Pediatric Coronavirus Disease 2019: Clinical Features and Management

Sahi, Puneet Kaur; Jhamb, Urmila; Dabas, Aashima

doi:10.1007/s13312-021-2216-4

Cited by 10 publications

(9 citation statements)

References 40 publications

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“…Less than 5% of COVID-19 infections that have been diagnosed globally have been in children ( 1 ). One percent of COVID-19 instances were in children under the age of 10, according to a survey of 72,314 cases by the Chinese Center for Disease Control and Prevention ( 2 – 4 ) Due to COVID-19's negative impact on a pressure- or volume-overloaded heart in congenital heart disease (CHD), patients with CHD are thought to be at high risk for its negative effects ( 5 ).…”

Section: Introductionmentioning

confidence: 99%

Clinical outcomes of COVID-19 infection in congenital heart disease: A single-center experience in Indonesia

Siagian

Oetama

Pohan

et al. 2022

Front. Cardiovasc. Med.

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BackgroundCongenital heart disease (CHD) patients are thought to be vulnerable to COVID-19 complications. In this study, we would like to assess the outcomes and clinical characteristics in COVID-19 CHD patients.MethodA single-center, observational study was conducted in National Cardiovascular Center Harapan Kita (NCCHK). This study included patients with CHD who were hospitalized for COVID-19. The extracted data were baseline characteristics, clinical findings, supportive examination findings, complications, outcomes, and length of stay of the patients. The data were then analyzed using SPSS 26.0 software.ResultTwenty-six patients with CHD and COVID-19 infection were included in our study. There were 24 resolved cases and 2 deaths, four patients experienced complications such as renal insufficiency (1), sepsis (2), and multiorgan failure (1). The median length of stay was 13 days. The most common symptoms experienced by the patients were breathlessness (65.4%), cough (57.7%), and fever (42.3%).ConclusionWe observed a relatively mild COVID-19 clinical course despite prior research showing that patients with cardiovascular comorbidities, such as CHD, have a higher case-fatality rate. This could be because of the smaller sample size, non-standardized diagnosis, severity, treatment, and age group.

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Section: Introductionmentioning

confidence: 99%

Clinical outcomes of COVID-19 infection in congenital heart disease: A single-center experience in Indonesia

Siagian

Oetama

Pohan

et al. 2022

Front. Cardiovasc. Med.

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“…As there is no routine indication of anticoagulants in children with COVID-19 like adults, this might explain the lower prevalence of its use in our review. More randomized trials are urgently needed specifically targeting pediatric population and especially those with MIS-C.[ 86 87 ]…”

Section: Discussionmentioning

confidence: 99%

COVID-19 treatment in children

Panda

Sharawat

Vivekanand

et al. 2021

Journal of Family Medicine and Primary Care

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Background: Exact information about the efficacy of various medications proposed by regulatory bodies in children with COVID-19 is limited due to the lack of controlled trials in the existing literature. Methods: Different electronic databases (MEDLINE, EMBASE, Web of Science, COCHRANE CENTRAL, LitCovid, medRxiv, and bioRxiv) were searched for articles describing the management of COVID-19 cases in children with 18 shortlisted medications. Prospective/retrospective studies/case series (with at least 20 cases) reporting COVID-19 in patients aged ≤14 years were searched to collect information regarding clinical details and severity of participants, medications used, and outcome. The pooled estimate of these parameters across studies was performed using a random-effect or fixed-effect meta-analysis depending on the degree of heterogeneity. Results: From a total of 5794 records, 97 studies/case series (8243 patients) fulfilled the eligibility criteria and were included in this systematic review. A total of 21% children received at least one medication specifically used for COVID-19. While antivirals were used in 15.3% of children, remedesivir was the most commonly used antiviral drug in 6.2% of included children without many reports of serious adverse effects. There was a more prevalent use of anti-inflammatory medications including corticosteroids (27.8%, P = 0.01). Total 91% of severe cases described in literature in children received some anti-inflammatory medications. Among them, corticosteroids (17%) and Intravenous immune globulin (IVIG) (17.5%) were the most predominant followed by interferon (4.2%), tocilizumab (1.5%), and anakinra (0.8%). The most predominant therapy among multisystem inflammatory syndrome in children (MIS-C) cases were IVIG (81%), followed by aspirin (67%), corticosteroids (64%), inotropes (62%), and anticoagulation (56%, mostly low molecular weight heparin, LMWH). Overall mortality was only 1.3%, but when we analyzed separately including only cases with moderate and severe disease, the mortality rate was 4.6%. Conclusion: Among pharmacological modalities, anti-inflammatory agents like corticosteroids and antivirals like remdesivir have the most promising evidence for severe cases of pediatric COVID-19. Intravenous immunoglobulin and other anti-inflammatory/immunomodulatory agents like anakinra, aspirin, and anticoagulants have important therapeutic role in cases with MIS-C. Most of the mild cases recover with conservative treatment only.

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“…Children were classified as asymptomatic infection who had positive RT-PCR test without any clinical features, upper respiratory tract infection when there was fever, cough, nasal congestion, etc without signs of pneumonia in chest radiology, mild COVID-19 pneumonia with respiratory symptoms and radiological evidence whereas severe COVID-19 pneumonia was defined in presence of fast breathing, hypoxemia (SpO 2 < 90%), altered sensorium, feeding difficulty. 7 Critical infection had any one of following: respiratory failure, shock or multiple organ failure. 8 Sample for RT-PCR were taken from nasopharyngeal swab with AllplexTM 2019-nCoV Assay by Seegene Inc. CT value represents the number of replication cycles required for detection of virus.…”

Section: Methodsmentioning

confidence: 99%

Pediatric Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2): Clinical Characteristics and Cycle Threshold Value (CT value) of Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) of Nasopharyngeal Samples

Kumar

Arora

Marwah

et al. 2022

J. Nepal Paedtr. Soc.

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Introduction: We aimed to characterize epidemiological and clinical characteristics of children and adolescents with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection, and to evaluate relationship of cycle threshold value (CT value) of Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) test (As surrogate marker of viral load) with patient age and severity of infection. Methods: We retrospectively collected data of children and adolescents admitted in our center from April 2020 to July 2020 with positive RT-PCR test for SARS-CoV-2. Results: Total 62 children, with median (IQR) of age 96 (54 - 122) months and 39 adolescents with median (IQR) of age 19.5 (18.2 - 20) years were included. 56 (90%) children and 34 (87%) adolescents had history of SARSCoV-2 positive cases in their family. Only nine (14%) children had associated risk factor for severe SARS-CoV-2 infection. Fever was the commonest symptom which was present in 24 (39%) children and 16 (41%) adolescents. Cough was present in 17 (27%) children and 10 (26%) adolescents. Diarrhea was found in 14 (23%) children and three (8%) adolescents. CT values of RT-PCR test were similar in children and adolescence (p = 0.48). However, asymptomatic children had higher CT values than symptomatic children (p = 0.01). Conclusions: Majority of children have asymptomatic or mild SARS-CoV-2 infection with similar CT values in children and adolescents.

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Pediatric Coronavirus Disease 2019: Clinical Features and Management

Cited by 10 publications

References 40 publications

Clinical outcomes of COVID-19 infection in congenital heart disease: A single-center experience in Indonesia

Clinical outcomes of COVID-19 infection in congenital heart disease: A single-center experience in Indonesia

COVID-19 treatment in children

Pediatric Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2): Clinical Characteristics and Cycle Threshold Value (CT value) of Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) of Nasopharyngeal Samples

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