TP75. TP075 PEDIATRIC LUNG INFECTION最新文献_第2页

Factors Associated with Hospital Length of Stay by Viral Croup in a Fourth Level Pediatric Hospital in Bogota 波哥大某四级儿科医院病毒群住院时间的相关因素

TP75. TP075 PEDIATRIC LUNG INFECTION Pub Date : 1900-01-01 DOI: 10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3397

S. Restrepo, G.J. Giraldo-Duarte, M. Villamil

引用次数: 0

ChildhoodAsthma After Viral Lower Respiratory Tract Infection Before 3 Years of Age: A Comparison Between Enterovirus D68 (EVD-68), Rhinovirus (RhV), and Respiratory Syncytial Virus (RSV) 3岁前病毒性下呼吸道感染后儿童哮喘:肠病毒D68 (EVD-68)、鼻病毒(RhV)和呼吸道合胞病毒(RSV)的比较

TP75. TP075 PEDIATRIC LUNG INFECTION Pub Date : 1900-01-01 DOI: 10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3394

S. Khazaei Nejad, C. Kim, E. Rooney, R. Dick-Godfry, S. Krishnan, S. Nolan, E. de la Riva-Velasco, R. Rachel, K. Wallace, A. Dozor, J. Welter, G. Wange

引用次数: 0

Physiologic Effects ofL-Epinephrine Delivered Continuously in the Vapor Phase l -肾上腺素在气相中连续传递的生理效应

TP75. TP075 PEDIATRIC LUNG INFECTION Pub Date : 1900-01-01 DOI: 10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3392

M. Winter, C. Newth, C. Castro, J. Hotz, P. Ross

引用次数: 0

Characterization of Chest-X-Ray in Young Children and Adolescents with PCR Confirmed SARS-COV-2 Infection PCR确诊的儿童和青少年SARS-COV-2感染的胸部x线特征

TP75. TP075 PEDIATRIC LUNG INFECTION Pub Date : 1900-01-01 DOI: 10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3393

H. Aguilar, J. Molto, J. Zember, R. Sanchez-Jacob, C. Diez, J. Weinstock, X. Xu Chen, R. Kahanowitch, M.A. Arroyo Morr, M. Linguraru, G. Nino

{"title":"Characterization of Chest-X-Ray in Young Children and Adolescents with PCR Confirmed SARS-COV-2 Infection","authors":"H. Aguilar, J. Molto, J. Zember, R. Sanchez-Jacob, C. Diez, J. Weinstock, X. Xu Chen, R. Kahanowitch, M.A. Arroyo Morr, M. Linguraru, G. Nino","doi":"10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3393","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3393","url":null,"abstract":"Rationale: The specific chest X-ray (CXR) abnormalities in pediatric COVID19 and their relation to clinical outcomes remain to be defined. Addressing this gap is important given the age-related differences in the clinical and imaging features of COVID-19 and the challenge of differentiating SARS-CoV-2 infections from other types of viral lower respiratory infections (LRTIs) in young children. Methods: We conducted a single-center crosssectional study that included a sample of children, adolescents, and young adults (0-25 years) who had a (+) PCR test for SARS-CoV-2 and a CXR. We also included a random sample of young children (0-2 years, n=68) diagnosed with PCR-confirmed viral LRTI during 2018-2019 to compare CXR features with those seen in pediatric COVID-19. Results: A total of 422 pediatric COVID19 cases were identified during the study period. We enrolled 104 individuals with (+) PCR for SARS-CoV-2 and available CXR and sub-divided them according to age groups including young children (0-2 years, n=27), school-age children (3-10 years, n= 27), adolescents (11-18 years, n=41) and young adults (19-25 years, n=9). Overall, 52 (50%) of pediatric patients with COVID-19 were hospitalized and 26 (25%) required admission to PICU. The most common imaging abnormality identified was the presence of ground-glass opacifications (GGO)/focal consolidations (36%). The presence of GGO/consolidation was affected by age being more common among young adults (44%). Individuals requiring hospitalization or ICU admission had significantly more GGO/opacities in CXR (p<0.05). Typical lung imaging features of viral respiratory infections in the pediatric population such as increased perihilar markings and hyperinflation were more common in non-COVID-19 viral LRTI cases than in SARS-CoV-2 infection in young children (p<0.05) Conclusions: Chest X-ray imaging is a useful non-invasive tool to evaluate lung compromise in pediatric COVID-19 cases. The severity of GGO/consolidations is predictive of clinically relevant outcomes (e.g. hospitalization). Hyperinflation/perihilar markings could potentially aid in distinguishing COVID-19 from other types of viral LRTI in young children.","PeriodicalId":310689,"journal":{"name":"TP75. TP075 PEDIATRIC LUNG INFECTION","volume":"78 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133826460","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}

