{"id":1374,"date":"2020-03-31T10:51:55","date_gmt":"2020-03-31T08:51:55","guid":{"rendered":"https:\/\/www.pediatrics.cz\/?page_id=1374"},"modified":"2020-03-31T10:51:56","modified_gmt":"2020-03-31T08:51:56","slug":"covid-19-2","status":"publish","type":"page","link":"https:\/\/www.pediatrics.cz\/covid-19-2\/","title":{"rendered":"COVID-19"},"content":{"rendered":"\n<h4 class=\"block-heading\"><strong>Vertik\u00e1ln\u00ed p\u0159enos, klinick\u00e9 p\u0159\u00edznaky u novorozenc\u016f matek s pozitivn\u00ed infekc\u00ed COVID-19<\/strong><\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">COVID-19 &nbsp; NEW YORK , March 26, 2020,<strong> <\/strong>By Denise Baey<br>JAMA Pediatrics, <a href=\"https:\/\/jamanetwork.com\/journals\/jama\/fullarticle\/2763853\"><strong>https:\/\/jamanetwork.com\/journals\/jama\/fullarticle\/2763853<\/strong><\/a><br><strong>Souhrn: <\/strong>Je posp\u00e1n vertik\u00e1ln\u00ed p\u0159enos a klinick\u00fd pr\u016fb\u011bh onemocn\u011bn\u00ed u 33 novorozenc\u016f matek s potvrzenou infekc\u00ed COVID-19 ve Wu Chanu. <strong>Klinick\u00e9 p\u0159\u00edznaky onemocn\u011bn\u00ed byly pozorov\u00e1ny jen u 3 novorozenc\u016f ze 33. <\/strong>V\u0161ichni t\u0159i novorozenci se narodili c\u00edsa\u0159sk\u00fdm \u0159ezem. <strong>Prvn\u00ed d\u00edt\u011b, <\/strong>narozen\u00e9 matce s COVID-19 a pneumoni\u00ed, bylo 2. den \u017eivota apatick\u00e9, m\u011blo teplotu, rtg uk\u00e1zalo pneumonii, procalcitonin byl zv\u00fd\u0161en\u00fd, dal\u0161\u00ed laborato\u0159 bpn. Vy\u0161et\u0159en\u00ed SARS-CoV-2 z nasofaryngu bylo pozitivn\u00ed 2. a 4. den \u017eivota a negativn\u00ed od 5. dne. <strong>Dal\u0161\u00ed d\u00edt\u011b, <\/strong>tak\u00e9<strong> <\/strong>narozen\u00e9 matce<strong> <\/strong>s COVID-19 a pneumoni\u00ed, bylo od druh\u00e9ho dne \u017eivota letargick\u00e9, zvracelo a m\u011blo hore\u010dku. Laborato\u0159 uk\u00e1zalo leukocyt\u00f3zu, lymfopenii a vy\u0161\u0161\u00ed frakci CK-MB. RTG uk\u00e1zalo pneumonii a vy\u0161et\u0159en\u00ed SARS-CoV-2 v nasofaryyngu bylo pozitivn\u00ed 2. a 4. den \u017eivota a negativn\u00ed 6. den. <strong>T\u0159et\u00ed d\u00edt\u011b, <\/strong>tak\u00e9<strong> <\/strong>matky s COVID-19 a pneumoni\u00ed, m\u011blo p\u0159ed porodem akutn\u00ed intrauterinn\u00ed hypoxii, bylo k\u0159\u00ed\u0161eno a sk\u00f3re podle Apgarov\u00e9 bylo 3 \u2013 4 \u2013 5 bod\u016f. Rozvinul se m\u00edrn\u00fd IRDS a bylo vysloveno i podez\u0159en\u00ed na sepsi. Rtg vy\u0161et\u0159en\u00ed uk\u00e1zalo m\u00edrnou formu IRDS ale i pneumonii. P\u0159\u00edtomna byla leukocyt\u00f3za, trombocytopenie a koagulopatie.&nbsp; P\u0159i ATB a dal\u0161\u00ed l\u00e9\u010db\u011b se stav upravil do 14 dn\u00ed. Vy\u0161et\u0159en\u00ed SARS-CoV-2 v materi\u00e1lu z nosu i stolice bylo pozitivn\u00ed 2. a 4. den \u017eivota a negativn\u00ed 7. den. Vertik\u00e1ln\u00ed p\u0159enos z matky na d\u00edt\u011b byl potvrzen i u \u010dtvrt\u00e9ho, asymptomatick\u00e9ho, novorozence s leukocyt\u00f3zou a pozitivn\u00edmi protil\u00e1tkami v IgM  (45.8 AU\/ml) i IgG. Naopak v\u00fdsledky RT-PCR testu z materi\u00e1lu odebran\u00e9ho z nasofaryngu mezi 2. hodinou a 16 dny po narozen\u00ed byly negativn\u00ed. Proto\u017ee IgM protil\u00e1tky nep\u0159ech\u00e1zej\u00ed p\u0159es placentu, p\u0159edpokl\u00e1d\u00e1 se, \u017ee plod byl infikov\u00e1n cca 3 t\u00fddny p\u0159ed porodem a do porodu se ji\u017e viru zbavil?