November 28, 2020. Acta Paediatr. Coronaviruses in Children: A Review of Potential Mechanisms of Childhood Protection.
Descriptions of the pathophysiology of coronavirus infections suggest several viral targets and immunomodulatory pathways that influence disease severity. Limited evidence suggests the age variability of viral cell receptors and transmembrane cofactors required for coronavirus entry and replication.
- However, the resulting cytokine storm and the effect of higher melatonin in children are age-dependent and may explain less disease variability. Current evidence suggests that host factors may play a role in the development of severe disease in children and may remain protective despite the potential mutation of the virus in the future.
- However, more research will need to be conducted to further investigate why children are protected from developing severe forms of COVID-19.November 23, 2020. JAMA Pediatr.
Pediatric Patients Tested for Severe Acute Respiratory Syndrome Coronavirus 2 Across the United States
A total of 135,794 pediatric patients (53% male; mean age [SD] 8.8 [6.7] years; 3% Asian patients, 15% black patients, 11% Hispanic patients and 59% white patients; 290 per 10,000 population [range, 155-395 per 10,000 population in health care systems]) were tested for SARS-CoV-2 and 5374 (4%) were infected with the virus (12 per 10,000 population [range, 7-16 per 10,000 population]) .
- Compared to white patients, boys of Black, Hispanic, and Asian race / ethnicity had lower testing rates; however, they were much more likely to test positive.
- In this large cohort study of US pediatric patients, SARS-CoV-2 infection rates were low and clinical manifestations were typically mild. Black, Hispanic and Asian race / ethnicity, adolescence and young adulthood, chronic conditions were associated with the infection. Diagnosis of Kawasaki disease was not an effective proxy for childhood multisystem inflammatory syndrome.
October 30, 2020. MedRxiv. Baseline characteristics, management, and outcomes of 55,270 children and adolescents diagnosed with COVID-19 and 1,952,693 with influenza in France, Germany, Spain, South Korea and the United States: an international network cohort study
A total of 55,270 children / adolescents diagnosed with Covid-19 and 3,693 hospitalized with COVID-19 and 1,952,693 diagnosed with influenza were studied. Despite negligible mortality, complications including pneumonia, ARDS, and MIS-C were more frequent in children / adolescents with COVID-19 than in those with the flu.
Dyspnea, anosmia, and gastrointestinal symptoms could help the differential diagnosis. A wide range of drugs have been used for the hospital management of pediatric COVID-19. October 18, 2020. MedRxiv.
Systematic review of reviews of symptoms and signs of COVID-19 in children and adolescents
Systematic Review of Reviews of the Prevalence of COVID-19 Symptoms and Signs in Individuals Under the Age of 20 Sept. 30, 2020. Med Hypotheses. COVID-19 in children:
Could pertussis vaccine play the protective role?
Whooping cough is a vaccine-preventable infectious disease of the airways and shares many similarities with COVID-19, including transmission and clinical features. Although pertussis is caused by a bacterium (Bordetella pertussis), while COVID-19 is a viral infection (SARS-CoV-2), previous data have shown that cross-reactivity and heterologous adaptive responses can be observed with unrelated biological agents. as between bacteria and viruses. 29 September 2020.
Pediatr Crit Care Med. Caring for Critically Ill Children With Suspected or Proven Coronavirus Disease 2019 Infection: Recommendations by the Scientific Sections’ Collaborative of the European Society of Pediatric and Neonatal Intensive Care
This article analyzes the current clinical knowledge of coronavirus disease 2019 in children in severe conditions, some specific treatments based on limited experience are discussed, and the lack of controlled studies in children at this time is highlighted.