Background Acute kidney injury (AKI) is a complication of coronavirus disease 2019 (COVID-19). The reported incidence of AKI, however, varies among studies. We aimed to evaluate the incidence of AKI and its association with mortality and morbidity in children infected with severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2) who required hospital admission. Methods This was a multicenter retrospective cohort study from three tertiary centers, which included children with confirmed COVID-19. All children were evaluated for AKI using the Kidney Disease Improving Global Outcomes (KDIGO) definition and staging. Results Of 89 children included, 19 (21 %) developed AKI (52.6 % stage I). A high renal angina index score was correlated with severity of AKI. Also, multisystem inflammatory syndrome in children (MIS-C) was increased in children with AKI compared to those with normal kidney function (15 % vs. 1.5 %). Patients with AKI had significantly more pediatric intensive care admissions (PICU) (32 % vs. 2.8 %, p < 0.001) and mortality (42 % vs. 0 %, p < 0.001). However, AKI was not associated with prolonged hospitalization (58 % vs. 40 %, p = 0.163) or development of MIS-C (10.5 % vs. 1.4 %, p = 0.051). No patient in the AKI group required renal replacement therapy. Residual renal impairment at discharge occurred in 9 % of patients. This was significantly influenced by the presence of comorbidities, hypotension, hypoxia, heart failure, acute respiratory distress, hypernatremia, abnormal liver profile, high C-reactive protein, and positive blood culture. Conclusions AKI occurred in one-fifth of children with SARS-CoV-2 infection requiring hospital admission, with one-third of those requiring PICU. AKI was associated with increased morbidity and mortality, and residual renal impairment at time of discharge.

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Background Asthma is a common chronic illness worldwide. Asthmatic children are forced to alter their way of living to avoid its complications or exacerbations, which negatively affects their psychological and social well-being. High prevalence of behavioral and emotional difficulties was noticed among children with asthma. Methods Cross-sectional study that was conducted over 8 months involving asthmatic children within the ages of 7-17 years presenting to two governmental hospitals in Jeddah, Saudi Arabia. Three questionnaires were used: asthma control test, the strengths and difficulties questionnaire, and the pediatrics asthma quality of life questionnaire. Using SPSS, Pearson's chi-square and independent sample t-tests were used to find associations. Results Among the 106 respondents, 84% of the sample had poor asthma control. Significantly poorer quality of life was observed in children with uncontrolled asthma (p = <0.001). Children with controlled and uncontrolled asthma were equally affected psychosocially with no relation between asthma control and their psychosocial well-being (p = 0.58). Conclusion The majority of asthmatic children were uncontrolled with poor quality of life. This study recommends that the psychosocial well-being should be assessed during clinic visits for a better holistic approach and effective improvement of outcome. Further researches are needed to study the psychological effect of asthma.

Asthma is considered one of the most important health issues worldwide. However, few epidemiological studies have been conducted in Saudi Arabia to assess the prevalence of asthma among children, and their results are highly variable. Thus, in this study, we investigated the prevalence of childhood asthma in Saudi Arabia. Previous studies of the prevalence of childhood asthma in Saudi Arabia were reviewed and 12 were included in this review. These studies were conducted at various locations in Saudi Arabia between 1986 and 2017. The prevalence of children asthma in Saudi Arabia varies among different regions throughout the country. The highest prevalence was reported in Alhofuf (33.7%) and the lowest in Abha (9%). However, various surveying methods were used and different age groups were assessed. This review highlights the need to conduct a national-level study using a single validated tool to assess the prevalence of childhood asthma in Saudi Arabia in order to calculate the burden of asthma and determine the targeted allocation of resources and manpower.

Bronchiolitis is the leading cause of admissions in children less than two years of age. It has been recognized as highly debated for many decades. Despite the abundance of literature and the well-recognized importance of palivizumab in the high risk groups, and despite the existence of numerous, high-quality, recent guidelines on bronchiolitis, the number of admissions continues to increase. Only supportive therapy and few therapeutic interventions are evidence based and proved to be effective. Since Respiratory Syncytial Virus (RSV) is the major cause of bronchiolitis, we will focus on this virus mostly in high risk groups like the premature babies and children with chronic lung disease and cardiac abnormalities. Further, the prevention of RSV with palivizumab in the high risk groups is effective and well known since 1998; we will discuss the updated criteria for allocating infants to this treatment, as this medication is expensive and should be utilized in the best condition. Usually, diagnosis of bronchiolitis is not challenging, however there has been historically no universally accepted and validated scoring system to assess the severity of the condition. Severe RSV, especially in high risk children, is unique because it can cause serious respiratory sequelae. Currently there is no effective curative treatment for bronchiolitis. The utility of different therapeutic interventions is worth a discussion.

