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1. Impact of SARS-CoV-2 Infection on the Association Between Laboratory Tests and Severe Outcomes Among Hospitalized Children.

Author

Xie, Jianling, Kuppermann, Nathan, Florin, Todd, Tancredi, Daniel, Funk, Anna, Kim, Kelly, Salvadori, Marina, Yock-Corrales, Adriana, Shah, Nipam, Breslin, Kristen, Chaudhari, Pradip, Bergmann, Kelly, Ahmad, Fahd, Nebhrajani, Jasmine, Mintegi, Santiago, Gangoiti, Iker, Plint, Amy, Avva, Usha, Gardiner, Michael, Malley, Richard, Finkelstein, Yaron, Dalziel, Stuart, Bhatt, Maala, Kannikeswaran, Nirupama, Caperell, Kerry, Campos, Carmen, Sabhaney, Vikram, Chong, Shu-Ling, Lunoe, Maren, Rogers, Alexander, Becker, Sarah, Borland, Meredith, Sartori, Laura, Pavlicich, Viviana, Rino, Pedro, Morrison, Andrea, Neuman, Mark, Poonai, Naveen, Simon, Norma-Jean, Kam, April, Kwok, Maria, Morris, Claudia, Palumbo, Laura, Ambroggio, Lilliam, Navanandan, Nidhya, Eckerle, Michelle, Klassen, Terry, Payne, Daniel, Cherry, Jonathan, Waseem, Muhammad, Dixon, Andrew, Ferre, Isabel, and Freedman, Stephen

Subjects
C-reactive protein, COVID-19, SARS-CoV-2, child, lymphopenia, procalcitonin
Abstract

BACKGROUND: To assist clinicians with identifying children at risk of severe outcomes, we assessed the association between laboratory findings and severe outcomes among severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected children and determined if SARS-CoV-2 test result status modified the associations. METHODS: We conducted a cross-sectional analysis of participants tested for SARS-CoV-2 infection in 41 pediatric emergency departments in 10 countries. Participants were hospitalized, had laboratory testing performed, and completed 14-day follow-up. The primary objective was to assess the associations between laboratory findings and severe outcomes. The secondary objective was to determine if the SARS-CoV-2 test result modified the associations. RESULTS: We included 1817 participants; 522 (28.7%) SARS-CoV-2 test-positive and 1295 (71.3%) test-negative. Seventy-five (14.4%) test-positive and 174 (13.4%) test-negative children experienced severe outcomes. In regression analysis, we found that among SARS-CoV-2-positive children, procalcitonin ≥0.5 ng/mL (adjusted odds ratio [aOR], 9.14; 95% CI, 2.90-28.80), ferritin >500 ng/mL (aOR, 7.95; 95% CI, 1.89-33.44), D-dimer ≥1500 ng/mL (aOR, 4.57; 95% CI, 1.12-18.68), serum glucose ≥120 mg/dL (aOR, 2.01; 95% CI, 1.06-3.81), lymphocyte count

Published
2023

2. Corticosteroids and Other Treatments Administered to Children Tested for SARS-CoV-2 Infection in Emergency Departments.

Author

Freedman, Stephen B, Kuppermann, Nathan, Funk, Anna L, Kim, Kelly, Xie, Jianling, Tancredi, Daniel, Dalziel, Stuart R, Neuman, Mark I, Mintegi, Santiago, Plint, Amy C, Gómez-Vargas, Jessica, Finkelstein, Yaron, Ambroggio, Lilliam, Klassen, Terry P, Salvadori, Marina, Malley, Richard, Payne, Daniel C, Florin, Todd A, and Pediatric Emergency Research Network-COVID-19 Study Team

Subjects
Pediatric Emergency Research Network-COVID-19 Study Team, Humans, Adrenal Cortex Hormones, Nucleic Acids, Cross-Sectional Studies, Adolescent, Child, Emergency Service, Hospital, SARS-CoV-2, COVID-19 Drug Treatment, COVID-19, adrenal cortex hormones, child, hospitalized, emergency service, hospital, Emerging Infectious Diseases, Pediatric, Vaccine Related, Prevention, Clinical Trials and Supportive Activities, Biodefense, Clinical Research, Lung, Infectious Diseases, Respiratory, child, hospitalized, emergency service, hospital, Paediatrics and Reproductive Medicine, Pediatrics
Abstract

