Ba c k g r o u n d: Past studies reported evidence of associations between air pollution and resp... more Ba c k g r o u n d: Past studies reported evidence of associations between air pollution and respiratory symptoms and morbidity for children. Few studies examined associations between air pollution and emergency room (ER) visits for wheezing, and even fewer for gastroenteric illness. We conducted a multicity analysis of the relationship between air pollution and ER visits for wheezing and gastroenteric disorder in children 0–2 years of age. Met h o d s: We obtained ER visit records for wheezing and gastroenteric disorder from six Italian cities. A city-specific case–crossover analysis was applied to estimate effects of particulate matter (PM), nitrogen dioxide, sulfur dioxide, ozone, and carbon monoxide, adjusting for immediate and delayed effects of temperature. Lagged effects of air pollutants up to 6 prior days were examined. The city-specific results were combined using a random-effect meta-analysis. Res u l t s: CO and SO 2 were most strongly associated with wheezing, with a 2....
STUDY OBJECTIVES Obstructive sleep apnea (OSA) in children is associated with acute metabolic, ca... more STUDY OBJECTIVES Obstructive sleep apnea (OSA) in children is associated with acute metabolic, cardiovascular, and neuro-cognitive abnormalities. The long-term outcomes of childhood OSA into adulthood has not been established. We performed a 20-year follow-up of patients with polysomnographically documented OSA in childhood compared to a healthy control group to evaluate the long-term anthropometric, sleep, cognitive, and cardiovascular outcomes. METHODS Children diagnosed to have severe OSA between the ages of 1 - 17 years (4.87 ± 2.77) were prospectively contacted by telephone as young adults after approximately 20 years. Data collected included reported anthropometric, educational level, health history, and the Berlin questionnaire. RESULTS Young adults with confirmed severe OSA in childhood had significantly higher adulthood BMI (p=0.038), lower academic degrees (p<0.001), and more snoring (p=0.045) compared to controls. The AHI during childhood trended towards predicting cardiovascular outcomes and the Berlin questionnaire in adulthood. CONCLUSIONS Adults with history of severe childhood OSA have a high risk of having snoring, elevated BMI, and lower academic achievement in adulthood. Thus, children with severe OSA may be at increased risk of chronic diseases later in life. The intervening COVID-19 pandemic has introduced considerable additional neurobehavioral morbidity complicating the identification of the full long-term consequences of childhood OSA.
ABSTRACT Background / Purpose: In literature, the role of smoking on the development of respirato... more ABSTRACT Background / Purpose: In literature, the role of smoking on the development of respiratory diseases is already known. The aim of the research is to study the relationship between environmental tobacco smoke (ETS) in childhood and the onset of obstructive sleep apnea syndrome (OSAS).We compared the percentage of children exposed to passive smoke between a group of pediatric OSAS patients and a control group of children from the general population in order to verify if ETS can be considered as a risk factor for the onset of the disease. Main conclusion: In conclusion, the present study demonstrates that passive smoke can be considered a risk factor for the development of OSAS and that it can influence the severity of the disease. For this reason it will be very important to produce informative campaigns to inform people about the health problems caused by the smoke that remains on clothes, people and objects.
We studied the variations in peripheral capillary oxygen saturation (SpO2) during wake time in re... more We studied the variations in peripheral capillary oxygen saturation (SpO2) during wake time in relation to pacifier use and to the following different positions: supine at 0°, supine at 30° (in babies under one year) vs. sitting (in babies between 1 and 3 years of age). We observed 54 patients under the age of three years, weighing over 1.800 g. Peripheral oxygen saturation was recorded for at least 40 min per patient in the following positions: 20 min lying supine at 0° (10 min with a pacifier and 10 min without); 20 min lying supine at 30° inclination or in a sitting position if the baby was older than one year (10 min with a pacifier and 10 min without). Pacifier use improved the peripheral oxygen saturation both in the 0° supine position, and at 30° in a sitting position. No significant differences were observed in the SpO2 levels comparing the different positions. In conclusion a pacifier thus seems to have a positive effect on respiration.
