Paciente pediátrico y COVID 19, más que un misterio
Palabras clave:
Pandemia, COVID-19, pediatría, muerte, coronavirus, imágenes diagnósticas, radiografía , ecografía.Resumen
En diciembre de 2019, en la ciudad de Wuhan (China) se describieron los primeros casos de una nueva enfermedad, inicialmente descubierta por producir un síndrome respiratorio agudo severo. La investigación llevada a cabo en estos pacientes constató que el agente etiológico era un virus perteneciente a la familia de los Coronaviridae. Se le asignó el nombre de SARS-CoV-2. A la enfermedad producida por el mismo se le llamó COVID-19 (acrónimo de Coronavirus Disease, correspondiendo el 19 al año de su aparición), por medio de la siguiente revisión se quiere exponer como
fisiopatológicamente se comporta el paciente pediátrico frente a la infección por coronavirus y recopilar en la diferente evidencia literaria que hace su baja prevalencia y posibles factores de protección de este grupo etario.
Especialmente porque la literatura se segmenta entre la baja incidencia del virusen este grupo etario al inicio de la pandemia y se contrapone como a incrementado la positividad manifiesta y mortalidad en este nicho. Finalmente se detallará el
comportamiento del Covid 19 a nivel sistémico y las mejores opciones terapéuticas disponibles hasta el momento. Tomando como aporte transversal el apoyo de los servicios de imágenes diagnosticas en el diagnóstico temprano y seguimiento que pueda ser vital para disminuir letalidad y secuelas futuras en el niño.
Citas
COVID-19 en Pediatría: valoración crítica de la evidencia, Comité/Grupo de Pediatría Basada en la Evidencia de la AEP y AEPap. 2021.
Corman VM, Landt O, Kaiser M, Molenkamp R, Meijer A, Chu DK, et al. Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR. Euro Surveill Bull Eur Sur Mal Transm Eur Commun Dis Bull. 2020;25: 2000045
Van Kasteren PB, van der Veer B, van den Brink S, Wijsman L, de Jonge J, van den Brandt A, et al. Comparison of seven commercial RT-PCR diagnostic kits for COVID-19. J Clin Virol Off Publ Pan Am Soc Clin Virol. 2020;128:104412.
Ravi N, Cortade DL, Ng E, Wang SX. Diagnostics for SARS-CoV-2 detection: A comprehensive review of the FDA-EUA COVID-19 testing landscape. Biosens Bioelectron. 2020;165:112454.
Zhen W, Manji R, Smith E, Berry GJ. Comparison of Four Molecular In Vitro Diagnostic Assays for the Detection of SARS-CoV-2 in Nasopharyngeal Specimens. J Clin Microbiol. 2020;58: e00743-20.
Mahendiratta S, Batra G, Sarma P, Kumar H, Bansal S, Kumar S, et al. Molecular diagnosis of COVID-19 in different biologic matrix, their diagnostic validity and clinical relevance: A systematic review. Life Sci. 2020;258:118207.
Rapid-HTA-of-alternative-diagnostic-tests.pdf . 2020. Disponible en: https://www.hiqa.ie/sites/default/files/2020-10/Rapid-HTA-of-alternativediagnostic-tests.pdf
Wandernoth P, Kriegsmann K, Groh-Mohanu C, Daeumer M, Gohl P, Harzer O, et al. Detection of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) by Mass Spectrometry. Viruses. 2020;12:849.
Riccò M, Ranzieri S, Peruzzi S, Valente M, Marchesi F, Balzarini F, et al. RT-qPCR assays based on saliva rather than on nasopharyngeal swabs are possible but should be interpreted with caution: results from a systematic review and meta-analysis. Acta Bio-Medica Atenei Parm. 2020;91:e2020025.
Palmas G, Moriondo M, Trapani S, Ricci S, Calistri E, Pisano L, et al. Nasal Swab as Preferred Clinical Specimen for COVID-19 Testing in Children. Pediatr Infect Dis J. 2020; 39:e267-70.
Capecchi E, Di Pietro GM, Luconi E. Is Nasopharyngeal Swab Comparable With Nasopharyngeal Aspirate to Detect SARS-CoV-2 in Children? Pediatr Infect Dis J. 2020:39:e288-e289.
