Co-detection of respiratory pathogens with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains poorly understood. This study aimed to assess the effect of interactions between different respiratory pathogens on clinical variables.

We retrospectively reviewed the results of comprehensive multiplex polymerase chain reaction (PCR) testing from November 2020 to March 2023 in Shinjuku, Tokyo, estimating co-detection rates and analyzing interactions between SARS-CoV-2 and other pathogens. A multiple logistic regression model adjusted for age, sex, and testing period was used to identify factors influencing co-detection.

Among 57,746 patients tested, 10,516 (18.2%) were positive for at least one of 22 pathogens, and 881 (1.5%) had co-detection. SARS-CoV-2 showed negative interactions with adenovirus, other coronaviruses, human metapneumovirus, parainfluenza virus, respiratory syncytial virus, and rhino/enterovirus. Co-detection with SARS-CoV-2 was most frequent in children aged 0-4 years. A multiple logistic regression indicated that younger age was the strongest factor associated with SARS-CoV-2 co-detection.

These findings highlight the prevalence of SARS-CoV-2 co-detection in young children, warranting further research on its clinical implications and severity.

This article is based on our study, first reported in the article "SARS-CoV-2 co-detection with other respiratory pathogens-descriptive epidemiological study," published in Respiratory Investigation (2024; 62 (5): 884-8).

Eight major epidemics of the novel coronavirus (SARS-CoV-2) infection (COVID-19) were observed between January 2020 and March 2023. Since the sixth wave (January 2022), when the Omicron strain became the mainstream of the epidemic, the number of pediatric patients with COVID-19 has increased rapidly, and the number of severe patients has also increased accordingly. As of November 2022, 103 patients with COVID-19-associated acute encephalopathy have been reported, with acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) (27 cases, 26.2%) and clinically mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) (9 cases, 8.7%) being the most frequent. There were 18 patients with cytokine storm encephalopathy (17.5%), including eight with hemorrhagic shock and encephalopathy syndrome (HSES), six with encephalopathy with acute fulminant cerebral edema (AFCE), and four with acute necrotizing encephalopathy (ANE). These frequencies were higher than those reported in 2017 for ANE (2.8%) and HSES (1.7%), before the COVID-19 outbreak. The prognosis of COVID-19-related acute encephalopathy was poor (11 deaths, 10.7%) owing to the high frequency of HSES and AFCE, which have a severe clinical course.

Objective: Teeth may be damaged during surgery under general anesthesia, and this incidental injury is a general complication. The purpose of this study was to investigate the frequency and prognosis of dental trauma during four years of surgeries under general anesthesia at our hospital and to identify preventive measures.

Methods: All patients who underwent surgery under general anesthesia at Tokyo Women's Medical University Yachiyo Medical Center between APR-2018 and MAR-2022 were included in the study. The evaluation parameters were age, gender, surgical schedule, and examination during perioperative oral management. For cases of dental trauma, the occurrence, details, outcomes, and the use of mouthguards were investigated. The Mann-Whitney U test, χ² test, and Fisher's exact test were performed, with the significance level set at 5%.

Results: Of the 11,828 patients, 13 experienced dental trauma. No statistically significant differences were found in age and gender, but many cases of emergency surgery or underwent perioperative oral management that was triggered. Twelve of the dental trauma patients did not wear mouthguards, with the most common issue being dislodged restorations in seven patients. One patient wearing a mouthguard experienced dislodgement of a large fixed partial denture (bridge). The outcome of five patients (38%) was tooth extraction.

Conclusion: Dental trauma occurred in 0.1% of the 13 general anesthesia procedures performed at our institution. The impact of dental issues before surgery was suggested as the factor contributing to this trauma. The need to evaluate the fit of dental prosthesis in addition to wobbly teeth in perioperative oral management was realized. Mouthguards are effective in preventing the attachment of dislodged restorations and tooth injury during anesthesiologic tracheal intubation, and collaboration with anesthesiologists is important in risk cases.

Background: Renal injury can occur in pediatric patients with torso trauma. However, studies in Japan focusing on injury mechanisms and clinical features remain limited. Our hospital adopts a North American-style emergency room (ER) system, in which pediatricians provide initial care for all children. This study aimed to share clinical insights and emphasize the role of pediatricians in managing renal injury.

Methods: We retrospectively reviewed 13 cases of renal injury over a 16-year period. All cases involved a history of torso trauma with either hematuria or renal injury identified on computed tomography (CT).

Results: Most injuries resulted from domestic accidents, sports-related activities, or playground incidents, rather than high-energy trauma. Some patients initially presented with symptoms such as abdominal pain or loss of appetite. Detailed history-taking revealed cases of domestic violence. Notably, some cases of renal injury showed no abnormalities on urinalysis or ultrasonography.

Conclusion: Even minor daily accidents can lead to renal injury. Therefore, a thorough history of the abdominal trauma is essential. In cases of hematuria without ultrasound abnormalities, renal injury should still be considered, and contrast-enhanced CT may be necessary for accurate diagnosis. When physical abuse is suspected, prompt coordination between the hospital team and local authorities is crucial.