au:Paula, Camila Sanson Yoshino de
Page of 1 Next
1. Differences in children and adolescents with SARS-CoV-2 infection: a cohort study in a Brazilian tertiary referral hospital
Marques, Heloisa Helena de Sousa ; Pereira, Maria Fernanda Badue ; Santos, Angélica Carreira dos ; Fink, Thais Toledo ; Paula, Camila Sanson Yoshino de ; Litvinov, Nadia ; Schvartsman, Claudio ; Delgado, Artur Figueiredo ; Gibelli, Maria Augusta Bento Cicaroni ; Carvalho, Werther Brunow de ; Odone Filho, Vicente ; Tannuri, Uenis ; Carneiro-Sampaio, Magda ; Grisi, Sandra ; Duarte, Alberto José da Silva ; Antonangelo, Leila ; Francisco, Rossana Pucineli Vieira ; Okay, Thelma Suely ; Batisttella, Linamara Rizzo ; Carvalho, Carlos Roberto Ribeiro de ; Brentani, Alexandra Valéria Maria ; Silva, Clovis Artur ; Eisencraft, Adriana Pasmanik ; Rossi Junior, Alfio ; Fante, Alice Lima ; Cora, Aline Pivetta ; Reis, Amelia Gorete A. de Costa ; Ferrer, Ana Paula Scoleze ; Andrade, Anarella Penha Meirelles de ; Watanabe, Andreia ; Gonçalves, Angelina Maria Freire ; Waetge, Aurora Rosaria Pagliara ; Silva, Camila Altenfelder ; Ceneviva, Carina ; Lazari, Carolina dos Santos ; Abellan, Deipara Monteiro ; Santos, Emilly Henrique dos ; Sabino, Ester Cerdeira ; Bianchini, Fabíola Roberta Marim ; Alcantara, Flávio Ferraz de Paes ; Ramos, Gabriel Frizzo ; Leal, Gabriela Nunes ; Rodriguez, Isadora Souza ; Pinho, João Renato Rebello ; Carneiro, Jorge David Avaizoglou ; Paz, Jose Albino ; Ferreira, Juliana Carvalho ; Ferranti, Juliana Ferreira ; Ferreira, Juliana de Oliveira Achili ; Framil, Juliana Valéria de Souza ; Silva, Katia Regina da ; Kanunfre, Kelly Aparecida ; Bastos, Karina Lucio de Medeiros ; Galleti, Karine Vusberg ; Cristofani, Lilian Maria ; Suzuki, Lisa ; Campos, Lucia Maria Arruda ; Perondi, Maria Beatriz de Moliterno ; Diniz, Maria de Fatima Rodrigues ; Fonseca, Maria Fernanda Mota ; Cordon, Mariana Nutti de Almeida ; Pissolato, Mariana ; Peres, Marina Silva ; Garanito, Marlene Pereira ; Imamura, Marta ; Dorna, Mayra de Barros ; Luglio, Michele ; Rocha, Mussya Cisotto ; Aikawa, Nadia Emi ; Degaspare, Natalia Viu ; Sakita, Neusa Keico ; Udsen, Nicole Lee ; Scudeller, Paula Gobi ; Gaiolla, Paula Vieira de Vincenzi ; Severini, Rafael da Silva Giannasi ; Rodrigues, Regina Maria ; Toma, Ricardo Katsuya ; Paula, Ricardo Iunis Citrangulo de ; Palmeira, Patricia ; Forsait, Silvana ; Farhat, Sylvia Costa Lima ; Sakano, Tânia Miyuki Shimoda ; Koch, Vera Hermina Kalika ; Cobello Junior, Vilson .
OBJECTIVES: To compare demographic/clinical/laboratory/treatments and outcomes among children and adolescents with laboratory-confirmed coronavirus disease 2019 (COVID-19). METHODS: This was a cross-sectional study that included patients diagnosed with pediatric COVID-19 (aged <18 years) between April 11, 2020 and April 22, 2021. During this period, 102/5,951 (1.7%) of all admissions occurred in neonates, children, and adolescents. Furthermore, 3,962 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection samples were processed in patients aged <18 years, and laboratory-confirmed COVID-19 occurred in 155 (4%) inpatients and outpatients. Six/155 pediatric patients were excluded from the study. Therefore, the final group included 149 children and adolescents (n=97 inpatients and 52 outpatients) with positive SARS-CoV-2 results. RESULTS: The frequencies of sore throat, anosmia, dysgeusia, headache, myalgia, nausea, lymphopenia, pre-existing chronic conditions, immunosuppressive conditions, and autoimmune diseases were significantly reduced in children and adolescents (p<0.05). Likewise, the frequencies of enoxaparin use (p=0.037), current immunosuppressant use (p=0.008), vasoactive agents (p=0.045), arterial hypotension (p<0.001), and shock (p=0.024) were significantly lower in children than in adolescents. Logistic regression analysis showed that adolescents with laboratory-confirmed COVID-19 had increased odds ratios (ORs) for sore throat (OR 13.054; 95% confidence interval [CI] 2.750-61.977; p=0.001), nausea (OR 8.875; 95% CI 1.660-47.446; p=0.011), and lymphopenia (OR 3.575; 95% CI 1.355-9.430; p=0.010), but also had less hospitalizations (OR 0.355; 95% CI 0.138-0.916; p=0.032). The additional logistic regression analysis on patients with preexisting chronic conditions (n=108) showed that death as an outcome was significantly associated with pediatric severe acute respiratory syndrome (SARS) (OR 22.300; 95% CI 2.341-212.421; p=0.007) and multisystem inflammatory syndrome in children (MIS-C) (OR 11.261; 95% CI 1.189-106. 581; p=0.035). CONCLUSIONS: Half of the laboratory-confirmed COVID-19 cases occurred in adolescents. Individuals belonging to this age group had an acute systemic involvement of SARS-CoV-2 infection. Pediatric SARS and MIS-C were the most important factors associated with the mortality rate in pediatric chronic conditions with COVID-19.
