COVID-19 Infection in Children, Infants and Pregnant Subjects: An Overview of Recent Insights and Therapies (original) (raw)
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COVID-19 Infection in Children and Infants: Current Status on Therapies and Vaccines
Children
Since the beginning in December 2019, the SARS-CoV-2 outbreak appeared to affect mostly the adult population, sparing the vast majority of children who only showed mild symptoms. The purpose of this investigation is to assess the status on the mechanisms that give children and infants this variation in epidemiology compared to the adult population and its impact on therapies and vaccines that are aimed towards them. A literature review, including in vitro studies, reviews, published guidelines and clinical trials was performed. Clinical trials concerned topics that allowed a descriptive synthesis to be produced. Four underlying mechanisms were found that may play a key role in providing COVID-19 protection in babies. No guidelines are available yet for therapy due to insufficient data; support therapy remains the most used. Only two vaccines are approved by the World Health Organization to be used in children from 12 years of age, and there are currently no efficacy or safety data f...
Advancement of SARS-CoV-2 infection in children
2021
Novel coronavirus disease 2019 (COVID-19) is a disease characterized by respiratory symptoms caused by novel coronavirus (SARS-CoV-2). Its pathogenesis is suggested to be related with ACE2 receptors, present in various organs. Children, as a special group of patients with COVID-19, have their own unique characteristics in terms of the disease's course. The majority of children present with asymptomatic course or have mild symptoms. In severe cases COVID-19 may manifest as a multisystem inflammatory syndrome;thus, correct identification of children at risk is particularly important in the diagnostic process. The treatment options for this disease are still based on general therapy, and related drug therapy is still at the clinical trial stage.
Irish Journal of Medical Science (1971 -), 2021
Background Almost every day, new information about the COVID-19 pandemic continues to emerge. COVID-19 presents a mild clinical picture in children. However, how it goes in newborns and pregnant is still entirely unclear. Aims To present the clinical course of SARS-CoV-2 positive newborns and outcomes of babies born to mothers diagnosed with COVID-19. Methods The present cohort-study examined two groups. The first group includes fourteen newborns born to mothers diagnosed with COVID-19. The second group evaluates twelve newborns infected with SARS-CoV-2. Results Fourteen infants born to mothers diagnosed with COVID-19 were not infected with SARS-CoV-2. They had no symptoms and pathological laboratory findings. Additionally, forty-one newborns suspected of COVID-19 were evaluated, and 12 of them were detected to be infected with SARS-CoV-2. The most common symptoms were feeding intolerance (vomiting or refusing to feed, 58%), cough (50%), elevated fever (42%), and respiratory distress (42%). Conclusion We did not come across any signs of vertical SARS-CoV-2 transmission. COVID-19 diagnosed newborns entirely healed with conservative treatment.
SARS‐CoV‐2 infection and neonates: Evidence‐based data after 18 months of the pandemic
Pediatric Allergy and Immunology, 2022
After 18 months of the COVID‐19 pandemic, data concerning SARS‐CoV‐2 infection in pregnant women and their neonates are progressively taking the place of complete uncertainty. Here, we summarize updated evidence regarding several critical aspects of perinatal SARS‐CoV‐2 infection, including 1) vertical transmission of the virus in utero, which is possible but seems rare according to current epidemiological data; 2) how COVID‐19 during pregnancy can shape maternal and neonatal outcomes, either directly or indirectly; 3) how recommendations regarding the management of infected dyads have been progressively modified in light of new scientific evidence; and 4) how maternal infection or vaccination can induce the passive protection of fetuses and neonates against the infection, through the transfer of specific antibodies before and after birth.
Lessons Learned so Far from the Pandemic: A Review on Pregnants and Neonates with COVID-19
The Eurasian Journal of Medicine, 2020
There are concerns regarding the risk and the course of COVID-19 in pregnancy and in the neonates. In this review, we aimed to present the current understanding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection during pregnancy and neonatal periods considering diagnosis, treatment, prognosis, and prevention. Few studies on pregnant women with COVID-19 have been conducted between December 2019 and April 2020. The majority of patients applied in the third trimester and presented with fever and cough. Ground-glass opacities and consolidation on computed tomography were reported to be common. COVID-19 was proposed to have a milder course than SARS and the Middle East respiratory syndrome coronavirus in pregnant women. Hydroxychloroquine and antiproteases (lopinavir/ritonavir) were reported to be safe; however, therapeutic efficacy and safety of remdesivir still lack evidence. As ribavirin and favipiravir have teratogenic effects, there are some debates on the use of ribavirin in severe cases. There is still no clear evidence of vertical transmission of SARS-CoV-2 during delivery. Occupational safety issues of pregnant healthcare workers on the frontline should be considered as their risk to develop severe pneumonia is higher because of altered maternal immune response. Knowledge about neonatal outcomes of COVID-19 was based on studies of the last trimester of pregnancy. There is much to be learnt about COVID-19 in pregnant women and in the neonates, especially concerning prognosis-and treatment-related issues.
