Pediatric Respirology and Critical Care Medicine

: 2020  |  Volume : 4  |  Issue : 1  |  Page : 1-

Infection and COVID-19

Daniel Kwok-Keung Ng 
 Department of Paediatrics, Hong Kong Sanatorium and Hospital, Happy Valley, Hong Kong, China

Correspondence Address:
Daniel Kwok-Keung Ng
Department of Paediatrics, Hong Kong Sanatorium and Hospital, 2, Village Road, Happy Valley, Hong Kong

How to cite this article:
Ng DK. Infection and COVID-19.Pediatr Respirol Crit Care Med 2020;4:1-1

How to cite this URL:
Ng DK. Infection and COVID-19. Pediatr Respirol Crit Care Med [serial online] 2020 [cited 2021 Jan 16 ];4:1-1
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I am writing this editorial with a mixed feeling, a sense of hope with different vaccines against SARS-CoV-2 arriving with preliminary data showing promising results. The vaccines come from China, the USA, the UK and Russia. On the other hand, the situation in my home town, Hong Kong, has taken a turn for the worse with an upsurge of COVID-19 after loosening of infection control measures for the community. Similar upsurge is seen all over the world. This is indeed time for people to pull together to fight this pandemic. It is also important to remember that other diseases continue to affect our children.

Co-infection is common in those with severe paediatric COVID-19, and Sitthikool and Aksilp[1] reported from Thailand the use of procalcitonin in the detection of bacterial infection in those critically ill children. A level of procalcitonin >1.1 ng/ml has a positive and a negative predictive value of around 70% for bacterial infection. Interestingly, the changes in procalcitonin correlated with the changes of the severity score, Pediatric Logistic Organ Dysfunction.

Nutrition is a key to health and prevention of diseases, COVID-19 included. Kuti and Oyelami[2] reported a very important finding about the impact of antioxidants and severity of pneumonia from Nigeria. They found a lower level of non-enzymatic antioxidants in those with severe pneumonia. As these antioxidants, that is flavonoids, phenols, carotenoids, Vitamin C and tocopherol, are found mainly in vegetables and fruits, it is important to advocate this healthy diet in any encounter with patients. It is well known that obesity is a risk factor for severe COVID-19; lower antioxidant level might well play a part as obese persons usually consume less vegetables and fruits.

Chronic respiratory diseases are risk factors for severe COVID-19, and cystic fibrosis (CF) patients would be at high risk for severe COVID-19. It was an assumption that CF is very rare in non-Caucasian population although we, the paediatric respirologist, know we do have CF cases in our practice, but we do not have the overall picture. In this issue, Kabra et al.[3] reported the first-ever CF survey in Asia involving 15 Asian countries that shed some light on this issue. In this survey, the personal observation of the paediatric respirologists was reported with all the limitations intrinsic to these personal observations. Nevertheless, it did show that paediatric respirologists must be trained to manage CF in Asia and Asian Paediatric Pulmonology Society (APPS) is ideally placed to provide this training. It is also noteworthy that none of the current diagnostic tests are available in Myanmar, Vietnam and Macao, and means to improve access to the tests should be undertaken.

I would also like to remind the readers that the current issue is labelled January–March 2020 although it is in fact published in November 2020 because of the publication delay. My sincerest apology for any inconvenience so caused to the authors.

May I end with a quote from Winston Churchill ‘Success is not final. Failure is not fatal. It is the courage to continue that counts’.


1Sitthikool K, Aksilp C. Accuracy of procalcitonin in detecting severe bacterial infections among critically ill children. Pediatr Respirol Crit Care Med 2019;3:13-7.
2Kuti BP, Oyelami AO. Serum nonenzymatic anti-oxidants in nigerian children with severe pneumonia: Association with complications and hospital outcomes. Pediatr Respirol Crit Care Med 2019;3:2-7.
3Ahmed S, Cheok G, Goh AE, Han A, Hong SJ, Indawati W, et al. Cystic fibrosis in Asia. Pediatr Respirol Crit Care Med 2019;3:8-12.