Septic shock presentation in adolescents with COVID-19

Dallan, Cecilia; Romano, Fabrizio; Siebert, Johan N.; Politi, Sofia; Lacroix, Laurence; Sahyoun, Cyril

doi:10.1016/s2352-4642(20)30164-4

Cited by 85 publications

(128 citation statements)

References 17 publications

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“…The main extrapulmonary manifestations found were gastrointestinal (GI), with high prevalence of diarrhea, abdominal pain, and vomiting. 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 Other GI symptoms found were related to inflammatory process, such as pharyngeal erythema, 19 swollen tongue, and pronounced lingual papillae. 31 Reduced feeding, 21 , 32 odynophagia, 15 , 26 and feeding intolerance 33 were also reported and are important signs for pediatric cases.…”

Section: Resultsmentioning

confidence: 99%

“…Acute kidney injury was identified in 38 patients, 16 , 20 representing a frequent complication. Cardiac manifestations were often described as alterations in myocardial enzymes, 18 , 24 , 34 tachycardia, 26 , 27 , 34 , 36 , 37 , 38 and shock, 16 with eight and 25 presentations, respectively. Vascular manifestations included aneurysms 26 and ischaemic infarctions 15 were identified and associated with obesity.…”

Section: Resultsmentioning

confidence: 99%

“… 30 Neurological manifestations were frequently described as neurocognitive symptoms, including headache, irritability, lethargy, and somnolence. 13 , 14 , 15 , 16 , 23 , 24 , 26 , 29 , 31 , 33 Axial hypotonia, 22 generalized hypertonia, 23 and muscular pain 39 indicated the presence of neuromuscular manifestations.…”

Section: Resultsmentioning

confidence: 99%

“…3 ). 13 , 27 Dermatologic presentations were defined as skin rashes, 13 , 15 , 26 , 27 , 31 perineal or facial desquamation, 13 erythemas 22 and exanthems. 19 Complete Kawasaki disease and KD shock syndrome was confirmed in 21 and 28 patients, respectively.…”

Section: Resultsmentioning

confidence: 99%

“… 12 However, due to the outrageous number of infected children, some fatal cases are being reported, associated with extrapulmonary complications, pointing to a need of medical and scientific attention. 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 …”

Section: Introductionmentioning

confidence: 99%

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Extrapulmonary manifestations of COVID-19 in children: a comprehensive review and pathophysiological considerations

Pousa¹,

Mendonça²,

Oliveira³

et al. 2021

Jornal de Pediatria

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Objective The aim of this review was to summarize the most common extrapulmonary manifestations in pediatric patients with COVID-19, as well as to discuss clinical, epidemiological, and pathophysiological aspects of these clinical presentations in children. Source of data An extensive search of literature was performed in order to identify pediatric cases with extrapulmonary manifestations between January 1, 2020 and June 21, 2020. Generic keywords, such as “Novel coronavirus” or “Novel coronavirus 2019” or “2019 nCoV” or “COVID-19” or “SARS-CoV-2” were searched on PubMed database, associated either with age filters or generic pediatric terms. Summary of findings A total of 28 articles, including 199 patients, were considered suitable to review and data extraction. The main findings were summarized in tables. The main non-pulmonary manifestations in pediatric patients, in decreasing order of frequency, were gastrointestinal, renal, cardiovascular, neurological, hematological and lymphatic, cutaneous, hepatic, ocular, olfactory, and gustatory. Multisystem impairment and Kawasaki-like disease were also described. Conclusions Differences in immune response of children and variations of tissue expression of angiotensin converting enzyme 2, the virus receptor, are likely to influence clinical, epidemiological, and pathophysiological patterns of the disease.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Extrapulmonary manifestations of COVID-19 in children: a comprehensive review and pathophysiological considerations

Pousa¹,

Mendonça²,

Oliveira³

et al. 2021

Jornal de Pediatria

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American College of Rheumatology Clinical Guidance for Multisystem Inflammatory Syndrome in Children Associated With SARS–CoV‐2 and Hyperinflammation in Pediatric COVID‐19: Version 1

