Treatment outcomes and their predictors in children hospitalized with varicella complicated by bacterial superinfections after pandemic of COVID-19 - a retrospective multicenter analysis of real-life data in Poland.

PURPOSE: The aim of this study was to analyze treatment outcomes and their predictors in children hospitalized due to varicella complicated by bacterial superinfections after pandemic of COVID-19. METHODS: This retrospective study analyzed data collected in a multicenter, nationwide, observational database dedicated for children aged 0-17 years hospitalized due to bacterial complications of varicella in 9 Polish tertiary healthcare inpatient centers. The primary endpoint of this study was the treatment outcome established after the end of hospital management assessed at a 4-point scale. The secondary endpoint was defined as the necessity of surgical intervention. RESULTS: There were 458 patients with a median age of 4 (IQR 2-6) years. After the completed treatment, 319 (69%) participants were found fully recovered; 132 (29%) had transient complications; 2 (0.5%) had persistent complications; and 1 child (0.5%) died. Multivariate analysis revealed that implementation of ibuprofen in pre-treatment management of a child with varicella was associated with a 4.07-fold (2.50-6.60) increase in risk of complications after the treatment and it was associated with 2.87 times (1.39-5.89) higher risk of surgical intervention necessity. For other pre-hospital interventions (implementation of acyclovir, antibiotics or antihistaminics) no significant impact was observed. GAS infection increased the necessity of surgical intervention by 7.51 (3.64-15.49) times. CONCLUSIONS: One-third of patients treated for bacterial complications of varicella have post-treatment complications, most of them transient. GAS infection increases the need for surgical intervention. The use of ibuprofen in the treatment of varicella significantly increases the risk of complications and the need for surgical intervention.

The frequency of occurrence anti-HAV antibodies to health employees ­ own observations

INTRODUCTION: In the years 1997-2016, Poland was counted among the countries with a low and very low endemicity of hepatitis A. Based on the epidemiological data from NIZP­PZH (National Institute of Public Health - National Institute of Hygiene), since 2017, an increase in the incidence of hepatitis A has been observed in Poland. Considering the low number of cases by 2016 and a high percentage of seronegative persons, an increased risk of HAV infections should be expected. OBJECTIVE: The aim of the project was to assess the presence of anti-HAV IgG antibodies in the employees of the Provincial Hospital for Infectious Diseases and Observation in Bydgoszcz. MATERIAL AND METHODS: The study was conducted on 123 people who are employees of the hospital. The presence of anti-HAV antibodies was detected using HAV IgG Elisa FORTRESS DIAGNOSTICS kits. RESULTS: The presence of anti-HAV IgG antibodies was found in 28/123 (22.8%) subjects. Anti-HAV IgG antibodies were almost exclusively found in people over 40 years of age. Only one case involved a younger person. CONCLUSIONS: The low incidence of anti-HAV antibodies in the IgG class among medical personnel confirms the reasonableness of vaccinations against hepatitis A in this group.

Encephalitis in the Course of HHV-7 Infection in an Infant.

Most cases of acute infections caused by human herpesvirus 7 (HHV-7) are asymptomatic or very mild. Clinical symptoms disappear spontaneously; however, the infection becomes latent and persists for life with periodic asymptomatic reactivation. Little is known about the virus's ability to cross the blood-brain barrier. Our case of an immunocompetent infant indicates that HHV-7 infection should be considered a cause of neuroinfection, not only in immunocompromised patients but also in the youngest immunocompetent patients.

Significance of expression of selected miRNAs in the diagnosis of hepatological complications of Epstein-Barr virus infection in children.

Aim of the study: To assess the expression of selected miRNAs as predictive factors of hepatological complications in Epstein-Barr virus (EBV)-infected children. Material and methods: This study included 68 children infected with EBV aged 1 to 18 years hospitalised between 01.12.2018 and 31.12.2020 in the Department of Paediatrics, Infectious Diseases and Hepatology. The expression of 5 miRNAs (miR-122-5p, miR-21-3p, miR-34a-5p, miR-26b-5p, miR-199a-5p) was analysed by real-time PCR using the TaqMan Fast Advanced Master Mix kit. Results: In the group of EBV-infected children, statistically significantly higher expression for miR-21-3p, miR-122-5p, miR-26b-5p and miR-34a-5p was confirmed. In a group of 54 children diagnosed with hepatitis, along with an increase in alanine aminotransferase (ALT) and g-glutamyl transpeptidase (GGTP) activity, an increase in expression of miR-21-3p, miR-122-5p, miR-26b-5p, miR-34a-5p and miR-199a-5p was observed. Conclusions: Increased expression of miR-21-3p, miR-122-5p, miR-26b-5p, miR-34a-5p and miR-199a-5p in EBV-infected children appears to be a risk factor for hepatological complications progressing to biliary pole defects.

