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Curr Pediatr Rev . Atypical Manifestations of Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Children: A Review

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  • Curr Pediatr Rev . Atypical Manifestations of Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Children: A Review


    Curr Pediatr Rev


    . 2021 Apr 6.
    doi: 10.2174/1573396317666210406153302. Online ahead of print.
    Atypical Manifestations of Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Children: A Review


    Sofia ?enou 1 , Shamez Ladhani 2 , Gabriel Dimitriou 1 , Despoina Gkentzi 1



    Affiliations

    Abstract

    Background: In December 2019, a local outbreak of pneumonia presented in Wuhan (China), and quickly identified to be caused by a novel coronavirus, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The disease caused by SARS-CoV-2 was named COVID-19 and was soon declared as pandemic because of the millions of infections and thousands of deaths worldwide. Children infected with SARS-CoV-2 usually develop asymptomatic or mild disease compared to adults. They are also more likely to have atypical and non-specific clinical manifestations than adults.
    Methods: A literature search was performed in PubMed and Scopus to summarize the extrapulmonary manifestations of SARS-CoV-2 infection in children since the beginning of the pandemic. Peer-reviewed papers in English were retrieved using the following keywords and combinations: 'pediatric', 'child', 'infant', 'neonate', 'novel coronavirus', 'SARS-CoV-2', 'COVID 19' and 'gastrointestinal', 'renal', 'cardiac', 'dermatologic' or 'ophthalmologic'. We included published case series and case reports providing clinical symptoms and signs in SARS-CoV2 pediatric patients.
    Results: Although fever and symptoms of upper respiratory infection are the most frequently presented, a variety of other atypical presentations has also been reported. The clinical spectrum includes dermatological, ophthalmological, neurological, cardiovascular, renal, reproductive, and gastrointestinal presentations. In addition, a rare multi-inflammatory syndrome associated with SARS-CoV-2 infection has been reported in children, often leading to shock requiring inotropic support and mechanical ventilation.
    Conclusions: Clinicians need to be aware of the wider range of extrapulmonary atypical manifestations of SARS-CoV-2 infection in children, so that appropriate testing, treatment, and public health measures can be implemented rapidly.

    Keywords: COVID-19; SARS-CoV2; atypical manifestations.; children; extrapulmonary manifestations.

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