Boletín de Alerta Bibliográfica - Unidad de Desarrollo de la Investigación, Tecnologías y Docencia
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2020
8(34):1-50
Boletín
de Alerta
Bibliográfica
Unidad de Desarrollo de la Investigación,
Tecnologías y Docencia
ÍNDICE TEMÁTICO CARDIOLOGÍA DERMATOLOGÍA DIAGNÓSTICO / TRATAMIENTO EPIDEMIOLOGÍA FISIOTERAPIA GASTROENTEROLOGÍA / HEPATOLOGÍA HEMATOLOGÍA NEFROLOGÍA NEONATOS / MADRE E HIJO NEUROLOGÍA / NEUROCIRUGÍA NEUMOLOGÍA NUTRICIÓN OFTALMOLOGÍA ONCOLOGÍA PROFESIONALES DE LA SALUD RADIOLOGÍA REUMATOLOGÍA SALUD MENTAL SALUD PÚBLICA / POLÍTICAS EN SALUD / GESTIÓN EN SALUD SÍNDROME INFLAMATORIO MULTISISTÉMICO (MIS-C) TELESALUD Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2020;8(34):1-50
CARDIOLOGÍA
Publicaciones
Santi AD, Aquino P, Dorfman M. Atrial fibrillation in a pediatric patient with covid-19
infection. Cardiol Young. 2020 Oct 19;1–9.
Doi: 10.1017/s1047951120003893
Abstract
The SARS-CoV-2 (COVID-19) pandemic has challenged our initial predictions of its ramifications, both short and
long term. Cardiovascular manifestations of COVID-19 in pediatric patients remains a topic of investigation as
literature is lacking. We describe new onset atrial fibrillation in a pediatric patient with a history of COVID-19
infection. Understanding of cardiogenic effects of COVID-19 can help minimize delay in diagnosis.
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2020;8(34):1-50
DERMATOLOGÍA
Publicaciones
Promenzio L, Arcangeli F, Cortis E, Sama E, Longhini F. Erythema Pernio-like in four
Adolescents in the era of the Coronavirus-2 Infection. Rev Recent Clin Trials. 2020 Oct
16.
Doi: 10.2174/1574887115666201016153031
Abstract
Background: Although epidemic, novel coronavirus (SARS-CoV-2) infection rarely affects pediatric population.
However, in the last months an increasing number of Italian pediatricians has reported the occurrence of
erythema pernio-like in children following a flu-like syndrome, after the outbreak of SARS-CoV-2 infection.
Objective: To report cutaneous manifestation of SARS-CoV-2 infection in 4 adolescents.
Methods: Observational study reporting 4 adolescents with skin lesions, 2 weeks after the occurrence of a flu-
like syndrome.
Results: Fourteen days after a flu-like syndrome, adolescents exhibited skin lesions to toes and feet. These le-
sions were rounded, with blurred limits, with a 5-15 mm diameter, red-violaceous-bluish colored, sometimes
resulting in bullous lesions in correspondence of the central or apical portion, which tended to be covered with
blackish crusts after evolution. Lesions were also accompanied by pain of variable intensity and evolved within
two or three weeks to self-resolution without particular sequelae. In two patients, pharyngeal and nasal swabs
were negative for SARS-CoV-2 infection, at the presentation of skin lesions. After 2 months from clinical mani-
festations, patients were tested positive for SARS-CoV-2 antibodies.
Conclusions: In pediatric and adolescent population, the occurrence of an erythema pernio-like after a flu-like
syndrome could be associated to SARS-CoV-2 infection.
Andina D, Colmenero I, Santonja C, Muñoz de León I, Noguera-Morel L, Hernández-
Martín A, et al. Suspected COVID-19-related reticulated purpura of the soles in an in-
fant. Pediatr Dermatol. 2020 Oct 21.
Doi: 10.1111/pde.14409
Abstract
A growing number of skin lesions during the COVID-19 pandemic are being recognized. Acral ischemic le-
sions identical to chilblains are most typical in children and young adults. We report an infant girl, aged 1
month and 29 days, with a peculiar reticulated purpuric eruption on her soles, with positive immunohisto-
chemistry for SARS-CoV-2 in the endothelia of dermal blood vessels. The patient had an excellent outcome
without specific therapy.
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2020;8(34):1-50
Rotulo GA, Signa S, Rosina S, Pastorino C, Bondi E, Maghnie M. Giant Urticaria and
Acral Peeling in a Child with COVID-19. J Pediatr. 2020 Oct 21.
Case Reports
Doi: 10.1016/j.jpeds.2020.10.039
Nepogodiev D. Favourable perioperative outcomes for children with SARS-CoV-2. Br J
Surg. 2020 Oct 19.
Letter
Doi: https://doi.org/10.1002/bjs.12038
Pavone P, Marino S, Marino L, Cacciaguerra G, Guarneri C, Nunnari G, et al. Chilblains-
like lesions and SARS-CoV-2 in children: an overview in therapeutic approach. Derma-
tol Ther. 2020 Nov 3;e14502.
Doi: 10.1111/dth.14502
Abstract
SARS-CoV-2 (Severe Acute Respiratory Syndrome, Coronavirus, type 2) is the virus responsible for the glo-
bal pandemic of Coronavirus disease 2019 (COVID-19) that began in China in December 2019. The variabili-
ty of nasal olfactory symptoms in pediatric patients is interlinked with possible warning signs, including
respiratory, gastrointestinal, ocular, or dermatological symptoms. Skin findings in patients with COVID-19
can range from petechiae to papulovesicular rashes to diffuse urticaria and can be confused with rashes of
non-COVID-19 conditions. These lesions typically appear early during COVID-19 and are thought to be se-
condary to viral replication or circulating cytokines. Herein we discuss two pediatric cases, presenting with
skin lesions, which tested positive for SARS-CoV-2, thus, briefly reviewing current literature for similar re-
ports and related management. Although these lesions heal spontaneously in most cases, an adequate
"targeted" therapeutic approach can shorten the time and the discomfort of the skin disease.
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2020;8(34):1-50
DIAGNÓSTICO Y TRATAMIENTO
Publicaciones
Ulyte A, Radtke T, Abela IA, Haile SR, Braun J, Jung R, et al. Seroprevalence and immuni-
ty of SARS-CoV-2 infection in children and adolescents in schools in Switzerland: design
for a longitudinal, school-based prospective cohort study. Int J Public Health. 2020 Oct
15.
Doi: 10.1007/s00038-020-01495-z
Abstract
Objectives: This longitudinal cohort study aims to assess the extent and patterns of seroprevalence of se-
vere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies in school-attending children, and
their parents and school personnel. It will examine risk factors for infection, the relationship between sero-
positivity and symptoms, and temporal persistence of antibodies.
Methods: The study (Ciao Corona) will enroll a regionally representative, random sample of schools in the
canton of Zurich, where 18% of the Swiss population live. Children aged 5-16 years, attending primary and
secondary schools, and their parents and school personnel are invited. Venous blood and saliva samples
are collected for serological testing in June/July 2020, in October/November 2020, and in March/April
2021. Bi-monthly questionnaires will cover SARS-CoV-2 symptoms and tests, health, preventive behavior,
and lifestyle information. Hierarchical Bayesian logistic regression models will account for sensitivity and
specificity of the serological tests in the analyses and complex sampling structure, i.e., clustering within
classes and schools.
