Paediatrics and International Child Health最新文献

{"title":"A rare case of metapneumovirus-induced rhabdomyolysis and multi-organ dysfunction in a 4-year-old child.","authors":"Aakash Chandran Chidambaram,&nbsp;Rohit Bhowmick,&nbsp;Narayanan Parameswaran,&nbsp;Dhandapany Gunasekaran","doi":"10.1080/20469047.2020.1814567","DOIUrl":"https://doi.org/10.1080/20469047.2020.1814567","url":null,"abstract":"<p><p>Human metapneumovirus (hMPV) is a common cause of acute respiratory tract infections in children. In immunocompetent individuals, the course of hMPV infection is usually benign and self-limiting. A developmentally normal, previously healthy 4-year-old girl presented with pneumonia and later developed rhabdomyolysis and multi-organ dysfunction syndrome (MODS) which was fatal. Extensive microbiological investigation for a possible viral aetiology was positive only for hMPV, thus making it the first reported case of hMPV infection-related rhabdomyolysis.<b>Abbreviations</b>: ARDS, acute respiratory distress syndrome; CK, creatinine kinase; hMPV, human metapneumovirus; MODS, multi-organ dysfunction syndrome; RSV, respiratory syncytial virus.</p>","PeriodicalId":19731,"journal":{"name":"Paediatrics and International Child Health","volume":"41 2","pages":"166-169"},"PeriodicalIF":1.8,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20469047.2020.1814567","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38461691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global mobility, travel and migration health: clinical and public health implications for children and families.","authors":"Elizabeth E Dawson-Hahn,&nbsp;Vaidehi Pidaparti,&nbsp;William Hahn,&nbsp;William Stauffer","doi":"10.1080/20469047.2021.1876821","DOIUrl":"https://doi.org/10.1080/20469047.2021.1876821","url":null,"abstract":"<p><p>Exponential growth of the world's population combined with increased travel has dramatically increased the spread of infectious diseases. Although there has been significant focus on migration, the major contributors to the transmission of communicable diseases are travel and tourism not migration. Given that children represent up to 10% of international travellers, it is critical to the health of all age groups to ensure that tailored guidance for children is considered in public health policy and guidelines, and pandemic responses. To further support pandemic preparedness, public health systems need to strengthen ties with communities and health systems. In addition, travel and migration issues need to be included as core competencies in medical education. Ensuring that clinicians who care for children have knowledge of travel and migration health will foster a better health outcome in an increasingly mobile population at risk of emerging infectious diseases.<b>Abbreviations</b> CDC: Centers for Disease Control and Prevention; DGMQ: CDC Division of Global Migration and Quarantine; EID: emerging infectious diseases; EU: European Union; VFR: visiting friends and relatives; IOM: United Nations International Organization for Migration; LPR: lawful permanent resident; US: United States of America; WHO: World Health Organization.</p>","PeriodicalId":19731,"journal":{"name":"Paediatrics and International Child Health","volume":"41 1","pages":"3-11"},"PeriodicalIF":1.8,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20469047.2021.1876821","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25518671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial.","authors":"Philip R Fischer","doi":"10.1080/20469047.2021.1872262","DOIUrl":"https://doi.org/10.1080/20469047.2021.1872262","url":null,"abstract":"","PeriodicalId":19731,"journal":{"name":"Paediatrics and International Child Health","volume":"41 1","pages":"1-2"},"PeriodicalIF":1.8,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20469047.2021.1872262","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25582737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Human and novel coronavirus infections in children: a review.","authors":"Nipunie Rajapakse,&nbsp;Devika Dixit","doi":"10.1080/20469047.2020.1781356","DOIUrl":"https://doi.org/10.1080/20469047.2020.1781356","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Coronaviruses, seven of which are known to infect humans, can cause a spectrum of clinical presentations ranging from asymptomatic infection to severe illness and death. Four human coronaviruses (hCoVs)-229E, HKU1, NL63 and OC43-circulate globally, commonly