and IgG antibodies against T. gondii. Peripheral blood mononuclear cells (PBMCs) were isolated from the blood specimens by gradient centrifugation method. Real-time polymerase chain reaction (PCR) was performed using primer B1 on PBMC samples in children’s blood to determine the status of Toxoplasma infection. Results: Seroprevalence of IgG and IgM antibodies against T. gondii was 24.8% and 0.7%, respectively, in working children; however, in the control group, 12.1% and 2.2% had IgG and IgM antibodies against T. gondii, respectively. The mean IgG titer was 160 ± 86.39 IU/mL and 69.36 ± 88 IU/mL for working children and the control group, respectively (P < 0.0001); however, the mean IgM titer was 4.65 ± 3.04 IU/mL and 3.85 ± 4 IU/mL for working children and control group, respectively (P = 0.8187). Real-time PCR results indicated two (0.7%) positive cases among working children and three (1.65%) samples in the control group. The present study showed a significant difference between working children and the control group regarding the frequency of IgG antibodies (P = 0.0012). However, there was no significant difference in the frequency of IgM antibodies in the two mentioned groups. Conclusions: Seroprevalence of IgG antibody against T. gondii was more in working children than in the control group in Tehran. This investigation revealed a significant difference in frequency and titer of IgG antibodies between working children and the control group. More exposure to the soil and contaminated hands before drinking water or food may be considered factors in the development of toxoplasmosis infection in these children.","PeriodicalId":44261,"journal":{"name":"Archives of Pediatric Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45404985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-14DOI: 10.5812/pedinfect-123107
M. Sharifdini, M. Zarean, M. Sadredinamin, Mitra Zare- Bavani, S. Sharifi-yazdi, B. Nikmanesh
Background: Toxocariasis is a parasitic disease causing hypereosinophilia. This study aimed to investigate the serological prevalence of toxocariasis among hypereosinophilic children in Children’s Medical Center, Tehran, Iran, as well as to explore its relationship with epidemiological variables and some blood indices. Methods: This descriptive cross-sectional study was performed in 2020 on children referred to referral children hospital for routine tests. A total of 282 children diagnosed with hypereosinophilia were selected and included in the study, and then, their serum was collected. After obtaining informed consent from their parents, the parents were asked to fill out a questionnaire. The serological ELISA test was used to assess the anti-Toxocara IgG antibody. Data were analyzed using SPSS software 18. Results: Out of 282 hypereosinophilic children, 17 (6%) had serological results positive for anti-Toxocara antibody. The mean age of children with toxocariasis was higher than that of children without toxocariasis (P = 0.312). Furthermore, ESR and CRP variables were significantly higher in infected children than those in non-infected children (P < 0.05). Conclusions: The results of the present study confirmed the relationship between toxocariasis and hypereosinophilia. Since the symptoms of toxocariasis are non-specific and may go undiagnosed, it was found necessary to examine toxocariasis in cases of hypereosinophilic individuals.
{"title":"Seroprevalence of Toxocariasis Among Hypereosinophilic Children: A Single Center Study, Tehran, Iran","authors":"M. Sharifdini, M. Zarean, M. Sadredinamin, Mitra Zare- Bavani, S. Sharifi-yazdi, B. Nikmanesh","doi":"10.5812/pedinfect-123107","DOIUrl":"https://doi.org/10.5812/pedinfect-123107","url":null,"abstract":"Background: Toxocariasis is a parasitic disease causing hypereosinophilia. This study aimed to investigate the serological prevalence of toxocariasis among hypereosinophilic children in Children’s Medical Center, Tehran, Iran, as well as to explore its relationship with epidemiological variables and some blood indices. Methods: This descriptive cross-sectional study was performed in 2020 on children referred to referral children hospital for routine tests. A total of 282 children diagnosed with hypereosinophilia were selected and included in the study, and then, their serum was collected. After obtaining informed consent from their parents, the parents were asked to fill out a questionnaire. The serological ELISA test was used to assess the anti-Toxocara IgG antibody. Data were analyzed using SPSS software 18. Results: Out of 282 hypereosinophilic children, 17 (6%) had serological results positive for anti-Toxocara antibody. The mean age of children with toxocariasis was higher than that of children without toxocariasis (P = 0.312). Furthermore, ESR and CRP variables were significantly higher in infected children than those in non-infected children (P < 0.05). Conclusions: The results of the present study confirmed the relationship between toxocariasis and hypereosinophilia. Since the symptoms of toxocariasis are non-specific and may go undiagnosed, it was found necessary to examine toxocariasis in cases of hypereosinophilic individuals.","PeriodicalId":44261,"journal":{"name":"Archives of Pediatric Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2022-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43625600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-25DOI: 10.5812/pedinfect-121640
M. Ataollahi, Seyedeh Sedigheh Hamzavi, S. Dehghani, M. Haghighat, M. Imanieh, N. Honar, K. Jahanshahi, Behnaz Darban, Hoda Haghshenas, M. Bagherzadeh, Abbas Avazpour, Fereshteh Karbasian, Fatima Mohamad Ghandour
Background: The coronavirus disease 2019 (COVID-19) pandemic has affected human life for more than a year. Coronavirus disease 2019 is well known for its respiratory manifestations; however, other important symptoms help with its diagnosis. Although clinical presentations in adults have been understood, clinical data in pediatric COVID-19 cases are still lacking. Objectives: We investigated gastrointestinal (GI) manifestations of COVID-19 in pediatric cases. Methods: This study included 184 cases with GI manifestations referred to the pediatric emergency department of Namazi hospital from 20 March to 20 November 2020. Their clinical and laboratory data were extracted and analyzed with SPSS22. Results: Of 184 patients, 51 had positive SARS-CoV-2 PCR results. The most common symptom in SARS-CoV-2-positive patients was vomiting in 22 (43%) patients, followed by watery diarrhea in 12 (23.5%) and dysentery in 11 (21%). Significantly elevated CRP (P value = 0.002), ESR (P value < 0.001), and lymphocyte count (P value = 0.037) were found in PCR-positive patients. Conclusions: Our result demonstrates that COVID-19 could present with different GI symptoms. Also, the symptoms and lab data could help clinicians diagnose COVID-19, besides other differential diagnoses in pediatric patients with GI symptoms.
