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Aim: Most children with COVID‐19 have mild symptoms, but data on the Omicron variant are rare. This paper describes unexpected cases with convulsions during 1 week in January 2022. Methods: Four children with COVID‐19 were admitted with convulsions to the paediatric department in Örebro, Sweden, when Omicron accounted for more than 98% of the country's COVID‐19 cases. Three children tested positive for the virus, and one had clinical COVID‐19. I was able to contact the parents of three boys, who gave consent for these case studies. Results: Two boys aged 3 and 21 months tested positive for the virus and a 14‐year‐old boy tested negative, but had a cold and family members who had tested positive. The teenager had a history of urinary tract infections, but the younger boys had no earlier comorbidities. None had a history of epilepsy or febrile convulsions. The younger children had a fever and the teenager had upper respiratory symptoms. The 3‐month‐old child had repeated convulsions for several hours, the 21‐month‐old had continuous convulsions for 15–20 min, and the teenager had a convulsion for 30–60 s, followed by uncharacteristic aggression. Conclusion: Convulsions may be a sign of the Omicron variant in children with COVID‐19. [ABSTRACT FROM AUTHOR]

Aim: This paper summarised national data on the prevalence of overweight and obesity among 4‐year‐old children in Sweden in 2020, the first year of the COVID‐19 pandemic. It compares this with data from 2018. Differences between regions and sex were identified. Methods: Comparative data from Swedish Child Health Services were available for 18/21 regions. Chi‐square tests were used to compare data from 2018 and 2020 and to examine differences between the sexes. Sex and year were examined through interaction tests. Results: In 2020, 13.3% of the 100 001 children had overweight or obesity: 15.1% of the girls and 11.6% of the boys (p < 0.001). In 2018, 11.4% of the 105 445 children had overweight or obesity: 13.2% of the girls and 9.4% of the boys. This was an overall increase of 16.6% (p = 0.000) in the national Swedish data from 2018 to 2020. The increase between the years was greater for obesity (31.8%, p = 0.000) than for overweight (13.3%, p = 0.000). Conclusion: The prevalence of overweight and obesity among 4‐year‐olds in Sweden increased during the COVID‐19 pandemic and needs to be addressed. The prevalence needs to be followed as part of prevention programmes and to evaluate health interventions. [ABSTRACT FROM AUTHOR]

Aim: Sweden initially chose a different disease prevention and control path during the pandemic than many other European countries. In June 2020, the Swedish Government established a National Commission to examine the management of COVID‐19 in Sweden. This paper summarises, and discusses, its findings. Methods: Three reports published by the Commission were analysed. The first focused on the care of older people during the pandemic. The second examined disease and infection transmission and control and health care and public health. The third updated the first two reports and also covered economic aspects, crisis management and public communication. Results: By 25 February 2022, when the final report was published, 15 800 individuals, 1.5 per 1000 Swedish inhabitants, had died after COVID‐19. The death rates were high in spring 2020, but overall excess mortality in 2020–2021 was +0.79%, which was lower than in many other European countries. The Commission suggested that the voluntary measures that were adopted were appropriate and maintained Swedes' personal freedom during the pandemic. However, more extensive and earlier measures should have been taken, especially during the first wave. Conclusion: The Swedish COVID‐19 Commission felt that earlier and more extensive pandemic action should have been taken, particularly during the first wave. [ABSTRACT FROM AUTHOR]

Very young age could be a potential risk factor for community‐acquired severe acute respiratory syndrome coronavirus 2, due to immature immune systems. We retrospectively enrolled 39 infants up to 6 months of age who had presented to our tertiary Italian children's hospital emergency room between 9 March 2020 and 8 March 2021 and tested positive for the virus. Of those, 38 had a non‐specific mild or asymptomatic clinical course and only one patient was admitted to intensive care with severe symptoms. We concluded that very young infants with COVID‐19 had a generally favourable disease course. [ABSTRACT FROM AUTHOR]

