Face masks effectively reduce airborne disease transmission, but data on their physiological impact on children remain limited compared to adults. This study evaluates the physiological and thermal effects of surgical masks (SM) and filtering face piece mask (FFP2) on children during typical classroom sessions. In a randomized crossover study with repeated measures conducted in late summer, 39 children (23 girls and 16 boys; age 8-14 years, mean 11 +/- 1 years) were monitored during 90-minute school lessons under three conditions: no mask (NM), surgical mask (SM), and FFP2 mask. Continuous recordings included core body temperature (T-core), heart rate (HR), breathing rate (BR), and oxygen saturation (sO(2)). Additionally, microclimate parameters under the mask, such as relative humidity (RHmask), temperature (T-mask and T-skin), and inhaled/exhaled carbon dioxide (pCO(2in/ex)), were measured. Subjective exertion was assessed using the BORG scale. No significant changes in HR, BR, sO(2), or T-core were observed. Wearing SM or FFP2 mask led to a minor statistically significant, yet clinically irrelevant, increase in pCO(2in/ex) (< 2 mmHg) compared to NM. While T-mask and RHmask increased significantly (with FFP2 showing higher values than SM), T-skin rose only slightly across all conditions. Subjective exertion (BORG) increased marginally with FFP2 masks but remained in the "very slight" range. Wearing SM or FFP2 masks for up to 90 min does not impair cardiopulmonary function or oxygenation in healthy children. Observed physiological changes were within normal limits, primarily associated with local thermal effects and minimal discomfort. Face masks are therefore considered safe for short-term use in school settings.

During the omicron wave of the COVID-19 pandemic and with SARS-CoV-2 vaccines becoming available, seroprevalence rates rose in children and adolescents. This study investigated the impact of both SARS-CoV-2 infections and vaccinations on the incidence of acute and prolonged symptoms in real-world conditions during the transition from the pandemic to the endemic phase. Participants from a pediatric population based seroprevalence study (CorKID study) were followed up at least two and for almost four years by survey of health status features and symptoms suggestive of post-COVID syndrome (PCS). In a subgroup (n = 259) SARS-CoV-2 antibody serology was further investigated. 789 participants of the original CorKID study cohort (n = 2.121; 37.2%) were included. 67.9% reported at least one SARS-CoV2 infection. 46.6% had received one or more SARS-CoV-2 vaccinations. In the vast majority of serologically tested participants antibodies again SARS-CoV-2 spike (98.9%) or nucleocapsid (93.3%) antigen were detected following infection and/or vaccination. At least 30% experienced one unrecognized SARS-CoV-2 infection. The overall health status was comparable between children, irrespective of SARS-CoV-2 infections and similar to pre-pandemic assessment. However, a subset of young adolescents exhibited a decline in physical performance compared to pre-pandemic conditions. After infection, PCS-like symptoms persisted in 7% of the respondents for more than three months and up to four years. SARS-CoV-2 vaccinated participants (47%) reported 12% less acute flu-like infections other than SARS-CoV-2. Nearly all participants developed SARS-CoV-2 antibodies in this longitudinal study through either vaccination or infection during the Omicron wave. About 7% of participants suffered from PCS symptoms, predominately fatigue and exhaustion. Furthermore, participants who received vaccinations against SARS-CoV-2 reported a lower frequency of acute infections during follow-up.

Background Olfactory dysfunction associated with SARS-CoV-2 infection in children has not been verified by a validated olfactory test. We aimed to determine whether these complaints are objectifiable (test-based hyposmia), how often they occur during acute SARS-CoV-2 infection compared to other upper respiratory tract infections (URTI), as well as in children recovered from COVID-19 compared to children with long COVID.Methods Olfactory testing (U-sniff test; hyposmia<8 points) and survey-based symptom assessments were performed in 434 children (5-17 years; 04/2021-06/2022). 186 symptom-free children served as controls. Of the children with symptoms of acute respiratory tract infection, SARS-CoV-2 PCR test results were positive in 45 and negative in 107 children (URTI group). Additionally, 96 children were recruited at least 4 weeks (17.6 +/- 15.2 weeks) after COVID-19, of whom 66 had recovered and 30 had developed long COVID.Results Compared to controls (2.7%), hyposmia frequency was increased in all other groups (11-17%, p<0.05), but no between-group differences were observed. Only 3/41 children with hyposmia reported complaints, whereas 13/16 children with complaints were normosmic, with the largest proportion being in the long-COVID group (23%, p<0.05).Conclusion Questionnaires are unsuitable for assessing hyposmia frequency in children. Olfactory complaints and hyposmia are not specific for SARS-CoV-2 infection. The number of complaints in the long-COVID group could result from aversive olfactory perception, which is undetectable with the U-sniff test.