{"title":"Prevalence of COVID-19 in Children with Gastrointestinal Manifestations: A Cross-Sectional Study of 184 Cases in 2020 - 2021","authors":"M. Ataollahi, Seyedeh Sedigheh Hamzavi, S. Dehghani, M. Haghighat, M. Imanieh, N. Honar, K. Jahanshahi, Behnaz Darban, Hoda Haghshenas, M. Bagherzadeh, Abbas Avazpour, Fereshteh Karbasian, Fatima Mohamad Ghandour","doi":"10.5812/pedinfect-121640","DOIUrl":"https://doi.org/10.5812/pedinfect-121640","url":null,"abstract":"Background: The coronavirus disease 2019 (COVID-19) pandemic has affected human life for more than a year. Coronavirus disease 2019 is well known for its respiratory manifestations; however, other important symptoms help with its diagnosis. Although clinical presentations in adults have been understood, clinical data in pediatric COVID-19 cases are still lacking. Objectives: We investigated gastrointestinal (GI) manifestations of COVID-19 in pediatric cases. Methods: This study included 184 cases with GI manifestations referred to the pediatric emergency department of Namazi hospital from 20 March to 20 November 2020. Their clinical and laboratory data were extracted and analyzed with SPSS22. Results: Of 184 patients, 51 had positive SARS-CoV-2 PCR results. The most common symptom in SARS-CoV-2-positive patients was vomiting in 22 (43%) patients, followed by watery diarrhea in 12 (23.5%) and dysentery in 11 (21%). Significantly elevated CRP (P value = 0.002), ESR (P value < 0.001), and lymphocyte count (P value = 0.037) were found in PCR-positive patients. Conclusions: Our result demonstrates that COVID-19 could present with different GI symptoms. Also, the symptoms and lab data could help clinicians diagnose COVID-19, besides other differential diagnoses in pediatric patients with GI symptoms.","PeriodicalId":44261,"journal":{"name":"Archives of Pediatric Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2022-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44624737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Spontaneous pneumothorax is a rare complication of coronavirus disease 2019 (COVID-19), primarily reported in adults. Pediatric cases with bilateral pneumothorax are much less reported. Case Presentation: We presented the case of a five-year-old previously healthy boy who developed persistent fever, abdominal pain, generalized maculopapular rash, and dyspnea before admission. His chest computed tomography (CT) showed a viral involvement pattern of pneumonia suggestive of COVID-19. Subsequently, he was confirmed with multisystem inflammatory syndrome in children (MIS-C). While he responded well to the therapies, on the fifth day of admission, he developed respiratory distress again. A chest roentgenogram showed bilateral spontaneous pneumothorax. Bilateral chest tubes were inserted, and his condition improved significantly after five days of admission to the intensive care unit. Two weeks later, he was discharged in good condition. Conclusions: Children with MIS-C associated with COVID-19 may develop primary spontaneous pneumothorax. Owing to the clinical picture overlapping with MIS-C associated with COVID-19, the timely diagnosis of pneumothorax may be challenging in such patients.
