Pediatric Inpatients Research Articles

Epidemiological and clinical characteristics of respiratory syncytial virus and influenza infections in hospitalized children before and during the COVID-19 pandemic in Central China.

Globally, the epidemiology of non-SARS-CoV-2 respiratory viruses like respiratory syncytial virus (RSV) and influenza virus was remarkably influenced by the implementation of non-pharmacological interventions (NPIs) during the COVID-19 pandemic. Our study explored the epidemiological and clinical characteristics of pediatric patients hospitalized with RSV or influenza infection before and during the pandemic after relaxation of NPIs in central China. This hospital-based prospective case-series study screened pediatric inpatients (age ≤ 14 years) enrolled with acute respiratory infections (ARI) for RSV or influenza infection from 2018 to 2021. The changes in positivity rates of viral detection, epidemiological, and clinical characteristics were analyzed and compared. Median ages of all eligible ARI patients from 2018-2019 were younger than those from 2020-2021, so were ages of cases infected with RSV or influenza (RSV: 4.2 months vs. 7.2 months; influenza: 27.3months vs. 37.0 months). Where the positivity rate for influenza was considerably decreased in 2020-2021 (1.4%, 27/1964) as compared with 2018-2019 (2.9%, 94/3275, P < 0.05), it was increased for RSV (11.4% [372/3275] vs. 13.3% [262/1964], P < 0.05) in the same period. The number of severe cases for both RSV and influenza infection were also decreased in 2020-2021 compared with 2018-2019. The implemented NPIs have had varied impacts on common respiratory viruses. A more effective prevention strategy for RSV infections in childhood is needed.

Case-mix adjustment of patient-reported experience measures in National Regional Center for Pediatric.

The aim of the study was to identify case-mix adjusters for the Chinese version of the Child Hospital Consumer Assessment of Healthcare Providers and Systems (Child-HCAHPS) and assess the impact of case-mix adjustment on patient experience measures in China. This study analyzed data collected from six National Regional Center for Pediatric across China retrospectively. Participants were children aged ≤17 years and their guardians who completed the survey. The Chinese Child-HCAHPS was used to measure pediatric inpatient care experience. Candidate case-mix adjusters were assessed using a summary measure of explanatory power. Changes in scores and rankings of the six centers were quantified to assess the impact of adjustment. A total of 2708 respondents completed the survey from January to March 2021, with a response rate of 7-15%. The child's global health status and the respondent being the child's mother were identified as case-mix adjusters, and case-mix adjustment models for 18 patient experience items were constructed. Kendall's τ correlation of hospital rankings before and after adjustment ranged from 0.73 to 1.00. Although the impact of case-mix adjustment may appear modest in our sample, it demonstrated the feasibility, necessity, and methodology for further development of case-mix adjustment models in pediatric healthcare facilities in China. Case-mix adjustment models adjust for factors that are unamendable by healthcare providers that may affect patient experience ratings, thereby improving the comparability of institutional-level ratings. Standardized case-mix adjustment protocols for quality measures need to be modified in different settings. This is the first study to identify adjustment variables and the possible impact of case-mix adjustment on pediatric inpatients' experience measures in a Chinese population. This study provided evidence on the feasibility and necessity for further development of case-mix adjustment models for pediatric healthcare facilities in China.

Factors Determining the Mood and Emotions of Nurses Working in Pediatric Wards-A Pilot Study.

