COVID-19 in the Paediatric Population: Difference between revisions
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== Introduction == | == Introduction == | ||
As the SARS-CoV-2 virus (COVID-19) has spread across the globe | As the SARS-CoV-2 virus (COVID-19) has spread across the globe it has presented unique challenges for every population it has impacted. While the impacts, symptom, and long term implications have been variable, one thing is clear, the virus will continue to effect many aspect of healthcare for some time. Given this, it is important for providers to recognize the unique ways that COVID-19 impacts the populations they work with. The following page will focus on the impacts of COVID-19 on the paediatric population, exploring some of the unique aspects that the virus presents in this diverse group of patients.<br> | ||
== Characteristics and Clinical Presentation == | == Characteristics and Clinical Presentation == | ||
Generally speaking, COVID-19 has presented trends suggesting that it is less | Generally speaking, COVID-19 has presented trends suggesting that it is less severe in the paediatric and adolescent populations (<19 years of age) when compared to adult populations. However, as new variants develop and spread through both developed and undeveloped countries, reports of complications such as multi-system inflammatory syndrome (MIS-C) and others have been reported. Additionally, the impacts of prior and current public response, restrictions, and fear presented by the virus itself is only now being recognized as aspects of routine care such as vaccination and annual check-ups were and still are being disrupted. | ||
Data | <u>'''Data and Trends from the Early Years of the Pandemic'''</u> | ||
While much focus was placed on the adult and older adult populations during the early days of the pandemic, a multitude of studies using data collected during this period now offer intriguing insights as to how the burgeoning virus impacted paediatric patients as well. | |||
Given the increased virulence of SARS-CoV-2, the question has been raised as to why children and adolescents do not represent a higher percentage of cases given that their immune systems are relatively less developed than adults. Several explanations have been suggested for this trend. The first suggested hypothesis is based on the involvement of one specific cellular signaling process that the virus takes advantage of (ACE2 receptors and protease TMPRSS2) | Data sets from 2020-2021 largely showed trends suggestive of lower illness severity and mortality among paediatric patients, with these cases accounting for between 1% and 10% of total cases. With this, the greatest distribution of infections in children tended to center around school-aged individuals. Worldwide for this time period, data from China, Korea, Spain, Italy, and the United States collectively supported this consensus for an age group that included individuals <19 years of age.<ref name=":0">Kammoun, R, and K Masmoudi. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7212977/ Paediatric aspects of COVID-19: An update]. Respiratory medicine and research. 2020; 78: 100765.</ref><ref name=":1" /> | ||
'''<u>Presentation of COVID-19 in Children and Adolescents</u>''' | |||
In the younger population, signs and symptoms of COVID-19, based on data from the early pandemic, tended to be more variable compared with infected adults. In general, the most common symptoms were fever and a cough, however, other complaints frequently included nausea/vomiting, diarrhea, nasal congestion, and shortness of breath. Asymptomatic presentations also tended to occur more often with this population compared to adults. Additionally, development of severe cases was also lower among children, with these cases generally felling in the age groups of <1 year and 10-14 years of age. It is suggested that factors including viral load and comorbidities such as asthma, immune-suppression (i.e. cancer treatment), and congenital heart disease were predictive of increased risk of sever illness or hospitalization.<ref name=":0" /><ref name=":1">Irfan O, Muttalib F, Tang K, Jiang L, Zohra LS, Bhutta Z. [https://adc.bmj.com/content/106/5/440.abstract Clinical characteristics, treatment and outcomes of paediatric COVID-19: a systematic review and meta-analysis.] Archives of Disease in Childhood 2021;106: 440-448.</ref> | |||
Given the increased virulence of SARS-CoV-2, the question has been raised as to why children and adolescents do not represent a higher percentage of cases, given that their immune systems are relatively less developed than adults. Several explanations have been suggested for this trend. The first suggested hypothesis is based on the involvement of one specific cellular signaling process that the virus takes advantage of (ACE2 receptors and protease TMPRSS2). This particular signaling pathways is less developed in children and adolescents, and therefore presents less of an resource for the virus to exploit. Additional hypothesis suggest that due to the active development of the immune system at younger ages, the innate immune system is more active and thus provides additional protection. A third hypothesis posits that simply the presence of fewer comorbidities in these populations puts children at a reduced risk for infection and severe illness.<ref name=":1" /><br> | |||
== Diagnostic Procedures == | == Diagnostic Procedures == | ||
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<references /> | <references /> | ||
[[Category:Paediatrics]] | |||
[[Category:COVID-19]] | |||
[[Category:Conditions]] | |||
Revision as of 22:08, 24 April 2023
Introduction[edit | edit source]
As the SARS-CoV-2 virus (COVID-19) has spread across the globe it has presented unique challenges for every population it has impacted. While the impacts, symptom, and long term implications have been variable, one thing is clear, the virus will continue to effect many aspect of healthcare for some time. Given this, it is important for providers to recognize the unique ways that COVID-19 impacts the populations they work with. The following page will focus on the impacts of COVID-19 on the paediatric population, exploring some of the unique aspects that the virus presents in this diverse group of patients.
