Maria C Cardenas1, Samyd S Bustos2,3, Elizabeth Ann L Enninga4, Lynne Mofenson5, Rana Chakraborty1,4. 1. Division of Pediatric Infectious Diseases, Department of Mayo Clinic, Rochester, MN, USA. 2. Department of Surgery, Mayo Clinic, Rochester, MN, USA. 3. Center for Regenerative Medicine, Mayo Clinic, Rochester, MN, USA. 4. Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN, USA. 5. Elizabeth Glaser Pediatric AIDS Foundation, Washington, DC, USA.
Abstract
AIM: This study is a comprehensive review with the purpose of collecting the most relevant data in several sections including current treatment guidelines in the pediatric population. METHODS: literature was systematically searched in different databases. Results were limited to 2019+ and English, French and Spanish language. RESULTS: Children can exhibit mild and less severe COVID-19 disease than adults and also have asymptomatic carriage of SARS-CoV-2, while severe disease is more frequently noted during infancy (<1 year). SARS-CoV-2 binds the angiotensin-converting enzyme 2 (ACE-2) receptor; age-, racial-, and gender-specific differences in ACE-2 expression need to be elucidated in order to explain the differential clinical profiles between children and adults. Multi-system inflammatory syndrome in children (MIS-C) is an important condition to recognize in children. The decision to use antiviral or immunomodulatory therapy in a child or adolescent should be individualized based on the clinical scenario. Remdesivir is the only FDA-approved therapy available for children older than 12 years old who require hospitalization for COVID-19. CONCLUSION: Further studies are urgently required to address prevention and treatment in at-risk and infected children, especially with underlying comorbidities. The chapter on the overall impact of COVID-19 in children has not yet been written. Nevertheless, SARS-CoV-2 has now joined a long list of human pandemics, which may forever change the world's history. This article is protected by copyright. All rights reserved.
AIM: This study is a comprehensive review with the purpose of collecting the most relevant data in several sections including current treatment guidelines in the pediatric population. METHODS: literature was systematically searched in different databases. Results were limited to 2019+ and English, French and Spanish language. RESULTS:Children can exhibit mild and less severe COVID-19 disease than adults and also have asymptomatic carriage of SARS-CoV-2, while severe disease is more frequently noted during infancy (<1 year). SARS-CoV-2 binds the angiotensin-converting enzyme 2 (ACE-2) receptor; age-, racial-, and gender-specific differences in ACE-2 expression need to be elucidated in order to explain the differential clinical profiles between children and adults. Multi-system inflammatory syndrome in children (MIS-C) is an important condition to recognize in children. The decision to use antiviral or immunomodulatory therapy in a child or adolescent should be individualized based on the clinical scenario. Remdesivir is the only FDA-approved therapy available for children older than 12 years old who require hospitalization for COVID-19. CONCLUSION: Further studies are urgently required to address prevention and treatment in at-risk and infectedchildren, especially with underlying comorbidities. The chapter on the overall impact of COVID-19 in children has not yet been written. Nevertheless, SARS-CoV-2 has now joined a long list of human pandemics, which may forever change the world's history. This article is protected by copyright. All rights reserved.
Authors: Karen E A Burns; Matthew Laird; James Stevenson; Kimia Honarmand; David Granton; Michelle E Kho; Deborah Cook; Jan O Friedrich; Maureen O Meade; Mark Duffett; Dipayan Chaudhuri; Kuan Liu; Frederick D'Aragon; Arnav Agarwal; Neill K J Adhikari; Hayle Noh; Bram Rochwerg Journal: JAMA Netw Open Date: 2021-12-01