In addition, different types of antibody tests give different detection rates and different seropositivity and this means that disagreements among tests are possible.3,4 In the present study, Breuer et al.1 utilised a dual-assay model to minimise the variance in sensitivity. We would like to share our thoughts on the paper published recently in I Acta Paediatrica i that stated that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies started to decline just four months after children became infected with the virus.1 Breuer et al.1 also concluded that reopening schools did not affect infection rates. Indeed, long-term antibody levels after vaccination are an important issue, and recent studies have found different levels of antibodies in previously uninfected adult individuals.2 Nevertheless, Breuer et al. did not explore antibody levels in vaccinated children, as at the time of their study only adults were being vaccinated. [Extracted from the article]

Aim: The COVID‐19 omicron variant surge highlighted the evolving impact of COVID‐19. Febrile infants <60 days old are high risk for serious bacterial infections (SBI). This study evaluated the rate of SBI based on COVID‐19 infection. Methods: We conducted a retrospective chart review at an urban, academic paediatric emergency department. The study enrolled infants 60 days old or less with documented fever. The primary outcome was SBI diagnosed by blood, urine, and/or cerebrospinal fluid cultures. We compared the rate of SBI between COVID‐19 groups with an omicron variant and 29‐ to 60‐day‐old subgroup analyses. Results: Two hundred and thirty‐three (233) infants meet the criteria. The incidence of SBI was 18.7% in the COVID‐19 negative and 1.7% in the COVID‐19‐positive group which is statistically significant (p < 0.001). Omicron subgroup analysis did not achieve statistical significance (p = 0.62) while COVID‐19‐positive infants 29–60 days old had a statistically significant lower rate of SBI (p = 0.006). Conclusion: The omicron variant surge provided an additional understanding of the impact of COVID‐19 on these high‐risk infants. These results can lead to decreased invasive testing and exposure to antibiotics as well as examine the utility of viral testing for risk stratification. [ABSTRACT FROM AUTHOR]

Aim: To test the method of engaging co‐researcher adolescents in data collection and explore stated motives for their selection of social media material related to COVID‐19. Methods: Twenty‐three adolescents, 13–19‐years old, in Sweden participated as co‐researchers collecting material from their social media related to COVID‐19. Specifically, they motivated their selection of social media material in field notes. Their motives were explored using content analysis. Results: Adolescent co‐researchers understood and performed the task well, providing insight into the social media exchanges of adolescents during the pandemic. An overarching theme for the motivation for their selection emerged: Social media is an important tool for adolescents' communication and information exchange during COVID‐19. Four categories were identified: Keeping track of the talk of the town; Recognition of personally relevant topics; Adolescents as information consumers; Social media as a means for expressing feelings, advice and existential reflections. Co‐researchers reported challenges relating to the quality of pandemic‐related information available to adolescents. Conclusion: Including young people as co‐researchers on matters relevant to them was successful. This study also underlines the need to consider the role of social media in information exchange during crises and to co‐produce health communication with adolescents to meet their specific needs. [ABSTRACT FROM AUTHOR]

Aim: Critically review research methods used to elicit children and young people's views and experiences in the first year of COVID‐19, using an ethical and child rights lens. Methods: A systematic search of peer‐reviewed literature on children and young people's perspectives and experiences of COVID‐19. LEGEND (Let Evidence Guide Every New Decision) tools were applied to assess the quality of included studies. The critical review methodology addressed four ethical parameters: (1) Duty of care; (2) Children and young people's consent; (3) Communication of findings; and (4) Reflexivity. Results: Two phases of searches identified 8131 studies; 27 studies were included for final analysis, representing 43,877 children and young people's views. Most studies were from high‐income countries. Three major themes emerged: (a) Whose voices are heard; (b) How are children and young people heard; and (c) How do researchers engage in reflexivity and ethical practice? Online surveys of children and young people from middle‐class backgrounds dominated the research during COVID‐19. Three studies actively involved children and young people in the research process; two documented a rights‐based framework. There was limited attention paid to some ethical issues, particularly the lack of inclusion of children and young people in research processes. Conclusion: There are equity gaps in accessing the experiences of children and young people from disadvantaged settings. Most children and young people were not involved in shaping research methods by soliciting their voices. [ABSTRACT FROM AUTHOR]

