Critically ill children with SARS-COV-2 Omicron infection at a national children medical center, Guangdong, China.

BACKGROUND: SARS-CoV-2 infection is described as asymptomatic, mild, or moderate disease in most children. SARS-CoV-2 infection related death in children and adolescents is rare according to the current reports. COVID-19 cases increased significantly in China during the omicron surge, clinical data regarding pediatric critical patients infected with the omicron variant is limited. In this study, we aim to provide an overview of the clinical characteristics and outcomes of critically ill children admitted to a national children's medical center in Guangdong Province, China, during the outbreak of the omicron variant infection. METHODS: We conducted a retrospective study from November 25, 2022, to February 8, 2023, which included 63 critically ill children, under the age of 18, diagnosed with SARS-CoV-2 infection. The patients were referred from medical institutions of Guangdong province. The medical records of these patients were analyzed and summarized. RESULTS: The median age of patients was 2 years (Interquartile Range, IQR: 1.0-8.0), sex-ratio (male/female) was 1.52. 12 (19%) patients (age ≥ 3 years) were vaccinated. The median length of hospital stay was 14 days (IQR: 6.5-23) in 63 cases, and duration of fever was 5 days (IQR: 3-8.5), pediatric intensive care unit (PICU) stay was 8 days (IQR 4.0-14.0) in 57 cases. 30 (48%) cases had clear contact history with family members who were infected with SARS-CoV-2. Three children who tested positive for SARS-CoV-2 infection did not show any abnormalities on chest imaging examination. Out of the total patients, 33 (52%) had a bacterial co-infection, with Staphylococcus aureus being the most commonly detected bacterial pathogen. Our cohort exhibited respiratory and nervous system involvement as the primary features. Furthermore, fifty (79%) patients required mechanical ventilation, with a median duration of 7 days (IQR 3.75-13.0). Among these patients, 35 (56%) developed respiratory failure, 16 (25%) patients experienced a deteriorating progression of symptoms and ultimately succumbed to the illness, septic shock was the most common condition among these patients (15 cases), followed by multiple organ failure in 12 cases, and encephalopathy identified in 7 cases. CONCLUSION: We present a case series of critically ill children infected with the SARS-CoV-2 omicron variant. While there is evidence suggesting that Omicron may cause less severe symptoms, it is important to continue striving for measures that can minimize the pathogenic impact of SARS-CoV-2 infection in children.

Endophytic fungus Serendipita indica accelerates ascorbate-glutathione cycle of white clover in response to water stress.

Ascorbate-glutathione cycle is an important pathway for plants to scavenge reactive oxygen species (ROS) under environmental stress conditions. The objective of this study was to investigate the effects of the endophytic fungus Serendipita indica on biomass, chlorophyll concent, ROS levels, antioxidant enzyme activities, and ascorbate-glutathione cycle in white clover under ample water and water stress conditions. The results showed that 46 days of soil water stress distinctly promoted root colonization by S. indica. Under water stress, S. indica inoculation significantly promoted shoot and root biomass, total chlorophyll content, and activities of superoxide dismutases (SOD; e.g., Fe-SOD and Cu/Zn-SOD) and peroxidase in roots, coupled with a decrease in malondialdehyde content in roots. In the ascorbate-glutathione cycle of roots, S. indica also significantly increased the activity of ascorbate peroxidase and glutathione reductase activities in water-stressed white clover, along with the increase in reduced ascorbic acid and reduced/oxidized glutathione contents, thus accelerating the ascorbate-glutathione cycle in inoculated plants to scavenge more ROS (e.g., hydrogen peroxide). As a result, S. indica enhanced the tolerance of white clover in response to water stress by enhancing antioxidant enzyme activities and accelerating the ascorbate-glutathione cycle.