Virological and immunological features of SARS-CoV-2-infected children who develop neutralizing antibodies

As the global COVID-19 pandemic progresses, it is paramount to gain knowledge on adaptive immunity to SARS-CoV-2 in children to define immune correlates of protection upon immunization or infection. We analyzed anti-SARS-CoV-2 antibodies and their neutralizing activity (PRNT) in 66 COVID-19-infected children at 7 (\ub12) days after symptom onset. Individuals with specific humoral responses presented faster virus clearance and lower viral load associated with a reduced in vitro infectivity. We demonstrated that the frequencies of SARS-CoV-2-specific CD4+CD40L+ T cells and Spike-specific B cells were associated with the anti-SARS-CoV-2 antibodies and the magnitude of neutralizing activity. The plasma proteome confirmed the association between cellular and humoral SARS-CoV-2 immunity, and PRNT+ patients show higher viral signal transduction molecules (SLAMF1, CD244, CLEC4G). This work sheds lights on cellular and humoral anti-SARS-CoV-2 responses in children, which may drive future vaccination trial endpoints and quarantine measures policies

Epidemiology, Clinical Features and Prognostic Factors of Pediatric SARS-CoV-2 Infection: Results From an Italian Multicenter Study

Background: Many aspects of SARS-CoV-2 infection in children and adolescents remain unclear and optimal treatment is debated. The objective of our study was to investigate epidemiological, clinical and therapeutic characteristics of pediatric SARS-CoV-2 infection, focusing on risk factors for complicated and critical disease. Methods: The present multicenter Italian study was promoted by the Italian Society of Pediatric Infectious Diseases, involving both pediatric hospitals and general pediatricians/family doctors. All subjects under 18 years of age with documented SARS-CoV-2 infection and referred to the coordinating center were enrolled from March 2020. Results: As of 15 September 2020, 759 children were enrolled (median age 7.2 years, IQR 1.4; 12.4). Among the 688 symptomatic children, fever was the most common symptom (81.9%). Barely 47% of children were hospitalized for COVID-19. Age was inversely related to hospital admission (p < 0.01) and linearly to length of stay (p = 0.014). One hundred forty-nine children (19.6%) developed complications. Comorbidities were risk factors for complications (p < 0.001). Viral coinfections, underlying clinical conditions, age 5\u20139 years and lymphopenia were statistically related to ICU admission (p < 0.05). Garazzino et al. SARS-CoV-2 in Children and Adolescents Conclusions: Complications of COVID-19 in children are related to comorbidities and increase with age. Viral co-infections are additional risk factors for disease progression and multisystem inflammatory syndrome temporarily related to COVID-19 (MIS-C) for ICU admission

Antibiotic Prescriptions for Children With Community-acquired Pneumonia: Findings From Italy

Community-acquired pneumonia (CAP) is one of the most common reasons of prescribing antibiotics for children, often with overuse of broad-spectrum antibiotics. The aim of this study is to describe the antibiotic prescriptions for Italian children with CAP, at the primary care level

Left ventricular longitudinal strain alterations in asymptomatic or mildly symptomatic paediatric patients with SARS-CoV-2 infection

Compared with adult patients, clinical manifestations of children's coronavirus disease-2019 (COVID-19) are generally perceived as less severe. The objective of this study was to evaluate cardiac involvement in previously healthy children with asymptomatic or mildly symptomatic severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection

COVID-19 Pandemic: Perspective of an Italian Tertiary Care Pediatric Center

Since February 2020, Italy has been faced with the dramatic spread of novel Coronavirus SARS-CoV-2. This impetuous pandemic infection forced many hospitals to reorganize their healthcare systems. Predicting a rapid spread of the SARS-CoV-2 virus within our region, the Department for Women's and Children's Health promptly decided (i) to revise the distribution of the clinical areas in order to create both designated COVID-19 and COVID-19-free areas with their own access, (ii) to reinforce infection prevention control (IPC) measures for all healthcare workers and administrative staff and (iii) to adopt the new "double-gate approach": a phone call pre-triage and nasopharyngeal swab for SARS-CoV-2 detection before the admission of all patients and caregivers. Between 21 February 2020 till 04 May 2020, only seven physicians, two nurses and two of the administrative staff resulted positive, all during the first week of March. No other cases of intra-department infection were documented among the healthcare workers since all the preventive procedures described above were implemented. It is predicted that similar situations can happen again in the future, and thus, it is necessary to be more prepared to deal with them than we were at the beginning of this COVID-19 pandemic