Results and conclusions: This unique school-based study will allow describing temporal trends of immuni-
ty, evaluate effects of preventive measures and will inform goal-oriented policy decisions during subse-
quent outbreaks.
Curtis M, Bhumbra S, Felker MV, Jordan BL, Kim J, Weber M, et al. Guillain-Barré Syn-
drome in a Child With COVID-19 Infection. Pediatrics. 2020 Oct 22.
Doi: 10.1542/peds.2020-015115
Arango Ferreira C, Correa-Roda M. Acute Meningoencephalitis as Initial Presentation of
SARS-CoV-2 Infection in Pediatrics. Pediatr Infect Dis J. 2020 Nov;39(11):e386–7.
Letter
Doi: 10.1097/inf.0000000000002885
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2020;8(34):1-50
Nepogodiev D. Favourable perioperative outcomes for children with SARS-CoV-2. Br J
Surg. 2020 Oct 19.
Letter
Doi: https://doi.org/10.1002/bjs.12038
Kasi SG, Dhir SK, Verma S, Pemde HK, Balasubramanian S, Agarwalla S, et al. Immuni-
zation During the COVID-19 Pandemic: Recommendations from Indian Academy of
Pediatrics Advisory Committee on Vaccines and Immunization. Indian Pediatr. 2020
Oct 24.
Doi: 10.1007/s00038-020-01495-z
Abstract
During the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, immunization practices
of all age groups, especially routine childhood vaccines, have been interrupted. Immunization is considered
an essential health activity, which needs to be resumed as early as possible. This pandemic has created seve-
ral unique issues related to routine immunization of individual children at clinics, which needs to be addres-
sed. In this communication, the Advisory Committee on Vaccines and Immunization Practices (ACVIP) of In-
dian Academy of Pediatrics addresses the common questions and issues related to SARS-CoV-2 and routine
immunization services. This also includes the recommendations for routine immunization of SARS-CoV-2 sus-
pect and positive children, and for the logistics to be followed for immunization services.
Salvatore S, Marinoni M, Agosti M. Additional Concerns Regarding Children With Co-
ronavirus Disease 2019. JAMA Pediatr. 2020 Oct 26.
Comment & Response
Doi: 10.1001/jamapediatrics.2020.2922
Zimmermann P, Goetzinger F, Ritz N. Additional Concerns Regarding Children With Co-
ronavirus Disease 2019. JAMA Pediatr. 2020 Oct 26.
Comment & Response
Doi: 10.1001/jamapediatrics.2020.2916
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2020;8(34):1-50 Cai X, Jiang H, Zhang S, Xia S, Du W, Ma Y, et al. Clinical manifestations and pathogen
characteristics in children admitted for suspected COVID-19. Front Med. 2020 Oct 27.
Doi: 10.1007/s00038-020-01495-z
Abstract
Coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus-2
(SARS-CoV-2), has spread around the world. However, approaches to distinguish COVID-19 from pneumo-
nia caused by other pathogens have not yet been reported. We retrospectively analyzed the clinical data of
97 children with probable COVID-19. A total of 13 (13.4%) patients were confirmed positive for SARS-CoV-2
infection by nucleic acid RT-PCR testing, and 41 (42.3%) patients were found to be infected with other
pathogens. Notably, no pathogen was detected in 43 (44.3%) patients. Among all patients, 25 (25.8%) had
familial cluster exposure history, and 52 (53.6%) had one or more coexisting conditions. Fifteen (15.5%)
patients were admitted or transferred to the PICU. In the 11 confirmed COVID-19 cases, 5 (45.5%) and 7
(63.6%) were positive for IgM and IgG against SARS-CoV-2, respectively. In 22 patients with suspected CO-
VID-19, 1 (4.5%) was positive for IgG but negative for IgM. The most frequently detected pathogen was
Mycoplasma pneumonia (29, 29.9%). One patient with confirmed COVID-19 died. Our results strongly indi-
cated that the detection of asymptomatic COVID-19 or coexisting conditions must be strengthened in pe-
diatric patients. These cases may be difficult to diagnose as COVID-19 unless etiologic analysis is conducted.
A serologic test can be a useful adjunctive diagnostic tool in cases where SARS-CoV-2 infection is highly sus-
pected but the nucleic acid test is negative.
Kandeil A, Gomaa MR, El Taweel A, Mostafa A, Shehata M, Kayed AE, et al. Common
childhood vaccines do not elicit a cross-reactive antibody response against SARS-CoV-
2. PLoS One. 2020 Oct 28;15(10):e0241471.
Doi: 10.1371/journal.pone.0241471
Abstract
Anecdotal evidence showed a negative correlation between Bacille Calmette-Guérin (BCG) vaccination and
incidence of COVID-19. Incidence of the disease in children is much lower than in adults. It is hypothesized
that BCG and other childhood vaccinations may provide some protection against SARS-CoV-2 infection
through trained or adaptive immune responses. Here, we tested whether BCG, Pneumococcal, Rotavirus,
Diphtheria, Tetanus, Pertussis, Hepatitis B, Haemophilus influenzae, Hepatitis B, Meningococcal, Measles,
Mumps, and Rubella vaccines provide cross-reactive neutralizing antibodies against SARS-CoV-2 in BALB/c
mice. Results indicated that none of these vaccines provided antibodies capable of neutralizing SARS-CoV-2
up to seven weeks post vaccination. We conclude that if such vaccines have any role in COVID-19 immuni-
ty, this role is not antibody-mediated.
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2020;8(34):1-50EPIDEMIOLOGÍA
Publicaciones
Levy C, Basmaci R, Bensaid P, Bru CB, Coinde E, Dessioux E, et al. Changes in Reverse
Transcription Polymerase Chain Reaction-positive Severe Acute Respiratory Syndrome
Coronavirus 2 Rates in Adults and Children According to the Epidemic Stages. Pediatr
Infect Dis J. 2020 Nov;39(11):e369–72.
Doi: 10.1097/inf.0000000000002861
Abstract
From March 2, 2020, to April 26, 2020, 52,588 reverse transcription polymerase chain reaction (RT-PCR) tests
for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were performed in France, 6490 in children
and 46,098 in adults. The rate of RT-PCR-positive SARS-CoV-2 tests for children (5.9%) was always less than that
for adults (20.3%) but vary according to the epidemic stage. The risk ratio of RT-PCR-positive SARS-CoV-2 tests
for adults compared with children was 3.5 (95% confidence interval: 3.2-3.9) for the whole study period.
Cai J, Wang X, Zhao J, Ge Y, Xu J, Tian H, et al. Comparison of Clinical and Epidemiolo-
gical Characteristics of Asymptomatic and Symptomatic SARS-CoV-2 Infection in Chil-
dren. Virol Sin. 2020 Nov 4.
