Diagnosis of Covid-19 in Children and Nursing Approach: A Systematic Review

Yıl 2021, , 98 - 106, 23.04.2021

Abdullah Sarman , Suat Tuncay , Emine Sarman

https://doi.org/10.30565/medalanya.843403

Cited By: 2

Öz

Aim: This study was carried out to summarize the systematic literature review on current information about Serious acute respiratory syndrome 2 (SARS-CoV-2 or Covid-19 in children and to determine nursing approach.

Methods: Regarding the research, 156 publications were examined between 21 Janu¬ary and 15 November 2020. The review was conducted with the key words of “SARS-CoV-2”, “coronavirus”, “Covid-19”, “child”, “nursing”, which are openly accessible on databases such as PubMed, Science Direct and the WHO.

Results: Covid-19 infection may be asymptomatic or characterized by fever and fatigue in children; they can be potential carriers of the disease. Several upper respiratory symp¬toms have been seen, such as nasal congestion and a runny nose. In some patients, abdominal pain, nausea, vomiting and diarrhea occurs. Fever and cough were evident in pediatric patients. As the condition progresses, dyspnea, cyanosis and other signs may arise after typically one week of the disease, along with systemic toxic signs, in¬cluding restlessness or malaise, decreased appetite, poor feeding and reduced activity. Children’s condition might progress quickly and turn to respiratory failure, which cannot be improved by conventional oxygen within 1-3 days. Metabolic acidosis, septic shock, irreversible bleeding and coagulation dysfunction can take place in such severe cases. However, Covid-19 may cause an inflammatory reaction in some children. Those start¬ing with gastrointestinal symptoms may progress to severe conditions and newborns whose mothers are infected with Covid-19 could have severe complications.

Conclusion: This systematic review has shown that children generally develop mild Covid-19 disease and these infections are often acquired through community sources. Diagnosis of the disease is difficult in children and there is limited data on children with Covid-19. The disease mainly causes fever, respiratory symptoms and other flu-like manifestations in children. The signs and symptoms of the disease should be carefully monitored. Nurses should know the course and symptoms of the disease well in children and take precautions.

Anahtar Kelimeler

2019-nCoV, care, child, covid-19, nursing

Çocuklarda Covid-19’un Tanılanmasında Hemşirelik Yaklaşımı: Sistematik Bir İnceleme

Öz

Amaç: Bu çalışma, çocuklarda ciddi akut solunum sendromu 2 (SARS-CoV-2 veya Covid-19) hakkındaki güncel literatürü sistematik olarak özetlemek ve hemşirelik yaklaşımını belirlemek amacıyla yapılmıştır.

Yöntem: Araştırmaya konu olan kısım ile ilgili olarak, 21 Ocak ve 15 Kasım 2020 tarihleri arasında 156 araştırmaya ulaşılmıştır. İnceleme PubMed, Science Direct ve WHO veri tabanlarında “SARS-CoV-2”, “koronavirüs”, “Covid-19”, “çocuk”, “hemşirelik” anahtar kelimeleri ile gerçekleştirilmiştir.

Bulgular: Covid-19 enfeksiyonu, çocuklarda asemptomatik olabilir ve hastalığın potansiyel taşıyıcıları olabilirler. Burun tıkanıklığı ve burun akıntısı gibi çeşitli üst solunum yolu semptomları görülür. Bazı hastalarda karın ağrısı, bulantı, kusma ve ishal görülür. Pediatrik hastalarda daha çok ateş ve öksürük görülmektedir. Durum ilerledikçe, huzursuzluk veya halsizlik, iştahsızlık, zayıf beslenme ve daha az aktivite gibi sistemik toksik belirtilerle birlikte tipik olarak hastalığın bir haftasından sonra dispne, siyanoz ve diğer belirtiler ortaya çıkabilir. Çocukların durumu hızlı bir şekilde ilerleyebilir ve 1-3 gün içinde geleneksel oksijenle düzeltilemeyen solunum yetmezliğine dönüşebilir. Metabolik asidoz, septik şok, geri döndürülemez kanama ve pıhtılaşma disfonksiyonu bu tür ağır vakalarda meydana gele-bilir. Bununla birlikte, Covid-19 bazı çocuklarda inflamatuar bir reaksiyona neden olabilir. Gastrointestinal semptomların görüldüğü çocuklarda ve anneleri Covid-19 ile enfekte olan yenidoğanlarda hastalığın ilerlemesiyle birlikte ciddi komplikasyonlar oluşabilir.

