Division of Neonatology and Paediatric Intensive Care, Department of Paediatrics, University Hospital of Geneva, University of Geneva, Geneva, Switzerland.
Division of Paediatric Critical Care Medicine, Department of Paediatrics, Beatrix Children's Hospital, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
Pediatr Crit Care Med. 2021 Jan 1;22(1):56-67. doi: 10.1097/PCC.0000000000002599.
In children, coronavirus disease 2019 is usually mild but can develop severe hypoxemic failure or a severe multisystem inflammatory syndrome, the latter considered to be a postinfectious syndrome, with cardiac involvement alone or together with a toxic shock like-presentation. Given the novelty of severe acute respiratory syndrome coronavirus 2, the causative agent of the recent coronavirus disease 2019 pandemic, little is known about the pathophysiology and phenotypic expressions of this new infectious disease nor the optimal treatment approach.
From inception to July 10, 2020, repeated PubMed and open Web searches have been done by the scientific section collaborative group members of the European Society of Pediatric and Neonatal Intensive Care.
There is little in the way of clinical research in children affected by coronavirus disease 2019, apart from descriptive data and epidemiology.
Even though basic treatment and organ support considerations seem not to differ much from other critical illness, such as pediatric septic shock and multiple organ failure, seen in PICUs, some specific issues must be considered when caring for children with severe coronavirus disease 2019 disease.
In this clinical guidance article, we review the current clinical knowledge of coronavirus disease 2019 disease in critically ill children and discuss some specific treatment concepts based mainly on expert opinion based on limited experience and the lack of any completed controlled trials in children at this time.
在儿童中，2019 年冠状病毒病通常较轻，但可发展为严重低氧性衰竭或严重的多系统炎症综合征，后者被认为是一种感染后综合征，可单独累及心脏，也可伴有类似于中毒性休克的表现。鉴于导致近期 2019 年冠状病毒病的严重急性呼吸综合征冠状病毒 2 的新颖性，对于这种新发传染病的病理生理学和表型表达以及最佳治疗方法知之甚少。
从 2020 年 7 月 10 日开始，欧洲小儿和新生儿重症监护学会的科学组合作成员进行了反复的 PubMed 和开放网络搜索。
除了描述性数据和流行病学数据外，受 2019 年冠状病毒病影响的儿童的临床研究很少。
尽管在儿科重症监护病房（PICU）中，重症患儿的基本治疗和器官支持考虑似乎与其他危重病（如小儿败血症性休克和多器官衰竭）没有太大区别，但在护理重症 2019 年冠状病毒病患儿时，必须考虑一些具体问题。
在这篇临床指导文章中，我们回顾了目前关于危重症儿童 2019 年冠状病毒病的临床知识，并根据目前缺乏任何在儿童中完成的对照试验的有限经验和专家意见，讨论了一些具体的治疗概念。
