COVID-19 ve Yenidoğan
Özet
Bu bölümde, SARS-CoV-2 enfeksiyonunun çocuklarda, gebelerde ve yenidoğanlardaki bulaş yolları, klinik özellikleri, tanı, takip ve tedavi süreçleri kapsamlı bir şekilde incelenmektedir. Birincil olarak solunum damlacıkları ve yakın temas yoluyla bulaşan virüs, ACE2 reseptörüne bağlanarak hücre içine girmektedir. Çocuklar yetişkinlere oranla virüse karşı daha az duyarlıdır ve hastalık genellikle hafif seyreder; bu durum aşılar, ACE2 reseptör eksikliği veya sitokin fırtınasının gelişmemesi ile açıklanmaktadır. Çocuklarda hafif ateş ve sindirim sistemi semptomları görülebileceği gibi enfeksiyon sonrasında MIS-C adı verilen nadir ancak ciddi multiorgan enflamasyonu gelişebilmektedir. Gebe kadınlarda enfeksiyon sıklığı ve şiddeti gebe olmayanlarla benzerdir; ancak var olan ek hastalıklar morbiditeyi artırabilir. Yalnızca COVID-19 tanısı sezaryen doğum için bir neden sayılmamalı, her hasta özelinde değerlendirme yapılmalıdır. Çalışmalar anneden bebeğe dikey (vertikal) bulaşın olmadığını ve virüsün anne sütüne geçmediğini göstermektedir. Bu nedenle, maske ve el hijyeni sağlanarak emzirmeye devam edilmelidir. Yenidoğanlarda hemen banyo yaptırılması tavsiye edilmezken enfekte bebekler çoğunlukla hafif semptomlarla iki hafta içinde iyileşmektedir. Taburculuk kriteri olarak ise semptomların gerilemesi, en az 3-5 gün ateşsiz dönem ve 48 saat arayla alınan iki negatif PCR testi tespiti şart koşulmaktadır.
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