Journal of Pediatrics Review
Volume:10 Issue: 1, Jan 2022

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a new coronavirus disease that is highly contagious and affects all age groups of children. The incubation period of Coronavirus disease (COVID-19) ranges from 2 to 14 days. Diagnosis of COVID-19 is made by conducting nasal and pharyngeal swabs and analyzing sputum, stool, and blood samples for COVID-19 nucleic acid using reverse-transcription polymerase chain reaction (RT-PCR). A nasal swab is more sensitive and specific than a pharyngeal swab. Lung CT imaging is a confirmation and complimentary method which is more sensitive than RT-PCR analysis. The mortality rate of COVID-19 infection is very low in children. Treatment of COVID-19 is supportive care and home isolation for 2 weeks (1). The disease has now spread to most countries. Clinical manifestations of COVID-19 vary from asymptomatic to a severe form in children (2).

The associated multisystem inflammatory syndrome in children (MIS-C) with coronavirus disease (COVID-19) is a novel syndrome that has phenotypic similarity to Kawasaki disease (KD). 

This study systematically reviewed the demographic profile, clinical spectrum, treatment options, and outcomes of children and young adults under 21 years of age suffering from MIS-C. 

PubMed and Embase databases were searched from inception to July 3, 2020. A total of 39 studies involving 799 participants were included in the review. Critical appraisal of included studies was done using Joanna Briggs Institute Critical Appraisal Checklist for studies reporting prevalence data. A narrative synthesis was performed through descriptive summaries of demographic variables, clinical features, investigations, treatment details, and clinical outcomes.

The main complaints of the patients were fever (96.4%) followed by gastrointestinal symptoms. Serological evidence of preceding severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was documented in 79.1% of the participants. Ventricular dysfunction (50.2%) was the most common echocardiographic finding. Intensive care was required for 77% of included participants, with 27.2% being mechanically ventilated. Also, 78.1% of the participants received intravenous immunoglobulins. The overall mortality rate was 1.5%.

MIS-C associated with COVID-19 clinically resembles a hyperinflammatory state. More extensive studies will help in better defining this entity and delineating its phenotypic subtypes.

To the best of our knowledge, limited studies explored gastrointestinal (GI) symptoms and hepatopancreatic involvement in children with coronavirus disease 2019 (COVID- 19) infection. 

This review study aimed to evaluate the GI symptoms and abnormal liver and pancreas function in children with COVID-19 infection.

In this review study, databases of Scopus, PubMed, Google Scholar, and Web of Science were searched using the relevant keywords of “COVID-19,” “children,” “gastrointestinal,” “liver,” and “pancreas.” Descriptive and cross-sectional studies were reviewed in the current study, with the main focus on GI symptoms and elevated liver enzymes in children with COVID-19 infection. 

Overall, 27 studies from countries of Iran, Spain, Turkey, Italy, and the United States were selected. Although the prevalence of GI symptoms varied in different studies, our review showed that most children with COVID-19 infection experienced GI symptoms. In addition to GI symptoms, there is the possibility of elevated liver enzymes, such as alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, and creatine phosphokinase in children with COVID-19 infection. 

COVID-19 infection may present various GI, hepatic, and pancreatic manifestations in children. The difference in the prevalence of these symptoms can probably be attributed to the geographical region of the study and the history of the disease.

COVID-19 is an unknown and novel virus that creates a challenge with all comorbid conditions, including diabetes mellitus (DM). Although DM has not been determined as a definite risk factor for COVID-19 in childhood, clinicians should consider the potential association between DM and COVID-19. 

This study aimed to review COVID-19 and DM comorbidity in children.

ISI Web of Science, PubMed, and Google Scholar were investigated to find relevant articles regarding COVID-19 and DM.

Data revealed 50% higher fatal outcomes of COVID-19 in DM children than in healthy ones. Because of the importance of DM in children, it seems mandatory to consider type 1 diabetes and its consequences on COVID-19.

Understanding the pathophysiology of COVID-19 and its interaction with DM are helpful for better management of the disease. These considerations can help clinicians make better decisions about the treatment modalities, management, and diabetic ketoacidosis treatment.

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. 

This study aimed to review respiratory manifestations in children with COVID-19.

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.”

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.

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.

A novel coronavirus emerged from Wuhan, China, in December 2019. Dental healthcare providers are at the highest risk of exposure since the primary source of the virus is saliva, and dentists are the front-line personnel working with the oral cavity. Since orthodontic treatment is a long-term procedure for children and teenagers, and because of the critical gap in preparing a specific guideline on orthodontic treatment procedures, orthodontic practitioners have faced numerous complicated issues in this regard. This mini-review aimed to summarize the facts that the orthodontic settings should be aware of the dental difficulties during COVID-19 with a particular focus on orthodontic treatment. 

In this short review, electronic databases of Medline, Scopus, Web of Science, and Google Scholar were searched for relevant articles and guidelines from January 2019 to March 2021 using the following key terms: “COVID-19,” “SARS-CoV-2,” “Pandemic,” “Orthodontics,” and “Orthodontists.”

