COVID-19 (peds): Difference between revisions
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{{Peds top}} [[COVID-19]]. For transmission precautions see: [[Prevention of COVID-19 transmission in the healthcare setting]]. | |||
==Background== | ==Background== | ||
*No data currently exists to determine if children with underlying medical conditions (asthma, or special healthcare needs) at increased risk | |||
=== Epidemiology among Children === | === Epidemiology among Children === | ||
*2% of cases amongst < 2 years of age (NOTE: 13% in only one major city in China) | *2% of cases amongst < 2 years of age (NOTE: 13% in only one major city in China) | ||
*Mostly because of household exposures (from adults) | *Mostly because of household exposures (from adults) | ||
*Vast majority of cases in US are in adults | *Vast majority of cases in US are in adults | ||
*Transmission in pediatrics | |||
**Shedding for longer than adults (up to 22 days, some up to 30 days) | |||
**Mostly goes from adults to children (not the other way around) | |||
=== | ==Clinical Features== | ||
===Acute Pediatric Presentation=== | |||
*Fever (50-80%), cough, congestion, rhinorrhea, sore throat | *Fever (50-80%), cough, congestion, rhinorrhea, sore throat | ||
*GI in some cases (at least one case with GI sx first then respiratory symptoms after) | *GI in some cases (at least one case with GI sx first then respiratory symptoms after) | ||
*50% of peds cases with fever, 30% with cough | *50% of peds cases with fever, 30% with cough | ||
Disease Course | ===Pediatric Disease Course=== | ||
*Mostly mild (for unclear reasons) except for only 2 cases: | *Mostly mild (for unclear reasons) except for only 2 cases: | ||
**13 month developed ARDS and ICU care | **13 month developed ARDS and ICU care | ||
**3 year old needed ICU | **3 year old needed ICU | ||
*No deaths in children under 10 (from china so far) | *No deaths in children under 10 (from china so far) | ||
*Radiographic: same as adults (bilateral, pulmonary lesions, GGO; some with unilateral). | *Radiographic: same as adults (bilateral, pulmonary lesions, GGO; some with unilateral). | ||
*Can rarely develop Multisystem inflammatory syndrome([[Multisystem inflammatory syndrome in children|MIS-C]]) | |||
=== | ==Differential Diagnosis== | ||
{{Pediatric fever DDX}} | |||
=== | ==Evaluation== | ||
===Workup=== | |||
===Diagnostic Findings=== | |||
*Mild CRP or AST elevations | *Mild CRP or AST elevations | ||
*No consistency on WBC (mild leukocytosis, leukopenia) | *No consistency on WBC (mild leukocytosis, leukopenia) | ||
*Few coinfections have been reported (with RSV, Influenza, mycoplasma). | *Few coinfections have been reported (with RSV, Influenza, mycoplasma). | ||
**Coinfection unlikely (but possible) at this time | **Coinfection unlikely (but possible) at this time | ||
==Management== | |||
''See [[prevention of COVID-19 transmission in the healthcare setting]] for PPE recommendations'' | |||
*Supportive care, isolation at home best unless needing hospitalisation | *Supportive care, isolation at home best unless needing hospitalisation | ||
*Infection prevention and support!!! handwashing and PPE | *Infection prevention and support!!! handwashing and PPE | ||
*No remdesavir trials in children | *No [[remdesavir]] trials in children | ||
=== | ==Disposition== | ||
=== | ==See Also== | ||
{{Special:Prefixindex/COVID-19 |hideredirects=1}} | |||
==External Links== | |||
==References== | |||
<references/> | |||
[[Category:ID]] | |||
[[Category:Pediatrics]] | |||
Latest revision as of 18:31, 7 February 2024
This page is for pediatric patients. For adult patients, see: COVID-19. For transmission precautions see: Prevention of COVID-19 transmission in the healthcare setting.
Background
- No data currently exists to determine if children with underlying medical conditions (asthma, or special healthcare needs) at increased risk
Epidemiology among Children
- 2% of cases amongst < 2 years of age (NOTE: 13% in only one major city in China)
- Mostly because of household exposures (from adults)
- Vast majority of cases in US are in adults
- Transmission in pediatrics
- Shedding for longer than adults (up to 22 days, some up to 30 days)
- Mostly goes from adults to children (not the other way around)
Clinical Features
Acute Pediatric Presentation
- Fever (50-80%), cough, congestion, rhinorrhea, sore throat
- GI in some cases (at least one case with GI sx first then respiratory symptoms after)
- 50% of peds cases with fever, 30% with cough
Pediatric Disease Course
- Mostly mild (for unclear reasons) except for only 2 cases:
- 13 month developed ARDS and ICU care
- 3 year old needed ICU
- No deaths in children under 10 (from china so far)
- Radiographic: same as adults (bilateral, pulmonary lesions, GGO; some with unilateral).
- Can rarely develop Multisystem inflammatory syndrome(MIS-C)
Differential Diagnosis
Pediatric fever
- Upper respiratory infection (URI)
- UTI
- Sepsis
- Meningitis
- Febrile seizure
- Juvenile rheumatoid arthritis
- Pneumonia
- Acute otitis media
- Whooping cough
- Unclear source
- Kawasaki disease
- Neonatal HSV
- Specific virus
Evaluation
Workup
Diagnostic Findings
- Mild CRP or AST elevations
- No consistency on WBC (mild leukocytosis, leukopenia)
- Few coinfections have been reported (with RSV, Influenza, mycoplasma).
- Coinfection unlikely (but possible) at this time
Management
See prevention of COVID-19 transmission in the healthcare setting for PPE recommendations
- Supportive care, isolation at home best unless needing hospitalisation
- Infection prevention and support!!! handwashing and PPE
- No remdesavir trials in children