Comparison of influenza and COVID-19-associated hospitalizations among children < 18 years old in the United States - FluSurv-NET (October-April 2017-2021) and COVID-NET (October 2020-September 2021)

BackgroundInfluenza virus and SARS-CoV-2 are significant causes of respiratory illness in children. MethodsInfluenza and COVID-19-associated hospitalizations among children <18 years old were analyzed from FluSurv-NET and COVID-NET, two population-based surveillance systems with similar catchment areas and methodology. The annual COVID-19-associated hospitalization rate per 100 000 during the ongoing COVID-19 pandemic (October 1, 2020-September 30, 2021) was compared to influenza-associated hospitalization rates during the 2017-18 through 2019-20 influenza seasons. In-hospital outcomes, including intensive care unit (ICU) admission and death, were compared. ResultsAmong children <18 years old, the COVID-19-associated hospitalization rate (48.2) was higher than influenza-associated hospitalization rates: 2017-18 (33.5), 2018-19 (33.8), and 2019-20 (41.7). The COVID-19-associated hospitalization rate was higher among adolescents 12-17 years old (COVID-19: 59.9; influenza range: 12.2-14.1), but similar or lower among children 5-11 (COVID-19: 25.0; influenza range: 24.3-31.7) and 0-4 (COVID-19: 66.8; influenza range: 70.9-91.5) years old. Among children <18 years old, a higher proportion with COVID-19 required ICU admission compared with influenza (26.4% vs 21.6%; p<0.01). Pediatric deaths were uncommon during both COVID-19- and influenza-associated hospitalizations (0.7% vs 0.5%; p=0.28). ConclusionsIn the setting of extensive mitigation measures during the COVID-19 pandemic, the annual COVID-19-associated hospitalization rate during 2020-2021 was higher among adolescents and similar or lower among children <12 years old compared with influenza during the three seasons before the COVID-19 pandemic. COVID-19 adds substantially to the existing burden of pediatric hospitalizations and severe outcomes caused by influenza and other respiratory viruses. SummaryAnnual hospitalization rates and proportions of hospitalized children experiencing severe outcomes were as high or higher for COVID-19 during October 2020-September 2021 compared with influenza during the three seasons before the COVID-19 pandemic, based on U.S. population-based surveillance data.

Innate Immune Memory: Activation of Macrophage Killing Ability by Developmental Duties.

Innate immune systems in many taxa exhibit hallmarks of memory in response to previous microbial exposure. A new study demonstrates that innate immune memory in Drosophila embryonic macrophages can also be induced by the successful engulfment of apoptotic cells, highlighting the importance of early exposure events for developing responsive immune systems.

Unilateral ovarian fibrothecoma with menorrhagia

Ovarian fibrothecoma is a relatively new term that is used to describe an ovarian sex cord stromal tumour that has mixed features of both fibroma and thecoma. The prevalence of ovarian fibrothecoma tumours is very rare and is reported to be about 1.2% of all ovarian tumours. We report a case of a 32-year-old woman who presented with acute menorrhagia with no previous medical, surgical or gynecological history. She was amenorrhic for four years after the insertion of a levonorgestrelreleasing intrauterine system (LNG-IUS) for contraception. The efficacy and location of LNG-IUS was reflected due to the sudden onset of menorrhagia. On pelvic examination and ultrasound the LNG-IUS could not be visualized and a uterine fibroid was noted. A diagnostic laparoscopy was done to identify the LNG-IUS, which revealed an incidental large ovarian mass on the left ovary. CA-125 level was elevated to 45 kU/L (Normal range <35 kU/L). Total abdominal hysterectomy, left salpingo-oopherectomy and cystectomy were performed. On histopathology, the mass was proven to be an ovarian fibrothecoma. No signs of malignancy were noted on peritoneal fluid cytology. The LNG-IUS was found inside the uterus. Our case is reported on the basis of the rare incidence of ovarian fibrothecoma and the possible effect it may have on the efficacy of LNG-IUS causing menorrhagia.

Ulerythema ophryogenes, a rarely reported cutaneous manifestation of noonan syndrome: case report and review of the literature.

BACKGROUND: Ulerythema ophryogenes (also known as keratosis pilaris atrophicans faciei) is a rarely reported cutaneous manifestation of Noonan syndrome. OBJECTIVE: Recognizing ulerythema ophryogenes as a cutaneous association in Noonan syndrome may aid in the diagnosis of this relatively common genetic condition. METHODS: We present a case of a patient with Noonan syndrome and ulerythema ophryogenes associated with a SOS1 mutation and review the literature on this association. RESULTS: To the best of our knowledge, this is the second case of Noonan syndrome proven to be due to an SOS1 mutation in which ulerythema ophryogenes was clinically recognized and specifically diagnosed. CONCLUSIONS: The presence of ulerythema ophryogenes in a patient with Noonan syndrome increases the likelihood of a SOS1 mutation. Further reports by dermatologists and medical geneticists documenting ulerythema ophryogenes and not just descriptions of sparse or absent eyebrows will help support this genotype-phenotype correlation.