The aim of this study was to describe the rate and types of community-acquired respiratory infections observed in a pediatric ED during the SARS-CoV-2 related lockdown in Italy and to compare data with the same period of previous year. Methods: A retrospective analysis of medical charts of patients arrived at the ED of Gaslini Children's Hospital from 10th March 2020 to 30th April 2019 and the same frame of 2020 were performed. We compared two groups by demographics, duration of fever before ED admission, triage code, number of patients hospitalized after ED evaluation. We calculated proportion and incidence rate for airborne infections, fever, and urinary tract infections (UTI), appendicitis, and gastroenteritis for control. Results: 1362 children arrived at the ED during the lockdown compared to 5628 in the same period of 2019 (−75,8%). No difference was noticed (27.7% vs 28.4%) in the total amount of infectious episodes. A significant reduction in rate of incidence and proportion were observed for upper respiratory tract infections (21,4% vs 28%), otitis (2,6% vs 16,2%), streptococcal infections (0,5% vs 5,2%) and bronchiolitis (2,1% vs 5,7%). Conversely, FUO (27,8 vs 11,1%), infectious mononucleosis (2,6% vs 0,4%), UTI (7,4% vs 2,9%) and appendicitis (6,8% vs 1,1%) significantly increased. Median time from the onset of fever and arrival in ED was significantly lower in 2020 group. Conclusion:Our results demonstrated a reduction in community-acquired respiratory infections during the lockdown for COVID-19. The increase in rate of FUO and febrile conditions, together with the short time from fever onset and ED visit could be related to the fear for a SARS-CoV-2 infection.

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Assessment of endothelial dysfunction in cancer survivors may have a role in the early identification of non-communicable diseases and cardiovascular late effects. Oncological therapies may impair endothelial function. Therefore, in patients such as childhood cancer survivors who could benefit from early cardioprotective pharmacological interventions, it is essential to monitor endothelial function, even if the optimal methodology for investigating the multifaceted aspects of endothelial dysfunction is still under debate. Biochemical markers, as well as invasive and non-invasive tools with and without pharmacological stimuli have been studied. Human clinical studies that have examined lifestyle or cancer treatment protocols have yielded evidence showing the involvement of lipid and lipoprotein levels, glycemic control, blood pressure, adiposity, inflammation, and oxidative stress markers on the state of endothelial health and its role as an early indicator of cardiometabolic risk. However, with regards to pharmacological interventions, cautious interpretation of the result attained whilst monitoring the endothelial function is warranted due to methodological limitations and substantial heterogeneity of the results reported in the published studies. In this narrative review, an overview of evidence from human clinical trials examining the effects of cancer therapies on endothelial disease is provided together with a discussion of endothelial function assessment using the different non-invasive techniques available for researchers and clinicians, in recent years.

Purpose:A variable proportion of children with COVID-19-related illness required pediatric intensive care admission (ICU), although, in many cases, only for monitoring, frequent and complex therapies, or for concerns related to relevant comorbidities or young age. This may have determined inappropriate admissions, waste of resources, ICU overcrowding and psychological effects on children and families. Pediatric Intermediate Care Unit (IMCU) may represent an appropriate unit to care for children who need monitoring and treatment beyond what can be offered in a general pediatric floor but do not qualify for pediatric ICU admission. Methods:We conducted a single-center retrospective study of all patients aged 0-18 with acute COVID-19 or meeting diagnostic criteria for multisystem inflammatory syndrome in children, admitted to a newly established pediatric IMCU at Gaslini Hospital, Genoa, Italy, between 1 March 2020 and 31 January 2022. Results:Among 550 patients hospitalized for acute COVID-19 or MIS-C, 106 (19.2%) were admitted to IMCU. Three patients (2.8%) needed escalation to intensive care. Overall, the need for pediatric ICU admission was considerably low for both acute COVID-19 patients (0.8%) and MIS-C patients (3.1%) compared to literature data. Conclusions: The IMCU represented an adequate setting for COVID-19 children who needed a higher level of care, but not requiring critical care, thus allowing better ICU bed utilization and cost savings. Further studies are needed to better assess the impact of an IMCU on hospital costs, ICU activity, and long-term psychological effect among children and their families.