Manifestations Of COVID-19 In Children Research Articles

Gastrointestinal and Hepatic Manifestations of COVID-19 in Children: A Systematic Review and Meta-analysis.

Children with COVID-19 may present with gastrointestinal (GI) symptoms and liver dysfunction. To determine the type and prevalence of gastrointestinal (GI) and hepatic manifestations of COVID-19 in children and its association with severity of illness. A systematic literature search was done from inception until January 4, 2021 using PubMed, Cochrane Library, Google Scholar and prepublication repositories with no language restrictions. Studies that reported the demographic and clinical features of children with COVID-19 and provided data on their GI and hepatic signs and symptoms were included. Prevalence of GI and hepatic manifestations were pooled using Stata14. We included 58 studies with total of 4497 participants. Overall, one-third of children with COVID-19 presented with at least one GI symptom (33.8%; 95% confidence interval (CI) 23.0, 45.4; I2 97.5%; 42 studies, 3327 participants) with abdominal pain, nausea or vomiting, and diarrhea each occurring in approximately 20%. Children with severe COVID-19 were more likely to present with GI symptoms (odds ratio 2.59; 95% CI 1.35, 4.99; I2 24%; 4 studies, 773 participants). The pooled prevalence of elevated transaminases was 11% for both AST (11.3%, 95% CI 4.9, 19.3; I2 74.7%; 11 studies, 447 participants) and ALT (11.2%, 95% CI 7.1, 16.0; I2 40.8%; 15 studies, 513 participants). Hepatic findings such as jaundice (2-17%), hepatomegaly (2%) or behavioral changes (2%) from hepatic encephalopathy were variably reported by a few studies.The degree of heterogeneity was not improved on exclusion of studies with poor quality, but markedly improved on subgroup analysis according to geographical region and presence of MIS-C. Studies from China showed that children with COVID-19 had significantly lower pooled prevalence for any of the GI symptoms with low degree of heterogeneity, particularly for diarrhea, nausea/vomiting, and abdominal pain, all of which had I2 of 0%. Those with multisystem inflammatory syndrome in children (MIS-C) had significantly more common GI symptoms and increased transaminases than those without. One-third of children with COVID-19 exhibit at least one GI symptom and more likely present in those with severe disease. Elevated transaminases were present in 10%. Prevalence of GI and hepatic manifestations were higher among children with MIS-C.

Pediatric Multisystem Inflammatory Syndrome (MIS-C) associated with Covid-19 culminating in multiple complications: A case report

On January 30, 2020, the World Health Organization (WHO) declared a Public Health Emergency of International Concern, due to the novel coronavirus 2019 (definitively named on February 12, 2020 as COVID-19). Initially, Covid-19 infection did not appear to affect the paediatric population, with few reported cases, negligible morbidity, and mortality, and generally asymptomatic. However, subsequently, the English National Health System (NHS) issued an alert about new clinical manifestations of COVID-19 in children, which may be temporarily linked to a previous SARS-CoV-2 infection and determined by history of exposure, serology, or viral detection by RT-PCR, described as a paediatric multisystem inflammatory syndrome temporally associated with SARS-COV-2 (MIS-C). This paper reports the case of a 3-year-old and 6-month-old male patient, neuropathic, microcephalic, epileptic who sought medical attention with persistent fever and abdominal pain. Laboratory tests showed myositis, hepatitis, pancreatitis, positive PCR, elevated D-dimer and serology for covid-19 with non-reactive IgM and reactive IgG, thus meeting the diagnostic criteria for MIS-C. As for its prognosis, MIS-C is a dangerous and potentially fatal disease. The estimated mortality rate for MIS-C is between 0% and 5.3%, which is considered low but much higher than the overall mortality rate for children with COVID-19 (0.09%). Treatment depends on the severity of the disease, the risk of complications, and the possibility of follow-up, with most patients requiring hospitalization.

