scholarly journals Coronavirus Desease 2019 (COVID-19) in Children: Lessons from Pediatric Rheumatology

2020 ◽  
Vol 58 (5) ◽  
pp. 469-479
Author(s):  
M. I. Kaleda ◽  
I. P. Nikishina ◽  
E. S. Fedorov ◽  
E. L. Nasonov

The clinical presentation and outcomes of infection with the novel coronavirus (COVID-19) are characterized by exceptional variability in manifestations, which depend on many factors, one of which is the patient’s age. One of the severe life-threatening manifestations in adults is severe acute respiratory syndrome (SARS-CoV-2), in some cases accompanied by the development of multiple organ failure. During the first two to three months of the COVID-19 pandemic, the global medical community was of the opinion that this disease in children is usually mild and not fatal. However, with the accumulation of new information, it became clear that there is a growing recognition of the existence of multisystem inflammatory syndrome in children, chronologically associated with SARS-CoV-2, which can lead to serious consequences. The article presents the main epidemiological, clinical and laboratory characteristics of the syndrome, as well as discusses the issues of its pathogenesis, differential diagnosis with a number of other acute conditions associated with an dysbalance of cytokines.

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 977-982
Author(s):  
Mohamed J. Saadh ◽  
Bashar Haj Rashid M ◽  
Roa’a Matar ◽  
Sajeda Riyad Aldibs ◽  
Hala Sbaih ◽  
...  

SARS-COV2 virus causes Coronavirus disease (COVID-19) and represents the causative agent of a potentially fatal disease that is of great global public health concern. The novel coronavirus (2019) was discovered in 2019 in Wuhan, the market of the wet animal, China with viral pneumonia cases and is life-threatening. Today, WHO announces COVID-19 outbreak as a pandemic. COVID-19 is likely to be zoonotic. It is transmitted from bats as intermediary animals to human. Also, the virus is transmitted from human to human who is in close contact with others. The computerized tomographic chest scan is usually abnormal even in those with no symptoms or mild disease. Treatment is nearly supportive; the role of antiviral agents is yet to be established. The SARS-COV2 virus spreads faster than its two ancestors, the SARS-CoV and Middle East respiratory syndrome coronavirus (MERS-CoV), but has lower fatality. In this article, we aimed to summarize the transmission, symptoms, pathogenesis, diagnosis, treatment, and vaccine to control the spread of this fatal disease.


2021 ◽  
pp. 014556132110060
Author(s):  
Jérôme R. Lechien ◽  
Rémi Hervochon ◽  
Stéphane Hans

A 42-year-old man was referred for a week history of severe dysphagia, odynophagia, fever (39 °C), fatigue, abdominal pain, pharyngeal swelling, and multiple neck lymphadenopathies. The medical history reported a mild form of COVID-19 one month ago. The biology reported an unspecified inflammatory syndrome. The patient developed peritonitis, myocarditis, and hepatitis. A myocardium biopsy was performed. A diagnosis of Kawasaki-like disease (KLD) was performed. The occurrence of KLD in adults is rare but has to be known by otolaryngologists regarding the otolaryngological clinical presentation that may precede the multiple organ failure.


2021 ◽  
Vol 13 ◽  
Author(s):  
Sabitha Vadakedath ◽  
Venkataramana Kandi ◽  
Tarun Kumar Suvvari ◽  
L V Simhachalam Kutikuppala ◽  
Vikram Godishala ◽  
...  

: The novel Coronavirus (SARS-CoV-2) that has emerged and spread throughout the world causing CoV disease-19 (COVID-19) has since its discovery affected not only humans and animals but also the environment. Because of the highly infectious nature of the virus, and the respiratory aerosol transmission route, face masks and personal protective equipment have become mandatory for public and healthcare workers, respectively. Also, the complex nature of the pathogenicity of the virus, wherein, it has been associated with mild, moderate, and severe life-threatening infections, has warranted increased laboratory testing and placing the infected people in isolation and under constant observation in quarantine centers or at dedicated hospitals. Some infected people, who are generally healthy, and do not show symptoms have been placed in home quarantines. At this juncture, there has been increased amount of biomedical waste (BMW), and infectious general waste along with plastic disposable recyclable and non-recyclable waste. The increased BMW along with the potentially hazardous plastic waste collection, segregation, transport, and disposal has assumed increased significance during the ongoing pandemic. Therefore, this review attempts to investigate the current scenario of BMW management and strategies to minimize BMW and prevent potential environmental pollution.


