Number of case, age, sex, date of admission | COVID-19 test | First presentation symptoms and signs | Ongoing presentation | Abdomino pelvic Ultrasonography | Chest imaging | Echocardiography | Laboratory data at admission | Ongoing laboratory data | treatments | Total admission days, PICU stay, Out come | First impression |
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Case 1: 12 years old boy, 28 march | Covid-19 RT- PCR: positive | fever and chills, rash, diarrhea, fatigue, toxic appearance | Second day: respiratory distress, heart and respiratory failure | Chest CT-scan: patchy ground glass opacity and interlobar septal thickening | First day: mild MR, Mild TR, mild diastolic dysfunction, LVEF 50%, Second day: moderate MR and TR, moderate diastolic dysfunction LVEF 30% | CBC: WBC: 8.7, N: 90, L: 10, Hb: 9.5, Plt: 75, CRP: 1+, ESR: 32, urea: 75, Cr: 2.5, AST: 62, ALT: 30, UA: Pro: 1+, WBC: many, RBC: 10–12 ABG: PH: 7.2, Hco3: 11.8, Pco2: 30, Po2: 32 | Cr: 3.2, urea: 126, D. dimer: 6888, CRP: 50 | Vasoactives, Oseltamivir, meropenem, vancomycin, hydroxychloroquine, Kaletra, IVIG 1 g/kg, hydrocortisone 2 mg/kg/dose, packed cell | Total: 3 days ICU: 3 days Died | COVID-19 infection | |
Case 2: 5 years old girl, 8 April | COVID-19 RT-PCR positive | Fever, vomiting, diarrhea and skin rash, cough and otalgia, conjunctivitis, Loss of appetite | 3 to 5 days after admission: Tachypnea, drowsiness, generalized edema, headache, myalgia, pharyngeal congestion, purulent conjunctivitis, Abdominal pain | mild to moderate free fluid in abdomen and bilateral mild to moderate plural effusion | Normal CT-scan at admission. But on day 5, bilateral plural effusion and patchy infiltration, ground glass apearance | mild TR, trivial MR, normal coronary arteries on 2 occasion | CBC: WBC: 8.1, N: 60, Hb: 10, , Plt: 150, ESR: 71, CRP:28, Alb: 2.6 | CBC: WBC: 6.6, N: 74, L: 20, Hb: 7.4, Plt: 86, ESR: 28, CRP: 23, Alb: 2.2, total protein: 4 Vitamin D: 15 | Hydroxychloroquine, Azithromycin, Ceftriaxone, changed to meropenem,, IVIG 1gr/kg, Albumin, Red Packed cell | Total: 13 PICU: 5 Alive, without sequel | Sepsis |
Case 3: 13 months old boy, 13 April | COVID-19 RT-PCR positive | Fever, generalized erythematous patches, papule and some target shape lesion on edematous base | 3 days after admission, Respiratory distress, decrease spo2: 84% in ambient room and generalized edema | mild intra-abdominal fluid | at admission: Normal chest CT-scan. At day 3: Chest CT-scan: bilateral plural effusion, basilar patchy infiltration and reverse halo sign | Mild TR, mild MR and normal coronary arties on 2 occasion | CBC: WBC: 8.2, N: 65, Hb: 10.8, PLT: 189, Alb: 3.4 ESR: 54, CRP: 96 | day 3: CBC, WBC: 14.5, N: 58, L: 29, Hb: 7.5, Plt: 141 ESR: 60, CRP: 26, Alb: 2.2, | hydroxychloroquine, Ceftriaxone, changed to meropenem, Vancomycin, IVIG 1gr/kg, Albumin, Red Packed cell | Total: 8 PICU: 2 days, Alive, complete improvement without sequel | Acute hemorrhagic edema of infancy |