Kotkan kaupungin kiinteistöjen pelastussuunnitelmien käyttöönotto

Tämän opinnäytetyön aiheena oli kehittää Kotkan kaupungin kiinteistöjen uusien pelastussuunnitelmien käyttöönottoa. Tavoitteena oli kehittää selkeät ohjeet, joiden avulla kaupungin kiinteistöjen haltijat pystyvät laatimaan ja ylläpitämään oman kiinteistönsä pelastussuunnitelman internetpohjaisen Pelsu-pelastussuunnitelman verkko- ja mobiilityökalun avulla. Työssä käydään läpi pelastuslain määrittämiä vaatimuksia pelastussuunnitelmille. Lisäksi työssä esitellään Pelsu verkko- ja mobiilityökalun kehittänyt yritys Plan Brothers sekä tutustutaan tarkemmin myös Pelsun tarjoamiin työkaluihin ja ohjelman hyötyihin. Tämänhetkinen Kotkan kaupungin kiinteistöjen pelastussuunnitelmien tilanne käydään läpi tutkimalla nykyisiä pelastussuunnitelmia ja tuomalla esiin niissä havaitut puutteet. Ohjeiden laatiminen pelastussuunnitelmien luomista ja päivittämistä varten toteutettiin kuvakaappauksin ja tekstiosioin. Osaaminen ohjeiden tekoon saatiin osallistumalla Pelsu-perehdytykseen ja harjoittelemalla ohjelman verkko- ja mobiilityökalun käyttöä omilla tunnuksilla. Työssä valmistettiin monisivuiset mutta selkeät ohjeet, joita seuraamalla voidaan luoda kiinteistön internetpohjainen pelastussuunnitelma. Työssä annetaan myös suosituksia, joiden avulla pelastussuunnitelmat saadaan jaettua kaikille toimijoille helposti ja tehokkaasti. Lisäksi otetaan kantaa myös pelastussuunnitelmien ylläpitoon ja siihen kuinka Kotkan organisaatioiden tulisi ottaa Pelsun käyttö osaksi työrutiinejaan.The subject of the thesis was to develop the commissioning of rescue plans in the real estate services of the City of Kotka. The objective was to create explicit instructions that can be used by the tenants (of the city’s real estates) to draft and maintain the rescue plans of their premises using an internet based Pelsu web and mobile software. The study discusses the requirements that the rescue act defines for the rescue plans. The study also exhibits the company Plan Brothers that has developed the Pelsu web and mobile software. It also explores the tools and benefits that the Pelsu software provides. The current situation of the city rescue plans is gone through by studying the present rescue plans and by bringing out the flaws in them. The instructions for creating and updating the rescue plans are executed with screenshots and text parts. The know-how for creating the instructions is gathered by participating in orientation about Pelsu and by practicing the use of the web and mobile software with the author’s own user identification. The result of this thesis is a multipage but clear instructions that can be followed to create the real estate’s internet-based rescue plan. The study also gives recommendations on how the rescue plans can be distributed to all the operators easily and effectively. In addition, an opinion is given on maintenance of the rescue plans and on adoption of Pelsu by the different branches of the local authority as part of their work routine

Deep Neck Abscesses in Children: An Italian Retrospective Study

Retropharyngeal and parapharyngeal abscesses (RPAs, PPAs) usually affect young children. Surgical drainage and/or antibiotic therapy are treatment of choice, but no specific guidelines exist. In order to reduce the risk of severe complications, appropriate diagnosis and therapy are necessary. The aims of the study were to review diagnosis and management of children with RPAs/PPAs and to compare surgical versus medical approach

Parents' Perspective of Antibiotic Usage in Children: A Nationwide Survey in Italy

Antibiotics represent the most widely prescribed drugs in children worldwide, both in hospital and community settings. A comprehensive approach to understanding the reasons and determinants of antibiotic prescription in the pediatric age is needed. This study aimed to assess parents' attitudes and perspectives about antibiotic use