COVID-19 Pandemisine Pediatrik Yaklaşım

Öz

Yeni koronavirüs hastalığı (2019-nCoV, COVID-19) ilk kez Çin’de 2019 yılı sonlarında bildirilmiştir. Kısa sürede tüm dünyayı etkilemiş ve pandemi olarak kabul edilmiştir. Çocuklarda kliniği erişkinlere göre hafif seyretmektedir ve çocuklarda prognoz iyidir. Tanısı gerçek zamanlı polimeraz zincir reaksiyonu testi ile konulur. Çocuklarda spesifik laboratuvar testi yoktur. Bağışıklığı baskılanmış ve altta yatan hastalığı olan çocuklarda hastalık daha ağır seyreder. Şu an için çocuklarda COVID-19 enfeksiyonuna yönelik tedavi için yeterli ve kesinleşmiş veriler bulunmamaktadır. Bu derlemede güncel literatür bilgileri ışığında COVID-19 hastalığının çocuklarda epidemiyolojisi, kliniği, tanısı, tedavi yaklaşımları ve olası sık görülen temas durumlarına karşı korunma önlemlerinin sunulması amaçlanmıştır.

Anahtar Kelimeler

• Koronavirüs
• COVID-19
• Çocuk
• Pediatri

Pediatric Approach to COVID-19 Pandemic

Öz

The novel coronavirus disease (2019-nCoV, COVID-19) was first reported in China in late 2019. It has impacted the world in a short time and characterized as a pandemic. The clinical picture in children is milder than adults and prognosis are good in children. The diagnosis is made by a real-time polymerase chain reaction test. There is no specific laboratory test for COVID-19 infection in children. The disease progresses more severely in children with an underlying condition and immunocompromised children. There are currently no sufficient and conclusive data on treatment for COVID-19 infection in children. This review aims to present the epidemiology, clinical picture, diagnosis, treatment approaches, and possible preventive measures of COVID-19 disease in children in light of the current literature.

Anahtar Kelimeler

• Coronavirus, COVID-19, Child, Pediatrics

Kaynakça

1. 1. Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, Zhao X, Huang B, Shi W, Lu R, Niu P, Zhan F, Ma X, Wang D, Xu W, Wu G, Gao GF, Tan W. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382:727-733.
2. 2. World Health Organization. Coronavirus disease 2019 (COVID-19). Situation Report-51. (Erişim tarihi: 1 Mayıs 2020, https://apps.who.int/iris/handle/10665/331475).
3. 3. T.C Sağlık Bakanlığı. COVID-19 (SARS-CoV2 Enfeksiyonu) Rehberi. (Erişim tarihi: 1 Mayıs 2020, https://covid19.saglik. gov.tr/depo/rehberler/COVID-19_Rehberi.pdf).
4. 4. Choi S-H, Kim HW, Kang J-M, Kim DH, Cho EY. Epidemiology and clinical features of coronavirus disease 2019 in children. Clin Exp Pediatr. 2020;63(4):125-132.
5. 5. 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. The Lancet. 2020;395(10223):514- 523.
6. 6. Liu W, Zhang Q, Chen J, Xiang R, Song H, Shu S, et al. Detection of Covid-19 in children in early January 2020 in Wuhan, China. N Engl J Med. 2020;382(14):1370-1371.
7. 7. 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):670-673.
8. 8. Dong Y, Mo X, Hu Y, Qi X, Jiang F, Jiang Z, et al. Epidemiology of COVID-19 among children in China. Pediatrics. 2020;145(6):e20200702.

