Pediatric Patients and COVID-19

Mahendra, Malini; Mahendra, Vibha; Murugan, Shobana

The burden of illness in illness in pediatrics is much lower than what has been reported for adults, with <1% of pediatric patients requiring admission to the intensive care unit. Respiratory symptoms are the most common presentation of COVID-19. A minority of patients who are critically ill have presented with a hyperinflammatory shock that has been described as the pediatric multisystem inflammatory syndrome associated with COVID-19. Research suggests that differential expression of ACE2 receptors, difference in the immune response, and exposure to other viruses may be etiologies for why most children have milder forms of COVID-19 than adults. Precautions taken while caring for COVID-19-positive adults should also be applied to the pediatric patient. Strong consideration should be given to premedicating the child with COVID-19 preoperative to reduce crying and screaming (which may increase spread of the virus). At the time of writing, the World Health Organization and United States Centers for Disease Control do not recommend any specific treatment strategies in children because novel therapies have not been shown clear benefit.