Mood and emotions are important aspects of social interactions. In recent years, there has been a growing interest in the participation of these emotional states in the implementation of tasks resulting from specific professions. The aim of the study is to identify the factors that determine the mood and emotions of nurses working in pediatric wards. The pilot studies presented in the paper were carried out using the diagnostic survey method. The collected data were obtained from the authors' own questionnaire and the standardized measurement tool "Scale for Measuring Mood and Six Emotions" by Bogdan Wojciszke and Wiesław Baryła. The study included 121 nurses working in hospital pediatric wards. The survey questionnaire results were obtained online using Google Forms. Self-assessment of the health condition of nurses is statistically significantly correlated with all emotions and mood (p < 0.05). The better the self-assessment of health, the greater the positive mood measured by the General Mood Scale (GMS) and Mood Scales (MS). The financial situation showed a statistically significant correlation with guilt (p = 0.048), sadness (p = 0.041), and negative mood (p = 0.035). Single people, regardless of gender, were characterized by a greater experience of love (H = 13.497; p < 0.001). The higher the education, the greater the experience of love (p = 0.009). For people with specialization, the presence of negative emotions such as anger (p = 0.039) and guilt (p = 0.049) turned out to be statistically significant. The better the health of children staying in the ward, the higher the negative mood of nurses (p = 0.035). There was a statistically significant relationship between certain demographic factors, self-assessment of health conditions with the specificity of working in pediatric wards, and the experience of mood and different emotions by nurses working with pediatric inpatients.

Pediatric Inpatients with Coronavirus Disease 2019 in Chiba Prefecture

Pediatric Inpatients with Coronavirus Disease 2019 in Chiba Prefecture

Antimicrobial use among paediatric inpatients in a Nigerian tertiary hospital: A three-year point prevalence survey.

Antimicrobials are among the most widely prescribed therapeutic agents among paediatric population. Irrational use of these agents increases the risk of antimicrobial resistance. We described the prevalence and pattern of antimicrobial use among paediatric inpatients from 2017 to 2019. The study was a repeated point prevalence survey over a 3-year period using the global point prevalence standardized tools among all paediatric inpatients. The prevalence of antimicrobial use, the prescription indicators and patterns of antimicrobial use were estimated. Among 191 paediatric inpatients assessed, the 3-year period prevalence antimicrobial use was 85.9% (164/191) with prevalence of 80.6% in 2017, 94.6% in 2018, and 83.6% in 2019. Antimicrobial agents used ranged from one agent (20.1%) to five different agents (5.5%). Parenteral route (66.6%) was the preferred route of administration. The reason for the use of antimicrobial agents (92.6%) and the stop/review date (99.5%) were mostly well documented. Only 4.5% of the antimicrobial use were targeted. There were no antimicrobial guidelines or policy guiding the use of antimicrobial agents, except the national guideline on the treatment of malaria and tuberculosis. Ceftriaxone, a third generation cephalosporin was the most commonly used agent across the period under review. Community-acquired infection was the commonest indication for antimicrobial use. Our findings of high antimicrobial prevalence has raised the attention for the need to develop hospital-based antimicrobial guideline and antimicrobial stewardship program to protect the vulnerable children, their contacts and the environment from the impact of antimicrobial resistance.

A cross-sectional study evaluating health-related quality of life of Chinese pediatric patients with hematological malignancies using EQ-5D-Y.

The study aimed to assess health-related quality of life (HRQoL) and to estimate the health utility of pediatric patients with hematological malignancies (HMs) in China. A cross-sectional study recruited a series of pediatric inpatients diagnosed with HM from November 2018 to May 2019 in the Shanghai Children's Medical Center. Subjects were interviewed to collect sociodemographic information about themselves and their guardians. The EQ-5D-Y was completed by each patient to rate their own HRQoL, which later derived the health utility. The health status was also assessed by clinicians following the Eastern Cooperative Oncology Group (ECOG) system. Upon the descriptive analysis and univariate analysis, multivariate generalized linear models were built to explore the associations of risk factors with HRQoL measures of utility, Visual Analog Scale (VAS) score, and the five EQ-5D-Y domains. The 96 subjects had a mean age of 10.5 years and included 62 (64.4%) boys. There were 46 (47.9%) and 25 (26.0%) children diagnosed with acute lymphoblastic leukemia and non-Hodgkin's lymphoma, respectively. The means (SD) of utility and EQ-VAS scores were 0.88 (0.10) and 85.8 (15.1), respectively. Twenty-six (27.1%) patients were graded poor health by the ECOG standard (score 2/3). Both univariate and multivariate analyses found strong correlations between ECOG and HRQoL. After adjusting for covariates, poor ECOG score was significantly associated with an impaired utility and VAS of -0.103 and -8.65, respectively. With regard to individual HRQoL domains, worse ECOG was more likely to report health problems with an increased risk of 2.94 to 12.50; residence, income, guardians' education, and disease duration were also found to be significantly related to either the utility or certain health domains. The HRQoL of Chinese pediatric patients with HM is considered relatively poor and of great concern to healthcare. With the strong correlations between EQ-5D-Y-related HRQoL measures and the traditional clinical index ECOG, the EQ-5D-Y is able to provide valuable evidence for clinical decision-making at the individual level. At the same time, its health utility can inform resource allocation at a macro level.

