Latin America (LATAM) children offer special insight into Severe Acute Respiratory Syndrome Coronavirus 2 (SARS COV2) due to high-risk race/ethnicity, variability in medical resources, diverse socioeconomic background, and numerous involved organ systems. This multinational study of LATAM youth examined the distinguishing features of acute or late multisystem SARS COV2 with versus without cardiac involvement. A consecutive sample of youth 0–18 years old ( N = 98;50% male) presenting with multisystem SARS COV2 to 32 centers in 10 Latin American countries participating in a pediatric cardiac multi-imaging society were grouped as with versus without cardiac involvement, defined as abnormal echocardiographic findings or arrhythmia. Collected clinical data were analyzed by Student’s t -test or Fisher’s exact test. Cardiac ( N = 48, 50% male) versus no cardiac ( N = 50, 50% male) were similar in age; weight; nonrespiratory symptoms; and medical history. The cardiac group had 1 death and symptoms including coronary artery dilation, ejection fraction <50%, pericardial effusion, peripheral edema, arrhythmia, and pulmonary artery thrombus. The cardiac group had higher risk of ICU admission (77% vs 54%, p = 0.02); invasive ventilation (23% vs 4%, p = 0.007); vasoactive infusions (27% vs 4%, p = 0.002); prominent respiratory symptoms (60% vs 36%, p < 0.03); abnormal chest imaging (69% vs 34%, p = 0.001); troponin (33% vs 12%, p = 0.01); alanine aminotransferase (33% vs 12%, p = 0.02); and thrombocytopenia (46% vs 22%, p = 0.02). Receiver operating curve analysis showed that abnormal laboratories had 94% sensitivity and 98% negative predictive value on the need for ICU interventions. Conclusion : In LATAM children with multisystem SARS COV2, cardiac involvement was prevalent. Cardiac involvement was more likely to require ICU interventions, certain abnormal labs, and respiratory involvement. What is Known: • SARS COV2 can be asymptomatic in children but in some cases can have serious multisystemic involvement. • Hispanic ethnicity is purportedly at high risk of SARS COV2 in nations where they are often disadvantaged minority populations. What is New: • Latin American children presenting with multisystem SARS COV2 frequently have cardiac involvement which was associated with ICU interventions; prominent respiratory symptoms; abnormal chest X-ray; elevated troponin, ALT, and thrombocytopenia. • Elevated troponin, ALT or thrombocytopenia had high sensitivity and negative predictive value on the need for intensive care interventions. Supplementary Inf...
This work explores the extreme violence against women before and during the COVID-19 pandemic in Peru, considering different restriction periods. This is relevant in view of increased violence against women. The objective of this work was to identify the feminicide and attempted feminicide during different quarantine periods due to the COVID-19 health emergency in Peru, and to determine the variables related to these. Data of administrative records of the cases of feminicide and attempted feminicide were analyzed. Our results show that cases of attempted feminicide occurred in higher proportions during the prequarantine period compared to the other periods. In the case of feminicide, its highest percentage occurred during quarantine with a relationship relatively intense when the victim has suffered physical and psychological violence. Also, we find that attempted feminicide was 4.3 times more likely to happen to urban resident victims, 7.9 times more likely when women suffered physical violence, and 7.4 times when they were victims of psychological violence. During quarantine, attempted feminicide was more likely when a victim lives in an urban area (3.5 times), when the victim suffered physical and psychological violence (21.7 and 5.2 times, respectively), and 3.1 times more likely when the attempted feminicide occurred inside the household. The cases of attempted feminicide that occurred during restrictive measures are 5.0 times more likely when a victim belongs to urban areas, 23.4 times more likely when the woman suffered physical violence, and 4.3 times more likely when she was a victim of psychological violence.
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