OBJECTIVE: We investigated whether immunoglobulin levels on admission are associated with disease severity, time to negativization of SARS-CoV-2 RT-PCR test, and length of hospital stay in children with severe illness requiring hospitalization. MATERIAL AND METHODS: Forty-four pediatric patients hospitalized and treated for COVID-19 were included. The patients were divided into two groups as those with mild-to-moderate (n=35) and those with severe disease (n=9) for ease of evaluation. The relationship of immunoglobulin levels with disease severity, time to SARS-CoV-2 RT-PCR test negativization and length of hospital stay was examined. RESULTS: The study population had a median (min-max) age of 13 (1-18) years and consisted of 25 (56.8%) girls and 19 (43.2%) boys. IgG levels were normal in 89.2% (n=33) and elevated in 5.7% (n=2) of the children with mild-to-moderate disease. Among patients with severe disease, IgG levels were normal in 44.4% (n=4) and elevated in 55.6% (n=5). A significant difference was found between the groups in terms of IgG levels (p=0.002). When the relationship of IgG level with length of hospital stay and time to SARS-CoV-2 RT-PCR test negativization was investigated, no significant correlation was observed between time to SARS-CoV-2 RT-PCR test negativization and Ig G level (p=0.096, z=1.667). However, the length of hospital stay was significantly longer in patients with elevated IgG levels (p=0.096, p=0.002). CONCLUSIONS: Higher-than-normal endogenous IgG levels may be independently associated with the development of severe illness and prolonged hospital stay in children hospitalized for COVID-19.

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Background. Fever is one of the leading causes of hospital admissions in children. Although there are many ways to measure body temperature, the optimal method and the anatomic site are still controversial. In this study, we aimed to evaluate the performance of new methods of measuring body temperature and to compare the accuracy, sensitivity and specificity of these methods.Methods. The body temperatures of the patients who were hospitalized as inpatients or who presented to the emergency room as outpatients between November 2014-March 2015 were measured and recorded. Mercury and digital axillary measurements, tympanic, temporal artery and non-contact skin temperatures were measured. Measurements were compared with each other.Results. According to our results temperature tends to increase over time for up to 8 minutes after placement when using axillary thermometers. Non-contact skin thermometers should be used only for follow-up of patients with fever, because of their low sensitivity and low negative predictivity. At the first examination, tympanic thermometers and axillary thermometers may be preferable for the diagnosis of fever. Conclusions.According to our results, using non-contact thermometers seems feasible and logical during the follow-up ofpatients with fever, but not in cases whose exact body temperature should be known. For the first examination of the patient to diagnose fever, tympanic thermometers and axillary thermometers may be preferable. Future studies are warranted to expose the optimum way of measuring body temperature in children.

Objective Routine screening of household members of index cases is a priority in regions where brucellosis is endemic. This study aimed to identify seropositive and seronegative pediatric patients by screening the siblings of our pediatric patients diagnosed with brucellosis (index cases) and to investigate the relationships among these groups by comparatively evaluating their demographic, epidemiological, clinical, and laboratory characteristics. Materials and Methods Eighty-five pediatric household members of 59 pediatric patients diagnosed with acute brucellosis were evaluated. A total of 144 children were included in the study. Results Among 85 pediatric household members, 34 (40%) children were seropositive and 51 (60%) were seronegative. The predominant clinical symptom was arthralgia (81.4%), and the main finding was abnormal liver function tests (LFTs). The most frequent osteoarticular involvement was monoarticular arthritis (88%). Index cases and seropositive patients showed significantly greater elevations in LFTs compared with seronegative patients (p < 0.001 and p < 0.001). C-reactive protein values of index cases and seropositive patients were significantly higher compared with seronegative patients (p < 0.001 and p = 0.001). Neutrophil and platelet counts of index cases were significantly lower than those of seronegative patients (p = 0.017 and p = 0.002). Index cases and seropositive patients were given treatment, and after follow-up of at least 1 year, none of the seropositive patients relapsed, but relapse occurred in nine (15.3%) children from the index group. Two (3.9%) seronegative patients were diagnosed with acute brucellosis. Conclusion Additional cases of brucellosis can be detected by screening household members of index cases in endemic areas. Elevations in LFTs when detected early in the asymptomatic period may provide a clue for brucellosis.

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