Recent studies have shown that several children diagnosed with COVID-19 have developed Kawasaki Disease (KD)-like symptoms. This systematic review aims to assess the demographic, laboratory, and clinical characteristics of children with KD-like syndrome during the COVID-19 pandemic and evaluate efficacy of treatments and patients' outcome. A comprehensive search was carried out systematically through PubMed, Scopus, and Web of Science (WoS), medRxiv, and bioRxiv by two reviewers independently for all studies or preprints data on the demographic, laboratory, and clinical characteristics of children with K.D-like signs during the COVID-19 outbreak. Overall, 378 studies were identified by the systematic search, of which 25 studies were included in the study. The included studies involved 599 patients in total. Thirteen studies (52%) were case reports or case series, and the rest (48%) were cohort studies. In 19 studies, patients were diagnosed with Multisystem inflammatory syndrome in children (MIS-C). In 16 studies COVID-19 was diagnosed in all patients based on their polymerase chain reaction result, serological findings, and computed tomography results. Higher C-reactive protein and erythrocyte sedimentation rate level were the most prevalent laboratory findings. In most studies, patients had leucopenia with marked lymphopenia, hypoalbuminemia, and increased ferritin, as well as hyponatremia. Abnormal echocardiography and respiratory outcomes were the most common clinical outcomes. In 11 studies, all patients required intensive care unit admission. Findings of the present systematic review show that the incidence of KD-like syndrome in the COVID-19 pandemic increased significantly. Moreover, this study offers new insights in the KD-like syndrome pathogenesis and clinical spectrum during COVID-19 pandemic.

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IntroductionWaist circumference-to-height ratio (WHtR) is a simple anthropometric index with good screening power and fast interpretation for early detection of childhood abdominal obesity. This systematic review and meta-analysis aims to determine the best cut-off value of WHtR to use in clinical setting.MethodsComprehensive searches were conducted in PubMed, Scopus, and Web of Science by the end of March 2021. Observational studies investigated the best WHtR cut-off to detect abdominal obesity in children and adolescents were included. Thirteen articles (n = 180,119) were included in this systematic review and eight documents were included in the meta-analysis.ResultsThe overall optimal cut-off was 0.49 with pooled sensitivity, specificity and diagnostic odds ratio (DOR) of 0.93 (95% confidence interval (CI): 0.93–0.96), 0.88 (95% CI: 0.85–0.91) and 102.6 (95% CI: 50.7–207.5), respectively. The optimal WHtR cut-off to predict abdominal obesity in girls and boys were both 0.49.DiscussionThe current study shows that we could use this cut-off as a simple index for predicting abdominal obesity in children and adolescents without the need for any charts in practice.

Human astroviruses (HAstVs) have frequently been detected in individuals with acute gastroenteritis (AGE). However, a precise estimate of the overall prevalence of the virus in children with AGE as well as the possible association of the virus with gastrointestinal complications is not available up to now. The present study estimated the overall prevalence of HAstVs in children with gastrointestinal complications as well as the association between the virus and symptoms. We systematically searched four international databases (PubMed, Scopus, Web of Science, and Google scholar) to find studies on the prevalence of HAstVs in people with AGE published between Jan 2000 and Sep 2021. Analysis of the 223 included studies presented a 4.2% (95% CI 3.8%–4.8%) prevalence of the virus in AGE individuals. Based on case‐control studies, a significant association between these viruses and AGE was detected (OR: 2.059, 95% CI; 1.438–2.949). HAstV‐1 and HAstV‐VA‐2 is the most and least common genotypes in the AGE patients, respectively (59.0%, 95% CI: 52.1%–65.6% vs. 4.9%, 95% CI: 2.6%–9.1%). Due to the statistically significant association between HAstV and gastrointestinal complications, more attention should be paid to these viruses in people with AGE and more studies should employ case‐control design.

Background: The administration of Haemophilus influenzae type b (Hib) conjugate vaccine led to a decrease of over 90% in the prevalence of severe Hib diseases in the countries with universal coverage vaccine. After addition of Hib vaccine to the national vaccination program and since no study has yet investigated this subject. Objectives: The current study aimed at investigating the serologic response and assessing oropharyngeal colonization with Hib after the last dose of vaccine. Methods: A total of 500 blood and oropharyngeal samples were collected from one-year-old children referred to Karaj health care centers, Iran. Demographic information and risk factors of the children were collected. Oropharyngeal and blood samples were transferred to the laboratory to determine antibody titer by the enzyme-linked immunosorbent assay (ELISA) technique, culture testing, and polymerase chain reaction (PCR). Results: In the current study, 11.8% of children (95% confidence interval (CI): 8.97-14.63) had an anti-Hib IgG titer of ≥ 5 µg/mL. Geometric mean titer (GMT) of vaccine antibody was 6.92 µg/mL (95% CI: 6.76-7.08); 9% of oropharyngeal culture results were positive for H. influaenzae (non-type b) and 8.2% were confirmed by PCR. Prevalence of oropheryngeal Hib colonization was 0.02%. There was no significant correlation between the titer of H. influaenzae antibody and positive culture of H. influaenzae and the other studied variables (P > 0.05). Conclusions: In Iran, similar to most countries, pentavalent vaccine in national vaccination program decreased the prevalence of Hib colonization. Prevalence of Hib colonization is an important factor in invasive diseases incidence. It is suggested that further studies asses the prevalence of invasive Hib diseases after national vaccination.