Introduction: Sleep-related problems are pervasive among youth with psychiatric symptoms, heterog... more Introduction: Sleep-related problems are pervasive among youth with psychiatric symptoms, heterogeneous in nature, and vary by frequency, intensity, duration, and impairment. This poses a challenge for measurement of sleep problems in these populations. Although there are well-validated self-reports of sleep functioning in pediatric samples, we presently lack validated clinician-rated interviews of sleep-related problems for youth. Therefore, we developed and validated a multidimensional clinician-administered interview for sleep-related problems that are common in youth with psychiatric symptoms. Methods: Participants were 46 youth (ages 9-15; M = 11.60; SD =1.63) from sleep trial (Sleeping Tigers) delivered through the Child Anxiety Treatment Study (CATS). An independent evaluator administered the Focal Interview of Sleep (FIOS), assessing the frequency, duration and intensity of seven sleep problems (e.g., trouble going to bed, trouble falling asleep, sleepy, tired, irritable, etc.) at baseline and post-treatment. Three FIOS scores, including Number of Sleep Problems, Impairment and Total Score were derived from these ratings. Youth completed actigraphy, sleep diary, and the Sleep Self-Report; and parents rated youth sleep (i.e., Children's Sleep Habits Questionnaire), and behavior and emotions (i.e., Child Behavior Checklist 6-18). Parents and youth also completed the Mood and Feelings Questionnaire and Screen for Child Anxiety and Related Emotional Disorders. Results: Interrater reliability was excellent (ICC=.75-1.00) for FIOS Duration, Frequency and Intensity scores by sleep problem type. Internal consistency was mostly excellent (range α = .65 to .94) for sleep problems. FIOS scores demonstrated strong treatment sensitivity. Convergent validity was fair for parent-and child-report of youth sleep, and sleep quality per sleep diary. There was limited support for discriminant validity, as evidenced by non-significant Fisher's R to Z transformation for the difference between FIOS Total and behavioral/emotional problems, anxiety and mood. Baseline FIOS predicting one-year sleep outcomes was non-significant. Conclusion: Findings suggest the FIOS is a psychometrically sound clinician-rated measure of sleep-related problems in youth with psychiatric symptoms. Future research can focus on discriminant and predictive validity, as well as replication in larger, more heterogeneous samples. Support (If Any
Five years after the first edition, we have revised and updated the guidelines, re-examining the ... more Five years after the first edition, we have revised and updated the guidelines, re-examining the queries and relative recommendations, expanding the issues addressed with the introduction of a new entity, recently proposed by the American Academy of Pediatrics: BRUE, an acronym for Brief Resolved Unexplained Events. In this manuscript we will use the term BRUE only to refer to mild, idiopathic cases rather than simply replace the acronym ALTE per se.In our guidelines the acronym ALTE is used for severe cases that are unexplainable after the first and second level examinations.Although the term ALTE can be used to describe the common symptoms at the onset, whenever the aetiology is ascertained, the final diagnosis may be better specified as seizures, gastroesophageal reflux, infection, arrhythmia, etc. Lastly, we have addressed the emerging problem of the so-called Sudden Unexpected Postnatal Collapse (SUPC), that might be considered as a severe ALTE occurring in the first week of life.
... Ferini Strambi L, Levrini L, Mondini S, Nespoli L, Nosetti L, Pagani J, Zucconi M; Gruppo di ... more ... Ferini Strambi L, Levrini L, Mondini S, Nespoli L, Nosetti L, Pagani J, Zucconi M; Gruppo di Studio Interdisciplinare Disturbi Respiratori nel Sonno. Gruppo di Studio interdisciplinare disturbi respiratori nel sonno, Società Italiana di Pediatria, Rome, Italy. mariapia.villa@uniroma1 ...
... circa 7.000 neonati/anno) prima del 1992, anno in cui l'American Academy of Pediatrics (A... more ... circa 7.000 neonati/anno) prima del 1992, anno in cui l'American Academy of Pediatrics (AAP) ha raccomandato che i neonati Luana Nosetti, Alessandra Cristina Niespolo, Luigi ... Regola anche la differenziazione in neuroni motori o colinergici nel SNC (Sistema nervoso centrale ...
