COVID-19 Pandemic – A Paediatric Perspective
SARS CoV-2, the virus responsible for the current pandemic COVID-19 has resulted in 4.2 million cases and 2.9 lakhs deaths globally by mid- May 2020. Children are less likely to be symptomatic or develop severe symptoms with SARS-CoV-2 infection. Recent US reports show that rate of hospitalization is less in children (5.7%) when compared to adults (10%). Most common presenting complaints include fever, cough and sore throat; eight cases of Kawasaki disease/toxic shock syndrome like presentation with multi organ dysfunction has also been published from UK. For management, clinical categorization as A, B and C is helpful. Patients with comorbidities, on immunosuppressants, severe respiratory symptoms, altered sensorium and shock need hospitalization, close monitoring and care. Mainstay of diagnosis is with RT-PCR of nasopharyngeal swab. Treatment includes supportive care for category A, Hydroxychloroquine and Azithromycin for category B and C. In addition, if there is clinical worsening, Lopinavir/Ritonavir, Remdesivir (not available in India) and Tocilizumab may be considered. Appropriate protective gears and reduction of aerosol generating procedures are effective infection control strategies.
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