infect children and typically cause mild upper respiratory tract infections. Three novel coronaviruses of zoonotic origin have emerged during the past two decades: severe acute respiratory syndrome coronavirus (SARS-CoV-1), Middle East respiratory syndrome coronavirus (MERS-CoV) and the recently discovered severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which is the cause of the ongoing coronavirus disease 2019 (COVID-19) pandemic. These novel coronaviruses are known to cause severe illness and death predominantly in older adults and those with underlying comorbidities. Consistent with what has been observed during the outbreaks of SARS and MERS, children with COVID-19 are more likely to be asymptomatic or to have mild-to-moderate illness, with few deaths reported in children globally thus far. Clinical symptoms and laboratory and radiological abnormalities in children have been similar to those reported in adults but are generally less severe. A rare multisystem inflammatory syndrome in children (MIS-C) which has resulted in critical illness and some deaths has recently been described. Clinical trials for therapeutics and vaccine development should include paediatric considerations. Children may play an important role in the transmission of infection and outbreak dynamics and could be a key target population for effective measures to control outbreaks. The unintended consequences of the unprecedented scale and duration of pandemic control measures for children and families around the world should be carefully examined.&lt;b&gt;Abbreviations:&lt;/b&gt; 2019-nCoV, 2019 novel coronavirus; ADEM, acute demyelinating encephalomyelitis; AAP, American Academy of Pediatrics; ACE-2, angiotensin-converting enzyme 2; ARDS, acute respiratory distress syndrome; BCG, bacillus Calmette-Guérin; BNP, brain natriuretic peptide; CDC, Centers for Disease Control and Prevention; CRP, C-reactive protein; CSF, cerebrospinal fluid; COVID-19, coronavirus disease 2019; CT, computed tomography; CXR, chest X-ray; DOL, day of life; hCoV, human coronavirus; ICU, intensive care unit; IL, interleukin; IVIG, intravenous immunoglobulin; KD, Kawasaki disease; LDH, lactate dehydrogenase; MERS, Middle East respiratory syndrome; MERS-CoV, Middle East respiratory syndrome coronavirus; MEURI, monitored emergency use of unregistered and experimental interventions; MIS-C, multi-system inflammatory syndrome in children; PCR, polymerase chain reaction; PICU, paediatric intensive care unit; RNA, ribonucleic acid; RCT, randomised-controlled trial; RSV, respiratory syncytial virus; SARS, severe acute respiratory syndrome; SARS-CoV-1, severe acute respiratory syndrome coronavirus 1; SARS-CoV-2, severe acute respiratory syndrome coron","PeriodicalId":19731,"journal":{"name":"Paediatrics and International Child Health","volume":"41 1","pages":"36-55"},"PeriodicalIF":1.8,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20469047.2020.1781356","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38088907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Zika virus in Brazil and worldwide: a narrative review.","authors":"Marlos Melo Martins,&nbsp;Roberto De Andrade Medronho,&nbsp;Antônio José Ledo Alves Da Cunha","doi":"10.1080/20469047.2020.1776044","DOIUrl":"https://doi.org/10.1080/20469047.2020.1776044","url":null,"abstract":"<p><p><b>Background</b>: In the past 5 years, the Zika virus (ZIKV) has gone from being associated with mild infection to one of the most studied viruses worldwide. Between 2015 and 2016, the first reports of pregnant women with confirmed and/or suspected ZIKV infection described fetuses and newborns with severe congenital malformations, in particular microcephaly and central nervous system malformations, leading to a strong suspicion of its association with the virus. Despite all the knowledge rapidly acquired since the beginning of the ZIKV outbreak, many questions are still to be answered and further studies on the infection and its consequences are required.<b>Aim</b>: To present the currently available evidence on the epidemiological and clinical aspects of ZIKV infection.<b>Methods</b>: Non-systematic review carried out in MEDLINE (PubMed), LILACS (VHL), Scopus, Web of Science, Cochrane and CAPES Portal databases for the past five years using the search terms arboviruses, flavivirus, Zika and ZIKV.