Henderson

Canna

Friedman

et al. 2020

Arthritis & Rheumatology

426

613

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Objective To provide guidance on the management of multisystem inflammatory syndrome in children (MIS‐C), a condition characterized by fever, inflammation, and multiorgan dysfunction that manifests late in the course of severe acute respiratory syndrome coronavirus 2 (SARS–CoV‐2) infection, and to provide recommendations for children with hyperinflammation during coronavirus disease 2019 (COVID‐19), the acute, infectious phase of SARS–CoV‐2 infection. Methods A multidisciplinary task force was convened by the American College of Rheumatology (ACR) to provide guidance on the management of MIS‐C associated with SARS–CoV‐2 and hyperinflammation in COVID‐19. The task force was composed of 9 pediatric rheumatologists, 2 adult rheumatologists, 2 pediatric cardiologists, 2 pediatric infectious disease specialists, and 1 pediatric critical care physician. Preliminary statements addressing clinical questions related to MIS‐C and hyperinflammation in COVID‐19 were developed based on evidence reports. Consensus was built through a modified Delphi process that involved 2 rounds of anonymous voting and 2 webinars. A 9‐point scale was used to determine the appropriateness of each statement (median scores of 1–3 for inappropriate, 4–6 for uncertain, and 7–9 for appropriate), and consensus was rated as low, moderate, or high based on dispersion of the votes along the numeric scale. Approved guidance statements were those that were classified as appropriate with moderate or high levels of consensus, as prespecified prior to voting. Results The ACR task force approved a total of 128 guidance statements addressing the management of MIS‐C and hyperinflammation in pediatric COVID‐19. These statements were refined into 40 final clinical guidance statements, accompanied by a flow diagram depicting the diagnostic pathway for MIS‐C. Conclusion Our understanding of SARS–CoV‐2–related syndromes in the pediatric population continues to evolve. The guidance provided in this “living document” reflects currently available evidence, coupled with expert opinion, and will be revised as further evidence becomes available.

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American College of Rheumatology Guidance for the Management of Pediatric Rheumatic Disease During the COVID‐19 Pandemic: Version 1

Wahezi

Rubinstein

et al. 2020

Arthritis & Rheumatology

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Objective To provide clinical guidance to rheumatology providers who treat children with pediatric rheumatic disease (PRD) in the context of the coronavirus disease 2019 (COVID‐19) pandemic. Methods The task force, consisting of 7 pediatric rheumatologists, 2 pediatric infectious disease physicians, 1 adult rheumatologist, and 1 pediatric nurse practitioner, was convened on May 21, 2020. Clinical questions and subsequent guidance statements were drafted based on a review of the queries posed by the patients as well as the families and healthcare providers of children with PRD. An evidence report was generated and disseminated to task force members to assist with 3 rounds of asynchronous, anonymous voting by email using a modified Delphi approach. Voting was completed using a 9‐point numeric scoring system with predefined levels of agreement (categorized as disagreement, uncertainty, or agreement, with median scores of 1–3, 4–6, and 7–9, respectively) and consensus (categorized as low, moderate, or high). To be approved as a guidance statement, median vote ratings were required to fall into the highest tertile for agreement, with either moderate or high levels of consensus. Results The task force drafted 33 guidance statements, which were voted upon during the second and third rounds of voting. Of these 33 statements, all received median vote ratings within the highest tertile of agreement and were associated with either moderate consensus (n = 6) or high consensus (n = 27). Statements with similar recommendations were combined, resulting in 27 final guidance statements. Conclusion These guidance statements have been generated based on review of the available literature, indicating that children with PRD do not appear to be at increased risk for susceptibility to SARS–CoV‐2 infection. This guidance is presented as a “living document,” recognizing that the literature on COVID‐19 is rapidly evolving, with future updates anticipated.

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Septic shock presentation in adolescents with COVID-19

Cited by 85 publications

References 17 publications

Extrapulmonary manifestations of COVID-19 in children: a comprehensive review and pathophysiological considerations

Extrapulmonary manifestations of COVID-19 in children: a comprehensive review and pathophysiological considerations

American College of Rheumatology Clinical Guidance for Multisystem Inflammatory Syndrome in Children Associated With SARS–CoV‐2 and Hyperinflammation in Pediatric COVID‐19: Version 1

American College of Rheumatology Guidance for the Management of Pediatric Rheumatic Disease During the COVID‐19 Pandemic: Version 1

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