Doi: 10.1007/s12250-020-00312-4
Abstract
To understand the epidemiological and clinical features of the symptomatic and asymptomatic pediatric cases of
COVID-19, we carried out a prospective study in Shanghai during the period of January 19 to April 30, 2020. A
total of 49 children (mean age 11.5 ± 5.12 years) confirmed with SARS-CoV-2 infection were enrolled in the
study, including 11 (22.4%) domestic cases and 38 (77.6%) imported cases. Nine (81.8%) local cases and 12
(31.6%) imported cases had a definitive epidemiological exposure. Twenty-eight (57.1%) were symptomatic and
21 (42.9%) were asymptomatic. Neither asymptomatic nor symptomatic cases progressed to severe diseases.
The mean duration of viral shedding for SARS-CoV-2 in upper respiratory tract was 14.1 ± 6.4 days in asympto-
matic cases and 14.8 ± 8.4 days in symptomatic cases (P > 0.05). Forty-five (91.8%) cases had viral RNA detected
in stool. The mean duration of viral shedding in stool was 28.1 ± 13.3 days in asymptomatic cases and 30.8 ±
18.6 days in symptomatic participants (P > 0.05). Children < 7 years shed viral RNA in stool for a longer duration
than school-aged children (P < 0.05). Forty-three (87.8%) cases had seropositivity for antibodies against SARS-
CoV-2 within 1-3 weeks after confirmation with infection. In conclusion, asymptomatic SARS-CoV-2 infection
may be common in children in the community during the COVID-19 pandemic wave. Asymptomatic cases shed
viral RNA in a similar pattern as symptomatic cases do. It is of particular concern that asymptomatic individuals
are potentially seed transmission of SARS-CoV-2 and pose a challenge to disease control.
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2020;8(34):1-50FISIOTERAPIA
Publicaciones
Magalhães PF, Lanza FC, Bernardo Figueiredo B. Clinical features and physiotherapy
management for Covid-19 in children. Minerva Pediatr. 2020 Oct 27.
Doi: 10.23736/s0026-4946.20.06100-9
Abstract
Background: COVID-19 has quickly become a worldwide threat to health, travel, and commerce. Studies
adressing the clinical-functional presentation of viral infection and physiotherapy management in children
are scarce. The purpose statement was to provide current perspectives on the physiotherapy interventions
for managing children based on COVID-19 evidences.
Methods: In this review, databases were searched between 1th January and 26 th March 2020. The follo-
wing descriptors were considered: (novel coronavirus); (novel corona virus); Coronavirus; (corona vírus);
2019-nCoV; nCovor; COVID-19; SARSCoV-2; in the electronic databases National Library of Medicine
(PubMed/Medline), Scientific Electronic Library Online (SciELO) and Physiotherapy Evidence Database
(PEDro). The results were described through the International Classification of Functioning, Disability and
Health.
Results: 16 papers were included in this review. COVID-19 seems to lead to restriction of participation and
interfere in tasks, such as recreation and leisure activities, respiratory muscle function and exercise toleran-
ce. Personal protective equipments and contact precautions are important part of treatment. Effective
oxygen therapy should be given immediately in presence of hypoxia. Nasal high-flow oxygen therapy, non-
invasive ventilation, lung-protective ventilation strategies and prone position, should be undertaken when
necessary under appropriate conditions. Airway clearance techniques should be administered only strictly
needed and early activities must be encouraged.
Conclusions: Potential physiotherapy interventions for children with COVID-19/SARS-CoV-2 consist on ven-
tilatory management, airway clearance techniques and early activities and mobilization.
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2020;8(34):1-50GASTROENTEROLOGÍA / HEPATOLOGÍA
Publicaciones
Scaramuzza AE, Rabbone I, Maffeis C, Schiaffini R, Diabetes Study Group of the Italian
Society for Pediatric Endocrinology, Diabetes. Seasonal flu and COVID-19 recommen-
dations for children, adolescents and young adults with diabetes. Diabet Med. 2020
Oct 17;e14427.
Letter
Doi: 10.1111/dme.14427
Samies NL, Yarbrough A, Boppana S. Pancreatitis in Pediatric Patients with COVID-19.
J Pediatric Infect Dis Soc. 2020 Oct 19.
Doi: 10.1093/jpids/piaa125
Gonzalez Jimenez D, Velasco Rodríguez-Belvís M, Ferrer Gonzalez P, Domínguez Orte-
ga G, Segarra O, Medina Benitez E, et al. COVID-19 Gastrointestinal Manifestations
Are Independent Predictors of PICU Admission in Hospitalized Pediatric Patients. Pe-
diatr Infect Dis J. 2020 Oct 22.
Doi: 10.1097/inf.0000000000002935
Abstract
Multicenter study conducted in 15 hospitals including 101 COVID-19 pediatric inpatients aiming to describe
associated gastrointestinal (GI) manifestations. GI symptoms were present in 57% and were the first mani-
festation in 14%. Adjusted by confounding factors, those with GI symptoms had higher risk of pediatric in-
tensive care unit admission. GI symptoms are predictive of severity in COVID-19 children admitted to hospi-
tals.
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2020;8(34):1-50 Wang J, Cui H, Tang H, Deng X. Gastrointestinal symptoms and fecal nucleic acid tes-
ting of children with 2019 coronavirus disease: a systematic review and meta-
analysis. Sci Rep. 2020 Oct 20;10(1):17846.
Doi: 10.1038/s41598-020-74913-0
Abstract
In order to understand the clinical manifestations and incidence of gastrointestinal symptoms of coronavi-
rus disease (COVID-19) in children and discuss the importance of fecal nucleic acid testing.We retrospecti-
vely analyzed studies on gastrointestinal symptoms and fecal nucleic acid detection in pediatric COVID-19
patients from January 1, 2020 to August 10, 2020, including prospective clinical studies and case reports.
The results of fecal nucleic acid detection were analyzed systematically. Stata12.0 software was used for
meta-analysis.The results showed that the most common gastrointestinal symptoms in children with CO-
VID-19 were vomiting and diarrhea, with a total incidence of 17.7% (95% Cl 13.9-21.5%). However, the pre-
valence of gastrointestinal symptoms in other countries (21.1%, 95% CI 16.5-25.7%) was higher compared
to China (12.9%, 95% CI 8-17.7%). In Wuhan, the pooled prevalence was much higher (41.3%, 95% CI 3.2-
79.4%) compared to areas outside Wuhan in China (7.1%, 95% CI 4.0-10.3%). The positive rate of fecal nu-
cleic acid testing in COVID-19 children was relatively high at 85.8% (91/106). Additionally, 71.2% (52/73)
were still positive for fecal nucleic acid after respiratory tract specimens turned negative. One and two
weeks after the respiratory tract specimens turned nucleic acid-negative, 45.2% (33/73) and 34.2% (25/73)
patients, respectively, remained fecal nucleic acid-positive. The longest interval between the respiratory
tract specimens turning negative and fecal specimens turning negative exceeded 70 days. Conclusions and
relevance: gastrointestinal symptoms in pediatric COVID-19 are relatively common. Attention should be
paid to the detection of fecal nucleic acids in children. Fecal nucleic acid-negative status should be conside-
red as one of the desegregation standards.