引用次数: 0

Coinfected with SARS-CoV-2 and Influenza B: A 2-Week-Old Presenting with Apnea 同时感染SARS-CoV-2和乙型流感:2周大的呼吸暂停

TP75. TP075 PEDIATRIC LUNG INFECTION Pub Date : 1900-01-01 DOI: 10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3405

R. Maddali, J. Raynor, K. Cervellione, L. Lew

{"title":"Coinfected with SARS-CoV-2 and Influenza B: A 2-Week-Old Presenting with Apnea","authors":"R. Maddali, J. Raynor, K. Cervellione, L. Lew","doi":"10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3405","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3405","url":null,"abstract":"Introduction: Apnea in the first weeks of life in a term infant can lead to extensive evaluation. Several respiratory viral infections are known to be associated with apnea. A paucity of data exists on SARS-CoV-2 in infants. We describe a 2-week-old girl presenting with apnea coinfected with SARS-CoV-2 and influenza B. Case: 2-week-old girl presented with an apneic episode lasting three minutes while lying supine after a feed with stiffening of the body and turning red in color. She experienced nasal congestion in preceding two days not associated with fever, cough or vomiting. She was born at term with birth weight 3365 grams (75%ile), length 48.9 cm (50%ile) and head circumference 33.5 cm (25-50%ile). The mother tested COVID-19 negative at time of delivery. Within the same household are two school age siblings. At admission, the weight was 4082 grams, temperature 37.2C, pulse 154 beats per minute and respiratory rate 33 breaths per minute. The heart and lung examinations were normal and there were no neurological deficits. Laboratory findings disclosed white blood cell count of 16.9 K/uL, serum glucose 113 mg/dL, calcium 11.3 mg/dL, total carbon dioxide 18 mmol/L, O2 saturation in room air 100% and CRP <0.05 mg/dL. Urinalysis was negative. Chest x-ray revealed hyperinflated lungs with prominent central markings, no focal consolidation, no pleural abnormality and unremarkable cardiothymic silhouette suggestive of a viral process. SARS-CoV-2 PCR-NP and influenza B tested positive. Influenza A, respiratory syncytial virus and human metapneumovirus were negative. Electrocardiogram traced normal sinus rhythm without abnormal QT interval. She had an uneventful clinical course and was subsequently discharged after two days of observation. Discussion: Brief resolved unexplained event (BRUE) was the admitting diagnosis. BRUE is when an infant younger than 12 months stops breathing associated with change in muscle tone, color or is unresponsive, transient in nature and with no known cause. Positive SARS-CoV-2 and influenza B test results excluded this diagnosis. In house exposure to school age siblings or by community spread present likely modes of transmission. Since our patient is younger than six months, she was not protected by influenza vaccine. The patient did not have fever, cough, leukopenia or elevated CRP as previously reported in children with COVID-19. Effects of SARS-CoV-2 on young infants are not completely known. SARSCoV-2 may also be the cause of apnea. Coinfection does not increase frequency of apnea. Full recovery was demonstrated.","PeriodicalId":310689,"journal":{"name":"TP75. TP075 PEDIATRIC LUNG INFECTION","volume":"63 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132689831","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}

引用次数: 0

A Clinical Prediction Tool for Respiratory Syncytial Virus Lower Respiratory Tract Infection Requiring Intensive Care Unit Admission 需要重症监护病房住院的呼吸道合胞病毒下呼吸道感染的临床预测工具

TP75. TP075 PEDIATRIC LUNG INFECTION Pub Date : 1900-01-01 DOI: 10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3408

B. Snyder, N. Achten, T. Gebretsadik, P. Wu, E. Mitchel, L. Bont, T. Hartert

引用次数: 0

Respiratory Syncytial Virus Delays Airway Epithelial Cell Restitution Through RhoA-Activated Actin Cytoskeleton Remodeling 呼吸道合胞病毒通过rhoa激活的肌动蛋白细胞骨架重塑延迟气道上皮细胞的修复

TP75. TP075 PEDIATRIC LUNG INFECTION Pub Date : 1900-01-01 DOI: 10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3403

D. Linfield, N. Gao, A. Raduka, T. Harford, G. Piedimonte, F. Rezaee

引用次数: 1

Utility of Procalcitonin Levels in Identifying Bacterial Infections in Children With and Without COVID-19 降钙素原水平在识别COVID-19患儿细菌感染中的应用

TP75. TP075 PEDIATRIC LUNG INFECTION Pub Date : 1900-01-01 DOI: 10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3410

