Clinical experience with severe acute respiratory syndrome Coronavirus 2-related illness in children : hospital experience in Cape Town, South Africa

CITATION: van der Zalm, M. M. et al. 2021. Clinical Experience With Severe Acute Respiratory Syndrome Coronavirus 2-Related Illness in Children: Hospital Experience in Cape Town, South Africa. Clinical infectious diseases, 72(12):e938–e944. doi:10.1093/cid/ciaa1666The original publication is available at https://academic.oup.com/cid/Background: Children seem relatively protected from serious severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related disease, but little is known about children living in settings with high tuberculosis and human immunodeficiency virus (HIV) burden. This study reflects clinical data on South African children with SARS-CoV-2. Methods: We collected clinical data of children aged <13 years with laboratory-confirmed SARS-CoV-2 presenting to Tygerberg Hospital, Cape Town, between 17 April and 24 July 2020. Results: One hundred fifty-nine children (median age, 48.0 months [interquartile range {IQR}, 12.0-106.0 months]) were included. Hospitalized children (n = 62), with a median age of 13.5 months (IQR, 1.8-43.5 months) were younger than children not admitted (n = 97; median age, 81.0 months [IQR, 34.5-120.5 months]; P < .01.). Thirty-three of 159 (20.8%) children had preexisting medical conditions. Fifty-one of 62 (82.3%) hospitalized children were symptomatic; lower respiratory tract infection was diagnosed in 21 of 51 (41.2%) children, and in 11 of 16 (68.8%) children <3 months of age. Respiratory support was required in 25 of 51 (49.0%) children; 13 of these (52.0%) were <3 months of age. One child was HIV infected and 11 of 51 (21.2%) were HIV exposed but uninfected, and 7 of 51 (13.7%) children had a recent or new diagnosis of tuberculosis. Conclusions: Children <1 year of age hospitalized with SARS-CoV-2 in Cape Town frequently required respiratory support. Access to oxygen may be limited in some low- and middle-income countries, which could potentially drive morbidity and mortality. HIV infection was uncommon but a relationship between HIV exposure, tuberculosis, and SARS-CoV-2 should be explored.https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciac266/6591403Publishers versio

Retrospective study of diffuse intrinsic pontine glioma in the Belgian population : a 25 year experience

Retrospective study of diffuse intrinsic pontine glioma in the Belgian population : a 25 year experienc

Bronchoscopy in children with COVID‐19 : a case series

CITATION: Goussard, P. et al. 2020. Bronchoscopy in children with COVID‐19 : a case series. Pediatric Pulmonology, 55:2816–2822, doi:10.1002/ppul.25015.The original publication is available at https://onlinelibrary.wiley.comIntroduction: The coronavirus disease‐2019 (COVID‐19) era is a challenging time for respiratory teams to protect their patients and staff. COVID‐19 is predominantly transmitted by respiratory droplets; in the clinical setting, aerosol generating procedures pose the greatest risk for COVID‐19 transmission. Bronchoscopy is associated with increased risk of patient‐to‐health care worker transmission, owing to aerosolized viral particles which may be inhaled and also result in environmental contamination of surfaces. Methods: We describe our experience with the use of modified full‐face snorkeling masks for pediatric bronchoscopy procedures in four COVID‐19 infected children when filtering facepieces/respirators were in limited supply. Results: Bronchoscopy was urgently required in four children, and could not be delayed until COVID‐19 test results were available. During the pandemic peak, when respirators were in short supply, modified full‐face snorkel masks (SEAC Libera, SEAC, Italy) were worn by the bronchoscopy team. Each mask was fitted with an O‐ring, adapter, and heat and moisture exchanger filter. To date, there have been no COVID‐19 infections among the bronchoscopy team staff, whereas the overall Hospital staff COVID‐19 prevalence rate has exceeded 13.5% (667/4949). Conclusion: Emergency bronchoscopy procedures on COVID‐19 infected patients or patients with unknown infection status can be safely performed using modified full‐ face snorkel masks.https://onlinelibrary.wiley.com/doi/full/10.1002/ppul.25015Publisher's versio

Randomised, controlled, open-label pragmatic trial evaluating changes in functional exercise capacity after primary care PUlmonary REhabilitation in patients with long COVID: protocol of the PuRe-COVID trial in Belgium

Introduction Long COVID is a prevalent condition with many multisystemic symptoms, such as fatigue, dyspnoea, muscle weakness, anxiety, depression and sleep difficulties, impacting daily life and (social and physical) functioning. Pulmonary rehabilitation (PR) may improve physical status and symptoms of patients with long COVID, yet the evidence is limited. Therefore, this trial aims to study the effect of primary care PR on exercise capacity, symptoms, physical activity and sleep in patients with long COVID.Methods and analysis PuRe-COVID is a prospective, pragmatic, open-label, randomised controlled trial. A sample of 134 adult patients with long COVID will be randomised to a 12 week PR programme in primary care, supervised by a physiotherapist or to a control group, following no PR. A 3 month and 6 month follow-up period is foreseen. The primary endpoint will be the change in exercise capacity measured by 6-minute walk distance (6MWD) at 12 weeks, hypothesising a more significant improvement in the PR group. Other parameters, such as pulmonary function tests (including maximal inspiratory pressure/maximal expiratory pressure), patient-reported outcomes (COPD Assessment Test, modified Medical Research Council Dyspnoea Scale, Checklist Individual Strength, post-COVID-19 Functional Status, Nijmegen questionnaire, Hospital Anxiety and Depression Scale, Work Productivity and Activity Impairment Questionnaire and EuroQol-5D-5L), physical activity measured by an activity tracker, hand grip strength and sleep efficiency, are secondary and exploratory outcomes.The recruitment started on 19 April 2022, and 52 patients were included as of 14 December 2022.Ethics and dissemination Ethical approval was obtained in Belgium from the relevant institutional review boards on 21 February 2022 (Antwerp University Hospital, approval number 2022-3067) and on 1 April 2022 (Ziekenhuis Oost-Limburg in Genk, approval number Z-2022-01). Findings from this randomised controlled trial will be disseminated in peer-reviewed publications and presentations at international scientific meetings.Trial registration number NCT05244044