EXÁMENES DE DIAGNÓSTICO Y MANIFESTACIONES CLÍNICAS DE COVID-19 EN NIÑOS: REVISIÓN INTEGRATIVA

Nunes, Michelle Darezzo Rodrigues; Pacheco, Sandra Teixeira de Araújo; Costa, Cícero Ivan Alcantara; Silva, Jaciane Alexandre da; Xavier, Welker da Silva; Victória, Juliana Zambrano

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Special Section COVID-19 • Texto contexto - enferm. 29 • 2020 • https://doi.org/10.1590/1980-265X-TCE-2020-0156 copiar

EXÁMENES DE DIAGNÓSTICO Y MANIFESTACIONES CLÍNICAS DE COVID-19 EN NIÑOS: REVISIÓN INTEGRATIVA

Autoría SCIMAGO INSTITUTIONS RANKINGS

RESUMEN

Objetivo:

identificar en la literatura la producción científica sobre exámenes y manifestaciones clínicas de COVID-19 en niños y discutir el papel de la enfermería en su atención.

Métodos:

revisión integradora, cuya búsqueda tuvo lugar entre abril y junio de 2020, en las bases de datos de Web of Science, CINAHL, BDENF, IBECS, LILACS, MEDLINE (a través de PubMed) para responder a la pregunta orientadora: lo que revelan los artículos de investigación sobre COVID -19 en niños? Se incluyeron artículos de investigación originales, publicados de enero a mayo de 2020. Estudios sin metodología de investigación (informes de casos, reflexión, recomendaciones), artículos de revisión, estudios que se centraron en otros temas o se llevaron a cabo exclusivamente con recién nacidos, bebés, población de adolescentes y adultos.

Resultados:

las búsquedas en las bases de datos buscadas capturaron 314 referencias. Después de las exclusiones, se seleccionaron 59 estudios para ser leídos en su totalidad; de estos, se seleccionaron 14 artículos para componer esta revisión, agrupados empíricamente, de acuerdo con sus similitudes, en dos categorías: Exámenes utilizados en COVID-19 en niños; y Principales hallazgos clínicos en COVID-19 en niños.

Conclusión:

los estudios enfatizan los exámenes COVID-19 y los hallazgos clínicos en niños; por lo tanto, el papel de la enfermería se destaca al preparar y realizar estos exámenes, ya que son un instrumento para evaluar y monitorear a los niños con COVID-19, así como para promover una atención adecuada y calificada para minimizar los signos y síntomas de esta enfermedad. enfermedad, con miras a la pronta restauración de su salud.