Chen JH-K, Yip CC-Y, Poon RW-S, Chan K-H, Cheng VC-C, Hung IF-N, et al. Evaluating the use of posterior oropharyngeal saliva in a point-of-care assay for the detection of SARS-CoV-2. Emerg Microbes Infect. 2020;9:1356-9.
Butler-Laporte G, Lawandi A, Schiller I, Yao MC, Dendukuri N, McDonald EG, et al. Comparison of Saliva and Nasopharyngeal Swab Nucleic Acid Amplification Testing for Detection of SARSCoV-2: A Systematic Review and Meta-analysis. JAMA Intern Med. 2021; 181:353-360
Atum M, Boz AAE, Çakır B, Karabay O, Köroğlu M, Öğütlü A, et al. Evaluation of Conjunctival Swab PCR Results in Patients with SARS-CoV-2 Infection. Ocul Immunol Inflamm. 2020;28:745-8.
Xu CLH, Raval M, Schnall JA, Kwong JC, Holmes NE. Duration of Respiratory and Gastrointestinal Viral Shedding in Children With SARS-CoV-2: A Systematic Review and Synthesis of Data. Pediatr Infect Dis J. 2020;39:e249-e256 94
Mallett S, Allen AJ, Graziadio S, Taylor SA, Sakai NS, Green K, et al. At what times during infection is SARS-CoV-2 detectable and no longer detectable using RT-PCR-based tests? A systematic review of individual participant data. BMC Med. 2020;
Han MS, Choi EH, Chang SH, Jin B-L, Lee EJ, Kim BN, et al. Clinical Characteristics and Viral RNA Detection in Children with Coronavirus Disease 2019 in the Republic of Korea. JAMA Pediatr. 2021;175:73-80.
Smithgall MC, Scherberkova I, Whittier S, Green DA. Comparison of Cepheid Xpert Xpress and Abbott ID Now to Roche cobas for the Rapid Detection of SARS-CoV-2. J Clin Virol. 2020; 128:104428.
Zhen W, Smith E, Manji R, Schron D, Berry GJ. Clinical Evaluation of Three Sample-to-Answer Platforms for Detection of SARS-CoV-2. McAdam AJ, editor. J Clin Microbiol. 2020;58: e00783- 20.
LeBlanc JJ, Gubbay JB, Li Y, Needle R, Arneson SR, Marcino D, et al. Real-time PCR-based SARS-CoV-2 detection in Canadian laboratories. J Clin Virol Off Publ Pan Am Soc Clin Virol. 2020; 128:104433.
Nagura-Ikeda M, Imai K, Tabata S, Miyoshi K, Murahara N, Mizuno T, et al. Clinical Evaluation of Self-Collected Saliva by Quantitative Reverse Transcription-PCR (RT-qPCR), Direct RTqPCR, Reverse Transcription-Loop-Mediated Isothermal Amplification, and a Rapid Antigen Test To Diagnose COVID-19. J Clin Microbiol. 2020; 58:e01438-20.
Hogan CA, Garamani N, Lee AS, Tung JK, Sahoo MK, Huang C, et al. Comparison of the Accula SARS-CoV-2 Test with a Laboratory-Developed Assay for Detection of SARS-CoV-2 RNA in Clinical Nasopharyngeal Specimens. J Clin Microbiol. 2020; 58:e01072-20
Cradic K, Lockhart M, Ozbolt P, Fatica L, Landon L, Lieber M, et al. Clinical Evaluation and Utilization of Multiple Molecular In Vitro Diagnostic Assays for the Detection of SARS-CoV-2. Am J Clin Pathol. 2020; 154:201-7.
Dinnes J, Deeks JJ, Adriano A, Berhane S, Davenport C, Dittrich S, et al. Rapid, point-of-care antigen and molecular-based tests for diagnosis of SARS-CoV-2 infection. Cochrane Database Syst Rev. 2020;8:CD013705.
