COVID-19 in Children and Adolescents: Characteristics and Specificities in Immunocompetent and Oncohematological Patients

SARS-CoV-2 pandemic affected fewer children and adolescents with lower morbidity and mortality rates than those reported for adults. This review focused on the clinical course, risk factors for severe COVID 19, mortality, treatment options, and prevention measures in the pediatric and adolescent setting with special attention to pediatric oncohematological patients. SARS-CoV-2 infection was often asymptomatic in these subgroups of patients, but 47 to 68% of them required hospitalization, and 9–10% of those hospitalized needed intensive care with a COVID 19 attributable mortality of about 4%. The multisystem inflammatory syndrome associated with COVID 19 was less frequent than that reported in the non-oncohematological pediatric population. Noteworthy, the course of COVID 19 was more severe in low-middle income countries. The key measures to prevent SARS-CoV-2 infection are reducing patient exposure to the SARS-CoV-2 and vaccination, now available for parents and caregivers and patients and siblings above 12 years of age. The treatment of COVID 19 in pediatric patients is mainly based on supportive care with dexamethasone and heparin prophylaxis for severely ill patients. Other measures, such as convalescent plasma, remdesivir, and monoclonal antibodies, have been used in limited cases or within experimental protocols. Further studies are needed regarding the risks factors and outcomes of SARS-CoV-2 infection in pediatric immunocompromised patients.