2. Severe clinical spectrum with high mortality in pediatric patients with COVID-19 and multisystem inflammatory syndrome
Pereira, Maria Fernanda Badue ; Litvinov, Nadia ; Farhat, Sylvia Costa Lima ; Eisencraft, Adriana Pasmanik ; Gibelli, Maria Augusta Bento Cicaroni ; Carvalho, Werther Brunow de ; Fernandes, Vinicius Rodrigues ; Fink, Thais de Toledo ; Framil, Juliana Valéria de Souza ; Galleti, Karine Vusberg ; Fante, Alice Lima ; Fonseca, Maria Fernanda Mota ; Watanabe, Andreia ; Paula, Camila Sanson Yoshino de ; Palandri, Giovanna Gavros ; Leal, Gabriela Nunes ; Diniz, Maria de Fatima Rodrigues ; Pinho, João Renato Rebello ; Silva, Clovis Artur ; Marques, Heloisa Helena de Sousa ; Rossi Junior, Alfio ; Delgado, Artur Figueiredo ; Andrade, Anarella Penha Meirelles de ; Schvartsman, Claudio ; Sabino, Ester Cerdeira ; Rocha, Mussya Cisotto ; Kanunfre, Kelly Aparecida ; Okay, Thelma Suely ; Carneiro-Sampaio, Magda Maria Sales ; Jorge, Patricia Palmeira Daenekas .
OBJECTIVES: To assess the outcomes of pediatric patients with laboratory-confirmed coronavirus disease (COVID-19) with or without multisystem inflammatory syndrome in children (MIS-C). METHODS: This cross-sectional study included 471 samples collected from 371 patients (age<18 years) suspected of having severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The study group comprised 66/371 (18%) laboratory-confirmed pediatric COVID-19 patients: 61 (92.5%) patients tested positive on real-time reverse transcription-polymerase chain reaction tests for SARS-CoV-2, and 5 (7.5%) patients tested positive on serological tests. MIS-C was diagnosed according to the criteria of the Center for Disease Control. RESULTS: MIS-C was diagnosed in 6/66 (9%) patients. The frequencies of diarrhea, vomiting, and/or abdominal pain (67% vs. 22%, p=0.034); pediatric SARS (67% vs. 13%, p=0.008); hypoxemia (83% vs. 23%, p=0.006); and arterial hypotension (50% vs. 3%, p=0.004) were significantly higher in patients with MIS-C than in those without MIS-C. The frequencies of C-reactive protein levels >50 mg/L (83% vs. 25%, p=0.008) and D-dimer levels >1000 ng/mL (100% vs. 40%, p=0.007) and the median D-dimer, troponin T, and ferritin levels (p<0.05) were significantly higher in patients with MIS-C. The frequencies of pediatric intensive care unit admission (100% vs. 60%, p=0.003), mechanical ventilation (83% vs. 7%, p<0.001), vasoactive agent use (83% vs. 3%, p<0.001), shock (83% vs. 5%, p<0.001), cardiac abnormalities (100% vs. 2%, p<0.001), and death (67% vs. 3%, p<0.001) were also significantly higher in patients with MIS-C. Similarly, the frequencies of oxygen therapy (100% vs. 33%, p=0.003), intravenous immunoglobulin therapy (67% vs. 2%, p<0.001), aspirin therapy (50% vs. 0%, p<0.001), and current acute renal replacement therapy (50% vs. 2%, p=0.002) were also significantly higher in patients with MIS-C. Logistic regression analysis showed that the presence of MIS-C was significantly associated with gastrointestinal manifestations [odds ratio (OR)=10.98; 95%CI (95% confidence interval)=1.20-100.86; p=0.034] and hypoxemia [OR=16.85; 95%CI=1.34-211.80; p=0.029]. Further univariate analysis showed a positive association between MIS-C and death [OR=58.00; 95%CI=6.39-526.79; p<0.0001]. CONCLUSIONS: Pediatric patients with laboratory-confirmed COVID-19 with MIS-C had a severe clinical spectrum with a high mortality rate. Our study emphasizes the importance of investigating MIS-C in pediatric patients with COVID-19 presenting with gastrointestinal involvement and hypoxemia.
Showingitens per page
Page of 1 Next
No documents were found for your search
Glossary and search help
You can enrich your search in a very simple way. Use the search indexes combined with the connectors (AND or OR) and specify more your search.
For example, if you want to search for articles about
cases of dengue in Brasil in 2015, use:
ti:dengue and publication_year:2015 and aff_country:Brasil
See below the complete list of search indexes that can be used:
|subject||subject (title words, abstract and keywords)|
|ta||journal short title (e.g. Cad. Saúde Pública)|
|journal_title||journal full title (e.g. Cadernos de Saúde Pública)|
|la||publication language code (e.g. pt - Portuguese, es - Spanish)|
|publication_year||publication year of publication|
|aff_country||country code of the author's affiliation|
|aff_institution||author affiliation institution|
|in||SciELO colection code (e.g. scl - Brasil, col - Colômbia)|
|use_license||article usage license code|