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Introduction: In children, the manifestations of coronavirus disease 2019 (COVID-19) in the acute phase are considered mild compared with those in adults; however, some children experience a severe disease that requires hospitalization. This study was designed to present the operation and follow-up results of the Post-COVID-19 Detection and Monitoring Sequels Clinic of Hospital Infantil de Mexico Federico Gómez in managing children with a history of SARS-CoV-2 infection. Methods: This was a prospective study conducted from July 2020 to December 2021, which included 215 children aged 0-18 years who tested positive for SARS-CoV-2 on polymerase chain reaction and/or immunoglobulin G test. The follow-up was conducted in the pulmonology medical consultation; ambulatory and hospitalized patients were assessed at 2, 4, 6, and 12 months. Results: The median age of the patients was 9.02 years, and neurological, endocrinological, pulmonary, oncological, and cardiological comorbidities were the most commonly observed among the patients. Moreover, 32.6% of the children had persistent symptoms at 2 months, 9.3% at 4 months, and 2.3% at 6 months, including dyspnea, dry cough, fatigue, and runny nose; the main acute complications were severe pneumonia, coagulopathy, nosocomial infections, acute renal injury, cardiac dysfunction, and pulmonary fibrosis. The more representative sequelae were alopecia, radiculopathy, perniosis, psoriasis, anxiety, and depression. Conclusions: This study showed that children experience persistent symptoms, such as dyspnea, dry cough, fatigue, and runny nose, although to a lesser extent than adults, with significant clinical improvement 6 months after the acute infection. These results indicate the importance of monitoring children with COVID-19 through face-to-face consultations or telemedicine, with the objective of offering multidisciplinary and individualized care to preserve the health and quality of life of these children.
RESUMO
Introducción. Desde hace algún tiempo se ha reportado la aparición de cepas de Streptococcus pneumoniae resistentes o con sensibilidad intermedia a penicilina y a otros antibióticos con recuperación importante en la práctica clínica de muchos centros hospitalarios. Ante la ausencia de información en nuestro medio determinamos la susceptibilidad de aislamientos clínicos de S. pneumoniae a antimicrobianos de uso común. Material y métodos. En 88 cepas de S. pneumoniae aisladas de enero de 1991 a agosto de 1994 se determinó la susceptibilidad por el método de dilución en agar con el fin de detectar la concentración mínima inhibitoria (MIC) para 13 antimicrobianos de uso común. Se utilizó como control la cepa de S. pneumoniae ATCC 49619 y los valores de corte para MIC según las tablas de la NCCLS(National Committee for Clinical Laboratory Standars). Resultados. Con esta metodología encontramos que de las cepas estudiadas 15 (17 por ciento) fueron resistentes a penicilina con MIC ò 2 µgm/mL, mientras que 24 (27.2 por ciento) tuvieron una susceptibilidad intermedia. Así mismo 11 812.5 por ciento) fueron resistentes a ampicilina 6 (8 por ciento), a clorafenicol 14 (15.9 por ciento y a trimetoprim-sulfametoxazol 49 (56 por ciento). Aunque no hubo cepas resistentes a cefotaxima, 4 (4.5 por ciento) exhibieron una susceptibilidad intermedia. Todas las cepas fueron susceptibles a vancomicina, amoxicilina y amoxicilina/clavulanato. Conclusiones. La resistencia de S. pneumoniae a penicilina en las cepas probadas de nuestra institución es alta; sin embargo su implicación clínica no se ha establecido, por lo tanto es aventurado sugerir un cambio en los esquemas antimicrobianos habituales para este tipo de infecciones