Severe pediatric COVID-19 with acute respiratory distress syndrome: a narrative review

The novel coronavirus has rapidly arisen to be a global pandemic since its discovery in December 19th. SARS-CoV-2, a type of betacoronavirus, mainly infects cells which express angiotensin-converting enzyme 2 (ACE2) receptors, causing alveolar damage and excessive inflammation in the lungs, and it can even cause diffuse alveolar damage and thrombosis in severe cases. The clinical manifestations range from mild pneumonia to severe illness, and even death. The prevalence of infection in children is similar to that of adults, though the symptoms are mild or even asymptomatic, among them, fever and cough are the most common symptoms. However, there are also reports of admission to the intensive care unit (ICU) or even death in children. Among them, acute respiratory distress syndrome (ARDS) is a common complication, with high mortality rates. Currently there are no specific drugs for the novel coronavirus pneumonia, and a large number of clinical trials are underway to search out the most suitable treatment. Respiratory support is still the basic management for ARDS induced by the novel coronavirus. This review summarizes the epidemiology, pathogenesis, clinical manifestations, diagnosis and progress of treatment methods in severe pediatric coronavirus disease 19 with ARDS, hoping that when the novel coronavirus continues to spread, clinicians can better understand, diagnose and treat the pediatric patients. © Pediatric Medicine. All rights reserved.