COVID-19 clinical manifestations in children and adolescents admitted to intensive care in the city of São Carlos: a case series
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Abstract
Introduction: Children with COVID-19 may be asymptomatic or present a heterogeneous clinical presentation. The present case series aimed to report clinical manifestations of COVID-19 in children and adolescents admitted to pediatric intensive care units (PICU) in the city of São Carlos, Brazil, during 2020 and 2021. Reports: The subjects were six children aged 3 months to 13 years, with COVID-19. The data were collected from electronic charts. All cases were domestic contact with a COVID-19 case. Two cases had multisystem inflammatory syndrome (MIS-C) and one had jaundice and ascites. One case had a seizure. One case required invasive ventilation and two cases presented gastrointestinal symptoms. There were no deaths in the cases. The length of PICU stays varied from one to 16 days. Conclusion: In the six cases reported, COVID-19 clinical manifestations in children and adolescents who required intensive care in São Carlos revealed a heterogeneous presentation and no lethality. It is worth emphasizing that a history of contact with a symptomatic respiratory person should guide the suspicion of COVID-19 in children and indicate a proper follow-up, as COVID-19 may be severe in this population.
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Rabha AC, Oliveira Junior FI, Oliveira TA, et al. Clinical manifestations of children and adolescents with covid-19: report of the first 115 cases from Sabará hospital infantil. Rev Paul Pediatr. 2020;39 e2020305. http://dx.doi.org/10.1590/1984-0462/2021/39/2020305
Sinaei R, Pezeshki S, Parvaresh S, Sinaei R. Why COVID‑19 is less frequent and severe in children: a narrative review. World J Pediatr. 2020;25:1-11. https://doi.org/10.1007/s12519-020-00392-y
Zimmermann P, Curtis N. Why is COVID-19 less severe in children? A review of the proposed mechanisms underlying the age-related difference in severity of SARS-CoV-2 infections. Arch Dis Child. 2021;106(5). http://dx.doi.org/10.1136/archdischild-2020-320338
Care Case Report Guidelines. CARE Checklist of information to include when writing a case report. Available from: https://static1.squarespace.com/static/5db7b349364ff063a6c58ab8/t/5db7bf175f869e5812fd4293/1572323098501/CARE-checklist-English-2013.pdf
World Health Organization (WHO). Multisystem inflammatory syndrome in children and adolescents with COVID-19: Scientific Brief. Available from: https://www.who.int/publications/i/item/multisystem-inflammatory-syndrome-in-children-and-adolescents-with-covid-19
Girona-Alarcon M, Bobillo-Perez S, Sole-Ribalta A, Hernandez L, Guitart C, Suarez R, et al. The different manifestations of COVID-19 in adults and children: a cohort study in an intensive care unit. BMC Infect Dis. 2021;21:87. https://doi.org/10.1186/s12879-021-05786-5
Rudan I, Adeloye D, Katikireddi SV, Murray J, Simpson C, et al. The COVID-19 pandemic in children and young people during 2020-2021: Learning about clinical presentation, patterns of spread, viral load, diagnosis and treatment. J Glob Health. 2021;11:01010. https://doi.org/10.7189/jogh.11.01010
Morparia K, Park MJ, Kalyanaraman M, McQueen D, Bergel M, Phatak T. Abdominal Imaging Findings in Critically Ill Children With Multisystem Inflammatory Syndrome Associated With COVID-19. Pediatr Infect Dis J. 2021;40(2):e82-3. https://doi.org/10.1097/INF.0000000000002967
Perez A, Kogan-Liberman D, Sheflin-Findling S, Raizner A, Ahuja KL, Ovchinsky N. Presentation of Severe Acute Respiratory Syndrome-Coronavirus 2 Infection as Cholestatic Jaundice in Two Healthy Adolescents. J Pediatr. 2020;226:278-80. https://doi.org/10.1016/j.jpeds.2020.07.054
Valderas C, Méndez G, Echeverría A, Suarez N, Júlio K, Sandoval F. COVID‑19 and neurologic manifestations: a synthesis from the child neurologist’s corner. World J Pediatr. 2022;18(6):373-82. https://doi.org/10.1007/s12519-022-00550-4
Gürlevik SL, Günbey C, Ozsurekci Y, Oygar PD, Kesici S, Gocmen R, et al. Neurologic manifestations in children with COVID-19 from a tertiary center in Turkey and literature review. Eur J Paediatr Neurol. 2022;37:139-54. https://doi.org/10.1016/j.ejpn.2022.02.003
Kurd M, Hashavya S, Benenson S, Gilboa T. Seizures as the main presenting manifestation of acute SARS-CoV-2 infection in children. Seizure. 2021;92:89-93. https://doi.org/10.1016/j.seizure.2021.08.017
Hillesheim D, Tomasi YT, Figueiró TH, Paiva, KM. Síndrome respiratória aguda grave por COVID-19 em crianças e adolescentes no Brasil: perfil dos óbitos e letalidade hospitalar até a 38a Semana Epidemiológica de 2020. Epidemiol Serv Saude. 2020;29(5):e2020644. https://doi.org/10.1590/S1679-49742020000500021
Tezer H, Deniz M. From asymptomatic to critical illness - different clinical manifestations of COVID-19 in children. Turk J Med Sci. 2021;51(SI-1):3262-72. https://doi.org/10.3906/sag-2106-168
Xing Y, Ni W, Wu Q, Li WJ, Li GJ, Wang WD, et al. Prolonged viral shedding in feces of pediatric patients with coronavirus disease 2019. J Microbiol Immunol Infect. 2020;53(3):473-80. https://doi.org/10.1016/j.jmii.2020.03.021