Comparative study shows that 1 in 7 Spanish children with COVID-19 symptoms were still experiencing issues after 12 weeks.

AIM: We investigated prolonged symptoms in children after COVID-19, including the clinical characteristics and risk factors. METHODS: This multicentre retrospective study focused on 451 children under 18 years old who were diagnosed with symptomatic COVID-19 between 14 March and 31 December 2020. Persistent symptoms were analysed with a telephone questionnaire by the attending physicians from 1 August to 30 September 2021. A control group of 98 with no history of COVID-19, who were treated for other reasons, was also included. RESULTS: Most (82.0%) of the cases had mild infections that required outpatient care and 5.1% were admitted to the paediatric intensive care unit (PICU). We found that 18.4% had symptoms that lasted 4-12 weeks. There were also 14.6% who were symptomatic for longer than 12 weeks and the odds risks were higher for children aged 5 years or more (OR 3.0), hospitalised (OR 3.9), admitted to the PICU (OR 4.3) and with relatives who were symptomatic for 12 weeks or more (OR 2.8). The controls had similar percentages of prolonged symptoms, despite having no history of COVID-19, especially those who were older than 5 years. CONCLUSION: This study confirmed that a worrying percentage of children had prolonged symptoms after COVID-19.

Gut and respiratory tract microbiota in children younger than 12 months hospitalized for bronchiolitis compared with healthy children: can we predict the severity and medium-term respiratory outcome?

Growing evidence indicates that gut and respiratory microbiota have a potential key effect on bronchiolitis, mainly caused by respiratory syncytial virus (RSV). This was a prospective study of 96 infants comparing infants with bronchiolitis (n = 57, both RSV and non-RSV associated) to a control group (n = 39). Gut (feces) and respiratory [nasopharyngeal aspirate (NPA)] microbial profiles were analyzed by 16S rRNA amplicon sequencing, and respiratory viruses were identified by PCR. Clinical data of the acute episode and follow-up during the first year after infection were recorded. Pairwise comparisons showed significant differences in the gut (R2 = 0.0639, P = 0.006) and NPA (R2 = 0.0803, P = 0.006) microbiota between cases and controls. A significantly lower gut microbial richness and an increase in the NPA microbial diversity (mainly due to an increase in Haemophilus, Streptococcus, and Neisseria) were observed in the infants with bronchiolitis, in those with the most severe symptoms, and in those who subsequently developed recurrent wheezing episodes after discharge. In NPA, the higher microbial richness differed significantly between the control group and the non-RSV bronchiolitis group (P = 0.01) and between the control group and the RSV bronchiolitis group (P = 0.001). In the gut, the richness differed significantly between the control group and the non-RSV group (P = 0.01) and between the control group and the RSV bronchiolitis group (P = 0.001), with higher diversity in the RSV group. A distinct respiratory and intestinal microbial pattern was observed in infants with bronchiolitis compared with controls. The presence of RSV was a main factor for dysbiosis. Lower gut microbial richness and increased respiratory microbial diversity were associated with respiratory morbidity during follow-up. IMPORTANCE: Both the intestinal and respiratory microbiota of children with bronchiolitis, especially those with respiratory syncytial virus infection, are altered and differ from that of healthy children. The microbiota pattern in the acute episode could identify those children who will later have other respiratory episodes in the first year of life. Preventive measures could be adopted for this group of infants.

[Early decentralization of health services in Argentina: the construction of the health system in Córdoba, 1930-1955]. / La temprana descentralización de los servicios de salud en la Argentina: la construcción del sistema sanitario en Córdoba, 1930-1955.

This paper analyzes the process of construction of the Argentine public health system, highlighting the limitations that occurred in the proposed nationalization of health policy in the postwar period and the central role played by subnational jurisdictions, making the provision of services rendered on a provincial basis. More precisely, in this respect it is seen how the expansion of health services in some provinces shows us how, in the second quarter of the twentieth century, it was primarily the result of the action of local rather than national departments. In order to better elucidate this process, the trajectory of public healthcare facilities in the province of Córdoba between 1930 and 1955 was studied.

[The democratization of health. The health policies during the Peronist government in Córdoba (1943-1955)]. / La democratización de la salud. Las políticas sanitarias durante los gobiernos peronistas en Córdoba (1943-1955).

The purpose of this paper is to analyze changes produced in the public health system of Córdoba during the peronist government and the performance of the provincial state in the process. We study the increase of health services, public social spending, health agencies and bureaucracies of the state of Córdoba between 1943 and 1955.

La finalidad de este artículo es analizar los cambios producidos en los sistemas de salud públicos en Córdoba durante los gobiernos peronistas y la actuación del Estado provincial en el proceso. En la investigación se analiza el incremento de los servicios de salud, el gasto público social y las agencias y burocracias sanitarias del Estado cordobés entre 1943 y 1955.

La temprana descentralización de los servicios de salud en la Argentina: la construcción del sistema sanitario en Córdoba, 1930-1955 / Early decentralization of health services in Argentina: the construction of the health system in Córdoba, 1930-1955

Este trabajo analiza el proceso de construcción del sistema público de salud argentino, poniendo en evidencia las limitaciones que se produjeron en el proyecto de nacionalización de las políticas sanitarias en la postguerra y el papel central que tuvieron las jurisdicciones subnacionales, provincializando la provisión de los servicios. Más precisamente se visibiliza cómo, en el segundo cuarto del siglo XX, la ampliación de los servicios de salud en algunas provincias fue principalmente el resultado de la acción de las reparticiones locales antes que nacionales. Con el propósito de dilucidar mejor ese proceso, estudiamos la trayectoria de los dispositivos sanitarios públicos en la provincia de Córdoba entre 1930 y 1955.

This paper analyzes the process of construction of the Argentine public health system, highlighting the limitations that occurred in the proposed nationalization of health policy in the postwar period and the central role played by subnational jurisdictions, making the provision of services rendered on a provincial basis. More precisely, in this respect it is seen how the expansion of health services in some provinces shows us how, in the second quarter of the twentieth century, it was primarily the result of the action of local rather than national departments. In order to better elucidate this process, the trajectory of public healthcare facilities in the province of Córdoba between 1930 and 1955 was studied.