Search

In the period 2020-2022 as a result of epidemiological measures specific to the COVID-19 pandemic (protective mask, online teaching activity, social distancing) we witnessed a considerable decrease in the number of cases of respiratory viroids in children. With the lifting of prophylactic measures that coincided with the start of physical teaching activities and the onset of the cold season, we have been confronted in pediatric wards with an increase in the incidence of virological infections in the pediatric population. In this article we aim to analyze the particularities of respiratory virological diseases in children in the season 2022 - 2023 both from the etiological and epidemiological point of view and the characteristic clinical forms of the disease. We conducted a retrospective clinical study of cases admitted to the Clinical Departments of Infectious DiseasesPediatrics of the National Institute of Infectious Diseases “Prof. Dr. Matei Bals” in the period October 2022 - March 2023. During this period, we recorded 3.012 cases of respiratory virology in children, which represents the majority of pediatric pathology admitted (72,9 %). The peak incidence of respiratory virology occurred in December (688 cases). From the etiological point of view, most cases were SARS-CoV-2 infections, followed by influenza (predominantly type A), then a smaller number of infections with respiratory syncytial virus (RSV), rhinovirus, adenovirus, metapneumovirus. The most common clinical form of the disease was moderate (66.9%), with severe forms accounting for 10.5%. All pediatric cases of respiratory virology admitted to our wards have evolved favorably, with no deaths. [ABSTRACT FROM AUTHOR]

SARS-CoV-2 infection is usually a self-limiting viral infection in healthy children. Still, it’s effects on the neonatal population remain largely unknown. There has been evidence of adverse events on neonates, mostly consisting in case reports of patients with severe forms of COVID-19 and also recent cohort studied of the pediatric population including the neonatal subgroup. The clinical presentation appears different in the neonatal patients in contrast with older children, and may manifest also as a life-threatening respiratory infection with systemic complications. In this paper we present a clinical case of a premature boy with a corrected age of 40 weeks at admission to the Pediatric Infectious Diseases Clinical Department IX of the National Institute of Infectious Diseases “Prof. Dr. Matei Bals” with the diagnosis of SARS-CoV-2 infection. The positive diagnosis was established on suggestive clinical picture (fever, dry couch, rhinorrhea, loose stools and inappetence) and confirmed by SARS-CoV-2 rapid antigen test. Laboratory investigations at admission showed only moderate to severe anemia, mild inflammatory syndrome and a mild neonatal hyperbilirubinemia, with normal leukocyte count, normal glycaemia, ionograme and blood gases. Chest x-ray showed moderate interstitial pneumonia. In the second day of admission, after 24h of favorable evolution, with no fever and present appetite, he suddenly presented during defecation a presumptive vasovagal syndrome, with general hypotonia and a short period of desaturation. Laboratory investigations made during the episode showed normal glycaemia, normal ionograme, normal blood gases, moderate-severe anemia and important metabolic acidosis. A new chest x-ray showed evolution of the interstitial pneumonia. We did a blood transfusion and continued antiviral treatment, antibiotic treatment and perfusions. He maintained normal pulmonary and cardiac function for another 6 hours, after which he presented a tonic-clonic seizure and after administration of intrarectal benzodiazepines he presented cardio-pulmonary arrest. He was resuscitated, intubated and sedated and transfer to a children ICU. 2 weeks later after admission in the ICU he was discharged with favorable outcome. The case presented shows that although SARS-CoV-2 infection is often a mild condition in children, COVID-19 in neonates can have an unpredicted course. Rapid evolution to sever forms can be a possible disease outcome. Preterm birth with associated complications like bronchodysplasia or anemia, can predispose to sever evolution of the disease, and this child must be kept safe. There is also a neurotropic potential of the SARS-CoV-2 virus that has to be followed. [ABSTRACT FROM AUTHOR]

Norovirus represents the most frequent cause of pediatric gastroenteritis requiring medical care. We conducted a prospective study on 276 patients admitted to a tertiary hospital in Romania from January 2017 to December 2019 to estimate the clinic-epidemiological and evolutionary impact of Norovirus infection. Among the 276 patients, the median age was 2.34 years, and 57.61% were male. The frequency of hospitalizations in a year was higher in August, September, and October, and 72.1% of patients were from urban areas. Diarrhea (92.58%), vomiting (83.33%), anorexia (92.03%), and fever (57.61%) predominated, while abdominal pain (46.74%), nausea (30.8%), headache (18.84%), and myalgia (18.12%) were in lower percentages. Dehydration occurred in 99.28% of patients. Using the Pearson correlation coefficient, we formulated two hypotheses: in the 0-4 years category, the number of cases requiring hospitalization is inversely proportional to age (Pearson coefficient age-number of cases - 0.92), and the younger the age, the more it is associated with other infections and the longer the hospitalization duration. Conclusions. The clinic-epidemiological characteristics of patients with Norovirus infection are influenced by age – the younger the age, the longer the hospitalization duration and the higher the presence of associated infections; the average age is 2.34 years, with a predominance of males and children from urban areas. Hospitalization is high in August, September, and October, and diarrhea, vomiting, and anorexia predominate. [ABSTRACT FROM AUTHOR]