Academic Performance of Clerkship Students Working on a Longitudinal Inpatient Pediatrics Team.

To determine if the academic performance of students who worked on a longitudinal inpatient team in the pediatric clerkship differed from students on traditional teams. We hypothesized that working on the longitudinal team would be associated with improved performance. We retrospectively identified students who rotated in the pediatric clerkship at a single institution from 2017 through 2021. We used multiple linear and multiple ordered logistic regression to examine whether working on a longitudinal inpatient team in which the majority of students work with the same senior resident and attending for the entire inpatient block and function without interns was associated with improved academic performance. We included data from 463 students, 316 in the longitudinal team group and 147 in the traditional team group. Working on the longitudinal team was associated with a higher inpatient preceptor rating (adjusted mean rating 3, 95% confidence interval [CI] 2.97 to 3.03 vs 2.85, 95% CI 2.81 to 2.90; P = .02; on a scale of 0 to 4) and an increased probability of achieving a higher final grade in the pediatric clerkship (adjusted probability of achieving honors 22%, 95% CI 17% to 28% vs 11%, 95% CI 6% to 16%; P = .003). These differences did not persist in the clerkship immediately after pediatrics. Compared with a traditional inpatient team, working on a longitudinal team was associated with achieving a higher preceptor rating and final pediatric clerkship grade. Implementing similar models within clinical clerkships may help foster optimal student performance.

Development of Quality Indicators to Evaluate the Appropriateness of Empiric Antimicrobial Use in Pediatric Patients.

Use of quality indicators is one strategy recommended to assess antimicrobial prescribing for pediatric inpatients. To achieve consensus from infectious diseases clinicians on quality indicators that characterize appropriate empiric antimicrobial use for the management of infectious syndromes in pediatric inpatients. This study was completed using the Delphi technique. The research team developed an initial list of quality indicators, informed by a literature search. A multidisciplinary group of health care providers with expertise in infectious diseases was invited to participate. The list was disseminated to this panel of experts using Opinio survey software. The experts were asked to rate the indicators on a 9-point Likert scale in relation to the following criterion: "The importance of each item in determining appropriateness considering benefit or harm at the individual or population level". Consensus was defined as at least 75% agreement and a median score of 7 or higher. Twelve of 31 invited experts completed at least 1 round of the survey, and 10 completed all rounds. Consensus was achieved on 28 of 31 proposed indicators after 3 rounds. Indicators with consensus were categorized under "empiric choice" (n = 12 indicators), "dose" (n = 5), "duration" (n = 2), "administration" (n = 4), "diagnosis" (n = 2), and "documentation" (n = 3). Six of the indicators for which consensus was achieved were rephrased by the experts. Consensus was achieved on quality indicators to assess the appropriateness of empiric antimicrobial use in pediatric patients. Clinicians and researchers can use these consensus-based indicators to assess adherence to best practice.

Breaking Barriers to Rapid Whole Genome Sequencing in Pediatrics: Michigan's Project Baby Deer.

