{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T21:53:22Z","timestamp":1775771602320,"version":"3.50.1"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2021,6,15]],"date-time":"2021-06-15T00:00:00Z","timestamp":1623715200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,8,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Most pediatric coronavirus disease 2019 (COVID-19) is mild. We assessed nationally severe COVID-19, including pediatric inflammatory multisystem syndrome (PIMS), in hospitalized children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An ongoing, prospective, national surveillance was conducted from March 2020 through March 2021, at 20 hospitals treating children &amp;lt;18 years across Israel (~75% of Israeli hospitals).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 1007 cases (439 outpatients and 568 hospitalized) identified represent 0.35% of pediatric COVID-19 nationwide (n = 291 628). Of hospitalized cases, 464 (82%), 48 (8%), and 56 (10%) had mild, moderate\/severe, and PIMS disease, respectively. The mean \u00b1 SD age was 5.6 \u00b1 6.4 years. In mild, moderate\/severe, and PIMS disease, 55%, 23%, and 4% of patients were &amp;lt;1 year old, respectively. Obesity was reported in 1%, 4%, and 13% of patients, respectively (P &amp;lt; .001). The most common symptom was fever in 67%, 60%, and 100%, respectively, whereas respiratory symptoms were documented in 33%, 41%, and 38% of patients, respectively. Lymphopenia was recorded in 25%, 60%, and 86% of cases, respectively. PIMS diagnosis was mainly serology-based (in 59%). Gastrointestinal symptoms, cardiovascular involvement, rash, and conjunctivitis were noted in 82%, 61%, 57%, and 34% of PIMS episodes, respectively. Elevated C-reactive protein (100%), ferritin, troponin, D-dimer, low albumin, and thrombocytopenia were common in PIMS. Echocardiography revealed pathological findings in 33% of patients. PIMS mainstay treatment included corticosteroids (77%) and intravenous immunoglobulin (53%). No mortality was recorded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>At a national level, pediatric COVID-19 is mild, even in hospitalized cases, with only a third presenting with respiratory involvement. PIMS is rare, but necessitates a high index of suspicion, and with suitable treatment prognosis is favorable.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jpids\/piab035","type":"journal-article","created":{"date-parts":[[2021,5,6]],"date-time":"2021-05-06T15:36:51Z","timestamp":1620315411000},"page":"757-765","source":"Crossref","is-referenced-by-count":28,"title":["COVID-19 in a Subset of Hospitalized Children in Israel"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7690-0991","authenticated-orcid":false,"given":"Shalom","family":"Ben-Shimol","sequence":"first","affiliation":[{"name":"The Pediatric Infectious Disease Unit, Soroka University Medical Center, Beer-Sheva, Israel"},{"name":"Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gilat","family":"Livni","sequence":"additional","affiliation":[{"name":"Department of Pediatrics A, Schneider Children\u2019s Medical Center, Petah Tikva, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Orli","family":"Megged","sequence":"additional","affiliation":[{"name":"Pediatric Department and Pediatric Infectious Diseases Unit, Shaare Zedek Medical Center, Jerusalem, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Greenberg","sequence":"additional","affiliation":[{"name":"The Pediatric Infectious Disease Unit, Soroka University Medical Center, Beer-Sheva, Israel"},{"name":"Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4819-3871","authenticated-orcid":false,"given":"Dana","family":"Danino","sequence":"additional","affiliation":[{"name":"The Pediatric Infectious Disease Unit, Soroka University Medical Center, Beer-Sheva, Israel"},{"name":"Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5233-1213","authenticated-orcid":false,"given":"Ilan","family":"Youngster","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Diseases Unit, Shamir Medical Center, Zerifin, Israel"},{"name":"Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yael","family":"Shachor-Meyouhas","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Disease Unit, Ruth Rappaport Children\u2019s Hospital, Rambam Health Care Campus, Haifa, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Halima","family":"Dabaja-Younis","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Disease Unit, Ruth Rappaport Children\u2019s Hospital, Rambam Health Care Campus, Haifa, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oded","family":"Scheuerman","sequence":"additional","affiliation":[{"name":"Department of Pediatrics B, Schneider Children\u2019s Medical Center, Petah Tikva, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meirav","family":"Mor","sequence":"additional","affiliation":[{"name":"Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel"},{"name":"Infection Control Unit and Emergency Department, Schneider Children\u2019s Medical Center, Petach Tikva, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eli","family":"Somekh","sequence":"additional","affiliation":[{"name":"Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel"},{"name":"Department of Pediatrics, Mayanei Hayeshua Medical Center, Bnei Brak, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Husam","family":"Yakub Hanna","sequence":"additional","affiliation":[{"name":"Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel"},{"name":"Department of Pediatrics, Mayanei Hayeshua Medical Center, Bnei Brak, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noga","family":"Givon-Lavi","sequence":"additional","affiliation":[{"name":"The Pediatric Infectious Disease Unit, Soroka University Medical Center, Beer-Sheva, Israel"},{"name":"Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex","family":"Guri","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Kaplan Medical Center, Rehovot, Israel"},{"name":"School of Medicine, Hadassah-Hebrew University, Jerusalem, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eugene","family":"Leibovitz","sequence":"additional","affiliation":[{"name":"The Pediatric Infectious Disease Unit, Soroka 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