To measure the prevalence of habitual snoring and sleep-disordered breathing in preschool-aged ch... more To measure the prevalence of habitual snoring and sleep-disordered breathing in preschool-aged children. Cross-sectional survey with parental report and overnight ambulatory monitoring of children 3 to 6 years of age in 8 kindergartens (n = 604). Parents reported the child&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s information through an interviewer-based questionnaire or by a brief telephone interview. Snoring, oxygen saturation, body position, and heart rate were recorded for 1 night at home. Data were obtained on 98.5% of 604 children (447 questionnaires, 74%; 148 telephone interviews, 24.5%); groups were similar for sex and age. Two hundred sixty-five children had ambulatory monitoring at home. Habitual snoring (always and often) was reported in 34.5% and breathing cessation in 18.6%. Habitual snoring was associated with parental report of daytime symptoms (P =.001) and daytime somnolence (P =.032). Pathologic snoring was present in 12% of children (95% CI, 7.9-16.1). On multivariate analysis, parental report of habitual snoring was the strongest determinant of pathologic snoring (OR, 12.23; 95% CI, 3.56-41.94). Oxygen desaturation index &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; or =5 per hour was found in 13% of children (95% CI, 8.7-17.3). Parental report of habitual snoring is very common. Children with habitual snoring are more likely to have objectively measured snoring and daytime morbidity.
The role played by air pollutants on sleep-disordered breathing (SDB) in childhood thus far has b... more The role played by air pollutants on sleep-disordered breathing (SDB) in childhood thus far has been little analyzed, although susceptibility to environmental toxicity is higher in children than in adults. This ecological study, carried out in the province of Varese, Italy, explores the geographical pattern of SDB among children and investigates its relationship with combustion-related pollution. For each of the 754 patients admitted to the Sleep-Disorder Breathing Center of Varese due to sleep respiratory disturbances, the apnea-hypopnea index (AHI) upon which SDB diagnosis is based was recorded. Through spatial analysis methods, the geographical heterogeneity of SDB and its severity were analyzed using AHIbased indicators. From available nitrogen dioxide (NO2) levels, the geographical pattern of the pollutant\\u2014regarded as a marker for combustion-related mixtures\\u2014was obtained and compared with that of SDB. We identified an area of significantly higher SDB case density (p <.05) and found that the relative risk (RR) of SDB increased significantly for the children living in this area (RR = 1.307, 95% confidence interval [CI] [1.155, 1.477]). In this area, annual NO2 levels were 1.5 times the provincial average. For the whole study region, moreover, we found a significant positive correlation (p <.01) between SDB severity and NO2. These findings suggest that traffic-related pollution might contribute to SDB onset and level of severity
Obstructive sleep apnea syndrome (OSAS) was first reported in 1976 by Guilleminault. This conditi... more Obstructive sleep apnea syndrome (OSAS) was first reported in 1976 by Guilleminault. This condition has been defined as a disorder of breathing during sleep characterized by prolonged partial/complete upper airway obstruction that disrupts normal ventilation and normal sleep patterns. The prevalence of this condition varies among the different populations but it is between 1 and 2% in preschool children when adenoid and tonsils volume has a major peak. Loud snoring is very common in these children but not always present. The diagnosis may be suggested by the facial appearance and by personal history but it must be confirmed by a polysomnography recording. OSAS has many associated morbidities which involve the cardiovascular system, the neurocognitive performance, the growth and the metabolic homeostasis. Obesity is a common associated condition and it impairs the therapeutic success. It should be considered when planning the treatment program: it should be stressed the obesity epide...
Objective Coagulation and inflammatory parameters are mildly altered in children with SARS-CoV-2 ... more Objective Coagulation and inflammatory parameters are mildly altered in children with SARS-CoV-2 (COVID-19) infection, and laboratory evidence of a proinflammatory and procoagulant state has been noted in multisystem inflammatory syndrome in children (MIS-C). It is not clear whether this pediatric condition is related to thrombotic events. With this study we reviewed the literature for thrombotic complications in children with COVID-19 infection and MIS-C. Data sources We searched the Medline PubMed Advanced Search Builder, Scopus, Web Of Science, and Google Scholar electronic databases (until 1 January 2021) using the medical subject headings (MeSH) terms and text words (their combinations and truncated synonyms): (THROMBOSIS OR THROMBOPHILIA) AND (CHILD OR CHILDREN OR INFANT) AND (COVID-19 OR SARS-CoV-2). Study eligibility criteria Inclusion criteria were children with COVID-19 or SARS-COV-2 infection. The search was limited to articles published in English. Exclusion criteria wer...