Sonuç: Bu sistematik derleme sonuçları çocuklarda Covid-19 hastalığının genellikle hafif geliştiğini ve bu enfeksiyonun genellikle toplum kaynaklı edinildiğini göstermiştir. Çocuklarda hastalığın tanısı zordur ve Covid-19’lu çocuklar hakkında sınırlı sayıda veri vardır. Bu hastalık, çocuklarda temel olarak ateş, solunum semptomları ve diğer grip benzeri belirtilere neden olur. Bu yüzden, hastalığın semptom ve belirtileri dikkatle izlenmelidir. Hemşireler çocuklarda hastalığın seyrini, semptomlarını iyi bilmeli ve önlem almalıdır.

Anahtar Kelimeler

2019-nCoV, bakım, çocuk, covid-19, hemşirelik

Kaynakça

• 1. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. E Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507-13. doi:10.1016/S0140-6736(20)30211-7.
• 2. Caselli D, Aricò M. 2019-nCoV: polite with children! Pediatr Rep. 2020;12(1):8495. doi: 10.4081/pr.2020.8495.
• 3. World Health Organization. Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19). https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf Accepted; 24 February 2020.
• 4. World Health Organization. Weekly epidemiological update-15 December 2020. https://www.who.int/publications/m/item/weekly-epidemiological-update---15-december-2020 Accepted; 15 December 2020.
• 5. World Health Organization. Weekly epidemiological update-8 December 2020. https://www.who.int/publications/m/item/weekly-epidemiological-update-8-december-2020 Accepted; 8 December 2020.
• 6. Kelvin AA, Halperin S. Covid-19 in children: the link in the transmission chain. Lancet Infect Dis 2020;20(6):633-4. doi: 10.1016/S1473-3099(20)30236-X.
• 7. Bhuiyan MU, Stiboy E, Hassan MZ, Chan M, Islam MS, Haider N, et al. Epidemiology of Covid-19 infection in young children under five years: a systematic review and meta-analysis. Vaccine. 2021;39(4):667-77. doi: 10.1016/j.vaccine.2020.11.078.
• 8. An P, Zhang M. Novel coronavirus SARS-CoV-2: familial spread resulting in Covid-19 pneumonia in a pediatric patient. Diagn Interv Radiol. 2020;26(3):262-3. doi: 10.5152/dir.2020.20157.
• 9. Hong H, Wang Y, Chung H-T, Chen C-J. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506. doi: 10.1016/S0140-6736(20)30183-5.
• 10. Sun D, Li H, Lu X-X, Xiao H, Ren J, Zhang F-R, et al. Clinical features of severe pediatric patients with coronavirus disease 2019 in Wuhan: a single center’s observational study. World J Pediatr. 2020;16(3):251-9. doi: 10.1007/s12519-020-00354-4.
• 11. Weaver MS, Wiener L. Applying palliative care principles to communicate with children about Covid-19. J Pain Symptom Manage. 2020;60(1):e8-11. doi: 10.1016/j.jpainsymman.2020.03.020.
• 12. Edmonson C, McCarthy C, Trent-Adams S, McCain C, & Marshall J. Emerging global health issues: a nurse’s role. OJIN: Online J Issues Nurs. 2017;22(1):2. doi: 10.3912/OJIN.Vol22No01Man02.
• 13. Chan JF-W, Yuan S, Kok K-H, To KK-W, Chu H, Yang J, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet. 2020;395(10223):514-23. doi: 10.1016/S0140-6736(20)30154-9.
