Clinical manifestations presented by children infected with COVID-19: an integrative review

Authors

  • Jallyne Colares Bezerra Universidade da Integração Internacional da Lusofonia Afro-Brasileira (UNILAB), Redenção, Ceará, Brasil, jallynecolares@gmail.com. https://orcid.org/0000-0002-9527-8341
  • Hévila Ferreira Gomes Medeiros Braga Universidade da Integração Internacional da Lusofonia Afro-Brasileira (Universidade da Integração Internacional da Lusofonia Afro-Brasileira (UNILAB), Redenção, Ceará, Brasil, hevila.medeiros.hm@gmail.com. https://orcid.org/0000-0003-4188-2882
  • Francisca Mayra de Sousa Melo Faculdade Princesa do Oeste (FPO), Crateús, Ceará, Brasil, mayrasmelo18@gmail.com. https://orcid.org/0000-0002-9622-7669
  • Aline Pereira do Nascimento Universidade da Integração Internacional da Lusofonia Afro-Brasileira (UNILAB), Redenção, Ceará, Brasil, aline.nascimento86@hotmail.com. https://orcid.org/0000-0002-0496-4400
  • Flavio Brayan Balbino Silva Universidade da Integração Internacional da Lusofonia Afro-Brasileira (UNILAB), Redenção, Ceará, Brasil, brayanbalbino@gmail.com. https://orcid.org/0000-0002-6089-2747
  • Emanuella Silva Joventino Melo Universidade da Integração Internacional da Lusofonia Afro-Brasileira (UNILAB), Redenção, Ceará, Brasil, ejoventino@unilab.edu.br. https://orcid.org/0000-0001-9786-5059

DOI:

https://doi.org/10.5216/ree.v23.65966

Keywords:

Coronavirus Infections, COVID-19, Signs and Symptoms, Child Health, Psychiatric nursing - Depresión

Abstract

Objective: The objective was to analyze the scientific evidence on the clinical manifestations presented by children infected with COVID-19. Method: Integrative review conducted in PubMed, CINAHL, LILACS, Web of Science, SCOPUS and SCIENCE DIRECT databases from December 2019 to June 2020. Twenty articles were selected. Results: Two thematic categories emerged: “Mild or moderate clinical features” and “COVID-19 associated multisystem inflammatory syndrome”. Most children were infected by their parents or close relatives. The symptoms presented by children were predominantly mild or moderate and with quick recovery. The main clinical manifestations presented by children infected with SARS-CoV-2 were fever, gastrointestinal signs, respiratory signs, and more recently, symptoms similar to those of Kawasaki Disease, which was called COVID-19 associated multisystem inflammatory syndrome. Conclusion: Faced with this, health professionals must be alert to recognize these cases in order to offer appropriate and timely management during health care.

Downloads

Download data is not yet available.

References

Park JY, Han MS, Park KU, Kim JY, Choi EH. First Pediatric Case of Coronavirus Disease 2019 in Korea. J Korean Med Sci [Internet]. 2020 [acesso em: 3 maio 2020];35(11):e124. Disponível em: https://doi.org/10.3346/jkms.2020.35.e124.

Verdoni L, Mazza A, Gervasoni A, Martelli L, Ruggeri M, Ciuffreda M, et al. An outbreak of severe Kawasaki-like disease at the Italian epicentre of the SARS-CoV-2 epidemic: an observational cohort study. Lancet [Internet]. 2020 [acesso em: 13 maio 2020];395(10239):1771–8. Disponível em: https://doi.org/10.1016/S0140-6736(20)31103-X.

Horton R. Offline: COVID-19 is not a pandemic. Lancet [Internet]. 2020 [acesso em: 18 nov. 2020];396(10255):874. Disponível em: https://doi.org/10.1016/S0140-6736(20)32000-6.

Organização Pan-Americana de Saúde. Folha informativa sobre COVID-19. [Internet]. 2020 [acesso em: 27 set. 2020]. Disponível em: https://www.paho.org/pt/covid19.

Brasil. Ministerio da Saúde (BR). Painel coronavírus [Internet]. 2020 [acesso em: 27 set. 2020]. Disponível em: https://covid.saude.gov.br/.

Vilelas JMS. The new coronavirus and the risk to children’s health. Rev Lat-Am Enfermagem [Internet]. 2020 [acesso em: 3 maio 2020];28:e3320. Disponível em: http://dx.doi.org/10.1590/1518-8345.0000.3320.

