COVID-19 in Pediatric Patients: A Focus on CHD Patients

Zareef, Rana; Younis, Nour K.; Bitar, Fadi; Eid, Ali H.; Arabi, Mariam

doi:10.3389/fcvm.2020.612460

Cited by 28 publications

(31 citation statements)

References 74 publications

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“…Interestingly, COVID-19 presentation among the three discussed CHD patients was asymptomatic. Our findings are consistent with the data available in the literature concerning disease severity and manifestations in CHD pediatric population 15,16 . These patients, particularly those with complex lesions, are at-risk for acquiring severe and complicated COVID-19.…”

Section: Discussionsupporting

confidence: 93%

Pre-operative assessment of pediatric congenital heart disease patients in the COVID-19 era: lessons learned

et al. 2021

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Background: Equal to COVID-19 patients, non-COVID-19 patients are affected by the medical and social drawbacks of the COVID-19 pandemic. A significant reduction in elective life-changing surgeries has been witnessed in almost all affected countries. This study discusses an applicable and effective pre-operative assessment protocol that can be applied during the COVID-19 era. Methods: Our study is a descriptive retrospective observational study that involves pediatric patients with CHD requiring open heart surgeries at our tertiary care center between March and November 2020. We reviewed the charts of eligible patients aged 18 years and below. We identified the total numbers of scheduled, performed, and postponed surgeries, respectively. A thorough description of the clinical and physical presentation of the postponed cases, who tested positive for SARS-CoV-2, is provided. Results: 68 open heart surgeries were scheduled at our center between March and November 2020. Three surgeries (4%) were postponed due to COVID-19. The three patients were asymptomatic COVID-19 cases detected on routine SARS-CoV-2 PCR testing. No symptoms of cough, chest pain, dyspnea, rhinorrhea, diarrhea, abdominal pain, anosmia, and ageusia were reported by our patients. All patients were afebrile and hemodynamically stable. Owing to the pre-operative assessment protocol that was implemented after the first case was detected, only three healthcare workers were at risk of COVID-19 transmission and were imposed to infectious evaluation and home quarantine. Conclusion: Adopting our discussed preoperative COVID-19 assessment protocol for CHD patients is an effective method to detect COVID-19 infections, optimize patient care, and ensure healthcare workers’ safety.

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Section: Discussionsupporting

confidence: 93%

Pre-operative assessment of pediatric congenital heart disease patients in the COVID-19 era: lessons learned

et al. 2021

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“…As proposed, COVID-19 disease may be worsened due to the higher inflammatory burden, and the increased risk of thromboembolic events, as well as the changes in ACE2 levels seen in CVD patients. In terms of pediatric COVID-19 patients, those with CHD (cyanotic defects, depressed myocardial contractility, pulmonary hypertension, immunodeficiencies) are more likely to require ICU admission and artificial respiratory support [ 20 ]. Targeted therapies have been developed against some of the pathophysiological mechanisms found in adult patients and we will discuss evidence on the implications that these therapies have in clinical practice.…”

Section: Covid-19 and Cardiovascular Diseasementioning

confidence: 99%

Pharmacotherapeutic agents for the management of COVID-19 patients with preexisting cardiovascular disease

Khan

Singh

Abrar

et al. 2021

Expert Opinion on Pharmacotherapy

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Introduction The coronavirus disease 2019 (COVID-19) pandemic is the largest public health challenge of the twenty-first century. While COVID-19 primarily affects the respiratory system, manifesting as interstitial pneumonitis and severe acute respiratory distress syndrome (ARDS), it also has implications for the cardiovascular system. Moreover, those admitted to hospital with severe COVID-19 are more likely to have cardiovascular comorbidities such as hypertension and diabetes mellitus. The underlying pathophysiology of why COVID-19 onset can further decline cardiac pathologies as well as trigger acute onset of new cardiac complications is not yet well understood. Areas covered In this review, the authors extensively review literature focused on the current understanding and approaches of managing patients who have underlying cardiovascular diseases and concomitant COVID-19 infection. Furthermore, the authors explore the possible cardiovascular implications of the suggested COVID-19 therapeutic agents that are used to treat this lethal disease. Expert opinion Current evidence is evolving around the many trialed pharmacotherapeutic considerations for the management of coronavirus disease 2019 (COVID-19) in patients with cardiovascular disease. While we await such data, clinicians should advocate for careful consideration of all concomitant medications for those presenting with COVID-19 on a patient-by-patient basis.

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“…The clinical course of COVID-19 in pediatric patients is mild in almost all cases [ 24 – 26 ]. However, severe and critical illness can affect a minor percentage of infected patients.…”

Section: Potential Therapeutics For Children With Covid-19mentioning

confidence: 99%

“…It includes hydration with intravenous and/or oral fluids, fever reduction with antipyretics, and oxygen supplementation. The use of remdesivir and the off-label use of additional antiviral medications and immunomodulators are spared for hospitalized patients with respiratory distress and complicated disease [ 26 , 30 ].…”

Section: Potential Therapeutics For Children With Covid-19mentioning

confidence: 99%

COVID-19: potential therapeutics for pediatric patients

et al. 2021

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The global spread of COVID-19 has imparted significant economic, medical, and social burdens. Like adults, children are affected by this pandemic. However, milder clinical symptoms are often experienced by them. Only a minimal proportion of the affected patients may develop severe and complicated COVID-19. Supportive treatment is recommended in all patients. Antiviral and immunomodulatory medications are spared for hospitalized children with respiratory distress or severe to critical disease. Up till now, remdesivir is the only USFDA-approved anti-COVID-19 medication indicated in the majority of symptomatic patients with moderate to severe disease. Dexamethasone is solely recommended in patients with respiratory distress maintained on oxygen or ventilatory support. The use of these medications in pediatric patients is founded on evidence deriving from adult studies. No randomized controlled trials (RCTs) involving pediatric COVID-19 patients have assessed these medications’ efficacy and safety, among others. Similarly, three novel monoclonal anti-SARS-CoV-2 spike protein antibodies, bamlanivimab, casirivimab and imdevimab, have been recently authorized by the USFDA. Nonetheless, their efficacy has not been demonstrated by multiple RCTs. In this review, we aim to dissect the various potential therapeutics used in children with COVID-19. We aspire to provide a comprehensive review of the available evidence and display the mechanisms of action and the pharmacokinetic properties of the studied therapeutics. Our review offers an efficient and practical guide for treating children with COVID-19.

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COVID-19 in Pediatric Patients: A Focus on CHD Patients

Cited by 28 publications

References 74 publications

Pre-operative assessment of pediatric congenital heart disease patients in the COVID-19 era: lessons learned

Pre-operative assessment of pediatric congenital heart disease patients in the COVID-19 era: lessons learned

Pharmacotherapeutic agents for the management of COVID-19 patients with preexisting cardiovascular disease

COVID-19: potential therapeutics for pediatric patients

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