Severe manifestations of SARS-CoV-2 in children and adolescents: from COVID-19 pneumonia to multisystem inflammatory syndrome: a multicentre study in pediatric intensive care units in Spain

Background Multisystem inflammatory syndrome temporally associated with COVID-19 (MIS-C) has been described as a novel and often severe presentation of SARS-CoV-2 infection in children. We aimed to describe the characteristics of children admitted to Pediatric Intensive Care Units (PICUs) presenting with MIS-C in comparison with those admitted with SARS-CoV-2 infection with other features such as COVID-19 pneumonia. Methods A multicentric prospective national registry including 47 PICUs was carried out. Data from children admitted with confirmed SARS-CoV-2 infection or fulfilling MIS-C criteria (with or without SARS-CoV-2 PCR confirmation) were collected. Clinical, laboratory and therapeutic features between MIS-C and non-MIS-C patients were compared. Results Seventy-four children were recruited. Sixty-one percent met MIS-C definition. MIS-C patients were older than non-MIS-C patients (p = 0.002): 9.4 years (IQR 5.5-11.8) vs 3.4 years (IQR 0.4-9.4). A higher proportion of them had no previous medical history of interest (88.2% vs 51.7%, p = 0.005). Non-MIS-C patients presented more frequently with respiratory distress (60.7% vs 13.3%, p < 0.001). MIS-C patients showed higher prevalence of fever (95.6% vs 64.3%, p < 0.001), diarrhea (66.7% vs 11.5%, p < 0.001), vomits (71.1% vs 23.1%, p = 0.001), fatigue (65.9% vs 36%, p = 0.016), shock (84.4% vs 13.8%, p < 0.001) and cardiac dysfunction (53.3% vs 10.3%, p = 0.001). MIS-C group had a lower lymphocyte count (p < 0.001) and LDH (p = 0.001) but higher neutrophil count (p = 0.045), neutrophil/lymphocyte ratio (p < 0.001), C-reactive protein (p < 0.001) and procalcitonin (p < 0.001). Patients in the MIS-C group were less likely to receive invasive ventilation (13.3% vs 41.4%, p = 0.005) but were more often treated with vasoactive drugs (66.7% vs 24.1%, p < 0.001), corticosteroids (80% vs 44.8%, p = 0.003) and immunoglobulins (51.1% vs 6.9%, p < 0.001). Most patients were discharged from PICU by the end of data collection with a median length of stay of 5 days (IQR 2.5-8 days) in the MIS-C group. Three patients died, none of them belonged to the MIS-C group. Conclusions MIS-C seems to be the most frequent presentation among critically ill children with SARS-CoV-2 infection. MIS-C patients are older and usually healthy. They show a higher prevalence of gastrointestinal symptoms and shock and are more likely to receive vasoactive drugs and immunomodulators and less likely to need mechanical ventilation than non-MIS-C patients

Severe manifestations of SARS-CoV-2 in children and adolescents: from COVID-19 pneumonia to multisystem inflammatory syndrome: a multicentre study in pediatric intensive care units in Spain

Background Multisystem inflammatory syndrome temporally associated with COVID-19 (MIS-C) has been described as a novel and often severe presentation of SARS-CoV-2 infection in children. We aimed to describe the characteristics of children admitted to Pediatric Intensive Care Units (PICUs) presenting with MIS-C in comparison with those admitted with SARS-CoV-2 infection with other features such as COVID-19 pneumonia. Methods A multicentric prospective national registry including 47 PICUs was carried out. Data from children admitted with confirmed SARS-CoV-2 infection or fulfilling MIS-C criteria (with or without SARS-CoV-2 PCR confirmation) were collected. Clinical, laboratory and therapeutic features between MIS-C and non-MIS-C patients were compared. Results Seventy-four children were recruited. Sixty-one percent met MIS-C definition. MIS-C patients were older than non-MIS-C patients (p = 0.002): 9.4 years (IQR 5.5–11.8) vs 3.4 years (IQR 0.4–9.4). A higher proportion of them had no previous medical history of interest (88.2% vs 51.7%, p = 0.005). Non-MIS-C patients presented more frequently with respiratory distress (60.7% vs 13.3%, p < 0.001). MIS-C patients showed higher prevalence of fever (95.6% vs 64.3%, p < 0.001), diarrhea (66.7% vs 11.5%, p < 0.001), vomits (71.1% vs 23.1%, p = 0.001), fatigue (65.9% vs 36%, p = 0.016), shock (84.4% vs 13.8%, p < 0.001) and cardiac dysfunction (53.3% vs 10.3%, p = 0.001). MIS-C group had a lower lymphocyte count (p < 0.001) and LDH (p = 0.001) but higher neutrophil count (p = 0.045), neutrophil/lymphocyte ratio (p < 0.001), C-reactive protein (p < 0.001) and procalcitonin (p < 0.001). Patients in the MIS-C group were less likely to receive invasive ventilation (13.3% vs 41.4%, p = 0.005) but were more often treated with vasoactive drugs (66.7% vs 24.1%, p < 0.001), corticosteroids (80% vs 44.8%, p = 0.003) and immunoglobulins (51.1% vs 6.9%, p < 0.001). Most patients were discharged from PICU by the end of data collection with a median length of stay of 5 days (IQR 2.5–8 days) in the MIS-C group. Three patients died, none of them belonged to the MIS-C group. Conclusions MIS-C seems to be the most frequent presentation among critically ill children with SARS-CoV-2 infection. MIS-C patients are older and usually healthy. They show a higher prevalence of gastrointestinal symptoms and shock and are more likely to receive vasoactive drugs and immunomodulators and less likely to need mechanical ventilation than non-MIS-C patients