Aim: We focused on the clinical picture, severity and prognosis of children who experienced long‐term respiratory issues after COVID‐19. Methods: This was a national Czech multicentre study of paediatric post‐COVID syndrome, which used a standard protocol to evaluate structural and functional anomalies and exclude alternative diagnoses. From 6 January to 30 June 2021, 11 paediatric pulmonologists enrolled all paediatric referrals aged 2–18 years with persistent respiratory symptoms more than 12 weeks after COVID‐19, namely cough, dyspnoea and chest pain. Medical histories were taken, and physical examinations, lung function testing, chest X‐ray and blood tests were performed. Results: The dominant symptoms in the 39 children (56.4% girls) were exertional dyspnoea (76.9%) and a chronic cough (48.7%), while dyspnoea at rest (30.8%) and chest pain (17.9%) were less prevalent. More than half (53.8%) reported more than 1 symptom, and 38.5% had abnormal results for 1 of the following tests: lung function, chest X‐ray or D‐dimers. The median age of the children was 13.5 years (interquartile range ±4.8 years), and the median recovery time was 4 months (range 1.5–8 months). Conclusion: Our initial data suggest that the long‐term respiratory impact of COVID‐19 was relatively mild in our cohort, with a favourable prognosis. [ABSTRACT FROM AUTHOR]

Aim: Safe, effective SARS‐CoV‐2 treatment has not yet been determined, though some drugs have favourable mortality and morbidity benefits in specific situations. No treatments have been explicitly tested in children, who are, therefore, once again therapeutic orphans. Method: We echo calls to enrol patients, including children, into trials but those children recruited to date have largely been additions to adult studies. Few were recruited during the initial pandemic despite the emergence of PIMS‐TS/MIS‐C, which surely demands paediatric‐specific research. Result: Must children be proscribed treatments effective in adults until child‐specific data emerges, even in a pandemic? Will appropriately powered dedicated trials ever determine specific child‐COVID‐19 treatment pathways? Is the protracted time frame to assemble such data acceptable to children with severe COVID‐19 today? Such factors are relevant in considering whether children should have access to compassionate, innovative, pandemic‐disease treatment. Conclusion: We argue that children should be permitted, indeed have a right, to access innovative treatments early in any future pandemic, following an individual best interests consideration. This will remain the case until formal studies powered to determine children's optimal treatment commence, when the moral duty switches to ensuring children are enrolled, with any preceding innovative‐use data made available to researchers. [ABSTRACT FROM AUTHOR]

Aim: During COVID‐19 restrictions, the paediatric clinic only accepted essential outpatient visits, schools closed, sports activities and social life were limited. Most employees worked at home. This quasi‐experiment evaluates how this affected glycaemic control and use of health services among children with diabetes. Methods: Paired t‐tests were used to compare HbA1c‐values before, during and after lockdown. Sub‐analyses were stratified by pre‐lockdown HbA1c‐values. Results: Overall mean HbA1c decreased from 58.3 to 56.9 mmol/mol (p = 0.025) from pre‐ to post‐lockdown, a decrease also seen during the same season the previous year. HbA1c decreased by −4.2 mmol/mol (p = 0.002) for patients with pre‐lockdown HbA1c > 59 mmol/mol, but increased slightly by 0.8 mmol/mol (p = 0.176) for patients with HbA1c < 52 mmol/mol. HbA1c measured 8 months post‐lockdown increased again, most pronounced for patients with lowest HbA1c. During lockdown, virtual contacts increased from 0.1 to 0.5 contacts/patient/month and stayed post‐lockdown at 0.3 contacts/patient/month. Conclusion: Compared to 2019, overall the COVID‐19 restrictions did not influence the glycaemic control negatively. However, patients with pre‐lockdown HbA1c < 52 mmol/mol experienced a deterioration, whereas those with HbA1c > 59 mmol/mol experienced an improvement. Less stress and more contact with parents may contribute to the last‐mentioned finding. The lockdown enforced more virtual contacts between patients and the clinic. [ABSTRACT FROM AUTHOR]