2011 ◽  
Vol 23 (1) ◽  
pp. 90-96 ◽  
Author(s):  
A.R. Tappuni

Immune reconstitution inflammatory syndrome (IRIS) is a phenomenon observed in patients recovering from immunodeficiency. The clinical presentation of IRIS involves the unmasking of covert infections or the worsening of overt conditions. Several causes and pathways have been suggested, most recognizing an inflammatory flare component occurring in the context of rapid immune reconstitution. In HIV-infected patients, IRIS inadvertently occurs as the consequence of successful antiretroviral therapy, and it is affiliated with improvement of the immune function, complicating the course of the disease and presenting treatment challenges to clinicians. The pathogenesis of IRIS is poorly understood, but in recovering HIV patients, its initiation and progression seem to be primarily linked to an increase in CD4+ T-helper and CD8+ T-suppressor cell count and a reduction in T-regulatory cells, all endorsed by exaggerated cytokine release and activity. The clinical presentation of IRIS is usually atypical. The manifestations depend on the trigger antigen, which can be an infective agent (viable or nonviable), a host antigen, or a tumor antigen. Most IRIS cases are self-limiting, but a few cases can be overwhelming and life-threatening; hence, early recognition is important. In most cases, there is no need to discontinue the antiretroviral therapy, although in the more severe cases, other clinical intervention may be necessary.


Blood ◽  
2020 ◽  
Vol 136 (11) ◽  
pp. 1330-1341 ◽  
Author(s):  
Eugenio D. Hottz ◽  
Isaclaudia G. Azevedo-Quintanilha ◽  
Lohanna Palhinha ◽  
Lívia Teixeira ◽  
Ester A. Barreto ◽  
...  

Abstract Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an emergent pathogen responsible for the coronavirus disease 2019 (COVID-19). Since its emergence, the novel coronavirus has rapidly achieved pandemic proportions causing remarkably increased morbidity and mortality around the world. A hypercoagulability state has been reported as a major pathologic event in COVID-19, and thromboembolic complications listed among life-threatening complications of the disease. Platelets are chief effector cells of hemostasis and pathological thrombosis. However, the participation of platelets in the pathogenesis of COVID-19 remains elusive. This report demonstrates that increased platelet activation and platelet-monocyte aggregate formation are observed in severe COVID-19 patients, but not in patients presenting mild COVID-19 syndrome. In addition, exposure to plasma from severe COVID-19 patients increased the activation of control platelets ex vivo. In our cohort of COVID-19 patients admitted to the intensive care unit, platelet-monocyte interaction was strongly associated with tissue factor (TF) expression by the monocytes. Platelet activation and monocyte TF expression were associated with markers of coagulation exacerbation as fibrinogen and D-dimers, and were increased in patients requiring invasive mechanical ventilation or patients who evolved with in-hospital mortality. Finally, platelets from severe COVID-19 patients were able to induce TF expression ex vivo in monocytes from healthy volunteers, a phenomenon that was inhibited by platelet P-selectin neutralization or integrin αIIb/β3 blocking with the aggregation inhibitor abciximab. Altogether, these data shed light on new pathological mechanisms involving platelet activation and platelet-dependent monocyte TF expression, which were associated with COVID-19 severity and mortality.


BioTechniques ◽  
2020 ◽  
Vol 69 (2) ◽  
pp. 108-112 ◽  
Author(s):  
Bijun Cheng ◽  
Tianjiao Li

The outbreak of viral pneumonia caused by the novel coronavirus SARS-CoV-2 that began in December 2019 caused high mortality. It has been suggested that the main protease (Mpro) of SARS-CoV-2 may be an important target to discover pharmaceutical compounds for the therapy of this life-threatening disease. Remdesivir, ritonavir and chloroquine have all been reported to play a role in suppressing SARS-CoV-2. Here, we applied a molecular docking method to study the binding stability of these drugs with SARS-CoV-2 Mpro. It appeared that the ligand–protein binding stability of the alliin and SARS-CoV-2 Mpro complex was better than others. The results suggested that alliin may serve as a good candidate as an inhibitor of SARS-CoV-2 Mpro. Therefore, the present research may provide some meaningful guidance for the prevention and treatment of SARS-CoV-2.


2020 ◽  
Vol 7 (1) ◽  
pp. 062-071
Author(s):  
Beatriz Gasser ◽  
Ricardo Andres Ramirez Uscategui

Since discovery of the novel coronavirus (SARS-CoV-2) in December of 2019, this viral pneumonia originated in Wuhan, China quickly spread around the world. This new disease, called COVID-19 can cause Acute Respiratory Distress Syndrome (ARDS) due to an uncontrolled inflammatory response like sepsis, that leads to multiple organ failure and even death. Several pharmacotherapeutics alternatives are being tested over the world, looking for most diverse drugs that might be able to fight the infection. The objective of this paper is to review the main pharmacotherapeutics techniques development, as remdesivir, chloroquine/hydroxychloroquine, lopinavir plus ritonavir, interferon-β, ivermectin, anticoagulants, convalescent plasma and vaccine, currently undergoing clinical trials in order to evaluate its effectiveness and safety to combat the COVID-19, presenting their characteristics, possible adverse effects and main scientific findings of its potential action. In conclusion, some therapies presented promising in-vitro results or in the treatment of some patients, nonetheless, multicentric blinded placebo controlled clinical trials are necessary to determine their effectiveness, safety, dosage, and best time point of treatment.