<b>Results</b>: The acute clinical of ZIKV infection in children seems very similar to that in adults, with fever (usully low), rash maculopapular and pruritus. Neurological complication associated with ZIKV reported in the literature include Guillain-Barré syndrome and meningoencephalitis. More recently, the term congenital Zika syndrome (CZS) has been adopted to describe a set of symptoms and signs in children whose mothers had ZIKV infection confirmed during pregnancy.<b>Conclusions</b>: More detailed knowledge of ZIKV infection in children allows the pediatrician to diagnose earlier, implement the correct treatment, monitor warnings signs for the most severe forms, and especially establish effective preventive measures.<b>Abbreviations:</b>: CDC, Centers for Disease Control; CZS, congenital Zika syndrome; DEET, N, N-diethyl-3-methylbenzamide; GBS, Guillain-Barré syndrome; PRNT, plaque reduction neutralisation test; RNA, ribonucleic acid; RT-PCR, reverse transcriptase polymerase chain reaction; STX, saxitoxin; ZIKV, Zika virus.</p>","PeriodicalId":19731,"journal":{"name":"Paediatrics and International Child Health","volume":"41 1","pages":"28-35"},"PeriodicalIF":1.8,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20469047.2020.1776044","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38082132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Review of Ebola virus disease in children - how far have we come?","authors":"Devika Dixit,&nbsp;Kasereka Masumbuko Claude,&nbsp;Lindsey Kjaldgaard,&nbsp;Michael T Hawkes","doi":"10.1080/20469047.2020.1805260","DOIUrl":"https://doi.org/10.1080/20469047.2020.1805260","url":null,"abstract":"<p><p>Ebola virus (EBOV) causes an extremely contagious viral haemorrhagic fever associated with high mortality. While, historically, children have represented a small number of total cases of Ebolavirus disease (EVD), in recent outbreaks up to a quarter of cases have been in children. They pose unique challenges in clinical management and infection prevention and control. In this review of paediatric EVD, the epidemiology of past EVD outbreaks with specific focus on children is discussed, the clinical manifestations and laboratory findings are described and key developments in clinical management including specific topics such as viral persistence and breastfeeding while considering unique psychosocial and anthropological considerations for paediatric care including of survivors and orphans and the stigma they face are discussed. In addition to summarising the literature, perspectives based on the authors' experience of EVD outbreaks in the Democratic Republic of the Congo (DRC) are described.<b>Abbreviations</b>: ARDS: acute respiratory distress syndrome; aOR: adjusted odds ratio; ALT: alanine transferase; ALIMA: Alliance for International Medical Action; AST: aspartate transaminase; BUN: blood urea nitrogen; CNS: central nervous system; CUBE: chambre d'urgence biosécurisée pour épidémie; COVID-19: coronavirus disease 2019; C_t: cycle threshold; DRC: Democratic Republic of Congo; ETC: ebola treatment centre; ETU: ebola treatment unit; EBOV: ebola virus; EVD: ebolavirus disease; FEAST: fluid expansion as supportive therapy; GP: glycoprotein; IV: intravenous; MEURI: monitored emergency use of unregistered interventions; NETEC: National Ebola Training and Education Centre; NP: nucleoprotein; ORS: oral rehydration solution; PALM: Pamoja Tulinde Maisha; PREVAIL: Partnership for Research on Ebola Virus in Liberia; PPE: personal protective equipment; PCR: polymerase chain reaction; PEP: post-exposure prophylaxis; RDTs: rapid diagnostic tests; RT: reverse transcriptase; RNA: ribonucleic acid; UNICEF: United Nations International Children's Emergency Fund; USA: United States of America; WHO: World Health Organization.</p>","PeriodicalId":19731,"journal":{"name":"Paediatrics and International Child Health","volume":"41 1","pages":"12-27"},"PeriodicalIF":1.8,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20469047.2020.1805260","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38350699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global emerging resistance in pediatric infections with TB, HIV, and gram-negative pathogens.","authors":"Leslie A Enane,&nbsp;John C Christenson","doi":"10.1080/20469047.2020.1853350","DOIUrl":"10.1080/20469047.2020.1853350","url":null,"abstract":"<p><p>Infants, children and adolescents are at risk of life-threatening, antimicrobial-resistant infections. Global burdens of drug-resistant TB, HIV and gram-negative pathogens have a particular impact on paediatric age groups, necessitating