G. Fisler, T. Brandt, G. Ostovar, M. Taylor, S. Shah

{"title":"Utility of Procalcitonin Levels in Identifying Bacterial Infections in Children With and Without COVID-19","authors":"G. Fisler, T. Brandt, G. Ostovar, M. Taylor, S. Shah","doi":"10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3410","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3410","url":null,"abstract":"Rationale: Elevated procalcitonin levels are associated with increased rates of bacterial infection in children. Observational studies have reported high levels of procalcitonin in COVID-19 and correlated procalcitonin level with illness severity. Data on rates of bacterial coinfections in COVID-19 are sparse;small studies suggest a low coinfection rate. We aim to quantify the positive predictive value (PPV) of procalcitonin in identifying bacterial infection in pediatric patients with and without COVID-19. Methods: A retrospective chart review was performed of 215 pediatric patients age 1 month to 21 years admitted to our tertiary children's hospital between February 1, 2013 and July 15, 2020 who had procalcitonin levels measured within 48 hours of admission. Confirmed bacterial infection was defined as positive blood, urine, or CSF culture, positive endotracheal/sputum culture with significant leukocytosis on gram stain, or CXR consistent with pneumonia. Contaminated blood cultures were excluded. Suspected bacterial infection was defined as either confirmed bacterial infection or administration of therapeutic antibiotics for >48 hours. Results: Of the 215 patients, 73 were PCR and/or antibody positive for SARS-CoV-2 (53% admitted to PICU, 29% required vasoactive medications) and 142 had alternative diagnoses (32% admitted to PICU, 9% required vasoactive medications). Median procalcitonin level was 1.28ng/mL in the COVID-19 cohort and 0.37ng/mL in the control cohort. There were 10 suspected and 5 confirmed bacterial infections in the COVID-19 cohort and 69 suspected and 44 confirmed bacterial infections in the control cohort. Procalcitonin was greater than 1ng/mL in 39 (53%) of COVID-19 subjects and 44 (31%) of control subjects. PPV of procalcitonin level over 1ng/mL for identifying suspected bacterial infection in the COVID-19 cohort was 10% (CI 1-20%) and in the control cohort was 75% (CI 62%-88%). PPV of procalcitonin level over 1ng/mL for identifying confirmed bacterial infection in the COVID-19 cohort was 3% (CI 0%-8%) and in the control cohort was 55% (CI 40%-69%). Conclusions: Our retrospective review demonstrated a low PPV of elevated procalcitonin level above the established threshold of 1ng/mL in identifying either culture-confirmed or suspected bacterial infection in pediatric patients hospitalized with COVID-19. Despite 29% of the COVID-19 cohort requiring vasoactive support, indicating a high pretest probability of bacterial sepsis, procalcitonin performed poorly as a marker of bacterial infection. Our results suggest that COVID-19 infection is associated with an elevated procalcitonin level independent of presence of bacterial infection. Given the importance of antibiotic stewardship, alternative means of identifying bacterial coinfection in COVID-19 are needed.","PeriodicalId":310689,"journal":{"name":"TP75. TP075 PEDIATRIC LUNG INFECTION","volume":"126 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132053136","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}

引用次数: 0

Pneumomediastinum Associated With Severe Cough Following SARS-CoV2 Infection SARS-CoV2感染后纵隔气肿与严重咳嗽相关

TP75. TP075 PEDIATRIC LUNG INFECTION Pub Date : 1900-01-01 DOI: 10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3418

S. Restrepo, D.M. Camacho-Acosta, A. Mancera-Gutierrez, M. Villamil, A. Moreno-Gómez, J. Valero-Halaby, N. Valero-Ovalle

{"title":"Pneumomediastinum Associated With Severe Cough Following SARS-CoV2 Infection","authors":"S. Restrepo, D.M. Camacho-Acosta, A. Mancera-Gutierrez, M. Villamil, A. Moreno-Gómez, J. Valero-Halaby, N. Valero-Ovalle","doi":"10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3418","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3418","url":null,"abstract":"Introduction: Pneumomediastinum (PM) is a low-frequency reason for consultation in pediatric services and is defined as the presence of free air in mediastinum structures as a result of overexpansion and rupture of alveolar septa, allowing air to pass through tissue barriers and occupy the mediastinum, neck and other cavities. Incidence of PM in newborns is 1,7-2,5 for every 1000, and in older children it is 1 for every 8000 to 15000 children. PM is more frequent in males and can be subdivided in two categories: spontaneous and secondary. Summary Case: We present the case of an 11-year-old boy without personal history of other pathologies, with history of a recent low-severity infection by Sars-CoV2 that lasted 4 weeks. He consulted pediatric emergency room for two days of odynophagia, acute cough episodes, thoracic pain and bilateral crackling sounds and tumefaction in the subclavicular and neck regions. He was without signs of dyspnea, and thoracic pain 7/10, SatO2 94% in room air, tumefaction was identified bilaterally in subclavicular and neck regions that expanded to the anterior side of the thorax. Crackling sounds were discovered in palpation of these regions, as well as diffuse pain. Respiratory sounds was normal. CXR showed air in the subcutaneous cellular tissue in the neck and thorax. Supplementary oxygen was administered via nasal cannula, as well as analgesic medication. Following studies were ordered to investigate possible causes: chest CT showed PM. The patient's clinical course was favorable and was discharged with no further complications.Discussion: PM is a low-frequency entity in pediatric health care. Several risk factors have been described such as asthma, respiratory infections, inhaled irritating substances and anatomical alterations such as tracheomalacia. Rarely it has been reported in patients affected by COVID-19 and such finding could represent a radiological indicator of potential progression of disease. While it is usually a self-limited condition and resolves by itself during clinical observation, PM can provoke potentially fatal respiratory or cardiovascular events. PM can be identified in simple thorax radiography, however, if it is small it can only be detected through chest CT. Literature reports cases in which PM in COVID-19 patients was not related to mechanical ventilation. This case highlights the association of COVID-19 with PM and the need for health care teams to be alert of this complication, even in patients with no previous history of any other pathological entities or comorbidities.","PeriodicalId":310689,"journal":{"name":"TP75. TP075 PEDIATRIC LUNG INFECTION","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114740476","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}

