Background Understanding the prevalence and clinical presentation of coronavirus disease 2019 in pediatric patients can help healthcare providers and systems prepare and respond to this emerging pandemic. Methods This was a retrospective case series of patients tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) across a pediatric healthcare network, including clinical features and outcomes of those with positive test results. Results Of 7256 unique children tested for SARS-CoV-2, 424 (5.8%) tested positive. Patients aged 18–21 years had the highest test positive rate (11.2%), while those aged 1–5 years had the lowest (3.9%). By race, 10.6% (226/2132) of black children tested positive vs 3.3% (117/3592) of white children. By indication for testing, 21.1% (371/1756) of patients with reported exposures or clinical symptoms tested positive vs 3.8% (53/1410) of those undergoing preprocedural or preadmission testing. Of 424 patients who tested positive for SARS-CoV-2, 182 (42.9%) had no comorbidities, 87 (20.5%) had asthma, and 55 (13.0%) were obese. Overall, 52.1% had cough, 51.2% fever, and 14.6% shortness of breath. Seventy-seven (18.2%) SARS-CoV-2–positive patients were hospitalized, of whom 24 (31.2%) required respiratory support. SARS-CoV-2-targeted antiviral therapy was given to 9 patients, and immunomodulatory therapy to 18 patients. Twelve (2.8%) SARS-CoV-2-positive patients required mechanical ventilation, and 2 patients required extracorporeal membrane oxygenation. Two patients died. Conclusions In this large cohort of pediatric patients tested for SARS-CoV-2, the rate of infection was low but varied by testing indication. The majority of cases were mild and few children had critical illness.

Pediatric liver transplant (LT) recipients are often transplanted at a young age, precluding them from receiving live virus vaccinations (LVV) such as varicella (VZV) vaccine and measles, mumps and rubella. This places them at profound risk for vaccine preventable illness. We sought to detail safety of vaccination. This was a retrospective cohort study of pediatric LT recipients at two children's hospitals. Among 204 LT recipients included in the study, 97 received at least one LVV after LT. Six patients who did not receive LVV after transplant had evidence of vaccine‐preventable infection following vaccination (one disseminated VZV disease, five VZV‐related rash), while one patient who received LVV after transplant developed a diffuse VZV‐related rash. Rejection rates were the same between those that did and did not receive a live virus vaccine post‐transplant. There were no serious adverse events caused by vaccination post‐transplant. LVV following LT was safe at our two institutions, although there exist limitations in our study due to its retrospective study design. Larger scale studies should be performed to evaluate the effectiveness of LVV in relation to immunosuppression.

These data demonstrate that corneal exposure to MPS during lens wear damages the surface epithelium and are consistent with our previous clinical data showing an increase in bacterial binding to exfoliated epithelial cells following MPS use with resultant increased risk for lens-mediated infection. These findings also demonstrate that the PA invasion assay may provide a highly sensitive quantitative metric for assessing the physiological impact of lens-solution biocompatibility on the corneal epithelium.

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Acute myeloid leukaemia (AML) requires intensive chemotherapy for cure. Regimens from the Children's Oncology Group (COG) represent the most common treatment approach to paediatric AML in North America. These regimens utilize up to five cycles of intensive chemotherapy, with a high anthracycline burden (~492-684 mg/m 2 doxorubicin equivalents), 1 contributing to acute morbidity and long-term cardiotoxicity. 2 The United Kingdom Medical Research Council (MRC) AML 15 randomized trial tested a new double induction regimen of fludarabine, high-dose cytarabine (HDAc), G-colony stimulating factor (GCSF) and idarubicin (FLAG-IDA) in adults and a small subset of paediatric patients. 3 MRC 15 included four cycles of chemotherapy with lower intensity and less anthracycline exposure (cumulatively, ~240 mg/m 2 doxorubicin equivalents), and demonstrated excellent survival. 3 As a result, we adopted MRC-15-based therapy as routine care. Between 2014 and 2021, we treated 30 patients with de novo AML (Table 1) and describe here disease response, morbidity and survival. Each case was characterized by cytogenetics, chromosomal microarray and a proprietary molecular testing panel (OncoKids®). 4 Treatment was delivered per MRC 15, 5 adapted to reflect institutional standard of care. Briefly, patients received double induction chemotherapy (fludarabine 30 mg/m 2 and cytarabine 2 g/m 2 IV days 2-6, idarubicin 8 mg/m 2 IV days 4-6, GCSF 5 mcg/kg days 1-7 [optionally omitted for patients with leukocytosis]) followed by double consolidation (cytarabine 3 g/m 2 q12 hours days 1,3,5). Following regulatory approval in 2017, patients with CD33+ received gemtuzumab ozogamicin (GO, 3 mg/m 2 IV day 7, maximum dose 4.5 mg) as per treating physician discretion. Tyrosine kinase inhibitors (TKI) were optionally included for patients with FLT3 mutations. Disease response was assessed by flow-cytometric minimal residual disease (MRD) following Induction I (and II, if positive) using a 'difference from normal' approach. 6 MRD+ was defined using COG threshold at the time of treatment (≥0.1%). 7 Final risk category was assigned from presenting molecular analyses and post-Induction I MRD using COG classification at the time of diagnosis (per AAML1031 or AAML1831) (Table S1).