Long COVID and COVID-19 in children

General
[https://onlinelibrary.wiley.com/doi/10.1111/apa.15673 Case report and systematic review suggest that children may experience similar long‐term effects to adults after clinical COVID‐19 Ludvigsson JF. Acta Paediatrica. 2020;00:1–8 doi.org/10.1111/apa.15673]

MIRS
Bautista-Rodriguez C. et al. (Nov 2020) Multisystem Inflammatory Syndrome in Children: An International Survey Pediatrics, e2020024554; DOI: 10.1542/peds.2020-024554

''ABSTRACT Objective. To describe presentation, hospital course and predictors of bad outcome in Multisystem Inflammatory Syndrome in Children (MIS-C). Methods. Retrospective data review of a case series of children meeting published definition for MIS-C discharged/died between March 1st and June 15th, 2020, from 33 participating European, Asian and American hospitals. Data was collected through a web-based survey and included clinical, laboratory, electrocardiographic and echocardiographic findings and treatment management. Results. We included 183 patients (109 males [59.6%]; mean age 7.0±4.7 years; black race, 56[30.6%]; obesity, 48[26.2%]) with MIS-C. Overall, 114/183(62.3%) had evidence of SARSCoV-2 infection. All presented with fever, 117/183 (63.9%) with gastrointestinal symptoms and 79/183 (43.2%) with shock, that was associated with black race, higher inflammation and imaging abnormalities. Twenty-seven patients (14.7%) fulfilled criteria for Kawasaki disease. They were younger with no shock, fewer gastrointestinal, cardio-respiratory and neurological symptoms. The remaining 77 patients (49.3%) had mainly fever and inflammation. Inotropic support, mechanical ventilation and ECMO were indicated in 72 (39.3%), 43 (23.5%) and 4 (2.2%) patients, respectively. A shorter duration of symptoms prior to admission was found to be associated with poor patient outcome and for ECMO/death, with 72.3% (95% CI 0.56-0.90, p=0.006) increased risk per day reduction and with 63.3% (95% CI 0.47-0.82, p<0.0001) increased risk per day reduction respectively. Conclusion. In this case series, children with MIS-C presented with a wide clinical spectrum, including KD-like, life-threatening shock and milder forms with mainly fever and inflammation. A shorter duration of symptoms prior to admission was associated with worse outcome. ''