The integration of precision medicine in the care of hospitalized children is ever evolving. However, access to new genomic diagnostics such as rapid whole genome sequencing (rWGS) is hindered by barriers in implementation. Michigan's Project Baby Deer (PBD) is a multi-center collaborative effort that sought to break down barriers to access by offering rWGS to critically ill neonatal and pediatric inpatients in Michigan. The clinical champion team used a standardized approach with inclusion and exclusion criteria, shared learning, and quality improvement evaluation of the project's impact on the clinical outcomes and economics of inpatient rWGS. Hospitals, including those without on-site geneticists or genetic counselors, noted positive clinical impacts, accelerating time to definitive treatment for project patients. Between 95-214 hospital days were avoided, net savings of $4155 per patient, and family experience of care was improved. The project spurred policy advancement when Michigan became the first state in the United States to have a Medicaid policy with carve-out payment to hospitals for rWGS testing. This state project demonstrates how front-line clinician champions can directly improve access to new technology for pediatric patients and serves as a roadmap for expanding clinical implementation of evidence-based precision medicine technologies.

Peripheral vascular catheter use in Latin America (the vascular study): A multinational cross-sectional study.

Peripheral intravenous catheter (PIVC) insertion is one of the most common clinical procedures worldwide, yet little data are available from Latin America. Our aim was to describe processes and practices regarding PIVC use in hospitalized patients related to hospital guidelines, characteristics of PIVC inserters, prevalence of PIVC complications, and idle PIVCs. In 2019 we conducted a multinational, cross-sectional study of adult and pediatric patients with a PIVC in hospitals from five Latin American countries: Argentina, Brazil, Chile, Colombia, and Mexico. We used two data collection tools to collect hospital guidelines and patient-specific data on the day of the study. The vessel health and preservation (VHP) model guided synthesis of the study aims/questions and suggested opportunities for improvement. A total of 9,620 PIVCs in adult (86%) and pediatric inpatients in 132 hospitals were assessed. Routine replacement 8-72 hourly was recommended for adults in 22% of hospitals, rather than evidence-based clinical assessment-based durations, and 69% of hospitals allowed the use of non-sterile tape rather than the international standard of a sterile dressing. The majority (52%) of PIVCs were inserted by registered nurses (RNs), followed by nursing assistants/technicians (41%). Eight percent of PIVCs had pain, hyperemia, or edema, 6% had blood in the extension tubing/connector, and 3% had dried blood around the device. Most PIVCs had been inserted for intravenous medications (81%) or fluids (59%) in the previous 24 h, but 9% were redundant. Given the variation in policies, processes and practices across countries and participating hospitals, clinical guidelines should be available in languages other than English to support clinician skills and knowledge to improve PIVC safety and quality. Existing and successful vascular access societies should be encouraged to expand their reach and encourage other countries to join in multinational communities of practice.

Prevalence and factors related to anaemia in children aged 6–59 months attending a quaternary health facility in Maputo, Mozambique

ABSTRACT Globally, anaemia prevails as a public health issue, being also a concern in Mozambique, where about two-thirds of children 6–59 months of age are affected by this condition. We carried out this study to estimate anaemia prevalence and evaluate structural determinants and haematological parameters association among children aged 6–59 months attending pediatric inpatient and outpatient services in a Quaternary Health Facility in Maputo City Province, Mozambique. We collected data from 637 inpatients or outpatients who attended pediatric consultations at the Maputo Central Hospital. The overall rate of anaemia in children aged 6–59 months was 62.2% (396/637), with 30.9% moderate anaemia (197/637), 23.9% mild anaemia (152/637), and 7.4% severe anaemia (47/637). Among our study participants, critical factors for anaemia were those concerning the age group, child´s caregiver schooling, malaria and size of the liver.

