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.
Aim. Comparision of the incidence of cervical lymphadenitis caused by nontuberculous mycobacteria in two equal time periods before and after the ending of widespread calmetization (tuberculosis vaccination). Backgroung. From 2011 to 2018, 89 children were registered in the Tuberculosis Register with cervical lymphadenitis caused by nontuberculous mycobacteria, as confirmed by cultivation. In the majority of cases, the infection was caused by a mycobacterium belonging to the Mycobacterium avium complex. Only 7 cases of cervical lymphadenitis of the same etiology were registered during the same time interval between 2003 and 2010. The authors consider the ending of widespread calmetization (tuberculosis vaccination) in 2010 to be the main cause of the growing incidence. Method. A comparison of data for the period 2003-2018 about cases of the illness caused by atypical mycobacteria as reported in the Tuberculosis Register. Results. The average incidence per year in the first interval was 0.04/100 000 children and in the second interval 0.53/100 000 children. During the second time interval, there was an increase from 0.14/100 000 children in 2011 to 1.40/100 000 children in 2018. While the incidence during the first time interval did not show any time trend (P=0.885), the year 2010 marks a significant turning point, with growth during the second interval being highly statistically significant (P<0.001).
We present an otherwise healthy, fully immunized 12-year-old girl who was transferred intubated and ventilated to our Paediatric Intensive Care Unit with fever, cough, and acute respiratory failure. The epidemiologic history was positive for COVID-19, and, furthermore, she tested PCR positive resulting from a nasopharyngeal swab. CT of the thorax revealed bilateral consolidation with the tree-in-bud signs. Her condition required artificial ventilation support for 13 days. Remdesivir, pronation, high dose Ascorbic acid with Thiamine, and combined antimicrobial therapy were successfully used. Our patient made a full clinical recovery. The case demonstrates that even though critical course of COVID-19 infection in children is scarce, it might occur. We hereby would like to share our experience with the medical community.
Článek pojednává o epidemiologii, diagnostice a léčbě dětské tuberkulózy. Podrobněji se věnuje i netuberkulózním mykobakteriózám, konkrétně aviární lymfadenitidě. Samostatný odstavec je zaměřen na problematiku TBC a NTM v ordinaci PLDD.
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