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.
The ongoing outbreak of the novel coronavirus (SARS-CoV-2) has exposed many pediatric patients from around the world to coronavirus disease. Although pleural effusions are classified as atypical features of COVID-19 infection, we report a 6-year-old boy who had a positive IgG antibody ELISA test for COVID-19 and presented with respiratory distress, bilateral pleural effusions, and signs and symptoms of multisystem inflammatory syndrome. The RT-PCR test of the pleural fluid specimen was positive for novel coronavirus. To our knowledge, this is the first pediatric report of a COVID-19-positive pleural fluid.
Myiasis is an infestation caused by dipterous larvae. Nosocomial myiasis usually occurs in bedridden patients. Herein, we report a nasal myiasis in a 12-year-old female with cerebral palsy (CP) from Tehran, Iran and provide morphological identification of Lucilia sericata as the causative agent. The infection was identified 10 days after the hospital admission. It can be categorized as a nosocomial infection. As far as we are aware, this is the first report of nasal myiasis in the pediatric age group from Tehran, Iran.
Introduction: Brain ischemic stroke in children especially in infancy is a rare condition. Stroke presents with a variety of symptoms and usually is an underestimated diagnosis in infants. The current pandemic of novel coronavirus disease type 2 (COVID-19), involves different organs in the human body, like the central nervous system. Researchers believe that there is a probable association between this retroviral infection and stroke but there were a few cases of strokes in the pediatrics field with positive RT-PCR for SARS-CoV-2. Case presentation: Herein we introduce a 17-month-old girl with a hemiparesis and focal status epilepticus that was admitted to Firoozabadi hospital. The onset of symptoms was approximately 4 days before the admission with non-bloody, watery diarrhea, nausea, vomiting, and low-grade fever. The brain MRI with DWI sequence confirmed acute ischemic stroke (AIS). Because of her multisystemic involvement, the COVID-19 RT-PCR test was requested and the result was positive. So according to the positive PCR test and negative of other results along with fever and gastrointestinal involvement picture - which is a common form of COVID-19 infection in pediatric patients- her neurological symptoms could be explainable with COVID-19 infection. Based on our knowledge, this is the first case of acute ischemic stroke (AIS) due to SARS CoV-2 infection that was reported under two years of age in the world. Conclusion: COVID-19 infection in pediatric patients has different presentations. In a significant number of these patients, the involvement of more than 2 body organs could be seen, known as “Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with Coronavirus Disease 2019 (COVID-19). There are some reports of stroke due to COVID-19 infection and it's related to hypercoagulability state so far and we introduce one infant case of that. According to this new emerging coronavirus and probability of nervous system involvement with this virus, we recommended checking the COVID-19 RT-PCR test in nasopharynx and cerebrospinal fluid of all children presented with neurological symptoms, even in the post-COVID-19 era.
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