Ba c k g r o u n d: Past studies reported evidence of associations between air pollution and resp... more Ba c k g r o u n d: Past studies reported evidence of associations between air pollution and respiratory symptoms and morbidity for children. Few studies examined associations between air pollution and emergency room (ER) visits for wheezing, and even fewer for gastroenteric illness. We conducted a multicity analysis of the relationship between air pollution and ER visits for wheezing and gastroenteric disorder in children 0–2 years of age. Met h o d s: We obtained ER visit records for wheezing and gastroenteric disorder from six Italian cities. A city-specific case–crossover analysis was applied to estimate effects of particulate matter (PM), nitrogen dioxide, sulfur dioxide, ozone, and carbon monoxide, adjusting for immediate and delayed effects of temperature. Lagged effects of air pollutants up to 6 prior days were examined. The city-specific results were combined using a random-effect meta-analysis. Res u l t s: CO and SO 2 were most strongly associated with wheezing, with a 2....
STUDY OBJECTIVES Obstructive sleep apnea (OSA) in children is associated with acute metabolic, ca... more STUDY OBJECTIVES Obstructive sleep apnea (OSA) in children is associated with acute metabolic, cardiovascular, and neuro-cognitive abnormalities. The long-term outcomes of childhood OSA into adulthood has not been established. We performed a 20-year follow-up of patients with polysomnographically documented OSA in childhood compared to a healthy control group to evaluate the long-term anthropometric, sleep, cognitive, and cardiovascular outcomes. METHODS Children diagnosed to have severe OSA between the ages of 1 - 17 years (4.87 ± 2.77) were prospectively contacted by telephone as young adults after approximately 20 years. Data collected included reported anthropometric, educational level, health history, and the Berlin questionnaire. RESULTS Young adults with confirmed severe OSA in childhood had significantly higher adulthood BMI (p=0.038), lower academic degrees (p<0.001), and more snoring (p=0.045) compared to controls. The AHI during childhood trended towards predicting cardiovascular outcomes and the Berlin questionnaire in adulthood. CONCLUSIONS Adults with history of severe childhood OSA have a high risk of having snoring, elevated BMI, and lower academic achievement in adulthood. Thus, children with severe OSA may be at increased risk of chronic diseases later in life. The intervening COVID-19 pandemic has introduced considerable additional neurobehavioral morbidity complicating the identification of the full long-term consequences of childhood OSA.
ABSTRACT Background / Purpose: In literature, the role of smoking on the development of respirato... more ABSTRACT Background / Purpose: In literature, the role of smoking on the development of respiratory diseases is already known. The aim of the research is to study the relationship between environmental tobacco smoke (ETS) in childhood and the onset of obstructive sleep apnea syndrome (OSAS).We compared the percentage of children exposed to passive smoke between a group of pediatric OSAS patients and a control group of children from the general population in order to verify if ETS can be considered as a risk factor for the onset of the disease. Main conclusion: In conclusion, the present study demonstrates that passive smoke can be considered a risk factor for the development of OSAS and that it can influence the severity of the disease. For this reason it will be very important to produce informative campaigns to inform people about the health problems caused by the smoke that remains on clothes, people and objects.
We studied the variations in peripheral capillary oxygen saturation (SpO2) during wake time in re... more We studied the variations in peripheral capillary oxygen saturation (SpO2) during wake time in relation to pacifier use and to the following different positions: supine at 0°, supine at 30° (in babies under one year) vs. sitting (in babies between 1 and 3 years of age). We observed 54 patients under the age of three years, weighing over 1.800 g. Peripheral oxygen saturation was recorded for at least 40 min per patient in the following positions: 20 min lying supine at 0° (10 min with a pacifier and 10 min without); 20 min lying supine at 30° inclination or in a sitting position if the baby was older than one year (10 min with a pacifier and 10 min without). Pacifier use improved the peripheral oxygen saturation both in the 0° supine position, and at 30° in a sitting position. No significant differences were observed in the SpO2 levels comparing the different positions. In conclusion a pacifier thus seems to have a positive effect on respiration.
