Despite the enormous advances in knowledge about the SARS-CoV-2 infection, the optimal treatment for COVID-19 is still not well defined. The use of convalescent plasma seems to be a promising method of treatment but requires further evaluation. Although it is usually mild, in children with underlying chronic diseases, the course of SARS-CoV-2 infection may be very severe. We described a series of 13 pediatric patients (mean age 10.4 years, median 12) treated with convalescent plasma as a method of COVID-19 therapy. Medical history, with particular emphasis on comorbidities, clinical course, laboratory parameters, supportive treatment and virus elimination time, were analyzed. The mean hospitalization time was 22.6 days (median 20). The most common abnormalities included increased levels of C-reactive protein, D-dimer, and lymphopenia. Median time from symptom onset to convalescent plasma transfusion was 10.6 days (median 7 days). Six patients (46.2%) had a viral clearance on RT-PCR method from a nasopharyngeal swab within 3 days of transfusion, while in the remaining patients the mean elimination time was 12.1 days (median 6 days). Clinical improvement was achieved in all patients; no adverse effects were found in any of the cases. Convalescent plasma may be a promising treatment for COVID-19 in children.

Toxocara spp. infestations present with a wide spectrum of symptoms, from general inflammation of internal organs with eosinophilic granuloma formulation through ocular or brain involvement. There is also an asymptomatic form. The known factors that influence the clinical form of the disease are the intensity of the infestation, the localization of the larvae, the age of the patient, the efficiency of the immune system and the history of reinfection. The aim of our study was to evaluate the production of interleukins 4 (IL-4) and 10 (IL-10) in children in the course of Toxocara spp. infections with hepatic involvement. The analysis of peripheral leucocytes, eosinophils, immunoglobulin E, and IL-4 and IL-10 concentrations presented significantly higher values in children with radiologically confirmed liver granuloma than in uncomplicated hepatomegaly. Based on statistical analysis, we confirmed the IL-4/IL-10 ratio variation in the analysed groups: patients with liver lesions showed a ratio of <1, while children without granulomas had a ratio of >2. The relevant analysis confirmed a positive statistical correlation in both seropositive groups for IgE and IL-4, and only in the granuloma group for IgE and IL-10.

Children with COVID-19 develop moderate symptoms in most cases. Thus, a proportion of children requires hospital admission. The study aimed to assess the history, clinical and laboratory parameters in children with COVID-19 concerning the severity of respiratory symptoms. The study included 332 children (median age 57 months) with COVID-19. History data, clinical findings, laboratory parameters, treatment, and outcome, were evaluated. Children were compared in the groups that varied in the severity of symptoms of respiratory tract involvement. Children who required oxygen therapy represented 8.73%, and intensive care 1.5% of the whole cohort. Comorbidities were present in 126 patients (37.95%). Factors increasing the risk of oxygen therapy included comorbidities (odds ratio (OR) = 92.39; 95% confidence interval (95% CI) = (4.19; 2036.90); p < 0.00001), dyspnea (OR = 45.81; 95% CI (4.05; 518.21); p < 0.00001), auscultation abnormalities (OR = 34.33; 95% CI (2.59; 454.64); p < 0.00001). Lactate dehydrogenase (LDH) > 280 IU/L and creatinine kinase > 192 IU/L were parameters with a good area under the curve (0.804-LDH) and a positive predictive value (42.9%-CK). The clinical course of COVID-19 was mild to moderate in most patients. Children with comorbidities, dyspnea, or abnormalities on auscultation are at risk of oxygen therapy. Laboratory parameters potentially useful in patients evaluated for the severe course are LDH > 200 IU/L and CK > 192 IU/L.

