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Objective Knowledge about COVID-19 in children is limited due to the paucity of reported data. The pediatric age group comprises only less than 5% of total COVID-19 worldwide, therefore, large studies in this population are unlikely in the immediate future. Hence, we planned to synthesize the current data that will help in a better understanding of COVID-19 in children. Evidence acquisition Four different electronic databases (MEDLINE, EMBASE, Web of Science, and CENTRAL) were searched for articles related to COVID-19 in the pediatric population. We included studies reporting disease characteristics and outcomes of COVID-19 in patients aged less than 19 years. We performed a random-effect meta-analysis to provide pooled estimates of various disease characteristics. Results 27 studies (4857 patients) fulfilling the eligibility criteria were included in this systematic review, from a total of 883 records. About half of the patients had each of fever and cough, 11% (6–17%) had fast breathing, and 6–13% had gastrointestinal manifestations. Most of the patients had mild to moderate disease, and only 4% had a severe or critical illness. Leukopenia was the commonest reported laboratory abnormality. Conclusion 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.

BackgroundThe majority of the children with SARS-CoV-2 infection present with respiratory symptoms, hence various chest imaging modalities have been used in the management. Knowledge about the radiological findings of coronavirus disease (COVID-19) in children is limited. Hence, we systematically synthesized the available data that will help in better management of COVID-19 in children.MethodsFour different electronic databases (MEDLINE, EMBASE, Web of Science and CENTRAL) were searched for articles reporting radiological findings in children with COVID-19. Studies reporting thoracic radiological findings of COVID-19 in patients aged ResultsA total of 1984 records were screened of which forty-six studies (923 patients) fulfilled the eligibility criteria and were included in this systematic review. A chest computed tomography (CT) scan was the most frequently used imaging modality. While one-third of the patients had normal scans, a significant proportion (19%) of clinically asymptomatic children had radiological abnormalities too. Unilateral lung involvement (55%) was frequent when compared with bilateral and ground-glass opacities were the most frequent (40%) definitive radiological findings. Other common radiological findings were non-specific patchy shadows (44%), consolidation (23%), halo sign (26%), pulmonary nodules and prominent bronchovascular marking. Interstitial infiltration being the most frequent lung ultrasound finding.ConclusionCT scan is the most frequently used imaging modality for COVID-19 in children and can detect pneumonia before the appearance of clinical symptoms. Undefined patchy shadows, grand-glass opacities and consolidation are commonly observed imaging findings in COVID-19 pneumonia.

We observed that 760 (92.1%) out of 825 healthy newborns at our institution had vitamin D deficiency (VDD) at birth. These observations highlight the importance of regular screening and supplementation of vitamin D in the early years of life.

A 32-year-old man presented with a fairly large intramedullary mass lesion involving D5 to L1 segment of spinal cord. It was hyperintense on both T1Weighted (W) and T2W sequences, with signal suppression on fat-saturation images leading to the diagnosis of dermoid cyst (with extensive intramedullary occupancy of dorsolumbar cord) with multiple tiny fat deposits along proximal cervicodorsal cord. Keywords: Dermoid, Intramedullary, Spinal

We describe a case of bilateral persistent fetal vasculature (PFV) in a 3-month-old boy who presented with bilateral white pupillary reflex and a possible diagnosis of retinoblastoma. On ultrasonography, there was an echogenic band in the posterior segment of both eyes which connected the posterior surface of the lens capsule to the optic disc. Colour Doppler revealed the presence of vascularity in the band along its entire length. No calcification or mass lesion was seen. These findings are diagnostic of PFV. Most cases of PFV are unilateral and sporadic in nature and closely mimic retinoblastoma. Although rare, PFV should be considered in the differential diagnosis when examining a case of bilateral leukocoria. Paediatricians should be aware of this rare but serious entity.

An 8-year-old developmentally normal boy was brought to emergency following a fall from a bicycle on the road. He could not remember how he fell and regained consciousness in about 5 min. He had an abrasion on the right forearm and cheek. On neurological examination, he was fully conscious and alert with an orientation to time, place and person. There was no neurological deficit at the time of presentation in the emergency ward. The child was kept under observation. Two hours later, he experienced one episode of generalised tonic–clonic seizure which lasted for 3 min. Seizures were managed as per standard protocol. CT scan of the brain was done (figure 1), which showed a homogeneously hypodense midline lesion with …