The Essentials for Nurses About Recognition and Treatment of MIS-C

‘A massive systemic inflammatory response.’

While on the whole the United States is seeing a decline in COVID cases, this most recent wave of the Delta variant has seen an unprecedented number of children infected and hospitalized for COVID-19.

While children generally fare better than adults from the virus, infection may make them susceptible to a rare condition known as multisystem inflammatory syndrome in children (MIS-C).

This rare but serious condition was described by Shields and colleagues in our May issue as “a massive systemic inflammatory response that has physiologic correlations to Kawasaki disease, Kawasaki disease shock syndrome, toxic shock syndrome, macrophage activation syndrome, and cytokine release syndrome.”

The CDC reports that, as of October 4, the number of patients meeting the case definition for MIS-C was 5,217 (up from 4,000 reported in June) and the total number of deaths meeting the case definition was 46.

The CDC case definition includes the following:

2021-10-28T10:36:09-04:00October 20th, 2021|COVID-19, infectious diseases, Nursing|0 Comments
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Delta, Mu, and Others: What to Know About Covid Variants

Daily Trends in COVID-19 Cases in the U.S. Reported to CDC (9-21-21): red line shows 7-day moving average. Click image to enlarge.

According to the CDC, the delta variant now makes up more than 99% of COVID-19 cases across the U.S. Recently, though, the media has been drawing attention to the mu variant. Should we worry?

How serious are variants?

Viruses constantly change. Mutations might make a virus easier to spread or more virulent, change its clinical presentation, or alter its response to tests, vaccines, or treatment. Or there may be no observable change in its characteristics at all. Some variants simply fade away; others stick around, but can’t compete with more dominant variants and never really get a “foothold” in a particular population. At this time—and this is a pretty big caveat—the COVID-19 mu variant seems stuck in this last category, at least in the U.S.

What about mu?

Although the mu variant has been identified in more than 39 countries, including the U.S., there have been only about 2,000 cases here, mostly in California, Florida, Texas, and New York. The World Health Organization (WHO) calls mu a “variant of interest” […]

2021-09-14T14:36:42-04:00September 14th, 2021|COVID-19, infectious diseases, Nursing|1 Comment
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Pregnancy and COVID: What We Now Know

Meagan Garibay, RN, BSN, CIC, an infection preventionist at Comanche County Memorial Hospital in Lawton, Oklahoma, received the COVID vaccine in December 2020, when she was 35 weeks pregnant. Photo courtesy of WAVE 3 News.

Few aspects of pregnancy and birth have been unaffected by the COVID pandemic. In the past year, pregnant people and their health care providers have had to alter everything from the way they assess risk to the manner in which care is accessed.

Although little information about pregnancy and COVID was available early in the pandemic, emerging evidence is providing a clearer picture. As a result, in the past year recommendations have shifted—sometimes radically so—for both women and their health care providers. Based on the latest available research, this month in AJN Reports we cover what we now know about COVID and maternal health, including guidance about risk and vaccination.

Higher risks for pregnant people with COVID.

As the articles explains, research suggests pregnant people who have COVID are at higher risk of […]

2021-06-03T08:43:24-04:00June 3rd, 2021|COVID-19, infectious diseases, Public health|0 Comments
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Isn’t It Ironic: A Nurse Reflects on Her J&J Vaccination

Irony: a state of affairs or an event that seems deliberately contrary to what one expects and is often amusing as a result. -dictionary.com

Vaccine, by Julianna Paradisi

On a recent Saturday afternoon I received the Johnson and Johnson/Janssen COVID-19 vaccine. The following Tuesday, its further administration was put on pause, “out of an abundance of caution,” after reports that six women between the ages of 18 and 48 developed a rare but serious form of blood clot six to 13 days after receiving the vaccine. One of the six women died.

There is nothing amusing about the irony that people seeking protection from COVID-19 may have developed a life-threatening adverse reaction from the vaccine. For health care providers, and perhaps especially for nurses, such events are heartbreaking.

Lifting the J&J pause.

On Friday, April 23, the Centers for Disease Control and Prevention (CDC) and the FDA lifted the 10-day pause on the J&J vaccine, without restrictions, instead issuing a fact sheet to medical providers warning them of the potential for the extremely rare but serious blood clots.

When the pause was lifted, over 7 million people had received the vaccine, with additional confirmed cases of blood clots that had been reported bringing the […]

2021-04-26T11:16:05-04:00April 26th, 2021|COVID-19, infectious diseases, Nursing, nursing perspective, Public health|0 Comments
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Nurse Volunteers on the Front Lines of the Vaccination Effort

Joanne Disch, PhD, RN, FAAN, is professor ad honorem at the University of Minnesota School of Nursing, Minneapolis, and Ellen Elpern, MSN, RN, is a retired advanced practice nurse, formerly at Rush University Medical Center, Chicago.

Nurse volunteers as an essential resource.

As of April 15, 2021, there have been over 31 million cases of COVID-19 in the United States and over 561,000 deaths. Sobering numbers. But there are some heartening numbers as well: 198 million vaccination shots have been administered so far, with 3 million doses now being given per day. To reach and continue to meet the current pace has required an extraordinary ramp-up of sites—and of the number of individuals administering the vaccines. An essential resource that’s emerged is the use of nurses as volunteers to help staff these sites.

For more than a year, the public has witnessed the compassion, competence, and heroism of nurses who are on the front lines of the COVID pandemic. Those of us who are nurses and not in the clinical setting watched with pride and empathy, knowing better than most what these nurses were experiencing—and wishing there were something that we could do. Stepping forward to volunteer for service in a vaccine clinic is one way to make a difference. These volunteer opportunities are as varied as the vaccination sites themselves, but in all cases the effort is being enriched by the active engagement of nurses, retired and otherwise.

Defuniak Springs, Florida

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2021-04-16T09:15:42-04:00April 16th, 2021|COVID-19, infectious diseases, Nursing, nursing career|0 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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