Gathering recommendations of experts and several guidelines led to the following crucial steps in orthodontic procedures: screening through a telehealth questionnaire; admitting just patients into the dental center; ventilating the waiting room; measuring the temperature of patients’ bodies; disinfecting the dental unit and instruments after each visit; using personal protective equipment; washing hands; minimizing the use of high-speed handpieces to reduce the aerosol generation; and sterilization of archwires, orthodontic markers, photographic retractors, molar bands, burs, miniscrews, and unit waterline with proper methods.

All dentists should be up-to-date on cross-transmission of SARS-CoV-2 and follow the international infection control protocols as well as national/provincial/local guidelines and apply them to the regional settings after generalization and matching with the condition.

The COVID-19 pandemic has affected human beings in many ways. The presence of SARS-CoV-2 in conjunctival cells and its secretion has been reported in the literature. In addition, there were significant reports of ocular complications that coincide with COVID-19 disease. This study aims to evaluate the COVID-19 symptoms associated with ocular manifestations. 

We conducted a literature search with the keywords of “SARS-CoV-2,” “COVID-19,” “nCoV-19,” “SARS,” “MERS,” and “severe acute respiratory syndrome coronavirus‐2” combined with key terms of “eye,” “ocular,” “ophthalmologic,” “ophthalmic,” “conjunctivitis,” “conjunctiva,” “uveitis,” “optic,” “retina,” “retinitis,” “cornea,” “scleritis,” and “glaucoma” in LitCovid hub, PubMed, Scopus, ISI Web of Sciences, Cochrane, and Embase databases, as well as non-review articles.

The COVID-19 pandemic and its lockdown has drastically changed people’s lifestyles and health. The pandemic has also affected medical performance in various fields, including ophthalmology. This study summarized some findings in several areas of ophthalmology, including: 1) The surface of the eye (conjunctivae, cornea), 2) Intraocular manifestations (uveitis, retinitis), 3) Neurological features of the eye, 4) COVID-related ocular coagulopathy (retinal vein occlusion), 5) Ophthalmological follow-up failure due to lockdown, 6) Rare manifestations, and 7) Diagnostic and protective measures. Data collection about the ophthalmological experience was done during this respiratory viral infection pandemic, and the most relevant literature was reviewed.

Data findings showed a wide range of ocular manifestations and complications associated with COVID-19 and its pandemic. Conjunctivitis is the most common ocular manifestation of COVID-19.

Several studies have reported neurological manifestations and complications related to specific coronavirus genotypes, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In this study, we examined one of the rare clinical manifestations of Coronavirus disease 2019 (COVID-19), which was one of the first cases of acute transverse myelitis in children in the world. 

This case report was dedicated to a little girl with COVID-19 admitted with weakness, lethargy, and constipation. Her magnetic resonance imaging (MRI) showed signal changes accompanied by edema. The patient did not show an optimal response to the methylprednisolone succinate and intravenous human immunoglobulins (IVIG) and experienced cardiorespiratory arrest. The patient was eventually discharged with partial recovery in limb power. 

his study demonstrates the importance of rapid diagnosis and treatment of the sequelae of COVID-19 infections.

The coronavirus disease 2019 (COVID-19) outbreak started in December 2019. The disease can manifest in various respiratory and non-respiratory symptoms and clinical findings. The signs and symptoms of this disease in children are not entirely known yet. Ground-glass opacity and pleural effusion in the chest computed tomography scan have been reported in infected patients. The pleural effusion has been reported in a few cases. The present case report describes a pediatric patient with the chief complaints of fever, diarrhea, and vomiting who presented to an emergency department with a differential diagnosis of a gastrointestinal infection. However, he was diagnosed with COVID-19, which was complicated by respiratory distress and pleural effusion.

COVID-19 is a highly infectious and contagious disease. Since the outbreak of COVID-19, most studies on children have focused on the incidence and prognosis of the disease, and few studies have investigated the epidemiological characteristics of the disease. 

This study aimed to investigate some epidemiological aspects of the disease in children with COVID-19. 

We examined children with COVID-19 (under 18 years) hospitalized in the North East of Iran from the beginning of the outbreak until the end of September 2020. Study information was collected from patients’ medical records and interviews with their parents. We recorded demographic data; history of diseases and taking medicine in children; educational, occupational, and smoking status of parents; patients’ residence conditions; and any report of COVID-19 in patients’ families and relatives.

Of 107 children studied, 57% were male, and 52.3% had no underlying disease. The mean age of patients was 67 months. The Mean±SD weight of the children was 20.36±13.75 kg, and their Mean±SD length of hospital stay was 9±8 days. Multisystem inflammatory syndrome in children (MIS-C) was observed in 34.6% of patients, and its relationship with death was highly significant (P=0.001). The length of hospital stay was influenced by the history of medication consumption (P=0.013) and underlying disease (P=0.001), and its increase was associated with an increased risk of MIS-C (P=0.032) and death (P=0.047).

Male sex, length of hospital stay, and MIS-C were identified as risk factors associated with worsening the outcome of COVID-19 disease in children.