The epidemiology of COVID-19 in children has evolved throughout the pandemic, with initially low infection rates rising significantly due to the emergence of the more transmissible Omicron variant. Adolescents, children from ethnic minorities and lower-income households, and those with obesity are at increased risk of contracting SARS-CoV-2 infection. The immune response in children leads to milder symptoms compared to adults, with fever and cough being most frequent; tough symptoms vary by SARS-CoV-2 variant and age. Diagnostic methods to confirm current or past infection include RT-PCR, rapid antigen tests and serology. Treatment is mainly supportive, with antivirals and glucocorticoids reserved for severe cases. While serious conditions like MIS-C and other post-COVID-19 conditions are rare, they require careful management. Vaccination has proven effective in reducing severe disease and protecting against post-COVID-19 conditions. Continued surveillance, including wastewater monitoring and universal or pooled testing, remains crucial for controlling community spread. Key questions remain regarding the duration and quality of immunity following re-infection or vaccination, the impact of co-infections, and optimal treatment protocols for different pediatric populations.

中文翻译：

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儿童 COVID-19：不断发展的流行病学、免疫学、症状、诊断、治疗、covid 后遗症、预防策略和未来方向。


在整个大流行期间，儿童 COVID-19 的流行病学发生了变化，由于传播性更强的 Omicron 变体的出现，最初的低感染率显着上升。青少年、少数民族和低收入家庭的儿童以及肥胖者感染 SARS-CoV-2 的风险增加。与成人相比，儿童的免疫反应导致症状较轻，发烧和咳嗽最为频繁;顽固的症状因 SARS-CoV-2 变体和年龄而异。确认当前或既往感染的诊断方法包括 RT-PCR、快速抗原检测和血清学检查。治疗主要是支持性的，抗病毒药物和糖皮质激素仅用于严重病例。虽然像 MIS-C 和其他 COVID-19 后疾病这样的严重疾病很少见，但它们需要仔细管理。疫苗接种已被证明可有效减少严重疾病和预防 COVID-19 后疾病。持续监测，包括废水监测和普遍或集中检测，对于控制社区传播仍然至关重要。关于再次感染或接种疫苗后免疫力的持续时间和质量、混合感染的影响以及针对不同儿科人群的最佳治疗方案，关键问题仍然存在。