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Introduction: Primary headaches are frequent complaints among adolescents. Tension-type headache (TTH), which causes symptoms influencing the patients' quality of life, can be associated with various medical disorders. Aim of the study: To research the reason for TTH in adolescents. Material and methods: The study included 76 patients, aged from 14 to 17 years, diagnosed due to TTH. Patients with the carotid intima-media thickness (cIMT) in the 90 th percentile (the cutoff point: 0.42 mm for boys, and 0.41 mm for girls) were included in group 1, and the rest in group 2. All the patients underwent laboratory tests with serum levels of IL-6, IL-10, TNF-α, and sICAM-1. Twenty-six (34%) patients were enrolled in group 1 and 50 (66%) in group 2. Results: There were no significant differences in age, sex, height, BMI, and systolic and diastolic blood pressure between patients from both studied groups. The mean cIMT value (mean, SD) for all patients from the study group was 0.41 ±0.012 mm: for girls 0.39 ±0.014 mm and for boys 0.44 ±0.016 mm. In 16-year-old adolescents, the cIMT was significantly higher in boys than girls. In 17-year-old patients, cIMT was significantly higher in boys only in group 1. The significantly higher concentrations of IL-6, TNF-α, and sICAM-1 were found in patients from group 1. Whereas the IL-10 level was significantly higher in the control group. In over one-third of patients (34%) with TTH, the cIMT was in the 90 th percentile, despite having normal BMI, blood pressure, and lipid profile in serum. Conclusions: The inflammatory process in the vascular wall could be considered as the reason for the higher cIMT value and/or TTH in adolescents.

To perform a precise auscultation for the purposes of examination of respiratory system normally requires the presence of an experienced doctor. With most recent advances in machine learning and artificial intelligence, automatic detection of pathological breath phenomena in sounds recorded with stethoscope becomes a reality. But to perform a full auscultation in home environment by layman is another matter, especially if the patient is a child. In this paper we propose a unique application of Reinforcement Learning for training an agent that interactively guides the end user throughout the auscultation procedure. We show that intelligent selection of auscultation points by the agent reduces time of the examination fourfold without significant decrease in diagnosis accuracy compared to exhaustive auscultation.

Background: Due to the high risk of COVID-19 transmission by asymptomatic patients, the aim of this study was to evaluate chest computed tomography (CT) and blood differential test as an additional COVID-19 screening tool for patients undergoing elective or urgent surgery. Patients and Methods: The preoperative assessment of 118 patients hospitalized from June to July 2020 included real-time reverse transcriptase polymerase chain reaction RNA test before elective surgery or rapid antigen test in emergency patients. The diagnostics were supplemented by chest CT and a complete blood count with a blood smear in all patients. Results: None of the hospitalized patients had molecular, serological or radiographic symptoms of COVID-19 infection. The chest CT revealed non-COVID-19 pathologies in a total of 48 patients. Leukocytosis and lymphopenia were typical of emergency patients. Conclusion: Routine chest CT scans have no benefit in screening for potential COVID-19 changes in asymptomatic patients. Blood differential tests are readily available, which makes them more helpful in COVID-19 screening.Infection with the new coronavirus COVID-19 has become a global problem. An infectious disease that spreads well beyond a local epidemic to become a major global epidemiological and socio-economic challenge has not been observed for decades.

Introduction:The COVID-19 pandemic progresses. The clinical manifestation of the disease and the severity of its course vary significantly. There are considerable differences between symptoms of SARS-CoV-2 infection in the child and adult populations. The gastrointestinal (GI) symptoms are an essential element in understanding the pathophysiology of the disease and in drawing conclusions concerning the diagnostic, therapeutic, and epidemiological management of COVID-19. The aim of the study was to characterize the gastroenterological symptoms of COVID-19 in the paediatric population and to find differences in the course of the disease between paediatric patients with and without GI symptoms of COVID-19. Material and methods: We report the clinical characteristics of 321 children with COVID-19 (age 0-215 months) hospitalized between March 2020 and April 2021. The following division was used when processing the data: the first wave of cases in Poland lasted from the beginning of the pandemic to June 2020, the 2 nd wave September-November 2020, and the 3 rd wave February-May 2021. We specifically compared the differences between patients with and without GI symptoms. Results: Among all included patients, 95 (29.5%) had GI symptoms -the most common included abdominal pain (15.27%) and diarrhoea (14%). Approximately 3% of patients with GI symptoms required surgical intervention. As the pandemic progressed, GI symptoms were reported with increasing frequency -during the first wave 9%, the second wave 25%, and the third wave 38%. Patients with GI symptoms had more frequent and statistically significantly higher inflammatory parameters. During treatment, GI patients more often required the administration of antibiotics. The most common abdominal ultrasound abnormalities were liver enlargement, a slight amount of free fluid in the peritoneal cavity, and moderately enlarged individual lymph nodes. Conclusions: Gastrointestinal symptoms form an image of COVID-19, which is a possible prognostic risk factor for severe course of the disease. Gastrointestinal symptoms should be treated as a possible isolated image of COVID-19.