DESCRIPTORES
Preescolar; Niño; Coronavírus; Enfermería pediátrica; Revisión

Citation/Year/ Country/Field	Objective	Subjects	Method	Main results obtained	Level of evidence
Feng K et al1414. Feng K, Yun YX, Wang XF, Yang GD, Zheng YJ, Lin CM, et al. [Analysis of CT features of 15 Children with 2019 novel coronavirus infection]. Zhonghua ErKe Za Zhi. [Internet]. 2020 [cited 2020 Apr 14];58(0):e007. [Article in Chinese]. Available from: https://dx.doi.org/10.3760/cma.j.issn.0578-1310.2020.0007 https://dx.doi.org/10.3760/cma.j.issn.05... . 2020 China Medicine	To analyze the characteristics of the site and shape of pulmonary lesions in CT scan of children with new coronavirus.	15 children (4 to 14 years old)	Non-randomized clinical study	The lesions were located mainly under the pleura and showed irregular subpleural shadows or single nodular frosted glass shadows and halo signs.	III
Li W et al1515. Li W, Cui H, Li K, Fang Y, Li S. Chest computed tomography in children with COVID-19 respiratory infection. Pediatr Radiol. [Internet] 2020 [cited 2020 Apr 14];50(6):796-9. Available from: https://dx.doi.org/ 10.1007/s00247-020-04656-7 https://dx.doi.org/ 10.1007/s00247-020-0... 2020 China Medicine	To describe thoracic CT scan findings in children with COVID-19.	5 children (10 months to 6 years)	Retrospective study	Two children showed no signs of abnormality on thoracic Ct. Three showed characteristic radiological abnormality.	IV
Wang D et al1616. Wang D, Ju XL, Xie F, Lu Y, Li FY, Huang HH, et al. Clinical analysis of 31 cases of 2019 novel coronavirus infection in children from six provinces (autonomous region) of northern China. Zhonghua ErKe Za Zhi. [Internet]. 2020 [cited 2020 Apr 14];58(4):E011. Available from: https://dx.doi.org/10.3760/cma.j.cn112140-20200225-00138. https://dx.doi.org/10.3760/cma.j.cn11214... 2020 China Medicine	To analyze the clinical characteristics of coronavirus-infected children.	31 children (1 month to 7 years old)	Retrospective cohort study	Four cases were asymptomatic. Twenty cases had fever, fourteen had cough, three had fatigue, and three had diarrhea.	IV
Zheng F et al1717. Zheng F, Liao C, Fan Q-H, Chen H-B, Zhao X-G, Xie Z-G, et al. Clinical characteristics of children with Coronavirus disease 2019 in Hubei, China. Curr Med Sci. [Internet]. 2020 [cited 2020 Apr 14];40(2):275-80. Available from: https://dx.doi.org/ 10.1007/s11596-020-2172-6 https://dx.doi.org/ 10.1007/s11596-020-2... 2020 China Medicine	To describe the clinical characteristics of pediatric cases infected with COVID-19.	25 children (2 to 9 years old)	Cross-sectional multicenter cohort study	Children under 3 years old accounted for the majority of critical cases.	IV
Sun D et al1818. Sun D, Li H, Lu X-X, Xiao H, Ren J, Zhang F-R, et al. Clinical features of severe pediatric patients with coronavirus disease 2019 in Wuhan: a single center’s observational study. World J Pediatr. [Internet] 2020 [cited 2020 Apr 14];19;1-9. Available from: https://dx.doi.org/10.1007/s12519-020-00354-4 https://dx.doi.org/10.1007/s12519-020-00... 2020 China Medicine	To describe the clinical characteristics of severe pediatric patients with COVID-19.	8 children (2 months to 15 years old)	Retrospective cohort study	The most common symptoms were tachypnea, fever, cough, expectoration, and nausea/vomiting.	IV
Lu X et al1919. Lu X, Zhang L, Du H, Zhang J, Li YY, Qu J, et al. SARS-CoV-2 Infection in children. N Engl J Med. [Internet] 2020 [cited 2020 May 01];382:17. Available from: https://www.nejm.org/doi/pdf/10.1056/nejmc2005073?articleTools=true https://www.nejm.org/doi/pdf/10.1056/nej... 2020 China Medicine	To assess the clinical characteristics of children infected with COVID-19.	171 children (1 day to 14 years old)	Observational study	Fever was present in most children. Other common signs and symptoms include cough and erythema.	IV
Liu W et al 2020. Liu W, Zhang Q, Chen J, Xiang R, Song H, Shu S, et al. Detection of Covid-19 in children in early January 2020 in Wuhan, China. N Engl J Med. [Internet]. 2020 [cited 2020 Apr 11];382(14):1370-1 Available from: https://dx.doi.org/ 10.1056/NEJMc2003717 https://dx.doi.org/ 10.1056/NEJMc2003717... 2020 China Medicine	To observe the clinical characteristics of COVID-19 in hospitalized children.	366 children (1 to 6 years old)	Retrospective study	All had high fever (>39°C). Only 1 required hospitalization in a pediatric intensive care unit.	III