ObjectiveWe sought to determine if corticosteroid administration is associated with a SARS-CoV-2 nucleic acid test-positive result and to describe therapies administered to SARS-CoV-2 infected children.MethodsWe collected cross-sectional data from participants recruited in 41 pediatric emergency departments (ED) in 10 countries between March 2020 and June 2021. Participants were

Published
2022

10. The Pediatric Emergency Research Network

Author

Klassen, Terry, Dalziel, Stuart R, Babl, Franz E, Benito, Javier, Bressan, Silvia, Chamberlain, James, Chang, Todd P, Freedman, Stephen B, Kohn-Loncarica, Guillermo, Lyttle, Mark D, Mintegi, Santiago, Mistry, Rakesh D, Nigrovic, Lise E, Oostenbrink, Rianne, Plint, Amy C, Rino, Pedro, Roland, Damian, Van De Mosselaer, Gregory, and Kuppermann, Nathan

Subjects
Clinical Trials and Supportive Activities, Clinical Research, Pediatric, Infectious Diseases, Generic health relevance, Child, Emergency Medical Services, Emergency Medicine, Health Promotion, Health Services Research, Humans, International Cooperation, Pediatrics, multicenter randomized controlled trials, implementation, health care disparities, health equity, Paediatrics and Reproductive Medicine, Emergency & Critical Care Medicine
Abstract

ObjectivesThe Pediatric Emergency Research Network (PERN) was launched in 2009 with the intent for existing national and regional research networks in pediatric emergency care to organize globally for the conduct of collaborative research across networks.MethodsThe Pediatric Emergency Research Network has grown from 5- to 8-member networks over the past decade. With an executive committee comprising representatives from all member networks, PERN plays a supportive and collaborative rather than governing role. The full impact of PERN's facilitation of international collaborative research, although somewhat difficult to quantify empirically, can be measured indirectly by the observed growth of the field, the nature of the increasingly challenging research questions now being addressed, and the collective capacity to generate and implement new knowledge in treating acutely ill and injured children.ResultsBeginning as a pandemic response with a high-quality retrospective case-controlled study of H1N1 influenza risk factors, PERN research has progressed to multiple observational studies and ongoing global randomized controlled trials. As a recent example, PERN has developed sufficient network infrastructure to enable the rapid initiation of a prospective observational study in response to the current coronavirus disease 2019 pandemic. In light of the ongoing need for translation of research knowledge into equitable clinical practice and to promote health equity, PERN is committed to a coordinated international effort to increase the uptake of evidence-based management of common and treatable acute conditions in all emergency department settings.ConclusionsThe Pediatric Emergency Research Network's successes with global research, measured by prospective observational and interventional studies, mean that the network can now move to improve its ability to promote the implementation of scientific advances into everyday clinical practice. Achieving this goal will involve focus in 4 areas: (1) expanding the capacity for global randomized controlled trials; (2) deepening the focus on implementation science; (3) increasing attention to healthcare disparities and their origins, with growing momentum toward equity; and (4) expanding PERN's global reach through addition of sites and networks from resource-restricted regions. Through these actions, PERN will be able to build on successes to face the challenges ahead and meet the needs of acutely ill and injured children throughout the world.

Published
2021

11. Prospective cohort study of children with suspected SARS-CoV-2 infection presenting to paediatric emergency departments: a Paediatric Emergency Research Networks (PERN) Study Protocol.