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2020;8(34):1-50HEMATOLOGÍA
Publicaciones
Pérez-Heras I, Fernandez-Escobar V, Del Pozo-Carlavilla M, Díaz-Merchán R, Valerio-
Alonso ME, Domínguez-Pinilla N. Two Cases of SARS-CoV-2 Infection in Pediatric On-
cohematologic Patients in Spain. Pediatr Infect Dis J. 2020 Nov;39(11):1040–2.
Doi: 10.1097/inf.0000000000002841
Abstract
Since December 2019, severe acute respiratory syndrome coronavirus 2 infection has spread worldwide.
We all are concerned about immunocompromised children, especially hematologic and oncologic pediatric
patients. We want to share our experience with 2 pediatric cancer patients with severe acute respiratory
syndrome coronavirus 2 infection. Both presented mild disease and good outcome. No respiratory sym-
ptoms were identified, but both developed diarrhea, one probably secondary to lopinavir/ritonavir. Pedia-
tric cancer patients may have milder disease than adults, but larger studies are needed to make conclu-
sions
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2020;8(34):1-50NEFROLOGÍA
Publicaciones
Bjornstad EC, Krallman KA, Askenazi D, Zappitelli M, Goldstein SL, Basu RK, et al. Preli-
minary Assessment of Acute Kidney Injury in Critically Ill Children Associated with
SARS-CoV-2 Infection: A Multicenter Cross-Sectional Analysis. Clin J Am Soc Nephrol.
2020 Nov 3.
Letter
Doi: 10.2215/cjn.11470720
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2020;8(34):1-50NEONATOS / MADRE E HIJO
Publicaciones
Ahanchian H, Moazzen N, Joghatayi SH, Saeidinia A, Khoshkhui M, Aelami MH, et al.
Death due to COVID-19 in an Infant with Combined Immunodeficiencies. Endocr Me-
tab Immune Disord Drug Targets. 2020 Oct 21.
Doi: 10.2174/1871530320666201021142313
Abstract
Novel coronavirus disease 2019 (COVID-19) has affected millions of people, which led to death especially in
older cases with underlying diseases. Meanwhile pediatric patients with inherited defects of T cell should
potentially be prone to viral diseases. Herein, we report an infant with combined immunodeficiency who
died because of COVID-19.
Giovanni JE, Hrapcak S, Melgar M, Godfred-Cato S. Global Reports of Intussusception
in Infants With SARS-CoV-2 Infection. Pediatr Infect Dis J. 2020 Oct 22.
Doi: 10.1097/inf.0000000000002946
Abstract
Idiopathic intussusception is a common cause of bowel obstruction in infants, presenting as refractory ab-
dominal pain or mass, vomiting, lethargy, and currant jelly stool. Coronavirus disease 2019 is not well cha-
racterized in children, especially infants, but symptoms in children have included nausea, vomiting, dia-
rrhea, and abdominal pain. From January to July 2020, intussusception was reported in 5 infants 4–10
months of age who had laboratory-confirmed SARS-CoV-2 infection. All 5 infants presented with currant
jelly stool and at least 1 other abdominal symptom, and none presented with respiratory symptoms. Four
infants recovered but the fifth infant progressed to a critical illness and death. While an association bet-
ween SARS-CoV-2 infection and intussusception has not been established, infants with symptoms consis-
tent with intussusception may warrant testing for viral pathogens, including SARS-CoV-2, especially if pre-
senting to healthcare with a history of SARS-CoV-2 exposure or with signs and symptoms of COVID-19. Mo-
re investigation is needed to determine whether intussusception is part of the clinical spectrum of COVID-
19 in infants or a coincidental finding among infants with SARS-CoV-2 infection.
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2020;8(34):1-50 Rebello CM, Fascina LP, Annicchino G, Pinho JRR, Yoshida R de AM, Zacharias RSB.
Vertical transmission of SARS-CoV-2 from infected pregnant mother to the neonate
detected by cord blood real-time polymerase chain reaction (RT-PCR). Pediatr Res.
2020 Oct 26.
Correspondence
Doi: 10.1038/s41390-020-01193-9
Trieu C, Poole C, Cron RQ, Hallman M, Rutledge C, Bliton K, et al. Severe Neonatal Co-
ronavirus Disease 2019 Presenting as Acute Respiratory Distress Syndrome. Pediatr
Infect Dis J. 2020 Nov;39(11):e367–9.
Doi: 10.1097/inf.0000000000002864
Abstract
Since initial identification of severe acute respiratory syndrome coronavirus 2 in 2019, the virus has proved
to be highly transmissible, resulting in a global pandemic with emerging reports of infected neonates. This
report highlights a severe case of neonatal coronavirus disease 2019 with acute respiratory distress syndro-
me.
McCarty KL, Tucker M, Lee G, Pandey V. Fetal Inflammatory Response Syndrome Asso-
ciated with Maternal SARS-CoV-2 Infection. Pediatrics. 2020 Oct 29.
Doi: 10.1542/peds.2020-010132
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2020;8(34):1-50 Di Toro F, Gjoka M, Di Lorenzo G, De Seta F, Maso G, Risso FM, et al. Impact of COVID-
19 on maternal and neonatal outcomes: a systematic review and meta-analysis. Clin
Microbiol Infect. 2020 Nov 1 .
Doi: 10.1016/j.cmi.2020.10.007
Abstract
Background: Previous outbreaks of severe acute respiratory syndrome coronavirus 1 (SARS-CoV-1) and
Middle East respiratory syndrome coronavirus (MERS-CoV) have been associated with unfavourable preg-
nancy outcomes. SARS-CoV-2 belongs to the human coronavirus family, and since this infection shows a
pandemic trend it will involve many pregnant women.
Aims: This systematic review and meta-analysis aimed to assess the impact of coronavirus disease 19
(COVID-19) on maternal and neonatal outcomes.
Sources: PubMed, EMBASE, MedRxiv, Scholar, Scopus, and Web of Science databases were searched up to
8th May 2020. Articles focusing on pregnancy and perinatal outcomes of COVID-19 were eligible. Partici-
pants were pregnant women with COVID-19.
Content:: The meta-analysis was conducted following the PRISMA and MOOSE reporting guidelines. Bias
risk was assessed using the Joanna Briggs Institute (JBI) manual. The protocol was registered with PROSPE-
RO (CRD42042020184752). Twenty-four articles, including 1100 pregnancies, were selected. The pooled
prevalence of pneumonia was 89% (95%CI 70-100), while the prevalence of women admitted to the inten-
sive care unit was 8% (95%CI 1-20). Three stillbirths and five maternal deaths were reported. A pooled pre-
valence of 85% (95%CI 72-94) was observed for caesarean deliveries. There were three neonatal deaths.
The prevalence of COVID-19-related admission to the neonatal intensive care unit was 2% (95%CI 0-6). Ni-
neteen out of 444 neonates had a positive nasopharyngeal swab; one out of five neonates had elevated
concentrations of serum IgM and IgG, but a negative swab.
Implications: Although adverse outcomes such as ICU admission or patient death can occur, the clinical
course of COVID-19 in most women is not severe, and the infection does not significantly influence the
pregnancy. A high caesarean delivery rate is reported, but there is no clinical evidence supporting this mo-
de of delivery. Indeed, in most cases the disease does not threaten the mother, and vertical transmission
has not been clearly demonstrated. Therefore, COVID-19 should not be considered as an indication for
elective caesarean section.
