Background The clinical presentation of COVID‐19 ranges from a mild, self‐limiting disease, to multiple organ failure and death. Most severe COVID‐19 cases present low lymphocytes counts and high leukocytes counts, and accumulated evidence suggests that in a subgroup of patients presenting severe COVID‐19, there may be a hyperinflammatory response driving a severe hypercytokinaemia which may be, at least in part, signalling the presence of an underlying endothelial dysfunction. In this context, available data suggest a prognostic role of neutrophil‐lymphocyte ratio (NLR) in various inflammatory diseases and oncological processes. Following this rationale, we hypothesized that NLR, as a marker of endothelial dysfunction, may be useful in identifying patients with a poor prognosis in hospitalized COVID‐19 cases. Design A retrospective observational study performed at Hospital Universitario HM Puerta del Sur, Madrid, Spain, which included 119 patients with COVID‐19 from 1 March to 31 March 2020. Patients were categorized according to WHO R&D Expert Group. Results Forty‐five (12.1%) patients experienced severe acute respiratory failure requiring respiratory support. Forty‐seven (12.6%) patients died. Those with worse outcomes were older (P = .002) and presented significantly higher NLR at admission (P = .001), greater increase in Peak NLR (P < .001) and higher increasing speed of NLR (P = .003) compared with follow‐up patients. In a multivariable logistic regression, age, cardiovascular disease and C‐reactive protein at admission and Peak NLR were significantly associated with death. Conclusions NLR is an easily measurable, available, cost‐effective and reliable parameter, which continuous monitoring could be useful for the diagnosis and treatment of COVID‐19.

Aims and Objectives We aimed to determine the impact of COVID‐19 related home confinement on the paediatric population by focusing on anxiety, behavioural disturbances and somatic symptoms. Background To limit the spread of the COVID‐19 outbreak, governments have imposed nationwide lockdowns to prevent direct contact; this has affected everyday lives and activities such as attending school classes. Such isolation may have impacted children’s anxiety levels. Design and Methods We conducted a cross‐sectional observational study using a web‐based anonymous questionnaire from 22–26 April, 2020, among children ( N = 2,292) in Spain. For children below 7 years of age, parents reported the children’s behavioural, emotional and somatic symptoms and family environment data on a questionnaire designed by the researchers. Children over 7 years answered the Revised Children’s Manifest Anxiety Scale either independently or with their parents’ assistance. Results Children over 7 years, boys in particular, scored high on the anxiety spectrum. Moreover, participants who knew someone who had suffered from COVID‐19 at home or whose parent was directly involved in the pandemic, obtained higher Total Anxiety scores. Significantly high values were found in all aspects of anxiety among those who feared infection or whose parents been unemployed. Of the children below 7 years, 56.3% had four or more anxiety‐related symptoms, the most frequent of which were tantrums, emotional changes, restlessness and fear of being alone. The number of symptoms reported was significant when someone in the family home had been infected with COVID‐19. Conclusions The COVID‐19 home confinement had a significant impact on children, causing anxiety, behavioural problems and somatic manifestations. Relevance to clinical practice Nurses play a key role in screening children who have experience confinement owing to the COVID‐19 pandemic in order to detect early anxiety symptoms using tele‐health. Suitable direct interventions can then be implemented or interdisciplinary manage could be started.

A global pandemic caused by SARS-CoV-2 is still beaten our world. The disease, termed COVID-19 by the WHO, has a wide range of clinical manifestations, ranging from a mild, self-limiting form of the disease to multiple organ failure and death, forcing governments to take measures to mitigate the transmission and reduce the economic impact. However, the paediatric manifestation appears to take a milder form of the disease but they are not oblivious to the consequences of the disease. They suffered personal and parental lost, broke their social relationships, forced to home confinement, school closures, all of them with secondary implications. As a result, children’s anxiety levels and manifestations have increased during pandemic. To prevent and counteract this situation, measures were implemented like increase physical activity, a balanced diet, and regular sleep pattern; and in relationship sphere use social media to stay in touch with school mates and relatives.