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[COVID-19 in children and adolescents with chronic lung diseases]
1Abteilung für Pädiatrische Pneumologie und Allergologie, Universitätskinderklinik Regensburg am KUNO Standort Klinik St. Hedwig, Krankenhaus Barmherzige Brüder Regensburg Steinmetzstr. 1-3, 93049 Regensburg, Deutschland.
Insights
Children and adolescents with chronic lung diseases generally experience milder COVID-19 outcomes than adults. However, vigilance for severe cases and long-term effects like PIMS is crucial, alongside mitigating pandemic-related healthcare disruptions.
Area of Science:
- Pediatric Pulmonology
- Infectious Diseases
- Epidemiology
Context:
- Early SARS-CoV-2 pandemic concerns focused on children with chronic lung diseases.
- Initial fears suggested a high risk for severe COVID-19 in pediatric respiratory patients, mirroring adult data.
- Limited epidemiological data and clinical experience in children necessitated further investigation.
Purpose:
- To present current epidemiological data on COVID-19 in children and adolescents with chronic lung diseases.
- To describe clinical experiences with three selected pediatric cases of SARS-CoV-2 infection.
- To review literature and discuss current recommendations for managing this patient group.
Summary:
- COVID-19 incidence is lower in children than adults, with generally milder disease courses.
- Adult risk factors for severe COVID-19 do not directly translate to pediatric patients.
- While severe outcomes are less common, fatal cases and conditions like pediatric inflammatory multisystem syndrome (PIMS) occur.
Impact:
- Highlights the need for continued monitoring of pediatric COVID-19, including potential long-term effects.
- Emphasizes avoiding negative impacts of public health measures on routine care for children with chronic conditions.
- Underscores the importance of addressing healthcare access issues, such as missed appointments during lockdowns, to prevent undertreatment.
Background:
At the beginning of the SARS-CoV‑2 pandemic the focus of attention was on children and adolescents with chronic lung diseases. Due to a lack of epidemiological data and clinical experience, it was feared that children with respiratory diseases were a risk group for particularly severe courses of COVID-19, as has been reported for adults.
Objective:
The currently available (epidemiological) data on this patient group are presented as well as a description of our own experiences based on three selected cases.
Material And Methods:
A review of the literature was carried out and three selected case reports and a discussion of current recommendations are presented.
Results:
The incidence of COVID-19 is significantly lower in children than in adults. Furthermore, the known risk factors in adults cannot be simply transferred to pediatric patients. In the majority of cases, children and adolescents with chronic lung diseases show a milder course of SARS-CoV‑2 infections.
Conclusion:
Although the hitherto available data show that children and adolescents have a lower risk for COVID-19 courses than adults, it should not be ignored that fatal outcomes have also been reported in pediatric patients. Moreover, late effects, such as the pediatric inflammatory multisystem syndrome (PIMS) can sometimes lead to a fatal outcome. Nevertheless, care must be taken that this vulnerable patient group does not suffer from avoidable negative side effects of restriction and isolation measures. As an example, the no-show behavior in outpatient departments during the lockdown might have led to a relevant undertreatment of underlying chronic health conditions.
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