Introduction: Sleep-related problems are pervasive among youth with psychiatric symptoms, heterog... more Introduction: Sleep-related problems are pervasive among youth with psychiatric symptoms, heterogeneous in nature, and vary by frequency, intensity, duration, and impairment. This poses a challenge for measurement of sleep problems in these populations. Although there are well-validated self-reports of sleep functioning in pediatric samples, we presently lack validated clinician-rated interviews of sleep-related problems for youth. Therefore, we developed and validated a multidimensional clinician-administered interview for sleep-related problems that are common in youth with psychiatric symptoms. Methods: Participants were 46 youth (ages 9-15; M = 11.60; SD =1.63) from sleep trial (Sleeping Tigers) delivered through the Child Anxiety Treatment Study (CATS). An independent evaluator administered the Focal Interview of Sleep (FIOS), assessing the frequency, duration and intensity of seven sleep problems (e.g., trouble going to bed, trouble falling asleep, sleepy, tired, irritable, etc.) at baseline and post-treatment. Three FIOS scores, including Number of Sleep Problems, Impairment and Total Score were derived from these ratings. Youth completed actigraphy, sleep diary, and the Sleep Self-Report; and parents rated youth sleep (i.e., Children's Sleep Habits Questionnaire), and behavior and emotions (i.e., Child Behavior Checklist 6-18). Parents and youth also completed the Mood and Feelings Questionnaire and Screen for Child Anxiety and Related Emotional Disorders. Results: Interrater reliability was excellent (ICC=.75-1.00) for FIOS Duration, Frequency and Intensity scores by sleep problem type. Internal consistency was mostly excellent (range α = .65 to .94) for sleep problems. FIOS scores demonstrated strong treatment sensitivity. Convergent validity was fair for parent-and child-report of youth sleep, and sleep quality per sleep diary. There was limited support for discriminant validity, as evidenced by non-significant Fisher's R to Z transformation for the difference between FIOS Total and behavioral/emotional problems, anxiety and mood. Baseline FIOS predicting one-year sleep outcomes was non-significant. Conclusion: Findings suggest the FIOS is a psychometrically sound clinician-rated measure of sleep-related problems in youth with psychiatric symptoms. Future research can focus on discriminant and predictive validity, as well as replication in larger, more heterogeneous samples. Support (If Any
Five years after the first edition, we have revised and updated the guidelines, re-examining the ... more Five years after the first edition, we have revised and updated the guidelines, re-examining the queries and relative recommendations, expanding the issues addressed with the introduction of a new entity, recently proposed by the American Academy of Pediatrics: BRUE, an acronym for Brief Resolved Unexplained Events. In this manuscript we will use the term BRUE only to refer to mild, idiopathic cases rather than simply replace the acronym ALTE per se.In our guidelines the acronym ALTE is used for severe cases that are unexplainable after the first and second level examinations.Although the term ALTE can be used to describe the common symptoms at the onset, whenever the aetiology is ascertained, the final diagnosis may be better specified as seizures, gastroesophageal reflux, infection, arrhythmia, etc. Lastly, we have addressed the emerging problem of the so-called Sudden Unexpected Postnatal Collapse (SUPC), that might be considered as a severe ALTE occurring in the first week of life.
... Ferini Strambi L, Levrini L, Mondini S, Nespoli L, Nosetti L, Pagani J, Zucconi M; Gruppo di ... more ... Ferini Strambi L, Levrini L, Mondini S, Nespoli L, Nosetti L, Pagani J, Zucconi M; Gruppo di Studio Interdisciplinare Disturbi Respiratori nel Sonno. Gruppo di Studio interdisciplinare disturbi respiratori nel sonno, Società Italiana di Pediatria, Rome, Italy. mariapia.villa@uniroma1 ...
... circa 7.000 neonati/anno) prima del 1992, anno in cui l'American Academy of Pediatrics (A... more ... circa 7.000 neonati/anno) prima del 1992, anno in cui l'American Academy of Pediatrics (AAP) ha raccomandato che i neonati Luana Nosetti, Alessandra Cristina Niespolo, Luigi ... Regola anche la differenziazione in neuroni motori o colinergici nel SNC (Sistema nervoso centrale ...
