La enfermedad covid-19 en la infancia y adolescencia

espanolLa enfermedad Covid-19 es una pandemia viral producida por el nuevo coronavirus SARS-CoV-2. El contagio en los pacientes pediatricos desde otras personas es fundamentalmente por via respiratoria. No se ha documentado la transmision vertical madre a nino ni por la ingestion de leche materna. Los pacientes pediatricos representan globalmente del 1 al 5% del total de casos Covid-19. La proporcion de ninos menores de 14 anos infectados en Espana ha sido del 0,6%, lo que supone unos 1.400. Se estima que un 3,8% de menores de 18 anos son seroprevalentes. La Covid-19 se comporta en pediatria en general como una enfermedad leve, aunque en un pequeno numero de casos produce cuadros graves, incluso la muerte. Los ninos con mas riesgo de Covid-19 grave son los menores de 1 ano, o los que tienen patologias cronicas subyacentes. Los sintomas principales son la fiebre y tos, disnea, mialgias, rinorrea, cefalea, vomitos, dolor abdominal, diarrea y perdida del gusto o del olfato. El diagnostico se basa en los aspectos clinicos junto a la realizacion de PCR para SARS-CoV-2. El tratamiento depende de la severidad de la infeccion. En casos leves o moderados se tratan aplicando medidas de confort y antitermicos si se precisaran. En casos graves o criticos, se aplicaran las medidas de soporte que se consideren necesarias: apoyo respiratorio, administracion de liquidos y electrolitos, soporte cardiocirculatorio etc. No existe actualmente evidencia cientifica para recomendar un tratamiento antiviral especifico en la infancia. Su uso debe ser estrictamente individualizado, valorando el riesgo-beneficio en cada paciente. Algunos de los empleados han sido el remdesivir y la hidroxicloroquina. Las normas de prevencion de la transmision del virus son el aislamiento domiciliario durante 15 dias, medidas de higiene, distancia social con otras personas y evitar compartir objetos personales, ropa y utensilios de cocina y bano. EnglishCovid-19 is a viral pandemic caused by the new coronavirus SARS-CoV-2. Infection in pediatric patients is transmitted by the respiratory route. Vertical transmission from mother to child or during breast feeding has not been documented. Pediatric patients globally represent 1 to 5% of total Covid-19 cases. The proportion of children under 14 years of age infected in Spain has been 0.6%, which is about 1,400. Seroprevalence has been 3,8%. in persons under 18. In general, Covid-19 behaves in pediatric patients as a mild disease, although in a small number of cases it produces serious conditions and even death. The children with the highest risk of serious Covid-19 are those under 1 year of age, or those with underlying chronic pathologies. The main symptoms are fever and cough, shortness of breath, myalgia, runny nose, headache, vomiting, abdominal pain, diarrhea and loss of taste or smell. The diagnosis is based on the clinical aspects combined with molecular diagnosis through RT-qPCR for SARS-CoV2. Treatment depends on the severity of the infection. Mild or moderate cases are treated on an outpatient basis applying comfort measures and antipyretics if needed. In serious or critical cases the patient are admitted at the hospital, where support measures like respiratory support, administration of liquids and electrolytes, cardiocirculatory support, etc., will be applied if necessary. There is currently no scientific evidence to recommend specific antiviral treatment in childhood. The use of these drugs should be strictly individualized, assessing the risk-benefit. remdesivir and hydroxychloroquine have been used in some cases. The measures to prevent the transmission of the virus are home isolation for 15 days, hygiene measures, social distance with other people and avoiding sharing personal objects, clothing and kitchen and bathroom utensils.