Author

Funk, Anna L, Florin, Todd A, Dalziel, Stuart R, Mintegi, Santiago, Salvadori, Marina I, Tancredi, Daniel Joseph, Neuman, Mark I, Payne, Daniel C, Plint, Amy C, Klassen, Terry P, Malley, Richard, Ambroggio, Lilliam, Kim, Kelly, Kuppermann, Nathan, and Freedman, Stephen B

Subjects
Humans, Hospitalization, Risk Factors, Prospective Studies, Research Design, International Cooperation, Child, Emergency Service, Hospital, Pediatric Emergency Medicine, COVID-19, SARS-CoV-2, epidemiology, paediatric a&e and ambulatory care, paediatric infectious disease & immunisation, paediatric intensive & critical care, Clinical Sciences, Public Health and Health Services, Other Medical and Health Sciences
Abstract

IntroductionRelatively limited data are available regarding paediatric COVID-19. Although most children appear to have mild or asymptomatic infections, infants and those with comorbidities are at increased risk of experiencing more severe illness and requiring hospitalisation due to COVID-19. The recent but uncommon association of SARS-CoV-2 infection with development of a multisystem inflammatory syndrome has heightened the importance of understanding paediatric SARS-CoV-2 infection.Methods and analysisThe Paediatric Emergency Research Network-COVID-19 cohort study is a rapid, global, prospective cohort study enrolling 12 500 children who are tested for acute SARS-CoV-2 infection. 47 emergency departments across 12 countries on four continents will participate. At enrolment, regardless of SARS-CoV-2 test results, all children will have the same information collected, including clinical, epidemiological, laboratory, imaging and outcome data. Interventions and outcome data will be collected for hospitalised children. For all children, follow-up at 14 and 90 days will collect information on further medical care received, and long-term sequelae, respectively. Statistical models will be designed to identify risk factors for infection and severe outcomes.Ethics and disseminationSites will seek ethical approval locally, and informed consent will be obtained. There is no direct risk or benefit of study participation. Weekly interim analysis will allow for real-time data sharing with regional, national, and international policy makers. Harmonisation and sharing of investigation materials with WHO, will contribute to synergising global efforts for the clinical characterisation of paediatric COVID-19. Our findings will enable the implementation of countermeasures to reduce viral transmission and severe COVID-19 outcomes in children.Trial registration numberNCT04330261.

Published
2021

12. Predicting severe pneumonia in the emergency department: a global study of the Pediatric Emergency Research Networks (PERN)-study protocol.

Author

Florin, Todd Adam, Tancredi, Daniel Joseph, Ambroggio, Lilliam, Babl, Franz E, Dalziel, Stuart R, Eckerle, Michelle, Mintegi, Santiago, Neuman, Mark, Plint, Amy C, Kuppermann, Nathan, and Pediatric Emergency Research Networks (PERN) Pneumonia Investigators

Subjects
Pediatric Emergency Research Networks (PERN) Pneumonia Investigators, Humans, Pneumonia, Prognosis, Models, Statistical, Prospective Studies, Child, Infant, Emergency Service, Hospital, paediatric A&E and ambulatory care, paediatric infectious disease & immunisation, paediatrics, paediatric A, E and ambulatory care, paediatric infectious disease, immunisation, Patient Safety, Pediatric, Infectious Diseases, Health Services, Pneumonia & Influenza, Lung, Clinical Research, Emergency Care, 4.2 Evaluation of markers and technologies, Clinical Sciences, Public Health and Health Services, Other Medical and Health Sciences
Abstract

IntroductionPneumonia is a frequent and costly cause of emergency department (ED) visits and hospitalisations in children. There are no evidence-based, validated tools to assist physicians in management and disposition decisions for children presenting to the ED with community-acquired pneumonia (CAP). The objective of this study is to develop a clinical prediction model to accurately stratify children with CAP who are at risk for low, moderate and severe disease across a global network of EDs.Methods and analysisThis study is a prospective cohort study enrolling up to 4700 children with CAP at EDs at ~80 member sites of the Pediatric Emergency Research Networks (PERN; https://pern-global.com/). We will include children aged 3 months to

Published
2020

15. Characteristics of oncology patients with fever and invasive bacterial infections diagnosed.

Author

Gomez, Borja, Almarza, Fernando, López‐Almaraz, Ricardo, Quintana, Oriol, and Mintegi, Santiago

