Liver Involvement in Children with COVID-19 and Multisystem Inflammatory Syndrome: A Single-Center Bulgarian Observational Study

Lazova, Snezhina; Alexandrova, Tea; Gorelyova-Stefanova, Nadzhie; Atanasov, K; Tzotcheva, Iren; Velikova, Tsvetelina

doi:10.3390/microorganisms9091958

Cited by 20 publications

(26 citation statements)

References 33 publications

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“…Bulgaria and the Bulgarian public health system were also in a difficult situation. In this regard, several studies on SARS-CoV-2 infection had been conducted in our country, including: a seroepidemiological survey [ 10 ]; research on clinical characteristics of patients with COVID-19 [ 11 , 12 ]; studies of immune response to SARS-CoV-2 vaccines [ 13 , 14 , 15 ]; research into adverse events of COVID-19 vaccines [ 16 ]; studies dealing with inconclusive SARS-CoV-2 PCR samples [ 17 ]; and studies of liver involvement in children with COVID-19 and multisystem inflammatory syndrome [ 18 ]. The Bulgarian vaccination process started on 26 December 2020.…”

Section: Discussionmentioning

confidence: 99%

Students’ Attitudes toward COVID-19 Vaccination: An Inter-University Study from Bulgaria

Moskova

Zasheva

Kunchev

et al. 2022

IJERPH

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In Bulgaria, vaccination coverage against the SARS-CoV-2 virus is low. The reasons for this fact are many and varied. The aim of the present study was to establish what the attitudes towards the COVID-19 vaccination process are among students from various specialties from several Bulgarian universities. In this research, 600 students participated, divided into two groups: Doctor of Medicine (MD) students (n = 300) and non-MD students, i.e., students of specialties, such as mathematics, engineering, finance and economics, law, human sciences, etc. (n = 300). Each respondent completed a questionnaire which was divided into three parts with closed questions. The mean age of all students was 21.19 ± 1.87 years (95% CI: 20.48–21.90). The female sex dominated among the analyzed participants (sex ratio: female/male = 1/0.85). Nearly 62% (371/600) of individuals declared that they have been COVID-19 vaccinated with at least one dose (p < 0.001). Overall, 33% of the participants sought information on vaccines from video sharing platforms and 36.0% (216/600) from social media platforms. From the conducted multivariable logistic regression the odds of vaccination against COVID-19 were 6.225 times higher in individuals with a positive attitude towards these vaccines than in people with a negative attitude towards them (p < 0.001). We have found that those students who trust the international health organizations had an OR of 2.365 (p = 0.004) to be SARS-CoV-2 vaccinated. We estimated that the odds of vaccination against SARS-CoV-2 among children were 4.794 times higher in parents (students) who had been vaccinated than in non-vaccinated parents (students) (p < 0.001). Our results could support the national public health organizations, the national educational/scientific systems, and the management of Bulgarian universities in making future decisions about the field of COVID-19 control and prevention.

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Section: Discussionmentioning

confidence: 99%

Students’ Attitudes toward COVID-19 Vaccination: An Inter-University Study from Bulgaria

Moskova

Zasheva

Kunchev

et al. 2022

IJERPH

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“…Terms like multisystem inflammatory syndrome (52), MISC/MIS-C (48/17), Kawasaki disease/Kawasaki-disease/Kawasaki-like disease (11/10/4), macrophage activation syndrome/MAS (7/4), and toxic shock syndrome/TSS (8/2) are referring to studies that describe clinical or laboratory values of coronavirus disease 2019-related multisystem inflammatory syndrome in children or Kawasaki disease or TSS or MAS. Among MISC-related studies, some of them were addressing organ damage or impairment (liver [ 35 ], cardiac [ 32 , 36 , 37 , 38 , 39 ], and neurologic [ 40 ]).…”

Section: Discussionmentioning

confidence: 99%

Clinical and Laboratory Characteristics of Pediatric COVID-19 Population—A Bibliometric Analysis

Maniu

Totan

2022

JCM

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The literature on the COVID-19 landscape has rapidly expanded in the pandemic period. The current study undertakes a bibliometric analysis of research in the topic of the clinical and laboratory characteristics of pediatric COVID-19 cases. Our aim is to perform a comprehensive bibliometric review of current research trends and patterns of this research domain. Publications retrieved from the Web of Science Core Collection and VOSviewer were used for analysis and network visualization. We analyzed geographical distribution and temporal trends, collaboration and citation patterns of authors, institutions, and countries, and core research themes from co-occurrence of keywords and terms. The analysis showed that contributions in the research field were from 302 publications, 1104 institutions, 62 countries, and 172 journals. Many publications were authored by American and Chinese authors, and many were published in the Pediatric Infectious Disease Journal, Pediatric Pulmonology, and Frontiers in Pediatrics. The top cited and co-cited journals were the New England Journal of Medicine, Nature, JAMA, Lancet Infectious Diseases, and BMJ. The network visualization maps of keywords and terms offered a global overview of the clinical and laboratory characteristics of pediatric COVID-19 patients. The bibliometric profile of the researched domain, based on analyzing a large collection of publications/data, could (i) enrich the researchers and non-researchers understanding of the field existing patterns and trends, and (ii) be useful in clinical practice (diagnostic and management) and public health policy.

