Hemolytic disease of the fetus and newborn can cause hydrops and intrauterine death due to fetal anemia. Immunoglobulin and plasmapheresis have been used to defer blood transfusions to later gestational ages and treat fetal anemia in patients who were immunized early in pregnancy, with different success.

Background: Data on the outcome and risk factors of pediatric patients with SARS-CoV-2 infection (COVID-19) following hematopoietic stem cell transplantation (HSCT) are limited. Objectives: We aimed to describe risk factors for a severe course and mortality. Method: In this nationwide study, data were collected retrospectively from 28 transplant centers. Results: One hundred ninety-six children [(63.8% male; median age 8.75 (IQR, 4.86-14.30)] who received allogeneic (n: 184, 93.9%) or autologous (n: 12, 6.1%) HSCT were included. The median time from HSCT to SARS-CoV-2 infection was 207.5 days (IQR, 110.2-207.5). The most common clinical manifestation was fever (58.2%), followed by cough (33.7%); 43 cases (21.9%) were asymptomatic. Lower respiratory tract disease (LRTD) and multisystem inflammatory syndrome in children (MIS-C) developed in 58 (29.6%) and 8 (4.1%) patients, respectively. Twenty-six patients (13.3%) required ICU admission. Nine patients died at a median of 17 days (min-max 1-33) after COVID-19 diagnosis, 6 of whom died due to the disease, with a COVID-19 lethality rate of 3.1%. The 6-week overall survival was 95.4% (95% CI 92.5-98.3). Multivariate analysis found that HSCT with a mismatched donor (OR, 8.98, p: 0.039) and LRTD (OR, 61.55, p: 0.001) were independent risk factors for ICU admission; MIS-C (OR, 9.55, p: 0.044) and lymphopenia (OR, 4.01, p: 0.030) at diagnosis were risk factors for mortality. Conclusion: Overall mortality was lower in children than in adult counterparts, and HSCT with a mismatched donor, lymphopenia, LRTD, MIS-C and ICU admission were important risk factors for adverse outcomes.

Background: Tissue Doppler (TD) measurements give a better information in evaluating the myocardial functions than conventional echocardiography in beta-thalassemia major (β-TM). The aim of this study was to determine cardiac status of thalassemia patients by using both T2*MRI and TD. Methods: The study group included thalassemia patients (n=33) with normal systolic functions defined by conventional echocardiography. The control group (n=37) consisted of age and sex matched healthy individuals. TD measurements from three different regions of myocardium were obtained in both groups. Ferritin was examined in both groups, T2*MRI was performed only patients with thalassemia. Results: Systolic and diastolic functions were found normal by conventional echocardiography in thalassemia patients. However, cardiac functions were significantly impaired when evaluated by TD (p<0.05). T2*MRI and TD measurements didn’t differ according to serum ferritin levels (p>0.05). Twenty-one patients (63.6%) had myocardial iron overload. Both isovolumetric acceleration time of left ventricle and myocardial performance index (MPI-septal) were found significantly impaired in these patients (p<0.05). There was negative correlation between MPI-septal and T2*MRI measurements in thalassemia patients (r:-0.343, p=0.050). TD measurements obtained from septum were found similar with the control (p>0.05) but, the same measurements from left and right ventricular walls were significantly impaired in iron unloaded group (p< 0.05). Coclusion: Iron unloaded patients according to T2*MRI had left and right ventricular dysfunction determined by TD. Therefore, we suggest that combining T2*MRI with TD measurements, for evaluating cardiac status in β-TM, in whose with normal T2*MRI scores, would be better management of cardiac complications.