Clinical Manifestations of Children and Adolescents With Covid-19: Report of the First 115 Cases From Sabará Hospital Infantil

Abstract

Objective: To describe the clinical manifestations and severity of children and adolescents affected by COVID-19 treated at Sabará Hospital Infantil. Methods: This is a cross-sectional, retrospective, and observational study. All cases of COVID-19 confirmed by RT-qPCR of patients seen at the hospital (emergency room, first-aid room, and ICU) were analyzed. The severity of the cases was classified according to the Chinese Consensus. Results: Among the 115 children included, a predominance of boys (57%) was verified, and the median age was two years. A total of 22 children were hospitalized, 12 in the ICU. Of the total, 26% had comorbidities with a predominance of asthma (13%). Fever, cough, and nasal discharge were the most frequent symptoms. Respiratory symptoms were reported by 58% of children and gastrointestinal symptoms, by 34%. Three children were asymptomatic, 81 (70%) had upper airway symptoms, 15 (13%) had mild pneumonia, and 16 (14%) had severe pneumonia. Hospitalized children were younger than non-hospitalized children (7 months vs. 36 months). In hospitalized patients, a higher frequency of irritability, dyspnea, drowsiness, respiratory distress, low oxygen saturation, and hepatomegaly was observed. Chest radiography was performed in 69 children with 45% of abnormal exams. No child required mechanical ventilation and there were no deaths. Conclusions: Most of children and adolescents affected by COVID-19 had mild upper airway symptoms. Clinical manifestations of COVID-19 were more severe among younger children who exhibited gastrointestinal and respiratory symptoms more frequently.

Childhood Asthma and COVID-19: A Nested Case-Control Study

“…Other studies have reported asthma prevalence rates among pediatric COVID-19 cases to vary from 0.5% (Wuhan, China) (22) to 20% (Washington, DC) (23) , and from 2% (Lombari and Luguria, Italy) (24) to 24% (New York City) (25) among admitted pediatric COVID-19 patients. This may be partly explained by variability in the local asthma prevalence, though at least one study in Brazil found a lower asthma prevalence rate among children with COVID-19 infection compared to the local general pediatric asthma prevalence (13% vs 20-25%), suggesting that there may be other contributors to the variability among studies (26) .…”

Gastrointestinal, hepatic and pancreatic manifestations of COVID-19 in children

“… [21] Data from larger paediatric cohorts recently confirmed such findings. [ 1 , 2 , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] ] Diarrhoea is reported in two to 33% of patients, whereas nausea and/or vomiting is reported at a rate ranging from five to 35% ( table 1 ). The presence of abdominal pain - though not always reported - ranges from six to 35% ( table 1 ).…”

Manifestações gastrointestinais em pacientes pediátricos com infecção por coronavírus no Brasil

“…Foram comparados os sintomas apresentados por pacientes de duas faixas etárias: faixa etária de até 3 anos e faixa etária de 3 a 18 anos. A presença de diarreia e vômitos foi encontrada com maior frequência entre os menores de 3 anos (comparativamente 24,1% vs. 1,8%, p= 0,001; 25,9% vs. 8,8%, p=0,02), ao passo que, o sintoma dor abdominal foi relatado com mais frequência entre os maiores (14% vs. 3,4%, p = 0,04) 8 .…”