Highlights in this issue

Abstract

Many countries have closed schools and kindergartens to minimise COVID-19, but the role that children play in transmitting the virus is unclear. Ludvigsson carried out a systematic review and concluded that children were unlikely to be the main drivers of the pandemic.1 de Niet et al2 comment on the same topic. Snapiri et al3 present a group of paediatric patients who were diagnosed with appendicitis at a later stage, due to fear of the pandemic, and report higher complications than the same period in 2019. Mastnak4 suggest in a perspective paper that some of the psychopathological problems related to the pandemic could be prevented with music therapy. Haward et al5 express concerns about assumptions that extremely premature babies are less deserving of ventilator care than adults during the pandemic. The authors also describe other unrecognised areas in paediatric ethics that require our immediate attention. There are two different indications where body position has had a great impact on active medical practice. One of them is infants and sudden infant death syndrome, which favours the supine position, and the other is adult patients with acute lung insufficiency, which favours the prone position. This is covered by three papers in this issue. Poets et al6 studied oxygenation and intermittent hypoxia in supine versus prone positions in very preterm infants and Lindahl7 comments on the findings. Lindahl also looks at how some centres have started treating adult COVID-19 patients with rapidly deteriorating lung function in the prone position. His mini-review reports that this has led to considerable improvement in oxygenation in some cases and provides some insights into the mechanisms behind this that could also be relevant for paediatric medicine.8 Kivistö et al explored trends in asthma medication dispensed to children and adolescents aged 0-19 years in Finland and Sweden from 2006 to 2017.9 The authors report that inhaled corticosteroids were 1.5 times more likely to be dispensed for children aged 0-4 years in Sweden than Finland. The prevalence of short-acting β2-adrenergic receptor agonists increased in both countries, particularly in Finland. The accompanying editorial by Wennergren10 discusses why trends in asthma medication and hospitalisation differ for children in Finland and Sweden. Readers may also be interested in the paper by Bigman,11 which reports that exclusive breastfeeding for the first 3 months of life may reduce the risk of respiratory allergies and some asthma in children when they reach 6 years of age. Examining the placentas of sick newborn infants may help to personalise their neonatal care. De Angelis et al studied sick newborn infants who were transferred from smaller neonatal care centres to the neonatal intensive care unit at a children's hospital in Genoa, Italy. They found that placentas were seldom transferred with the infants for pathological examination.12 The authors attribute this finding to insufficient understanding of the importance of placental pathology in smaller neonatal care centres, as well as suboptimal routines for storing and handling placentas. They propose steps that could overcome these barriers. Papadogiannakis comments on the paper.13 Figures 1, 3: istockphoto.com, 2: Lindahl et al, 4: Alamy