Pediatrics Related Questions
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Frequently Asked Inpatient Questions Microchapter |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:
Pediatrics Related Questions
Are children with congenital heart diseases at increased risk of COVID-19?
- A study published in the Journal of the American Heart Association investigated the effects of COVID-17 in the pediatric and adolescent population with congenital heart disease(CHD).[1] The results found that patients with CHD are more susceptible to being infected by COVID-19 and may in fact have worse outcomes and complications due to the disease. This is as a result of their already disturbed physiologic states as well as other co-morbidities associated with congenital heart diseases.[1] For these individuals, primary prevention and infection control processes are especially crucial.
Are children with underlying conditions at increased risk of hospitalization?
- Almost all children infected with COVID-19 have excellent outcomes. However of those hospitalized due to the disease, the majority are children under the age of 1,[2][3] and those with underlying conditions. The most commonly reported conditions include:[2] [4]
- pulmonary diseases i.e; asthma
- congenital heart disease and other cardiovascular conditions
- Immunosuppression due to cancer or any of its treatment therapies, high dose of glucocorticoids, e.t.c
Is there and an association between KAWASAKI disease and COVID-19?
- Kawasaki disease, also known as lymph node syndrome, mucocutaneous node disease, infantile polyarteritis, and Kawasaki syndrome, is a poorly understood self-limited vasculitis that affects many organs, including the skin, mucous membranes, lymph nodes, blood vessel walls, and the heart.[5] The emergence of COVID-19 has seen new presentations of known medical conditions for the first time.[6] Numerous reports have shown a spike in new/concurrent cases of Kawasaki disease in COVID-19 positive patients. Information regarding the novel COVID-19 is still being gathered and although an exact association hasn't been established between Kawasaki disease and COVID-19, more research and investigations are still being conducted.[7]
Is Multi-system Inflammatory Syndrome in Children (MIS-C) fatal? What precautions can be taken to avoid it?
- As described in the Health Advisory, “Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with Coronavirus Disease 2019 (COVID-19),”[8] the case definition for MIS-C is[9]:
- An individual aged <21 years presenting with fever(>38.0°C for ≥24 hours, or report of subjective fever lasting ≥24 hours), laboratory evidence of inflammation (Including, but not limited to, one or more of the following: an elevated C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), fibrinogen, procalcitonin, d-dimer, ferritin, lactic acid dehydrogenase (LDH), or interleukin 6 (IL-6), elevated neutrophils, reduced lymphocytes, and low albumin), and evidence of clinically severe illness requiring hospitalization, with multisystem (>2) organ involvement (cardiac, renal, respiratory, hematologic, gastrointestinal, dermatologic or neurological); AND
- No alternative plausible diagnoses; AND
- Positive for current or recent SARS-CoV-2 infection by RT-PCR, serology, or antigen test; or exposure to a suspected or confirmed COVID-19 case within the 4 weeks prior to the onset of symptoms.
- There have been very few cases of death reported in hospitalized patients.[9]
- The best-known way to prevent MIS-C is primary prevention against COVID-19.[10] Individuals should follow already established social-distancing and sanitation guidelines.
Should routinely-recommended Hepatitis A and B vaccines continue to be administered to children?
Should vaccinations for HBV exposed infants be continued during the COVID 19 pandemic?
Sources
- ↑ 1.0 1.1 Alsaied T, Aboulhosn JA, Cotts TB, Daniels CJ, Etheridge SP, Feltes TF, Gurvitz MZ, Lewin MB, Oster ME, Saidi A (June 2020). "Coronavirus Disease 2019 (COVID-19) Pandemic Implications in Pediatric and Adult Congenital Heart Disease". J Am Heart Assoc. 9 (12): e017224. doi:10.1161/JAHA.120.017224. PMID 32441586 Check
|pmid=value (help). - ↑ 2.0 2.1 "Coronavirus Disease 2019 in Children - United States, February 12-April 2, 2020". MMWR Morb. Mortal. Wkly. Rep. 69 (14): 422–426. April 2020. doi:10.15585/mmwr.mm6914e4. PMC 7147903 Check
|pmc=value (help). PMID 32271728 Check|pmid=value (help). - ↑ "UpToDate".
- ↑ "Kawasaki disease overview - wikidoc".
- ↑ "Association Between COVID-19 and Kawasaki Disease: Vigilance Required From Otolaryngologists - Henya Sandhaus, Dana Crosby, Arun Sharma, Stacie R. Gregory,".
- ↑ "Trending Clinical Topic: Kawasaki Disease and COVID-19".
- ↑ "HAN Archive - 00432 | Health Alert Network (HAN)".
- ↑ 9.0 9.1 "Information for Healthcare Providers about Multisystem Inflammatory Syndrome in Children (MIS-C) | CDC".
- ↑ "Multisystem inflammatory syndrome in children (MIS-C) and COVID-19 - Mayo Clinic".