Characteristics and Clinical Presentation[edit | edit source]
Generally speaking, COVID-19 has presented trends suggesting that it is less severe in the paediatric and adolescent populations (<19 years of age) when compared to adult populations. However, as new variants develop and spread through both developed and undeveloped countries, reports of complications such as multi-system inflammatory syndrome (MIS-C) and others have been reported. Additionally, the impacts of prior and current public response, restrictions, and fear presented by the virus itself is only now being recognized as aspects of routine care such as vaccination and annual check-ups were and still are being disrupted.
Data and Trends from the Early Years of the Pandemic
While much focus was placed on the adult and older adult populations during the early days of the pandemic, a multitude of studies using data collected during this period now offer intriguing insights as to how the burgeoning virus impacted paediatric patients as well.
Data sets from 2020-2021 largely showed trends suggestive of lower illness severity and mortality among paediatric patients, with these cases accounting for between 1% and 10% of total cases. With this, the greatest distribution of infections in children tended to center around school-aged individuals. Worldwide for this time period, data from China, Korea, Spain, Italy, and the United States collectively supported this consensus for an age group that included individuals <19 years of age.[1][2]
Presentation of COVID-19 in Children and Adolescents
In the younger population, signs and symptoms of COVID-19, based on data from the early pandemic, tended to be more variable compared with infected adults. In general, the most common symptoms were fever and a cough, however, other complaints frequently included nausea/vomiting, diarrhea, nasal congestion, and shortness of breath. Asymptomatic presentations also tended to occur more often with this population compared to adults. Additionally, development of severe cases was also lower among children, with these cases generally felling in the age groups of <1 year and 10-14 years of age. It is suggested that factors including viral load and comorbidities such as asthma, immune-suppression (i.e. cancer treatment), and congenital heart disease were predictive of increased risk of sever illness or hospitalization.[1][2]
Given the increased virulence of SARS-CoV-2, the question has been raised as to why children and adolescents do not represent a higher percentage of cases, given that their immune systems are relatively less developed than adults. Several explanations have been suggested for this trend. The first suggested hypothesis is based on the involvement of one specific cellular signaling process that the virus takes advantage of (ACE2 receptors and protease TMPRSS2). This particular signaling pathways is less developed in children and adolescents, and therefore presents less of an resource for the virus to exploit. Additional hypothesis suggest that due to the active development of the immune system at younger ages, the innate immune system is more active and thus provides additional protection. A third hypothesis posits that simply the presence of fewer comorbidities in these populations puts children at a reduced risk for infection and severe illness.[2]
Diagnostic Procedures[edit | edit source]
add text here relating to diagnostic tests for the condition
Outcome Measures[edit | edit source]
add links to outcome measures here (see Outcome Measures Database)
Management / Interventions
[edit | edit source]
add text here relating to management approaches to the condition
Differential Diagnosis
[edit | edit source]
add text here relating to the differential diagnosis of this condition
Resources
[edit | edit source]
add appropriate resources here
References[edit | edit source]
- ↑ 1.0 1.1 Kammoun, R, and K Masmoudi. Paediatric aspects of COVID-19: An update. Respiratory medicine and research. 2020; 78: 100765.
- ↑ 2.0 2.1 2.2 Irfan O, Muttalib F, Tang K, Jiang L, Zohra LS, Bhutta Z. Clinical characteristics, treatment and outcomes of paediatric COVID-19: a systematic review and meta-analysis. Archives of Disease in Childhood 2021;106: 440-448.