<br><strong>Ji\u0159\u00ed Zeman<\/strong><br>KDDL VFN a 1. LF UK<\/p>\n\n\n\n<h4 class=\"block-heading\"><strong>Zku\u0161enosti s COVID-19 na d\u011btsk\u00e9 ambulanci FN Motol<\/strong><\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">4.3.2020, p\u011bt dn\u00ed po n\u00e1vratu rodiny z ly\u017ea\u0159sk\u00e9 oblasti Passo Tonale\/Ponte di Legno, se u otce dvou syn\u016f objevil chrapot, r\u00fdma, faryngitis a svalov\u00e1 slabost. 5.3. byl na Bulovce proveden v\u00fdt\u011br&nbsp; z nasofaryngu a 6.3. byla potvrzena pozitivita na COVID-19. Jeho 12-let\u00fd syn m\u011bl prvn\u00ed p\u0159\u00edznaky od r\u00e1na 8.3. Hore\u010dka 38,2\u00b0C m\u011b\u0159en\u00e1 axil\u00e1rn\u011b se zimnic\u00ed, bolesti sval\u016f, nauzea a opakovan\u00e9 zvracen\u00ed.&nbsp; Dostal antipyretika a or\u00e1ln\u00ed rehydrataci. V 17 hodin odpoledne byl proveden dom\u00e1c\u00ed odb\u011br z nasofaryngu zdravotn\u00edkem infek\u010dn\u00ed sanitky a dal\u0161\u00ed den byla ozn\u00e1mena pozitivita COVID-19. TO ji\u017e byl chlapec afebriln\u00ed, ale \u00fanavn\u00fd a od 10.3. se c\u00edtil zdr\u00e1v. Po celou dobu nem\u011bl \u017e\u00e1dn\u00e9 respira\u010dn\u00ed p\u0159\u00edznaky. Oba kontroln\u00ed testy 17.3 a 20.3 byly s nesignifikantn\u00edm v\u00fdsledkem a byly posl\u00e1ny k p\u0159ehodnocen\u00ed do n\u00e1rodn\u00ed referen\u010dn\u00ed laborato\u0159e. Posledn\u00ed odb\u011br odesl\u00e1n k vy\u0161et\u0159en\u00ed 24.3., v\u00fdsledek b\u00fdv\u00e1 za 3-5 dn\u016f od odb\u011bru.&nbsp; Jeho man\u017eelka (1978) m\u011bla prvn\u00ed p\u0159\u00edznaky od 10.3., to je 11. den po n\u00e1vratu z It\u00e1lie. Objevila se r\u00fdma, such\u00fd ka\u0161el, bolesti pr\u016fdu\u0161ek, zv\u00fd\u0161en\u00e1 \u00fanava. Maxim\u00e1ln\u00ed teplota nanejv\u00fd\u0161 subfebriln\u00ed. Odb\u011br z nasofaryngu byl tak\u00e9 pozitivn\u00ed, klinick\u00e1 \u00faprava se dostavila v pr\u016fb\u011bhu 10 dn\u00ed. 10.3. m\u011bl pozitivn\u00ed v\u00fdsledek vy\u0161et\u0159en\u00ed na COVID-19 i mlad\u0161\u00ed 10-let\u00fd syn. Jeho obt\u00ed\u017ee za\u010daly such\u00fdm ka\u0161lem a m\u00edrnou r\u00fdmou, za dva dny se p\u0159idaly subfebrilie do 37,5 \u00b0C axil\u00e1rn\u011b, bolesti hlavy a sval\u016f a p\u0159i ka\u0161li m\u011bl bolesti na hrudn\u00edku. Dost\u00e1val peror\u00e1ln\u00ed analgetika, p\u0159\u00edznaky ustoupily v pr\u016fb\u011bhu t\u0159\u00ed dn\u00ed. Prvn\u00ed kontroln\u00ed vy\u0161et\u0159en\u00ed na COVID-19 z 20.3. bylo negativn\u00ed, nyn\u00ed \u010dek\u00e1 na v\u00fdsledek druh\u00e9ho kontroln\u00edho vy\u0161et\u0159en\u00ed. Nikoho z rodiny nebyl hospitalizov\u00e1n.