The study aimed to analyse the clinical course of COVID-19 in 300 infants, selected from 1283 children diagnosed with COVID-19 between March and December 2020, registered in the SARSTerPED multicenter database. Most of the infants were registered in October and November 2020. 44% of the group were girls, and 56% were boys. At diagnosis, the most common symptoms were fever in 77% of the children, cough in 40%, catarrh in 37%. Pneumonia associated with COVID-19 was diagnosed in 23% of the children, and gastrointestinal symptoms in 31.3%. In 52% of the infants, elevated levels of D-dimers were observed, and in 40%, elevated levels of IL-6 serum concentration were observed. During the second wave of the pandemic, 6 times more infants were hospitalized, and the children were statistically significantly younger compared to the patients during the first wave (3 months vs 8 months, p < 0.0001 respectively). During the second wave, the infants were hospitalized for longer. COVID-19 in infants usually manifests as a mild gastrointestinal or respiratory infection, but pneumonia is also observed with falls in oxygen saturation, requiring oxygen therapy. Gastrointestinal symptoms are common in infants infected with SARS-CoV-2, and infant appetite disorders may lead to hospitalization. The clinical course of the disease differed significantly between the first and second wave of the pandemic. It seems that infants may play a role in the transmission of SARS-COV-2 infections in households, despite mild or asymptomatic courses; eating disorders in infants should be an indication for COVID-19 testing.

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Little is known about the causes and the frequency of meningitis and encephalitis in Poland. We did a retrospective single-center cohort study of children under 18 years old hospitalized with infectious meningitis or encephalitis. Incidence rates were calculated using collected data from patients from the North-East Poland only. A total of 374 children hospitalized between 1 January 2015 and 31 December 2019 were included in the study. A total of 332 (89%) children had meningitis, and 42 (11%) had encephalitis. The etiology of the infection was established in 331 (89%) cases. Enteroviruses accounted for 224 (60%) of all patients. A total of 68 (18%) cases were tick-borne infections. Bacterial pathogens were detected in 26 (7%) children. The median length of hospital stay for children with enteroviral meningitis was 7 days (IQR 7–9), increasing to 11 days (8–13) in those treated with antibiotics. The incidence of meningitis was estimated to be 32.22 (95% CI, 25.33–40.98) per 100,000 and that of encephalitis to be 4.08 (95% CI, 2.07–8.02) per 100,000. By the broad use of molecular diagnostic methods, we managed to identify etiology of the infection in the majority of children. Our data suggest that thorough diagnostics of central nervous system infections are needed to rationalize treatment.

Pediatric inflammatory multisystem syndrome (PIMS) is a new entity in children, likely associated with previous coronavirus disease 19 (COVID-19). Most of reports about PIMS come from countries particularly hit by the COVID-19 pandemic. Our aim was to investigate the nature of inflammatory syndromes in Poland (a country with low COVID-19 prevalence) and to perceive the emergence of PIMS in our country. On May 25th, we have launched a nationwide survey of inflammatory syndromes in children for retrospective (since 4th March 2020) and prospective data collection. Up to 28th July, 39 reported children met inclusion criteria. We stratified them according to age (&amp;lt;5 and &ge; 5 years old) and COVID-19 status. The majority of children had clinical and laboratory features of Kawasaki disease, probably non-associated with COVID-19. However, children &ge;5 years of age had PIMS characteristics, and 9 children had COVID-19 confirmation. This is the first to our knowledge report of PIMS register from the country with low COVID-19 prevalence, and it proves that PIMS may emerge in any area involved in the COVID-19 pandemic. In a context of limited COVID-19 testing availability, other risk factors of PIMS, e.g. older age should be considered in the differential diagnosis of inflammatory syndromes in children.

STRESZCZENIE:Higiena rąk jest postrzegana jako najprostsza, a zarazem najważniejsza metoda zapobiegania infekcjom w oddziałach szpitalnych. Pomimo tego wskaźnik przestrzegania wytycznych higieny rąk wśród pracowników ochrony zdrowia, a szczególnie wśród lekarzy, pozostaje na niskim poziomie. W ostatnich latach przeprowadzono wiele kampanii promują-cych higienę rąk. Mimo intensywnych starań wskaźnik przestrzegania higieny rąk -po począt-kowej poprawie -wciąż pozostaje na niskim poziomie. Dokonano analizy czynników mogą-cych mieć wpływ na to zjawisko, takich jak: brak wiedzy naukowej, przepracowanie, zmęcze-nie kampaniami itp. Szczególnie podkreślono rolę indywidualnego zachowania, złych nawyków oraz etycznego kryzysu wśród pracowników ochrony zdrowia, które mogą być odpowiedzialne za nieprzestrzeganie higieny rąk podczas opieki nad pacjentem.SŁOWA KLUCZOWE: etyka, higiena rąk, kampanie promujące, negatywne czynniki, personel medyczny, wskaźnik przestrzegania higieny rąk ABSTRACT: Hand hygiene has been identified as one of the simplest, but most important, methods to prevent cross-infection in healthcare facilities. In spite of this fact, the hand hygiene compliance rate remains low among healthcare workers, especially among physicians. In recent years a lot of promotional campaigns for hand hygiene were performed. Despite these intensive efforts compliance about hand hygiene after initial improved is still poor. We investigated factors associated with this phenomenon, such as lack of scientific information, overwork, campaign fatigue etc. We want to emphasize the role of individual behavior, bad habits of employees and an ethical crisis among healthcare workers in low hand hygiene compliance during patient care.