• 14. Novel Coronavirus Pneumonia Emergency Response Epidemiology Team. The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (Covid-19) in China. Zhonghua Liu Xing Bing Xue Za Zhi. 2020;41(2):145-51. doi: 10.3760/cma.j.issn.0254-6450.2020.02.003.
• 15. Lee P-I, Hu Y-L, Chen P-Y, Huang Y-C, Hsueh P-R. Are children less susceptible to Covid-19? J Microbiol Immunol Infect. 2020;53(3):371-2. doi: 10.1016/j.jmii.2020.02.011.
• 16. Cao Q, Chen Y-C, Chen C-L, Chiu C-H. SARS-CoV-2 infection in children: transmission dynamics and clinical characteristics. J Formos Med Assoc. 2020;119(3):670-3. doi: 10.1016/j.jfma.2020.02.009.
• 17. Ma X, Su L, Zhang Y, Zhang X, Gai Z, Zhang Z. Do children need a longer time to shed SARS-CoV-2 in stool than adults? J Microbiol Immunol Infect. 2020;53(3):373-76. doi: 10.1016/j.jmii.2020.03.010.
• 18. Pediatric Committee, Medical Association of Chinese People’s Liberation Army EC of CJ of CP. Emergency response plan for the neonatal intensive care unit during epidemic of 2019 novel coronavirus. Zhongguo Dang Dai Er Ke Za Zhi. 2020;22(2):91-5. doi: 10.7499/j.issn.1008-8830.2020.02.002.
• 19. Pediatric Branch of Hubei Medical Association Pediatric Branch of Wuhan Medical Association Pediatric Medical Quality Control Center of Hubei. Recommendation for the diagnosis and treatment of novel coronavirus infection in children in Hubei (Trial version 1). Zhongguo Dang Dai Er Ke Za Zhi. 2020;22(2):96-9. doi: 10.7499/j.issn.1008-8830.2020.02.003.
• 20. Wan Y, Shang J, Graham R, Baric RS, Li F. Receptor recognition by novel coronavirus from Wuhan: an analysis based on decade-long structural studies of SARS. J Virol. 2020;94(7):e00127-20. doi: 10.1128/JVI.00127-20.
• 21. Zheng F, Liao C, Fan Q-H, Chen H-B, Zhao X-G, Xie Z-G, et al. Clinical characteristics of children with coronavirus disease 2019 in Hubei, China. Curr Med Sci. 2020;40(2):275-80. doi: 10.1007/s11596-020-2172-6.
• 22. Qiu H, Wu J, Hong L, Luo Y, Song Q, Chen D. Clinical and epidemiological features of 36 children with coronavirus disease 2019 (Covid-19) in Zhejiang, China: an observational cohort study. Lancet Infect Dis. 2020;20(6):689-96. doi: 10.1016/S1473-3099(20)30198-5.
• 23. Le HT, Nguyen L V, Tran DM, Do HT, Tran HT, Le YT, et al. The first infant case of Covid-19 acquired from a secondary transmission in Vietnam. Lancet Child Adolesc Health. 2020;4(5):405-6. doi: 10.1016/S2352-4642(20)30091-2.
• 24. Ji L-N, Chao S, Wang Y-J, Li X-J, Mu X-D, Lin M-G, et al. Clinical features of pediatric patients with Covid-19: a report of two family cluster cases. World J Pediatr. 2020;16(3):267-70. doi: 10.1007/s12519-020-00356-2.
• 25. Cui Y, Tian M, Huang D, Wang X, Huang Y, Fan L, et al. A 55-day-old female infant infected with Covid-19: presenting with pneumonia, liver injury, and heart damage. J Infect Dis. 2020;221(11):1775-81. doi: 10.1093/infdis/jiaa113.