Subjects
BACTERIAL diseases, ESCHERICHIA coli, CANCER chemotherapy, CANCER patients, BACTEREMIA
Abstract

Aim: To describe the characteristics of febrile oncology patients seen in the Paediatric Emergency Department and microbiological characteristics of the invasive bacterial infections (IBIs) diagnosed. Methods: We conducted a prospective observational study of febrile oncology patients seen between 2016 and 2022. We divided haematologic cancers by the aggressiveness of the chemotherapy received at the time. Results: We included 418 episodes (272 haematologic cancers, 146 solid tumours). The median duration of fever was 2 h (interquartile range: 1–3) and 97.6% of patients were well‐appearing on arrival. We diagnosed 61 IBIs (14.6%), including six episodes of bacterial sepsis. One other episode was coded as sepsis without microbiological confirmation, yielding seven episodes overall (1.7%). Rates of IBI and sepsis were higher among patients with high‐risk haematologic cancers than those with low‐risk haematologic cancers or solid tumours (22.9%, 5.4% and 10.3%, p < 0.01; 3.4%, 0% and 0.7%, p = 0.06, respectively). Leading causes were S. epidermidis (42.6%) and E. coli (14.7%). Gram‐positive bacteria caused 67.2% of non‐septic IBIs and 50% of septic episodes. Conclusion: Most febrile oncology patients are well‐appearing and present with a very short history of fever. Prevalence of IBI and sepsis and the main disease‐causing bacteria differ by cancer type and the presence of sepsis. [ABSTRACT FROM AUTHOR]

Published
2024
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19. Preparedness and Response to Pediatric COVID-19 in European Emergency Departments: A Survey of the REPEM and PERUKI Networks

Author

Hachimi-Idrissi, Said, Sjølin Frederiksen, Marianne, Uustalu, Ulle, Cheron, Gerard, Hoffmann, Florian, Thors, Valtyr, Barrett, Michael J., Shavit, Itai, Pucuka, Zanda, Jankauskaite, Lina, Mação, Patrícia, Orfanos, Ioannis, Lacroix, Laurence, Bressan, Silvia, Buonsenso, Danilo, Farrugia, Ruth, Parri, Niccolo’, Oostenbrink, Rianne, Titomanlio, Luigi, Roland, Damian, Nijman, Ruud G., Maconochie, Ian, Da Dalt, Liviana, and Mintegi, Santiago

Published
2020
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21. Manejo y factores de riesgo de gravedad asociados a lesiones no intencionadas en urgencias de pediatría en España

Author

Bardón Cancho, Eduardo J., Arribas Sánchez, Cristina, Rivas García, Arístides, Marañón Pardillo, Rafael, Fernández, Santiago M., Mintegi, Santiago, Obieta, Anaida, Chaves, Nuria, Farrés, Claudia, Estopiñá, Gloria, David Panzino, Fernando, Benito, Helvia, González, Leticia, Amalia Pérez, María, Rodríguez, Agustín, Lorente Romero, Jorge, and Vázquez López, Paula

Published
2020
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28. Expert panel diagnosis demonstrated high reproducibility as reference standard in infectious diseases

Author

van Houten, Chantal B., Naaktgeboren, Christiana A., Ashkenazi-Hoffnung, Liat, Ashkenazi, Shai, Avis, Wim, Chistyakov, Irena, Corigliano, Teresa, Galetto, Annick, Gangoiti, Iker, Gervaix, Alain, Glikman, Daniel, Ivaskeviciene, Inga, Kuperman, Amir A., Lacroix, Laurence, Loeffen, Yvette, Luterbacher, Fanny, Meijssen, Clemens B., Mintegi, Santiago, Nasrallah, Basheer, Papan, Cihan, van Rossum, Annemarie M.C., Rudolph, Henriette, Stein, Michal, Tal, Roie, Tenenbaum, Tobias, Usonis, Vytautas, de Waal, Wouter, Weichert, Stefan, Wildenbeest, Joanne G., de Winter-de Groot, Karin M., Wolfs, Tom F.W., Mastboim, Niv, Gottlieb, Tanya M., Cohen, Asi, Oved, Kfir, Eden, Eran, Feigin, Paul D., Shani, Liran, and Bont, Louis J.

