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    Clinical and Laboratory Evaluations of Patients Diagnosed as Having Multisystem Inflammatory Syndrome Associated with Coronavirus Disease 2019 in Children: A Single Center Experience from Konya
    (Georg Thieme Verlag Kg, 2023) Genceli, Mustafa; Akcan, Ozge Metin; Erdogan, Kubra Nur; Kilic, Ahmet Osman; Yazar, Abdullah; Akin, Fatih; Gunes, Muhammed
    Objective Multisystem inflammatory syndrome in children (MIS-C), characterized by fever, inflammation, and multiorgan dysfunction, was newly defined after severe acute respiratory syndrome coronavirus 2 infection. The clinical spectrum of MIS-C can be classified as mild, moderate, and severe. We aimed to evaluate demographics, clinical presentations, laboratory findings, and treatment modalities of patients with MIS-C according to clinical severity.Methods We performed a retrospective study of patients who were diagnosed as having MIS-C between September 2020 and October 2021 in the Necmettin Erbakan University Meram Faculty of Medicine, Turkey.Results A total of 48 patients (24 females and 24 males) with a median age at diagnosis of 10.3 years (range: 42 months-17 years) were enrolled, the most common clinical severity of MIS-C was moderate. The common presentations of patients were fever (97%), nonpurulent conjunctivitis (89.6%), rashes (81.3%), fatigue (81.3%), strawberry tongue (79.2%), and myalgia (68.8%). The most common laboratory findings were lymphopenia (81.2%), thrombocytopenia (54.1%), elevated D-dimer levels (89.5%), C-reactive protein (CRP; 100%), procalcitonin (97%), erythrocyte sedimentation rate (87.5%), ferritin (95.8%), interleukin 6 (IL-6) (86.1%), and probrain natriuretic peptide (pro-BNP) (97%). High levels of CRP, procalcitonin, pro-BNP, and urea were associated with the severity of MIS-C ( p < 0.05). Fifteen of the patients were found to have pulmonary involvement. Ascites were the most common finding on abdominal ultrasonography (11 patients) and were not seen in a mild form of the disease. During the study period, two patients died.Conclusion It is important to make patient-based decisions and apply a stepwise approach in treating patients with MIS-C due to the increased risk of complications and mortality.
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    Could COVID-19 be a trigger for manic attack in an adolescent?
    (Springer-Verlag Italia Srl, 2021) Uzun, Necati; Kilic, Ahmet Osman; Akinci, Mehmet Akif; ozgul-Katircioglu, Dilek; Erden, Semih
    [Abstract Not Availabe]
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    Outcomes of COVID-19 Infections in children: A single-center retrospective study
    (Wiley, 2022) Genceli, Mustafa; Akcan, Ozge Metin; Pekcan, Sevgi; Akin, Fatih; Ozdemir, Mehmet; Kilic, Ahmet Osman; Yazar, Abdullah
    The COVID-19 pandemic is an important cause of morbidity and mortality, which has had a negative impact worldwide. Our aim was to describe clinical findings and outcomes of severe acute respiratory syndrome (SARS)-CoV-2 viral infection and COVID-19 cared for at a large pediatric tertiary care hospital during the first year of the pandemic. Patients aged 1 month to 18 years who were diagnosed as having COVID-19 between March 2020 and April 2021 were included. The files of patients diagnosed with COVID-19 were reviewed retrospectively. Results: Four hundred sixty seven children were included in the study. There were 34 (7.3%) patients under 1 year of age, 111 (23.8%) between 1 and 5 years, 98 (30.4%) between 5 and 10 years, 142 (30.4%) between 11 and 15 years, and 82 (17.6%) age over 15 years. Fever (88.2%), vomiting (32.4%), and diarrhea (29.4%) in patients aged under 1 year, sore throat (36.6%) in patients aged 11-15 years, and dysgeusia (11%), anosmia (14.6%), headache (18.3%), malaise (40.8%), myalgia (28%), and shortness of breath (17.1%) in those aged over 15 years were found to be significantly more common in comparison with the other age groups (p < 0.05). Thirty-five (7.5%) patients were asymptomatic, 365 (78.1%) had mild disease, 35 (7.5%) were moderate, 27 (5.8%) were severe, and five (1.07%) were critical. Leukocyte count, erythrocyte sedimentation rate, ferritin, and C-reactive protein values were significantly higher in hospitalized patients. Three patients died during the study period (0.64%). While SARS-CoV-2 infection may be asymptomatic and COVID-19 usually has a mild clinical course, some children have severe disease or mortality.