• 26. Wang D, Ju XL, Xie F, Lu Y, Li FY, Huang HH, et al. Clinical analysis of 31 cases of 2019 novel coronavirus infection in children from six provinces (autonomous region) of northern China. Zhonghua Er Ke Za Zhi. 2020;58(4):269-74. doi: 10.3760/cma.j.cn112140-20200225-00138.
• 27. Lu X, Zhang L, Du H, Zhang J, Li YY, Qu J, et al. SARS-CoV-2 infection in children. N Engl J Med. 2020;382(17):1663-5. doi: 10.1056/NEJMc2005073.
• 28. Xu Y, Li X, Zhu B, Liang H, Fang C, Gong Y, et al. Characteristics of pediatric SARS-CoV-2 infection and potential evidence for persistent fecal viral shedding. Nat Med. 2020;26(4):502-5. doi: 10.1038/s41591-020-0817-4.
• 29. Liu Z, Magal P, Seydi O, Webb G. Understanding unreported cases in the Covid-19 epidemic outbreak in Wuhan, China, and the importance of major public health interventions. Biology. 2020;9(3):50. doi: 10.3390/biology9030050.
• 30. Liu H, Liu F, Li J, Zhang T, Wang D, Lan W. Clinical and CT imaging features of the Covid-19 pneumonia: focus on pregnant women and children. J Infect. 2020;80(5):e7-13. doi: 10.1016/j.jinf.2020.03.007.
• 31. Tang A, Tong Z, Wang H, Dai Y, Li K, Liu J, et al. Detection of novel coronavirus by RT-PCR in stool specimen from asymptomatic child, China. Emerg Infect Dis. 2020;26(6):1337-9. doi: 10.3201/eid2606.200301.
• 32. Cai SJ, Wu LL, Chen DF, Li YX, Liu YJ, Fan YQ, et al. Analysis of bronchoscope-guided tracheal intubation in 12 cases with Covid-19 under the personal protective equipment with positive pressure protective hood. Zhonghua Jie He He Hu Xi Za Zhi. 2020;43(4):332-4. doi: 10.3760/cma.j.cn112147-20200222-00153.
• 33. Wang J, Qi H, Bao L, Li F, Shi Y. A contingency plan for the management of the 2019 novel coronavirus outbreak in neonatal intensive care units. Lancet Child Adolesc Health. 2020;4(4):258-9. doi: 10.1016/S2352-4642(20)30040-7.
• 34. Liew MF, Siow WT, MacLaren G, See KC. Preparing for Covid-19: early experience from an intensive care unit in Singapore. Crit Care. 2020;24(1):83. doi: 10.1186/s13054-020-2814-x.
• 35. Li F, Feng ZC, Shi Y. Proposal for prevention and control of the 2019 novel coronavirus disease in newborn infants. Arch Dis Child Fetal Neonatal Ed. 2020;105(6):683-4. doi: 10.1136/archdischild-2020-318996.
• 36. Marraro GA, Spada C. Consideration of the respiratory support strategy of severe acute respiratory failure caused by SARS-CoV-2 infection in children. Zhongguo Dang Dai Er Ke Za Zhi. 2020;22(3):183-94. doi: 10.7499/j.issn.1008-8830.2020.03.002.
• 37. Wang Y, Zhu L-Q. Pharmaceutical care recommendations for antiviral treatments in children with coronavirus disease 2019. World J Pediatr. 2020;16(3):271-4. doi: 10.1007/s12519-020-00353-5.
• 38. Totura AL, Bavari S. Broad-spectrum coronavirus antiviral drug discovery. Expert Opin Drug Discov. 2019;14(4):397-412. doi: 10.1080/17460441.2019.1581171.
• 39. Wang J, Shi Y. Managing neonates with respiratory failure due to SARS-CoV-2-authors’ reply. Lancet Child Adolesc Health. 2020;4(4):e9. doi: 10.1016/S2352-4642(20)30072-9.