Published
2019
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29. Antibiotic prescription for febrile children in European emergency departments: a cross-sectional, observational study

Author

Moll, Henriette A., Oostenbrink, Rianne, van Veen, Mirjam, Noordzij, Jeroen G., Smit, Frank, van Wermeskerken, Anne-Marie, Angoulvant, Francois, Dubos, Francois, Gras-Leguen, Christele, Desmarest, Marie, Aurel, Marie, Gajdos, Vincent, Joffre, Christelle, Mintegi, Santiago, Acedo, Yordana, Herrero Garcia, Laura, Medina, Inmaculada, Cózar, Juan Alonso, Fernandez Arribas, Jose Luis, Pinto, Sara, Sá, Gabriela, Mação, Patrícia, Silva, Daniela, Zarcos, Maria, Seiler, Michelle, Gervaix, Alain, Maconochie, Ian, Olesen, Hanne, Bønnelykke, Christiane, Parri, Niccolò, Fichera, Vito, Arrhigini, Alberto, Bressan, Silvia, Da Dalt, Liviana, Moldovan, Diana, Dreghiciu, Daniela-Maria, Bognar, Zsolt, Yilmaz, Hayri L., Sari Gökay, Sinem, van de Maat, Josephine, van de Voort, Elles, Nieboer, Daan, and Moll, Henriette

Published
2019
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30. Features Associated With Radiographic Pneumonia in Children with SARS-CoV-2

Author

Florin, Todd A, primary, Freedman, Stephen B, additional, Xie, Jianling, additional, Funk, Anna L, additional, Tancredi, Daniel J, additional, Kim, Kelly, additional, Neuman, Mark I, additional, Yock-Corrales, Adriana, additional, Bergmann, Kelly R, additional, Breslin, Kristen A, additional, Finkelstein, Yaron, additional, Ahmad, Fahd A, additional, Avva, Usha R, additional, Lunoe, Maren M, additional, Chaudhari, Pradip P, additional, Shah, Nipam P, additional, Plint, Amy C, additional, Sabhaney, Vikram J, additional, Sethuraman, Usha, additional, Gardiner, Michael A, additional, Sartori, Laura F, additional, Wright, Bruce, additional, Navanandan, Nidhya, additional, Mintegi, Santiago, additional, Gangoiti, Iker, additional, Borland, Meredith L, additional, Chong, Shu-Ling, additional, Kwok, Maria Y, additional, Eckerle, Michelle, additional, Poonai, Naveen, additional, Romero, Carlos Miguel Angelats, additional, Waseem, Muhammad, additional, Nebhrajani, Jasmine R, additional, Bhatt, Maala, additional, Caperell, Kerry, additional, Campos, Carmen, additional, Becker, Sarah M, additional, Morris, Claudia R, additional, Rogers, Alexander J, additional, Kam, April J, additional, Pavlicich, Viviana, additional, Palumbo, Laura, additional, Dalziel, Stuart R, additional, Morrison, Andrea K, additional, Rino, Pedro B, additional, Cherry, Jonathan C, additional, Salvadori, Marina I, additional, Ambroggio, Lilliam, additional, Klassen, Terry P, additional, Payne, Daniel C, additional, Malley, Richard, additional, Simon, Norma-Jean, additional, and Kuppermann, Nathan, additional

Published
2024
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35. How Are Clinicians Treating Children With Sepsis in Emergency Departments in Latin America?: An International Multicenter Survey

Author

Kohn-Loncarica, Guillermo A., Fustiñana, Ana L., Jabornisky, Roberto M., Pavlicich, Sonia V., Prego-Pettit, Javier, Yock-Corrales, Adriana, Luna-Muñoz, Consuelo R., Casson, Nils A., Álvarez-Gálvez, Eugenia A., Zambrano, Ibelice R., Contreras-Núñez, Cristina, Santos, César M., Paniagua-Lantelli, Guadalupe, Gutiérrez, Camilo E., Amantea, Sérgio L., González-Dambrauskas, Sebastián, Sánchez, María José, Rino, Pedro B., Mintegi, Santiago, and Kissoon, Niranjan

