ABSTRACT
BACKGROUND: SARS-CoV-2 continues to mutate over time, and reports on children infected with Omicron BA.5 are limited. We aimed to analyze the specific symptoms of Omicron-infected children and to improve patient care. METHODS: We selected 315 consecutively hospitalized children with Omicron BA.5 and 16,744 non-Omicron-infected febrile children visiting the fever clinic at our hospital between December 8 and 30, 2022. Specific convulsions and body temperatures were compared between the two cohorts. We analyzed potential associations between convulsions and vaccination, and additionally evaluated the brain damage among severe Omicron-infected children. RESULTS: Convulsion rates (97.5% vs. 4.3%, P < 0.001) and frequencies (median: 2.0 vs. 1.6, P < 0.001) significantly differed between Omicron-infected and non-Omicron-infected febrile children. The body temperatures of Omicron-infected children were significantly higher during convulsions than when they were not convulsing and those of non-Omicron-infected febrile children during convulsions (median: 39.5 vs. 38.2 and 38.6 °C, both P < 0.001). In the three Omicron-subgroups, the temperature during convulsions was proportional to the percentage of patients and significantly differed ( P < 0.001), while not in the three non-Omicron-subgroups ( P = 0.244). The convulsion frequency was lower in the 55 vaccinated children compared to the 260 non-vaccinated children (average: 1.8 vs. 2.1, P < 0.001). The vaccination dose and convulsion frequency in Omicron-infected children were significantly correlated ( P < 0.001). Fifteen of the 112 severe Omicron cases had brain damage. CONCLUSIONS: Omicron-infected children experience higher body temperatures and frequencies during convulsions than those of non-Omicron-infected febrile children. We additionally found evidence of brain damage caused by infection with omicron BA.5. Vaccination and prompt fever reduction may relieve symptoms.
ABSTRACT
OBJECTIVE: To investigate the effect of glucose level, variability on the prognosis of traumatic patients. METHODS: A retrospective study involving 300 traumatic patients admitted to intensive care unit (ICU) was performed. The average glucose (GluAve), glucose standard deviation (GluSD) and glucose coefficient of variation (GluCV) during the first 72 hours were calculated. Patients were divided into survivor group (n=249) and non-survivor group (n=51) based on outcomes. The GluAve, GluSD and GluCV were compared between the two groups. Patients were allocated into five subgroups based on GluAve (3.9-5.5, 5.6-6.6, 6.7-7.7, 7.8-9.9, ≥10.0 mmol/L) as well as four subgroups on GluCV (<15%, 15%-30%, 30%-50%, >50%). The mortality in hospital was compared among the different subgroups and the different GluCV in the same level of GluAve subgroups, respectively. Multifactor logistic regression was used to determine the risk factor of hospital death. RESULTS: The levels of GluAve, GIuSD, GluCV of non-survivor group were higher than those of survivor group [11.31±4.38 mmol/L vs. 8.50±3.40 mmol/L, 2.85±1.94 mmol/L vs. 1.87±1.67 mmol/L, (28.30±23.08)% vs. (20.90±13.70)%, all P<0.05]. With the gradual increment of GluAve and GluCV level, the mortality was raised accordingly (χ (2)(1)=26.332, P=0.000; χ (2)(2)=65.522, P=0.000). In the subgroup of GluAve 7.8-9.9 mmol/L, the mortality was 9.09% (3/33) with GluCV <15% versus 46.15% (6/13) with GluCV >50% (P<0.01) respectively, and in the subgroup of GluAve ≥10.0 mmol/L, the mortality corresponding rates were 21.05% (4/19) with GluCV < 15% and 61.54% (8/13) with GluCV > 50% (P<0.05). The multivariable logistic regression analysis demonstrated that GluAve and GluCV were risk factors of mortality[GluAve odds ratio (OR)=1.150, 95% confidence interval (95%CI) was 1.042 to 1.270, P=0.006; GluCV OR=1.022, 95%CI was 0.999 to 1.040, P=0.040], GluSD had no effect on mortality. CONCLUSIONS: The increase in GluAve and GluCV in traumatic patients are significantly correlated with mortality. Control the level and the variability of blood glucose might be an important aspect of the multiple trauma death reduction.
