Clinical variants of the coronavirus disease in children (review of literature)

Abstract

The problem of coronavirus disease (COVID) requires further study and generalization because the pathogenetic mechanisms are not fully elucidated, and the clinical data are varied. Therefore, it is necessary to accumulate data about the features of coronavirus disease in patients of different age groups in order to enrich the clinical experience. The treatment and diagnosis outcomes were used to make a conclusion about clinical manifestation in pediatric COVID patients. The data were extracted using PubMed/MEDLINE and Google Scholar databases. Generally, important components of coronavirus disease pathogenesis are viral tropism for cell host, cytokine storm, endothelial dysfunction, hemodynamic instability, and dehydration. These pathogenic ways lead to multiorgan injury, so clinical signs of coronavirus infection might be different. It depends on a system that suffers from coronavirus. However, pediatric COVID infection can be mild with respiratory signs, or it can be a multisystem inflammatory syndrome. On the other hand, there are typically laboratory features of coronavirus disease, including a significant rise in inflammatory and coagulation markers such as C-reactive protein, procalcitonin, fibrinogen and D-dimer. Moreover, coronavirus has displaced other expected etiological factors of some acute upper and lower respiratory tract infections and caused acute stenosis laryngitis, bronchiolitis, or pneumonia. Interestingly, coronavirus might be a cause of Kawasaki disease, therefore, physicians should pay attention to all clinical and laboratory signs in children in order to make a clear decision about diagnosis and treatment. The benefits of this study consist in presentation of pediatric COVID features. Modern knowledge will allow to choose necessary diagnostic test in time. General practitioners will be able to refer the patients to hospital before complication arise.