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. 2021 Nov;95(5):382.e1-382.e8.
doi: 10.1016/j.anpede.2021.10.002. Epub 2021 Oct 21.

COVID-19 pandemic. What have we learned?

Cristina Calvo  1 , Alfredo Tagarro  2 , Ana Méndez Echevarría  3 , Belén Fernández Colomer  4 , M Rosa Albañil Ballesteros  5 , Quique Bassat  6 , M José Mellado Peña  3
Affiliations

COVID-19 pandemic. What have we learned?

Cristina Calvo et al. An Pediatr (Engl Ed). 2021 Nov.

Abstract
in English, Spanish

Since the COVID-19 pandemic was declared in March 2020, we have learned a lot about the SARS-CoV-2 coronavirus, and its role in pediatric pathology. Children are infected in a rate quite similar to adults, although in most cases they suffer mild or asymptomatic symptoms. Around 1% of those infected require hospitalization, less than 0.02% require intensive care, and mortality is very low and generally in children with comorbidities. The most common clinical diagnoses are upper or lower respiratory infections, gastrointestinal infection and, more seriously, multisystemic inflammatory syndrome (MIS-C). Most episodes do not require treatment, except for MIS-C. Remdesivir has been widely used as a compassionate treatment and its role has yet to be defined. The newborn can become infected, although vertical transmission is very low (<1%) and it has been shown that the baby can safely cohabit with its mother and be breastfed. In general, neonatal infections have been mild. Primary care has supported a very important part of the management of the pandemic in pediatrics. There has been numerous collateral damage derived from the difficulty of access to care and the isolation suffered by children. The mental health of the pediatric population has been seriously affected. Although it has been shown that schooling has not led to an increase in infections, but rather the opposite. It is essential to continue maintaining the security measures that make schools a safe place, so necessary not only for children's education, but for their health in general.

Desde que en marzo de 2020 se declarara la pandemia COVID-19 hemos aprendido muchas cosas del coronavirus SARS-CoV-2, y de su papel en la enfermedad pediátrica.

Los niños se infectan en un porcentaje bastante similar a los adultos, si bien en la mayoría de las ocasiones sufren cuadros leves o asintomáticos. Alrededor de un 1% de infectados precisan hospitalización, menos de un 0,02% precisan cuidados intensivos, y la mortalidad es muy baja y generalmente en niños con comorbilidades. Los cuadros clínicos más habituales son infecciones respiratorias de vías altas o bajas, cuadros gastrointestinales y con mayor gravedad el síndrome inflamatorio multisistémico (MIS-C). La mayoría de los episodios no precisan tratamiento, salvo el MIS-C. El remdesivir se ha empleado generalmente como tratamiento compasivo y aún está por definir su papel.

El recién nacido puede infectarse, si bien la transmisión vertical es muy baja (< 1%), y se ha demostrado que el bebé puede cohabitar de manera segura con su madre y recibir lactancia materna. En general las infecciones neonatales han sido leves.

La atención primaria ha soportado una parte muy importante del manejo de la pandemia en pediatría. Se han producido numerosos daños colaterales derivados de la dificultad de acceso a la asistencia y del aislamiento que han sufrido los niños. La salud mental de la población pediátrica se ha visto seriamente afectada. A pesar de que se ha demostrado que la escolarización no ha supuesto un incremento de los contagios, sino más bien todo lo contrario. Es fundamental seguir manteniendo las medidas de seguridad que permitan hacer de las escuelas un lugar seguro, tan necesario no solo para la educación infantil, sino para su salud en general.

Keywords: COVID-19; Colegios; Neonates; Neonatos; SARS-CoV-2; Schools.

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Figures

Figure 1
Figure 1
Waves of the COVID-19 pandemic in Spain.
Figure 2
Figure 2
Management of neonates born to mothers with suspected SARS-CoV-2 infection. * In case of mothers undergoing evaluation or that tested positive, if the mother is oligosymptomatic or asymptomatic, rooming in of mother and infant is recommended with contact and droplet isolation measures (hand hygiene, face mask and crib 2 m apart from mother’s bed) and promotion of breastfeeding. ** In symptomatic infants born to mothers with confirmed infection or strong suspicion of infection based on clinical/epidemiological factors, ruling out infection requires 2 negative viral PCR tests (at birth and at 24−48 h). In asymptomatic infants, 1 or 2 PCR tests will be done depending on test availability.
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Supplementary concepts