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    Serum Vitamins A, D, and Zinc Levels in Children with Coronavirus Disease 2019 and Multisystem Inflammatory Syndrome in Children
    (Georg Thieme Verlag Kg, 2022) Yilmaz, Asli Imran; Unal, Gokcen; Keles, Sevgi; Pekcan, Sevgi; Kilic, Ahmet Osman; Akcan, Ozge Metin; Erdogan, Kubra Nur
    Objective Vitamin D, due to its immunomodulating effect, zinc, and vitamin A, which affect cellular and humoral immunity, are thought to affect the clinical severity of coronavirus disease 2019 (COVID-19) infection. The present study evaluates the association between vitamin A, D, and zinc deficiencies and disease severity in pediatric patients with COVID-19 infections. Methods The levels of vitamin A, D, and zinc at the time of diagnosis of 123 pediatric patients who presented to our hospital and were diagnosed as having hospitalized, nonhospitalized COVID-19 infection group, and multisystem inflammatory syndrome in children (MIS-C) were evaluated. The correlations of the measured levels with the disease severity and the need for intensive care or hospitalization were analyzed. Results Among the 123 patients, 21.1% (n = 26), 42.2% (n = 52), and 36.7% (n = 45) had a diagnosis of MIS-C, belonged to the hospitalized COVID-19 infection group, or belonged to the nonhospitalized COVID-19 infection group, respectively. Zinc levels were significantly lower in the MIS-C group than in the nonhospitalized group (p < 0.05). Vitamin A levels were found to be significantly lower in the MIS-C group than in the nonhospitalized group (p < 0.01) and significantly lower in the hospitalized group when compared with the nonhospitalized group (p < 0.001). Deficiencies in vitamin A, vitamin D, and zinc levels were found to be most common in the MIS-C group (42.3%) and in hospitalized COVID-19 group (15.3%). In the nonhospitalized COVID-19 group, it was found to be the lowest at 6.6%. Conclusion Based on the results of the present study and a literature review, it can be said that vitamin A, D, and zinc deficiencies may associate with the severity of COVID-19, although more studies are required to clarify this subject further.
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    Simulation Based Endotracheal Intubation Education for Residents of Pediatrics
    (Emergency Medicine Physicians Assoc Turkey, 2021) Kilic, Ahmet Osman; Ture, Esra; Yazar, Abdullah; Akin, Fatih; Reisli, Ismail
    Aim: Endotracheal intubation is an important element of cardiopulmonary resuscitation. Gaining adequate experience with endotracheal intubation during pediatric residency is important. Our clinic initiated a simulation-based endotracheal intubation training for pediatric residents. This study aimed to evaluate the success of our endotracheal intubation training. Materials and Methods: Residents received two programs of the simulation-based endotracheal intubation training at 1 year apart. Success rates were compared in terms of endotracheal intubation performance. Results: Intubation success rates after the first and second programs were 80% (28/35) and 100% (35/35), respectively, and the difference was significant (chi(2)=7.667, p=0.006). The mean durations of successful endotracheal intubation in both programs were 14.14 +/- 4.16 sec and 8.22 +/- 3.58 sec, respectively. Intubation durations in the second program were significantly lower than those of the first (p<0.01). Conclusion: In this study, the simulation based-endotracheal intubation training, which was performed 1 year apart using high-fidelity manikins, increased the success rate of endotracheal intubation attempts and shorten the intubation time.