Page 395 - Abstract Book KONIKA 18

Respirology

P-RES-011
Long Covid Syndrome in A Teenage Boy: A Case Report

Mahezarani Ning Anindyta, Madeleine Ramdhani Jasin,Nastiti Kaswandani
Department of Child Health, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital,
Jakarta, Indonesia
Abstract
Background Many reports ongoing symptoms after recovering from COVID-19 which may persist until
6 months from initial onset, defined as long COVID syndrome. Manifestations are commonly fatigue,
muscle pain, dyspnea, and neurological problems. However, long COVID syndrome is rarely reported in
children. Objective To describe a clinical manifestation and outcome of long COVID syndrome in children.
Case Presentation A 12-year-old boy presented with shortness of breath since 1 week before admission. He
had no fever, and rarely coughing. The patient had suffered from COVID-19 thrice, and the last infection was
2 weeks prior to admission, and negative results were obtained a week after. First COVID-19 episode was 9
months prior, while second episode was 7 months prior. He experienced cough and anosmia in both episodes,
added with diarrhea in second episode. Symptoms persisted for a week, then gradually resolved in 1-2 weeks,
confirmed with negative PCR results. However, since 2 weeks after second episode of COVID-19, he started
experiencing loss of concentration, anxiety, and persisting fatigue, which were exacerbated during the 3rd
episode. During current physical examination, he looked restless, had no fever, tachypneic but no desaturation,
normal lung and cardiac examination, and epigastric pain. Laboratory evaluation shows normal CBC, normal
CRP and PCT, normal thorax X-ray and echocardiography, and SARS-CoV2 PCR was negative. He was
diagnosed with long COVID syndrome, involving neuropsychiatric and gastropathy. Management involved
reassurance, psychotherapy, and pharmacotherapy including omeprazole and sertraline. Regular observation
for 2 weeks showed significant improvement in symptoms and quality of life, thus pharmacotherapy was
discontinued. Conclusion This case highlights that long COVID syndrome should be one of the differential
diagnosis in persisting symptoms after acute phase of COVID-19 in children.
Keywords: children; long covid syndrome; COVID-19

P-RES-012
Unilateral Pulmonary Aplasia: A Case Report

Maria Theresia, Amalia Setyati
Department of Child Health, Faculty of Medicine, Public Health, and Nursing Universitas Gadjah Mada/
Dr. Sardjito Central General Hospital, Yogyakarta, Central Java, Indonesia
Abstract
Background Pulmonary aplasia is a rare abnormality thought to have an incidence between 34 to 97
in 10000 live birth. Presentation is with common respiratory symptoms and sometimes asymptomatic.
Objective Report of a rare case in a child with common respiratory symptoms. Case A 3-month old female
infant was referred to the hospital with a fever, cough, severe respiratory distress, and cyanosis. The patient
previously experienced shortness of breath, interrupted feeding, and sometimes looked bluish when crying.
On physical examination, the infant had tachypnea, chest retractions, and cyanosis. Air entry was absent
on the left side, while crackles were noted on the right side of the chest, heart sound, S1 single, S2 louder.
Computed tomography (CT) scan of the chest showed the absence of vascular structures are seen in the left
thorax and rudimentary left primary bronchi are very likely to be left pulmonary aplasia (type 2), pneumonia in
the lateral segment of the right middle lobe, and posterior basal segment of the right inferior lobe pulmonary,
and right pleural effusion. Echocardiography showed truncus arteriosus type 1 and pulmonary hypertension.
The patient was also diagnosed with heart failure. The patient was given empiric antibiotics, furosemide,
and spironolactone. During the 2-week treatment, respiratory distress improved with a target saturation of
75-85% and was discharged from the hospital after her condition was improving. Conclusion In the case of
recurrent respiratory problems, congenital abnormalities should be considered and a Computed Tomography
(CT) scan is recommended.
Keywords: pulmonary aplasia; unilateral; child

KONIKA XVIII Abstract Book 347