2025 – PAGE 311 – INFECTIOUS DISEASES

VIRUSES

SEVERE ACUTE RESPIRATORY SYNDROME CORONAVIRUS 2 (AKA COVID-19)

SARS-CoV-2 causes COVID-19. In children, incubation is 2-14 days, with symptoms typically appearing within 4-5 days post-exposure. Common manifestations also include fever, cough, congestion, headache, sore throat, nausea, vomiting, diarrhea, and loss of taste/smell, but disease is usually milder in children. Labs reveal nonspecific findings like lymphopenia and elevated inflammatory markers. CXR often shows lung infiltrates. Complications can occur like multisystem inflammatory syndrome in children (MIS-C) – a delayed 2-6 week post-infectious syndrome with fever, abdominal pain, shock, cardiac changes, and organ dysfunction. Home testing kits are readily available, but the gold standard for diagnosis is PCR testing of nasopharyngeal swabs. Supportive care at home with mask use to prevent household spread, isolation to a single room when possible, and supportive measures suffices for most outpatients. Severe disease warrants therapies like antivirals in high-risk children >40kg. Steroids, IVIG, and monoclonal antibodies may reduce complications necessitating hospitalization. Annual vaccination, including variant-specific boosters, is advised for ages 6 months up. Research continues to evolve recommendations, including specific treatments being made available to children on an Emergency Use Authorization basis.