Introduction The COVID-19 pandemic resulted in quarantine/lockdown measures in most countries. Quarantine may create intense psychological problems including post-traumatic stress disorder (PTSD) especially for the vulnerable critically developing children/adolescents. Few studies evaluated PTSD associated with infectious disasters but no Saudi study investigated PTSD associated with COVID-19 in children/adolescents. This study was undertaken to screen for PTSD in children/adolescent in Saudi Arabia to identify its prevalence/risk factors during COVID-19 pandemic and its quarantine. Methods A cross-sectional survey was conducted after 2 months form start of quarantine for COVID-19 pandemic utilizing the original English version and an Arabic translated version for the University of California at Los Angeles Brief COVID-19 Screen for Child/Adolescent PTSD that can be parent-reported or self-completed by older children/adolescents. Participants (Saudi citizens/non-Saudi residents) were approached online via social media. Results Five hundred and thirty seven participants were enrolled. The participants were 262 boys and 275 girls with a mean age of 12.25±3.77 years. Symptoms of no, minimal, mild and potential PTSD were identified in 15.5%, 44.1%, 27.4% and 13.0% of children/adolescents, respectively. The age, gender, school grade, and residence were not predictive of PTSD symptoms. Univariate analysis of risk factors for PTSD revealed that work of a close relative around people who might be infected was significantly different between groups of PTSD symptoms, but this difference disappeared during multivariate analysis. Children/adolescents of Saudi citizens had significantly lower median total PTSD score than children/adolescents of expatriate families (p = 0.002). Conclusion PTSD associated with the COVID-19 and its resultant quarantine shouldn’t be overlooked in different populations as it is expected in a considerable proportion of children/adolescents with variable prevalence, risk factors and severity. Parents/healthcare providers must be aware of PTSD associated with COVID-19 or similar disasters, so, they can provide children/adolescent with effective coping mechanisms.

Objectives: To determine the demographic and clinical characteristics, underlying comorbidities, and outcomes of children with coronavirus disease 2019 (COVID-19) infection. Methods: In this retrospective study, we reported 62 pediatric patients (age <14 years) with confirmed COVID-19 between March 2 and July 1, 2020, at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Results: Comorbid conditions, including cardiac, neurological, respiratory, and malignant disorders, were reported in 9 patients (14.5%). The most prominent presenting complaints were fever (80.6%) and cough (48.4%). Most of our patients (80.6%) had mild disease, 11.3% had moderate disease, and 8.1% exhibited severe and critical illness. Twenty-one patients (33.9%) were hospitalized, with 4 patients (6.5%) admitted to the pediatric intensive care unit, and 3 (4.8%) patients died. Conclusion: All pediatric age groups are susceptible to COVID-19, with no gender difference. COVID-19 infection may result in critical illness and even mortality in subsets of pediatric patients.

Objectives:To assess vaccination timeliness, risk factors associated with delays and the reasons for delayed vaccinations among children below the age of 3 years in Jeddah, Kingdom of Saudi Arabia.Methods:This is a cross-sectional study conducted in Jeddah, Saudi Arabia during the period of May 2016 to August 2017. Data were obtained from parents of children under the age of 3 years using a structured questionnaire comprised of questions about sociodemographics, physical well-being of the child and the reasons that are used to justify delayed vaccinations. Vaccinations were considered delayed if they occurred more than 30 days after the time designated on the primary vaccination schedule. Logistic regression was used to assess the risk factors for vaccination delays.Results:The study included 351 children. Delayed vaccinations were observed in 85/351 (24.2%) of the sample. Delays were noted to occur most frequently for Measles, Mumps, Rubella vaccine (MMR), second dose of meningococcal conjugate quadrivalent vaccine (MCV4), second dose of oral polio vaccine (OPV) and fourth dose of pneumococcal conjugate vaccine (PCV) in 19/125 (15.2%) of the sample. Traveling at the time of vaccination was the most common delay reason and was reported in 31/142 (21.3%) of the sample.Conclusion:Adherence to vaccination is fairly common in this part of the country. However, vaccination delays are still present and should be addressed to improve health care.