A multicenter study of confirmed COVID-19 cases: preliminary data on 2690 pediatric patients in Argentina during the first year of the pandemic

Abstract

Introduction. The current evidence indicates that the severity of the coronavirus disease 2019 (COVID-19) is lower in the pediatric population but local data are still limited. Objective: To characterize the clinical and epidemiological aspects of COVID-19 infection in patients younger than 18 years in Argentina. Population and methods. Cross-sectional, observational, and analytical study of confirmed COVID-19 patients aged 0-18 years seen between March 2020 and March 2021 at 19 referral children's hospitals of Argentina. A multivariate analysis was done to identify predictors of severe cases. Results. A total of 2690 COVID-19 cases were included: 77.7% lived in the Metropolitan Area of Buenos Aires; 50.1% were males; patients' median age was 5.6 years. Of them, 90% were seen during epidemiological weeks 20-47 of 2020; 60.4% had a history of contact with COVID-19 patients; and 96.6% in their family setting. Also, 51.4% had respiratory symptoms; 61.6%, general symptoms; 18.8%, gastrointestinal symptoms; 17.1%, neurological symptoms; 7.2%, other symptoms; and 21.5% were asymptomatic. In addition, 59.4% of patients were hospitalized and 7.4% had a severe or critical course. A total of 57 patients developed multisystem inflammatory syndrome. A history of asthma, bronchopulmonary dysplasia, congenital heart disease, moderate to severe malnutrition, obesity, chronic neurological disease and/or age younger than 6 months were independent predictors of severity. Living in a vulnerable neighborhood was a protective factor. Conclusions. More than half of cases referred a history of contact with COVID-19 patients in the family setting. Hospitalization was not based on clinical criteria of severity. Severity was associated with the presence of certain comorbidities.

Clinical Characteristics of Children With SARS-CoV-2 Infection in a Hospital in Latin America

“…Every study reviewed, and ours, show that COVID-19 symptoms are similar to and indistinguishable from those of other common viral diseases affecting preschoolers and school-age children and comprise: fever, respiratory and gastrointestinal complaints ( 18 , 19 , 21 – 23 ). In this series, most patients suffered from acute upper respiratory infection, with a few cases of pneumonia and hypoxemia.…”

Clinical presentation of pediatric patients with symptomatic SARS-CoV-2 infection during the first months of the COVID-19 pandemic in a single center in Mexico City

“…Of the 13 deaths, only one patient was without comorbidity and was 1 year old—a consistent risk factor in several studies ( 24 , 26 , 27 ). Very low mortality of 0.5% was reported in Argentina during the first year of the pandemic ( 28 ). In Brazil, in an analysis carried out approximately in the same period as the present study, the hospital mortality of pediatric patients was 7.6%, observing that there was a higher risk in children under 2 years of age, indigenous, and with some comorbidity ( 29 ).…”

Impact of the COVID-19 pandemic on children with cancer. Mortality according to the three waves. A report from the Argentine National Pediatric Cancer Registry (ROHA-NET)

“…This is twice the rate published for the general population of patients under 18 years of age in Argentina. 29 This difference may be explained by the greater number of tests performed in cancer patients as a result of screening prior to admissions, procedures, and transfers. 30 In the majority of patients, clinical manifestations consisted of mild respiratory symptoms with minimal requirement for hospital admission and not leading to an increase in COVID-19-related morbidity or mortality, coinciding with reports from other countries.…”