COVID-19, Maternal and Child Health, Nutrition – Literature Repository April 2021 Key Terms Date Title Journal / Source Type of Summary & Key Points Specific Observations Full Citation Published Publication This represents the final version (updated 30 April, 2021). New publications since our last update have been highlighted in blue. COVID-19; 29-Apr-21 A COVID-19- Pediatric Letter to The authors described the case of a SARS-CoV-2-positive infant in The authors described the case Pierre L, Kondamudi N, pediatric; Positive Infant Emergency Care the Editor the United States presenting with sudden cardiac arrest [date not of a SARS-CoV-2-positive infant Adeyinka A, et al. A COVID-19- cardiac arrest; Presenting With specified]. The 36-day-old infant was found unresponsive and not in the United States presenting Positive Infant Presenting With United States Sudden Cardiac breathing, and emergency medical services were called. Cardio- with sudden cardiac arrest. Sudden Cardiac Arrest. Pediatr Arrest pulmonary resuscitation, including endotracheal intubation, The infant manifested a robust Emerg Care. 2021;37(5):e280- ventilation, and intra-osseous access, was initiated in the field. The inflammatory response which e281. spontaneous return of circulation was accomplished in is suggestive of MIS-C, but with doi:10.1097/PEC.00000000000 approximately 5 min. The patient was asymptomatic before the absence of fever and skin 02432. onset of this catastrophic event and with no bacterial pathogen rashes. detected in the initial workup. The infant manifested a robust inflammatory response evidenced by high white blood cell count, elevated C-reactive protein, abnormal coagulation, elevated D- dimer levels, low fibrinogen, elevated ferritin, and positive SARS- CoV-2 IgG antibody. This clinical picture is suggestive of MIS-C, but fever and skin rashes were absent. Chest X-ray showed normal lungs without any cardiomegaly. Echocardiogram revealed reduced left ventricular function with a shortening fraction of 18% to 20% and an ejection fraction of 36% to 40%. There was mild mitral regurgitation without ventricular dilatation and no identifiable structural heart defects. This article demonstrates a case of COVID- 19 presenting with sudden cardiac arrest in a child. COVID-19; 29-Apr-21 An autopsy study EClinicalMedicine Case Series The authors described the pathology findings in 5 children and The authors described the Duarte-Neto AN, Caldini EG, pediatric; MIS- of the spectrum of adolescents (age range=7 months-15 years) who died with SARS- pathology findings in 5 Gomes-Gouvêa MS, et al. An C; autopsy; severe COVID-19 CoV-2 infection in Brazil between 18 March-15 August 2020. Tissue children and adolescents who autopsy study of the spectrum pathology; in children: From samples from vital organs (lungs, heart, brain, kidneys, liver, and died with SARS-CoV-2 infection of severe COVID-19 in children: Brazil SARS to different spleen) were analyzed by histology, electron microscopy (EM), RT- in Brazil between 18 March-15 From SARS to different phenotypes of PCR and immunohistochemistry (IHC). 2 patients had other severe August 2020. In all patients, phenotypes of MIS-C. MIS-C diseases previous to SARS-CoV-2 infection: 1 adolescent with SARS-CoV-2 was detected in EClinicalMedicine. adrenal carcinoma, who had diffuse alveolar damage (DAD) and lungs, heart, and kidneys by at 2021;35:100850. thrombotic events, and 1 infant with Edwards syndrome, with least one method (RT-PCR, IHC doi:10.1016/j.eclinm.2021.100 severe COVID-19-related pneumonia, DAD, and syncytial giant cell or EM) and in endothelial cells 850. hepatitis attributed to SARS-CoV-2 infection. The other 3 patients from heart and brain in 2 fulfilled the criteria for MIS-C with extrapulmonary manifestations patients with MIS-C (IHC). In attributed to SARS-CoV-2 infection (myocarditis, colitis, and acute addition, the study revealed encephalopathy with status epilepticus). Autopsy findings varied for the first time the presence amongst patients and included mild to severe COVID-19 of SARS-CoV-2 in the brain pneumonia, pulmonary micro-thrombosis, cerebral oedema with tissue of a child with MIS-C reactive gliosis, myocarditis, intestinal inflammation, and with acute encephalopathy, haemophagocytosis. SARS-CoV-2 RNA, antigens and virions were and in the intestinal tissue of a detected in several tissues by RT-PCR, IHC and EM, respectively. In child with acute colitis. all patients, SARS-CoV-2 was detected in lungs, heart, and kidneys by at least one method (RT-PCR, IHC or EM) and in endothelial cells from heart and brain in 2 patients with MIS-C (IHC). In addition, the study revealed for the first time the presence of SARS-CoV-2 in the brain tissue of a child with MIS-C with acute encephalopathy, and 1 COVID-19, Maternal and Child Health, Nutrition – Literature Repository April 2021 Key Terms Date Title Journal / Source Type of Summary & Key Points Specific Observations Full Citation Published