Characterising and managing paediatric SARSCoV-2 infection: Learning about the virus in a global classroom

Aim This study is a comprehensive review with the purpose of collecting the most relevant data in several sections including current treatment guidelines in the paediatric population. Methods Literature was systematically searched in different databases. Results were limited to 2019+ and English, French and Spanish language. Results Children can exhibit mild and less severe COVID-19 disease than adults and also have asymptomatic carriage of SARS-CoV-2, while severe disease is more frequently noted during infancy (<1 year). SARS-CoV-2 binds the angiotensin-converting enzyme 2 (ACE-2) receptor; age-, racial-, and gender-specific differences in ACE-2 expression need to be elucidated in order to explain the differential clinical profiles between children and adults. Multisystem inflammatory syndrome in children (MIS-C) is an important condition to recognise in children. The decision to use antiviral or immunomodulatory therapy in a child or adolescent should be individualised based on the clinical scenario. Remdesivir is the only FDA-approved therapy available for children older than 12 years old who require hospitalisation for COVID-19. Conclusion Further studies are urgently required to address prevention and treatment in at-risk and infected children, especially with underlying comorbidities. The chapter on the overall impact of COVID-19 in children has not yet been written. Nevertheless, SARS-CoV-2 has now joined a long list of human pandemics, which may forever change the world's history.

Automated summary

Children may have milder symptoms of COVID-19 and can also be asymptomatic carriers of SARS-CoV-2, while severe disease is more common in infants. Multisystem inflammatory syndrome in children (MIS-C) is an important condition to be recognized. Individualized decisions on antiviral or immunomodulatory therapy should be made based on the clinical scenario.