Comparison of effects of quercetin and ascorbic acid on inflammatory cytokines and antioxidant biomarkers in infant rats using an experimental sepsis model.

OBJECTIVE: There is ongoing research on treatments that promote antioxidant and anti-inflammatory mechanisms, which will reduce mortality in sepsis. In this study, we compared the anti-inflammatory and antioxidant activities of quercetin and ascorbic acid using a sepsis model induced in infant rats. METHODS: A total of 28 infant rats 21-days-old that had just completed the lactation period were divided into four groups: control, sepsis, sepsis + quercetin, and sepsis + ascorbic acid. The sepsis model was created with an intraperitoneal injection of bacterial lipopolysaccharide. After 24 hours, blood samples were collected for analysis of serum levels of inflammatory cytokines (IL-1ß, IL-6, TNF-α, and CRP) and antioxidants (CAT, GPx, SOD, and GST). RESULTS: The superoxide dismutase levels were significantly higher in the sepsis + ascorbic acid group compared to the sepsis and sepsis + quercetin groups. The levels of the most active cytokines in sepsis were significantly lower in the serum samples of the septic subjects who received quercetin and ascorbic acid. CONCLUSION: The antioxidant activity, which is impaired in sepsis, was increased by both molecules. We observed that these two molecules, which are free of side effects, have a positive influence on the progression of sepsis to severe and fatal sepsis in childhood (Tab. 2, Ref. 38).

Clinical features and outcomes of 76 patients with COVID-19-related multi-system inflammatory syndrome in children.

OBJECTIVES: Multi-system inflammatory syndrome in children (MIS-C) is a less understood and a rare complication of coronavirus disease-2019 (COVID-19). Given the scarce data regarding this novel disease, we aimed to describe the clinical features and outcomes of our patients with MIS-C and to evaluate the associated factors for the pediatric intensive care unit (PICU) admission. METHODS: The MIS-C patients under 18 years old diagnosed and treated in three referral centers between July 2020 and March 2021 were included. Data of the patients were retrospectively obtained from their medical records. RESULTS: Overall, 76 subjects (24 females) with a mean age of 8.17 ± 4.42 years were enrolled. Twenty-seven (35.5%) patients were admitted to the PICUs. The two most common systemic involvement patterns were cardiac and gastrointestinal. There was only one lethal outcome in a patient with underlying acute lymphoblastic leukemia. Those with higher procalcitonin levels at admission were found to stay longer in the hospital (r = 0.254, p = 0.027). The risk of PICU admission increased with age (aOR: 1.277; 95% CI: 1.089-1.498; p = 0.003) and with decreased initial serum albumin levels (aOR: 0.105; 95% CI: 0.029-0.378; p = 0.001). CONCLUSION: Although there is a wide clinical variability among the patients with MIS-C, we suggest that those with older age and lower initial serum albumin levels merit close monitoring due to their higher risk for PICU admission. Key Points • Although there is a wide variability regarding the management process among clinicians, MIS-C is a rare, severe, less understood complication of COVID-19 that may cause rapid clinical deterioration in the patients. • Clinicians should be aware of this condition in children with persistent fever and a family history of COVID-19. • Older age and low serum albumin levels are the independent predictors for the pediatric intensive care unit admission among MIS-C patients.