Brasil. Ministério da Saúde (BR). Fluxo de Manejo Clínico Pediátrico na Atenção Especializada [Internet]. 2020 [acesso em: 3 maio 2020]. Disponível em: https://www.saude.ms.gov.br/wp-content/uploads/2020/03/Fluxo-de-manejo-clinico-pedi-trico.pdf.

Mahase E. Covid-19: concerns grow over inflammatory syndrome emerging in children. BMJ [Internet]. 2020 [acesso em: 8 maio 2020];369:m1710. Disponível em: https://doi.org/10.1136/bmj.m1710.

Li Y, Guo F, Cao Y, Li L, Guo Y. Insight into COVID-2019 for pediatricians. Pediatr Pulmonol [Internet]. 2020 [acesso em: 8 maio 2020];55(5):E1–E4. Disponível em: https://doi.org/10.1002/ppul.24734.

Souza MT, Silva MD, Carvalho R. Integrative review: what is it? How to do it? Einstein [Internet]. 2010 [acesso em: 3 jun. 2020];8(1):102–6. Disponível em: http://dx.doi.org/10.1590/s1679-45082010rw1134.

Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med. [Internet]. 2009 [acesso em: 3 jun. 2020];6(7):e1000097. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2707599/.

Brasil. Ministério da Saúde (BR). Estatuto da Criança e do Adolescente. 3. ed. Brasília, DF: Editora do Ministério da Saúde [Internet]. 2008. [acesso em: 16 nov. 2020]. Disponível em: http://bvsms.saude.gov.br/bvs/publicacoes/estatuto_crianca_adolescente_3ed.pdf.

Xu Y, Li X, Zhu B, Liang H, Fang C, Gong Y, et al. Characteristics of pediatric SARS-CoV-2 infection and potential evidence for persistent fecal viral shedding. Nat Med [Internet]. 2020 [acesso em: 4 jun. 2020];26:502– 55. Disponível em: https://doi.org/10.1038/s41591-020-0817-4.

Soltani J, Sedighi I, Shalchi Z, Sami G, Moradveisi B, Nahidi S. Pediatric coronavirus disease 2019 (COVID-19): An insight from west of Iran. North Clin Istanb [Internet]. 2020 [acesso em: 17 jun. 2020];7(3):284–91. Disponível em: https://doi.org/10.14744/nci.2020.90277.

Sun D, Li H, Lu X, Xiao H, Ren J, Zhang F, et al. Clinical features of severe pediatric patients with coronavirus disease 2019 in Wuhan: a single center’s observational study. World J Pediatric [Internet]. 2020 [acesso em: 5 jun. 2020];16:251-9 Disponível em: https://doi.org/10.1007/s12519-020-00354-4.

Sociedade Brasileira de Pediatria (BR). Síndrome inflamatória multissistêmica em crianças e adolescentes provavelmente associada à COVID-19: uma apresentação aguda, grave e potencialmente fatal [Internet]. 2020 [acesso em: 29 ago. 2020]. Disponível em: https://www.sbp.com.br/fileadmin/user_upload/22532d-NA_Sindr_Inflamat_Multissistemica_associada_COVID19.pdf.

Souza TH, Nadal JA, Nogueira RJN, Pereira RM, Brandão MB. Clinical manifestations of children with COVID-19: A systematic review. Pediatr Pulmonol [Internet]. 2020 [acesso em: 29 ago. 2020];55(8):1892– 9. Disponível em: https://doi.org/10.1002/ppul.24885.

Wang J, Wang D, Chen GC, Tao XW, Zeng LK. SARS- CoV-2 infection with gastrointestinal symptoms as the first manifestation in a neonate. Chin J Contemp Pediatr [Internet]. 2020 [acesso em: 28 jun. 2020];22(3):211– 4. Disponível em: https://doi.org/10.7499/j.issn.1008-8830.2020.03.006.

Lee PI, Hu YL, Chen PY, Huang YC, Hsueh PR. Are children less susceptible to COVID-19? J Microbiol Immunol Infect [Internet]. 2020 [acesso em: 20 jun. 2020];53(3):371–2. Disponível em: https://doi.org/10.1016/j.jmii.2020.02.011.

