Maria Tsolia (Greece)
National and Kapodistrian University of Athens Second Department of PaediatricsAuthor Of 9 Presentations
Summary and Closing Remarks
Welcome
Q&A
Conclusions
Opening Remarks
Welcome Words by the Meeting Chairs
CHARACTERISTICS OF CHILDREN HOSPITALIZED WITH MIS-C DURING THREE PANDEMIC WAVES IN GREECE
Abstract
Backgrounds:
The Multisystem Inflammatory Syndrome in Children (MIS-C) is a rare but potentially severe complication of COVID-19.
Methods
This is a retrospective observational study of children aged <18 years hospitalized with MIS-C in 10 tertiary hospitals in Greece during three pandemic waves characterized by different SARS-CoV-2 variant: i. from August 2020 to January 2021 (EU1-B.1.177), ii. from February 2021 to July 2021 (Alpha-B.1.1.7) and iii. from August 2021 to December 2021 (Delta-B.1.617.2). The aim of the study was to document the incidence over time, clinical characteristics and outcome of children admitted with MIS-C in Greek hospitals during the COVID-19 pandemic.
Results:
In total, 119 patients were included, 91.6% (109/119) met the WHO criteria of MIS-C diagnosis: 26.9% (32/119), 39.5% (47/119) and 33.6% (40/119) were hospitalized during the 1st, 2nd, and 3rd study period, respectively. Demographic and clinical characteristics are shown in Table 1. No cases were found before October 2020. The incidence of MIS-C significantly decreased over the three waves from 3.3/1000 to 0.25/1000 confirmed COVID-19 cases (P <0.0001). No other significant difference was observed in the clinical manifestations and disease severity of children hospitalized with MIS-C over the three waves.
Conclusions/Learning Points:
This study indicates that the incidence of MIS-C may vary according to the predominant variant. Outcome remains favourable regardless of the variant leading to MIS-C. Larger studies are needed to clarify if clinical characteristics and/or disease severity may differ, as well.
THE IDENTIFICATION AND SUBSEQUENT CROSS-PLATFORM VALIDATION OF A HOST GENE EXPRESSION SIGNATURE FOR DIFFERENTIATING BETWEEN MIS-C AND OTHER INFECTIOUS AND INFLAMMATORY DISEASES
Abstract
Backgrounds:
Multisystem Inflammatory Syndrome in Children (MIS-C) occurs several weeks after SARS-CoV-2 infection with symptoms including fever, shock and multiorgan failure. Clinical features of MIS-C overlap with Kawasaki Disease (KD), bacterial, and viral infections, making accurate diagnosis challenging. Host genes, measurable through whole blood transcriptomics, are an alternative tool for diagnosing infectious and inflammatory diseases.
Methods
Patients with MIS-C, KD, bacterial, and viral infections were recruited to the EU-funded PERFORM and DIAMONDS studies and the NIH-funded PREVAIL study. Patients were phenotyped using a standardised algorithm. Genome wide RNA sequencing of whole blood was undertaken, and feature selection was performed to identify a diagnostic signature for distinguishing between MIS-C and other infectious and inflammatory conditions. The expression levels of the genes identified were measured using RT-qPCR assays in an independent validation cohort.
Results:
Through feature selection and differential expression analysis, 11 genes with diagnostic potential were identified and taken forward into cross-platform validation using RT-qPCR. With up to 11 genes, it was possible to distinguish between MIS-C vs. KD, bacterial, and viral infections with high accuracy, with an AUC of 92.9% (95% CI: 88.2%-97.6%) in the validation cohort. The diagnostic gene signature retained its high performance when tested within the groups separately in the validation cohort: MIS-C vs. bacterial infections (AUC: 94.6%), vs. viral infections (AUC: 93.1%), and vs. KD (AUC: 89.8%).
Conclusions/Learning Points:
Despite the clinical similarities between MIS-C and other infectious and inflammatory conditions, there are key differences in gene expression profiles that can be used in diagnostic contexts. It will be necessary for the genes reported here to undergo further validation prior to their development into tests with clinical utility.