• 40. Hong H, Wang Y, Chung H-T, Chen C-J. Clinical characteristics of novel coronavirus disease 2019 (Covid-19) in newborns, infants and children. Pediatr Neonatol. 2020;61(2):131-2. doi: 10.1016/j.pedneo.2020.03.001.
• 41. Zhang G-X, Zhang A-M, Huang L, Cheng L-Y, Liu Z-X, Peng X-L, et al. Twin girls infected with SARS-CoV-2. Zhongguo Dang Dai Er Ke Za Zhi. 2020;22(3):221-5. doi: 10.7499/j.issn.1008-8830.2020.03.008.
• 42. International Working Group on Financing Preparedness. From Panic and Neglect to Investing in Health Security: Financing Pandemic Preparedness at A National Level (English). Washington, DC: World Bank; 2017.
• 43. Corless IB, Nardi D, Milstead JA, Larson E, Nokes KM, Orsega S, et al. Expanding nursing’s role in responding to global pandemics 5/14/2018. Nurs Outlook. 2018;66(4):412-5. doi: 10.1016/j.outlook.2018.06.003.
• 44. Ludvigsson JF. Systematic review of Covid-19 in children show milder cases and a better prognosis than adults. Acta Paediatr. 2020;109:1088-95. doi: 10.1111/apa.15270.
• 45. Chen Y, Liu Q, Guo D. Emerging coronaviruses: genome structure, replication, and pathogenesis. J Med Virol. 2020;92(4):418-23. doi: 10.1002/jmv.25681.
• 46. Wang L-S, Hu X-J, Zhou W-H. . An interpretation on perinatal and neonatal management plan for prevention and control of SARS-CoV-2 infection (2nd Edition). Zhongguo Dang Dai Er Ke Za Zhi. 2020;22(3):199-204. doi: 10.7499/j.issn.1008-8830.2020.03.004.
• 47. World Health Organization. Infection Prevention and Control During Health Care When Novel Coronavirus (nCoV) Infection is Suspected. https://www.who.int/publications-detail-redirect/10665-331495 Accepted; 19 March 2020.
• 48. Cai J, Xu J, Lin D, Yang Z, Xu L, Qu Z, et al. A case series of children with 2019 novel coronavirus infection: clinical and epidemiological features. Clin Infect Dis. 2020;71(6):1547-51. doi: 10.1093/cid/ciaa198.
• 49. Loutfy MR, Wallington T, Rutledge T, Mederski B, Rose K, Kwolek S, et al. Hospital preparedness and SARS. Emerg Infect Dis. 2004;10(5):771-6. doi: 10.3201/eid1005.030717.
• 50. Chen Z, DU L-Z, Fu J-F, Shu Q, Chen Z-M, Shi L-P, et al. Emergency plan for inter-hospital transfer of newborns with SARS-CoV-2 infection. Zhongguo Dang Dai Er Ke Za Zhi. 2020;22(3):226-30. doi: 10.7499/j.issn.1008-8830.2020.03.009.
• 51. Chen Z-M, Fu J-F, Shu Q, Chen Y-H, Hua C-Z, Li F-B, et al. Diagnosis and treatment recommendations for pediatric respiratory infection caused by the 2019 novel coronavirus. World J Pediatr. 2020;16(3):240-6. doi: 10.1007/s12519-020-00345-5.
• 52. Vessey JA, Betz CL. Everything old is new again: Covid-19 and public health. J Pediatr Nurs. 2020;52:A7-8. doi: 10.1016/j.pedn.2020.03.014.
• 53. Sarman A, Tuncay S. Principles of approach to suspected or infected patients related Covid‐19 in newborn intensive care unit and pediatric intensive care unit. Perspect Psychiatr Care. 2020. [Epub ahead of print] doi: 10.1111/ppc.12643.