Signs and symptoms commonly seen in COVID-19 in newborns, children, and adolescents and pediatric subjects

The recent findings reported that the most frequent coronavirus disease 2019 (COVID-19) clinical course in pediatric subjects ranged from mild to moderate form in with nonspecific symptoms such as fever, cough, dyspnea, fatigue, muscle pain, headache, and nasal congestion. On the contrary, a lower frequency of severe COVID-19 forms was reported, including refractory metabolic acidosis, coagulation disorders, tachypnea, severe pneumonia, and septic shock. Recent literature is associated with the COVID-19 pediatric subject to the acute multisystem inflammatory syndrome (MIS-C) with abdominal symptoms and left ventricular systolic dysfunction. The recent findings seem to support that the unvaccinated and comorbid children could present more severe clinical forms. Few data of COVID-19 hospitalization in pediatric intensive care unit (PICU) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission in schools were reported during the first wave. The main reasons could be correlated to the early school's closure, while the swabs were destined more frequently to adult symptomatic subjects. The pandemic state generated rise in psychological disorders, anxiety, and depression more frequently during the first year of the disease spread, with a higher prevalence in older adolescents. © 2023 Elsevier Inc. All rights reserved.

Coronary calcifications as a new prognostic marker in COVID-19 patients: role of CT.

OBJECTIVE: COVID-19 pneumonia, caused by the virus Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), was declared a pandemic by the WHO on 11th March 2020. While Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) represents the diagnostic gold standard of infection, computed tomography (CT) has been shown to have an important role in supporting the diagnosis, quantifying the severity, and assessing the efficacy of treatment and its response. Coronary artery calcification (CAC) is a CT finding that estimates atherosclerosis and can be quantified using the coronary artery calcium score (CACS). The purpose of this study is to demonstrate the correlation between coronary artery calcification and mortality rate in COVID-19 patients. PATIENTS AND METHODS: Three hundred seventeen (317) hospitalized patients with SARS-CoV-2 infection were ruled in this retrospective study. All patients underwent a non-ECG-gated chest CT to evaluate lung parenchymal involvement. In the same cohort, we observed the two main coronary arteries (common trunk, circumflex, anterior interventricular and right coronary heart) using a visual score, so patients were divided into four groups based on Ordinal CAC Score (OCS) levels. RESULTS: The multivariate analysis proved that the OCS value was statistically correlated with the mortality rate (p < 0.001). In fact, in the group of patients with an OCS value of 0, the mortality rate was 10.1% (10/99 patients), in the group with OCS between 1 and 4 was 18.9% (21/111), in the OCS group of patients ranged from 5 to 8 was 30.4% (24/79) and in the OCS group between 9 and 12 was 46.4% (13/28). CONCLUSIONS: We suggest that calcific atheromasia of the coronary arteries in patients with COVID-19 can be considered a prognostic marker of clinical outcome.