During the winter months of 2020/2021 a wave of multisystem inflammatory syndrome in children (MIS-C) emerged in Poland. We present the results of a nationwide register aiming to capture and characterise MIS-C with a focus on severity determinants. The first MIS-C wave in Poland was notably high, hence our analysis involved 274 children. The group was 62.8% boys, with a median age of 8.8 years. Besides one Asian, all were White. Overall, the disease course was not as severe as in previous reports, however. Pediatric intensive care treatment was required for merely 23 (8.4%) of children, who were older and exhibited a distinguished clinical picture at hospital admission. We have also identified sex-dependent differences; teenage boys more often had cardiac involvement (decreased ejection fraction in 25.9% vs. 14.7%) and fulfilled macrophage activation syndrome definition (31.0% vs. 15.2%). Among all boys, those hospitalized in pediatric intensive care unit were significantly older (median 11.2 vs. 9.1 years). Henceforth, while ethnicity and sex may affect MIS-C phenotype, management protocols might be not universally applicable, and should rather be adjusted to the specific population.

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Introduction The pathophysiology of multisystem inflammatory syndrome associated with SARS-CoV-2 infection (MIS-C) remains poorly understood. This study aimed to define peripheral blood immune features in patients with MIS-C. Material and methods We analyzed seven children diagnosed with MIS-C between April 1 and May 15, 2021, in St. Joseph’s Children’s Hospital in Poznan (Poland). Results All patients had elevated inflammatory markers, IgG antibodies against SARS-CoV-2, and lymphopenia with a marked decrease in CD4+ and CD8+ T cells. The majority of CD4+ T cells were naive cells. Almost all (6/7) of the analyzed patients had a higher CD4+/CD8+ T cell ratio than average values. B cells were within the normal range – the majority were non-memory cells. Conclusions Children with MIS-C do not resemble adults during COVID-19 recovery. The immune profile of the studied patients differs from that of children with Kawasaki disease (KD), but it is similar to that of adults with severe COVID-19. The proposed explanation is a profound lymphopenia caused by SARS-CoV-2 infection – which persists for weeks – as a result leading to uncontrolled inflammation. In COVID-19 patients the T cell level returns to normal after the second week of the disease. Our data suggest that in children prolonged lymphopenia after COVID-19 can be a practical marker for possible MIS-C alert. If there is a continuum from lymphopenia to MIS-C, there is room for screening and prevention. Further studies are needed to determine whether steroid treatment introduced in a child with prolonged lymphopenia could stop the inflammatory process.

The study aimed to analyze the effect of BNT162b2 vaccination among Polish healthcare workers in terms of serologic response and adverse events. Material and Methods: A questionnaire survey covered data in the period January 1-March 31, 2021 gathered in 2 hospitals in Wielkopolska, Poland. Additionally, serological analysis (SARS-CoV-2 anti-S protein IgG) was performed. Results: A total of 617 medical workers were vaccinated with BNT162b2 (Comirnaty, Pfizer). Data from the questionnaires were received from all of the staff after the first and the second dose. No severe side effects were observed. The most common side effect following the first and second doses of vaccination was pain at the injection site. After the first dose, 3 (1.4 %) women aged 18-55 years, 5 women (3.9 %), and 3 men (8.3 %) aged >55 years had negative SARS-CoV-2 anti-S protein IgG result. After the second dose, all those who agreed to have antibodies tested responded to vaccination with positive SARS-CoV-2 anti-S protein IgG results. Conclusions: Vaccination tolerance was good in the studied population; no severe side effects were observed. After the second dose, all tested healthcare workers responded to vaccination with antibody production. Int J Occup Med Environ Health. 2022;35(6)

Introduction. The Hospital Emergency De partment (ED) is the place of diagnostics and treat ment within the scope necessary to stabilise vital func tions in persons in the condition of sudden threat to life. Patients may report at the Hospital Emergency Depart ment without a referral, which in the situation of lack of the definition of "a sudden threat to life" may result in overusing Hospital Emergency Departments. Aim. The aim of the study was to analyse the hospitalisation of patients at the Hospital Emergency Department depending on the patients' age, mode of admission and discharge, seasonality and time of admission. Material and methods. The group consisted of 6373 children admitted to the Hospital Emergency Department of the Bielański Hospital, Warsaw in 2014. The average age of the patients was 4.5 (5 days to 18 years old). Results. 55% of the patients (3499/6373) were referred to hospital by their General Practitioner (GP), 13% (811/6373) by Emergency Medical Services (EMS), 1% (93/6373) by paediatric surgeons. 31% (1970/6373) of the patients came to the hospital without any referral. Hospitalisation turned out necessary in the case of 36.8% (2346/6373) patients. In 60.6% (3861/6373) of the cases there were no indications to perform hospital treatment. Among the patients who came to the hospital with a referral, 40.4% (1414/3499) required hospitalisation at the paediatrics department, 45% (365/811) of those brought by the EMS and 27.3% (538/1970) of those who came without a referral. The average time spent by patients at the Hospital Emergency Department amounted to 128 minutes (from 2 to 873 minutes). 21.2% (1349/6373) of the patients were examined between 6 p.m. and 9 p.m. Conclusions. In both groups, with or without a referral to the hospital, fewer than half of the patients required hospitalisation (40.4 and 27.2%, respectively). During winter months, there are twice as many patients coming as during the summer. The majority of patients report at the Hospital Emergency Department right after the end of the working hours of the district clinics. S t r e s z c z e n i e Wstęp. W szpitalnym oddziale ratunkowym (SOR) ma miejsce wstępna diagnostyka oraz podejmowane jest leczenie w zakresie niezbędnym dla stabilizacji funkcji życiowych u osób, które znajdują się w stanie nagłego zagrożenia zdrowotnego. Pacjenci mogą zgłaszać się do SOR-u bez skierowania, co w sytuacji braku definicji "nagłego zagrożenia zdrowotnego" może powodować nadużywanie SOR-u. Cel pracy. Celem pracy była analiza hospitalizacji pacjentów w SOR-ze w zależności od wieku pacjentów, sposobu zgłoszenia się i wypisu oraz sezonowości i godziny przyjęcia. Materiał i metody. Grupę badaną stanowiło 6373 dzieci przyjętych w SOR-ze Szpitala Bielańskiego w Warszawie w 2014 roku. Średni wiek pacjentów wynosił 4,5 roku (od 5 dni do 18 lat).