COVID 19 IN CHILDREN: AN EXPERIENCE FROM A PAEDIATRIC TERTIARY CARE SETTING
Keywords:Key words: SARS-COV-2, Multisystem inflammatory syndrome, inflammatory markers
AbstractBackground: The pandemic of COVID 19 has affected a number of people around the globe. The data from paediatric population is scarce. The present study is aimed to present the paediatric perspective of the disease in terms of different clinical presentations, laboratory parameters, complications, and outcomes so as to develop an insight into disease manifestations in children. Methods: This descriptive case series was conducted in the department of Paediatrics after approval of institutional review board. All children admitted in paediatric unit with confirmed SARS-COV-2 infection either by PCR or antibody test were included in the study. Patients’ characteristics were documented on a predesigned proforma and analysed using SPSS 26.0. Results: A total of 17 patients comprising 13 (76.5%) male and 4(23.5%) female were included in the study. The major clinical features were fever, cough and shortness of breath documented in 15 (88.2 %) patients. Major complications were shock in 13 (76.5%), respiratory complications in 16 (94.11%), CNS complications in 4 (23.5%), cardiac complications in 5 (29.4%), hepatic involvement in 3 (17.6%) Acute Kidney Injury in 4 (23.5%) patients and 9 (52.9 %) patients were labelled as having Multisystem Inflammatory Syndrome in Children (MIS-C). A total of 7 (41.2%) patients had coexistent comorbid diseases. A total of 13 (76.47%) patients were discharged, 2 (11.8%) patients expired and 2 (11.8%) left against medical advice. Conclusion: The clinical presentation of paediatric patients with SARS-COV-2 infection is highly variable. Multisystem inflammatory syndrome associated with SARS-COV-2 must be considered in the differential diagnosis of children presenting with multiorgan dysfunction.
Kammoun R, Masmoudi K. Paediatric aspects of COVID-19: An update. Respir Med Res 2020;78:100765.
Wu Z, McGoogan JM. Characteristics of and Important Lessons from the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA 2020;323(13):1239–42.
Khan M, Khan H, Khan S, Nawaz M. Epidemiological and clinical characteristics of coronavirus disease (COVID-19) cases at a screening clinic during the early outbreak period: a single-centre study. J Med Microbiol 2020;69(8):1114–23.
Mercier JC, Maroni A, Levy M, Melki I, Meinzer U, Gaschignard J, et al. [COVID-19 in children: SARS-CoV-2-related inflammatory multisystem syndrome mimicking Kawasaki disease]. Bull Acad Natl Med 2021;205(6):579–86.
Ravikumar N, Nallasamy K, Bansal A, Angurana SK, Basavaraja GV, Sundaram M, et al. Novel Coronavirus 2019 (2019-nCoV) Infection: Part I - Preparedness and Management in the Paediatric Intensive Care Unit in Resource-limited Settings. Indian Pediatr 2020;57:324–34.
Dong Y, Mo X, Hu Y, Qi X, Jiang F, Jiang Z, et al. Epidemiology of COVID-19 Among Children in China. Paediatrics 2020;145(6):e20200702.
Lu Q, Shi Y. Coronavirus disease (COVID-19) and neonate: what neonatologist need to know. J Med Virol 2020;92(6):564–7.
Su L, Ma X, Yu H, Zhang Z, Bian P, Han Y, et al. The different clinical characteristics of corona virus disease cases between children and their families in China - the character of children with COVID-19. Emerg Microbes Infect 2020;9(1):707–13.
Hoffmann M, Kleine-Weber H, Krüger N, Müller M, Drosten C, Pöhlmann S. The novel coronavirus 2019 (2019-nCoV) uses the SARS-coronavirus receptor ACE2 and the cellular protease TMPRSS2 for entry into target cells. BioRxiv 2020;31:929042.
Ruggiero A, Attinà G, Chiaretti A. Additional hypotheses about why COVID-19 is milder in children than adults. Acta Paediatr 2020;10:15328.
WHO. Multisystem inflammatory syndrome in children and adolescents with COVID-19: scientific brief, 15 May 2020. [Internet]. World Health Organization. License: CC BY-NC-SA 3.0 IGO [cited 2021 June]. Available from: https://apps.who.int/iris/handle/10665/332095
Chen Q, Tian X, Luo Y, Liu J, Jiang L, Feng X, et al. Epidemiological and clinical characteristics analysis of 11 children with 2019 novel coronavirus infection in Chongqing: a single-center retrospective study. Transl Pediatr 2020;9(6):818–26.
Bhuiyan MU, Stiboy E, Hassan MZ, Chan M, Islam MS, Haider N, et al. Epidemiology of COVID-19 infection in young children under five years: A systematic review and meta-analysis. Vaccine 2021;39(4):667–77.
Chen ZM, Fu JF, Shu Q, Chen YH, Hua CZ, Li FB, et al. Diagnosis and treatment recommendations for paediatric respiratory infection caused by the 2019 novel coronavirus. World J Pediatr 2020;16(3):240–6.
Wei M, Yuan J, Liu Y, Fu T, Yu X, Zhang ZJ. Novel Coronavirus Infection in Hospitalized Infants Under 1 Year of Age in China. JAMA 2020;323(13):1313–4.
Zimmermann P, Curtis N. Coronavirus Infections in Children Including COVID-19: An Overview of the Epidemiology, Clinical Features, Diagnosis, Treatment and Prevention Options in Children. Pediatr Infect Dis J 2020;39(5):355–68.
Badal S, Bajgain KT, Badal S, Thapa R, Bajgain BB, Santana MJ. Prevalence, clinical characteristics, and outcomes of paediatric COVID-19: A systematic review and meta-analysis. J Clin Virol 2021;135:104715.
Patel NA. Paediatric COVID-19: Systematic review of the literature. Am J Otolaryngol 2020;41(5):102573.
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.