a paediatric-focused agenda to address emerging resistance. Dedicated approaches are needed to find, successfully treat and prevent resistant infections in paediatric populations worldwide. Challenges include the diagnosis and identification of resistant infections, limited access to novel antimicrobials or to paediatric-friendly formulations, limited access to research and clinical trials and implementation challenges related to prevention and successful completion of treatment. In this review, the particular complexities of emerging resistance in TB, HIV and gram-negative pathogens in children, with attention to both clinical and public health challenges, are highlighted. Key principles of a paediatric-focused agenda to address antimicrobial resistance are outlined. They include quality of care, increasing equitable access to key diagnostics, expanding antimicrobial stewardship and infection prevention across global settings, and health system strengthening. Increased access to research studies, including clinical trials, is needed. Further study and implementation of care models and strategies for child- or adolescent-centred management of infections such as HIV and TB can critically improve outcome and avoid development of resistance. As the current global pandemic of a novel coronavirus, SARS-CoV-2, threatens to disrupt health systems and services for vulnerable populations, this is a critical time to mitigate against a potential surge in the incidence of resistant infections.</p>","PeriodicalId":19731,"journal":{"name":"Paediatrics and International Child Health","volume":"41 1","pages":"65-75"},"PeriodicalIF":1.8,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20469047.2020.1853350","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38361761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Update on SARS-CoV-2 infection in children.","authors":"Marlos Melo Martins,&nbsp;Arnaldo Prata-Barbosa,&nbsp;Antônio José Ledo Alves da Cunha","doi":"10.1080/20469047.2021.1888026","DOIUrl":"https://doi.org/10.1080/20469047.2021.1888026","url":null,"abstract":"<p><p>Despite the worldwide spread of SARS-CoV-2 infection (COVID-19), knowledge of the different clinical presentations, ways of transmission, severity and prognosis in children and adolescents is limited. An increasing number of reports describe some of these characteristics in this age range. A non-systematic review was undertaken using MEDLINE (PubMed), LILACS (VHL), Scopus, Web of Science, Cochrane and CAPES Portal databases from 1 January until 30 September 2020 [103] with the search terms SARS-CoV-2, COVID-19, child, children, youth, adolescent and newborn to identify the more recent clinical aspects of SARS-CoV-2 infection in children. In general, SARS-CoV-2 infection in children tends to be asymptomatic or to have mild or moderate signs, and most young ones are infected by family members. Recent reports offer new insights into the disease. Current evidence on SARS-CoV-2 infection in children and adolescents is presented, especially concerning the clinical presentation, imaging and uncommon severe forms of the disease, particularly the COVID-19-associated multisystem inflammatory syndrome. The impact of COVID-19 infection in the perinatal period is described in detail. Knowledge of the various clinical presentations of SARS-CoV-2 in children and adolescents allows the paediatrician to diagnose earlier, monitor warnings signs, implement treatment and, especially, establish preventive measures.<b>Abbreviations</b> : ACE-2, angiotensin-converting enzyme 2; ARDS, acute respiratory distress syndrome; ARF, acute rheumatic fever; CAA, coronary artery aneurysms; CK-MB, creatine kinase-MB; COVID-19, coronavirus disease-2019; HLA, specific human leucocyte antigen; IPC, infection prevention and control; IVIG, intravenous immunoglobulin; KD, Kawasaki disease; MIS-C, COVID-19-associated multisystem inflammatory syndrome; RNA, ribonucleic acid; RT-PCR, reserve transcription-polymerase chain reaction; SARS-CoV-2, severe acute respiratory syndrome coronavirus-2; TCT, thoracic computed tomography; TSS, toxic shock syndrome; WHO, World Health Organization.