Acute COVID-19 Infection in a Pediatric Patient with ROHHAD.

The novel coronavirus (severe acute respiratory syndrome coronavirus-2) has led to a global pandemic. In the adult population, coronavirus disease 2019 (COVID-19) has been found to cause multiorgan system damage with predicted long-term sequelae. We present a case of a 10-year-old boy with a history of ROHHAD (rapid-onset obesity with hypothalamic dysregulation, hypoventilation, and autonomic dysregulation) who presented with hypoxia, emesis, and abdominal pain. Imaging found bilateral ground glass opacities in the lungs and a pericardial effusion. Laboratory evaluation was concerning for elevated inflammatory markers. Remdesivir, hydroxychloroquine, and anticoagulation (heparin and enoxaparin) were utilized. The patient's severe respiratory failure was managed with conventional mechanical ventilation, inhaled nitric oxide, and airway pressure release ventilation. We hope that this report provides insight into the course and management of the severe acute pediatric COVID-19 patient, specifically with underlying comorbidities such as ROHHAD. Clinical trial registration is none.

Aspiration of fruit gel snacks.

Aspiration of a foreign body is common in children and can cause upper airway obstruction, leading to significant morbidity or mortality. We report 3 cases of aspiration of a popular fruit-flavored gel snack that led to cardiopulmonary arrest and death in 1 case and respiratory failure in 2 other cases. There is increasing concern about the safety of this gel snack and its risk of aspiration, even in older children. Pediatricians should advise parents and children about the dangers of eating this candy during their health maintenance visits.