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“…With respect to the laboratory findings in children with COVID-19, studies suggest that the neutrophil count may be increased or decreased, while the lymphocyte count is usually decreased [ 41 ], which is expected in viral infections. Elevated liver enzymes (lactate dehydrogenase—LDH, aspartate aminotransferase—AST, and alanine aminotransferase—ALT) and D-dimer have been reported in severe cases of COVID-19 [ 42 , 43 ]. Similarly, elevated CRP and procalcitonin levels suggest a possible secondary bacterial infection and are the key indicators of inflammation, as leukocyte count is not a reliable indicator of disease severity in children.…”

Section: Discussionmentioning

confidence: 99%

Factors Associated with the Antibiotic Treatment of Children Hospitalized for COVID-19 during the Lockdown in Serbia

Prijić

Gazibara

Prijić

et al. 2022

IJERPH

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Unselective use of antibiotics to treat children with COVID-19 is one of the major issues during the pandemic in Serbia. Thus far, there has been no evidence about the predictors of multiple antibiotic use in the treatment of children with COVID-19. The purpose of this study was to assess the prevalence of antibiotic use, as well as to examine demographic and clinical factors associated with a greater number of antibiotics and with a longer antibiotic treatment administered to hospitalized children with COVID-19 during the lockdown in Serbia. This study included all children who were hospitalized from 6 March to 31 May 2020 at the only pediatric COVID-19 hospital, and who were confirmed to have SARS-CoV-2 infection. Demographic, clinical, and laboratory data were collected from medical records. The antibiotic treatment included the use of azithromycin, cephalosporin (ceftriaxone), ampicillin-amikacin, and hydroxychloroquine. The overall prevalence of antibiotics use in children hospitalized with COVID-19 regardless of age was 47.2% (43.3% in children aged 1–5 years and 44.4% in those aged 5–17 years). In children aged 1–5 years, not having a family member affected by COVID-19 (B = −1.38, 95% confidence interval [CI] −2.43, −0.34, p = 0.011), having pneumonia on chest X-ray (B = 0.81, 95%CI 0.34, 1.29, p = 0.002), being a boy (B = −0.65, 95%CI −1.17, −0.13, p = 0.018), and having higher C-reactive protein (CRP) values on admission (B = 0.12, 95%CI 0.07, 0.17, p = 0.001) were associated with the administration of a higher number of antibiotics. These factors, along with having fever (B = 3.20, 95%CI 1.03, 5.37, p = 0.006), were associated with a longer duration of antibiotic treatment in children aged 1–5 years. In children aged 5–17 years, having pharyngeal erythema (B = 1.37, 95%CI 0.61, 2.13, p = 0.001), fever (B = 0.43, 95%CI 0.07, 0.79, p = 0.018), and pneumonia on chest X-ray (B = 0.91, 95%CI 0.53, 1.29, p = 0.001), not having rhinorrhea (B = −1.27, 95%CI −2.47, −0.08, p = 0.037), being a girl (B = 0.52, 95%CI 0.08, 0.97, p = 0.021), and having higher CRP values on admission (B = 0.04, 95%CI 0.01, 0.06, p = 0.006) were associated with the administration of a higher number of antibiotics. These factors, not including the absence of rhinorrhea, were associated with a longer duration of antibiotics treatment in children aged 5–17 years. Demographic, epidemiological, clinical, and laboratory parameters were associated with the use of multiple antibiotics and a longer duration of antibiotic treatment both among children aged 1–5 years and those aged 5–17 years.

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Liver Involvement in Children with COVID-19 and Multisystem Inflammatory Syndrome: A Single-Center Bulgarian Observational Study

Cited by 20 publications

References 33 publications

Students’ Attitudes toward COVID-19 Vaccination: An Inter-University Study from Bulgaria

Students’ Attitudes toward COVID-19 Vaccination: An Inter-University Study from Bulgaria

Clinical and Laboratory Characteristics of Pediatric COVID-19 Population—A Bibliometric Analysis

Factors Associated with the Antibiotic Treatment of Children Hospitalized for COVID-19 during the Lockdown in Serbia

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