{"title":"Bilateral Spontaneous Pneumothorax in a Child with Multisystem Inflammatory Syndrome Associated With COVID-19","authors":"A. Saeed, Fateme Ziyaee, Faranak Rafiee, Mohammadhossein Bahmanzadegan Jahromi, Sareh Roosta","doi":"10.5812/pedinfect-128964","DOIUrl":"https://doi.org/10.5812/pedinfect-128964","url":null,"abstract":"Introduction: Spontaneous pneumothorax is a rare complication of coronavirus disease 2019 (COVID-19), primarily reported in adults. Pediatric cases with bilateral pneumothorax are much less reported. Case Presentation: We presented the case of a five-year-old previously healthy boy who developed persistent fever, abdominal pain, generalized maculopapular rash, and dyspnea before admission. His chest computed tomography (CT) showed a viral involvement pattern of pneumonia suggestive of COVID-19. Subsequently, he was confirmed with multisystem inflammatory syndrome in children (MIS-C). While he responded well to the therapies, on the fifth day of admission, he developed respiratory distress again. A chest roentgenogram showed bilateral spontaneous pneumothorax. Bilateral chest tubes were inserted, and his condition improved significantly after five days of admission to the intensive care unit. Two weeks later, he was discharged in good condition. Conclusions: Children with MIS-C associated with COVID-19 may develop primary spontaneous pneumothorax. Owing to the clinical picture overlapping with MIS-C associated with COVID-19, the timely diagnosis of pneumothorax may be challenging in such patients.","PeriodicalId":44261,"journal":{"name":"Archives of Pediatric Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2022-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45711502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-09DOI: 10.5812/pedinfect-119701
Ali Amanati, M. Vali, Hossein Fatemian, Z. Maleki, Hassan Foroozand, K. Sahebi, Mohammad Reza Rahmanian, Mohammad Javad Entezari Meybodi
Objectives: This systematic review and meta-analysis aimed to compare coronavirus disease 2019 (COVID-19) (Wuhan strain) features in children and adults during the initial pandemic phase. Methods: Until June 4, 2020, a systematic search was conducted on the EMBASE, PubMed, Web of Science, Google Scholar, and Scopus to find and collect studies based on available data among adults and children. The heterogeneity of the studies was assessed using I2 statistics and chi-square testing. The random-effect model was used to pool the effect sizes due to inter-study heterogeneity (chi-square P-value 0.1 and I2 >50%). Results: Fever (65.73%), cough (53.78%), expectoration (37.9%), gastrointestinal symptoms (37.01%), headache (23.41%), shortness of breath (21.65%), and myalgia (20.79%) were the most common symptoms reported in children, according to the pooled estimation analysis. Arthralgia (Effect estimate (ES): adults = 2.15, children = 17.94) and headache (ES: adults = 9.22, children = 23.41) were significantly observed higher in children (P-value = 0.019). Adult patients had a higher rate of abnormal computer tomography (CT)-scan findings, while most children had a normal study. Adults had significantly higher rates of comorbidities, whereas children had significantly higher rates of asthma (ES: 17.94% vs 8.85%; P-value = 0.026) and malignancy (ES: 10.36% vs 5.47%; P-value = 0.045). During initial pandemic phase, hydroxychloroquine (ES: 66.21% vs 29.01%; P-value = 0.001) and antibiotics (ES: 77.86% vs 38.01%; P-value = 0.001) were used much more frequently in adult patients. Adults used much more antibiotics than children. Nonetheless, antibiotics were given to around 40% of the children studied. Conclusions: Although children were afflicted less than adults in the early stages of the pandemic and had lower mortality, clinical and radiological findings, as well as prognostic factors, did not differ significantly between adults and children. However, with the advent of novel variants, clinical signs and symptoms, complications, and outcomes changed in children significantly.
目的：本系统综述和荟萃分析旨在比较2019冠状病毒病（新冠肺炎）（武汉毒株）在大流行初期儿童和成人的特征。方法：直到2020年6月4日，在EMBASE、PubMed、Web of Science、Google Scholar和Scopus上进行了系统搜索，以查找和收集基于成人和儿童可用数据的研究。使用I2统计和卡方检验来评估研究的异质性。由于研究间的异质性（卡方P值0.1，I2>50%），使用随机效应模型来汇集效应大小。结果：根据汇总估计分析，发烧（65.73%）、咳嗽（53.78%）、咳痰（37.9%）、胃肠道症状（37.01%）、头痛（23.41%）、呼吸急促（21.65%）和肌痛（20.79%）是儿童最常见的症状。儿童关节痛（效应估计值（ES）：成人=2.15，儿童=17.94）和头痛（ES：成人=9.22，儿童=23.41）的发病率明显较高（P值=0.019）。成人患者的计算机断层扫描异常率较高，而大多数儿童的研究正常。成人的合并症发生率明显更高，而儿童的哮喘（ES:17.94%对8.85%；P值=0.026）和恶性肿瘤发生率显著更高(ES:10.36% vs5.47%; P值=0.045). 在疫情初期，羟氯喹（ES:66.21%vs29.01%；P值=0.001）和抗生素（ES:77.86%对38.01%；P值=0.000）在成年患者中使用频率高得多。成年人使用的抗生素比儿童多得多。尽管如此，大约40%的研究儿童服用了抗生素。 结论：尽管在大流行的早期阶段，儿童的患病率低于成年人，死亡率也较低，但成人和儿童的临床和放射学结果以及预后因素没有显著差异。然而，随着新变种的出现，儿童的临床体征和症状、并发症和结果发生了显著变化。
