Risk factors for disease severity and mortality of children with Covid-19: A study at a Vietnamese Children's hospital.

INTRODUCTION: To find out risk factors for disease severity and mortality of pediatric COVID-19 in the fourth wave of COVID-19 in Vietnam. METHODS: This retrospective cohort study was performed at Children's Hospital 1 from July to December 2021. All children with COVID-19 confirmed by a positive Realtime RT-PCR SARS-CoV-2 result and treated at COVID-19 department for at least 72 h were included. RESULTS: Of the 850 cases admitting to COVID-19 department, 555 children with COVID-19 confirmed by positive RT-PCR and treated at our center for more than 72 h. Median age of confirmed cases was 22.3 (IQR: 3.2-88.6) months, 55.1% were male, and 84.5% had a history of close contact with confirmed COVID-19 patients. The rate of mild, moderate and severe/critical cases was 73,7%, 9.0% and 17.3%, respectively. One hundred ninety-two children (34.6%) had underlying diseases, in which, neurologic disease was the most common underlying disease (7.9%). Underlying disease, dyspnea, elevated CRP >20 mg/L and elevated ferritin were independent factors related to severe illness. Twenty-point two percent of patients in our study needed respiratory support, including 22 invasive mechanical ventilation cases. Eighteen cases (3.2%) died because of severe comorbidities, poor response to treatment. CONCLUSIONS: In our study, the severe/critical and mortality rates in pediatric COVID-19 cases were relatively high. All fatal cases had severe comorbidities. Underlying disease, dyspnea, and elevated inflammatory markers were independent factors related to severity in pediatric COVID-19 cases.

Measuring Health-Related Quality of Life in Vietnamese Patients After Kidney Transplantation.

Objectives: To consider that the health-related quality of life (HRQOL) has become an inherent part of the patient outcomes in the care and treatment after kidney transplantation (KT). This study aimed to measure HRQOL among a representative sample size of patients after KT by using both the Short Form 36 (SF-36) and the Kidney Disease Quality of Life 36 (KDQOL-36). Methods and Results: Data of this cross-sectional design were collected in the Organ Transplant Center, Viet Duc University Hospital (Hanoi, Vietnam) from January 2020 to March 2020 and included the patients aged 18 years or over after KT at 6 months, 1 year, and 3 years postoperatively. HRQOL was evaluated through face-to-face interviews by means of the SF-36 and KDQOL-36 measurement tools. According to the SF-36, the overall mean score of HRQOL was 69.13 ± 15.55 and the two domains were the highest scores of "Mental Health" (81.23 ± 14.28) and "General Health" (80.06 ± 14.81). When measuring with the KDQOL-36, the overall mean score was 68.67 ± 13.75 and was the highest in the domain "Symptoms and Problems of Kidney Disease" (87.06 ± 16.00). Both instruments had good reliability for those after KT. The reliability of the SF-36 was high with Cronbach's coefficients α = 0.90. There were positive relationships between the dimensions measured by the KDQOL-36 and SF-36 (correlation coefficient: 0.03-0.69). Similarly, the domains of the SF-36 also had positive correlations with the KDQOL-36 (correlation coefficient: 0.18-0.51). The correlation coefficient between overall HRQOL scores of the SF-36 and KDQOL-36 was 0.62, indicating a strong correlation between the SF-36 and KDQOL-36. Conclusions: There were slight fluctuations in the HRQOL score in domains in the 3-year follow-up stages, suggesting not having clear change. The mean SF-36 score was consistent with the mean KDQOL-36 score. High reliability and strong correlation were found between two instruments of the SF-36 and KDQOL-36. This study provides the reliability and constructs validity in the combination of two sets of the SF-36 and KDQOL-36 scales for the assessment of HRQOL among post-KT patients, thereby assisting physicians and health professionals in the clinical decision-making, assessment of therapeutic efficacy, and understanding of treatment risk.

Novel Drug Delivery System Based on Ginsenoside Rb1 Loaded to Chitosan/Alginate Nanocomposite Films.

Recently, drug delivery using natural and biodegradable nanoparticles has attracted huge attention. This study focused to deliver an anti-cancer and anti-inflammatory drug Ginsenoside Rb1 through chitosan-Alginate nanocomposite film prepared by solution method. Ginsenoside Rb1 is a dammaran saponin group, which is extracted from an herbaceous plant Panax notoginseng. Ginsenoside loaded alginate-chitosan nanocomposite films were characterized by Fourier transform infrared spectroscopy (FT-IR), scanning electron microscopy (SEM) and differential scanning calorimetry (DSC) methods. The FTIR spectra of alginate/chitosan/ginsenoside Rb1 nanocomposite films show that chitosan, alginate, and ginsenoside Rb1 are linked through the hydrogen bonding and dipolar-dipolar interactions. The FESEM image indicates that the chitosan and ginsenoside Rb1 dispersed well in the alginate matrix. The DSC diagrams display that melting temperature of alginate/chitosan/ginsenoside Rb1 nanocomposite films higher than that of chitosan and lower than that of alginate. It means that alginate and chitosan interact together. Investigation of the ginsenoside Rb1 release from alginate/chitosan/ginsenoside Rb1 nanocomposite films at different pH solutions and different ginsenoside Rb1 content has been carried out by ultraviolet-visible spectroscopy method. The rate of drug release is proportional to the increase in pH solution and inversely proportional to the content of loaded ginsenoside Rb1. The Rb1 release process includes two stages: burst release in the first 10 hours, then constant release afterwards. The suitable ratio of alginate/chitosan to prepare the alginate/chitosan/ginsenoside Rb1 nanocomposite films for further investigations was found out to be 8:2. Ginsenoside Rb1 release process from alginate/chitosan/ginsenoside Rb1 nanocomposite films was believed to be first-order kinetics in the first stage, and then the Rb1 release complies with Higuchi kinetic model in the slow release stage. This study demonstrated the novel synthesis methodology to design drug delivery system based on ginsenoside Rb1 loaded to chitosan/alginate nanocomposite films.