Aim: The COVID‐19 pandemic had a significant impact on parental presence in the Neonatal Intensive Care Unit (NICU) during the first wave. The NICU team at the Rosie Hospital, Cambridge, endeavoured to explore the impact on parent and staff experiences of supporting parents throughout the period when visiting was restricted, between 13th August and 11th September 2020. Methods: Bespoke surveys were designed following the first lockdown to gather information on the impact on staff and parents. The questions were developed in the context of initial observations and conversations with staff and parents. Results: The findings of this study have illustrated the extent of the restrictions on parental wellbeing and mood, with the restrictions having had an adverse effect on these. In addition, the findings illustrate the adverse effect that the parents reported due to the restricted presence in terms of their babies' wellbeing, parent‐infant bonding, partners' wellbeing, parental confidence, the ability to breastfeed confidently and parents' access to the medical teams. Conclusion: The findings of this study have a number of clinical implications for parents and staff. Namely, the data supported the decision not to close NICU again during the second and third waves. [ABSTRACT FROM AUTHOR]

Aim: To ascertain a delay in attendances to the emergency department (ED) during 2020 lockdown. Methods: Area‐based cohort study on paediatric (0‐15 years) attendances resulting in hospital admission in Tuscany, Italy, in February‐May 2020, and the corresponding periods in 2018‐19. We analysed times from symptom onset to arrival, the odds of arriving late (>90th centile of time) and paediatricians' judgements of a late presentation by logistic models. Results: As expected, ED attendance fell sharply (−62%) in 2020 vs 2018‐19. As for cases studied (455 in 2020 and 1161 in 2018–19), we documented a delay in arrival to the ED in 2020 versus 2018–19 for several groups of diagnoses, namely gastroenteritis, sepsis, wounds, burns and infections overall. Time to presentation over 90th centile was also higher in 2020 (odds ratio, OR: 1.44; 95% confidence interval: 1.00, 2.06), as were paediatricians' judgements of a late arrival (18.9% of cases in 2020 vs. 13.4% in 2018‐19; OR: 1.58; 1.14, 2.19) Conclusion: In a population‐based cohort, delayed attendances to ED ascertained both subjectively and objectively convey the message to families and to paediatricians to seek hospital care in case of severe or unremitting symptoms and not to wait longer than they normally would. [ABSTRACT FROM AUTHOR]

Keywords: Covid-19; pediatric emergency department; patient numbers EN Covid-19 pediatric emergency department patient numbers 130 132 3 12/17/21 20220101 NES 220101 Abbreviations PED paediatric emergency department MTS Manchester Triage System Austria partly spared its healthcare system from the catastrophic effects of the COVID-19 pandemic with an early lockdown. Paediatric primary care is mainly supplied by community-based paediatricians and general practitioners, who can refer patients to the ED. The COVID-19 pandemic reduced paediatric emergency department visits but did not significantly increase urgent cases. [Extracted from the article]

Impact of COVID-19 on non-breastfeeding practices In times of crisis, such as those humanity has suffered since the turn of the millennium, i.e., the economic, migration and health crises, breastfeeding has proven to be the beneficial constant for the mother-infant dyad. 3 Marino JA, Meraz K, Dhaliwal M, Payán DD, Wright T, Hahn-Holbrook J. Impact of the COVID-19 pandemic on infant feeding practices in the United States: food insecurity, supply shortages and deleterious formula-feeding practices. [Extracted from the article]

In 2020, antibiotic prescriptions decreased by 80%, followed by a non-significant increase of antibiotic prescriptions in April to June 2021.[4] Finland went into lockdown in March 2020, and the restrictions included closing schools and day-care centres. It compared about 69 000 pre-pandemic antibiotic prescriptions for children with respiratory tract infections from April to December 2019 with about 19 000 prescriptions during the same pandemic months in 2020. GLO:44C/01jan23:apa16553-toc-0001.jpg PHOTO (COLOR): . gl Many large register studies from different countries have reported reductions in both children's respiratory tract infections and antibiotic prescriptions after COVID-19 was declared a pandemic in March 2020.[[1], [3]] Restrictive measures that aimed to limit the spread of the virus ranged from recommending social distancing to full national lockdowns. [Extracted from the article]

The controversy surrounding vaccination of young people against COVID-19 Glikman et al. report that on May 2021, the CDC and the Israeli Ministry of Health (IMOH) concluded that the potential benefits of COVID-19 vaccination outweigh (...) the possible risk of perimyocarditis. We agree with the view already expressed by Glikman et al.1 that Israel has gained world leadership in technology and capacity of COVID-19 vaccination. [Extracted from the article]