{"title":"A Comprehensive Comparison of COVID-19 Characteristics (Wuhan Strain) Between Children and Adults During Initial Pandemic Phase: A Meta-Analysis Study","authors":"Ali Amanati, M. Vali, Hossein Fatemian, Z. Maleki, Hassan Foroozand, K. Sahebi, Mohammad Reza Rahmanian, Mohammad Javad Entezari Meybodi","doi":"10.5812/pedinfect-119701","DOIUrl":"https://doi.org/10.5812/pedinfect-119701","url":null,"abstract":"Objectives: This systematic review and meta-analysis aimed to compare coronavirus disease 2019 (COVID-19) (Wuhan strain) features in children and adults during the initial pandemic phase. Methods: Until June 4, 2020, a systematic search was conducted on the EMBASE, PubMed, Web of Science, Google Scholar, and Scopus to find and collect studies based on available data among adults and children. The heterogeneity of the studies was assessed using I2 statistics and chi-square testing. The random-effect model was used to pool the effect sizes due to inter-study heterogeneity (chi-square P-value 0.1 and I2 >50%). Results: Fever (65.73%), cough (53.78%), expectoration (37.9%), gastrointestinal symptoms (37.01%), headache (23.41%), shortness of breath (21.65%), and myalgia (20.79%) were the most common symptoms reported in children, according to the pooled estimation analysis. Arthralgia (Effect estimate (ES): adults = 2.15, children = 17.94) and headache (ES: adults = 9.22, children = 23.41) were significantly observed higher in children (P-value = 0.019). Adult patients had a higher rate of abnormal computer tomography (CT)-scan findings, while most children had a normal study. Adults had significantly higher rates of comorbidities, whereas children had significantly higher rates of asthma (ES: 17.94% vs 8.85%; P-value = 0.026) and malignancy (ES: 10.36% vs 5.47%; P-value = 0.045). During initial pandemic phase, hydroxychloroquine (ES: 66.21% vs 29.01%; P-value = 0.001) and antibiotics (ES: 77.86% vs 38.01%; P-value = 0.001) were used much more frequently in adult patients. Adults used much more antibiotics than children. Nonetheless, antibiotics were given to around 40% of the children studied. Conclusions: Although children were afflicted less than adults in the early stages of the pandemic and had lower mortality, clinical and radiological findings, as well as prognostic factors, did not differ significantly between adults and children. However, with the advent of novel variants, clinical signs and symptoms, complications, and outcomes changed in children significantly.","PeriodicalId":44261,"journal":{"name":"Archives of Pediatric Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2022-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47690112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-05DOI: 10.5812/pedinfect-121753
M. Jamalidoust, Zahra Ashkan, G. Pouladfar, Sadaf Asaei, Nasrin Aliabadi, P. Abbasi, M. Namayandeh, M. Ziyaeyan
Background: Given that immunocompromised patients are more at risk for the infection of SARS-CoV-2, epidemiological data are critical for assessing the corresponding prevalence among health care workers (HCWs) and patients at health centers. Objectives: This study aims to investigate the prevalence of SARS-CoV-2 infection among the staff of two hospitals that take care of immunocompromised patients, including pediatrics and adults with special medical conditions. Methods: This cross-sectional study includes all HCWs of the two hospitals; Abu Ali Sina Transplant Hospital (AASTH) and Amir al-Momenin Burn Injury Hospital (AABIH) in Shiraz, southern Iran, conducted from April 11, 2020, to June 16, 2021. The TaqMan real-time PCR assay was used to assess the SARS-CoV-2 infection rate in the suspected HCWs. Results: Out of 1232 sampled HCWs, 694 (56%) were female. Two hundred sixty-five samples (21.5%) and 967 samples (78.5%) were prepared from AABIH, and AASTH, respectively. The results showed that 30% (373) of the clinically suspected employees had positive test results. There was a significant correlation between the risk of exposure to COVID-19 patients and the PCR positivity rate, which could be explained by the fact that 58% of the infected HCWs were in a high-risk group, 20% medium-risk, and the remaining 22% were low-risk (P < 0.0001). The rates of positive cases in females were higher than that among male counterparts (P < 0.05). Conclusions: In order to protect health care workers and reduce the prevalence and transmission of diseases, deficiencies must be identified and eliminated.
