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Background: Knowledge about neurological manifestations of SARS-CoV-2 in children is limited. We describe neurological manifestations in an international cohort of hospitalized pediatric patients. Methods: This is a multi-national observational study involving tertiary healthcare institutions in Canada, Costa Rica and Iran. We included patients 1 day-18 years admitted for any medical reason February 1, 2020-January 31, 2021 with laboratory evidence of SARS-CoV-2 infection by RT-PCR or serological testing. Descriptive analyses and logistic regression were performed where appropriate using JASP version 0⋅13. Findings: 298 hospitalized children with confirmed SARS-CoV-2 infection (median age 3⋅9 years [IQR 0⋅6-10⋅1]) from Canada (n=152), Costa Rica (n=115) and Iran (n=31) were included. Fifty-one (17%) had neurological manifestations, of which headache (73%), seizures (23%) and altered mental status (6%) were most frequently seen. Children with neurological symptoms had equivalent rates of comorbidities overall but were more likely to have underlying chronic neurological conditions. Additionally, those with neurological symptoms were more likely to be admitted to the ICU (15/51 [29%] vs. 32/247 [13%]; p =0⋅0033) and had longer length of hospital stay (6 days [IQR 3-8] vs. 4 days [IQR 2-7]; p =0⋅0060). Abnormalities were found in all children with neurological manifestations who received neuroimaging (n=6). Neurological manifestations were seen in 19% of the Iranian cohort, 23% of the Costa Rican cohort, and 12% of the Canadian cohort. Country of residence Costa Rica (adjusted OR: 2⋅520, 95% CI: 1⋅325-4⋅791, p =0⋅005), ICU admission (adjusted OR: 2⋅678, 95% CI: 1⋅307-5⋅486, p =0⋅007) and number of acute SARS-CoV-2 infection symptoms (adjusted OR: 1⋅355, 95% CI: 1⋅232-1⋅491, p

Summary Background Better population data on respiratory viruses in children in tropical and southern hemisphere countries is needed. Methods The epidemiology of respiratory viruses among healthy children (6 months to

Background: Introduced in June 2017 by the World Health Organization (WHO) as a Neglected Tropical Diseases, snakebite envenoming is a global health problem. In Costa Rica, an incidence of 15 per 100,000 inhabitants and a mortality rate of 0·15 per 100,000 inhabitants per year were reported from 2005-2012. Children are also affected and prone to complications. Methods: Retrospective descriptive 14-year study of children with envenomings by Viperidae snakebites managed at the tertiary pediatric hospital in Costa Rica. Findings: 80 patients (pts) were included and classified as having mild (17 pts, 29·3%), moderate (58 pts, 72·5%) or severe (5 pts, 6·2%) envenoming. 52/80 (65%) patients received treatment within the first four hours, three (3·75%) between 5-8 hours, three between 9-12 hours, four (4%) between 13-16 hours, two (2·5%) between 17-20 hours, and seven (8·75%) after 20 hours. Edema was documented in 76/80 (95%), pain in 58 (72·5%), local bleeding in 23 (28·8%), emesis in 10 (12·5%), bullae formation in 8 (10%), and tissue necrosis in three (3·8%) pts. Complications presented according with degree of envenoming, being more common in severe cases: wound infection occurred in 14/58 (24·1%) with moderate envenoming and 5/5 pts with severe envenoming (p

Objetivo: Identificar los casos de síndrome de rubéola congénital (SRC) y su forma de presentación en niños menores de 3 meses atendidos en el Hospital Nacional de Niños de 1996 a 2000. Métodos: En el período de 1996 a 2000 se seleccionaron los pacientes de un día de edad a 3 meses, con un positivo de serología IgM por rubéola, identificados por medio del registro computarizado del laboratorio. Se revisó la historia clínica correspondiente, analizando las características de los pacientes. Resultados: Se identificaron 66 niños con serología positiva, 49 tenían historia clínica completa que permitió la revisión. De éstos, 29 (60 %) eran varones. La edad media en que se solicitó la serología fue de 33 días. La hepatosplenomegalia, la microcefalia y las polimalformaciones fueron las tres principales manifestaciones por las cuales se solicitó la serología. El diagnóstico inicial que predominó fue el TORCHS (toxoplasmosis, rubéola, citomegalovirus, herpes, sífilis). Tras la revisión final de los 49 casos, 45 pacientes se clasificaron como SRC y cuatro como infección por rubéola. Conclusiones: El presente estudio pone de manifiesto la necesidad de reforzar la vigilancia activa permanente del SRC. Se debe reforzar la búsqueda de signos y síntomas, así como los antecedentes maternos que permitan la sospecha adecuada y la comunicación oportuna de los casos de SRC. : Objective: To identify cases of congenital rubella syndrome (CRS) and their form of presentation in children aged < 3 months in the National Children's Hospital of Costa Rica between 1996 and 2000. Methods: Between 1996 and 2000, patients aged 1 day to 3 months with positive IgM serology for rubella, identified by means of the computerized database of the National Children's Hospital Laboratory, were selected. Their corresponding medical records were reviewed and the characteristics of these patients were analyzed. Results: Sixty-six children with positive serology were identified, of which 49 had a complete medical record that allowed review. Of these, 29 (60%) were boys. The mean age at which IgM serology was requested was 33 days. The principal manifestations leading to serology were hepatosplenomegaly, microcephaly and multiple congenital anomalies. The initial diagnosis was TORCH infection. Of the 49 patients, 45 were classified as CRS and four as infection with rubella. Conclusions: The present study highlights the need to increase active surveillance of CRS. Greater vigilance in applying the criteria for clinical diagnosis is required to allow an adequate degree of suspicion and early reporting of cases.

revelo la presen-cia del virus en ninos con infeccion respiratoria en los cua-les estudios por otros virus respiratorios fueron negativos.Analisis serologicos posteriores revelaron que a la edadde 5 anos, virtualmente todos los ninos han sido infectadospor este virus y que el mismo ha estado circulando apro-ximadamente por mas de 43 anos en algunas poblaciones