Predicción de la evolución de la bronquiolitis por virus respiratorio sincitial en lactantes menores de 6 meses.

Background. The need for mechanical ventilation (MV) in acute bronchiolitis (AB) by respiratory syncytial virus (RSV) varies depending on the series (6-18%). Our goal is to determine the admissions to PICU for MV in patients under 6 months with AB and define the risk factors for building a prediction model. Methods. Retrospective study of patients younger than 6 months admitted by BA-VRS between the periods April 1, 2010 and March 31, 2015 was made. The primary variable was the admission to PICU for MV. Related addition, to find risk factors in a model of binary logistic regression clinical variables were collected. A ROC curve model was developed and optimal cutoff point was identified. Results. In 695 cases, the need of MV in the PICU was 56 (8.1%). Risk factors included in the equation were: 1. male sex (OR 4.27) 2. postmenstrual age (OR: 0.76) 3. Weight income 37 weeks OR (0.32). The area under the curve, sensitivity and specificity were 0.943, 0.84 and 0.93 respectively. Conclusions. The PICU admission for MV was 8.1 in every 100 healthy infants hospitalized for AB and year. The prediction model equation can help to predict patients at increased risk of severe evolution.YesLa necesidad de ventilación mecánica (VM) en la bronquiolitis aguda por el virus respiratorio sincitial (VRS) varía según las series entre el 6 y el 18 %. Nuestro objetivo fue conocer los ingresos en la unidad de cuidados intensivos para VM de pacientes con bronquiolitis aguda menores de 6 meses y definir los factores de riesgo con el fin de construir un modelo de predicción. Método. Estudio retrospectivo de pacientes menores de 6 meses ingresados por bronquiolitis aguda por VRS entre los periodos 1 de abril de 2010 y 31 de marzo de 2015. La variable principal fue el ingreso en la unidad de cuidados intensivos pediátricos para ventilación mecánica. Además, se recogieron variables clínicas relacionadas para hallar factores de riesgo en un modelo de regresión logística binaria. Con el modelo se elaboró una curva ROC y se identificó un punto óptimo de corte. Resultados. De 695 casos, precisaron VM en unidad pediátrica de cuidados intensivos 56 (8,1%). Los factores de riesgo) incluidos en la ecuación fueron: 1. Sexo varón (OR: 4,27) 2. Edad postmenstrual (OR:0,76) 3. Peso al ingreso 37 semanas OR (0,32). El área bajo la curva, sensibilidad y especificidad fueron 0,943; 0,84 y 0,93 respectivamente. Conclusiones. Los ingresos en UCIP para VM fueron 8,1 por cada 100 lactantes sanos hospitalizados por BA y año. La ecuación elaborada del modelo de predicción puede ser de ayuda para predecir los pacientes con mayor riesgo de evolución grave

Predicción de la evolución de la bronquiolitis por virus respiratorio sincitial en lactantes menores de 6 meses

ABSTRACT Background. The need for mechanical ventilation (MV) in acute bronchiolitis (AB) by respiratory syncytial virus (RSV) varies depending on the series (6-18%). Our goal is to determine the admissions to PICU for MV in patients under 6 months with AB and define the risk factors for building a prediction model. Methods. Retrospective study of patients younger than 6 months admitted by BA-VRS between the periods April 1, 2010 and March 31, 2015 was made. The primary variable was the admission to PICU for MV. Related addition, to find risk factors in a model of binary logistic regression clinical variables were collected. A ROC curve model was developed and optimal cutoff point was identified.RESUMEN Fundamentos. La necesidad de ventilación mecánica (VM) en la bronquiolitis aguda por el virus respiratorio sincitial (VRS) varía según las series entre el 6 y el 18 %. Nuestro objetivo fue conocer los ingresos en la unidad de cuidados intensivos para VM de pacientes con bronquiolitis aguda menores de 6 meses y definir los factores de riesgo con el fin de construir un modelo de predicción. Método. Estudio retrospectivo de pacientes menores de 6 meses ingresados por bronquiolitis aguda por VRS entre los periodos 1 de abril de 2010 y 31 de marzo de 2015. La variable principal fue el ingreso en la unidad de cuidados intensivos pediátricos para ventilación mecánica. Además, se recogieron variables clínicas relacionadas para hallar factores de riesgo en un modelo de regresión logística binaria. Con el modelo se elaboró una curva ROC y se identificó un punto óptimo de corte

