COVID-19 (peds)

(Redirected from COVID-19 in pediatrics)

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).

Differential Diagnosis

Pediatric fever

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

Disposition

See Also

External Links

References

Authors:

Ross Donaldson