Acute acral eruptions in children during the COVID-19 pandemic: Characteristics of 103 children and their family clusters.

BACKGROUND: A marked increase in frequency of acute acral eruptions (AAE) was observed in children during the COVID-19 pandemic in the spring period. OBJECTIVES: In this observational multicenter study, based on children with AAE, we aimed to assess the proportion of household members possibly infected by SARS-CoV-2. METHODS: We collected data from all children observed with AAE, prospectively from April 7, 2020 to June 22, 2020, and retrospectively since February 28, 2020. The primary outcome was the household infection rate, defined as the proportion of family clusters having at least one member with COVID-19 infection other than the child with AAE ("index child"). The definition of a case was based on characteristic clinical signs and a positive PCR or serology. RESULTS: The study included 103 children in 10 French departments and in Quebec. The median age was 13 years and the interquartile range [8-15], with a female-to-male ratio of 1/1.15. In children with AAE, all PCR tests were negative (n=18), and serology was positive in 2/14 (14.3%) cases. We found no significant anomalies in the lab results. A total of 66 of the 103 families (64.1%) of included children had at least one other infected member apart from the index child. The total number of household members was 292, of whom 119 (40.8%) were considered possibly infected by SARS-CoV-2. No index children or households exhibited severe COVID-19. DISCUSSION: Among the 103 households included, 64.1% had at least one infected member. Neither children with AAE nor their households showed severe COVID-19.

[A national survey on pain management before tracheal intubation in neonates in French type III maternity units]. / Enquête nationale sur la prise en charge de la douleur liée à l'intubation trachéale du nouveau-né dans les maternités de niveau III.

BACKGROUND: Various analgesics and sedatives are currently available for critically ill newborns requiring tracheal intubation in the delivery room. Even if pain management has improved over the past few years, there are few recent data on the French clinical practices in the delivery room. OBJECTIVES: To describe the use of sedatives and/or analgesics before tracheal intubation in the delivery rooms of French type III maternity units. METHODS: A phone interview was conducted in 63 maternity units between April and August 2011. RESULTS: Sixty-two maternity units (98%) completed the interview. Twenty-nine percent of the preterm newborns requiring intubation for elective surfactant therapy and 77.4% requiring intubation for prophylactic surfactant therapy did not receive any sedative and/or analgesic treatment. Written guidelines were present in 58.1% of the units. The most frequent sedative and/or analgesic treatments were sufentanil, ketamine, midazolam, and propofol. The first vascular access was a central umbilical catheter or a peripheral venous catheter for most of the centers. CONCLUSION: The use of sedation-analgesia is still insufficient in French maternity units. Tracheal intubation without the use of analgesia and sedation should be performed only for life-threatening situations in the delivery room.