Authors’ conclusions: fever, gastrointestinal symptoms and Kawasaki disease like simptoms were the main presenting symptoms of multisystem inflammatory syndrome in children associated with SARS-CoV-2 infection. Although most children required intensive care and immunomodulatory therapies, favorable outcomes were reported in the majority with low-mortality rates.
Reviewers’ commentary: the results of this study describe the usual clinical pattern of patients with multisystem inflammatory syndrome, their care needs and their prognosis, although they do not provide information on the effectiveness of the different treatments used. The implementation of consensus protocols and their evaluation in prospective studies will allow us to establish their effectiveness.
Oltra Benavent M, Ochoa Sangrador C. Evid Pediatr. 2021;17:3
Authors’ conclusions: even among the symptomatic COVID-19 cases, severe manifestations are seen in very few children. Though fever and respiratory symptoms are most common, many children also have gastrointestinal manifestations.
Reviewers’ commentary: most frequent clinical manifestations of COVID-19 in children are usually fever and mild respiratory or gastrointestinal symptoms, although these data come from studies with selection and publication biases. Prospective population cohort studies with patients from all levels of care are necessary to understand the actual clinical spectrum of the disease. Analyzing possible clinical markers of risk of severe cases would be also useful.
Gimeno Díaz de Atauri Á, Fernández Rodríguez MM. Evid Pediatr. 2021;17:4
Authors’ conclusions: in patients with suspected COVID-19 and symptoms of less than five days of evolution, the PanbioTM rapid antigen test has poor diagnostic sensitivity.
Reviewers’ commentary: in children up to 16 years of age with symptoms compatible with COVID-19 and less than five days of evolution, a negative rapid antigenic test does not rule out SARS-CoV-2 infection and, in a situation of high suspicion of SARS-CoV-2, PCR should be considered.
Aparicio Rodrigo M, Martín Masot R. Evid Pediatr. 2021;17:5
Conclusions of the authors of the study: the BNT-162b2 vaccine, administered in two doses 21 days apart, is safe and provides 95% efficacy against COVID-19.
Reviewers’ comment: preliminary data suggest that the BNT-162b2 vaccine is effective and safe in preventing symptomatic COVID-19 disease in adults over 16 years of age. Although the duration of protection is unknown, and it has not yet been studied in children under 16 years of age, immunosuppressed or pregnant individuals. We do not know the infrequent or late adverse effects.
Esparza Olcina MJ, Juanes de Toledo B. Evid Pediatr. 2021;17:6
Authors’ conclusions: radiological findings in children with COVID-19 are often normal or mild, with unilateral involvement, ground-glass pattern, and affecting lower lobes. Chest CT should be reserved for severe cases or to identify other diagnoses.
Reviewers’ commentary: performing chest CT imaging should be limited to severe cases, if it is going to lead to a change in clinical attitude. Although the most frequent changes are unilateral involvement of lower lobes and ground glass pattern, it remains to be defined what type of test to perform, and which images may be indicative of a worse prognosis in pediatric population. The risk of radiation outweighs the benefits of chest CT in not severe cases.
Rivero Martín MJ, Pérez-Moneo Agapito B. Evid Pediatr. 2021;17:7
Authors’ conclusions: school closure did not have a measurable effect on the number of COVID-19 cases among children. Children were not a significant risk group for COVID-19 and they do not appear to play a very important role from the point of view of disease transmission.
Reviewers’ commentary: Despite its limitations, the results are consistent with most studies that examine the transmissibility of SARS-CoV-2 infection among children, and among children and teachers, demonstrating that school closure has little impact on the number of cases in the pediatric population and mortality from COVID-19.
Author’s ́ conclusions: neonatal COVID-19 infection is uncommon, rarely symptomatic, and the rate of infection is no greater when the baby is born vaginally, breastfed or remains with the mother.
Reviewer’s ́ commentary: data suggest that COVID-19 disease should not be an indication por caesarean birth, formula feeding or isolation of the infant from the mother. Mothers who breast-fed and room-in with their infants should continue to observe COVID-19 hygiene precautions.
González Rodríguez MP, Aizpurua Galdeano P. Evid Pediatr. 2021;17:9