Waltuch T, Gill P, Zinns LE, Whitney R, Tokarski J, Tsung JW, et al. Features of COVID-19 post-infectious cytokine release syndrome in children presenting to the emergency department. Am J Emer Med [Internet]. 2020 [acesso em: 28 jun. 2020];38(10):2246.e3–2246.e6. Disponível em: https://doi.org/10.1016/j.ajem.2020.05.058.

Zhang GX, Zhang AM, Huang L, Cheng LY, Liu ZX, Peng XL, et al. Twin girls infected with SARS-CoV-2. Chin J Contemp Pediatr [Internet]. 2020 [acesso em: 20 jun. 2020];22(3):221-5. Disponível em: https://doi.org/10.7499/j.issn.1008-8830.2020.03.008.

Cao Q, Chen YC, Chen CL, Chiu CH. SARS-CoV-2 infection in children:Transmission dynamics and clinical characteristics. J Formos Med Assoc [Internet]. 2020 [acesso em: 20 jun. 2020];119(3):670–3. https://doi.org/10.1016/j.jfma.2020.02.009.

Su L, Ma X, Yu H, Zhang Z, Bian P, Han Y, et al. The different clinical characteristics of corona virus disease cases between children and their families in China – the character of children with COVID-19. Emerg Microbes Infect [Internet]. 2020 [acesso em: 17 jun. 2020];9(1):707-13. Disponível em: https://doi.org/10.1080/22221751.2020.1744483.

Pain CE, Felsenstein S, Cleary G, Mayell S, Conrad K, Harave S, et al. Novel paediatric presentation of COVID-19 with ARDS and cytokine storm syndrome without respiratory symptoms. Lancet Rheumathol [Internet]. 2020 [acesso em: 10 jul. 2020];2(7):E376– E9. Disponível em: https://doi.org/10.1016/S2665-9913(20)30137-5.

Greene AG, Saleh M, Roseman E, Sinert R. Toxic shock- like syndrome and COVID-19: multisysteminflammatory syndrome in children (MIS-C). Am J Emer Med [Internet]. 2020 [acesso em: 12 jul. 2020];38(11):2492. e5–2492.e6. Disponível em: https://doi.org/10.1016/j.ajem.2020.05.117.

Blondiaux E, Parisot P, Redheuil A, Tzaroukian L, Levy Y, Sileo C, et al. Cardiac MRI in Children with Multisystem Inflammatory Syndrome with COVID-19. Radiol [Internet]. 2020 [acesso em: 17 jul. 2020];297(3):e283–e288. Disponível em: https://doi.org/10.1148/radiol.2020202288.

Royal College of Obstetricians and Gynaecologists. Coronavirus (COVID-19) Infection in Pregnancy. Information for healthcare professionals [Internet]. 2020 [acesso em: 4 maio 2020]. Disponível em: http://www.e-lactancia.org/media/papers/2020-04-03-coronavirus-covid-19-infection-in-pregnancy.pdf.

Kaushik S, Aydin SI, Derespina KR, Bansal PB, Kowalsky S, Trachtman R, et al. Multisystem Inflammatory Syndrome in Children Associated with Severe Acute Respiratory Syndrome Coronavirus 2 Infection (MIS-C): A Multi-institutional Study from New York City. J Pediatr [Internet]. 2020 [acesso em: 17 jul. 2020];224:24–9. Disponível em: https://doi.org/10.1016/j.jpeds.2020.06.045.

Chang LY, Lu CY, Shao PL, Lee PI, Lin MT, Fan TY, et al. Viral infections associated with Kawasaki disease. J Formos Med Assoc [Internet]. 2014 [acesso em: 30 ago. 2020];113(3):148–54. Disponível em: https://doi.org/10.1016/j.jfma.2013.12.008.

Papa A, Salzano AM, Di Dato MT, Varrassi G. Images in Practice: Painful Cutaneous Vasculitis in a SARS- Cov-2 IgG-Positive Child. Pain Ther [Internet]. 2020 [acesso em: 12 jul. 2020]. Disponível em: https://doi.org/10.1007/s40122-020-00174-4.

Newburger JW, Takahashi M, Gerber MA, Gewitz MH, Tani LY, Burns JC, et al. Diagnosis, treatment, and long- term management of Kawasaki Disease: a statement for health professionals from the committee on rheumatic fever, endocarditis and Kawasaki Disease, council on cardiovascular disease in the young, american heart association. Circulation [Internet]. 2004 [acesso em: 30 ago. 2020];110(17):2747–71. Disponível em: https://doi.org/10.1161/01.CIR.0000145143.19711.78.

