COVID-19 in Children: Respiratory Involvement and Some Differences With the Adults

Abstract

The coronavirus disease 2019 (COVID-19) represents a health problem with multidimensional impacts and heterogeneous respiratory involvement in children, probably due to the interaction between different and complex mechanisms that could explain its variable degrees of severity. Although the majority of reports reveal that children develop less severe cases, the number of patients is increasing with more morbidity. Most serious respiratory manifestations are acute respiratory distress syndrome (ARDS) and pneumonia. By understanding the key aspects that can be used to differentiate between pediatric and adult respiratory compromise by COVID-19, we can improve our knowledge, and thus decrease the negative impact of the disease in the pediatric population. In this mini review, we summarize some of the mechanisms and findings that distinguish between adult and pediatric COVID-19 and respiratory involvement, taking into account some issues related to the physiopathology, diagnosis, clinical and paraclinical presentation, severity, treatment, and control of the disease.

Pediatric Acute Respiratory Distress Syndrome (PARDS) On Pediatric COVID-19 Patients

“…Basically, pediatric treatment focuses on supportive care by respiratory support with supplemental oxygen and invasive or noninvasive ventilation, fluid and electrolyte support, judicious use of empiric antibiotics as Siti Rahmah, Lalu Wahyu Alfian Muharzami, Lastri Akhdani Almaesy, Putri Nurhayati, Ridha Sasmitha A/ KESANS Pediatric Acute Respiratory Distress Syndrome (Pards) On Pediatric Covid-19 Patients indicated for community-acquired or healthcare-associated pneumonia, systematic clinical follow-up, and laboratory monitoring. Special attention must be given to adequate nutritional support and temperature control (Jurado Hernández and Álvarez Orozco, 2021). Management of ARDS in adults is largely focused on supportive management, lung-protective ventilation and minimizing iatrogenic forms of lung injury, with extracorporeal life support as an option for patients who continue to deteriorate despite these supportive therapies (Bakhtiar and Maranatha, 2018;Fernando et al, 2021).…”

“…These circulation occurs because of the pathological T cells release granulocyte monocyte colony stimulating factor (GM-CSF). From the violent cytokines storm triggers a systemic inflammatory response causing multi organ involvement, ARDS, and shock (Pandit, Gupta and Sharma, 2020;Jurado Hernández and Álvarez Orozco, 2021).…”

Pediatric Endoscopy During COVID-19 Times

“…Children of any age can be infected by SARS-CoV-2, but is more commonly recognized in older children and adolescents. Overall, pediatric cases of COVID-19 are thought to represent <5% of total cases ( 10 ). However, the true rate of infection in children is likely much higher than this.…”

Mechanical ventilation practice of pediatric patients with Covid-19 in Indonesian tertiary hospital

“…SARS-CoV-2 enters the host cell by attaching viral spike (S) protein with angiotensin-converting enzyme 2 (ACE2) receptor and the priming of S protein by a host protease, such as TMPRSS2. 20,21 This attachment inhibits the enzyme physiologic activity, internalization, and disrupts the angiotensin balance, reducing the protection of the ACE2expressing organ, such as the lungs. Accor coding from lungs snRNA-seq data of all age groups, there is an increase of ACE2 and TMPRS2-expressing alveoli epithelial proportion in adults than in children.…”

“…The fatality of COVID-19 in children <0.1% from the total, which is much lower than fatality in the adults and elderly, around 5-15%. 1,3,4 In Indonesia, the prevalence of pediatric COVID-19 is 12.5% from total cases with 1.2% fatality, which is higher than worldwide. 5 COVID-19 in children reported in several studies to have a milder clinical manifestation.…”