1 Pediatric Hematology and Oncology Unit, Department of Pediatrics, Bolzano Hospital, Italy.
2 Pediatric Hematology Oncology, Department of Mother and Child, Azienda Ospedaliera Universitaria Integrata Verona, Italy.
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pandemic affected fewer children and adolescents with lower morbidity
and mortality rates than those reported for adults. This review focused
on the clinical course, risk factors for severe COVID 19, mortality,
treatment options, and prevention measures in the pediatric and
adolescent setting with special attention to pediatric
oncohematological patients. SARS-CoV-2 infection was often asymptomatic
in these subgroups of patients, but 47 to 68% of them required
hospitalization, and 9-10% of those hospitalized needed intensive care
with a COVID 19 attributable mortality of about 4%. The multisystem
inflammatory syndrome associated with COVID 19 was less frequent than
that reported in the non-oncohematological pediatric population.
Noteworthy, the course of COVID 19 was more severe in low-middle income
countries. The key measures to prevent SARS-CoV-2 infection are
reducing patient exposure to the SARS-CoV-2 and vaccination, now
available for parents and caregivers and patients and siblings above 12
years of age. The treatment of COVID 19 in pediatric patients is mainly
based on supportive care with dexamethasone and heparin prophylaxis for
severely ill patients. Other measures, such as convalescent plasma,
remdesivir, and monoclonal antibodies, have been used in limited cases
or within experimental protocols. Further studies are needed regarding
the risks factors and outcomes of SARS-CoV-2 infection in pediatric
Covid-19 in Adults and Adults with Cancer
|Table 1. Main Risk factors for severe clinical course and mortality in adults and children/adolescents.|
SARS-CoV-2 Infection and Covid-19 in Children and Adolescents
|Table 2. WHO Multisystem inflammatory syndrome in children and adolescent definition.
Covid-19 in Children and Adolescents with Cancer
|Table 3. Differences in
clinical course of COVID 19 infection between the general
pediatric/adolescent population and pediatric/adolescent patients with