Comunicación social

En este monográfico se recogen distintos artículos relacionados con la comunicación social

Comunicación social

Trabajo publicado como monográfico número 6 de la revista 'Tejuelo. Didáctica de la lengua y la literatura. Educación'Se recopilan las comunicaciones presentadas en el I Congreso Nacional de Comunicación Social y Educación, celebrado en Cáceres el 28 y 29 de marzo de 2011. Los trabajos reflexionan sobre la relación entre la educación y la comunicación social en el marco de la Sociedad de la Información y el Conocimiento. Las comunicaciones recogidas son: 'Atención a la diversidad: cambios en las prácticas discursivas de una orientadora novel', '¿Educación cultural o asimilación cultural? Una reflexión crítica a partir de la enseñanza de 'habilidades sociales' en la escuela secundaria', 'Habilidades sociales como herramienta para una inclusión educativa:una reflexión crítica', 'Aproximación a la homofobia desde la perspectiva de los estudiantes de educación social de la Universidad de Murcia', 'Resultados de la adaptación del EEES en España: un análisis de las asignaturas piloto en el período 2003-2007', 'El uso de las redes sociales como guía de autoaprendizaje en la facultad de comunicación de la UPV-EBU', 'Lo ponemos en el Tuenti. Comunicación y educación superior', 'Ubuntu-LEADER': el uso de los entornos y herramientas virtuales para el aprendizaje y la cooperación con Sudáfrica', 'El videojuego en red social: un nuevo modelo de comunicación' y 'La construcción de una subcultura de lo juvenil: el surgimiento del teenager'.ExtremaduraES

Severe manifestations of SARS-CoV-2 in children and adolescents: from COVID-19 pneumonia to multisystem inflammatory syndrome: a multicentre study in pediatric intensive care units in Spain

Background Multisystem inflammatory syndrome temporally associated with COVID-19 (MIS-C) has been described as a novel and often severe presentation of SARS-CoV-2 infection in children. We aimed to describe the characteristics of children admitted to Pediatric Intensive Care Units (PICUs) presenting with MIS-C in comparison with those admitted with SARS-CoV-2 infection with other features such as COVID-19 pneumonia. Methods A multicentric prospective national registry including 47 PICUs was carried out. Data from children admitted with confirmed SARS-CoV-2 infection or fulfilling MIS-C criteria (with or without SARS-CoV-2 PCR confirmation) were collected. Clinical, laboratory and therapeutic features between MIS-C and non-MIS-C patients were compared. Results Seventy-four children were recruited. Sixty-one percent met MIS-C definition. MIS-C patients were older than non-MIS-C patients (p = 0.002): 9.4 years (IQR 5.5–11.8) vs 3.4 years (IQR 0.4–9.4). A higher proportion of them had no previous medical history of interest (88.2% vs 51.7%, p = 0.005). Non-MIS-C patients presented more frequently with respiratory distress (60.7% vs 13.3%, p < 0.001). MIS-C patients showed higher prevalence of fever (95.6% vs 64.3%, p < 0.001), diarrhea (66.7% vs 11.5%, p < 0.001), vomits (71.1% vs 23.1%, p = 0.001), fatigue (65.9% vs 36%, p = 0.016), shock (84.4% vs 13.8%, p < 0.001) and cardiac dysfunction (53.3% vs 10.3%, p = 0.001). MIS-C group had a lower lymphocyte count (p < 0.001) and LDH (p = 0.001) but higher neutrophil count (p = 0.045), neutrophil/lymphocyte ratio (p < 0.001), C-reactive protein (p < 0.001) and procalcitonin (p < 0.001). Patients in the MIS-C group were less likely to receive invasive ventilation (13.3% vs 41.4%, p = 0.005) but were more often treated with vasoactive drugs (66.7% vs 24.1%, p < 0.001), corticosteroids (80% vs 44.8%, p = 0.003) and immunoglobulins (51.1% vs 6.9%, p < 0.001). Most patients were discharged from PICU by the end of data collection with a median length of stay of 5 days (IQR 2.5–8 days) in the MIS-C group. Three patients died, none of them belonged to the MIS-C group. Conclusions MIS-C seems to be the most frequent presentation among critically ill children with SARS-CoV-2 infection. MIS-C patients are older and usually healthy. They show a higher prevalence of gastrointestinal symptoms and shock and are more likely to receive vasoactive drugs and immunomodulators and less likely to need mechanical ventilation than non-MIS-C patients