Soheilirad Zahra, Karimian Pegah, Aghajani Delvar Motahare
Sabzevar University of Medical Sciences, Sabzevar, Iran.
Department of Pediatrics, School of Medicine, Iran University of Medical Sciences, Ali Asghar Children's Hospital, Tehran, Iran.
Tanaffos. 2022 Mar;21(3):283-292.
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.
本综述旨在确定2019冠状病毒病(COVID-19)在严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染后儿科患者中的特征。根据文献报道,儿童中COVID-19的发病率为1%-5%。然而,儿童感染该病毒新变种的发生率更高。最常见的特征是发热和呼吸道表现。儿童中COVID-19病情较轻、死亡率较低与他们接触较少、免疫系统不成熟以及血管紧张素转换酶2(ACE2)的不同特征有关,ACE2是病毒侵入宿主细胞的重要受体。在重症儿科患者中观察到了几种并发症,如合并感染、脑炎、多系统炎症综合征和多器官衰竭。最常见的实验室数据是降钙素原升高。炎症因子增强和淋巴细胞减少在该人群中不太常见。在CT检查结果中,磨玻璃影、肺实变、细网状阴影和小结节最为常见。虽然一些儿童被收入重症监护病房,但很少有机械通气的报道。母婴垂直宫内传播尚未得到证实。对于这一脆弱人群而言,治疗主要侧重于维持体液和电解质平衡、营养支持以及氧疗。