To measure the prevalence of habitual snoring and sleep-disordered breathing in preschool-aged ch... more To measure the prevalence of habitual snoring and sleep-disordered breathing in preschool-aged children. Cross-sectional survey with parental report and overnight ambulatory monitoring of children 3 to 6 years of age in 8 kindergartens (n = 604). Parents reported the child&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s information through an interviewer-based questionnaire or by a brief telephone interview. Snoring, oxygen saturation, body position, and heart rate were recorded for 1 night at home. Data were obtained on 98.5% of 604 children (447 questionnaires, 74%; 148 telephone interviews, 24.5%); groups were similar for sex and age. Two hundred sixty-five children had ambulatory monitoring at home. Habitual snoring (always and often) was reported in 34.5% and breathing cessation in 18.6%. Habitual snoring was associated with parental report of daytime symptoms (P =.001) and daytime somnolence (P =.032). Pathologic snoring was present in 12% of children (95% CI, 7.9-16.1). On multivariate analysis, parental report of habitual snoring was the strongest determinant of pathologic snoring (OR, 12.23; 95% CI, 3.56-41.94). Oxygen desaturation index &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; or =5 per hour was found in 13% of children (95% CI, 8.7-17.3). Parental report of habitual snoring is very common. Children with habitual snoring are more likely to have objectively measured snoring and daytime morbidity.
The role played by air pollutants on sleep-disordered breathing (SDB) in childhood thus far has b... more The role played by air pollutants on sleep-disordered breathing (SDB) in childhood thus far has been little analyzed, although susceptibility to environmental toxicity is higher in children than in adults. This ecological study, carried out in the province of Varese, Italy, explores the geographical pattern of SDB among children and investigates its relationship with combustion-related pollution. For each of the 754 patients admitted to the Sleep-Disorder Breathing Center of Varese due to sleep respiratory disturbances, the apnea-hypopnea index (AHI) upon which SDB diagnosis is based was recorded. Through spatial analysis methods, the geographical heterogeneity of SDB and its severity were analyzed using AHIbased indicators. From available nitrogen dioxide (NO2) levels, the geographical pattern of the pollutant\\u2014regarded as a marker for combustion-related mixtures\\u2014was obtained and compared with that of SDB. We identified an area of significantly higher SDB case density (p <.05) and found that the relative risk (RR) of SDB increased significantly for the children living in this area (RR = 1.307, 95% confidence interval [CI] [1.155, 1.477]). In this area, annual NO2 levels were 1.5 times the provincial average. For the whole study region, moreover, we found a significant positive correlation (p <.01) between SDB severity and NO2. These findings suggest that traffic-related pollution might contribute to SDB onset and level of severity
Obstructive sleep apnea syndrome (OSAS) was first reported in 1976 by Guilleminault. This conditi... more Obstructive sleep apnea syndrome (OSAS) was first reported in 1976 by Guilleminault. This condition has been defined as a disorder of breathing during sleep characterized by prolonged partial/complete upper airway obstruction that disrupts normal ventilation and normal sleep patterns. The prevalence of this condition varies among the different populations but it is between 1 and 2% in preschool children when adenoid and tonsils volume has a major peak. Loud snoring is very common in these children but not always present. The diagnosis may be suggested by the facial appearance and by personal history but it must be confirmed by a polysomnography recording. OSAS has many associated morbidities which involve the cardiovascular system, the neurocognitive performance, the growth and the metabolic homeostasis. Obesity is a common associated condition and it impairs the therapeutic success. It should be considered when planning the treatment program: it should be stressed the obesity epide...
Objective Coagulation and inflammatory parameters are mildly altered in children with SARS-CoV-2 ... more Objective Coagulation and inflammatory parameters are mildly altered in children with SARS-CoV-2 (COVID-19) infection, and laboratory evidence of a proinflammatory and procoagulant state has been noted in multisystem inflammatory syndrome in children (MIS-C). It is not clear whether this pediatric condition is related to thrombotic events. With this study we reviewed the literature for thrombotic complications in children with COVID-19 infection and MIS-C. Data sources We searched the Medline PubMed Advanced Search Builder, Scopus, Web Of Science, and Google Scholar electronic databases (until 1 January 2021) using the medical subject headings (MeSH) terms and text words (their combinations and truncated synonyms): (THROMBOSIS OR THROMBOPHILIA) AND (CHILD OR CHILDREN OR INFANT) AND (COVID-19 OR SARS-CoV-2). Study eligibility criteria Inclusion criteria were children with COVID-19 or SARS-COV-2 infection. The search was limited to articles published in English. Exclusion criteria wer...
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