Correlation of Ductal size with Left Ventricular Systolic Function Changes by Echocardiography in Children after Transcatheter Closure of Patent Ductus Arteriosus in a Tertiary Care Hospital

Background: Transcatheter closure of Patent Ductus Arteriosus (PDA) is considered an excellent treatment option for children requiring PDA closure due to its low morbidity and mortality rates. Theoretically, after PDA closure, there should be a gradual improvement in left ventricular volume overload and remodeling. However, numerous studies have shown that there is a temporary decline in left ventricular function immediately following PDA closure. Objectives: To see the correlation of ductal size with changes in left ventricular systolic function by echocardiography in children undergoing transcatheter closure of PDA. Materials and methods: It was a cross sectional study. All pediatric inpatients ≥6 months of age, diagnosed as a case of PDA and planned for device closure were enrolled in the study. M-Mode, 2D, Color Doppler and 2D speckle tracking echocardiography was done by GE Echo machine Model VividS70N using probes 5MHz (5s) and 6MHz(6s). Electrocardiogram (ECG ) gated echo was done at base line (prior to closure of PDA), after 24 hour post closure and after 1 month post closure, in order to evaluate the immediate and short term changes in left ventricular systolic function from the baseline, using the following parameters: Left Ventricular Ejection Fraction (LVEF) and Left Ventricular Fractional Shortening (LVFS). The total sample size was 35. Data were collected on a pre-tested questionnaire. Data analysis was carried out by using the SPSS version 22.0 windows software. Continuous data were expressed as mean ±SD and analyzed by paired t-test. Categorical data were expressed as frequency and percentages. Correlation was seen using Pearson’s correlation. P-value &lt; 0.05 was considered statistically significant. Results: The mean age of the study subjects was 46.69 ± 41.8 months with mean body surface area of 0.56 ±0.25m² (0.32-1.3). Females were predominant with 74.3% and males were 25.7%. The mean PDA size was 3.35 ± 0.77mm and the LA: Aorta ratio was 1.45 ± 0.24. The LVEF, LVFS were reduced from 70.11±3.81 to 57.34±5.0, 39.28±3.14 to 32.0±4.54 respectively 24hours after device closure. This reduction of LVEF, LVFS were statistically significant (p&lt;0.01). At 1 month post device follow up all the parameters returned to near baseline level. PDA size was found to be negatively correlated with early changes in left ventricular functions i.e. larger the PDA size, greater is the reduction in LV function post PDA device. Conclusions: Transcatheter closure of PDA can lead to transient reduction in left ventricular systolic function which improves gradually after a month; however, close monitoring is required. Larger the PDA size, greater is the reduction in LV function. As such moderate to large PDAs should be followed up more cautiously and immediate timely intervention is needed, if severe deterioration is found.

Changes in Distribution of Severe Neurologic Involvement in US Pediatric Inpatients With COVID-19 or Multisystem Inflammatory Syndrome in Children in 2021 vs 2020

Changes in Distribution of Severe Neurologic Involvement in US Pediatric Inpatients With COVID-19 or Multisystem Inflammatory Syndrome in Children in 2021 vs 2020

Current practice of antibiotics skin test in pediatric inpatients: A single-center experience

Current practice of antibiotics skin test in pediatric inpatients: A single-center experience

The Impact of Virtual Reality (VR) on Psychological and Physiological Variables in Children Receiving Chemotherapy: A Pilot Cross-Over Study.

Virtual reality (VR) is a novel technology which provides a great opportunity to reduce some of the adverse effects of chemotherapy. Our study aims to investigate the effects of VR on the emotional states of paediatric oncology patients (n = 29, age: 10-18 years) receiving chemotherapy in a clinical setting with a crossover design. Children played a VR game in the experimental, and a mobile game in the control condition. Psychological (happiness, joy, fear, nervousness, anxiety, alertness, patience) and physiological variables (heart rate, systolic blood pressure, electrodermal activity), as well as pain and nausea were measured before and after the sessions. Data were analysed with multiple 2-way repeated measures ANOVA. Joy (P = .003) and happiness (P < .001) increased significantly when using VR, while there was no change in the control condition. Anxiety decreased (P = .002) and patience increased (P = .015) in both conditions, implying no additional benefit of VR. Children were more fearful before the VR session (P = .005), which disappeared after it. In case of physiological parameters, electrodermal activity decreased (P = .01) significantly after playing the mobile game, but not after the VR one. Our investigation point to the positive effects of VR on mood in paediatric oncology inpatients, thus, it could be used as a new tool in improving patients' well-being during chemotherapeutical treatment. Our results indicate that VR is an effective tool in improving patients' well-being during chemotherapeutic treatment.