引用次数: 0

Severity of Seasonal Coronavirus Acute Respiratory Illness During Infancy Associated with Respiratory Viral Co-Infection 与呼吸道病毒合并感染相关的婴儿季节性冠状病毒急性呼吸道疾病的严重程度

TP75. TP075 PEDIATRIC LUNG INFECTION Pub Date : 1900-01-01 DOI: 10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3398

F. Cacho, T. Gebretsadik, J. Chappell, Z. Liu, K. Carroll, J.V. Williams, T. Hartert

{"title":"Severity of Seasonal Coronavirus Acute Respiratory Illness During Infancy Associated with Respiratory Viral Co-Infection","authors":"F. Cacho, T. Gebretsadik, J. Chappell, Z. Liu, K. Carroll, J.V. Williams, T. Hartert","doi":"10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3398","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3398","url":null,"abstract":"Background: There are limited data on the clinical characteristics of acute respiratory illness (ARI) in infants due to seasonal coronaviruses (CoV), long-term respiratory outcomes, and how CoV compare to other common viruses. Methods: Prospective cohort study of previously healthy term infants enrolled during hospitalization or acute care outpatient visits (emergency and clinic visits) for ARI from 2004-2008. ARI severity was determined using a 12-point respiratory severity score (RSS), and dichotomous LRTI or URI. ARI viral etiology was determined using real-time PCR for a panel of common respiratory viruses including seasonal CoV NL63, 229E, and OC43. In an exploratory analysis, proportions who subsequently developed childhood asthma were estimated by infection status in infancy. Clinical presentation of infant seasonal CoV infections was compared with published data on SARS-CoV-2 clinical characteristics in infants. Results: Among 665 infants, 28 (4%) had CoV detected. NL63, 229E, and OC43 comprised 25%, 25%, and 61% of detections, respectively, which included mixed-CoV infections. CoV exhibited winter seasonality. Among 28 CoV infections, 19 (68%) infants had co-infection with other viruses (RSV, HRV, influenza). Of 9 CoV-only detections, 2 (22%) were hospitalizations, 7 (78%) were outpatient, 8 (89%) were URI, 0 were bronchiolitis, and 1 (11%) was other diagnosis. Among CoV co-infections, 9 (47%) were hospitalizations, 10 (53%) were outpatient, 6 (32%) were URI, 11 (58%) were bronchiolitis, and 2 (11%) were other diagnoses. Average RSS was higher in infants with CoV co-infection than CoV-only infection (figure). Most common seasonal CoV symptoms were fever, cough, and rhinorrhea. Among those with long-term follow-up, childhood asthma (4-6 years) appeared more prevalent in RSV-only (62/152, 41%) and HRV-only infection groups (33/61, 54%) versus CoV-only (2/6, 33%);however, infants with CoV infection comprised a small proportion. Conclusions: Seasonal CoV represented the fourth most common viral etiology of ARI among infants seeking unscheduled medical care. CoV infection was less severe compared to RSV or HRV. This mild disease presentation is similar to current published reports of SARS-CoV-2 infection in infants. Greater illness severity was associated with CoV coinfection compared to CoV alone;however, CoV-only detection were few. Infants with seasonal CoV were less likely than infants with RSV or HRV to have later childhood long-term respiratory morbidity. These findings highlight the potential influence that respiratory co-pathogens may have in infant SARS-CoV-2 infection severity, and underscore the importance of identifying co-infecting pathogens.","PeriodicalId":310689,"journal":{"name":"TP75. TP075 PEDIATRIC LUNG INFECTION","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123761939","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}

引用次数: 0