Clinical characteristics of COVID-19
The clinical scenarios of COVID-19 are diverse and range from
asymptomatic to critical illness and even fatal
outcomes5. The symptoms of COVID-19 include dry cough,
fatigue, fever, myalgia, headache, diarrhea, and even respiratory
failure1. Olfactory and gustatory dysfunctions have
been also identified as distinct symptoms of SARS-CoV-2 infection,
especially in the western countries13. Thus, the
respiratory symptoms of COVID-19 may be confused with those of allergic
rhinitis (AR) and the common cold14. Skin
manifestations of COVID-19 include vesicular, urticarial, and
maculopapular eruptions and livedo, necrosis, and other vasculitis
forms15 and are more common among European and North
Americans than among Asians16. The heterogeneity of
COVID-19 warrants the elucidation of the phenotypes and endotypes of
COVID-19 that will benefit from precision
medicine17,18. In addition, persistent symptoms such
as fatigue, brain fog, body aches, and loss of smell may persist for
months following acute infection and are referred as post-acute COVID-19
syndrome or long-COVID19,20. After a 1-year follow-up,
most COVID-19 recovered patients regain their physical and functional
status, although it remains lower than individuals without
infection21.
Children at all ages appear to be susceptible to SARS-CoV-2 infection,
although most of them are asymptomatic or develop mild
symptoms22. Multisystem inflammatory syndrome in
children (MIS-C) has been described in COVID-19 patients with an overall
2% mortality23. MIS-C predominantly affects children
between 6 and 12 years. Most MIS-C children were critically ill, mostly
from shock and/or left ventricular dysfunction, with less severe or no
respiratory involvement24. Regarding the treatment of
MIS-C, intravenous immune globulin (IVIG) plus glucocorticoids was
associated with a lower risk of cardiovascular dysfunctions but not the
recovery from disease when compared to IVIG treatment
alone25,26.