BACKGROUND:In high-resource settings, the survival of children with immunocompromise (IC) has increased and immunosuppressive therapies are increasingly being used. This study aimed to determine the clinical characteristics, performance of diagnostic tools, and outcome of IC children with tuberculosis (TB) in Europe. METHODS:Multicenter, matched case-control study within the Pediatric Tuberculosis Network European Trials Group, capturing TB cases <18 years diagnosed 2000-2020. RESULTS:A total of 417 TB cases were included, comprising 139 children who are IC (human immunodeficiency virus, inborn errors of immunity, drug-induced immunosuppression, and other immunocompromising conditions) and 278 non-IC children as controls. Nonrespiratory TB was more frequent among cases than controls (32.4% vs 21.2%; P = .013). Patients with IC had an increased likelihood of presenting with severe disease (57.6% vs 38.5%; P < .001; odds ratio [95% confidence interval], 2.073 [1.37-3.13]). Children with IC had higher rates of false-negative tuberculin skin test (31.9% vs 6.0%; P < .001) and QuantiFERON-TB Gold assay (30.0% vs 7.3%; P < .001) results at diagnosis. Overall, the microbiological confirmation rate was similar in IC and non-IC cases (58.3% vs 49.3%; P = .083). Although the mortality in children with IC was <1%, the rate of long-term sequelae was significantly higher than in non-IC cases (14.8% vs 6.1%; P = .004). CONCLUSIONS:Children with IC and TB in Europe have increased rates of nonrespiratory TB, severe disease, and long-term sequelae. Immune-based TB tests have poor sensitivity in those children. Future research should focus on developing improved immunological TB tests that perform better in patients with IC, and determining the reasons for the increased risk of long-term sequelae, with the aim to design preventive management strategies.

Purpose In contrast to adults, immune protection against SARS-CoV-2 in children and adolescents with natural or hybrid immunity is still poorly understood. The aim of this study was to analyze different immune compartments in different age groups and whether humoral immune reactions correlate with a cellular immune response. Methods 72 children and adolescents with a preceding SARS-CoV-2 infection were recruited. 37 were vaccinated with an RNA vaccine (BNT162b2). Humoral immunity was analyzed 3–26 months (median 10 months) after infection by measuring Spike protein (S), nucleocapsid (NCP), and neutralizing antibodies (nAB). Cellular immunity was analyzed using a SARS-CoV-2-specific interferon-γ release assay (IGRA). Results All children and adolescents had S antibodies; titers were higher in those with hybrid immunity (14,900 BAU/ml vs. 2118 BAU/ml). NCP antibodies were detectable in > 90%. Neutralizing antibodies (nAB) were more frequently detected (90%) with higher titers (1914 RLU) in adolescents with hybrid immunity than in children with natural immunity (62.5%, 476 RLU). Children with natural immunity were less likely to have reactive IGRAs (43.8%) than adolescents with hybrid immunity (85%). The amount of interferon-γ released by T cells was comparable in natural and hybrid immunity. Conclusion Spike antibodies are the most reliable markers to monitor an immune reaction against SARS-CoV-2. High antibody titers of spike antibodies and nAB correlated with cellular immunity, a phenomenon found only in adolescents with hybrid immunity. Hybrid immunity is associated with markedly higher antibody titers and a higher probability of a cellular immune response than a natural immunity.

Background: Vulnerability to infectious diseases in refugees is dependent on country of origin, flight routes, and conditions. Information on specific medical needs of different groups of refugees is lacking. We assessed the prevalence of infectious diseases, immunity to vaccine -preventable diseases, and chronic medical conditions in children, adolescents, and adult refugees from Ukraine who arrived in Germany in 2022. Methods: Using different media, we recruited Ukrainian refugees at 13 sites between 9-12/2022. An antigen test for acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infection, serologies for a range of vaccine -preventable diseases, as well as interferon gamma release assays (IGRAs) for tuberculosis (TB), and SARS-CoV-2 were performed. We assessed personal and family history of chronic medical conditions, infectious diseases, vaccination status, and conditions during migration. Results: Overall, 1793 refugees (1401 adults and 392 children/adolescents) were included. Most participants were females (n = 1307; 72 center dot 3%) and from Eastern or Southern Ukraine. TB IGRA was positive in 13% (n = 184) of the adults and in 2% (n = 7) of the children. Serology -based immunological response was insufficient in approximately 21% (360/1793) of the participants for measles, 32% (572/1793) for diphtheria, and 74% (1289/1793) for hepatitis B. Conclusions: We show evidence of low serological response to vaccine -preventable infections and increased LTBI prevalence in Ukrainian refugees. These findings should be integrated into guidelines for screening and treatment of infectious diseases in migrants and refugees in Germany and Europe. Furthermore, low immunity for vaccine -preventable diseases in Ukrainians independent of their refugee status, calls for tailormade communication efforts. (c) 2024 The Author(s). Published by Elsevier Ltd on behalf of King Saud Bin Abdulaziz University for Health Sciences. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/ 4.0/).

