COVID-19 (peds): Difference between revisions
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**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 develop late Multisystem inflammatory syndrome([[Multisystem inflammatory syndrome in children|MIS-C]]) | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
Revision as of 22:58, 16 December 2020
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 develop late Multisystem inflammatory syndrome(MIS-C)
Differential Diagnosis
Pediatric fever
- Upper respiratory infection (URI)
- UTI
- Sepsis
- Meningitis
- Febrile seizure
- 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