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2020;8(34):1-50NEUROLOGÍA / NEUROCIRUGÍA
Publicaciones
Kim Y, Walser SA, Asghar SJ, Jain R, Mainali G, Kumar A. A Comprehensive Review of
Neurologic Manifestations of COVID-19 and Management of Pre-existing Neurologic
Disorders in Children. J Child Neurol. 2020 Oct 28;883073820968995.
Doi: 10.1177/0883073820968995
Abstract
Since the first reports of SARS-CoV-2 infection from China, multiple studies have been published regarding
the epidemiologic aspects of COVID-19 including clinical manifestations and outcomes. The majority of
these studies have focused on respiratory complications. However, recent findings have highlighted the
systemic effects of the virus, including its potential impact on the nervous system. Similar to SARS-CoV-1,
cellular entry of SARS-CoV-2 depends on the expression of ACE2, a receptor that is abundantly expressed in
the nervous system. Neurologic manifestations in adults include cerebrovascular insults, encephalitis or
encephalopathy, and neuromuscular disorders. However, the presence of these neurologic findings in the
pediatric population is unclear. In this review, the potential neurotropism of SARS-CoV-2, known neurologic
manifestations of COVID-19 in children, and management of preexisting pediatric neurologic conditions
during the COVID-19 pandemic are discussed.
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2020;8(34):1-50NEUMOLOGÍA
Publicaciones
Abrams EM, Sinha I, Fernandes RM, Hawcutt DB. Pediatric asthma and COVID-19: The
known, the unknown, and the controversial. Pediatr Pulmonol. 2020 Oct 15.
Doi: 10.1002/ppul.25117
Abstract
The novel coronavirus disease-2019 (COVID-19), caused by the pathogen severe acute respiratory syndro-
me-CoV-2, is causing a global pandemic, with over 26.9 million cases and 880,000 deaths as of September
6, 2020. While there has been speculation and observational research about the impact of COVID-19 on
asthma, much remains unknown. The goal of this article is to provide a scoping review on pediatric asthma
and COVID-19 and summarize what we do and do not know from the first wave of the pandemic.
Melé M, Henares D, Pino R, Asenjo S, Matamoros R, Fumadó V, et al. Low impact of
SARS-CoV-2 infection among paediatric acute respiratory disease hospitalizations. J
Infect. 2020 Oct 21.
Doi: 10.1016/j.jinf.2020.10.013
Abstract
Objective: This study describes the characteristics of children requiring admission with an acute lower-
respiratory disease (ALRD) during the SARS-CoV-2 pandemics.
Methods: Epidemiological, clinical, and microbiological data from patients with ALRD (pneumonia, bron-
chiolitis, bronchospasm) admitted to a reference paediatric hospital in Spain during the pandemic peak
(week 11-20/2020) were prospectively analysed.
Results: 110 patients were included. 7 were SARS-CoV-2(+) and they were older in comparison to SARS-
CoV-2(-). Among SARS-CoV-2(+) patients, pneumonia was the main clinical diagnosis (6/7) and bronchos-
pasm was absent. Only 1 of 29 infants diagnosed with bronchiolitis was SARS-CoV-2(+). Lower values of
leucocytes, lymphocytes, neutrophils, and platelets and higher values of creatinine were found in SARS-
CoV-2(+). Human-rhinovirus/enterovirus was the main detection (11/32). There were not differences in
PICU admission rates between SARS-CoV-2(+) and (-).
Conclusions: Most of the ALRD episodes identified during the pandemics were not related to SARS-CoV-2
infection. SARS-CoV-2 was mainly found causing pneumonia in older children.
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2020;8(34):1-50 Kotula JJ, Balakumar N, Khan D, Patel B. Bilateral pulmonary emboli in a teenager
with positive SARS-CoV-2 antibody. Pediatr Pulmonol. 2020 Oct 23.
Doi: 10.1002/ppul.25132
Abstract
Thromboembolic phenomena, particularly pulmonary emboli, have been described in adult patients with
SARS-CoV-2 infection, but have been less evident in children. We describe a case of a teenager with bilate-
ral pulmonary emboli leading to cardiovascular collapse in the setting ofa positiveSARS-CoV-2 IgM anti-
body.
Melé M, Henares D, Pino R, Asenjo S, Matamoros R, Fumadó V, et al. Low impact of
SARS-CoV-2 infection among paediatric acute respiratory disease hospitalizations. J
Infect. 2020 Oct 21.
Doi: 10.1016/j.jinf.2020.10.013
Abstract
Objective: This study describes the characteristics of children requiring admission with an acute lower-
respiratory disease (ALRD) during the SARS-CoV-2 pandemics.
Methods: Epidemiological, clinical, and microbiological data from patients with ALRD (pneumonia, bron-
chiolitis, bronchospasm) admitted to a reference paediatric hospital in Spain during the pandemic peak
(week 11-20/2020) were prospectively analysed.
Results: 110 patients were included. 7 were SARS-CoV-2(+) and they were older in comparison to SARS-
CoV-2(-). Among SARS-CoV-2(+) patients, pneumonia was the main clinical diagnosis (6/7) and bronchos-
pasm was absent. Only 1 of 29 infants diagnosed with bronchiolitis was SARS-CoV-2(+). Lower values of
leucocytes, lymphocytes, neutrophils, and platelets and higher values of creatinine were found in SARS-
CoV-2(+). Human-rhinovirus/enterovirus was the main detection (11/32). There were not differences in
PICU admission rates between SARS-CoV-2(+) and (-).
Conclusions: Most of the ALRD episodes identified during the pandemics were not related to SARS-CoV-2
infection. SARS-CoV-2 was mainly found causing pneumonia in older children.
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2020;8(34):1-50 Yu X. Children wearing facemasks during the COVID-19 pandemic has reduced pressu-
re on paediatric respiratory departments. Acta Paediatr. 2020 Oct 26.
Doi: 10.1111/apa.15639
Abstract
Pneumonia is usually the most commonly treated disease in paediatric respiratory departments, but we
have recently noticed an interesting trend (1). The COVID-19 pandemic has put hospitals under great
stress, but we have seen a sharp drop in paediatric respiratory patients in 2020 in a number of Chinese
hospitals.
Gajaweera H, Oladele D, Connett G. Evaluation of the impact of shielding to avoid CO-
VID-19 infection on respiratory symptoms in children with severe asthma. Arch Dis
Child. 2020 Oct 27.
Letter
Doi: 10.1136/archdischild-2020-320498
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2020;8(34):1-50NUTRICIÓN
Publicaciones
Kesavelu D, Franklyn N, Sreedharan L. Can Nutrition Play a Role as a Stimulant for CO-
VID 19 in Children? Rev Recent Clin Trials. 2020 Nov 4.
Doi: 10.2174/1574887115666201104154713
Abstract
Background: Nutrition plays a major part in the growth and well-being of a child and forms the basis of
their existence. A global pandemic like COVID19 poses some serious questions and challenges in the minds
of practicing pediatricians as what support to offer our children, theirparents and carers-alleviating their
anxiety about their child's diet and nutrition, that is critical at this time of crisis. Although the evidence for
pediatric nutrition and COVID19 is not strong, this article aims to critically look into pediatric nutrition du-
ring COVID19 pandemic and bring the most recent evidence into limelight and making the right choices
with pediatric nutrition.
