Çocuklarda Covid-19 enfeksiyonu tedavisi

Yıl 2022, Cilt: 15 Sayı: (Özel Sayı-1) 21. Mersin Pediatri Günleri Bildiri Kitabı, 1 - 6, 30.06.2022

Özlem Özgür Gündeşlioğlu

Öz

Koronavirüsler zarflı, tek zincirli RNA virüsleridir. İnsan koronavirüsleri 229E, OC43, NL63 ve HKU1 genellikle kendini sınırlayan, üst ve alt solunum yolu enfeksiyonlarına neden olurlar. Aralık 2019’da Çin’in Vuhan kentinde pnömoni ve akut solunum sıkıntısı sendromu gelişen olguların artışıyla birlikte bunun yeni bir koronovirüs alt tipi ile oluştuğu saptandı ve etken SARS-CoV-2 hastalık koronovirus hastalığı 19 (COVID-19) olarak adlandırıldı. 11 Mart 2020’de Dünya Sağlık Örgütü (DSÖ) tarafından pandemi olarak kabul edildi. Çocuklarda her yaş grubunda enfeksiyon görülmekte ancak yaş arttıkça COVID- 19 görülme sıklığının arttığı bildirilmiştir. Çocukların genellikle index vaka olan ev halkı üyelerinden enfekte olduğu bildirilmiştir. Çocuklarda COVID-19 erişkinlere kıyasla daha hafif seyirlidir. 18 çalışmanın değerlendirildiği bir meta analizde ise 20 yaş ve altı çocuk hastalarda asemptomatik enfeksiyon oranı %15-42 arasında bildirilmiştir. Ancak immun yetmezlik, altta yatan kronik hastalığı olan hastalarda ağır seyirli hastalık gelişmektedir. Çocuklarda halen COVID-19 tedavisi net olmayıp hasta bazlı tedavi önerilmektedir.

Anahtar Kelimeler

Covid-19, Çocuk, Tedavi

Kaynakça

• 1. Zimmermen P, Curtis N. Coronavirus Infections in Children Including COVID-19: An Overview of the Epidemiology, Clinical Features, Diagnosis, Treatment and Prevention Options in Children. Pediatr Infect Dis J. 2020;39:355-368.
• 2. World Health Organization. Coronavirus disease 2019 (COVID-19) Situation Report - 32. 2020. Available at: https://www.who.int/docs/defaultsource/ coronaviruse/situation-reports/20200221-sitrep-32-COVID-19. pdf?sfvrsn=4802d089_2. Accessed March 2, 2020.
• 3. Leidman E, Duca LM, Omura JD, Poroira K, Stephens JW, Sauber-Schatz EK. COVID 19 Trends Among Person Aged 0-24 Years-United States, March 1- December 12, 2020. MMWR Morb Mortal Wkly Rep. 2021; 70:88-94.
• 4. Dong Y, Mo X, Hu Y, Qi X, Jiang F, Jiang Z, et al. Epidemiological Characteristics of 2143 Pediatric Patients With 2019 Coronavirus Disease in China. Pediatrics doi: 10.1542/peds.2020-0702.
• 5. Hoang A, Chorath K, Moreira A, Evans M, Burmeister-Morton F, Burmeister F, et al. COVID-19 in 7780 pediatric patients: A Systematic Review. EClinicalMedicine. 2020 26;24:100433. doi: 10.1016/j.eclinm.2020.100433.
• 6. Viner RM, Ward JL, Hudson LD, Ashe M, Patel SV, Hargreaves D, et al. Systematic review of reviews of symptoms and signs of COVID-19 in children and adolescents. Arch Dis Child. 2020 Dec 17:archdischild-2020-320972. doi: 10.1136/archdischild-2020-320972.
• 7. Shekerdemian LS, Mahmood NR, Wolfe KK, Riggs BJ, Ross CE, McKiernan CA, et al. Characteristics and Outcomes of Children With Coronavirus Disease 2019 (COVID-19) Infection Admitted to US and Canadian Pediatric Intensive Care Units. JAMA Pediatr. 2020 Sep 1;174(9):868-873.
• 8. Götzinger F, Santiago-García B, Noguera-Julián A, Lanaspa M, Lancella L, Calò Carducci FI, et al. COVID-19 in children and adolescents in Europe: a multinational, multicentre cohort study. Lancet Child Adolesc Health. 2020 Sep;4(9):653-661.
• 9. Anastassopoulou C, Gkizarioti Z, Patrinos GP, Tsakris A. Human genetic factors associated with susceptibility to SARS-CoV-2 infection and COVID-19 disease severity. Hum Genomics. 2020 Oct 22;14(1):40. doi: 10.1186/s40246-020-00290-4.
• 10. World Health Organization. Diagnostic testing for SARS-CoV-2. Interim guidance. https://www.who.int/publications/i/item/diagnostic-testing-for-sars-cov-2 (Accessed on September 21, 2020).
• 11. Marin BG, Aghagoli G, Lavine K, Yang L, Siff EJ, Chiang SS et al, Predictors of COVID-19 severity: A literature review Rev Med Virol. 2021 ; 31(1): 1–10.
• 12. COVID-19 Treatment Guidelines Panel. Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. National Institutes of Health. Available at https://www.covid19treatmentguidelines.nih.gov/. (Accessed 19.03.2022)
• 13. Prada L, D Santos C, Baião RA, Costa J, Ferreira JJ, Caldeira D. Risk of SARS-CoV-2 Infection and COVID-19 Severity Associated With Exposure to Nonsteroidal Anti-Inflammatory Drugs: Systematic Review and Meta-Analysis. J Clin Pharmacol. 2021 Dec;61(12):1521-1533.
• 14. Deville JG, Song E, Quellette CP. Edwards MS (eds), Torchia MM (eds). COVID-19: Management in children. https://www.uptodate.com/contents/covid-19-management-in-children?search.
• 15. Bozzi G, Mangioni D, Minoia F, Aliberti S, Grasselli G, Barbetta L, et al. Anakinra combined with methylprednisolone in patients with severe COVID-19 pneumonia and hyperinflammation: An observational cohort study. J Allergy Clin Immunol. 2021 Feb;147(2):561-566.
• 16. United States Centers for Disease Control and Prevention. COVID-19. Ending isolation and precautions for people with COVID-19: Interim guidance. https://www.cdc.gov/coronavirus/2019-ncov/hcp/duration-isolation.html (Accessed on January 17, 2022).
• 17. Krammer F. SARS-CoV-2 vaccines in development. Nature 2020;586:516-27.