Xu Y et al2121. Xu Y, Li X, Zhu B, Liang H, Fang C, Gong Y, et al. Characteristics of pediatric SARS-CoV-2 infection and potential evidence for persistent fecal viral shedding. Nat Med. [Internet]. 2020 [cited 2020 May 01];26(4):502-5. Available from: https://dx.doi.org/10.1038/s41591-020-0817-4 https://dx.doi.org/10.1038/s41591-020-08... 2020 China Medicine	To assess the clinical characteristics of children infected with COVID-19.	10 children (2 months to 15 years old)	Prospective observational	Seven had fever on admission. Other symptoms were cough (5), sore throat (4), nasal congestion and rhinorrhea (2), and diarrhea (3). One was asymptomatic.	III
Li Y et al2222. Li Y, Cao J, Zhang X, Liu G, Wu X, Wu B, et al. Imaging characteristics of COVID-19 pneumonia in preschool children: a retrospective study. BMC Pediatrics. [Internet]. 2020 [cited 2020 June 11];20(1):227. Available from: https://dx.doi.org/10.1186/s12887-020-02140-7 https://dx.doi.org/10.1186/s12887-020-02... 2020 China Medicine	To investigate the thoracic imaging characteristics of COVID-19.	8 children (1 to 5 years old)	Retrospective study	COVID-19 thoracic CT scan findings in preschool children may be atypical and varied.	IV
Li H et al2323. Li H, Chen K, Liu M, Xu H, Xu Q. The profile of peripheral blood lymphocyte subsets and serum cytokines in children with 2019 novel coronavirus pneumonia. J Infect [Internet]. 2020 [cited 2020 June 11];81(2020):115-20. Available from: https://dx.doi.org/10.1016/j.jinf.2020.04.001 https://dx.doi.org/10.1016/j.jinf.2020.0... 2020 China Medicine	To investigate c-reactive protein, procalcitonin, serum creatinine, alanine aminotransferase, lymphocyte subsets, and cytokines.	40 children with pneumonia 2019-nCoV (16 days to 14 years old) and 16 due to respiratory syncytial virus (RSV) (2 to 5 years old)	Prospective descriptive study	All tests showed higher rates in children with RSV pneumonia, except for one child with COVID -19 who had much higher Interleukin-10 levels and was the only one with severe pneumonia.	IV
Xia W et al2424. Xia W, Shao J, Guo Y, Peng X, Li Z, Hu D. Clinical and CT features in pediatric patients with COVID-19 infection: Different points from adults. Pediatric Pulmonology. [Internet]. 2020 [cited 2020 June 11];55(5):1169-74. Available from: https://dx.doi.org/10.1002/ppul.24718 https://dx.doi.org/10.1002/ppul.24718... 2020 China Medicine	To discuss the clinical characteristics in pediatric patients with COVID-19.	20 children (16 days to 14 years old)	Retrospective study	Clinical characteristics included fever (12), cough (13), diarrhea (3), nasal secretion (3), sore throat (1), vomiting (2), tachypnea (2), and fatigue (1).	IV
Lu Y et al2525. Lu Y, Wen H, Rong D, Zhou Z, Liu H. Clinical characteristics and radiological features of children infected with the 2019 novel coronavirus. Clin Radiol [Internet]. 2020 [cited 2020 June 11];75(2020):520-25. Available from: https://dx.doi.org/10.1016/j.crad.2020.04.010 https://dx.doi.org/10.1016/j.crad.2020.0... 2020 China Medicine	To identify the common findings of COVID-19 in children.	9 children (2 months to 15 years old)	Retrospective study	Four children had only fever, two fever and cough, one had cough and a nasal obstruction and rhinorrhea. One was asymptomatic.	IV
Soltani et al2626. Soltani J, Sedighi I, Shalchi Z, Sami G, Moradveisi B, Nahidi S. Pediatric coronavirus disease 2019 (COVID-19): An insight from west of Iran. North Clin Istanb. [Internet] 2020[cited 2020 June 11];7(3):284-91. Available from: https://dx.doi.org/10.14744/nci.2020.90277 https://dx.doi.org/10.14744/nci.2020.902... 2020 Iran Medicine	To study the clinical characteristics of pediatric patients infected with COVID-19.	30 children (1 day to 14 years old)	Prospective descriptive study	The most common symptoms were tachypnea, fever, cough, and dyspnea. None of them presented runny nose.	IV
Ma et al2727. Ma H, Hu J, Tian J, Zhou X, Li H, Laws MT, et al. A single-center, retrospective study of COVID-19 features in children: a descriptive investigation. BMC Medicine. [Internet]. 2020 [cited 2020 June 11];18(1):123. Available from: https://dx.doi.org/10.1186/s12916-020-01596-9 https://dx.doi.org/10.1186/s12916-020-01... 2020 China and USA Medicine	To report relevant findings of patients positive for COVID-19.	50 children (2 to 16 years old)	Retrospective study	There was no clear association between changes in CT lesions and clinical outcomes.	III

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E-mail: textoecontexto@contato.ufsc.br

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[1] CORRESPONDING AUTHOR
Michelle Darezzo Rodrigues Nunes mid13@hotmail.com