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The first case of COVID-19 was traced back to the city of Wuhan,
China, in late November 2019, with an outbreak developing in
December. The virus quickly spread, with widespread ongoing
transmission occurring globally. Currently, COVID-19 has been
reported in every continent except Antarctica, with more
than 14 million people infected and over 600,000 dead
within the first 7 months of global spread. The COVID-19
outbreak was declared a Public Health Emergency of
International Concern on January 30, 2020, and a pandemic on
March 11, 2020, by the World Health Organization (WHO).
Pregnancy
1. Risk of infection is the same as in non-
pregnant individuals.
2. A higher risk of severe illness in pregnant
individuals is assumed due to the behavior of
similar respiratory infections, such as SARS
and influenza.
Refractory cases:
Nearly 50% of COVID-19 patients do not achieve clinical
and radiological remission within 10 days of hospitalization.
Male patients, older patients, individuals with anorexia, and
those with no/low fever at the time of admission have a
higher risk of presenting with a refractory progression.
Dr. Sonu Panwar
COVID-19 in children
The clinical presentation and severity of cases of COVID-
19 in patients < 18 years old is different from that of
adults. Children are at lower risk of developing severe or
critical infections, and complications appear to be
milder.
In children:
Approximately 55% of cases are asymptomatic or
mild
40% of cases are moderate (pneumonia and/or
abnormal chest imaging)
5% of cases are severe (dyspnea and hypoxia,
requiring oxygen therapy)
<1% of cases are critical (ARDS, respiratory
failure, shock, or multi-organ failure requiring ICU
transfer)
Dr. Sonu Panwar
Pediatric inflammatory multisystem syndrome is a
newly discovered complication occurring in
pediatric patients. The case definition by the Royal
College of Paediatrics and Child Health includes the
following criteria:
A child presenting with persistent fever ( 4 days),
inflammation (neutrophilia, elevated C-reactive
protein, and lymphopenia) and evidence of single-
or multi-organ dysfunction (shock or cardiac,
respiratory, renal, gastrointestinal, or neurological
disorder)
o This may include children fulfilling full or partial
criteria for Kawasaki disease.
Exclusion of any other microbial cause, including
bacterial sepsis, staphylococcal orstreptococcal
shock syndromes, and infections associated with
myocarditis (enterovirus)