Pediatric COVID-19: Low Incidence, but Possible Fatality—A Case Report and a Review of the Literature
Background: Pediatric COVID-19 is a current health burden mostly due to the lack of knowledge in terms of symptoms, clinical course and management. COVID-19-associated coagulopathy is one of the most recently described complications among adults, along with acquired thrombophilia resulting in an inc...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-12-01
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| Series: | Children |
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| Online Access: | https://www.mdpi.com/2227-9067/8/12/1128 |
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| author | Cristina Oana Mărginean Lorena Elena Meliț Iunius Simu Claudiu Puiac Janos Szederjesi Maria Oana Săsăran |
| author_facet | Cristina Oana Mărginean Lorena Elena Meliț Iunius Simu Claudiu Puiac Janos Szederjesi Maria Oana Săsăran |
| author_sort | Cristina Oana Mărginean |
| collection | DOAJ |
| description | Background: Pediatric COVID-19 is a current health burden mostly due to the lack of knowledge in terms of symptoms, clinical course and management. COVID-19-associated coagulopathy is one of the most recently described complications among adults, along with acquired thrombophilia resulting in an increased risk for venous, arterial and microvascular thrombosis. Case presentation: We report the case of a 4-year-old male child, admitted to our clinic for generalized seizures being intubated and mechanically ventilated before admission, with a personal history of ureterovesical junction obstruction, mild hydronephrosis, and an episode of generalized seizures. The laboratory tests revealed anemia, an increased number of monocytes, and a mildly increased C-reactive protein. A real-time polymerase chain reaction (RT-PCR) of the oropharyngeal swab was performed and it tested positive for SARS-CoV-2 in the child and both of his parents. The thoracic CT showed consolidation in the lower lobe of the left lung associated with an opacity in the right apex, suggesting possible atelectasis. We initiated antibiotic, antiviral, corticosteroids, as well as anticoagulants and antipyretics, continuing the chronic anticonvulsant therapy. The patient’s condition deteriorated progressively, and, after 72 h of hospitalization, he developed desaturation and bradycardia. The laboratory parameters on the third day showed leucopenia, neutropenia, increased creatine kinase, a high ferritin level, hypoalbuminemia, a prolonged prothrombin time and an increased international normalized ration. The patient died on the fourth day of admission. Conclusion: In spite of its low incidence and frequent benign clinical course, COVID-19 complications such as coagulopathy might represent a leading cause of death, even in pediatric patients. |
| first_indexed | 2024-03-10T04:24:54Z |
| format | Article |
| id | doaj.art-854b2c1a21854e1bad220278d4df3c07 |
| institution | Directory Open Access Journal |
| issn | 2227-9067 |
| language | English |
| last_indexed | 2024-03-10T04:24:54Z |
| publishDate | 2021-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Children |
| spelling | doaj.art-854b2c1a21854e1bad220278d4df3c072023-11-23T07:42:20ZengMDPI AGChildren2227-90672021-12-01812112810.3390/children8121128Pediatric COVID-19: Low Incidence, but Possible Fatality—A Case Report and a Review of the LiteratureCristina Oana Mărginean0Lorena Elena Meliț1Iunius Simu2Claudiu Puiac3Janos Szederjesi4Maria Oana Săsăran5Department of Pediatrics I, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, Gheorghe Marinescu Street No 38, 540136 Târgu Mureș, RomaniaDepartment of Pediatrics I, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, Gheorghe Marinescu Street No 38, 540136 Târgu Mureș, RomaniaDepartment of Radiology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, Gheorghe Marinescu Street No 38, 540136 Târgu Mureș, RomaniaDepartment of Emergency Medicine, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, Gheorghe Marinescu Street No 38, 540136 Târgu Mureș, RomaniaDepartment of Anestesiology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, Gheorghe Marinescu Street No 38, 540136 Târgu Mureș, RomaniaDepartment of Pediatrics III, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, Gheorghe Marinescu Street No 38, 540136 Târgu Mureș, RomaniaBackground: Pediatric COVID-19 is a current health burden mostly due to the lack of knowledge in terms of symptoms, clinical course and management. COVID-19-associated coagulopathy is one of the most recently described complications among adults, along with acquired thrombophilia resulting in an increased risk for venous, arterial and microvascular thrombosis. Case presentation: We report the case of a 4-year-old male child, admitted to our clinic for generalized seizures being intubated and mechanically ventilated before admission, with a personal history of ureterovesical junction obstruction, mild hydronephrosis, and an episode of generalized seizures. The laboratory tests revealed anemia, an increased number of monocytes, and a mildly increased C-reactive protein. A real-time polymerase chain reaction (RT-PCR) of the oropharyngeal swab was performed and it tested positive for SARS-CoV-2 in the child and both of his parents. The thoracic CT showed consolidation in the lower lobe of the left lung associated with an opacity in the right apex, suggesting possible atelectasis. We initiated antibiotic, antiviral, corticosteroids, as well as anticoagulants and antipyretics, continuing the chronic anticonvulsant therapy. The patient’s condition deteriorated progressively, and, after 72 h of hospitalization, he developed desaturation and bradycardia. The laboratory parameters on the third day showed leucopenia, neutropenia, increased creatine kinase, a high ferritin level, hypoalbuminemia, a prolonged prothrombin time and an increased international normalized ration. The patient died on the fourth day of admission. Conclusion: In spite of its low incidence and frequent benign clinical course, COVID-19 complications such as coagulopathy might represent a leading cause of death, even in pediatric patients.https://www.mdpi.com/2227-9067/8/12/1128SARS-CoV-2COVID-19coagulopathypneumoniachildren |
| spellingShingle | Cristina Oana Mărginean Lorena Elena Meliț Iunius Simu Claudiu Puiac Janos Szederjesi Maria Oana Săsăran Pediatric COVID-19: Low Incidence, but Possible Fatality—A Case Report and a Review of the Literature Children SARS-CoV-2 COVID-19 coagulopathy pneumonia children |
| title | Pediatric COVID-19: Low Incidence, but Possible Fatality—A Case Report and a Review of the Literature |
| title_full | Pediatric COVID-19: Low Incidence, but Possible Fatality—A Case Report and a Review of the Literature |
| title_fullStr | Pediatric COVID-19: Low Incidence, but Possible Fatality—A Case Report and a Review of the Literature |
| title_full_unstemmed | Pediatric COVID-19: Low Incidence, but Possible Fatality—A Case Report and a Review of the Literature |
| title_short | Pediatric COVID-19: Low Incidence, but Possible Fatality—A Case Report and a Review of the Literature |
| title_sort | pediatric covid 19 low incidence but possible fatality a case report and a review of the literature |
| topic | SARS-CoV-2 COVID-19 coagulopathy pneumonia children |
| url | https://www.mdpi.com/2227-9067/8/12/1128 |
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