</p>","PeriodicalId":19731,"journal":{"name":"Paediatrics and International Child Health","volume":"41 1","pages":"56-64"},"PeriodicalIF":1.8,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20469047.2021.1888026","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25398030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and laboratory characteristics of SARS-CoV2-infected paediatric patients in Jordan: serial RT-PCR testing until discharge.","authors":"Muna M Kilani,&nbsp;Mohanad M Odeh,&nbsp;Marwan Shalabi,&nbsp;Rami Al Qassieh,&nbsp;Mohammad Al-Tamimi","doi":"10.1080/20469047.2020.1804733","DOIUrl":"https://doi.org/10.1080/20469047.2020.1804733","url":null,"abstract":"<p><strong>Background: </strong>Data on COVID-19 in children are limited. This study aimed to identify the clinical characteristics, laboratory results and longitudinal RT-PCR- testing pattern in children infected with theSARS-CoV2 virus and admitted to a hospital in Jordan.</p><p><strong>Methods: </strong>The study is a retrospective chart review of patients admitted between 16 March and 23 April 2020. All infected children in Jordan were hospitalised. Serial RT-PCR testing was undertaken 7 days after the first test and then on alternate days until discharge. The association between patient symptoms and laboratory results and whether there was a statistically significant median difference in the number of days until negative RT-PCR results between patients was studied.</p><p><strong>Results: </strong>Sixty-one patients with positive SARS-CoV2 swabs were admitted, 34 (55.7%) of whom were symptomatic. The most common symptom was nasal congestion (21/61, 34.3%), followed by generalised malaise and headache (12/6, 19.7%). A rash was detected in 5/61 (8.2%) of them. Fifty-five patients (90.1%) underwent investigations: 4 (7.4%) of them had lymphopenia, 4 (7.4%) had eosinopenia, 8 (14.5%) had eosinophilia, and platelets were elevated in 5 (9.1%) children. CRP was measured in 33/61 (54.1%) patients and all were normal. ESR levels were available for 11/61 (18%) patients and were elevated in 5 (45.5%). There was a statistically significant association between laboratory results and symptom expression (<i>p</i> = 0.011). The longest time until the first negative RT-PCR result was 39 days.</p><p><strong>Conclusion: </strong>All children admitted who tested positive for SARS-CoV2 had mild symptoms and five had cutaneous manifestations. RT-PCR may remain positive for over one month.</p>","PeriodicalId":19731,"journal":{"name":"Paediatrics and International Child Health","volume":"41 1","pages":"83-92"},"PeriodicalIF":1.8,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20469047.2020.1804733","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38350164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 in the paediatric population of Kazakhstan.","authors":"Dinagul Bayesheva,&nbsp;Riza Boranbayeva,&nbsp;Bayan Turdalina,&nbsp;Ildar Fakhradiyev,&nbsp;Timur Saliev,&nbsp;Shynar Tanabayeva,&nbsp;Baurzhan Zhussupov,&nbsp;Talgat Nurgozhin","doi":"10.1080/20469047.2020.1857101","DOIUrl":"https://doi.org/10.1080/20469047.2020.1857101","url":null,"abstract":"<p><p><b>Background</b>: To date, there have been no studies of COVID-19 infection in children in Central Asia, particularly the Republic of Kazakhstan. This report analyses the epidemiological data on COVID-19 infection in children in Kazakhstan.<b>Methods</b>: The study included 650 paediatric patients diagnosed with COVID-19. Demographic and epidemiological data and the symptoms and radiological evidence of complications were collected and analysed. Children were sub-divided into four groups: neonates/infants, young children, older children and adolescents.<b>Results</b>: All of the 650 children were under 19 years of age, 56.3% of whom were male, and 122 (18.8%) were newborns and infants. The majority of cases (<i>n</i> = 558, 85.8%) were asymptomatic and only four cases were severe (0.6%). The symptoms were as follows in descending order: cough (14.8%), sore throat (12.8%), fever (9.1%) and rhinorrhoea (5.5%). Diarrhoea (2%), dyspnoea (1.8%) and muscle pain were rare (1.1%). Only three children required intensive care, including invasive ventilation. One patient had acute respiratory distress syndrome. There were no deaths.<b>Conclusion</b>: Most cases of COVID-19 infection in children in Kazakhstan were asymptomatic or the symptoms were mild. Only three patients required intensive care.</p>","PeriodicalId":19731,"journal":{"name":"Paediatrics and International Child Health","volume":"41 1","pages":"76-82"},"PeriodicalIF":1.8,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20469047.2020.1857101","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38369855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}