Context: Novel coronavirus (COVID-19) has become a new public health crisis, posing a great threat to the people all around the world. We aimed to review the articles on COVID-19 in pediatric population to help physicians and other healthcare workers understand the importance of detecting silent disease carriers in this age group and stop further transmission to other healthy individuals and manage symptomatic patients based on the latest recommendations. Methods: We searched databases including PubMed, Scopus, Google Scholar, and Medline and reviewed 70 articles from December 2019 to mid-July 2020. Relevant articles about COVID-19 in children were included. Results: According to the latest reports, 1% - 5% of infected patients were under 19 years old. Death in this age group was rare but it can occur in children with severe disease. The overall course of disease -mainly pulmonary involvement- of the infected children tend to be milder than adults. This may be related to both host factors and exposure. The lab tests and computed tomography (CT) scan findings are nonspecific and milder compared to those in older ages. The cornerstone of COVID-19 management in pediatric group is supportive care. Of note, there is not any approved specific drug for treatment of children affected by COVID-19. Conclusions: COVID-19 disease characteristics in children are not yet fully established, which poses a significant problem for pediatric medical specialists. It should be considered that most children are asymptomatic or have mild symptoms. Critical cases, although uncommon, can occur especially in children with underlying diseases.
Background: Retinopathy of prematurity is the leading cause of preterm infants' blindness. The preferred method for the management of aggressive posterior ROP is the anti-vascular endothelial growth factor (anti-VEGF). However, systemic and ocular adverse effects of anti-VEGF drugs remain a concern. Case Presentation: A case report of a preterm infant with a history of hypertension underwent intravitreal injection of aflibercept at the 50-week postmenstrual age because of aggressive posterior retinopathy of prematurity (ROP) in both eyes. Seven days after the intravitreal administration of aflibercept, he has a hypertension crisis and an ischemic stroke. Serial fundoscopies implied complete arrest of vascularization till seven months after receiving treatment. Conclusion: We report a case of an infant, with a history of hypertension, had an ischemic stroke just one week after the intravitreal injection of aflibercept for aggressive posterior ROP. We can conclude that in cases of preterm infants with systemic comorbidities, like uncontrolled hypertension, that predispose patients to thromboembolic events, we should be cautious about the potential increase in the risk of thromboembolic events after administration of anti-vascular endothelial growth factor agents (anti-VEGF), especially those with a longer half-life, like aflibercept.
Malignant peripheral nerve sheath tumor should be considered in the differential diagnosis of lacrimal gland tumors. Imaging studies may be helpful but tissue biopsy should be performed for accurate diagnosis. Complete excision of the mass lesion and adjunctive chemotherapy and radiotherapy should be considered in these cases.
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