CO-INFECTION WITH COVID-19 AND GENETIC DIVERSITY OF SARS-COV-2 IN CHILDREN

In the pediatric population, coronavirus infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is more commonly observed in asymptomatic and moderately symptomatic cases. However, when COVID-19 coexists with other infections, it can result in a more severe disease progression. Various subtypes of the SARS-CoV-2 virus are associated with different clinical presentations, with certain subtypes exhibiting a predominance of specific symptoms or manifestations. Clinical manifestations of COVID-19 in children, both during the acute phase of the disease and in the post-COVID-19 period, are not fully understood and different compared to adults. This article presents four clinical cases in which PCR-confirmed COVID-19 was observed in combination with infections caused by viruses such as Ebstein-Barr, varicella, and rotavirus. The severity of the disease in these cases was attributed to symptoms related to intoxication, as well as skin and intestinal syndromes. To understand important genomic signatures of SARS-CoV-2 virus circulating in the area, the genome-wide sequencing was performed for the SARS-CoV-2 samples isolated from nasopharyngeal swabs collected from four patients. Based on the genotyping results, all four samples were found belonging to the SARS-CoV-2 virus Omicron lineage. Three months after the initial testing, follow-up evaluations of the children indicated a higher likelihood of complete recovery. However, some underlying disease manifestations, including anemia and atopic dermatitis, persisted despite the resolution of COVID-19 symptoms.

Digestive manifestations of Covid-19 in children: a retrospective study.

The world is currently facing a pandemic due to a new species of the Coronaviridae family called SARS-CoV-2, discovered in the city of Wuhan in China in December 2019. The WHO has named the resulting disease COVID-19 (Coronavirus Disease 2019). It has been a global health problem due to its major socio-economic damage. The aim of this study was to show the prevalence of gastrointestinal and hepatic manifestations in symptomatic children with COVID-19. We performed a retrospective study, including 36 symptomatic children infected by SARS-CoV-2 hospitalized at the mother and child hospital of university hospital of Mohammed VI, Marrakech in Morocco, over a period of 7 months. Clinical and biological manifestations of the digestive system were evaluated for all patients. The digestive symptomatology came in second place after the respiratory manifestations. 14 patients (38.89 % of symptomatic patients) in our study had digestive symptoms on admission: 12 (33.33%) presented with diarrhea, 4 (11.11%) had abdominal pain and only one child (2.78%) had vomiting. Aspartate aminotransferase (AST) was elevated in one patient, while alanine transaminase (ALT) was elevated in 6 patients. The prothrombin level was normal in all patients. All patients were discharged with good general condition without morbidity and mortality. This study concludes with the high prevalence of digestive manifestations of COVID-19 in symptomatic children. There were no severe clinical or biological abnormalities in our study. Digestive manifestations during COVID-19 in children are frequent, which requires the awareness of health professionals.

Infection Control Measures for SARS CoV-2 in Pediatric Wards During the COVID-19 Pandemic

