COVID-19 Pneumonia in Children: From Etiology to Management

Parisi, Giuseppe Fabio; Indolfi, Cristiana; Decimo, Fabio; Leonardi, ﻿Salvatore; Giudice, Michele Miraglia Del

doi:10.3389/fped.2020.616622

Cited by 45 publications

(49 citation statements)

References 70 publications

(113 reference statements)

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“…Moreover, chest X-ray is considered the rst radiological investigation in children, and CT scan is reserved for suspicious cases of pulmonary embolism or worsening clinical condition [12]. Pulmonary abnormalities in children are unilateral in 55% and bilateral in 45% of affected children [13] and about 8% are affected the right upper lobe of the lung [14] which was a similar nding of our patient.…”

Section: Discussionsupporting

confidence: 78%

Supraclavicular Lymphadenitis Following COVID-19

Al-Ani

Rashid

2021

Preprint

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IntroductionCervical lymphadenopathy in children is a common problem in daily clinical practice. Many cases of cervical lymphadenopathy after the COVID-19 vaccine were reported. However, there is no yet reporting a case of supraclavicular cervical lymphadenopathy as a result of COVID-19.Case presentationA 12-years-old girl presented with fever, cough, fatigue, anosmia, and ageusia. COVID-19 was confirmed by real-time PCR. The symptoms were resolved within 10 days. After 7 days, she complained of supraclavicular swelling. Physical examination revealed painless, multiple, and mobile supraclavicular lymph nodes. Ultrasound and fine-needle aspiration cytology were suspicious. Therefore, an excisional biopsy of the largest node was performed. The specimen was sent for histopathology and immunohistochemistry evaluation which confirmed the benign nature of the lymph node.ConclusionTo our best knowledge, this is the first case of supraclavicular lymphadenopathy in a child with COVID-19. It is essential to put COVID-19 in the differential diagnosis of cervical lymphadenopathy.

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Section: Discussionsupporting

confidence: 78%

Supraclavicular Lymphadenitis Following COVID-19

Al-Ani

Rashid

2021

Preprint

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“…Pneumonia has not been reported in children with a mild SARS-CoV-2 infection who usually present with fever, cough and/or fatigue due to URTI (22,77). In moderate and severe cases of COVID-19, pneumonia can present with multiple associated symptoms, i.e., fever, cough, myalgia, signs of respiratory distress, cyanosis, neurological signs and symptoms, trouble feeding and signs of dehydration and hypoxemia (77). The presence of lower respiratory tract infection signs or symptoms at presentation was observed in the 25% of children (21).…”

Section: Clinical Features Of Pediatric Covid-19mentioning

confidence: 99%

Coronavirus Disease 2019 in Children

et al. 2021

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Since its appearance in Wuhan in mid-December 2019, acute respiratory syndrome coronavirus 2 (SARS-CoV-2) related 19 coronavirus disease (COVID-19) has spread dramatically worldwide. It soon became apparent that the incidence of pediatric COVID-19 was much lower than the adult form. Morbidity in children is characterized by a variable clinical presentation and course. Symptoms are similar to those of other acute respiratory viral infections, the upper airways being more affected than the lower airways. Thus far, over 90% of children who tested positive for the virus presented mild or moderate symptoms and signs. Most children were asymptomatic, and only a few cases were severe, unlike in the adult population. Deaths have been rare and occurred mainly in children with underlying morbidity. Factors as reduced angiotensin-converting enzyme receptor expression, increased activation of the interferon-related innate immune response, and trained immunity have been implicated in the relative resistance to COVID-19 in children, however the underlying pathogenesis and mechanism of action remain to be established. While at the pandemic outbreak, mild respiratory manifestations were the most frequently described symptoms in children, subsequent reports suggested that the clinical course of COVID-19 is more complex than initially thought. Thanks to the experience acquired in adults, the diagnosis of pediatric SARS-CoV-2 infection has improved with time. Data on the treatment of children are sparse, however, several antiviral trials are ongoing. The purpose of this narrative review is to summarize current understanding of pediatric SARS-CoV-2 infection and provide more accurate information for healthcare workers and improve the care of patients.

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“…Mechanisms have been proposed to explain the lower severity of respiratory involvement by COVID-19 in children compared to adults ( 30 ). From an immunological standpoint, the function of innate immunity with a predominance of natural killer cells and the previous development of immunological memory against other respiratory infectious processes seem to influence the response capacity against this beta coronavirus, minimizing its clinical impact ( 5 , 31 , 32 ).…”

Section: Pathophysiologymentioning

confidence: 99%

“…Although, this imaging study is not recommended for systematic use, it has shown utility mainly in the evaluation of children when the acute clinical course includes hypoxemia or dyspnea, deterioration in clinical or laboratory parameters (for example, a higher D-dimer), or there is a poor response to support therapy ( 9 , 65 , 66 ). Unlike adults, CT indications are more specific, such as in clinical worsening or suspicion of pulmonary embolism ( 30 , 65 ), because the avoidance of radiation is necessary. Typical features more reported in pneumonia are bilateral, peripheral, and/or sub-pleural GGOs and/or consolidation, especially in the lower lobe—and the “halo” sign.…”

Section: Radiological Findingsmentioning

confidence: 99%

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

Hernández

Orozco

2021

Front. Pediatr.

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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.

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COVID-19 Pneumonia in Children: From Etiology to Management

Cited by 45 publications

References 70 publications

Supraclavicular Lymphadenitis Following COVID-19

Supraclavicular Lymphadenitis Following COVID-19

Coronavirus Disease 2019 in Children

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

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