Case 4: 10 years old girl, 27 April | COVID-19 IgG: positive | Fever, itching skin rash, maculopapular and target shape rashes with more accumulation around neck and trunk and axilla cough, abdominal pain, oliguria, bilateral non purulent conjunctivitis, hypotension and toxic appearance | Generalized edema, right leg edema and sever pain, mild plural effusion | Urinary system ultrasonography was normal, color Doppler ultrasonography of lower limbs veins were normal | CXR and Chest CT-scan before admission: NL Chest CT-scan at day 4: COVID-19 compatible changes and mild bilateral plural effusion | mild MR, mild TR, Mild PI, EF: 60–64% in 3 occasion | CBC: WBC: 9, N: 69, L: 10, Hb: 7.5, Band: 12, Plt: 130, ESR: 30, CRP: 36, Urea: 78, cr: 2.3,, D Dimer: 6556 Alb: 2 | Third day: CBC: WBC: 13.9, N: 87 L: 6 Hb: 9.6 Plt: 211 | meropenem, clindamicine, vancomicine, vasoactives, IVIG 1 g/kg, red packed cell, albumin, enoxaparine, Vitamin D, zinc | Total: 11 PICU: 8 Alive, complete improvement without sequel | Toxic shock syndrome |
Case 5: 14 months old boy, 3 May | COVID-19 RT-PCR negative, IgM: positive | fever, irritability, macoulopapolar erythematous rashes, edema of hands and feet, Cracked and erythematous lips, erythematous tongue and bilateral non purulent conjunctivitis | Irritability, abdominal distension, giant coronary aneurysm | Liver span: 117 mm, spleen: 98 mm, greater than normal, mild intra-abdominal fluid, mild bilateral plural effusion | First day: CXR normal, Chest CT-scan showed non-significant changes Day 4: chest CT-scan: non-significant changes | First day: normal coronary arteries, minimal right Pleural effusion (5 mm), minimal MR, good EF | CBC: WBC: 22, N: 83, L: 5, 6, Band: 5, Hb: 10.6, plt: 197, ESR: 65, CRP: 38, Na: 129, AST: 200, ALT: 197, Alb: 2.3, PTT: 50, PT: 18, INR: 2 | Day 4: WBC 21.8, N: 79, L: 15, Hb: 8.7, Plt: 224, Alb: 3.2, AST: 57, ALT: 55, PT: 14.8, PTT: 42, INR: 1.3, Day 14: CBC: WBC: 25.7 N: 38, L: 44, Mono: 17, Hb: 11.6, Plt: 1168 CRP: 10.9, ESR: 25 | IVIG 2 g/kg/day × 2, Aspirin, hydroxychloroquine, zinc, Vitamin D, Cefotaxim, changeed to meropenem and vancomicine. Albumin, red packed cell, methyl prednisolone 2 mg/kg/day, vasoactives, heparin, warfarin, infliximab | Total: 24 PICU: 20 Alive, Giant coronary arteries aneurysm | Kawasaki disease |
Case 6: 6.5 years old boy, 4 May | COVID-19 RT-PCR negative, COVID-19 IgG positive | fever, anorexia abdominal pain, vomiting, loose defecation, erythematous rash around feet, hands, trunk and perioral, periorbital edema, erythema of oropharynx, right TM erythema | At day 2: dyspnea, repertory distress, spo2 87%, mild abdominal distension, irritability, anasarca edema | spleen: 117 mm, more than normal with normal parenchymal echo, free interloop fluid, sub hepatic and sub splenic, several reactive lymph nodes 15*7 mm in para aorta and peripancreatic | At admission: Chest CT, non-significant changes for COVID-19 At day 4: Chest CT-scan bilateral opacities compatible with COVID-19 | Day 2: minimal TR Day 4: mild TR, trivial MR | CBC: WBC: 4.7 N: 77, L: 14, band: 3, Hb: 10, Plt: 121, ESR: 48, CRP: 45, UA: blood: trace, WBC: 8–10, | CBC: WBC: 6.93 Hb: 7.8 Plt: 73 L: 14 N: 80 Alb: 2.3 CRP: 39 ESR: 58 | Ceftriaxone, Vancomycin, Meropenem, hydroxychloroquine, packed cell, Albumin | Total: 11 PICU: 7 Alive, without sequel | Urosepsis |
