Prevalence and association of oral manifestations with disease severity in patients diagnosed with COVID­19: A cross­sectional study.

Systemic disorders may exhibit early signs when conducting an oral examination. Since the onset of the COVID-19 pandemic, several studies have been published detailing the direct impact of the virus on the oral cavity. The present study aimed to determine whether indeed there are any significant disparities in oropharyngeal manifestations between individuals infected with severe acute respiratory syndrome coronavirus 2 and a control group, and whether the virus has the ability to invade and reproduce inside oral keratinocytes and fibroblasts, resulting in the development of oral ulcerations and superficial lesions. The present study provides an overview of the symptoms that occur at an early stage of the illness, and the most commonly affected regions of the oral cavity, including the tongue, lips, palate and oropharynx are examined. In the present retrospective study, 52 patients infected with COVID-19 were recruited between April, 2021 and October, 2022. In addition, 52 individuals who tested negative for the virus were recruited as the control group. The study was conducted through a thorough examination and questionnaire provided to all participants. The results revealed that among the cohort of patients from the COVID-19 group examined (n=52), a proportion (mean, 16.15) displayed oral manifestations. Specifically, 75% of the patients in the COVID-19 group described oral cavity pain, and 69% of these patients had changes in teeth color or dental caries. In summary, in relation to the control group, the prevalence of oropharyngeal symptoms was generally lower compared to the COVID-19 group, apart from oral cavity pain (30.8%), tonsillitis (17.3%), bleeding (34.6%), teeth color changes (36.5%), recurrence (15.4%) and abscesses (7.7%). Thus, on the whole, the patients without COVID-19 had fewer oral manifestations.

Risk factors in non­surviving patients with infection with carbapenemase­producing Enterobacterales strains in an intensive care unit.

Carbapenemase-producing Enterobacterales (CPE) are Gram-negative bacteria that belong to the Enterobacterales family and produce enzymes known as carbapenemases, which inhibit carbapenems, cephalosporins and penicillins. Carbapenem-resistant Enterobacterales (CRE) are resistant to carbapenems, cephalosporins and penicillins via mechanisms that may or may not produce carbapenemases. The identification of carbapenems is critical for the initiation of proper antibiotic therapy. The present case-control, retrospective study included 64 patients with CPE strains admitted to an intensive care unit between September, 2017 and October, 2021; of these, 34 patients with CPE succumbed and 30 control patients with CPE strains survived. CPE strains in the deceased patients were caused by Klebsiella spp. in 31 cases (91.2%) and Escherichia coli in 3 cases (8.8%). The univariate analysis revealed that the predictive factors associated with mortality in patients with CPE were admission with coronavirus disease 2019 (COVID-19) (P=0.001), invasive mechanical ventilation (P=0.001), and treatment with corticosteroids (P=0.006). The multivariate analysis revealed that admission with COVID-19 [odds ratio (OR), 16.26; 95% confidence interval (CI), 3.56-74.14; P≤0.05] and invasive mechanical ventilation (OR, 14.98; 95% CI, 1.35-166.22; P≤0.05) were associated with mortality as independent risk factors. Admission with COVID-19 increased the risk of mortality 16.26-fold and invasive mechanical ventilation increased the risk of mortality by 14.98-fold. On the whole, the present study demonstrates that the length of hospital duration in patients who acquired CPE did not influence mortality, whereas infection with COVID-19 increased and invasive mechanical ventilation were associated with an increased risk of mortality.

Immunomodulatory Effects of Vitamin D in Respiratory Tract Infections and COVID-19 in Children.

Acute respiratory tract infections (ARTIs) are one of the main reasons that the pediatric population goes to the doctor. The connection between ARTI and vitamin D (VD) is currently debated by the medical community, and so far, there has been little agreement with regard to the ideal level of 25(OH)D concentration that would provide protection for the respiratory tract, or the effectiveness of its administration in the treatment of respiratory infections. The purpose of this literature review was to bring attention to the immunomodulatory and antiviral function of vitamin D and its relation to the respiratory system by examining the main ARTIs, including SARS-CoV-2. The latter has affected the pediatric population in different ways, from asymptomatic patients to severe forms with multisystem inflammatory syndrome in children (MIS-C). Although there are not much clinical data on the SARS-CoV-2 disease in the pediatric population worldwide, we tried to find out whether there is a connection between the severity of this disease, other ARTIs, and vitamin D supplementation. We also aimed to find out if 25OHD deficiency had an adverse effect on the evolution of the disease and the recovery period in the case of younger patients affected by COVID-19. For this literature review, the PICO framework was selected as the methodological approach. Our results demonstrated many methods by which this vitamin may lower the risk of ARTI with regard to the COVID-19 infection. Despite these significant advancements, more research is needed to support the idea that 25(OH)D concentration can influence the evolution of respiratory tract infections in children.

Neurological manifestations found in children with multisystem inflammatory syndrome.

The pandemic that resulted from the spread of SARS-CoV-2 viral infections has affected the population worldwide but has characteristically shown a preponderance for affecting adults. However, cases of SARS-CoV-2 infection have been reported in children, showing a systemic echo and severe damage. Multisystem inflammatory syndrome in children (MIS-C) can occur, on average, 4 weeks after the infection of a child with SARS-CoV-2. The aim of the present study was to examine 30 cases of children affected by MIS-C in terms of symptoms, laboratory tests, and evolution. Patients included in the study presented with neurological symptomatology including headache, meningism, and drowsiness. Treatment was administered in concordance with the protocol for MIS-C. The evolution of the patients in the present study was favorable and the symptomatology remitted in days to weeks. The importance of identifying the features of this disease, its treatment, and that the most probable evolution is favorable is significant in the medical world, especially as the pandemic is ongoing.