背景：鉴于免疫功能低下的患者感染严重急性呼吸系统综合征冠状病毒2型的风险更大，流行病学数据对于评估医护人员和卫生中心患者的相应流行率至关重要。目的：本研究旨在调查两所照顾免疫功能低下患者的医院工作人员中严重急性呼吸系统综合征冠状病毒2型的感染率，包括儿科和有特殊疾病的成年人。方法：这项横断面研究包括两家医院的所有HCW；2020年4月11日至2021年6月16日，位于伊朗南部设拉子的Abu Ali Sina移植医院（AASTH）和Amir al-Momenin烧伤医院（AABIH）。TaqMan实时PCR检测用于评估疑似HCW中的严重急性呼吸系统综合征冠状病毒2型感染率。结果：在1232名采样的HCW中，694名（56%）为女性。从AABIH和AASTH分别制备了265个样品（21.5%）和967个样品（78.5%）。结果显示，30%（373）的临床疑似员工的检测结果呈阳性。接触新冠肺炎患者的风险与PCR阳性率之间存在显著相关性，这可以通过以下事实来解释：58%的感染HCW属于高风险组，20%属于中风险组，其余22%为低风险（P＜0.0001）。女性的阳性病例率高于男性（P＜0.05）。结论：为了保护医护人员，减少疾病的流行和传播，必须识别和消除缺陷。
{"title":"Prevalence and Clinical Presentation of COVID 19 in Health Care Workers in Two Main Hospitals During the Pandemic in Shiraz, Iran","authors":"M. Jamalidoust, Zahra Ashkan, G. Pouladfar, Sadaf Asaei, Nasrin Aliabadi, P. Abbasi, M. Namayandeh, M. Ziyaeyan","doi":"10.5812/pedinfect-121753","DOIUrl":"https://doi.org/10.5812/pedinfect-121753","url":null,"abstract":"Background: Given that immunocompromised patients are more at risk for the infection of SARS-CoV-2, epidemiological data are critical for assessing the corresponding prevalence among health care workers (HCWs) and patients at health centers. Objectives: This study aims to investigate the prevalence of SARS-CoV-2 infection among the staff of two hospitals that take care of immunocompromised patients, including pediatrics and adults with special medical conditions. Methods: This cross-sectional study includes all HCWs of the two hospitals; Abu Ali Sina Transplant Hospital (AASTH) and Amir al-Momenin Burn Injury Hospital (AABIH) in Shiraz, southern Iran, conducted from April 11, 2020, to June 16, 2021. The TaqMan real-time PCR assay was used to assess the SARS-CoV-2 infection rate in the suspected HCWs. Results: Out of 1232 sampled HCWs, 694 (56%) were female. Two hundred sixty-five samples (21.5%) and 967 samples (78.5%) were prepared from AABIH, and AASTH, respectively. The results showed that 30% (373) of the clinically suspected employees had positive test results. There was a significant correlation between the risk of exposure to COVID-19 patients and the PCR positivity rate, which could be explained by the fact that 58% of the infected HCWs were in a high-risk group, 20% medium-risk, and the remaining 22% were low-risk (P < 0.0001). The rates of positive cases in females were higher than that among male counterparts (P < 0.05). Conclusions: In order to protect health care workers and reduce the prevalence and transmission of diseases, deficiencies must be identified and eliminated.","PeriodicalId":44261,"journal":{"name":"Archives of Pediatric Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2022-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43853788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-22DOI: 10.5812/pedinfect-127250
A. Karimi, Ilia Mirzaei, S. Yaghobi
Introduction: SARS-CoV-2 is the cause of the recent pandemic. Although children are less affected by the virus, they can present with various presentations ranging from asymptomatic or fatigue and fever to multisystem inflammatory syndrome in children (MIS-C). Case Presentation: In this case report, we presented a case of a 9-year-old boy who presented with bilateral deep vein thromboses (DVTs) of the femoral and iliac veins as his main presentation of MIS-C, which occurred following a COVID-19 infection. A complete history was taken from the patient, and then a series of tests, including complete blood counts (CBCs), liver function tests (LFTs), and D-dimer, were performed. Bilateral doppler sonography to confirm the event and its location, as well as a decent follow-up method, were performed. Levels of anti-Xa assays followed the toxic levels of enoxaparin. The child was treated with a regimen of enoxaparin and corticosteroids, with a dosage of 1 mg/kg/12 h for both. The child was in the hospital for two weeks, after which he got better and was managed as an out-patient with a regularly scheduled appointment. Finally, once the radiologic evidence of DVTs was cleared, the patient tapered off his enoxaparin over the course of three weeks. Conclusions: Thrombotic events following COVID-19-associated MIS-C are an unlikely yet deadly event, especially in children. Prompt treatment with anticoagulants and corticosteroids alongside monitoring the patients are strongly advised.
