Pediatria pre prax 5/2020

COVID-19 in children

COVID-19 is an acute respiratory infection caused by the new coronavirus, similar to SARS and to the zoonotic virus in bats, respectively. This SARS-CoV-2 virus started to spread in December 2019 and rapidly caused a worldwide pandemic. In children, the known incidence of COVID-19 is low (0,9–12 %), it usually manifests as mild disease and, unlike in adults, is more frequently asymptomatic and/or presents with gastrointestinal symptoms. As opposed to adults, only a minor proportion of children and adolescents develop severe disease (pneumonia, ARDS) and require PICU support with less than 1 % case-fatality rate. COVID-19 is transmitted by droplets from the respiratory tract, by stool and by fomites within families and in the community (school, etc.). Infected children are not the primary sources of infection, they mostly contract the disease from adults (parents). As in adults, also in children, available data reflect only limited experience with the treatment of serious COVID-19 cases by various anti-virotics and immunomodulatory drugs, warranting more robust interventional studies. Apart from basic epidemiologic measures, mass vaccination is expected to be most important in the prevention of COVID-19, with vaccination in pre-school age expected to achieve herd immunity.

Keywords: virus SARS-CoV-2, COVID-19 infection, occurrence in children, pneumonia, ARDS, diagnostics, treatment, measures