Benou Sofia, Ladhani Shamez, Dimitriou Gabriel, Gkentzi Despoina
Department of Paediatrics, Patras Medical School, Rion 26504, Greece.
Paediatric Infectious Disease Research Group, St. George's University of London, Cranmer Terrace, London SW17 0RE, United Kingdom.
Curr Pediatr Rev. 2021;17(3):162-171. doi: 10.2174/1573396317666210406153302.
In December 2019, a local outbreak of pneumonia was presented in Wuhan (China) and quickly identified to be caused by a novel coronavirus, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The disease caused by SARS-CoV-2 was named COVID-19 and was soon declared a pandemic because of the millions of infections and thousands of deaths worldwide. Children infected with SARS-CoV-2 usually develop the asymptomatic or mild type of disease compared to adults. They are also more likely to have atypical and non-specific clinical manifestations than adults.
A literature search was performed through PubMed and Scopus to summarize the extrapulmonary manifestations of SARS-CoV-2 infection in children since the beginning of the pandemic. Peer-reviewed papers in English were retrieved using the following keywords and combinations: 'pediatric,' 'child,' 'infant,' 'neonate,' 'novel coronavirus,' 'SARS-CoV-2,' 'COVID 19' and 'gastrointestinal,' 'renal,' 'cardiac,' 'dermatologic' or 'ophthalmologic'. We included published case series and case reports providing clinical symptoms and signs in SARS-CoV2 pediatric patients.
Although fever and symptoms of upper respiratory infection are the most frequently presented, a variety of other atypical presentations has also been reported. The clinical spectrum includes dermatological, ophthalmological, neurological, cardiovascular, renal, reproductive, and gastrointestinal presentations. In addition, a rare multi-inflammatory syndrome associated with SARS-- CoV-2 infection has been reported in children, often leading to shock and requiring inotropic support and mechanical ventilation.
Clinicians need to be aware of the wider range of extrapulmonary atypical manifestations of SARS-CoV-2 infection in children, so that appropriate testing, treatment, and public health measures can be implemented rapidly.
2019年12月，中国武汉出现了局部肺炎疫情，并很快确定是由一种新型冠状病毒——严重急性呼吸综合征冠状病毒2（SARS-CoV-2）引起的。由SARS-CoV-2引起的疾病被命名为COVID-19，由于全球数百万例感染和数千人死亡，很快被宣布为大流行病。与成人相比，感染SARS-CoV-2的儿童通常表现为无症状或轻症。他们也比成人更易出现非典型和非特异性临床表现。
通过PubMed和Scopus进行文献检索，以总结自疫情开始以来SARS-CoV-2感染儿童的肺外表现。使用以下关键词及其组合检索英文同行评审论文：“儿科”“儿童”“婴儿”“新生儿”“新型冠状病毒”“SARS-CoV-2”“COVID-19”以及“胃肠道”“肾脏”“心脏”“皮肤”或“眼科”。我们纳入了已发表的病例系列和病例报告，这些报告提供了SARS-CoV-2感染儿科患者的临床症状和体征。
尽管发热和上呼吸道感染症状最为常见，但也有多种其他非典型表现的报道。临床谱包括皮肤、眼科、神经、心血管、肾脏、生殖和胃肠道表现。此外，儿童中还报告了一种与SARS-CoV-2感染相关的罕见多炎症综合征，常导致休克，需要使用血管活性药物支持和机械通气。
临床医生需要意识到SARS-CoV-2感染儿童存在更广泛的肺外非典型表现，以便能够迅速实施适当的检测、治疗和公共卫生措施。
