Background To date, few data on paediatric COVID-19 have been published, and most reports originate from China. This study aimed to capture key data on children and adolescents with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection across Europe to inform physicians and health-care service planning during the ongoing pandemic. Methods This multicentre cohort study involved 82 participating health-care institutions across 25 European countries, using a well established research network-the Paediatric Tuberculosis Network European Trials Group (ptbnet)-that mainly comprises paediatric infectious diseases specialists and paediatric pulmonologists. We included all individuals aged 18 years or younger with confirmed SARS-CoV-2 infection, detected at any anatomical site by RT-PCR, between April 1 and April 24, 2020, during the initial peak of the European COVID-19 pandemic. We explored factors associated with need for intensive care unit (ICU) admission and initiation of drug treatment for COVID-19 using univariable analysis, and applied multivariable logistic regression with backwards stepwise analysis to further explore those factors significantly associated with ICU admission. Findings 582 individuals with PCR-confirmed SARS-CoV-2 infection were included, with a median age of 5•0 years (IQR 0•5-12•0) and a sex ratio of 1•15 males per female. 145 (25%) had pre-existing medical conditions. 363 (62%) individuals were admitted to hospital. 48 (8%) individuals required ICU admission, 25 (4%) mechanical ventilation (median duration 7 days, IQR 2-11, range 1-34), 19 (3%) inotropic support, and one (<1%) extracorporeal membrane oxygenation. Significant risk factors for requiring ICU admission in multivariable analyses were being younger than 1 month (odds ratio 5•06, 95% CI 1•72-14•87; p=0•0035), male sex (2•12, 1•06-4•21; p=0•033), pre-existing medical conditions (3•27, 1•67-6•42; p=0•0015), and presence of lower respiratory tract infection signs or symptoms at presentation (10•46, 5•16-21•23; p<0•0001). The most frequently used drug with antiviral activity was hydroxychloroquine (40 [7%] patients), followed by remdesivir (17 [3%] patients), lopinavir-ritonavir (six [1%] patients), and oseltamivir (three [1%] patients). Immunomodulatory medication used included corticosteroids (22 [4%] patients), intravenous immunoglobulin (seven [1%] patients), tocilizumab (four [1%] patients), anakinra (three [1%] patients), and siltuximab (one [<1%] patient). Four children died (case-fatality rate 0•69%, 95% CI 0•20-1•82); at study end, the remaining 578 were alive and only 25 (4%) were still symptomatic or requiring respiratory support. Interpretation COVID-19 is generally a mild disease in children, including infants. However, a small proportion develop severe disease requiring ICU admission and prolonged ventilation, although fatal outcome is overall rare. The data also reflect the current uncertainties regarding specific treatment options, highlighting that additional data on antiviral and immunomodulatory drugs...

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BackgroundThe aim of this study was to review the current status and usage of guidelines in the diagnosis and treatment of community-acquired pneumonia (CAP) in European countries and to compare to established guidelines in the United States (US), United Kingdom (UK), and the World Health Organization (WHO).MethodsA questionnaire was developed and distributed by the Community-Acquired Pneumonia Paediatric Research Initiative (CAP-PRI) working group and distributed to medical centres across Europe.ResultsOut of 19 European centres, 6 (31.6 %) used WHO guidelines (3 in combination with other guidelines), 5 (26.3 %) used national guidelines, and 5 (26.3 %) used local guidelines. Chest radiograph and complete blood count were the most common diagnostic examinations, while evaluation of clinical symptoms and laboratory tests varied significantly. Tachypnoea and chest recession were considered criteria for diagnosis in all three guidelines. In US and UK guidelines blood cultures, atypical bacterial and viral detection tests were recommended. In European centres in outpatient settings, amoxicillin was used in 16 (84 %) centers, clarithromycin in 9 (37 %) centers and azithromycin in 7 (47 %) centers, whereas in hospital settings antibiotic treatment varied widely. Amoxicillin is recommended as the first drug of choice for outpatient treatment in all guidelines.ConclusionsAlthough local variations in clinical criteria, laboratory tests, and antibiotic resistance rates may necessitate some differences in standard empirical antibiotic regimens, there is considerable scope for standardisation across European centres for the diagnosis and treatment of CAP.Electronic supplementary materialThe online version of this article (doi:10.1186/s41479-016-0005-y) contains supplementary material, which is available to authorized users.

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Įvadas. Lietuvoje, kaip ir daugelyje pasaulio šalių, sergamumas kokliušu plečiasi, nors skiepijimų apimtys nuo šios infekcijos ir yra didelės. Kokliušu serga įvairaus amžiaus asmenys, tačiau jis pavojingiausias naujagimiams ir pirmųjų gyvenimo mėnesių kūdikiams. Šiai vaikų amžiaus grupei apsaugą nuo kokliušo galėtų užtikrinti transplacentaliai gauti specifiniai antikūnai iš mamos organizmo. Tyrimo tikslas -nustatyti specifinių antikūnų prieš B. pertussis toksiną (anti-PT IgG) titrus gimdyvių ir kūdikių virkštelių kraujyje bei įvertinti tikėtiną naujagimių imlumą B. pertussis infekcijai.Tiriamieji ir tyrimo metodika. Siekiant įvertinti mamos ir naujagimio imunitetą kokliušui, buvo tiriamas gimdyvės ir virkštelės kraujas, jame nustatomi G klasės antikūnai prieš B. pertussis toksiną.Rezultatai. Iš viso išanalizuota 400 kraujo mėginių (200 gimdyvių ir 200 virkštelių), juose nustatytas anti-PT IgG kiekis. Beveik 87 % nėščių-jų buvo seronegatyvios, anti-PT IgG kiekis jų kraujyje siekė <20 EU/ml. Virkštelės kraujo mėginiuose anti-PT IgG <20 EU/ml buvo 72,5 %.Išvados. Mūsų tyrimo rezultatai atskleidė, kad tiek vaisingo amžiaus moterų, tiek virkštelės kraujyje kokliušui specifinių antikūnų kiekiai yra labai maži, jie neužtikrina naujagimių apsaugos nuo šios ligos. Dėl nepakankamo iš mamos organizmo gautų kokliušui specifinių antikūnų kiekio naujagimių imlumas B. pertussis infekcijai yra didelis.Raktažodžiai: kokliušas, gimdyvė, virkštelės kraujas, naujagimis