Treatment outcomes and their predictors in children hospitalized with varicella complicated by bacterial superinfections after pandemic of COVID-19 - a retrospective multicenter analysis of real-life data in Poland

The aim of this study was to analyze treatment outcomes and their predictors in children hospitalized due to varicella complicated by bacterial superinfections after pandemic of COVID-19. This retrospective study analyzed data collected in a multicenter, nationwide, observational database dedicated...

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Published in:	European journal of clinical microbiology & infectious diseases
Main Authors:	Pokorska-Śpiewak, Maria, Szenborn, Leszek, Pietrzak, Maja, Marczyńska, Magdalena, Mania, Anna, Stopyra, Lidia, Moppert, Justyna, Toczyłowski, Kacper, Sulik, Artur, Szenborn, Filip, Jasonek, Jolanta, Barańska-Nowicka, Inga, Buciak, Adrianna, Majda-Stanisławska, Ewa, Ciechanowski, Przemysław, Karny, Katarzyna, Kuchar, Ernest, Figlerowicz, Magdalena, Pawłowska, Małgorzata
Format:	Journal Article
Language:	English
Published:	Germany 21-09-2024
Subjects:	Group a streptococcus (streptococcus pyogenes) Varicella Ibuprofen Antipyretics
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Summary:	The aim of this study was to analyze treatment outcomes and their predictors in children hospitalized due to varicella complicated by bacterial superinfections after pandemic of COVID-19. This retrospective study analyzed data collected in a multicenter, nationwide, observational database dedicated for children aged 0-17 years hospitalized due to bacterial complications of varicella in 9 Polish tertiary healthcare inpatient centers. The primary endpoint of this study was the treatment outcome established after the end of hospital management assessed at a 4-point scale. The secondary endpoint was defined as the necessity of surgical intervention. There were 458 patients with a median age of 4 (IQR 2-6) years. After the completed treatment, 319 (69%) participants were found fully recovered; 132 (29%) had transient complications; 2 (0.5%) had persistent complications; and 1 child (0.5%) died. Multivariate analysis revealed that implementation of ibuprofen in pre-treatment management of a child with varicella was associated with a 4.07-fold (2.50-6.60) increase in risk of complications after the treatment and it was associated with 2.87 times (1.39-5.89) higher risk of surgical intervention necessity. For other pre-hospital interventions (implementation of acyclovir, antibiotics or antihistaminics) no significant impact was observed. GAS infection increased the necessity of surgical intervention by 7.51 (3.64-15.49) times. One-third of patients treated for bacterial complications of varicella have post-treatment complications, most of them transient. GAS infection increases the need for surgical intervention. The use of ibuprofen in the treatment of varicella significantly increases the risk of complications and the need for surgical intervention.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0934-9723 1435-4373 1435-4373
DOI:	10.1007/s10096-024-04944-2