<p>新冠病毒(SARS CoV-2) Omicron變異株於兒童族群感染具有高病毒量及高傳染性，且臨床症狀與其他秋冬常見之呼吸道病毒感染類似，加上兒童非藥物介入措施(non-pharmacological interventions, NPI)順從性及疫苗接種率低，若無適當之感管措施，容易於兒童病房中造成群聚感染。兒科病房COVID-19群突發事件常發生於社區流行高峰時期，可能造成住院之高風險兒童出現重症，亦可能引起醫護人員感染，並導致醫療照護人力不足。預防兒童病房COVID-19群聚感染，除包括全院規範之感染措施外，另須特別加強住院時病人全面篩檢、醫療人員個人防護裝備選擇（尤其是眼睛黏膜保護）、減少不必要的氣溶膠產生之醫療處置及加強環境清消。而一旦於病房發現確診個案，亦需在第一時間進行隔離措施、流行病學調查及健康管理。具風險因子之兒童若有必要應盡速給予抗病毒藥物治療，並注意重症之危險徵兆。</p> <p> </p><p>Compared with prior variants, the SARS-CoV-2 Omicron variant causes high viral loads and high infectivity in the pediatric population. However, the clinical manifestations of COVID-19 in children are similar to those caused by other respiratory viruses. Besides, poor non-pharmacological interventions (NPI) compliance and low vaccination coverage in the pediatric population also contributed to the magnitude of the COVID-19 outbreak in Taiwan. Outbreaks of COVID-19 in pediatric wards might spread to the rest of the community, contribute to severe symptoms in children with underlying comorbidities, and infect healthcare workers leading to inadequate healthcare staffing. In addition to universal infection control measures, the infection control bundle for COVID-19 in pediatric wards should include measures such as universal screening for SARS CoV-2 before admission, provision of proper personal protection equipment (especially eye protection) of healthcare workers, minimization of the unnecessary aerosol generation procedures, and enforcement of environmental sanitization. If a new COVID-19 case is detected in the ward, it should be epidemiologically investigated, and the patient should be immediately quarantined and monitored. Children with comorbidities should be prescribed antiviral treatment and receive close monitoring for severe manifestations of COVID-19.</p> <p> </p>

Neurological manifestations of COVID-19 in the pediatric population - a literature review and development of clinical cases for didactic purposes

The COVID-19 is an acute respiratory syndrome with different reported non-respiratory symptoms, neurological manifestations included. The nervous system impairment during the infection occurs in adults and children, yet the pediatric population has particularities in the clinical course of the disease. We discuss the neurological manifestations of COVID-19 in children, developing cases to be applied in disciplines within a “problem-based” learning methodology. The proceedings of the research were developed with undergraduate medicine students in mind: a literature review on the topic was performed; then observed by the selection of 16 articles reviewed, summarized and discussed. This paper discusses proceedings, challenges and outcomes, of each stage of the research’s agenda. In the literature review, we found many neurological manifestations in the pediatric population. Other aspects relevant to the topic were also found, such as: association of comorbidities, alterations in complementary exams, prognoses and pathophysiological hypotheses. Based on the findings, we created three clinical cases for application in undergraduate studies. We concluded that the topic has great clinical and learning importance, yet more research is needed on the subject.

Oral Manifestations in Children Diagnosed with COVID-19: A Narrative Review.

The COVID-19 disease has many symptoms, including fever, dry cough, tachypnea, and shortness of breath, but other symptoms can accompany the disease. The disease can also have oral manifestations. The aim of this narrative review is to describe the oral manifestations of COVID-19 in children and adolescents by summarizing the current knowledge as it was described in various case reports and original articles. A review of the literature was carried out by searching the online databases PubMed, Web of Science and Scopus, between October 2022 and 12 November 2022. For this narrative review, 890 articles from three databases and manual search were screened. Saliva was discovered to be a potential screening tool for the infection with the SARS-CoV-2, although it is most reliable in the first few days of infection. Different alteration of the oral mucosa, such as ulcers, erosions and gingivitis were reported. Oral manifestations accompanied children with COVID-19-related multisystem inflammatory syndrome, Kawasaki disease, thrombocytopenic purpura and erythema multiforme. COVID-19 had an indirect effect on oral harmful habits by decreasing their frequency during the lockdown. Although they occur more rarely, oral manifestations can accompany COVID-19 disease in children and adolescents, and they can be an early sign of the disease.

COVID in children and the digestive system: clinical and pathogenetic correlation

Coronaviruses, seven of which are known to infect humans, can range from asymptomatic infection to malnutrition and death. Russia has over 12.4 million confirmed cases of COVID-19 at the time of writing, with nearly 334,000 deaths. While all other coronaviruses affect cardiovascular disease, the SARS-CoV-2 virus also has a tropism for the cardiovascular system, gastrointestinal tract, liver, pancreas, kidneys, and nervous system. In this review, we describe the important gastrointestinal manifestations of COVID-19 in children and discuss possible underlying pathophysiological mechanisms for their occurrence.