The Impact of SARS-CoV-2 Infection on Premature Birth—Our Experience as COVID Center
Medicina
Information about the impact of SARS-CoV-2 infection on pregnant women is still limited and raises challenges, even as publications are increasing rapidly. The aim of the present study was to determine the impact of SARS-CoV-2 infection on preterm birth pregnancies. We performed a prospective, observational study in a COVID-only hospital, which included 34 pregnant women with SARS-CoV-2 infection and preterm birth compared with a control group of 48 healthy women with preterm birth. The rate of cesarean delivery was 82% in the study group versus 6% for the control group. We observed a strong correlation between premature birth and the presence of COVID-19 symptoms (cough p = 0.029, fever p = 0.001, and chills p = 0.001). The risk for premature birth is correlated to a lower value of oxygen saturation (p = 0.001) and extensive radiologic pulmonary lesions (p = 0.025). The COVID-19 pregnant women with preterm delivery were older, and experienced an exacerbation of severe respiratory s...
Pregnant Women and Infants Infected with SARS-COV-2: A Brief Overview
International Electronic Journal of Medicine, 2020
Coronavirus disease 2019 (COVID-19) is now a global health concern and a wide range of people are at risk. Pregnant women are considered high-risk groups due to hormonal changes and weakness in the immune system. In the present study, the transmission of COVID-19 from mother to fetus and infection of children under the age of 10 with this virus were discussed. This study tries to investigate whether the coronavirus can be transmitted from a pregnant mother to her fetus and whether the virus can be transmitted to the baby through breast milk. According to researchers, children under the age of 10 do not get the disease; however, the first case of a baby with coronavirus was reported in Mashhad, Iran, based on the world’s up-to-date studies and the perceptions of medical experts.
SARS‐CoV‐2 infection and neonates: a review of evidence and unresolved questions
Pediatric Allergy and Immunology, 2020
Until mid-May 2020, more than 4 million cases of coronavirus disease 2019 (COVID-19), caused by "severe acute respiratory syndrome coronavirus 2" (SARS-CoV-2) infection, have been recorded worldwide, with almost 300.000 confirmed deaths. 1 More than 95% of COVID-19 patients are above 20 years of age, with significantly higher mortality rates in elderly males. 1 Nonetheless, a limited but growing number of SARS-CoV-2-infected neonates have been described. Infection in the first 28 days of life can be acquired horizontally, akin to several respiratory viruses including other coronaviruses, or possibly vertically, during pregnancy, parturition, or through breastmilk. 2 Due to the novelty of SARS-CoV-2 infection and to the paucity of reported cases, several questions with important health care and social implications regarding COVID-19 in early life are currently unresolved.
Neonatal SARS-CoV-2 Infection: Practical Tips
Pathogens
The recent viral pandemic in Wuhan, Hubei, China has led to the identification of a new species of beta-coronavirus, able to infect humans, the 2019-nCoV, later named SARS-CoV-2. SARS-CoV-2 causes a clinical syndrome named COVID-19, which presents with a spectrum of symptoms ranging from mild upper respiratory tract infection to severe pneumonia, with acute respiratory distress syndrome and frequent death. All age groups are susceptible to the infection, but children, especially infants, seem to be partially spared, having a more favorable clinical course than other age groups. There is currently no clear evidence showing vertical transmission and intrauterine SARS-CoV-2 infection in fetuses of women developing COVID-19 pneumonia in late pregnancy, and even if transmission is possible, the SARS-CoV2 positivity of the mother does not require delivery by caesarean section, does not contraindicate the management of the infant in rooming-in and allows breastfeeding. This review provides...
Acta Scientific Otolaryngology, 2022
As of March 11, 2020, the human coronavirus disease 2019 pandemic had begun. The most typical signs of a lower respiratory infection include fever, cough, and dyspnea. One or more organs may fail, leading to the development of the acute respiratory distress syndrome (ARDS). SARS-CoV-2 is capable of infecting humans of all ages, including infants as little as one day old. Of the 72,314 cases that were documented in China, just 2% included a child who was under the age of 19. Among the United States, Covid-19 is more prevalent in the 12-to 17-year-old age range. Since 2003, more than 1,100,000 illnesses and 62,784 deaths have been attributed to COVID-19. In the initial published study, just 0.39 percent of children were diagnosed with the disease. As of 2021, 18 children between the ages of 10 and 19 have died as a result of the disease. S1 has the most common mutation, which increases the virus' affinity for the ACE2 receptor by replacing D614G (Asp 614Gly). SARS-CoV-2 infection in children results in far fewer neurological complications than in adults. A probable case of COVID-19 is indicated by the presence of clinical signs and symptoms in a suitable epidemiological environment. Virus detection laboratory tests might be used to confirm the diagnosis. The incubation period of 2-14 days is critical in determining the time of infection. Coughing, tiredness, and exhaustion were the most common post-acute symptoms. At the most recent review in March 2021, all 151 children were confirmed to be healthy and free of these symptoms. Changes in innate and adaptive immunity, more frequent recurrences and concomitant infections, and pre-existing immunity to coronaviruses are all possible safeguards for children. Over the course of the months of December 2019 and February 2020, nine infants in China were diagnosed with SARS-CoV-2 infection. Approximately 1-2 weeks following the onset of symptoms, most of the paediatric patients had fully recovered. Babies who were infected by a member of their families were more likely to get infected themselves.