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Clinical Characteristics of Children With SARS-CoV-2 Infection During the Third Wave of the Pandemic: Single Center
Mihir Sarkar1, Ananya Ghosh2, Mithun Chandra Konar2
1Department of Pediatrics, Medical College and Hospital, Kolkata. Correspondence to: Dr Mihir Sarkar, 88, College Street, Department of Pediatrics, Medical College and Hospital, Kolkata, West Bengal 700 073. drmihir09@gmail.com.
Insights
Pulmonary dysfunction is common in children with thalassemia. Intensive chelation therapy with desferrioxamine (DFO) showed significant improvement in lung function tests, suggesting its benefit in managing lung complications.
Area of Science:
- Pediatric Hematology
- Pulmonology
- Medical Imaging
Background:
- Transfusion-dependent thalassemia is a chronic condition requiring regular blood transfusions.
- Iron overload is a major complication of thalassemia, affecting multiple organs, including the lungs.
- Pulmonary dysfunction is increasingly recognized in children with thalassemia.
Purpose of the Study:
- To evaluate pulmonary function in children with transfusion-dependent thalassemia.
- To assess the reversibility of lung dysfunction using intensive intravenous chelation with desferrioxamine (DFO).
Main Methods:
- A descriptive study involving 77 children with transfusion-dependent thalassemia.
- Pulmonary function tests (PFTs) including spirometry, total lung capacity (TLC), and diffusion capacity for carbon monoxide (DLCO) were performed.
- Iron load was assessed using serum ferritin (SF) and T2* MRI of the heart and liver. Follow-up PFTs were conducted on 13 children receiving intensive DFO therapy.
Main Results:
- 68.8% of patients exhibited lung dysfunction, primarily diffusional impairment (96%) and reduced TLC (22%).
- Pulmonary function parameters and T2* MRI values showed an inverse correlation with serum ferritin levels.
- Intensive DFO treatment for 4 weeks led to significant improvements in FEV1/FVC ratio, DLCO, and DSF.
Conclusions:
- Pulmonary dysfunction is prevalent in multi-transfused children with thalassemia.
- Routine PFT screening should be integrated into the management guidelines for these patients.
- Intensive chelation therapy shows promise in improving lung function in children with thalassemia.
Objective:
To evaluate pulmonary functions in children with transfusion-dependent thalassemia, and its reversal (lung dysfunction) using intensive intravenous chelation with desferrioxamine (DFO) (4 weeks).
Methods:
This descriptive study enrolled 77 children with transfusion-dependent thalassemia. Pulmonary function test (PFT) and iron load (serum ferritin (SF) and T2* MRI of heart and liver) were done. PFT included spirometry, total lung capacity (TLC) by helium dilution test and diffusion capacity by carbon monoxide (DLCO). Follow-up PFT was available for 13 children with moderate to severe lung dysfunction given intravenous DFO.
Results:
50 (68.8%) patients had lung dysfunction, most commonly diffusional impairment (48; 96%), and reduced TLC (11; 22%); and none had obstructive pattern. 9 (81.8%) patients with restrictive defect had moderate to severely deranged DLCO. PFT and T2* MRI values were inversely correlated with serum ferritin. Among 13 patients receiving intensive chelation for 4 weeks, significant improvement was noticed in forced expiratory volume in one minute/ forced vital capacity ratio (DFEV1/FVC) (P=0.009), DDLCO (P=0.006) and DSF (P=0.01).
Conclusions:
Pulmonary dysfunction is common in children with multi-transfused thalassemia, and routine screening by PFT needs to be part of the management guidelines.
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