The Absence of Permanent Sensorineural Hearing Loss in a Cohort of Children with SARS-CoV-2 Infection and the Importance of Performing the Audiological "Work-Up".

Currently, the novel coronavirus (SARS-CoV-2) causes an acute respiratory illness named COVID-19 and is a controversial risk factor for hearing loss (HL). Herein, we aim to describe the associated symptoms and to evaluate hearing function in the COVID-19 pediatric population. A retrospective cross-sectional observational study was carried out on 37 children who contracted COVID-19 infection with no previous audio-vestibular disorders. Clinical data on the infections were collected, and an audiological assessment of all affected children was performed by using different diagnostic protocols according to their age. Fever, upper respiratory and gastrointestinal manifestations were common presentations of infection. Audiological function was normal in 30 (81.08%) children, while 7 children showed an increased hearing threshold: 6 (16.21%) had transient conductive hearing loss (CHL) due to middle ear effusion and normalized at the follow-up and 1 had sensorineural hearing loss (SNHL). A single child was affected by bilateral SNHL (2.7%); however, he underwent a complete audiological work-up leading to a diagnosis of genetic HL due to a MYO6 gene mutation which is causative of progressive or late onset SNHL. HL needs to be considered among the manifestations of COVID-19 in children, nevertheless, we found cases of transient CHL. The onset of HL during or following COVID-19 infection does not eliminate the indication for maintaining audiological surveillance and audiological work-ups, including genetic diagnosis, to avoid the risk of mistaking other causes of HL.

An Overview of the Signs and Symptoms of Pediatric Patients Hospitalized with COVID-19

Introduction: Clinical symptoms and laboratory findings of Covid-19 in children are more diverse than in adults. The aim of this study is to determine the clinical and laboratory findings of covid-19 in hospitalized children. Materials and methods This cross-sectional descriptive study was conducted on 57 children aged 1 month to 12 years who were admitted with Covid-19, and their diagnosis were confirmed by PCR method from March 2020 to November 2021 in Mousavi Hospital of Zanjan, Iran. Demographic data, clinical and laboratory findings of patients were recorded, and relevant information was analyzed. Results In this study, 57 children with Covid-19, PCR positive, including 26 boys (45.6%) and 31 girls (54.4%) were evaluated. The most common clinical findings were fever, cough , respiratory distress, vomiting, diarrhea and seizures with fever in 45 (78.9%), 30 (52.6 ),24 (42.1%) , 21 (36.8%) ,18 (31.5) and 6 (10.5%) patients respectively. The most common laboratory findings were increased AST and ALT in 50 (87.7%) and 24 (42.1%) patients. Increased CRP and ESR were found in 21 (36.8%) and 15 (26.3%) patients, respectively. Lymphopenia and thrombocytopenia were reported in 14 (24.5%) and 4 (7.07%) patients, respectively. Conclusion The most common clinical manifestations of covid-19 in children were fever and cough. The increase of liver enzymes, especially AST, was significant in hospitalized children, while lymphopenia and thrombocytopenia were not common in affected children.

Cutaneous Manifestations of Novel Coronavirus Disease (COVID-19): A Case with Staphylococcal Scalded Skin Syndrome (SSSS)

Background: The coronavirus disease 2019 (COVID‐19) was first reported in December 2019 in Wuhan, China. Skin manifestations of COVID-19 have been reported sporadically. Staphy-lococcus aureus occurs after viral infection due to unregulated IFN-α. We designed this reported case to pay more attention to the rare skin manifestations following COVID-19. Case Report: The patient was a 12-month-old girl who presented with fever and skin rashes. Two days before admission, erythematous rashes spread around the mouth, nose, eyes, and trunk. Ery-thematous lesions begin to peel the next day. RT-PCR of the nasopharynx was positive for COVID-19. Treatment with vancomycin and clindamycin was started. The patient was discharged with complete recovery of skin lesions. Conclusion: One of the early manifestations of COVID-19 in children can be fever and rash. Clini-cal suspicion led to more attention to complications of bacterial superinfection such as staphylococ-cal scalded skin syndrome.