Methods: We performed a search on recent literature using the search terms "Covid19" + "Children" +
"Nutrition" to analyze the current evidence supporting nutrition as a stimulant for covid19. A review article
based on the above search results was written to highlight the importance of nutrition during this pande-
mic.
Results: Strong recommendations remain unchanged for breast feeding, healthy complimentary feeding,
use of supplemental formula where appropriate, Oral nutritional supplements, Zinc, n-3& n- 6 fatty acids,
probiotics all have a certain role to play as a stimulant for Covid19 in children.
Conclusion: Current evidence emphasizes the use of additional nutritional supplements especially in the
"at risk" groups, low socio-economic status and children with chronic medical problems. Paediatric nutri-
tion should never be overlooked and "one size does not fit all" as every child is different and their indivi-
dual nutritional needs vary.
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2020;8(34):1-50OFTALMOLOGÍA
Publicaciones
Danthuluri V, Grant MB. Update and Recommendations for Ocular Manifestations of
COVID-19 in Adults and Children: A Narrative Review. Ophthalmol Ther. 2020 Oct 15.
Doi: 10.1007/s40123-020-00310-5
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has instigated severe global turmoil both medically
and socioeconomically. Research continues to rapidly develop in order to fully comprehend the new severe
acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This study focuses on the rare ophthalmologic
manifestations of the SARS-CoV-2 disease process in both adults and children. There is evidence to suggest
that viral transmission can occur via tears and conjunctival secretions, although it is not a predominant fin-
ding. This review considers all the published studies describing ocular findings and SARS-CoV-2 viral trans-
mission through the eye. The review addresses the ongoing debate over the importance of ocular manifes-
tations during this pandemic. The most updated safety guidelines, protocols, timelines of ocular manifesta-
tions during the disease course, and treatment recommendations are discussed. The majority of patients
with COVID-19 with eye symptoms presented with them initially. It is possible that the virus becomes ino-
culated at the site of the eye and spreads via the nasolacrimal duct to the respiratory system. There are
also some reports which show that ocular findings present later in the disease course, suggestive of a co-
rrelation between ocular manifestation and increased disease severity as the infection becomes systemic.
We highlight the importance of recognizing conjunctivitis as an early finding of COVID-19, and that testing
or appropriate follow-up could be beneficial in both the pediatric and adult populations.
Camhi SS, Shah K, Cavuoto KM. Pediatric Eye Care: We Cannot Lose Sight of Its Impor-
tance despite the COVID-19 Pandemic. J Binocul Vis Ocul Motil. 2020 Oct 30;1–3.
Doi: 10.1007/s40123-020-00310-5
Abstract
Visual impairment affects over 19 million children globally and, if left untreated, can result in significant
ocular morbidity. Due to the treatable nature of many childhood visual disturbances, pediatric vision scree-
ning is essential for optimization of health and developmental outcomes. The coronavirus disease 2019
(COVID-19) pandemic has inevitably disrupted the provision of routine pediatric health care as evidenced
by reduced adherence to vaccination schedules. Further, the home environment, which many children ha-
ve now become confined to, is known to pose risk for eye trauma which may result in irreversible vision
loss. Therefore, it is imperative for pediatricians and pediatric ophthalmologists to focus on eye health and
safety, despite the backdrop of a global pandemic.
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2020;8(34):1-50ONCOLOGÍA
Publicaciones
Zhang L, He D, Niu W. Important Concerns Over SARS-CoV-2 Infection in Children With
Cancer. JAMA Oncol. 2020 Oct 15.
Commentary & Response
Doi: 10.1001/jamaoncol.2020.4756
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2020;8(34):1-50PROFESIONALES DE LA SALUD
Publicaciones
Tubbs-Cooley HL, Oster E, Auger KA. Under the Right Conditions, Center-Based Child
Care is an Unlikely COVID-19 Threat to Staff. Pediatrics. 2020 Oct 15.
Doi: 10.1542/peds.2020-034405
Hizal M, Aykac K, Yayla BCC, Yilmaz A, Altun D, Akkaya HE, et al. Diagnostic Value of
Lung Ultrasonography in Children with COVID-19. Pediatr Pulmonol. 2020 Oct 21.
Doi: 10.1097/inf.0000000000002866
Abstract
Objective: Healthcare workers (HCWs) are particularly exposed SARS-CoV-2 because they are critical in pre-
venting viral transmission and treating COVID-19 patients. Within HCWs, personnel of intensive care units
(ICUs) are at the forefront of treating patients with a severe course of COVID-19 infection and therefore
represent an extremely vulnerable group. Thus, our objective is to contribute to establish means of infec-
tion control protecting HCWs in the frontline of the current pandemic.
Design: An outbreak of SARS-CoV-2 was detected and contained in a pediatric ICU (PICU). The first positive
case was identified with a point-of-care diagnostic system on site. Real-time PCR-based testing systems
from self-collected nasopharyngeal samples swabs were used to test for viral RNA of SARS-CoV-2 in the
follow-up.
Setting: PICU within a tertiary university hospital in Germany.
Participants: Healthcare workers of the PICU.
Interventions: Positive HCWs were sent into quarantine. Containment measures were implemented inclu-
ding wearing of surgical-masks, physical distancing and systematic testing.
Results: Among 432 HCWs, 91 (25%) were tested. Forty-five percent reported symptoms corresponding to
characteristics of COVID-19. Of those, only 19,5% (8 HCWs) were tested positive for SARS-CoV-2. No infec-
tion occurred outside the PICU. After the implementation of containment measures, viral transmission was
stopped.
Conclusions: In the present study, a large outbreak within a team of healthcare workers of a PICU, affecting
almost one fifth of the entire personnel is documented, along with detailed insights about how the out-
break was contained and how operability of the unit was maintained.
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2020;8(34):1-50RADIOLOGÍA
Publicaciones
Hizal M, Aykac K, Yayla BCC, Yilmaz A, Altun D, Akkaya HE, et al. Diagnostic Value of
Lung Ultrasonography in Children with COVID-19. Pediatr Pulmonol. 2020 Oct 21.
Doi: 10.1002/ppul.25127
Abstract
Background: Lung ultrasound (LUS) has been successfully used in the diagnosis of different pulmonary di-
seases. Present study design to determine the diagnostic value of LUS in the evaluation of children with
COVID-19.
Method and objectives: Prospective multi-center study, 40 children with confirmed COVID-19 were inclu-
ded. LUS was performed to all patients at admission. The chest X-ray and CT were performed according to
the decision of the primary physicians. LUS results were compared with chest X-ray and CT findings and
diagnostic performance was determined.
Results: Of the 40 children median (range) was 10.5 (0.4-17.8) years. Chest X-ray and LUS were performed
on all and chest CT was performed on 28 (70%) patients at the time of diagnosis. Sixteen (40%) patients
had no apparent chest CT abnormalities suggestive of COVID-19, whereas 12 (30%) had abnormalities. LUS
confirmed the diagnosis of pulmonary involvement in 10 out of 12 patients with positive CT findings. LUS
demonstrated normal lung patterns among 15 patients out of 16 who had normal CT features. The sensiti-
vity and the area under the ROC curve (AUC) identified by the chest X-ray and LUS tests were compared
and statistically significantly different (McNemar's test: p-value 0.016 and 0.001 respectively) detected.
