RESUMEN
BACKGROUND Coronavirus disease 2019 (COVID-19) infection commonly presents as fever, cough, and shortness of breath in adults. Children are thought to have milder respiratory symptoms and to recover more quickly. We describe a new presentation of COVID-19 infection in children consisting of multisystem inflammation with decreased left ventricular function and evidence of lung disease. CASE REPORT Three children presented with fever, conjunctivitis, dry and cracked lips, rash, and/or cervical lymphadenopathy for at least 5 days. Two of these children required mechanical ventilation, and 1 of the 2 needed extracorporeal membrane oxygenation (ECMO) to support cardiorespiratory function. All of these children had moderate to severe hyponatremia and lymphopenia, which is usually seen in COVID-19. They were treated with intravenous immunoglobulin and high-dose aspirin. All of the children recovered. CONCLUSIONS Early recognition of children with multisystem inflammation is important because they are at increased risk for deterioration. Treatment with intravenous immunoglobulin and aspirin was used because this regimen has been shown to be beneficial in vasculitis of Kawasaki disease. The development of shock due to cardiac involvement may require ECMO.
Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/diagnóstico , Neumonía Viral/diagnóstico , Síndrome de Respuesta Inflamatoria Sistémica/virología , Antipiréticos/uso terapéutico , Aspirina/uso terapéutico , COVID-19 , Niño , Preescolar , Conjuntivitis/terapia , Conjuntivitis/virología , Infecciones por Coronavirus/terapia , Exantema/terapia , Exantema/virología , Oxigenación por Membrana Extracorpórea , Femenino , Fiebre/terapia , Fiebre/virología , Insuficiencia Cardíaca/terapia , Insuficiencia Cardíaca/virología , Humanos , Hiponatremia/terapia , Hiponatremia/virología , Inmunoglobulinas Intravenosas , Linfadenopatía/terapia , Linfadenopatía/virología , Linfopenia/terapia , Linfopenia/virología , Masculino , Pandemias , Neumonía Viral/terapia , Respiración Artificial , SARS-CoV-2 , Síndrome de Respuesta Inflamatoria Sistémica/diagnóstico , Síndrome de Respuesta Inflamatoria Sistémica/terapia , Vasculitis/terapia , Vasculitis/virologíaRESUMEN
Ocular complications in critical care patients are common. There has been a surge in intensive care admissions following the COVID-19 outbreak. The management of COVID-19 exposes patients to a number of specific risk factors for developing ocular complications, which include non-invasive ventilation, mechanical ventilation and prone positioning. Consequently, it is likely that there will be an increase in the number of ocular complications secondary to the management of COVID-19 patients in the intensive care unit setting, and these complications could lead to permanent visual loss and blindness. Increased awareness of eye care in the intensive care unit setting is therefore vital to help prevent visual loss and maintain quality of life for patients recovering from COVID-19.