MENGAJARKAN ANAK UNTUK TETAP WASPADA DENGAN MEMATUHI PROKES AGAR TERHINDAR DARI BAHAYA COVID 19 DISEKOLAH TKIT DAARUNAHL TAHUN 2022

The coronavirus pandemic in indonesia affects all age groups, including children. The incidence of covid-19 in children reaches 5% of the total incidence. The clinical manifestations of covid-19 in children often resemble seasonal diseases such as fever, cough, flu, and diarrhea, so parents ignore the child's condition without realizing that these symptoms are the smallest threat to the spread of covid-19 in the social sphere because children are the age at which a group of people are vulnerable to exposure to covid-19. Parents must be able to prepare their children to minimize exposure to the covid-19 virus by maximizing the implementation of health protocols in daily life. This community service was carried out by 3 lecturers from the faculty of science, pharmacy and health unma banten with the help of several students. This activity was guided and practiced at tkit daaru nahl cilegon which numbered 25 people so that children were not exposed to covid-19 as well as knowing correctly how to wash hands properly and correctly, complying with the covid-19 health protocols, and knowing how important it is to wear a mask during the covid-19 pandemic. With this community service, it is hoped that the application of hand washing with running water, not only using hand sanitizers, especially when hands look dirty and oily, but is done using running water and soap.

Gastrointestinal and hepatobiliary manifestations of COVID-19 in children: A Review

Background: Severe acute respiratory syndrome-coronavirus-2 (SARS-COV-2) is shaking the world heavily. SARS-COV-2 (COVID-19) infection has a wide variety of presentations as it affects almost every system of body. Gastrointestinal and hepatobiliary symptoms are frequently overlooked especially in children. Objectives: The purpose of this review was to discuss the gastrointestinal and hepatobiliary presentations of COVID-19 in children and compare with non-gastrointestinal presentations. Methods: This study was a narrative review. Recent available literature was searched by keywords. The most recent information from relevant articles were collected and reviewed. This write up was compiled after the review of articles from the last one and half year. Results: About 50.0% symptomatic children with COVID-19 had gastrointestinal manifestations. COVID-19 with gastrointestinal symptoms had delayed diagnosis, delayed hospitalization and worse outcome in compare with Covid-19 with non-gastrointestinal symptoms. Conclusion: Vomiting, diarrhoea, abdominal pain, anorexia, nausea are common gastrointestinal manifestations in children with COVID-19. Elevated transaminasemia is not uncommon. Bangladesh Med Res Counc Bull 2021; 47(1): 3-8

Features of clinical course and skin lesions associated with new coronavirus infection in children

Annotation. This article discusses the features of skin lesions and the clinical course of a new coronavirus infection in children. Among the extrapulmonary signs associated with COVID-19, dermatologic manifestations have increasingly appeared in the past few months. The aim of the study was to correlate available data in the literature on variants of dermatological manifestations of COVID-19 in children with clinical examples of skin lesions associated with this infection in patients seen by a specialized dermatologist. We used PubMed and Cyberleninka search engines for the period 2020–2021 Systematized variants of dermatological syndromes in children who had undergone COVID-19 described in reviews of materials by domestic and foreign researchers. The authors analyzed the primary medical records and photographic archives of children admitted to the outpatient clinic of a dermatologist at Yekaterinburg municipal clinical hospital No. 9 for 1 month after the established family contact with a new case of coronavirus infection. Analysis of scientific literature data showed that SARS-CoV-2 virus-associated skin lesions in children were more frequent in the mild course of infection, presumably with the implementation of an immunocomplex mechanism of vascular and epithelial damage. The pronounced vascular damage is a distinctive feature of COVID-19-related exanthemas, especially when localized on the fingers of the lower extremities. This article presents 5 clinical cases of children with various forms of acute dermatoses: urticaria, frostbite-like exanthema of the fingers, onychodystrophy, alopecia, and generalized pustular psoriasis of Zumbush. Only three children had laboratory confirmation of SARS-CoV-2 infection.

