COVID-19 Pandemisine Pediatrik Yaklaşım
Yıl 2020,
Cilt: 4 Sayı: 2, 170 - 176, 30.08.2020
Hakan Kardeş
,
Zühal Örnek
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.
Kaynakça
- 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. Mahase E. Covid-19: Cases of inflammatory syndrome in
children surge after urgent alert. BMJ. 2020;369:m1990.
- 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. 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. 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. 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. Singhal, T. Review of Coronavirus Disease-2019 (COVID-19).
Indian J Pediatr. 2020;87(4):281-286.
- 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. 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. 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. Carlotti APdCP, Carvalho WBd, Johnston C, Rodriguez IS,
Delgado AF. COVID-19 diagnostic and management protocol
for pediatric patients. Clinics. 2020;75:e1894.
- 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. 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. 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. 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. 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. 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. 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. 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. 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. Esposito S, Principi N. To mask or not to mask children to
overcome COVID-19. Eur J Pediatr. 2020;179(8):1267-1270.
- 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. 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).
Pediatric Approach to COVID-19 Pandemic
Yıl 2020,
Cilt: 4 Sayı: 2, 170 - 176, 30.08.2020
Hakan Kardeş
,
Zühal Örnek
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.
Kaynakça
- 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. Mahase E. Covid-19: Cases of inflammatory syndrome in
children surge after urgent alert. BMJ. 2020;369:m1990.
- 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. 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. 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. 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. Singhal, T. Review of Coronavirus Disease-2019 (COVID-19).
Indian J Pediatr. 2020;87(4):281-286.
- 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. 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. 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. Carlotti APdCP, Carvalho WBd, Johnston C, Rodriguez IS,
Delgado AF. COVID-19 diagnostic and management protocol
for pediatric patients. Clinics. 2020;75:e1894.
- 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. 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. 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. 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. 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. 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. 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. 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. 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. Esposito S, Principi N. To mask or not to mask children to
overcome COVID-19. Eur J Pediatr. 2020;179(8):1267-1270.
- 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. 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).