Rodrigues M, Oliveira JC, Carvalho F, Silva H, Moreira C, Granja S, et al. Doença de Kawasaki e complicações cardiovasculares em pediatria. NEC [Internet]. 2018 [acesso em: 30 ago. 2020];27(1):54–8. Disponível em: http://www.scielo.mec.pt/pdf/nas/v27n1/v27n1a10.pdf.

Castro PA, Urbano LMF, Costa IMC. Doença de Kawasaki. An Bras Dermatol [Internet]. 2009 [acesso em: 30 ago. 2020];84(4):317–29. Disponível em: https://doi.org/10.1590/S0365-05962009000400002.

Riphagen S, Gomez X, Gonzalez-Martinez C, Wilkinson N, Theocharis P. Hyperinflammatory shock in children during COVID-19 pandemic. Lancet [Internet]. 2020 [acesso em: 26 jul. 2020];395(10237):1607– 08. Disponível em: https://doi.org/10.1016/S0140-6736(20)31094-1.

New York City Health Department. Childhood Inflammatory Disease Related to COVID-19 [Internet]. 2020 [acesso em: 29 ago. 2020]. Disponível em: https://coronavirus.health.ny.gov/childhood-inflammatory-disease-related-covid-19.

New York City Health Department. 2020 Health Alert #13: Pediatric Multi-System Inflammatory Syndrome Potentially Associated with COVID-19 [Internet]. 2020 [acesso em: 29 ago. 2020]. Disponível em: https://www1.nyc.gov/assets/doh/downloads/pdf/han/alert/2020/covid-19-pediatric-multi-system-inflammatory-syndrome.pdf.

Ramcharan T, Nolan O, Lai CY, Prabhu N, Krishnamurthy R, Ritcher AG, et al. Paediatric Inflammatory Multisystem Syndrome: Temporally Associated with SARS-CoV-2 (PIMS-TS): Cardiac Features, Management and Short- Term Outcomes at a UK Tertiary Paediatric Hospital. Pediatr Cardiol [Internet]. 2020 [acesso em: 29 jul. 2020];41:1391–1401. Disponível em: https://doi.org/10.1007/s00246-020-02391-2.

Chiu JS, Lahoud-Rahme M, Schaffer D, Cohen A, Samuels-Kalow M. Kawasaki Disease Features and Myocarditis in a Patient with COVID-19. Pediatr Cardiol [Internet]. 2020 [acesso em: 10 jul. 2020]; 41: 1526–8. Disponível em: https://doi.org/10.1007/s00246-020-02393-0.

JiLN,ChaoS,WangYJ,LiXJ,MuXD,LinMG,etal. Clinical features of pediatric patients with COVID-19: a report of two family cluster cases. World J Pediatr [Internet]. 2020 [acesso em: 26 jul. 2020];16:267–70. Disponível em: https://doi.org/10.1007/s12519-020-00356-2.

Qiu H, Wu J, Hong L, Luo Y, Song Q, Chen D. Clinical and epidemiological features of 36 children with coronavirus disease 2019 (COVID-19) in Zhejiang, China: an observational cohort study. Lancet Infect Dis [Internet]. 2020 [acesso em: 29 jul. 2020];20(6):689– 96. Disponível em: https://doi.org/10.1016/S1473-3099(20)30198-5.

Wei L, Huaqian C, Kunwei L, Fang Y, Li S. Chest computed tomography in children with COVID-19 respiratory infection. Pediatr Radiol [Internet]. 2020 [acesso em: 29 jul. 2020];50:796–99. Disponível em: https://doi.org/10.1007/s00247-020-04656-7.

Downloads

Published

2021-07-13

How to Cite

1.
Bezerra JC, Braga HFGM, Melo FM de S, Nascimento AP do, Silva FBB, Melo ESJ. Clinical manifestations presented by children infected with COVID-19: an integrative review. Rev. Eletr. Enferm. [Internet]. 2021 Jul. 13 [cited 2024 Jul. 17];23:65966. Available from: https://revistas.ufg.br/fen/article/view/65966

Issue

Vol. 23 (2021)

Section

Review Article

License

Copyright (c) 2021 Revista Eletrônica de Enfermagem

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.