COVID-19 en pediatría: aspectos clínicos, epidemiológicos, inmunopatogenia, diágnóstico y tratamiento

José Ramón Acosta Torres; Maité Pérez Cutiño; Magela Rodríguez Prieto; Alejandro Morales González

COVID-19 en pediatría: aspectos clínicos, epidemiológicos, inmunopatogenia, diágnóstico y tratamiento

José Ramón Acosta Torres, Maité Pérez Cutiño, Magela Rodríguez Prieto, Alejandro Morales González

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Resumen

Introducción: La Organización Mundial de la Salud declaró desde el 11 de marzo de 2020 la infección por el coronavirus denominado SARS-CoV-2, como una pandemia, existente desde finales de 2019 en la provincia china de Wuhan. La enfermedad producida por este coronavirus se denomina COVID-19, entidad que ha mostrado una baja morbilidad y mortalidad en pediatría.

Objetivo: Examinar factores epidemiológicos, sintomatología, diagnóstico y tratamiento de la enfermedad en la edad pediátrica.

Métodos: Se revisó la literatura utilizando la base de datos PubMed para identificar artículos publicados hasta el 30 de abril 2020, informes, series de casos y datos de laboratorio.

Resultados: La edad de presentación con mayor frecuencia ocurrió en los pacientes mayores de 5 años con 2,5 % de casos graves, acompañados de fiebre, tos, congestión nasal, disnea, vómitos y diarreas como síntomas más frecuentes. Los datos de laboratorio indican una media de conteo leucocitario entre 6,1 y 6,8 × 10⁵, linfopenia con rango entre 2,5 y 40 %, y aumento de las enzimas alaniltranferasa y creatininfosfoquinasa, además del marcador antiinflamatorio proteína C reactiva, este último con concentraciones entre el 17 y 62,5 %. La transmisión vertical no ha sido verificada. El tratamiento utilizado con mayor frecuencia es Lopinavir/ ritonavir e interferón. La radiografía de tórax fue normal entre el 20 y el 66 %. No se registran fallecidos en las seis series revisadas.

Consideraciones finales: La infección por SARS-CoV-2 en pediatría evoluciona con un pronóstico favorable, pero se necesitan más investigaciones para un mejor conocimiento de la entidad.

Palabras clave: coronavirus; COVID-19; SARS-CoV-2; citocinas; retrovirales.

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