ABSTRACT
Background: During COVID-19 pandemic, most studies have focused on sampling technique in adults. Considering the need to be aware of the effectiveness and evaluation of sampling methods in children, we have motivated a search for introducing and performing sampling techniques, especially upper respiratory tract sampling in children. We systematically reviewed the literature to understand the performance of different sampling methods in children in COVID-19. Methods: We systematically reviewed PubMed, Google Scholar, medRxiv, and bioRxiv (last retrieval August 1st, 2021) for comparative studies of deferent sampling techniques by using the search keywords including: children, pediatric sampling, nasopharyngeal, COVID-19, oropharyngeal, swabs, SARS, CoV2. 8 relevant manuscripts were sourced from a total of 4852 search results. Results: Nasopharyngeal (NP) swabs testing significantly had higher positivity rate over oropharyngeal swab in detecting SARS-CoV-2. Nasal swab has a low sensitivity in detecting SARSCoV-2 in children when referred to the Nasopharyngeal Aspiration (NPA), whereas its specificity is high. Therefore, NPA can be as the gold standard for detection of SARS-CoV-2. Conclusion: Saliva is not a useful for diagnosing COVID-19 in children. Negative nasopharyngeal and oropharyngeal swabs do not rule out COVID-19 and in patients with strong clinical suspicion, and Bronchoalveolar lavage (BAL) can be helpful. Copyright © 2023, Journal of Iranian Medical Council. All rights reserved. This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
ABSTRACT
Typical presentations of Coronavirus Disease 2019 (Covid-19) including respiratory symptoms (cough, respiratory distress and hypoxia), fever and dyspnoea are considered main symptoms in adults, but atypical presentation in children could be a diagnostic challenge. We report three children whose initial presentation was gastrointestinal, and in whom Covid-19 infection was found, concluding that cases of acute appendicitis, mesenteric adenitis and flank tenderness may mask an infection with this virus, and should therefore be investigated.
Subject(s)
Abdominal Pain , Appendicitis , COVID-19 , Abdominal Pain/diagnosis , Abdominal Pain/virology , Appendicitis/diagnosis , Appendicitis/virology , COVID-19/complications , COVID-19/diagnosis , COVID-19/pathology , Child , Child, Preschool , Cough , Female , Headache , Humans , Lung/diagnostic imaging , Lung/pathology , Male , SARS-CoV-2 , VomitingABSTRACT
Although several typical manifestation of novel coronavirus disease 2019 (COVID-19) including respiratory symptoms, weakness, fever, and fatigue have been reported, some rare and novel manifestations have also been observed, particularly in children. We report a pediatric case of fulminant hepatic failure associated with COVID-19. Although the patient was treated for acute fulminant hepatic failure in the context of COVID-19, he died following the progression of the disease to stage 4 hepatic failure with encephalopathy and brain death.