Cross-sectional study of the clinical characteristics and outcomes of children hospitalized with COVID-19 in Lima, Peru

Abstract

Introduction Coronavirus 2019 (SARS-CoV-2) infection in children occurred in Peru as of March 2020, leading to pediatric patients' hospitalization in areas adapted for this purpose at the Edgardo Rebagliati Martins National Hospital. In the beginning, the demand for hospitalization was low, but it increased gradually. Consistent with international reports, the majority of patients presented mild or moderate symptoms. Nonetheless, there were also severe cases, even fatal ones. Objectives To describe the characteristics and clinical outcome of pediatric patients with COVID-19 hospitalized in a referral hospital in Lima, Peru, between March and August 2020. Methods A descriptive and inferential cross-sectional study was carried out. The population includes all hospitalized patients in the Department of Pediatrics, with clinical and surgical diagnoses associated with COVID-19. Results We included 100 patients, with an average age of 83.4 ± 54 months, with a predominance of male patients (55%). Hospitalized patients were grouped into five categories: respiratory failure (17%), multisystemic inflammatory syndrome (MIS-C) (31%), neurological presentation (19%), acute abdomen (20%), and patients with oncological problems (13%). Most of the patients (74%) had comorbidities. Regarding the presenting symptoms, intestinal pain predominated in the appendicitis group (90%, p < 0.001), fever was present in most patients with respiratory failure (64.7%); multisystemic inflammatory syndrome (90.3%), neurological manifestations (15.8%), acute abdomen (50%) and oncological conditions (61.5%) were also present in these patients. Kawasaki symptoms were found in 38.7% of the patients with multisystemic inflammatory syndrome. Mortality was 4%. Respiratory problems (29.4%) and multisystemic inflammatory syndrome (22.6%) required admission to intensive care, more frequently than the other presentations (p = 0.008). Conclusions We conclude that the vulnerability in the pediatric population is the one that has preexisting conditions. We divided our patients according to presentation, diagnosis, and complications, which were predominantly respiratory. We also had oncological patients with COVID-19.

Multisystem Inflammatory Syndrome Temporally Related to COVID-19 in Children From Latin America and the Caribbean Region: A Systematic Review With a Meta-Analysis of Data From Regional Surveillance Systems

“…In agreement with a study by Pereira et al ( 35 ) we observed an increased use of antibiotics, related to the main differential diagnoses of MIS-C, septic shock, and toxic shock syndrome. Antibiotic prescriptions among MIS-C patients may not have been appropriate in most cases and antimicrobial stewardship should be explored in MIS-C patients.…”

Factors associated with knowledge, attitudes and preventive practices towards COVID-19 in health care professionals in Lima, Peru

“…For instance, there is no mention of the effects the lack of KAP has already caused in Peru. Examples of some studies include: Infodemic 1 , 2 , 3 Self-medication 4 , 5 Medicinal plants use 6 , 7 , 8 , 9 Use of unproven treatments such as chlorine dioxide 6 , 10 Issues in children with the development of MIS-C 11 , 12 , 13 , 14 Impact in mental health 15 , 16 , 17 , 18 , 19 Technostress 20 Issues in adequate implementation of public health measures 21 , 22 , 23 Furthermore, Peru is leading some interesting aspects compared to Latin America in the implementation of telemedicine 24 , 25 , 26 , 27 …”

Difficult acute lymphoblastic leukaemia diagnosis in a paediatric patient with mixed presentation of COVID-19 acute respiratory failure and multisystemic inflammatory syndrome

“…According to a systematic review by Meena et al ,2 majority of patients with COVID-19 and malignancies were asymptomatic or with mild symptoms and later developed severe symptoms. These characteristics have been seen in cohorts of patients with COVID-19, including oncological patients, from different countries 10–13…”