{"title":"Thrombotic Presentation of MIS-C After COVID-19 Infection in a Nine-Year-Old Boy","authors":"A. Karimi, Ilia Mirzaei, S. Yaghobi","doi":"10.5812/pedinfect-127250","DOIUrl":"https://doi.org/10.5812/pedinfect-127250","url":null,"abstract":"Introduction: SARS-CoV-2 is the cause of the recent pandemic. Although children are less affected by the virus, they can present with various presentations ranging from asymptomatic or fatigue and fever to multisystem inflammatory syndrome in children (MIS-C). Case Presentation: In this case report, we presented a case of a 9-year-old boy who presented with bilateral deep vein thromboses (DVTs) of the femoral and iliac veins as his main presentation of MIS-C, which occurred following a COVID-19 infection. A complete history was taken from the patient, and then a series of tests, including complete blood counts (CBCs), liver function tests (LFTs), and D-dimer, were performed. Bilateral doppler sonography to confirm the event and its location, as well as a decent follow-up method, were performed. Levels of anti-Xa assays followed the toxic levels of enoxaparin. The child was treated with a regimen of enoxaparin and corticosteroids, with a dosage of 1 mg/kg/12 h for both. The child was in the hospital for two weeks, after which he got better and was managed as an out-patient with a regularly scheduled appointment. Finally, once the radiologic evidence of DVTs was cleared, the patient tapered off his enoxaparin over the course of three weeks. Conclusions: Thrombotic events following COVID-19-associated MIS-C are an unlikely yet deadly event, especially in children. Prompt treatment with anticoagulants and corticosteroids alongside monitoring the patients are strongly advised.","PeriodicalId":44261,"journal":{"name":"Archives of Pediatric Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2022-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48805665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: SARS-CoV-2 has been characterized since December 2019 as the etiology of severe pneumonia throughout the world. However, the majority of children and adolescents with the respective infection have mild COVID-19. In April 2020, a warning was issued by the National Health Service (NHS), based on which a multisystem inflammatory syndrome in children (MIS-C) could be associated with COVID-19, presenting with cardiovascular shock, fever, and hyperinflammation. The syndrome presents with fever and organ involvement but with no pathognomonic findings or diagnostic tests, while some of the manifestations are almost the same as those of Kawasaki disease. Objectives: Knowledge of clinical course, demographic data, treatment, and prognosis can contribute to the more efficient management of the patients and, consequently, a decrease in morbidity and mortality. Methods: Seventy-five patients < 18 years from September 22, 2020, to March 10, 2021, in Namazi hospital, Shiraz, Iran, with a diagnosis as per MIS-C defined criteria, were recruited. Results: Median age of the patients was 6.2 years, and 58.6% were male. Of the patients, 46% had positive SARS-CoV-2 RT-PCR, antibody, or both. Thirty percent of the total patients reported contact with proven COVID-19 cases. The abdominal free fluid in 17 patients, hepatitis in one patient, and stasis in both kidneys of one patient were detected. Upon echocardiography on the first day, 77%, 48%, 21%, and one patient were with tricuspid regurgitation, mitral regurgitation, abnormal LV function, and myocarditis, respectively; however, after 5 - 7 days, the repeated echocardiography revealed 44% of patients with tricuspid regurgitation, 30% with mitral regurgitation, and 6% with abnormal LV function. For the treatment, 18% of the patients received inotropes, 60% ASA, 32% IVIG, 84% glucocorticoids, and 25.3% received furosemide. All of the patients received antibiotics as well. Finally, 97% of the patients were discharged alive, while two cases died. Conclusions: The results of this study suggest the importance of cardiac consultation along with early hospital care during the course of MIS-C in order to prevent the associated short-term and long-term complications.
{"title":"Clinical and Laboratory Characteristics of the Multisystem Inflammatory Syndrome in Children: A Case Series of 75 Patients","authors":"Shabnam Hajiani Ghotbabadi, Maryam Mollaie, Seyedeh Sedigheh Hamzavi, Anahita Sanaei Dashti","doi":"10.5812/pedinfect-120863","DOIUrl":"https://doi.org/10.5812/pedinfect-120863","url":null,"abstract":"Background: SARS-CoV-2 has been characterized since December 2019 as the etiology of severe pneumonia throughout the world. However, the majority of children and adolescents with the respective infection have mild COVID-19. In April 2020, a warning was issued by the National Health Service (NHS), based on which a multisystem inflammatory syndrome in children (MIS-C) could be associated with COVID-19, presenting with cardiovascular shock, fever, and hyperinflammation. The syndrome presents with fever and organ involvement but with no pathognomonic findings or diagnostic tests, while some of the manifestations are almost the same as those of Kawasaki disease. Objectives: Knowledge of clinical course, demographic data, treatment, and prognosis can contribute to the more efficient management of the patients and, consequently, a decrease in morbidity and mortality. Methods: Seventy-five patients < 18 years from September 22, 2020, to March 10, 2021, in