Publication in the intestinal tissue of a child with acute colitis. The presence of SARS-CoV-2 in several organs, associated with cellular ultrastructural changes, reinforces the hypothesis that a direct effect of SARS-CoV-2 on tissues is involved in the pathogenesis of MIS-C. COVID-19; 28-Apr-21 Acute parotitis in Journal of Brief The authors described a case of acute parotitis in a 4‐year‐old The authors described a rare Ekemen Keles Y, Karadag Oncel pediatric; acute a 4-year-old in Paediatrics and Communic patient with COVID‐19 in Turkey. The 4‐year‐old male presented case of acute parotitis in a 4‐ E, Baysal M, et al. Acute parotitis; association with Child Health ation with a day of malaise, diarrhea, vomiting and mild abdominal pain. year‐old patient with COVID‐ parotitis in a 4-year-old in Turkey COVID-19 His parents tested positive for SARS-CoV-2 by RT-PCR one day 19 in Turkey. The patient was association with COVID-19. J earlier. At presentation, the patient was hemodynamically stable treated with a non‐steroidal Paediatr Child Health. 2021. with a completely normal physical examination. A combined anti‐inflammatory for 3 days, doi:10.1111/jpc.15527. oropharyngeal and nasopharyngeal swab was positive for SARS‐ after which the facial swelling CoV‐2 by RT-PCR. 4 days later, he was admitted with right‐sided resolved. facial swelling and pain, especially in the pre‐auricular area and cheek, with difficulty swallowing. The swelling measured 2 × 2 cm, extended from the pre‐auricular region to the mandible, and was soft and non‐fluctuant. There was no purulent discharge after parotid massage. Other systems examinations were normal. Neck ultrasonography showed diffuse, hypoechoic enlargement of the parotid gland, compatible with acute parotitis. No pathological lymphadenopathy was detected. The patient was treated with a non‐steroidal anti‐inflammatory agent. At follow‐up, 3 days later, his facial swelling had resolved. This case highlights the rare occurrence of COVID‐19‐associated parotitis in children. COVID-19; 28-Apr-21 Stroke in a child eNeurologicalSci Case The authors described a case of stroke in a pediatric patient with The authors described a case Khosravia B, Moradvaesib B, pediatric; with SARS-CoV-2 Report SARS-CoV-2 infection in Iran [date not specified]. The 10-year-old of stroke in a pediatric patient Abedini M, et al. Stroke in a stroke; Iran infection: A case female had a severe headache in the right temporal area followed with SARS-CoV-2 infection in child with SARS-CoV-2 report by facial distortion, tonic movements of the shoulders and the Iran. Enoxaparin was infection: A case report. right leg, and loss of consciousness for 5 min. She was hospitalized prescribed until lack of eNeurologicalSci. 2021. due to the seizures and tested positive for SARS-CoV-2 by thrombosis was confirmed doi:10.1016/j.ensci.2021.1003 nasopharyngeal RT-PCR. One week before, she had had a low- (5 days), followed by aspirin 45. grade fever and gastro-intestinal manifestations such as vomiting treatment. According to this and abdominal pain for 2 days. She had no previous history of case report, SARS-CoV-2 cough, shortness of breath, skin rash, or recent trauma. Acute infection may contribute to infarction was seen in the right putamen, globus pallidus, and the the occurrence and posterior part of the insula. A small focal dilatation within M1 development of ischemic segment of the left middle cerebral artery (MCA) was also stroke in children. observed. Enoxaparin was prescribed until lack of thrombosis was confirmed (5 days), followed by aspirin treatment. According to this case report, SARS-CoV-2 infection may contribute to the occurrence and development of ischemic stroke in children. 2 COVID-19, Maternal and Child Health, Nutrition – Literature Repository April 2021 Key Terms Date Title Journal / Source Type of Summary & Key Points Specific Observations Full Citation Published Publication COVID-19; 28-Apr-21 Can Hematological Turkish Journal of Letter to The authors conducted a retrospective study at a children’s In their hematological findings, Ötiken Arıkan K, Şahinkaya Ş, hematology; Findings of COVID- Hematology the Editor hospital in Izmir, Turkey, between 30 March-31 October 2020 to the authors found that the Böncüoğlu E, et al. Can pediatric 19 in Pediatric assess pediatric hematological findings. 9.1% (n=353) of the lymphocyte to white blood cell Hematological Findings of COVID-19 Patients Guide pediatric patients tested were diagnosed with COVID-19, 52.1% ratio was lower and the COVID-19 in Pediatric Patients Physicians about (n=184) of whom were male and the median age in the SARS-CoV- neutrophil-to-lymphocyte ratio Guide Physicians about Clinical Clinical Severity? 2 positive cohort was 9 years (range: 4 days-17 years). 2.5% (n=9), was higher in severe/critical Severity? [published online 83% (n=293), 10.8% (n=38) and 3.7& (n=13) cases were diagnosed cases of COVID-19 compared ahead of print, 2021 Apr 28].