COVID-19 Pandemic and Children: A Review

Abstract

The severe respiratory disease COVID-19 (coronavirus disease 2019) was first reported in late December 2019 in Wuhan City, China. Soon thereafter, the World Health Organization (WHO) officially declared it a pandemic. The adult population is highly affected by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2); however, infants and children are also not spared. Transmission in the pediatric population appears to be primarily from COVID-19–positive adults, largely from family contacts through droplets, direct contacts, and aerosols. There is also evidence of fecal-oral route of transmission. The incubation period of COVID-19 in children ranges from 2 to 10 days. Most children are asymptomatic. The most common symptoms amongst symptomatic children are fever and cough. Shortness of breath, sore throat, rhinorrhea, conjunctivitis, fatigue, and headache are other common symptoms. Diarrhea, vomiting, and abdominal pain are the common gastrointestinal symptoms that may be present with or without respiratory symptoms. Very few children are likely to develop severe disease.Supportive care is the mainstay of treatment. Though data are limited, antiviral therapies such as remdesivir, favipiravir, lopinavir/ritonavir, and other drugs like hydroxychloroquine/chloroquine have been used for severe COVID-19 cases, with remdesivir showing the greatest promise. A few children may develop an exaggerated immune response, characterized by exaggerated cytokine release and manifests with features similar to Kawasaki disease. The syndrome has been referred to by many names including pediatric inflammatory multisystem syndrome (PIMS) and more recently, as multisystem inflammatory syndrome in children (MIS-C); this life-threatening condition often requires a multidisciplinary team effort and use of immunomodulators.

Infection and disease spectrum in individuals with household exposure to SARS‐CoV‐2: A family cluster cohort study

“…Wu and McGoogan 4 reported that 64% of 1183 case clusters in 20 provinces outside of Hubei in China were outbreaks within family households. Furthermore, some studies reported elder ages of household contacts and spouse relationship with index case were risk factors for transmission of SARS‐CoV‐2 within household 17–19 …”

“…Children have a very different subset of illness, who may develop an exaggerated immune response, characterized by exaggerated cytokine release and manifests with features similar to Kawasaki disease. The syndrome has been referred to as multisystem inflammatory syndrome in children with negative clinical outcomes 19 . We further investigated the characteristics and outcomes of children with COVID‐19.…”

“…3,[8][9][10][11][12] Many cases of SARS-CoV-2 infection may be missed if contact tracing and testing protocol have not been implemented, especially in the cases of asymptomatic infection without the progress to overt COVID-19. [13][14][15][16] Thus, the frequency of SARS-CoV-2 infection and the proportions of individuals infected with SARS-CoV-2 who develop the clinical disease (COVID- 19) and severe COVID-19 are unknown. Wu and McGoogan 4 reported that 64% of 1183 case clusters in 20 provinces outside of Hubei in China were outbreaks within family households.…”

Therapeutic potential of miRNAs targeting SARS-CoV-2 host cell receptor ACE2

“…Although a significant number of individuals infected with the SARS-CoV-2 remain asymptomatic and unrecognized, infected patients typically develop pneumonia which may lead to severe complications such as acute respiratory distress syndrome and multiple organ failure. So far, significant number of adults and children were affected from this disease and pandemic continues to spread widely and rapidly across the world ( Rathore et al, 2020 ; Sacco et al, 2020 ). As of October 27, 2020, a total of 43,561,060 confirmed cases of COVID-19 and 1,160,389 deaths have been reported globally ( https://coronavirus.jhu.edu/map.html ).…”

Effects and Safety of Convalescent Plasma Administration in a Group of Polish Pediatric Patients with COVID-19: A Case Series

“…In comparative descriptions of infections in children and adults, the clinical course in the pediatric population is described as milder, the outcome better, the mortality lower [11]. Nevertheless, later manifestations of the infection, such as MIS-C (Multisystem inflammatory syndrome in children) or the Kawasaki-like syndrome, are characteristic of the pediatric population [12]. Convalescent plasma (CP) has been used in the management of COVID-19 in adult patients, but data in children are limited [13].…”