Linares M, Pérez-Tanoira R, Carrero A, Romanyk J, Pérez-García F, Gómez-Herruz P, et al. Panbio antigen rapid test is reliable to diagnose SARS-CoV-2 infection in the first 7 days after the onset of symptoms. J Clin Virol Off Publ Pan Am Soc Clin Virol. 2020; 133:104659.
Albert E, Torres I, Bueno F, Huntley D, Molla E, Fernández-Fuentes MÁ, et al. Field evaluation of a rapid antigen test (PanbioTM COVID-19 Ag Rapid Test Device) for COVID-19 diagnosis in primary healthcare centres. Clin Microbiol Infect. 2020;
Evidence-summary-for-alternative-specimens-for-SARS-CoV-2-detection.pdf. 2020. Disponible en: https://www.hiqa.ie/sites/default/files/2020-08/Evidence-summary-for-alternative-specimens-for-SARS-CoV-2-detection.pdf
Villaverde S, Domínguez-Rodríguez S, Sabrido G, Pérez-Jorge C, Plata M, Romero MP, et al. Diagnostic Accuracy of the Panbio SARS-CoV-2 Antigen Rapid Test Compared with RT-PCR Testing of Nasopharyngeal Samples in the Pediatric Population. J Pediatr. 2021; S0022- 3476(21)00034-2.
Hanson KE, Caliendo AM, Arias CA, Englund JA, Hayden MK, Lee MJ, et al. Infectious Diseases Society of America Guidelines on the Diagnosis of COVID-19: Serologic Testing. Clin Infect Dis. 2020;12:ciaa1343
Mekonnen D, Mengist HM, Derbie A, Nibret E, Munshea A, He H, et al. Diagnostic accuracy of serological tests and kinetics of severe acute respiratory syndrome coronavirus 2 antibody: A systematic review and meta-analysis. Rev Med Virol. 2020; e2181.
Chen M, Qin R, Jiang M, Yang Z, Wen W, Li J. Clinical applications of detecting IgG, IgM or IgA antibody for the diagnosis of COVID-19: A meta-analysis and systematic review. Int J Infect Dis IJID Off Publ Int Soc Infect Dis. 2021;104:415-22.
Serrano MM, Rodríguez DN, Palop NT, Arenas RO, Córdoba MM, Mochón MDO, et al. Comparison of commercial lateral flow immunoassays and ELISA for SARS-CoV-2 antibody detection. J Clin Virol. 2020; 129:104529.
Yoon S, Li H, Lee KH, Hong SH, Kim D, Im H, et al. Clinical Characteristics of Asymptomatic and Symptomatic Pediatric Coronavirus Disease 2019 (COVID-19): A Systematic Review. Med Kaunas Lith. 2020; 56:474
Martins MM, Prata-Barbosa A, Magalhães-Barbosa MC de, Cunha AJL da. Clinical and laboratory characteristics of sars-cov-2 infection in children and adolescents. Rev Paul Pediatr. 2021; 39:e2020231.
Liu C, He Y, Liu L, Li F, Shi Y. Children with COVID-19 behaving milder may challenge the public policies: a systematic review and meta-analysis. BMC Pediatr. 2020; 20:410.
Meena J, Yadav J, Saini L, Yadav A, Kumar J. Clinical Features and Outcome of SARS-CoV-2 Infection in Children: A Systematic Review and Meta-analysis. Indian Pediatr. 2020; 57:820-6.
Liguoro I, Pilotto C, Bonanni M, Ferrari ME, Pusiol A, Nocerino A, et al. SARS-COV-2 infection in children and newborns: a systematic review. Eur J Pediatr. 2020; 179:1029-46
Henry BM, Benoit SW, de Oliveira MHS, Hsieh WC, Benoit J, Ballout RA, et al. Laboratory abnormalities in children with mild and severe coronavirus disease 2019 (COVID-19): A pooled analysis and review. Clin Biochem. 2020; 81:1-8.
Mustafa NM, A Selim L. Characterisation of COVID-19 Pandemic in Paediatric Age Group: A Systematic Review and Meta-Analysis. J Clin Virol Off Publ Pan Am Soc Clin Virol. 2020;128:104395.