Chest X-ray displayed false-negative results for pulmonary involvement in 75% whereas for LUS it was
16.7%.
Conclusions: LUS might be a useful tool in the diagnostic steps of children with COVID-19. A reduction in
chest CT assessments may be possible when LUS is used in the initial diagnostic steps for these children.
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2020;8(34):1-50 Guitart C, Suárez R, Girona M, Bobillo-Perez S, Hernández L, Balaguer M, et al. Lung
ultrasound findings in pediatric patients with COVID-19. Eur J Pediatr. 2020 Oct 22.
Doi: 10.1007/s00431-020-03839-6
Abstract
During the pandemic caused by the novel coronavirus (COVID-19), lung ultrasound has been used to diag-
nose and monitor respiratory condition. The aim of the study was to describe lung ultrasound findings in
children with a COVID-19 infection. Patients younger than 18 years old and positive for COVID-19, admitted
to pediatric tertiary referral hospital were included. They were divided into two groups depending on the
presence of respiratory symptoms. Lung ultrasound results were categorized into four degrees according to
Soldati et al. score (J Ultrasound Med 39:1-7, 2020) and it was also described the presence and type of con-
solidation. Sixteen patients were recruited. The median age was 11 years old (IQR 2.8-12). Four children
(25%) required admission to the intensive care unit. Six patients (37.5%) presented with respiratory sym-
ptoms. Most of them showed S.score of 2 and subpleural consolidations were observed in four cases
(66.6%). Ten patients (62.5%) presented with non-respiratory symptoms, lung ultrasound showed S.score
from 0 to 2. Three (30%) were diagnosed of multisystem inflammatory syndrome and lung ultrasounds
showed S.score of 2 with bilateral pleural effusion.Conclusions: Children with COVID-19 and respiratory
symptoms mostly showed a S.score of 2 and 3 with subpleural consolidations, upon the lung ultrasound
assessment. What is Known: • Lung ultrasound is a useful tool for monitoring patients with respiratory
symptoms in both adults and children. Lung ultrasounds are altered in adult patients with COVID-19. What
is New: • Lung ultrasound might improve COVID-19 assessment, it could be a useful tool to diagnose and
monitor patients throughout the COVID-19 pandemic. Even COVID-19 patients with non-respiratory sym-
ptoms have lung alterations that are visible on lung ultrasound.
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2020;8(34):1-50 Peng X, Guo Y, Xiao H, Xia W, Zhai A, Zhu B, et al. Overview of chest involvement at
computed tomography in children with coronavirus disease 2019 (COVID-19). Pediatr
Radiol. 2020 Oct 21.
Doi: 10.1007/s00247-020-04826-7
Abstract
Background: Chest computed tomography (CT) findings in children with coronavirus disease 2019 (COVID-
19) have been rarely reported in a comprehensive and systematic manner.
Objective: We investigated the chest CT findings in children with COVID-19, and explored the differences in
these findings between symptomatic patients and asymptomatic patients.
Materials and methods: Demographic findings, clinical characteristics, duration of hospital stay and viral
shedding, and chest CT findings in 201 children infected with severe acute respiratory syndrome coronavi-
rus-2 (SARS-CoV-2) were retrospectively analyzed from January 15 to March 20, 2020, and divided into two
groups: symptomatic group (n=136) and asymptomatic group (n=65). Chi-square test and Student's t-test
were used for statistical analysis.
Results: Symptomatic patients were mainly young children ≤3 years old (54/63, 86%),while asymptomatic
patients were mainly children ≥ 6 years old (51/111, 46%). Fever (41%) and cough (41%) were the most
common symptoms. Overall, 119/201 (59%) patients had chest CT findings, and symptomatic patients ac-
counted for 82% (98/119). The CT findings presented as bilateral multiple lesions (60/119, 50.4%), ground-
glass opacities (83/119, 70%) and/or consolidation (44/119, 37%) with a peripheral and subpleural distribu-
tion (62/83, 75%). Fifteen of 87 (7.2%) patients with lung lesions showed complete lesion absorption, and
42/87 (48%) improved within a mean of 9.1 (standard deviation [SD] 3.2) days. The mean duration of viral
shedding was 8.7 (SD 4.9) days. Pleural effusion was very rare. No lymphadenopathy was found in either
group.
Conclusion: Symptoms associated with pulmonary involvement were most common in infants and young
children. The lung lesions of most patients were absorbed and improved in about 9 days.
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2020;8(34):1-50 Hizal M, Aykac K, Yayla BCC, Yilmaz A, Altun D, Akkaya HE, et al. Diagnostic Value of
Lung Ultrasonography in Children with COVID-19. Pediatr Pulmonol. 2020 Oct 21.
Doi: 10.1002/ppul.25127
Abstract
Background: Lung ultrasound (LUS) has been successfully used in the diagnosis of different pulmonary di-
seases. Present study design to determine the diagnostic value of LUS in the evaluation of children with
COVID-19.
Method and objectives: Prospective multi-center study, 40 children with confirmed COVID-19 were inclu-
ded. LUS was performed to all patients at admission. The chest X-ray and CT were performed according to
the decision of the primary physicians. LUS results were compared with chest X-ray and CT findings and
diagnostic performance was determined.
Results: Of the 40 children median (range) was 10.5 (0.4-17.8) years. Chest X-ray and LUS were performed
on all and chest CT was performed on 28 (70%) patients at the time of diagnosis. Sixteen (40%) patients
had no apparent chest CT abnormalities suggestive of COVID-19, whereas 12 (30%) had abnormalities. LUS
confirmed the diagnosis of pulmonary involvement in 10 out of 12 patients with positive CT findings. LUS
demonstrated normal lung patterns among 15 patients out of 16 who had normal CT features. The sensiti-
vity and the area under the ROC curve (AUC) identified by the chest X-ray and LUS tests were compared
and statistically significantly different (McNemar's test: p-value 0.016 and 0.001 respectively) detected.
Chest X-ray displayed false-negative results for pulmonary involvement in 75% whereas for LUS it was
16.7%.
Conclusions: LUS might be a useful tool in the diagnostic steps of children with COVID-19. A reduction in
chest CT assessments may be possible when LUS is used in the initial diagnostic steps for these children.
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2020;8(34):1-50REUMATOLOGÍA
Publicaciones
Arango YAN, Ariff Farfán Cortés AYA, Henao JPG, Slingsby CA, Rivera LMS. Síndrome
inflamatorio multisistémico en niños con COVID-19: una visión desde la reumatología.
Rev Colom Reum. 2020 Oct 17.
Doi: 10.1093/jpepsy/jsaa092
Abstract
Objective: A systematic review of mental health outcomes and needs of children and families during past
pandemics was conducted based on the PRISMA protocol. The objectives were to evaluate the quality of
existing studies on this topic, determine what is known about mental health outcomes and needs of chil-
dren and families, and provide recommendations for how COVID-19 policies can best support children and
families.
