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 or specific chemotherapeutic agents are approved for children.

Errataetall:

CommentIn: Indian J Pediatr. 2020 Nov;87(11):970-972. - PMID 32638337

Media Type:

Electronic Article

Year of Publication:

2020

Contained In:

Indian journal of pediatrics - Vol. 87, No. 6 (2020), p. 433-442

Language:

English

Contributors:

Sankar, Jhuma
Dhochak, Nitin
Kabra, S K
Lodha, Rakesh

Links:

Volltext

Keywords:

*Palliative Care
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4QWG6N8QKH
ARDS
Acute Lung Injury
Acute lung injury
Acute respiratory distress syndrome
Antiviral Agents
Betacoronavirus
COVID-19
Child
Child, Preschool
Clinical Laboratory Techniques
Coronavirus Infections
Disease Outbreaks
Humans
Hydroxychloroquine
Infant
Journal Article
Lopinavir
Multiorgan dysfunction
O3J8G9O825
Pandemics
Pneumonia, Viral
Protease Inhibitors
Respiratory Distress Syndrome, Adult
Reverse Transcriptase Polymerase Chain Reaction
Review
Ritonavir
SARS-CoV-2
Severe Acute Respiratory Syndrome
Severe pneumonia

Notes:

Date Completed 19.05.2020

Date Revised 09.09.2020

published: Print-Electronic

CommentIn: Indian J Pediatr. 2020 Nov;87(11):970-972. - PMID 32638337

Citation Status MEDLINE

Copyright: From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Physical Description:

Online-Ressource

doi:

10.1007/s12098-020-03292-1

PMID:

32338347

PPN (Catalogue-ID):

NLM310082021