Dermatological Manifestations of COVID-19 in Children

ContextThe clinical picture of pediatric severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) infection differs from adults as do the cutaneous manifestations. In this review, we summarize the varied morphological manifestations of SARS-CoV-2 infection in the pediatric population.Evidence acquisitionA comprehensive literature search was conducted (23 September, 2021) across multiple databases (PubMed, EMBASE, MEDLINE and Cochrane) with the relevant keywords. An additional filter of age group between 0–18 years was kept in each of the searches.ResultsChilblains constitute the most common cutaneous manifestation of pediatric coronavirus disease (COVID-19). Other commonly reported manifestations include maculopapular rash, urticaria, erythema multiforme, and papulovesicular eruptions. Majority of children with these manifestations are asymptomatic, highlighting the need to clinically suspect and appropriately manage such patients. A subset of pediatric patients develop severe multisystem involvement termed as multi-system inflammatory syndrome in children (MIS-C) that has varied mucocutaneous manifestations.ConclusionA wide variety of dermatological manifestation of SARS-CoV-2 infection is reported, and both the pediatrician and dermatologist need to be aware of the same to suspect and diagnose COVID-19 infection in children.Electronic Supplementary MaterialSupplementary material is available in the online version of this article at 10.1007/s13312-022-2521-6.

Cutaneous manifestations of COVID-19 in children: Four case presentations

The dermatological signs of Coronavirus disease 2019 (COVID19) in children are uncommon and different from adults. The majority of infected children were asymptomatic, and cutaneous symptoms of infection in children usually appear several weeks after the disease. This article describes four different cutaneous manifestations of COVID-19 in children, including chilblains, erythema multiforme-like lesions (EM), urticaria, and vesicular rash in terms of recalling to mind COVID-19 infection.

Rare and common manifestations of COVID-19 in children.

IntroductionIt has been almost 2 years since the first reports on cutaneous manifestations of COVID‐19. Those reported in children are different and include macular, papular, lichenoid, vesicular, urticarial, and vascular morphologies, among others. The prognosis of isolated cutaneous involvement in COVID‐19 in children is usually self‐limiting but the extreme variety of clinical presentations complicates the clinical approach.MethodsNumerous reviews have been systematically drafted and edited giving the clinicians a future direction for skin presentations during pandemics.Results and DiscussionHereby we report the rare and common manifestations of COVID‐19 in children and question the recurrence phenomena and age‐related distribution of the eruptions.

A Comprehensive Review of Neuromuscular Manifestations of COVID-19 and Management of Pre-Existing Neuromuscular Disorders in Children.

Since the emergence of SARS-CoV-2, several studies have been published describing neuromuscular manifestations of the disease, as well as management of pre-existing pediatric neuromuscular disorders during the COVID-19 pandemic. These disorders include muscular dystrophies, myasthenic syndromes, peripheral nerve disorders, and spinal muscular atrophy. Such patients are a vulnerable population due to frequent complications such as scoliosis, cardiomyopathy, and restrictive lung disease that put them at risk of severe complications of COVID-19. In this review, neuromuscular manifestations of COVID-19 in children and the management of pre-existing pediatric neuromuscular disorders during the COVID-19 pandemic are discussed. We also review strategies to alleviate pandemic-associated disruptions in clinical care and research, including the emerging role of telemedicine and telerehabilitation to address the continued special needs of these patients.