Case 7: 7.5 year old girl 4 May | COVID-19 RT-PCR negative | fever, irritability, abdominal pain, myalgia, vomiting, diarrhea and generalized erythematous maculopapular and patches | Facial edema, tachypnea and tachycardia developed and the patient got toxic with gallop in heart auscultation | Normal | Admission Chest CT: NL CXR: at day 3: bilateral mild Ground Glass opacity | Day 3: Mod MR, TR, low EF 50%, Dilated RV, LV: myocarditis Day 7: moderate MR, mild Pleural effusion, low LVEF, lack of tapering, brightness in RCA and LAD compatible with KD and Myocarditis | CBC: WBC: 9.8, N: 89, L: 10, Vitamin D: 4 ng/ml AST:93 ALT: 69 | CBC: WBC: 13.3 Hb: 7.5, Plt: 213 N: 85 L: 10 Alb: 1.9, ESR: 73, CRP: 35 Urea: 72 Cr: 1.1 | Ceftriaxone, changed to Vancomycin, Meropenem, hydroxychloroquine, Zinc, Vitamin D, magnesium sulfate, packed cell, Albumin, IVIg: 2 g/kg | Total: 12 PICU: 8 Alive, without sequel | myocarditis |
case 8: 20 months old boy, 9 may | COVID-19 RT-PCR negative, COVID-19 IgG, IgM negative | Fever, coryza, vomiting diarrhea, abdominal pain, irritability during urination and loss of appetite, erythematous papule in 2 centimeter diameter in the forehead, erythema of oropharynx | tachypnea with unilateral tongue swelling and drooling, with discrete ulcers under the tongue | Normal | Chest CT: bilateral ground opacity compatible with COVID-19 | lack of tapering in RCA and LAD, Mild dilatation of LA, LMCA: 3.7 mm, RCA: 2.2, LAD: 2.2, perivascular brightness around LAD, moderate MR, diastolic dysfunction | WBC: 52.5, N: 80, L: 10, band: 4, Hb: 9.5, Plt: 932, ESR: 100, CRP: 1+ SE: WBC: 4–5, RBC: 2–3 | ABG: PH: 7.33, Pco2: 37, HCO3: 19.9, PO2: 71, Alb: 2.5 | Ceftriaxone changed to clindamycin and Meropenem, hydroxychloroquine, Zinc, Vitamin D, IVIG 2 g/ kg, aspirin 80 mg/kg/day | Total: 11 PICU: 9 Alive, without sequel | KD |
Case 9: 7 years old boy, 23 may | COVID-19 IgM and IgG and RT.PCR negative | Fever with epigastric pain which shift to Right Lower Quadrant, nausea, vomiting | ill, abdominal distension and recurrent vomiting | Reactive lymph node, max diameter 6 mm, fat stranding in Right Lower Quadrant and free inter loop fluid | Chest CT: sub plural atelectasis, mild bilateral pleural effusion, some nodular like lesions in both inferior lobes of lungs compatible with COVID-19 | NL | CBC: WBC: 24,000, L: 6%, N: 90%, band: 4%, Hb: 11, Plt: 356, ESR: 72, CRP: 2+ | Day 2: CBC: WBC: 13.5, N: 77, L: 10, Mono: 11, Hb: 10.3, Plt: 347, ESR: 90, CRP: 25 Alb: 3.2 | Meronidazole, Ceftriaxine changed to meropenem, hydroxychloroquine, Vitamin D, Zinc | Total: 6 | Appendicitis |
Case 10: 18 months old girl 13 June | RT- PCR COVID-19 positive | Fever and status epilepticus | Second day: ill and lethargic, maculopapolar blench able rash, tachypnea | CXR: nl Chest CT in 2 occasion: bilateral nonspecific opacity in inferior lobes | Normal | CBC: WBC: 8.5, N: 80%, L: 14%, Hb: 11.8, PLT: 160 ESR: 15, CRP: 16 Alb: 2.3 | WBC: 1.88, N: 34, L: 59, M: 5, Hb: 10.2, plt: 103 CRP: 3 Alb: 2.5 | Meropenem, clindamycine, phenobarbital, hydroxychloroquine, Vitamin D Albumin, IVIG, 1 g/kg, Zinc | Total: 12 PICU: 9 | Prolonged febrile seizure |