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Review
. 2021 Jan 1;22(1):56-67.
doi: 10.1097/PCC.0000000000002599.

Caring for Critically Ill Children With Suspected or Proven Coronavirus Disease 2019 Infection: Recommendations by the Scientific Sections' Collaborative of the European Society of Pediatric and Neonatal Intensive Care

Peter C Rimensberger  1 , Martin C J Kneyber  2   3 , Akash Deep  4 , Mehak Bansal  5 , Aparna Hoskote  6 , Etienne Javouhey  7   8 , Gilles Jourdain  9 , Lynne Latten  10 , Graeme MacLaren  11   12 , Luc Morin  13 , Marti Pons-Odena  14   15 , Zaccaria Ricci  16 , Yogen Singh  17 , Luregn J Schlapbach  18   19 , Barnaby R Scholefield  20   21 , Ulrich Terheggen  22 , Pierre Tissières  13 , Lyvonne N Tume  23 , Sascha Verbruggen  24 , Joe Brierley  25 ; European Society of Pediatric and Neonatal Intensive Care (ESPNIC) Scientific Sections’ Collaborative Group
Affiliations
Review

Caring for Critically Ill Children With Suspected or Proven Coronavirus Disease 2019 Infection: Recommendations by the Scientific Sections' Collaborative of the European Society of Pediatric and Neonatal Intensive Care

Peter C Rimensberger et al. Pediatr Crit Care Med. .

Abstract

Objectives: In children, coronavirus disease 2019 is usually mild but can develop severe hypoxemic failure or a severe multisystem inflammatory syndrome, the latter considered to be a postinfectious syndrome, with cardiac involvement alone or together with a toxic shock like-presentation. Given the novelty of severe acute respiratory syndrome coronavirus 2, the causative agent of the recent coronavirus disease 2019 pandemic, little is known about the pathophysiology and phenotypic expressions of this new infectious disease nor the optimal treatment approach.

Study selection: From inception to July 10, 2020, repeated PubMed and open Web searches have been done by the scientific section collaborative group members of the European Society of Pediatric and Neonatal Intensive Care.

Data extraction: There is little in the way of clinical research in children affected by coronavirus disease 2019, apart from descriptive data and epidemiology.

Data synthesis: Even though basic treatment and organ support considerations seem not to differ much from other critical illness, such as pediatric septic shock and multiple organ failure, seen in PICUs, some specific issues must be considered when caring for children with severe coronavirus disease 2019 disease.

Conclusions: In this clinical guidance article, we review the current clinical knowledge of coronavirus disease 2019 disease in critically ill children and discuss some specific treatment concepts based mainly on expert opinion based on limited experience and the lack of any completed controlled trials in children at this time.

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Conflict of interest statement

Dr. Rimensberger has received a research grant from the European Union’s Horizon Research and Innovation Program (grant no 668259) through the Swiss State Secretariat for Education, Research, and Innovation (grant no 15.0342-1), 2016–2019 and research support by Getinge, SLE Ltd, and Stephan GmbH in 2013 and from ImtMedical in 2017. Dr. Jourdain had received a travel grant from Chiesi in 2015 and an accommodation grant by Teleflex in 2017. Dr. Pons-Odena’s institution received funding from Maquet, Philips, Fisher & Paykel, and Resmed, and he has been speaker for Maquet, Fisher & Paykel, and ResMed. Dr. Scholefield disclosed that he is funded by a National Institute for Health Research (Clinician Scientist) Fellowship award. Dr Terheggen has received a research grant by the Swiss National Foundation in 2016 and support for speaker activity from Hamilton, and he has received a nonrestricted grant from Nutricia Research. The remaining authors have disclosed that they do not have any potential conflicts of interest.

Figures

Figure 1.
Figure 1.
Proposed specific treatment options (beyond basic ICU treatment concepts) for coronavirus disease 2019 (COVID-19)–related severe respiratory disease (SARS) and multisystem inflammatory syndrome (MIS). ARDS = acute respiratory distress syndrome, BNP = brain natriuretic peptide, CRP = C reactive protein, CoV2 = coronavirus 2, KD = Kawasaki disease, IgG = immunoglobulin G, IL = interleukin, IVIG = IV immunoglobulin, LMWH = low molecular weight heparin, LV = left ventricular, TNF-a = tumor necrosis factor-alpha.
See this image and copyright information in PMC

Comment in

References

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Publication types

Supplementary concepts