Needlestick and sharp injuries and its associated factors among healthcare workers in Southern Ethiopia.

Needlesticks and sharp injuries are occupational hazards for healthcare workers that result from the accidental piercing of the skin. Needlestick injuries expose healthcare workers to blood and body fluids that may be infected and can be transmitted to them. Healthcare workers have been exposed to blood-borne pathogens through contaminated needles and other sharp materials every day. Around 20 blood-borne diseases can be transmitted through casual needlesticks and sharp injuries. To assess needlestick and sharp injuries and its associated factors among healthcare workers in Southern Ethiopia, 2021. The hospital-based cross-sectional study design was conducted among 341 healthcare workers in Worabe Comprehensive Specialized Hospital from June 10 to July 6, 2021. A stratified sampling technique was used and data were collected using standardized structural questionnaires by BSc nursing professionals. The collected data were checked for completeness and consistency by the investigator. The completed questionnaire was given an identification number and entered into EpiData version 3.5.1. The data were coded and analyzed using SPSS version 26 using a binary logistic regression model and presented with texts, tables, and graphs. The finding revealed that 30.6% of healthcare workers had experienced needlestick and sharp injuries within their working area. Healthcare workers not trained on safety measures of needlestick and sharp injury (adjusted odds ratio: 7.179 (3.494-14.749)), working in the delivery unit (adjusted odds ratio: 6.528 (3.171-11.834)), being older age (adjusted odds ratio: 3.394 (1.775-7.126)), working in inpatient unit (3.278 (1.804-5.231)), working in an emergency unit (adjusted odds ratio: 5.718 (4.326-6.398)), working in an operation room theater (adjusted odds ratio: 2.359 (1.781-4.430)), working as a medical laboratory technician (adjusted odds ratio: 1.070 (1.432-3.304)), working in pediatrics unit (adjusted odds ratio: 1.063 (1.431-2.843)), working as cleaners (adjusted odds ratio: 0.018 (0.002-0.195)), working <40 h per week (adjusted odds ratio: 0.036 (0.004-0.345)), and seldom needle recapping (adjusted odds ratio: 0.043 (0.015-0.125)) were statistically associated with needlestick and sharp injury. In this study, there is a high magnitude of needlestick or sharp injuries among healthcare workers. Lack of training on work-related safety measures; working in delivery; being older age; working in the inpatient unit, emergency, operation room, and pediatrics units; being laboratory technicians, and cleaners; working hours per week; and seldom needle recapping were significant predictors of needlestick and sharp injury.

Comparação de quatro ferramentas diferentes de triagem de risco nutricional em crianças hospitalizadas

