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COVID-19 in Children : Clinical Approach and Management

COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a major public health crisis threatening humanity at this point in time. Transmission of the infection occurs by inhalation of infected droplets or direct contact with soiled surfaces and fomites. It should be suspected in all symptomatic children who have undertaken international travel in the last 14 d, all hospitalized children with severe acute respiratory illness, and asymptomatic direct and high-risk contacts of a confirmed case. Clinical symptoms are similar to any acute respiratory viral infection with less pronounced nasal symptoms. Disease seems to be milder in children, but situation appears to be changing. Infants and young children had relatively more severe illness than older children. The case fatality rate is low in children. Diagnosis can be confirmed by Reverse transcriptase - Polymerase chain reaction (RT-PCR) on respiratory specimen (commonly nasopharyngeal and oropharyngeal swab). Rapid progress is being made to develop rapid diagnostic tests, which will help ramp up the capacity to test and also reduce the time to getting test results. Management is mainly supportive care. In severe pneumonia and critically ill children, trial of hydroxychloroquine or lopinavir/ritonavir should be considered. As per current policy, children with mild disease also need to be hospitalized; if this is not feasible, these children may be managed on ambulatory basis with strict home isolation. Pneumonia, severe disease and critical illness require admission and aggressive management for acute lung injury and shock and/or multiorgan dysfunction, if present. An early intubation is preferred over non-invasive ventilation or heated, humidified, high flow nasal cannula oxygen, as these may generate aerosols increasing the risk of infection in health care personnel. To prevent post discharge dissemination of infection, home isolation for 1-2 wk may be advised. As of now, no vaccine... Full description

Year of Publication: 2020
Contained in: Indian journal of pediatrics Vol. 87, No. 6 (2020), p. 433-442
All journal articles: Search for all articles in this journal
Language: English
Contributors: Sankar, Jhuma | Author
Dhochak, Nitin
Kabra, S K
Lodha, Rakesh
Full text access:
Electronic availability is being checked...
Links: Full Text (dx.doi.org)
Keywords: 2494G1JF75
4QWG6N8QKH
ARDS
Acute lung injury
Acute respiratory distress syndrome
COVID-19
Journal Article
Multiorgan dysfunction
O3J8G9O825
Review
SARS-CoV-2
Severe pneumonia
Additional Keywords: *Palliative Care
Acute Lung Injury
Antiviral Agents
Betacoronavirus
Child
Child, Preschool
Clinical Laboratory Techniques
Coronavirus Infections
Disease Outbreaks
Humans
Hydroxychloroquine
Infant
Lopinavir
Pandemics
Pneumonia, Viral
Protease Inhibitors
Respiratory Distress Syndrome, Adult
Reverse Transcriptase Polymerase Chain Reaction
Ritonavir
Severe Acute Respiratory Syndrome
ISSN: 0973-7693
Note: Copyright: From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Notes: Date Completed 19.05.2020
Date Revised 19.05.2020
published: Print-Electronic
Citation Status MEDLINE
Copyright: From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Physical Description: Online-Ressource
ID (e.g. DOI, URN): 10.1007/s12098-020-03292-1
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