Namazi hospital, Shiraz, Iran, with a diagnosis as per MIS-C defined criteria, were recruited. Results: Median age of the patients was 6.2 years, and 58.6% were male. Of the patients, 46% had positive SARS-CoV-2 RT-PCR, antibody, or both. Thirty percent of the total patients reported contact with proven COVID-19 cases. The abdominal free fluid in 17 patients, hepatitis in one patient, and stasis in both kidneys of one patient were detected. Upon echocardiography on the first day, 77%, 48%, 21%, and one patient were with tricuspid regurgitation, mitral regurgitation, abnormal LV function, and myocarditis, respectively; however, after 5 - 7 days, the repeated echocardiography revealed 44% of patients with tricuspid regurgitation, 30% with mitral regurgitation, and 6% with abnormal LV function. For the treatment, 18% of the patients received inotropes, 60% ASA, 32% IVIG, 84% glucocorticoids, and 25.3% received furosemide. All of the patients received antibiotics as well. Finally, 97% of the patients were discharged alive, while two cases died. Conclusions: The results of this study suggest the importance of cardiac consultation along with early hospital care during the course of MIS-C in order to prevent the associated short-term and long-term complications.","PeriodicalId":44261,"journal":{"name":"Archives of Pediatric Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2022-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44966220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-17DOI: 10.5812/pedinfect-121163
F. Palizban, Naeemeh Taslimi, Maryam Khoshnood Shariati, M. Fallahi, S. Tehranchi, Hanieh Najafiarab
Background: COVID-19 pandemic imposed significant challenges on the health systems. COVID-19 management policies such as lockdown have made access to the health centers difficult. Pregnant women are a high-risk group whose pregnancy outcomes may be affected by COVID-19 pandemic. So, it is necessary to determine changes in the prevalence of preterm births and complications of prematurity during the pandemic. Objectives: This study aimed to determine the prevalence of preterm births and complications of prematurity during the first year of COVID-19 pandemic compared with the previous year. Methods: In this cross-sectional study, we included all live births born between March 2019 to March 2021 in Mahdieh hospital, Tehran, Iran. We reviewed medical records to extract the prevalence of preterm births and prematurity complications. Then, the prevalence of preterm births and prematurity complications during COVID-19 pandemic compared with the previous year. We used Chi-square test to analyze categorical variables. Results: A total of 10,830 live births were included in this study. During COVID-19 pandemic, the prevalence of moderate or late prematurity had a 4.64% reduction (P < 0.001), and the prevalence of term birth increased by 5.37% (P < 0.001) compared with the previous year. The prevalence of respiratory distress syndrome (RDS) decreased significantly during COVID-19 pandemic compared with the previous year (23.64% vs. 26.56%, P < 0.001). The prevalence of retinopathy of prematurity (ROP) significantly increased during COVID-19 pandemic compared with the previous year (3.97% vs. 2.28%, P < 0.001). Additionally, sepsis was significantly more prevalent during COVID-19 pandemic compared with the previous year (6.84% vs. 1.23%, P < 0.001). Moreover, intraventricular hemorrhage (IVH) significantly increased during COVID-19 pandemic in comparison to the previous year (1.10% vs. 0.08%, P < 0.001). Conclusions: The prevalence of preterm birth decreased during COVID-19 lockdown. Also, major complications of prematurity such as RDS, ROP, sepsis, and IVH may be affected by COVID-19 lockdown.
{"title":"Prevalence of Preterm Births and Complications of Prematurity: A Comparison Between First Year of COVID-19 Pandemic and the Previous Year","authors":"F. Palizban, Naeemeh Taslimi, Maryam Khoshnood Shariati, M. Fallahi, S. Tehranchi, Hanieh Najafiarab","doi":"10.5812/pedinfect-121163","DOIUrl":"https://doi.org/10.5812/pedinfect-121163","url":null,"abstract":"Background: COVID-19 pandemic imposed significant challenges on the health systems. COVID-19 management policies such as lockdown have made access to the health centers difficult. Pregnant women are a high-risk group whose pregnancy outcomes may be affected by COVID-19 pandemic. So, it is necessary to determine changes in the prevalence of preterm births and complications of prematurity during the pandemic. Objectives: This study aimed to determine the prevalence of preterm births and complications of prematurity during the first year of COVID-19 pandemic compared with the previous year. Methods: In this cross-sectional study, we included all live births born between March 2019 to March 2021 in Mahdieh hospital, Tehran, Iran. We reviewed medical records to extract the prevalence of preterm births and prematurity complications. Then, the prevalence of preterm births and prematurity complications during COVID-19 pandemic compared with the previous year. We used Chi-square test to analyze categorical variables. Results: A total of 10,830 live births were included in this study. During COVID-19 pandemic, the prevalence of moderate or late prematurity had a 4.64% reduction (P < 0.001), and the prevalence of term birth increased by 5.37% (P < 0.001) compared with the previous year. The prevalence of respiratory distress syndrome (RDS) decreased significantly during