McLaren SH, Dayan PS, Fenster DB, Ochs JB, Vindas MT, Bugaighis MN, et al. Novel Coronavirus Infection in Febrile Infants Aged 60 Days and Younger. Pediatrics. 2020;146: e20201550.
Storch-de-Gracia P, Leoz-Gordillo I, Andina D, Flores P, Villalobos E, Escalada-Pellitero S, et al. Clinical spectrum and risk factors for complicated disease course in children admitted with SARS-CoV-2 infection. An Pediatr Barc Spain 2003. 2020; 93:323-33.
Shelmerdine SC, Lovrenski J, Caro-Domínguez P, Toso S, Collaborators of the European Society of Paediatric Radiology Cardiothoracic Imaging Taskforce. Coronavirus disease 2019 (COVID-19) in children: a systematic review of imaging findings. Pediatr Radiol. 2020; 50:1217-30.
Li W, Fang Y, Liao J, Yu W, Yao L, Cui H, et al. Clinical and CT features of the COVID-19 infection: comparison among four different age groups. Eur Geriatr Med. 2020; 11:843-50.
Mohammadi A, Mohebbi I, khademvatani K, Pirnejad H, Mirza-Aghazadeh J, Gharebaghi N, et al. Clinical and radiological characteristics of pediatric patients with COVID-19: focus on imaging findings. Jpn J Radiol. 2020; 38:987-992. 96
Ai T, Yang Z, Hou H, Zhan C, Chen C, Lv W, et al. Correlation of Chest CT and RT-PCR Testing for Coronavirus Disease 2019 (COVID-19) in China: A Report of 1014 Cases. Radiology. 2020; 296:E32-40.
Steinberger S, Lin B, Bernheim A, Chung M, Gao Y, Xie Z, et al. CT Features of Coronavirus Disease (COVID-19) in 30 Pediatric Patients. AJR Am J Roentgenol. 2020; 215:1303-1311.
He J-L, Luo L, Luo Z-D, Lyu J-X, Ng M-Y, Shen X-P, et al. Diagnostic performance between CT and initial real-time RT-PCR for clinically suspected 2019 coronavirus disease (COVID-19) patients outside Wuhan, China. Respir Med. 2020; 168:105980.
Alilio PM, Ebeling-Koning NE, Roth KR, Desai T. Lung point-of-care (POCUS) ultrasound in a pediatric COVID-19 case. Radiol Case Rep. 2020; 15:2314-8.
Kennedy TM, Malia L, Dessie A, Kessler DO, Ng L, Chiang EL, et al. Lung Point-of-Care Ultrasound in Pediatric COVID-19: A Case Series. Pediatr Emerg Care. 2020; 36:544-548.
Cho Y-J, Song K-H, Lee Y, Yoon JH, Park JY, Jung J, et al. Lung ultrasound for early diagnosis and severity assessment of pneumonia in patients with coronavirus disease 2019. Korean J Intern Med. 2020; 35:771-81.
Denna M, Scolfaro C, Silvestro E, Pruccoli G, Mignone F, Zoppo M, et al. Lung ultrasound in children with COVID-19. Pediatrics. 2020; 146: e20201157.
Castillo Martín Cristina. Infecciones emergentes causadas por coronavirus. los virus SARS-COV Y MERS-COV (Trabajo Fin de Grado Inédito). Universidad de Sevilla facultad de farmacia; 2017. Disponible en: idUS - Infecciones emergentes causadas por coronavirus. Los virus SARS-CoV y MERS-CoV
Díaz Pinzón JE. Estimación de las tasas de mortalidad y letalidad por COVID-19 en Colombia. Repert. Med. Cir. 2020;89-93. Disponible en: https://revistas.fucsalud.edu.co/index.php/repertorio/article/view/1103
Observatorio Demográfico América Latina y el Caribe 2020, Mortalidad por COVID-19 Evidencias y escenarios, Naciones Unidas CEPAL. Alicia Bárcena Secretaria Ejecutiva Mario Cimoli Secretario Ejecutivo Adjunto Raúl García-Buchaca Secretario Ejecutivo Adjunto para Administración y Análisis de Programas y otros.
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