9. 9. Novel Coronavirus Pneumonia Emergency Response Epidemiology Team. Vital surveillances: The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19)-China, 2020. China CDC Weekly. 2020;2(8):113-122. (Erişim Tarihi: 2 Haziran 2020, https:// slma.lk/wp-content/uploads/2020/02/TheEpidemiologicalCh aracteristicsofanOutbreakof2019NovelCoronavirusDiseases2 8COVID-1929E28094China2C20201.pdf).
10. 10. Bi Q, Wu Y, Mei S, Ye C, Zou X, Zhang Z, et al. Epidemiology and transmission of COVID-19 in shenzhen China: Analysis of 391 cases and 1,286 of their close contacts. Lancet Infect Dis. 2020;20:911-919.
11. 11. Costi S, Caporali R, Cimaz R. Dealing with COVID-19 in a pediatric rheumatology unit in Italy. Paediatr Drugs. 2020;16(4):1-2.
12. 12. Centers for Disease Control and Prevention.Coronavirus Disease 2019 in Children - United States, February 12–April 2, 2020. MMWR Morb Mortal Wkly Rep. 2020;69:422–426. (Erişim Tarihi: 20 Mayıs 2020, https://www.cdc.gov/mmwr/ volumes/69/wr/mm6914e4.htm).
13. 13. Chen H, Guo J, Wang C, Luo F, Yu X, Zhang W, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. The Lancet. 2020;395(10226):809-815.
14. 14. Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, et al. Early transmission dynamics in Wuhan, China, of novel coronavirus– infected pneumonia. N Engl J Med. 2020;382:1199-1207.
15. 15. Cai J, Xu J, Lin D, Xu L, Qu Z, Zhang Y, et al. A Case Series of children with 2019 novel coronavirus infection: Clinical and epidemiological features. Clin Infect Dis. 2020;ciaa198.
16. 16. 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):1663-1665.
17. 17. Yonker LM, Shen K, Kinane TB. Lessons unfolding from pediatric cases of COVID‐19 disease caused by SARS‐CoV‐2 infection. Pediatric Pulmonology. 2020;55(5):1085-1086.
18. 18. 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):371-372.
19. 19. T.C Sağlık Bakanlığı. COVID-19 (SARS-CoV-2 Enfeksiyonu) (Bilim Kurulu Çalışması) Çocuk hasta yönetimi ve tedavi rehberi. (Erişim Tarihi: 10 Haziran 2020, https://covid19bilgi. saglik.gov.tr/tr/covid-19-rehberi.html).
20. 20. Verdoni L, Mazza A, Gervasoni A, Martelli L, Ruggeri M, Ciuffreda M, et al. An outbreak of severe Kawasaki-like disease at the Italian epicentre of the SARS-CoV-2 epidemic: An observational cohort study. Lancet. 2020;395:1771-1778.
21. 21. Toubiana J, Poirault C, Corsia A, Bajolle F, Fourgeaud J, Angoulvant F, et al. Kawasaki-like multisystem inflammatory syndrome in children during the covid-19 pandemic in Paris, France: Prospective observational study. BMJ. 2020;369:m2094.
22. 22. Mahase E. Covid-19: Cases of inflammatory syndrome in children surge after urgent alert. BMJ. 2020;369:m1990.
23. 23. Centers for Disease Control and Prevention. Multisystem inflammatory syndrome in children (MIS-C) associated with coronavirus disease 2019 (COVID-19). (Erişim Tarihi: 9 Haziran 2020, https://www.cdc.gov/mis-c/hcp/).
24. 24. World Health Organization. Coronavirus disease 2019 (COVID-19): situation report, 121. (Erişim Tarihi: 9 Haziran 2020, https://apps.who.int/iris/handle/10665/332156).
25. 25. Zimmermann 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(5):355-368.
26. 26. Chen, Z., Fu, J., Shu, Q. et al. Diagnosis and treatment recommendations for pediatric respiratory infection caused by the 2019 novel coronavirus. World J Pediatr. 2020;16(3):240- 246.
27. 27. Singhal, T. Review of Coronavirus Disease-2019 (COVID-19). Indian J Pediatr. 2020;87(4):281-286.
