COVID-19 and what pediatric rheumatologists should know: a review from a highly affected country

On March 11th, 2020 the World Health Organization declared COVID-19 a global pandemic. The infection, transmitted by 2019 novel coronavirus (2019-nCov), was first discovered in December 2019, in Wuhan, Hubei Province, and then rapidly spread worldwide. Italy was early and severely involved, with a critical spread of the infection and a very high number of victims. Person-to-person spread mainly occurs via respiratory droplets and contact. The median incubation period is 5 days. The spectrum of respiratory symptoms may range from mild to severe, strictly depending on the age of the patient and the underlying comorbidities. In children COVID-19 related disease is less frequent and less aggressive. In Italy 1% of positive cases are under 18 years of age, and no deaths have been recorded before 29 years of age. For patients affected by rheumatic disease, despite the concerns related to the imbalance of their immune response and the effect of immunosuppressive treatments, there are still few data to understand the real consequences of this infection. Major scientific societies have issued recommendations to help rheumatologists in caring their patients. Interestingly, some of the drugs mostly used by rheumatologists appear to be promising in critical COVID-19 infected patients, where the hyperinflammation and cytokine storm seem to drive to the multiorgan failure. Pediatric rheumatologists are expected to play a supporting role in this new front of COVID-19 pandemic, both as general pediatricians treating infected children, and as rheumatologists taking care of their rheumatic patients, as well as offering their experience in the possible alternative use of immunomodulatory drugs. The COVID-19 epidemic is now a pandemic and may affect millions of people worldwide. For the time being, children seem to be spared, at least from the more severe consequences of this infection. All physicians dealing with patients with chronic diseases, in particular immunosuppressed subjects, should be aware of the possible risks linked to the drugs used to treat rheumatologic disorders. However, there now hints that some of these drugs might be beneficial to fight COVID-19 infection. Use of social isolation and hygienic measure are fundamental in order to decrease viral spread. To read more- https://ped-rheum.biomedcentral.com/articles/10.1186/s12969-020-00422-z

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AS IS CLEAR AND WAS CLEAR ALREADY THAT DRUGS LIKE HCQS AND AZITHROMYCIN IS USED BECAUSE OF DOUBTS OF RHEUMATIC SEROLOGY IN COVID 19 INFECTION.... SIMILARLY AMERICANS TALK ABOUT BCG VACCINATION IN CHILDHOOD WHICH IS NOT IN THEIR IMMUNISATION PROGRAM FOR CHILDREN, AND P. G. I CHD IS TESTING M. W. VACCINES WHICH IS USED IN LEPROSY, PNEUMONIA AND TB. SO AS IT'S TOTALLY A NEW VIRUS AND THERE ARE SO MANY HYPOTHETICAL EXPLANATIONS..... IT'S A GOOD ARTICLE AND LET'S HOPE FOR THE BEST...
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