GUIDELINE ADHERENCE IN FEBRILE CHILDREN BELOW THREE MONTHS VISITING EUROPEAN EMERGENCY DEPARTMENTS: AN OBSERVATIONAL MULTICENTER STUDY
Abstract
Backgrounds:
Febrile children below three months have a higher risk of serious bacterial infections, which often leads to extensive diagnostics and treatment. However, there is practice variation in management due to differences in guidelines and the usage and adherence. We aimed to assess whether management in febrile children below three months attending European Emergency Departments (EDs) was according to the available guidelines for fever.
Methods
This study is part of the MOFICHE study, which is an observational multicenter study including routine data of febrile children (0-18 years) attending twelve European EDs. In febrile children <3 months (excluding bronchiolitis), we analyzed actual management compared to the available guidelines for fever. Ten EDs applied the (adapted) NICE guideline and two EDs applied local guidelines. Management included diagnostic tests, antibiotic treatment and admission. Subgroup analyses in children <1 month and 1-3 months were performed. Data on follow-up was not collected.
Results:
We included 913 children (median age 1.7 months) with the majority triaged as intermediate/high urgent (53%), 40% having a respiratory tract infection and 56% having a viral illness. Management per ED varied: diagnostic tests 14-83%, antibiotic treatment 23-54%, admission 34-86%. Adherence to the guidelines varied: blood cultures were obtained in 43% (374/868), lumbar punctures in 30% (144/488), antibiotics were prescribed in 55% (270/492) and 67% (573/859) were admitted. Full adherence to all these four components occurred in 15% (132/868, range 0-38%), 31% (71/223) in children <1 month and 10% (61/645) in children 1-3 months respectively.
Conclusions/Learning Points:
There is large practice variation in management and guideline adherence was limited, but highest for admission which implies good safety netting. Future studies should focus on guideline revision with new biomarkers in order to optimize management in young febrile children.
Presenter of 6 Presentations
Summary and Closing Remarks
Welcome
Q&A
Conclusions
Opening Remarks
Welcome Words by the Meeting Chairs
Moderator of 3 Sessions
Session Description:
The agenda will focus on what we can learn from meningococcal epidemiology and the importance of MenB breadth of coverage and fHbp in protecting against meningococcal disease. The agenda will also include emerging data for the MenB-fHbp vaccine and discuss next steps for controlling meningococcal disease.
Facilitator Of
Session Description:
The agenda will focus on what we can learn from meningococcal epidemiology and the importance of MenB breadth of coverage and fHbp in protecting against meningococcal disease. The agenda will also include emerging data for the MenB-fHbp vaccine and discuss next steps for controlling meningococcal disease.
Poster Author Of 17 e-Posters
EP285 - ANTIBIOTIC TREATMENT IN CHILDREN WITH RESPIRATORY SYNCYTIAL VIRUS (RSV) BRONCHIOLITIS (ID 1003)
EP286 - ACUTE BRONCHIOLITIS: RESPIRATORY SYNCYTIAL VIRUS (RSV) VS NON-RSV BRONCHIOLITIS (ID 1143)
EP362 - BACTEREMIAS IN PEDIATRIC-ONCOLOGY PATIENTS OF A GREEK UNIVERSITY HOSPITAL: OUR EXPERIENCE OVER A 5-YEAR PERIOD OF TIME. (ID 975)