ABSTRACT Objective: Early detection of malnutrition risk in hospitalized children can improve health outcomes and quality of life; however, the number of studies where the pediatric screening tool is appropriate for Turkish children is limited. Therefore, this article aims to determine the prevalence of malnutrition risk in pediatric patients evaluated with Screening Tool for Risk on Nutritional Status and Growth, Screening Tool for the Assessment of Malnutrition in Pediatrics, Pediatric Yorkhill Malnutrition Score, and Simple Pediatric Nutrition Screening Tool with original and adjusted cutoffs and to evaluate which pediatric screening tool is appropriate for Turkish children. Methods: In this cross-sectional study, four published nutritional risk screening tools (Screening Tool for Risk on Nutritional Status and Growth, Screening Tool for the Assessment of Malnutrition in Pediatrics, Pediatric Yorkhill Malnutrition Score, Pediatric Nutrition Screening Tool) were applied to pediatric inpatients (n=604) aged 1 month to 17 years, admitted to a pediatric ward for at least 24 hours. Results: Pediatric Nutrition Screening Tool with adjusted cutoffs had the greatest recognition rate (94.2%) of acute malnutrition. Having a high nutritional risk by Pediatric Yorkhill Malnutrition Score was associated with an increased risk of acute (OR: 6.57 for Screening Tool for Risk on Nutritional Status and Growth, 5.84 for Screening Tool for the Assessment of Malnutrition in Pediatrics, and 20.35 for Pediatric Yorkhill Malnutrition Score) and chronic malnutrition (OR: 1.27 for Screening Tool for Risk on Nutritional Status and Growth, 3.28 for Screening Tool for the Assessment of Malnutrition in Pediatrics, and 1.72 for Pediatric Yorkhill Malnutrition Score). Classifying the at-risk category by the Pediatric Nutrition Screening Tool was related to raised odds of malnutrition (OR: 2.64 for original and 5.24 for adjusted cutoffs). This positive association was also observed for acute (OR: 4.07 for original cutoffs, and 28.01 for adjusted cutoffs) and chronic malnutrition (OR: 1.14 for original cutoffs, and 1.67 for adjusted cutoffs). Conclusion: Pediatric Nutrition Screening Tool with adjusted cutoffs and Pediatric Yorkhill Malnutrition Score have higher diagnostic accuracy than other screening tools in assessing the nutritional status of hospitalized Turkish children and detecting children, particularly with acute malnutrition.

The role of red blood cell distribution width (RDW) in the diagnosis of pediatric sepsis.

Early diagnosis of pediatric sepsis is difficult, so it is necessary to find a reliable auxiliary diagnostic method. The purpose of the study was to assess the role of RDW in the diagnosis of pediatric sepsis. We did a case control study reviewing pediatric inpatients (≥28 days, < 18 years old) who were diagnosed with sepsis between April 2020 and November 2022. According to the sepsis-3 and Pediatric Sequential Organ Failure Assessment (pSOFA) scoring standards, 66 septic inpatients of the pediatric intensive care unit (PICU) were included in the sepsis group and 66 non-septic inpatients of the PICU were included by using the random sampling method during the same period as the control group. RDW values in the sepsis group were higher than those in the control group (P < 0.001). The cut-off value, sensitivity, specificity and area under curve of RDW for sepsis were 39.15, 0.955, 0.758 and 0.943,respectively. Our study confirms that RDW may have a good value on the early diagnosis of pediatric sepsis.

Clinical and laboratory differences between pediatric hospitalized patients with sickle cell disease infected or not by SARS-CoV-2.

The aim of this study was to identify clinical and complete blood count differences between pediatric hospitalized patients with sickle cell disease infected or not by SARS-CoV-2 and compare the complete blood count of patients with sickle cell disease infected by SARS-CoV-2 before hospitalization and on admission. This study was a single-center prospective cohort. Data were collected from medical records of pediatric inpatients with sickle cell disease under 18 years old infected or not with SARS-CoV-2 from the first visit to the hospital until discharge and from the last medical appointment. All patients were tested for SARS-CoV-2 by the real-time reverse transcription polymerase chain reaction. Among 57 pediatric patients with sickle cell disease hospitalized from March to November 2020 in a Brazilian academic hospital, 11 (19.3%) had a positive result for SARS-CoV-2. Patients infected by SARS-CoV-2 had a higher prevalence of comorbidities than the ones who were not infected (63.6 vs. 30.4%; p=0.046). During hospital stay, no clinical or complete blood count differences between groups were found. There was a decrease in eosinophil count on hospital admission in patients with sickle cell disease infected by SARS-CoV-2 (p=0.008). Pediatric hospitalized patients with sickle cell disease infected by SARS-CoV-2 had more comorbidities and had a decrease in eosinophil count between hospital admission and the last medical appointment.

A Study On Antibiotic Utilization Among the Paediatric Inpatients of a Tertiary Care Hospital; A Retrospective Study.

A Study On Antibiotic Utilization Among the Paediatric Inpatients of a Tertiary Care Hospital; A Retrospective Study.