Online First

We still have much to learn about the longer term effects on children of Covid19 infection. In this report, abnormalities in the retina of children with proven Covid19 infection are identified, though in the absence of any clear visual problems, adding the visual system to the list of systems potentially requiring long term monitoring following infection with this virus.

Children have a very low risk of developing severe SARS-CoV-2 infections. Early in the pandemic it became clear from the experiences in China, Italy and Spain that this was also true for children with cancer. Not so for adult patients particularly those with haematological malignancies who were considered to be 'extremely vulnerable'. The recommendation however, from the UK's national Childhood Cancer and Leukaemia group (CCLG) in 2020 was that, other than particularly high risk patients (those with multiply relapsed disease or undergoing bone marrow transplant or CAR-T therapy) children with cancer, including those with haematological malignancies, need not be considered extremely vulnerable. This clearly written, concise paper by Millen et al compares patients with haematological and non-haematological malignancies enrolled on the UK Paediatric Coronavirus Cancer Monitoring Project from March 2020 until Feb 2021 and supports that recommendation.

Review to understand the evidence base for care bundles ie doing multiple improvements at once in children who are intubated to try and prevent unexpected extubation.

Population-based retrospective cohort study using individual linked data from 2007 to 2017 show social and ethnic group differences in children’s use of healthcare services in England, with deprivation associated with higher emergency and lower scheduled care use.

General paediatricians are getting better at diagnosing DMD but need to be aware of the more subtle symptoms of DMD and diagnose it earlier be aware of the rarer presentations.

A meta-analysis and systematic review of safety and efficacy of using low-level laser therapy for oral mucositis in paediatric cancer patients - as the title says. Looks promising but more data are required regarding efficacy, and the availability and cost of such an approach.

EU multicentre ED study of presenting vital signs in >5000 febrile children with an association between "shock index" and serious illness, but low sensitivity limits utility in screening.