EP366 - IMPACT OF COVID-19 PANDEMIC ON ANTIMICROBIAL RESISTANCE: TWO PARALLEL GLOBAL THREATS (ID 1011)
EP421 - RISK FACTORS FOR SEVERE COVID-19 DISEASE IN CHILDREN (ID 1019)
EP425 - THE EFFECT OF DIFFERENT SARS-COV-2 VARIANTS ON CHILDREN’S HOSPITALIZATIONS AND COVID-19 SEVERITY (ID 955)
EP426 - BRONCHIOLITIS AND COVID-19 IN INFANTS AND YOUNG CHILDREN: AN UNUSUAL PAIR (ID 967)
PD053 - COVID-19 BREAKTHROUGH DISEASE IN FULLY VACCINATED PAEDIATRIC PATIENTS WITH RHEUMATIC DISEASES (ID 1002)
PD060 - PREVALENCE OF RICKETTSIA CONORII AND RICKETTSIA TYPHI INFECTIONS IN POPULATION IN EUROPE: A SYSTEMATIC REVIEW AND META-ANALYSIS (ID 478)
PD083 - IMPACT OF COVID-19 ON ANTIMICROBIAL CONSUMPTION IN HOSPITALIZED CHILDREN (ID 812)
PD090 - ANTIMICROBIAL PRESCRIBING IN HOSPITALIZED CHILDREN WITH COVID-19 (ID 816)
PD105 - EPIDEMIOLOGY AND MICROBIOLOGY OF BACTERIAL ACUTE OTITIS MEDIA WITH OTORRHEA IN THE ERA OF PNEUMOCOCCAL CONJUGATE VACCINES IN A TERTIARY HOSPITAL IN ATHENS, GREECE (ID 577)
PD116 - STREPTOCOCCUS PNEUMONIAE MENINGITIS AND/OR SEPTICEMIA AND SEROTYPE SURVEILLANCE IN CHILDREN, DURING 2010-2021 IN GREECE (ID 1186)
PD122 - MANAGEMENT OF INFANTS 29-60 DAYS OLD HOSPITALIZED WITH FEVER: TIME TO REVISIT PRACTICE GUIDELINES? (ID 1880)
PD133 - MEASLES AND RUBELLA SEROPREVALENCE IN PREGNANT WOMEN DURING THE LAST MEASLES EPIDEMIC IN GREECE (ID 1854)
- Stayroula Papailiou (Greece)
- Alexandra Soldatou (Greece)
- Antonios Marmarinos (Greece)
- Margaritis Avgeris (Greece)
- Evangelia Papathoma (Greece)
- Michael Sindos (Greece)
- Sofia Georgantzi (Greece)
- Alexandros Rodolakis (Greece)
- Nicoletta Iacovidou (Greece)
- Dimitrios Gourgiotis (Greece)
- Maria Tsolia (Greece)
PD161 - SEROPREVALENCE OF SARS-COV-2 INFECTION AMONG CHILDREN AND THEIR PARENTS IN GREECE (ID 786)
- Dimitra Dimopoulou (Greece)
- Maria Kyritsi (Greece)
- Eleni Vergadi (Greece)
- Ekaterini Tsiligianni (Greece)
- Eleni Papadimitriou (Greece)
- Artemis Mavridi (Greece)
- Spyridon Giannakopoulos (Greece)
- Georgia Tsiourvopoulou (Greece)
- Maria Palyvou (Greece)
- Evangelia Angeli (Greece)
- Nikitas Brikos (Greece)
- IRINI ELEFTHERIOU (Greece)
- Nikos SPYRIDIS (Greece)
- Athanasios Michos (Greece)
- Vassiliki Spoulou (Greece)
- Despoina Gkentzi (Greece)
- Ekaterini Siomou (Greece)
- Vassiliki Papaevangelou (Greece)
- George A. Syrogiannopoulos (Greece)
- Emmanouil Galanakis (Greece)
- Christos Hadjichristodoulou (Greece)
- Maria Tsolia (Greece)
PD168 - MULTISYSTEM INFLAMMATORY SYNDROME IN CHILDREN (MIS-C): A NATIONWIDE COLLABORATIVE STUDY IN THE GREEK POPULATION (ID 774)
- STAVROULA LAMPIDI (Greece)
- Despoina Maritsi (Greece)
- IRINI ELEFTHERIOU (Greece)
- Evaggelia Farmaki (Greece)
- Nikos SPYRIDIS (Greece)
- KONSTANTINA CHARISI (Greece)
- Petrina Vantsi (Greece)
- Filippos G. Filippatos (Greece)
- Kleopatra Skourti (Greece)
- EFIMIA PAPADOPOULOU-ALATAKI (Greece)
- Kyriaki Papadopoulou-Legbelou (Greece)
- Parthena Kampouridou (Greece)
- Ioanna N. Grivea (Greece)
- Eleni Vergadi (Greece)
- Despoina Gkentzi (Greece)
- Despina Dimou (Greece)
- Patra Koletsi (Greece)
- Lampros Fotis (Greece)
- Vassiliki Papaevangelou (Greece)
- Gabriel Dimitriou (Greece)
- Emmanouil Galanakis (Greece)
- George A. Syrogiannopoulos (Greece)
- Vassiliki Spoulou (Greece)
- Athanasios Michos (Greece)
- Emmanuel Roilides (Greece)
- Maria Tsolia (Greece)