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COVID-19 in Pediatric Patients: An update on Features and Treatment Options
Zahra Soheilirad1, Pegah Karimian2, Motahare Aghajani Delvar3
1Sabzevar University of Medical Sciences, Sabzevar, Iran.
Insights
Pediatric COVID-19 (coronavirus disease 2019) typically presents with fever and respiratory symptoms. While generally milder in children due to immune factors, severe cases can lead to complications like multisystem inflammatory syndrome.
Area of Science:
- Pediatric Infectious Diseases
- Virology
- Public Health
Background:
- Coronavirus disease 2019 (COVID-19) affects children, with incidence rates varying.
- Newer severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants show increased pediatric infection rates.
- Understanding pediatric COVID-19 features is crucial for effective management.
Purpose of the Study:
- To review and identify the clinical features of COVID-19 in pediatric patients.
- To analyze common symptoms, complications, laboratory findings, and CT scan results in children with SARS-CoV-2 infection.
- To summarize current treatment approaches for pediatric COVID-19.
Main Methods:
- Literature review of studies on pediatric COVID-19.
- Analysis of reported incidence, clinical manifestations, and complications.
- Examination of laboratory and imaging (CT) findings.
- Review of treatment strategies for children with COVID-19.
Main Results:
- Common symptoms include fever and respiratory issues; severity is generally lower in children.
- Complications in severe cases include coinfections, encephalitis, and multisystem inflammatory syndrome.
- CT findings often show ground-glass opacities and pulmonary consolidation.
- Procalcitonin elevation was frequent, while enhanced inflammatory factors and lymphocytopenia were less common.
Conclusions:
- COVID-19 in children, while often less severe, requires monitoring for potential complications.
- Treatment focuses on supportive care, including fluid balance, nutrition, and oxygen therapy.
- Further research is needed to understand long-term effects and transmission dynamics.
Abstract:
This review aimed to identify the features of coronavirus disease 2019 (COVID-19) in pediatric patients after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. According to the literature, the incidence of COVID-19 was reported to be 1-5% among children. However, the incidence of infection with the new variant of the virus is higher in children. The most common features were fever and respiratory manifestation. The milder severity and lower mortality of COVID-19 among children are related to their less contact, immature immune system, and different features of angiotensin-converting enzyme 2 (ACE2), an important receptor of the virus to invade the host cells. Several complications were observed in severe pediatric patients, such as coinfections, encephalitis, multisystem inflammatory syndrome, and multiorgan failure. The most frequent laboratory data were the procalcitonin elevation. The enhanced inflammatory factors and lymphocytopenia were less common among this population. In the CT findings, the ground-glass opacities, pulmonary consolidation, fine mesh shadow, and tiny nodules were most common. While some children were admitted to the ICU, mechanical ventilation was rarely reported. The vertical intrauterine transmission from mother to child has not been proven. The treatment mainly focuses on maintaining balance in the fluids and electrolytes, nutritional support, and oxygen therapy for this vulnerable population.
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