Comparison of Leukocyte, Neutrophil, and Lymphocyte Levels in Child Patients that Experienced Breathlessness with COVID-19 and Non-COVID-19 (2020–2021) in Medan, Indonesia

BACKGROUND: COVID-19 is a disease caused by severe acute respiratory syndrome coronavirus-2. Various risk factors affect the morbidity and mortality of COVID-19, such as age, gender, ethnicity, comorbid conditions, and laboratory parameters. Clinical manifestations of COVID-19 in children are asymptomatic mild degrees or with acute upper respiratory tract symptoms and moderate degrees with clinical pneumonia. In the course of the COVID-19 pandemic, several biomarkers are needed that can be useful in risk stratification to predict the severity and fatality of COVID-19. Several biomarkers are used as markers of disease progression to a critical degree, such as leukocytes, lymphocytes, platelets, interleukin-6, and serum ferritin. Increased leukocytes and neutrophils and decreased lymphocytes are associated with severity and mortality in COVID-19. Laboratory findings in children with COVID-19 include decreased lymphocytes, leukopenia, and increased procalcitonin. In severe COVID-19, children often have abnormal laboratory parameters that suggest a systemic inflammatory response. AIM: This study aims to compare leukocytes, neutrophils, and lymphocytes levels in children with the complaints of shortness of breath with COVID-19 and non-COVID-19 pediatric patients. MATERIALS AND METHODS: This study is an analytic study with a cross-sectional approach to pediatric patients treated in Haji Adam Malik General Hospital Medan with the complaints of shortness of breath. Patient data were assessed based on the characteristic values of hemoglobin, leukocytes, neutrophils, lymphocytes, and COVID-19 polymerase chain reaction results and then analyzed using SPSS for Windows software. The study samples were 276 patients, with 43 confirmed positive COVID-19 patients and 233 negative patients. The source of this research data is data from the patient’s medical record for 1 year (2020–2021). RESULTS: The statistical analysis results found differences in the levels of leukocytes, neutrophils, and lymphocytes in children diagnosed with COVID-19 and non-COVID-19 (p < 0.05). However, there was no difference in hemoglobin levels in children who were congested with COVID-19 and non-COVID-19 (p > 0.05). CONCLUSION: These results are consistent with several cases and previous studies where the levels of leukocytes, neutrophils, and lymphocytes can be used as a detection tool and a diagnostic and prognostic tool in COVID-19 patients.

Respiratory Manifestations of COVID-19 in Children: A Narrative Review

Background: Coronavirus disease 2019 (COVID‐19, the seventh coronavirus) is a new infectious disease that spread worldwide and rapidly became a pandemic. COVID‐19 is rare in children and often asymptomatic. The respiratory system is mainly involved in COVID-19 infection. Objectives: This study aimed to review respiratory manifestations in children with COVID-19. Methods: We searched for studies published from January 2020 to January 2021 in PubMed, Google Scholar, and Scopus in English. The search words were “2019-nCoV,” “novel coronavirus,” “COVID-19,” “SARS-CoV-2,” “severe acute respiratory syndrome coronavirus 2,” “children,” “child,” “infant,” “teenager,” “adolescent,” “pediatric,” and “neonate.” Results: Cough was a common symptom in our study (18.8%-100%, mean=64%). Pneumonia prevalence in children with COVID-19 is 11%-67% (mean=46%). Mild respiratory symptoms (14% - 60%) and severe respiratory distress syndromes (14%) were reported in some studies. Upper respiratory tract infection (URTI) was reported in 4 studies ranging from 11.1% to 34.4% (mean=24.1%). Ground-glass opacities (GGO) was reported in 12.2% to 81% of cases (mean=49.01%). Isolated consolidations were reported in 17% and 58% of patients in two studies. Enhanced lung texture was reported in 1.3% to 50% (mean=20.07%) of patients. Bilateral patchy shadowing was seen in 12.3% to 68% (mean=46.58%) of patients. Conclusions: Cough is the most common manifestation of respiratory system involvement in children with COVID-19. GGO and bilateral patchy involvement are the most common finding on lung CT scans in children with COVID-19.