2021 ◽  
Vol 7 (4) ◽  
pp. 218-220
Author(s):  
Raghavendra H Gobbur ◽  
Ranjima M Mahesh

As COVID-19 continues to spread in India and other countries, the impact of the disease among children, initially considered less important, is becoming more relevant. The extent of the diversity of clinical presentation of COVID-19 in children are still unclear. We have already seen a new clinical picture of SARS-CoV-2 in children manifesting as a hyper-inflammatory syndrome, with multi-organ involvement similar to Kawasaki Disease and with potential evolution to a shock syndrome. This represented a new phenomenon affecting previously asymptomatic children with SARS-CoV-2 infection. COVID-19 may also manifest as viral hepatitis, acute pancreatitis, acute liver injury, acute kidney injury, ARDS, Sepsis, septic shock and meningo-encephalitis and cerebellar ataxia. The Multisystem Inflammatory Syndrome in Children (MIS-C) associated with SARS-CoV-2 infection occurs weeks after infection and may evolve unnoticed. MIS-Cs pathophysiology remains unclear. However, it appears to be a postinfectious hyperimmune response that may occur during or following asymptomatic or symptomatic infection. COVID-19 infection in children may lead to a potentially life threatening condition that we may not be aware of. We are in need of reporting of the diverse presentation of SARS CoV-2 virus in children. Here we describe a case of a previously normal 14-year-old boy who manifested with severe pain abdomen after SARS CoV-2 infection and was diagnosed as Acute Ileocolitis secondary to COVID-19. Child improved with steroid therapy and was asymptomatic after 3 weeks of treatment.


Author(s):  
Emrah Gün ◽  
Tanıl Kendirli ◽  
Edin Botan ◽  
Berrin Demir ◽  
Ergun Ergün ◽  
...  

Abstract Objective Multisystemic inflammatory syndrome in children (MIS-C) is characterized by persistent fever, systemic hyperinflammation, and multiple-organ dysfunction. There are a few reports about MIS-C presenting with acute abdomen. The aim of this study is to demonstrate the clinical characteristics and treatment options for MIS-C-related acute abdomen and appendicitis. Methods This was a retrospective study conducted between April 2020 and October 2020 in our pediatric intensive care unit in Turkey. Patients between the ages of 1 month and 18 years who presented with acute abdomen and were ultimately diagnosed with MIS-C were included. Results Seven patients with a median age of 12.5 (interquartile range 10.5–13) years were enrolled. Four were females. The most frequent symptoms were fever, abdominal pain, and vomiting. Three patients had involvement of the appendix that required surgical intervention. All pathology reports were compatible with appendicitis. The other patients also had an acute abdomen. One patient had malignant hyperthermia during induction of anesthesia, so surgery was postponed and medical management was commenced. The clinical picture regressed with immunomodulation. All patients were treated with intravenous immunoglobulin and steroids. Four patients with acute abdomens improved with immunomodulation, and surgery was not needed. Conclusion MIS-C may present with an acute abdomen. Immunomodulation should be considered instead of surgery if the clinical course is not complicated.


Author(s):  
S. O. Yastremska ◽  
O. M. Krekhovska-Lepiavko ◽  
B. A. Lokay ◽  
O. V. Bushtynska ◽  
S. V. Danchak

Summary. The first known case of infection from the novel coronavirus was recorded almost one year ago, in China’s Hubei province. The city of Wuhan was infamous the world over as the original virus epicenter, seeing more than half of China’s reported cases and deaths. The outbreak of COVID-19 virus, as sickened more than 14.7 million people. At least 610.200 people have died. The aim of the study – to analyze and systematize the literature data about the influence of chronic diseases on the manifestation of COVID-19 infection. Materials and Methods. The study uses publications of the world scientific literature on COVID-19 infection, in particular the causes and mechanisms of its development, treatment, complications and its consequences as well as the influence of different chronic disorders on the course of COVID-19. Results. A sample of patients hospitalized with COVID-19 across 14 states of the USA in March was analyzed by The Centers for Disease Control and Prevention. It was found that many (89 %) had underlying health problem and 94 % of patients were at the age 65 and older. The case fatality rate for those under age 60 was 1.4 percent. For those over age 60, the fatality rate jumps to 4.5 percent. The older the population, the higher the fatality rate. For those 80 and over, Covid-19 appears to have a 13.4 percent fatality rate. Moreover, it was recognized, that older adults don't present in a typical way of the course of different disorders, and we're seeing that with Covid-19 as well. Conclusions. Chronic diseases and conditions are on the rise worldwide. COVID-19 became the most challenging pandemic influencing all countries worldwide. Chronic diseases are suggested to be one of the main causes of different life-threatening complications of COVID-19 infection and one of the main factors of poor prognosis for the patients.


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