Background: The coronavirus disease 2019 (COVID-19) dramatically impacts healthcare delivery. Pulmonary diagnostic procedures have had frequent disruptions during this pandemic. Objectives: This study aimed to discover how the COVID-19 pandemic affected pediatric flexible fiberoptic bronchoscopy. Methods: This retrospective cross-sectional study was carried out on pediatric patients who underwent fiberoptic bronchoscopy at a tertiary pediatric hospital affiliated to Tehran University of Medical Sciences. Procedural analysis was done from 20 March 2019 to 20 February 2020 (the pre-pandemic period) and 20 March 2020 to 20 February 2021 (during the pandemic period). The two groups were compared with regard to bronchoscopic indications and findings. Results: Our results from the data registry showed that within (group 1), 290 patients vs. 241 patients from 20 March 2020 till 20 February 2021 (group 2) were admitted to the operation room at least once for bronchoscopy procedures. Although the findings of foreign body aspiration in bronchoscopy were more frequent in group 2, this difference was not significant in the two groups (P = 0.055). The number of cases without abnormality in group 2 was significantly less than in group 1 (P = 0.006). The prevalence of Laryngomalacia was also significantly higher in group 2 (P = 0.000). Conclusions: Our results confirmed the reduction of bronchoscopy in children after the COVID-19 epidemic. However, there was no change in the immediate indications for bronchoscopy, and this pandemic had the most significant impact on elective bronchoscopy.

Background: The pediatric community is considered a suitable target for controlling the spread and mortality of viral diseases. In late December 2019, a respiratory disease due to the novel coronavirus, later COVID‐19, hit the globe. The COVID‐19 global disruption had direct and indirect impacts on different aspects of child health. Therefore, surveillance, preventive approaches, and treatment plans for children came into the spotlight. Objective: This study aims to discuss the clinical pictures as well as laboratory and radiological findings of the infected children during the COVID‐19 pandemic. The focus of this study is to express the clinical manifestations of respiratory disease in pediatric SARS‐CoV‐2, available therapeutic options, vaccine recommendations, and long COVID sequelae in affected children. This review could serve as a hint for upcoming challenges in pediatric care during future pandemics. Results: The clinical presentation of COVID‐19 in pediatrics can range from mild pulmonary disease to acute respiratory distress syndrome (ARDS). Supportive care is a crucial component of the management of pediatric COVID‐19. However, the importance of specializing in how to treat patients with more severe conditions cannot be overstated. Additionally, clinicians must consider prevention strategies as well as potential complications. Conclusion: Although the infected patients are dipping day by day, there is a lack of clinical guidelines for pediatric SARS‐CoV‐2‐associated pulmonary diseases. Understanding of the physicians about all aspects of pediatric care during the COVID‐19 pandemic could lead to enhanced quality of future patient care and safety, reduced costs of health policies, and surveil the risk that patients with respiratory viruses can expose to society.

Introduction: Cystic fibrosis (CF) is a serious genetic life-shortening disease. Quality of life (QoL) measurement related to CF children is a relatively new field of research, which includes the patient’s perspective in research and clinical practice. Objectives: This study aimed to evaluate the QoL in children with CF and its association with FEV1 (forced expiratory volume in 1 second). Patients and Methods: This cross-sectional study was carried out on 7-14 years old children with CF attending children’s medical center from March 2017 to March 2018. Throat swab cultures and spirometry evaluation was performed for all patients. FEV1 was determined and the 6-min walk test (6MWT) was conducted. The patient’s psychological status was assessed using the Persian version of pediatric QoL inventory. ANOVA, t test, and chisquare tests were used for data analysis. Results: Seventy-six subjects with the mean age of 10.49±3.18 years were studied since 59% of them (n=44) were boys. The mean total QoL was 65.34±17.73. Patients with lower pulmonary function had a lower QoL. There was a significant association between FEV1 and school and emotional functioning (P=0.005 and P=0.002, respectively). A significant association was found between SPO2 (peripheral capillary oxygen saturation) reduction after 6MWT and FEV1 decline (P=0.001). Additionally, a significant association was detected between FEV1 and the distance walked during 6MWT (P=0.030). Conclusion: Regarding the association between pulmonary function and QoL in CF patients and lower QoL score in our study, the importance of assessing pulmonary function in these patients should not be neglected.

Background: The Lung Clearance Index (LCI) serves as a non-uniform ventilation index utilized for monitoring pulmonary function in patients with cystic fibrosis (CF). Lung Clearance Index exhibits higher sensitivity compared to forced expiratory volume in 1 second (FEV1) for early detection of lung disease and does not necessitate active patient cooperation, as required for FEV1 measured through spirometry. Presently, FEV1 is the standard parameter employed for monitoring lung function in CF patients. Objectives: The objective of this study was to assess the correlation between LCI and FEV1 in patients with cystic fibrosis. Methods: This cross-sectional study enrolled children aged 6 to 18 years with confirmed CF diagnosis, who were referred to the CF clinic at Children's Medical Center Hospital (Tehran, Iran). Participants completed consent forms and subsequently underwent pulmonary function tests. Lung Clearance Index was calculated using the exhaling-D device via the Multiple Breath Washout (MBW) method, followed by FEV1 assessment through spirometry. Results: The study included 52 patients with an average age of 12 years, among whom 52% were males. The mean ± standard deviation of FEV1 and LCI were 80.2% ± 25.3 and 8.9 ± 2.8, respectively. A significant inverse relationship was observed between these two parameters in the study (r = -0.49, P = 0.001). Conclusions: These findings further underscore the potential utility of LCI, which offers ease of administration and demonstrates high reliability and accuracy compared to FEV1 for monitoring pulmonary function in CF patients.