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Objective. To describe the impact of weight on length of stay (LOS) and oxygen requirement among hospitalized children with COVID-19. Methods. This is a retrospective review of 153 children admitted for COVID-19 from March 2020 to October 2021. Body mass index (BMI) percentile and weight-for-age (WFA) percentile were used to determine weight status for children ≥2 years and <2 years respectively. Results. We found 2 distinct patterns for patients <2 years and ≥2 years; The likelihood of needing oxygen and LOS ≥ 5 days was higher for children ≥2 years with BMI ≥ 85th percentile (P = .0415 and P = .0197). Among those <2 years, mean WFA percentile decreased with increasing oxygen need (P = .0325). There was a negative correlation between LOS and WFA percentile (r = -.31, P = .0123). Conclusion. It is important to stratify patients' risk according to their age, BMI and WFA percentile during hospitalization for COVID 19.
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BACKGROUND AND OBJECTIVE: Acetaminophen, one of the routine medicines used for temperature reduction in febrile children, is available in multiple routes of administration, including oral and rectal routes. Our objective is to compare the antipyretic effectiveness of oral acetaminophen versus rectal acetaminophen in pediatric patients with fever in terms of temperature reduction. METHODS: Medline and Embase databases were searched from inception to August 2021. Cohort studies, case-control studies, experimental studies, and randomized controlled trial studies comparing oral and rectal administered acetaminophen in pediatric patients were included. Two reviewers independently extracted data. RESULTS: A total of 5 randomized studies (n = 362) were included in the meta-analysis. No significant difference was found between oral and rectal acetaminophen in temperature reduction at 1 hour (weighted mean difference [WMD], 0.04°C; 95% confidence interval [CI], -0.10°C to 0.19°C; P = .501) or 3 hours (WMD, -0.14°C; 95% CI, -0.37°C to 0.10°C; P = .212) after administration (WMD, -0.14°C; 95% CI, -0.37°C to 0.10°C; P = .212). CONCLUSION: Oral and rectal acetaminophen have no significant difference in antipyretic effectiveness at 1 and 3 hours after administration. If both options are available, oral acetaminophen would be preferred because of a more predictable drug level after administration. However, for febrile children with specific circumstances for whom oral acetaminophen could not be administered, rectal acetaminophen may be an alternative option for a short period of time (<48 hours).