Presentation of Severe Acute Respiratory Syndrome-Coronavirus 2 Infection as Cholestatic Jaundice in Two Healthy Adolescents

Perez, Adriana; Kogan-Liberman, Debora; Sheflin-Findling, Shari; Raizner, Aileen; Ahuja, K. L.; Ovchinsky, Nadia

doi:10.1016/j.jpeds.2020.07.054

Cited by 17 publications

(15 citation statements)

References 17 publications

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“…Cases of patients in this study have been published previously at least in part (Appendix; available at www.jpeds.com ). 2 , 3 , 11 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 …”

Section: Methodsmentioning

confidence: 99%

Severe Acute Respiratory Syndrome Coronavirus 2 Clinical Syndromes and Predictors of Disease Severity in Hospitalized Children and Youth

Fernandes

Oliveira

Guerguis

et al. 2021

The Journal of Pediatrics

171

230

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Objective To characterize the demographic and clinical features of pediatric SARS-CoV-2 syndromes and identify admission variables predictive of disease severity. Study design We conducted a multicenter, retrospective and prospective study of pediatric patients hospitalized with acute SARS-CoV-2 infections and multisystem inflammatory syndrome in children (MIS-C) at eight sites in New York, New Jersey, and Connecticut. Results We identified 281 hospitalized patients with SARS-CoV-2 infections and divided them into three groups based on clinical features. Overall, 143 (51%) had respiratory disease, 69 (25%) had MIS-C, and 69 (25%) had other manifestations including gastrointestinal illness or fever. Patients with MIS-C were more likely to identify as non-Hispanic black compared with patients with respiratory disease (35% versus 18%, P =.02). Seven patients (2%) died and 114 (41%) were admitted to the ICU. In multivariable analyses, obesity (OR=3.39, 95% CI:1.26-9.10, P =.02) and hypoxia on admission (OR=4.01; 95% CI:1.14-14.15; P =.03) were predictive of severe respiratory disease. Lower absolute lymphocyte count (OR=8.33 per unit decrease in 10 9 cells/L, 95% CI:2.32-33.33, P =.001) and higher C-reactive protein (OR=1.06 per unit increase in mg/dL, 95% CI:1.01-1.12, P =.017) were predictive of severe MIS-C. Race/ethnicity or socioeconomic status were not predictive of disease severity. Conclusions We identified variables at the time of hospitalization that may help predict the development of severe SARS-CoV-2 disease manifestations in children and youth. These variables may have implications for future prognostic tools that inform hospital admission and clinical management.

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“…Cases of patients in this study have been published previously at least in part (Appendix; available at www.jpeds.com ). 2 , 3 , 11 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 …”

Section: Methodsmentioning

confidence: 99%

Severe Acute Respiratory Syndrome Coronavirus 2 Clinical Syndromes and Predictors of Disease Severity in Hospitalized Children and Youth

Fernandes

Oliveira

Guerguis

et al. 2021

The Journal of Pediatrics

171

230

View full text Add to dashboard Cite

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“…The presence of ACE2 receptors in biliary and liver epithelial cells predispose the liver to potential targeting by SARS-CoV2 infection. Cholestatic jaundice has been described in adolescents as a possible presentation of SARS-CoV2 infection ( 47 ). Additional liver injury may result from drug-induced liver injury from SARS-CoV2 directed therapies ( 48 ).…”

Section: Consensus and Votingmentioning

confidence: 99%

The Impact of Severe Acute Respiratory Syndrome Coronavirus Type 2 on Children With Liver Diseases

Nicastro

Ebel

Kehar

et al. 2021

J. pediatr. gastroenterol. nutr.

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Children are seldom affected by severe forms of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV2) infection; however, the impact of comorbidities in the clinical presentation and outcome of SARS-CoV2 in children is poorly characterized including that of chronic liver disease (CLD) and those taking immunosuppressive medications for autoimmune liver disease or following liver transplantation (LT). Although not the main target organ, a spectrum of liver involvement has been described in children infected with SARS-CoV2 and those presenting with Multisystem Inflammatory Syndrome in Children (MIS-C). The Hepatology Committee of the European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and the Society of Pediatric Liver Transplantation (SPLIT) present an evidence-based position paper on liver involvement in children with SARS-CoV2 infection and its impact on those with CLD as well as LT recipients. All children may exhibit acute liver injury from SARS-CoV2 infection, and those with CLD and may experience hepatic decompensation. Preventative and therapeutic measures are discussed.

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“…Acute hepatitis and cholestasis have also been reported in children infected with SARS CoV-2 (25). The mechanism underlying this pathogenesis has been investigated (26).…”

Section: Gastrointestinal System Involvement In Children With Covid-19mentioning

confidence: 99%

From asymptomatic to critical illness - different clinical manifestations of COVID-19 in children

Tezer¹,

Deniz²

2021

Turk J Med Sci

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The global pandemic infectious disease that was named the new coronavirus disease (COVID 19), spread throughout the world, causing a major public health emergency. The causative virus of COVID-19, called SARS CoV-2, can infect all age groups. Various clinical signs and symptoms have been observed in neonates, children, and adolescents during the COVID-19 outbreak. The clinical manifestations of COVID-19 might be different due to the medical conditions and comorbid status in elderly and pediatric patients. The rise in cases among children has been reported during the COVID-19 pandemic. Although infected children generally appear to be asymptomatic or have only mild symptoms, COVID-19 in children may also involve a wide spectrum of clinical manifestations ranging from asymptomatic carriers to life-threatening and fatal diseases, as COVID-19 is a systemic disease that can affect multiple organs. Due to the lack of knowledge in the current literature, it is necessary to describe the atypical clinical features, including extrapulmonary manifestations, in pediatric patients with COVID-19. This review is conducted to identify knowledge gaps regarding the broad spectrum of clinical signs and symptoms of children with COVID-19.

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Presentation of Severe Acute Respiratory Syndrome-Coronavirus 2 Infection as Cholestatic Jaundice in Two Healthy Adolescents

Cited by 17 publications

References 17 publications

Severe Acute Respiratory Syndrome Coronavirus 2 Clinical Syndromes and Predictors of Disease Severity in Hospitalized Children and Youth

Severe Acute Respiratory Syndrome Coronavirus 2 Clinical Syndromes and Predictors of Disease Severity in Hospitalized Children and Youth

The Impact of Severe Acute Respiratory Syndrome Coronavirus Type 2 on Children With Liver Diseases

From asymptomatic to critical illness - different clinical manifestations of COVID-19 in children

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