Published
2021
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49. Psychosocial Care for Injured Children: Worldwide Survey among Hospital Emergency Department Staff

Author

Osmond, Martin, Plint, Amy, Freedman, Stephen, Johnson, David, Murray, Diana, Williamson-Urquhart, Sarah, Curran, Janet, Dixon, Andrew, Meckler, Garth, Bialy, Liza, Doan, Quynh, Stang, Antonia, Mater, Ahmed, Beer, Darcy, Joubert, Gary, Crocco, Anthony, Davis, Adrienne, Moore, Andrea, Alqurashi, Waleed, Dubrovsky, Sasha, Trottier, Evelyne, Blanchet, Mathieu, Hurley, Katrina, Porter, Robert, Auerbach, Marc, Chang, Todd, Cruz, Andrea, Macias, Charles G., Florin, Todd A., Kharbanda, Anupam B., Mahajan, Prashant, Mistry, Rakesh, Schnadower, David, Stanley, Rachel, Nigrovic, Lise, Michelson, Kenneth, Zorc, Joe, Lyttle, Mark, Maconochie, Ian, Hartshorn, Stuart, Foster, Steven, Bevan, Cath, O'Sullivan, Ronan, Mitchelson, Mark, Maney, Julie-Ann, Potter, Sarah, Younge, Paul, Powell, Colin V.E., Robinson, Gisela, Blackburn, Carol, Bolger, Turlough, McNamara, Roisin, Leonard, Paul, Reuben, Adam, Choudhery, Vince, Mulligan, Joanne, Alcock, Roger, Davies, Ffion, Mehta, Bimal, Parikh, Ami, Ross, James, Criddle, John, Sutherland, Emer, Sajjanhar, Tina, Wong, Shye, Thiagarajan, Jai, Rowland, Andrew, Potier, Katherine, Dieppe, Clare, Thomas, Lucy, Smith, Jason, Vorwerk, Chris, Lenton, Kate, Burke, Derek, Barling, Jason, Mullen, Niall, Dickson-Jardine, Kirsty, Mintegui Raso, Santiago, Gómez, Borja, Da Dalt, Liviana, Gervaix, Alain, Moll, Henriette, Waisman, Yehezkel, Parri, Niccolò, Titomanlio, Luigi, Benito, Javier, Yilmaz, Hayri Levent, Teksam, Ozlem, Srivastava, Geetanjali, Bognar, Zsolt, Moldovan, Diana, Luaces-Cubells, Carles, Qureshi, Nadeem, Cheron, Gerard, Kreier, Felix, Velasco, Roberto, Leroy, Sandrine, Simon, Gabor, Van de Voorde, Patrick, Mintegi, Santiago, Ruddy, Richard, Dayan, Peter, Hickey, Robert, Kuppermann, Nathan, Chamberlain, James, Dean, J. Michael, Lerner, E. Brooke, Rogers, Alexander, Cohen, Daniel, Babcock, Lynn, Brousseau, David, Kwok, Maria, Macias, Charles, Bajaj, Lalit, Chun, Thomas, Bennett, Jonathan, Tzimenatos, Leah, Nelson, Douglas, Brown, Kathy, Powell, Elizabeth, Cheng, Nicholas, Zhang, Michael, Craig, Simon, Babl, Franz E., Dalziel, Stuart, Sinn, Kam, McCaskill, Mary, George, Shane, Jocelyn Neutze, Phillips, Natalie, Borland, Meredith, Barrow, Lisa, Rao, Arjun, Furyk, Jeremy, Kochar, Amit, Chamberlain, Jim, Kharbanda, Anupam, Babl, Franz, Alisic, Eva, Hoysted, Claire, Kassam-Adams, Nancy, Landolt, Markus A., Curtis, Sarah, and Lyttle, Mark D.

Published
2016
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