COVID-19 pandemic compared with the previous year (23.64% vs. 26.56%, P < 0.001). The prevalence of retinopathy of prematurity (ROP) significantly increased during COVID-19 pandemic compared with the previous year (3.97% vs. 2.28%, P < 0.001). Additionally, sepsis was significantly more prevalent during COVID-19 pandemic compared with the previous year (6.84% vs. 1.23%, P < 0.001). Moreover, intraventricular hemorrhage (IVH) significantly increased during COVID-19 pandemic in comparison to the previous year (1.10% vs. 0.08%, P < 0.001). Conclusions: The prevalence of preterm birth decreased during COVID-19 lockdown. Also, major complications of prematurity such as RDS, ROP, sepsis, and IVH may be affected by COVID-19 lockdown.","PeriodicalId":44261,"journal":{"name":"Archives of Pediatric Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2022-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45251151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-14DOI: 10.5812/pedinfect-118763
Arezoo Marjani, S. Garshasbi, Khadijeh Khanaliha, Roya Kahyesh-Esfandiary, Farzaneh Dehghani-Dehej, Roghayeh Babaei, M. Sadeghi, H. Keyvani, Maryam Esghaei, Atousa Fakhim, F. Bokharaei-Salim
Background: Working children are susceptible to infection with various infectious microorganisms. Unfortunately, the difficulties of working children are growing at a remarkable speed worldwide. Objectives: The aim of this research was to determine the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection, as well as to evaluate the level of anemia, calcium, and phosphorus in working children. Methods: This cross-sectional research was performed on 370 Iranian and Afghan working children from February 2018 to May 2019. Hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (HBsAb), hepatitis B core antibody (HBcAb), and anti-HCV Ab were evaluated using an enzyme-linked immunosorbent assay (ELISA). Furthermore, HCV-RNA and genomic HBV-DNA in the plasma and peripheral blood mononuclear cell (PBMC) specimens of the participants were investigated. The restriction fragment length polymorphism (RFLP) method was used to determine the genotype of HCV, and sequencing was performed to confirm. Results: The mean age of the participants was 10.1 ± 2.1 years (range, 6 - 15 years), and 229 (61.9%) were male. None of the studied children had any detectable HBV-DNA in the plasma and PBMC. The HCV genome was not detected in the plasma of the children, but HCV-RNA was assessed in the PBMC sample of 1 child (0.3%). Therefore, one of the children had occult HCV infection (OCI). The genotype of HCV in this child was subtype 1a. Furthermore, HBsAb was detected in Iranian (41.5%) and Afghan children (40.0%), and 2 (0.54%) of the working children were HBsAg positive. In 3 participants (0.8%), a positive HBcAb test result was noted. Conclusions: The prevalence of HCV and HBV infection in working children in Iran is extremely rare. However, there is a possibility of the presence of OCI in these children.
{"title":"Screening of Occult Hepatitis B and C Virus Infection in Working Children, Tehran, Iran","authors":"Arezoo Marjani, S. Garshasbi, Khadijeh Khanaliha, Roya Kahyesh-Esfandiary, Farzaneh Dehghani-Dehej, Roghayeh Babaei, M. Sadeghi, H. Keyvani, Maryam Esghaei, Atousa Fakhim, F. Bokharaei-Salim","doi":"10.5812/pedinfect-118763","DOIUrl":"https://doi.org/10.5812/pedinfect-118763","url":null,"abstract":"Background: Working children are susceptible to infection with various infectious microorganisms. Unfortunately, the difficulties of working children are growing at a remarkable speed worldwide. Objectives: The aim of this research was to determine the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection, as well as to evaluate the level of anemia, calcium, and phosphorus in working children. Methods: This cross-sectional research was performed on 370 Iranian and Afghan working children from February 2018 to May 2019. Hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (HBsAb), hepatitis B core antibody (HBcAb), and anti-HCV Ab were evaluated using an enzyme-linked immunosorbent assay (ELISA). Furthermore, HCV-RNA and genomic HBV-DNA in the plasma and peripheral blood mononuclear cell (PBMC) specimens of the participants were investigated. The restriction fragment length polymorphism (RFLP) method was used to determine the genotype of HCV, and sequencing was performed to confirm. Results: The mean age of the participants was 10.1 ± 2.1 years (range, 6 - 15 years), and 229 (61.9%) were male. None of the studied children had any detectable HBV-DNA in the plasma and PBMC. The HCV genome was not detected in the plasma of the children, but HCV-RNA was assessed in the PBMC sample of 1 child (0.3%). Therefore, one of the children had occult HCV infection (OCI). The genotype of HCV in this child was subtype 1a. Furthermore, HBsAb was detected in Iranian (41.5%) and Afghan children (40.0%), and 2 (0.54%) of the working children were HBsAg positive. In 3 participants (0.8%), a positive HBcAb test result was noted. Conclusions: The prevalence of HCV and HBV infection in working children in Iran is extremely rare. However, there is a possibility of the presence of OCI in these children.","PeriodicalId":44261,"journal":{"name":"Archives of Pediatric Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2022-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47111602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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