Archives of Pediatric Infectious Diseases
Volume:10 Issue: 2, Apr 2022

Guillain-Barre syndrome (GBS) characterizes a monophasic ascending, symmetrical paralysis, with areflexia, progressing over days to weeks. Normally, as a post-infectious autoimmune procedure, it leads to destroying myelin. Scattered reports exist regarding the concurrent evidence of COVID-19 infection and adults with possible GBS. However, few former cases were reported in children. Here in, we report an 11 years-old boy with GBS concurrent with COVID-19 infection.

Serious, and sometimes, deadly complications of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are devastating. Whereas most manifestations of COVID-19 are respiratory (fever, dry cough, fatigue, pneumonia), it is getting to be progressively recognized that numerous organ functions can be affected by this disease, and the nervous system is one of them as neurological complications can affect up to 36% of adult patients. However, the prevalence and pathophysiology of these complications have yet to be fully elucidated in children. Here, we discuss an infant with neurological symptoms manifested as chronic isolated aseptic meningitis associated with COVID-19, which was unresponsive to ordinary treatments and dramatically responsive to dexamethasone. Immune-mediated reactions may have had a major pathophysiologic role in this case.

The first cases of coronavirus disease 2019 (COVID-19) were identified in Wuhan, China, in December 2019, and then it immediately spread to other parts of the world. Conjunctivitis has been reported as one of the manifestations of the disease. In this study, we report a three-year-old child with a confirmed diagnosis of COVID-19 developing conjunctivitis in Iran.

The patient was a three-year-old male child who was referred to Namazee Hospital (Shiraz) due to fever, dry cough, tachypnea, and respiratory distress. He was admitted with the impression of a COVID-19 infection. On the sixth day of admission, the patient developed unilateral red-eye and foreign body sensation in the left eye. A conjunctival swab was done for collecting tears and conjunctival secretions from the lower eyelid fornix without topical anesthesia and was sent for assessing the presence of SARS-CoV-2 RNA, which was demonstrated to be positive after two days.

Our findings suggest that the COVID-19 virus can be present in tears and conjunctiva. Additionally, it should be taken into account that ocular complications may not appear in the early stages of infection.

SARS-CoV2 (COVID-19) is a serious and global infection that has spread to numerous countries, including Iran. Pneumothorax may occur in cases of COVID-19 as a consequence of lung parenchymal damage, which can disrupt the healing process and increase mortality.

This manuscript describes the case of a 2-year-old boy with hyper IgM syndrome and COVID-19 infection. The patient developed spontaneous pneumothorax and recovered without chest tube by supportive care and was discharged in good general condition after the completion of the antibiotic course and cessation of fever.

The severity, prognosis, and best treatment for spontaneous pneumothorax in COVID-19 infection, especially in children, remain nebulous. It is recommended that conservative treatment be performed if the patient has stable vital signs and no severe respiratory failure. However, this requires more detailed clinical evaluations.

Since the beginning of the coronavirus disease 2019 (COVID-19) outbreak, it was assumed that infection rate in pediatric patients is lower than in adults and that infection is less severe in children than adult patients. Recently, there have been several reports and case series presenting critically-ill children with COVID-19, but still, severe hypotension is rare in pediatric patients with COVID-19.

We describe three pediatric cases with COVID-19 who presented with multi-system organ failure and severe hypotension treated with the guidance of the parameters of an invasive continuous hemodynamic monitoring device. We also compare their parameters with few articles on pediatric sepsis parameters.

Although we usually start the treatment of hypotensive pediatric patients with hydration and epinephrine as an inotrope, in our cases, we required a different treatment plan according to the hemodynamic monitoring parameters, which indicates the value of the utilization of these devices in pediatric intensive care units

Idiopathic intracranial hypertension (IIH), also known as pseudotumor cerebri, is a rare neurological manifestation of coronavirus disease 2019 (COVID-19) infection.

In this case study, we present a 10-year-old girl with headache, diplopia, bilateral sixth nerve palsy, and papilledema following a history of seven days of fever about two weeks ago. In lumbar puncture, the opening pressure was 56 cmH2O. Cerebrospinal fluid analysis was normal. Brain magnetic resonance imaging (MRI) was suggestive of IIH. Nasopharyngeal reverse transcription-polymerase chain reaction (RT-PCR) was positive for COVID-19. Oral acetazolamide was prescribed, and the patient improved completely after three weeks of continuous medical treatment.

Since IIH is a rare neurological complication of COVID-19, we have to suspect COVID-19 infection in any patient with IIH.

Albeit most children infected with SARS-CoV-2 are asymptomatic or have mild respiratory symptoms, similar cases of Kawasaki disease and toxic shock syndrome increased at the end of April 2020 worldwide. Systemic inflammatory involvement characterizes these cases and is part of the spectrum of a SARS-CoV-2-related syndromes called multisystem inflammatory syndrome (MIS-C).

We report the case of a child with severe cardiovascular impairment due to MIS-C who developed cardiogenic shock secondary to acute myocarditis. The pathophysiology of myocardial outcomes caused by MIS-C remains unclear.

We intend to contribute to new prospective studies on the early diagnosis, clinical management, and follow-up of patients with severe cardiovascular impairment secondary to infection with SARS-CoV-2.

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It may have many undescribed clinical manifestations.

In this study, we report a 7-year-old male COVID-19 patient with low platelet count who presented with gingival bleeding and ecchymosis and had a good response to corticosteroid therapy.

This case highlights the need to be vigilant for atypical presentations or complications of COVID-19, one of which is SARS-CoV-2-induced immune thrombocytopenic purpura (ITP). It is necessary to pay attention to platelet count in addition to typical clinical features and radiographic findings. On the other hand, viral testing in thrombocytopenic patients should be considered for timely diagnosis of COVID-19 and taking necessary measurements for patient isolation in order to prevent the spread of disease and healthcare workers’ infection during this pandemic.

Central nervous system involvement by SARS-CoV-19 appears to be very rare in neonates. We report a case of viral meningitis in a neonate admitted to Kerman Afzalipour Hospital in Southeastern Iran.

The patient was a 15-day-old neonate who presented with lethargy, fever, and poor feeding the day before admission. After the initial evaluation and experimental treatment, viral meningitis was diagnosed with SARS- CoV-19 by polymerase chain reaction (PCR) analysis of cerebrospinal fluid. Empirical treatment was done with antibiotics and supportive care. After viral meningitis was confirmed, the antibiotics were discontinued. In a follow-up two weeks later, the neonate had a good condition with no particular problem.

This report is a case of SARS-CoV-2 meningitis in a neonate. Therefore, if there is epidemiological evidence, the central nervous system involvement due to this virus should also be considered in neonates.