In the current SARS-CoV-2 pandemic, wearing a face mask is mandatory again during school lessons. There are no controlled studies in children to date indicating an effect on cognitive performance from wearing face masks. In a randomized controlled trial, we analysed the influence of face masks on cognitive performance of pupils during regular school lessons. Pupils (n = 133, fifth to seventh grade) were randomized by alternating allocation into control (with masks, n = 65) and intervention groups (without mask, n = 68). After two school lessons with (control) and without (intervention) face masks in class, all pupils performed digital tests for cognitive performance regarding attention and executive functions (switch, Corsi block-tapping, 2-back and flanker task). Overall, there were no significant differences in cognitive performance between both groups, masks vs. no masks. Wearing face masks has no significant influence on attention and executive functions of pupils and can still be recommended during school lessons.

We would like to demonstrate the case of a 7 week old male infant (premature birth 35+3, twin-to-twin transfusion syndrome) presenting with biphasic stridor, cough, signs of dyspnea, desaturation and feeding problems. Before, the child had been admitted to another clinic and was treated with salbutamol and cortisone. Showing no signs of improvement, he was converted to our clinic. The infant was in a poor general condition on arrival with tachypnea, subcostal retractions and biphasic stridor. We performed a chest x-ray, an echocardiography and an ultrasound of the throat. The ultrasound showed hypoechoic soft tissue with prominent vessels near the larynx obstructing the upper airway. For further investigation bronchoscopy was performed showing a subglottic haemangioma nearly obstructing the entire airway. The child was intubated and on mechanical ventilation for 11 days. Immediately after bronchoscopy, a treatment with propranolol was initiated. The following bronchoscopy, 14 days after commencing propranolol treatment, showed almost normal findings. The child was discharged from the hospital after three weeks and showed no further respiratory symptoms since. Follow ups including larynx sonography every three months were always without pathological findings. The propranolol treatment ended after 12 months. Further investigation should rapidly be performed in cases of respiratory distress in an infant with uncommon symptoms, especially when showing no improvement under regular treatment. When suspecting a subglottic airway obstruction larynx sonography including colour Doppler is a safe and non-invasive diagnostic tool complementary to airway endoscopy.

The incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the population in the Ruhr area rose sharply starting in October 2020. Little is known regarding the SARS-CoV-2 infection rates in children and adolescents with acute infections, the viral load of a SARS-CoV-2 infection in different age groups, or the importance of known contacts with infected people within and outside the family.

Die notfallmässige Einweisung der 68-jährigen, schlanken Patientin erfolgte durch die Söhne, die bei ihrer Mutter eine akut aufgetretene Wesensveränderung feststellten. Gewöhnlich reinigte die Patientin jeden Samstag das Badezimmer. Auch an diesem Wochenende nahm sie ihre Reinigungsarbeiten in Angriff. Plötzlich begann die Patientin unermüdlich den Badezimmerboden zu schrubben, bis ihre Finger blutig waren.

QUESTIONS UNDER STUDYTo gain insight into the determinants of radiologists' professional satisfaction in Switzerland.METHODSData from 254 members of the Swiss Society of Radiology (76% men) obtained in a questionnaire survey were analysed by logistic regression analysis using socio-demographic, person- and workplace-related factors as independent variables (determinants) and satisfaction at work as the outcome variable.RESULTSIn terms of person-related factors within a complex logistical regression model, radiologists with low occupational self-efficacy and especially those with low mental wellbeing were at elevated risk for low professional satisfaction, with the latter determinant being the strongest predictor in the whole model. Regarding work-related determinants, low career satisfaction and high workload increased the risk of low job satisfaction while working in a university hospital was a protection factor against low job satisfaction with private practice being the reference. A total of 42% of the respondents enjoyed their job more, and 19% enjoyed it less compared to five years previously, while 39% experienced no change.CONCLUSIONDespite high workload, time and economic pressure, the majority of radiologists were professionally satisfied at a high level, which had even increased within the last five years. However, to keep this level of job satisfaction, career possibilities, especially in private practices, have to be improved. Furthermore, the radiologists' important contribution to the diagnostic and therapeutic process has to be recognised professionally as well as economically.