Methods: Seventeen studies were identified through a search of PsycINFO, PubMed, Scopus, Web of Scien-
ce, and Google Scholar.
Results: Studies examining child outcomes indicate that social isolation and quarantining practices exert a
substantial negative impact on child anxiety, post-traumatic stress disorder, and fear symptoms. Potential
risk factors such as living in rural areas, being female, and increasing grade level may exacerbate negative
mental health outcomes for children. Studies examining parental and family outcomes indicate that pa-
rents experience high stress, anxiety, and financial burden during pandemics. The age of the parent and
family socioeconomic status (SES) appeared to mitigate negative outcomes, where older parents and
higher SES families had lower rates of mental health problems. Parents' fear over the physical and mental
health of their children, concerns over potential job loss and arranging childcare contributes to elevated
stress and poorer well-being.
Conclusions: Findings from this review suggest current gaps in COVID-19 policies and provide recommen-
dations such implementing "family-friendly" policies that are inclusive and have flexible eligibility criteria.
Examples include universal paid sick leave for parents and financial supports for parents who are also
frontline workers and are at an elevated risk for contracting the disease.
Keywords: COVID-19; child; families; infectious disease outbreaks; mental health; pandemics; parents; poli-
cy..
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2020;8(34):1-50SALUD MENTAL
Publicaciones
Amorim R, Catarino S, Miragaia P, Ferreras C, Viana V, Guardiano M. Impacto de la
COVID-19 en niños con trastorno del espectro autista. Rev Neurol. 2020 Oct 16;71
(8):285–91.
Doi: 10.33588/rn.7108.2020381
Resumen
Introducción: Los niños con trastorno del espectro autista (TEA) a menudo experimentan el cambio de ruti-
nas como un desafío importante. La necesidad de adaptación durante la pandemia por la COVID-19 puede
haber causado problemas a estos niños.
Objetivo: Conocer cómo vivieron los niños con TEA y sus familias el aislamiento social durante la cuarente-
na.
Sujetos y métodos. Se realizó un estudio observacional, transversal y analítico. Se aplicó un cuestionario
anónimo que incluía las características demográficas y clínicas de los niños, junto con el impacto que tuvo
la pandemia en diferentes aspectos de la vida diaria de las familias.
Resultados: De los 99 cuestionarios obtenidos, 43 eran niños con TEA y 56 niños del grupo control. Los ni-
ños con TEA tuvieron predominantemente cambios en el comportamiento, a diferencia de los del grupo
control. La mayoría de los niños con TEA tuvo un impacto negativo en el manejo de las emociones frente a
los del grupo control, que expresaron un impacto mayoritariamente positivo/nulo. Los cuidadores puntua-
ron niveles de ansiedad más altos en ellos mismos que en sus hijos. Los niños con TEA y sus padres tenían
niveles más altos de ansiedad que los controles. En el grupo con TEA, los niños que no mantuvieron las ruti-
nas tuvieron niveles de ansiedad más altos.
Conclusión: Los resultados muestran un potencial impacto psicológico de la pandemia de la COVID-19 no
sólo en los niños con trastornos del neurodesarrollo, sino también en sus cuidadores. Debe estarse prepa-
rado para la vigilancia de los trastornos mentales en las familias tras la pandemia de la COVID-19.
Iqbal SA, Tayyab N. COVID-19 and Children: The Mental & Physical Reverberations of
the Pandemic. Child Care Health Dev. 2020 Nov 3.
Letter
Doi: 10.1111/cch.12822
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2020;8(34):1-50 Pedreira Massa JL. Salud mental y covid-19 en infancia y adolescencia: visión desde la psico-
patología y la salud pública. Rev Esp Salud Publica. 2020 Oct 16;94.
Enlace:
https://www.mscbs.gob.es/biblioPublic/publicaciones/recursos_propios/resp/ revis-
ta_cdrom/VOL94/C_ESPECIALES/RS94C_202010141.pdf
Resumen
La pandemia producida por COVID-19 ha tenido un impacto de relevancia en la sociedad y también ha afectado a la
infancia y adolescencia que, en general, ha sido el colectivo más silenciado. En este artículo se abordan los contenidos
que afectan a la salud mental de la infancia y la adolescencia en el seno de la pandemia por la COVID-19, para ello se
sitúa en la “cuarta oleada asistencial” en la categoría F54 de la CIE-10 (“factores psicológicos y del comportamiento en
trastornos o enfermedades clasificados en otro lugar”) (figura 1). El mecanismo de presentación puede ser: reactivo-
adaptativo ante la pandemia; factor desencadenante, ante una inestabilidad afectivo-emocional previa; descompen-
sación de un proceso preexistente. Las formas de presentación han tenido su fase de inicio, fundamentalmente, en el
confinamiento: con formas somatizadas, comportamentales, síntomas emocionales, reactivación de malos tratos a la
infancia y reacciones de duelo disfuncionales. Los síntomas más prevalentes son de tipo ansioso o ansioso-depresivo.
La respuesta al estrés de forma crónica, incluyendo el de bajo perfil e intensidad pero mantenido en el tiempo, posee
repercusiones de relieve para el conjunto de la infancia y la adolescencia. Sólo un escaso porcentaje presenta trastor-
nos mentales de relieve, pero hemos de reconocer que al proyectarse sobre el conjunto poblacional infanto-juvenil
podrían ser un número importante que pudiera ser subsidiario de una ayuda más específica. El retorno a la escolari-
dad va a representar otro momento importante, siendo de capital importancia las repercusiones del confinamiento,
sobre todo en cuanto a conductas de tipo adictivo con las tecnologías de la información y la comunicación. La inter-
vención por profesionales formados en salud mental de la infancia y la adolescencia es una prioridad para evitar evo-
luciones clínicas no deseadas o iatrogenia.
Fitzpatrick O, Carson A, Weisz JR. Using Mixed Methods to Identify the Primary Mental
Health Problems and Needs of Children, Adolescents, and Their Caregivers during the Coro-
navirus (COVID-19) Pandemic. Child Psychiatry Hum Dev. 2020 Oct 27.
Doi: 10.1007/s10578-020-01089-z
Abstract
Our understanding of child, adolescent, and caregiver mental health (MH) problems during the coronavirus pandemic,
and which interventions are needed, may be advanced by consumer input. 133 general population caregivers repor-
ted top MH problems and needs for themselves and their children (Mage = 8.21; SD = 4.94), using standardized and
idiographic measures. We applied linear regression models to quantitative data and thematic analysis to qualitative
data. Caregivers’ COVID-era depression and anxiety symptom means fell within the clinical range, as did their chil-
dren’s MH symptoms. Caregiver-reported child and adolescent symptoms were positively associated with number of
children in the home. Caregiver and caregiver-reported child and adolescent symptoms were more pronounced in
regions with more lenient COVID-19 restrictions. Among the kinds of help most urgently needed, MH services were
ranked #1 for caregivers and adolescents, #2 for 6–12 year-olds, and #3 for 1–5 year-olds. Top problems identified for
each age group highlight pressing pandemic-related intervention targets.
Bol alerta COVID-19 - Inst. Nac. Salud Niño San Borja (Perú) 2020;8(34):1-50You can also read