Are Selected Cytokines and Epstein-Barr Virus DNA Load Predictors of Hepatological Complications of Epstein-Barr Virus Infection in Children?

The aim of the study was to evaluate tumour necrosis factor-α (TNF-α), interleukin-6 (IL-6), soluble intracellular adhesion molecules 1 (s-ICAM-1) and Epstein-Barr virus (EBV) DNA load levels as predictors of hepatological complications of EBV infection in children. The study group consisted of 54 children aged one to eighteen years, who were hospitalised from 1 December 2018 to 31 December 2020 in the Department of Paediatrics, Infectious Diseases and Hepatology and who had hepatological complications in the course of serologically and molecularly confirmed EBV infection. It was shown that IL-6, TNF-α, and s-ICAM-1 concentrations were the highest in patients with hepatitis and biliary pole damage. Higher EBV DNA viremia positively correlated with increased C-reactive protein (CRP) and TNF-α levels and increased leukocyte, lymphocyte, and monocyte counts. Increases in lymphocyte counts and TNF-α concentrations were observed along with increases in gamma-glutamyl transpeptidase (GGTP) activity. Increased concentrations of IL-6, TNF-α, and s-ICAM-1 may indicate the risk of hepatitis with concomitant biliary pole damage during EBV infection.

Real-World Efficacy and Safety of an 8-Week Glecaprevir/Pibrentasvir Regimen in Children and Adolescents with Chronic Hepatitis C-Results of a Multicenter EpiTer-2 Study.

The aim of the study was to analyze the effectiveness and safety of anti-HCV treatment based on a pangenotypic direct-acting antiviral (DAA) regimen with glecaprevir/pibrentasvir (GLE/PIB) in children. The multi-center study was conducted in HCV-infected children who were treated in the period from November 2022 to January 2023. The analysis included 23 pediatric patients with a mean (SD) age of 9.61 (3.68) years. The cohort included 13 girls and 10 boys. The most common HCV genotypes were GT1b (n = 9, 39.1%), GT1a (n = 6, 26.1%) and GT3 (n = 5, 21.7%). The SVR was assessed at 12 weeks after the end of treatment and was 100% for both girls and boys. The conducted study showed a very good tolerance of the treatment in the entire analyzed group and confirmed a very high efficacy and safety for 8-week treatment with GLE/PIB in children over three years of age. It seems that our study is the first on the real-world use of an 8-week GLE/PIB pangenotypic therapy in a group of children aged 3-12 years and the first in Europe for adolescents aged 12-17.

The Seroprevalence of SARS-CoV-2 IgG Antibodies in Children Hospitalized for Reasons Other Than COVID-19.

The aim of the study was to assess the seroprevalence of SARS-CoV-2 IgG antibodies in children hospitalized for reasons other than COVID-19. The study was conducted among 686 children, aged 2 weeks to 18 years, hospitalized in the Department of Paediatrics, Infectious Diseases, and Hepatology in Bydgoszcz, Poland, in the period from 1 June 2021 to 30 April 2022. The presence of anti-SARS-CoV-2 antibodies was detected in 392 (57%) children. Since December 2021, a significantly larger proportion of children with a positive titer of anti-SARS-CoV-2 antibodies has been observed, constituting as much as 87.5% of patients hospitalized in April 2022. In total, 69% of children with detected anti-SARS-CoV-2 antibodies were children under 5 years of age. The highest mean amounts of titers of anti-SARS-CoV-2 antibodies were observed in children over 10 years of age. The conducted studies showed the presence of anti-SARS-CoV-2 antibodies in a significant group of hospitalized children and an increase in the percentage of these children during the fourth and fifth wave of COVID-19 in Poland caused by the Delta and Omicron variants, respectively. The vast majority of parents of the studied children had no knowledge of the COVID-19 infection in their charges, which may indicate asymptomatic infection or mild course of the disease.