Management of COVID-19-positive asymptomatic and mildly symptomatic children

Abstract

Coronavirus disease (COVID) in children is milder in comparison to adults with a better prognosis and minimal mortality. The most common clinical presentation of COVID-19 in children includes fever and cough, but a significant number of infected children may be asymptomatic contributing to transmission of the disease. Several hypotheses have been put forth to explain the less severe disease in children including lower expression of angiotensin converting enzyme 2 (ACE2) receptors in the lungs of pediatric patients which is the main receptor through which the virus enters the cells in the lung and mediates its effects, lower exposure to virions, higher likelihood of viral co-infection in children which may be responsible for limited replication of the severe acute respiratory syndrome coronavirus 2 by direct virus-to-virus interaction and competition and the protective role of Bacillus Calmette-Guerin vaccine. Reverse transcriptase-polymerase chain reaction testing of upper or lower respiratory tract secretions is the recommended confirmatory test and management is guided by the severity of illness in the child. In this review, we will discuss the management of asymptomatic and mildly symptomatic children.

Keywords

• asymptomatic
• children
• covid-19
• mildly symptomatic