28. 28. Chiotos K, Hayes M, Kimberlin DW, Jones SB, James SH, Pinninti SG, et al. Multicenter initial guidance on use of antivirals for children with COVID-19/SARS-CoV-2. J Pediatric Infect Dis Soc. 2020;piaa045.
29. 29. Rawson TM, Moore LS, Zhu N, Ranganathan N, Skolimowska K, Gilchrist M, et al. Bacterial and fungal co-infection in individuals with coronavirus: A rapid review to support COVID-19 antimicrobial prescribing. Clin Infect Dis. 2020;ciaa530.
30. 30. Gao J, Tian Z, Yang X. Breakthrough: Chloroquine phosphate has shown apparent efficacy in treatment of COVID-19 associated pneumonia in clinical studies. Biosci Trends. 2020;14(1):72-73.
31. 31. Carlotti APdCP, Carvalho WBd, Johnston C, Rodriguez IS, Delgado AF. COVID-19 diagnostic and management protocol for pediatric patients. Clinics. 2020;75:e1894.
32. 32. Hennon TR, Penque MD, Abdul-Aziz R, Alibrahim OS, McGreevy MB, Prout AJ, Schaefer BA, Ambrusko SJ, Pastore JV, Turkovich SJ, Gomez-Duarte OG, Hicar MD. COVID-19 associated multisystem inflammatory syndrome in children (MIS-C) guidelines; A Western New York approach. Prog Pediatr Cardiol. 2020;23(4):101232.
33. 33. Rhodes A, Evans LE, Alhazzani W, Levy MM, Antonelli M, Ferrer R, et al. Surviving sepsis campaign: International guidelines for management of sepsis and septic shock: 2016. Intensive Care Med. 2017;43(3):304-77.
34. 34. Pain CE, Felsenstein S, Cleary G, et al. Novel paediatric presentation of COVID-19 with ARDS and cytokine storm syndrome without respiratory symptoms. Lancet Rheumatol. 2020;2(7):e376-e379.
35. 35. Bhimraj A, Morgan RL, Shumaker AH, Lavergne V, Baden L, Cheng VC-C, et al. Infectious diseases Society of America guidelines on the treatment and management of patients with COVID-19. Clin Infect Dis. 2020;ciaa478.
36. 36. Elshafeey F, Magdi R, Hindi N, Elshebiny M, Farrag N, Mahdy S, et al. A systematic scoping review of COVID‐19 during pregnancy and childbirth. Int J Gynaecol Obstet. 2020;150(1):47-52.
37. 37. Liu W, Wang J, Li W, Zhou Z, Liu S, Rong Z. Clinical characteristics of 19 neonates born to mothers with COVID-19. Front Med. 2020;14(2):193-198.
38. 38. Wu Y, Liu C, Dong L, Zhang C, Chen Y, Liu J, et al. Coronavirus disease 2019 among pregnant Chinese women: Case series data on the safety of vaginal birth and breastfeeding. BJOG. 2020;127(9):1109-1115.
39. 39. Centers for Disease Control and Prevention. Care for Breastfeeding Women. (Erişim Tarihi: 14 Haziran 2020, https://www.cdc.gov/coronavirus/2019-ncov/hcp/care-forbreastfeeding- women.html).
40. 40. Türk Neonatoloji Derneği. COVID-19 (SARS-CoV2) enfeksiyonu veya şüphesi olan yenidoğan bebeklere neonatal ve perinatal dönemde yaklaşım önerileri. (Erişim Tarihi: 14 Haziran 2020, https://www.neonatology.org.tr/ storage/2020/04/Untitled-attachment-00052.pdf).
41. 41. Esposito S, Principi N. To mask or not to mask children to overcome COVID-19. Eur J Pediatr. 2020;179(8):1267-1270.
42. 42. Centers for Disease Control and Prevention. Visiting Parks and Recreational Facilities. (Erişim Tarihi: 20 Haziran 2020, https:// www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/ visitors.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc. gov%2Fcoronavirus%2F2019-ncov%2Fcommunity%2Fparksrec% 2Fvisitors.html).
43. 43. T.C. Sağlık Bakanlığı. COVID-19 Salgın yönetimi ve çalışma rehberi. (Erişim Tarihi: 20 Haziran 2020, https://covid19bilgi. saglik.gov.tr/tr/salgin-yonetimi-ve-calisma-rehberi.html).