<br><strong>Karol\u00edna \u0160pi\u010d\u00e1kov\u00e1<\/strong><br>Pediatrick\u00e1 klinika FN Motol<br><\/p>\n\n\n\n<h4 class=\"block-heading\"><strong>Pr\u016fb\u011bh onemocn\u011bn\u00ed COVID-19 u mal\u00fdch d\u011bt\u00ed v It\u00e1lii<\/strong><\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">Ve \u010dtvrtek 26.3.2020 organizovala EAP telekonferenci s pediatry z It\u00e1lie, kte\u0159\u00ed se staraj\u00ed o d\u011bti s COVID-19. V\u0161ech 9 pozitivn\u00edch d\u011bt\u00ed, kter\u00e9 byly hospitalizov\u00e1ny na D\u011btsk\u00e9 klinice v Padov\u011b, m\u011bly lehk\u00fd pr\u016fb\u011bh onemocn\u011bn\u00ed, nej\u010dast\u011bji s r\u00fdmou, ka\u0161lem, zvracen\u00edm a\/nebo pr\u016fjmem. U d\u011bt\u00ed s pr\u016fjmem byl virus prok\u00e1z\u00e1n i ve stolici, rtg plic byl u v\u0161ech bpn, nikdo nebyl p\u0159elo\u017een na JIP a d\u00e9lka hospitalizace\/obervace byla obvykle 3-5 dn\u00ed. U v\u0161ech d\u011bt\u00ed byl zdroj infekce nalezen u pozitivn\u00edch rodi\u010d\u016f. V dal\u0161\u00ed italsk\u00e9 nemocnici bylo zachyceno 5 pozitivn\u00edch novorozenc\u016f, dva s teplotou a dva s r\u00fdmou, 3 m\u011bly jen zv\u00fd\u0161en\u00fd CRP. V\u0161ichni jsou zat\u00edm klinicky v po\u0159\u00e1dku. Dotazn\u00edkov\u00e1 akce mezi \u00fa\u010dastn\u00edky konference z 18 zem\u00ed EU uk\u00e1zala, \u017ee t\u011b\u017ek\u00fd pr\u016fb\u011bh onemocn\u011bn\u00ed u mal\u00fdch d\u011bt\u00ed nen\u00ed \u010dast\u00fd, ale v\u0161ichni se shodli na nutnosti p\u0159\u00edsn\u00e9 triage p\u0159ed vstupem do nemocnic a pot\u0159eb\u011b chr\u00e1nit d\u011bti i jejich l\u00e9ka\u0159e a sestry.<br><strong>Ji\u0159\u00ed Zeman<\/strong><br>KDDL VFN a 1. LF UK<br><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Vertik\u00e1ln\u00ed p\u0159enos, klinick\u00e9 p\u0159\u00edznaky u novorozenc\u016f matek s pozitivn\u00ed infekc\u00ed COVID-19 COVID-19 &nbsp; NEW YORK , March 26, [&hellip;]<\/p>\n","protected":false},"author":4,"featured_media":0,"parent":0,"menu_order":26,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"kia_subtitle":"","footnotes":""},"class_list":["post-1374","page","type-page","status-publish","hentry"],"acf":[],"lang":"cs","translations":{"cs":1374},"pll_sync_post":[],"_links":{"self":[{"href":"https:\/\/www.pediatrics.cz\/api\/wp\/v2\/pages\/1374","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.pediatrics.cz\/api\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.pediatrics.cz\/api\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.pediatrics.cz\/api\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/www.pediatrics.cz\/api\/wp\/v2\/comments?post=1374"}],"version-history":[{"count":2,"href":"https:\/\/www.pediatrics.cz\/api\/wp\/v2\/pages\/1374\/revisions"}],"predecessor-version":[{"id":1489,"href":"https:\/\/www.pediatrics.cz\/api\/wp\/v2\/pages\/1374\/revisions\/1489"}],"wp:attachment":[{"href":"https:\/\/www.pediatrics.cz\/api\/wp\/v2\/media?parent=1374"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}