Clinical characteristics of children with COVID-19 admitted in a tertiary referral center in Perú

Abstract

Introduction The COVID-19 pandemic has a great impact on children's health. This study describes the clinical, epidemiological and treatment characteristics of children presenting COVID-19 at the Instituto Nacional de Salud del Niño San Borja (INSN-SB) Methods This was a retrospective study of patients with a confirmed diagnosis of COVID-19 from March to July 2020. Demographic, clinical, laboratory, radiological, and treatment information were collected. Data analysis included descriptive statistics and bivariate analysis to determine differences between patients in general wards and the intensive care unit (ICU). Results We included 91 patients, 33 being females (36.3%). The most affected age group was children > 2 years of age (63 cases) with a median age of 6 years (IQR 3-10), and 61.5% were from Lima. The previous contact was determined in 30.8% of cases. A positive SARS CoV-2 PCR result was obtained in 50.6%. The presence of comorbidity was 53.8%. The most frequent symptoms were: fever (39.6%), general malaise (23.1%), cough (19.8%), and respiratory distress (14.3%). The presence of multisystem inflammatory syndrome in children (MIS-C) was confirmed in 6 patients. Antibiotics were administered in 76.9%. The most frequent radiological pattern was bilateral interstitial infiltrates (57.7%). Mortality was higher in patients in the ICU than in the hospitalization ward (27.3% vs. 4.3%, respectively; p = 0.02) Conclusions COVID-19 in children presents mild and moderate clinical manifestations. The presence of comorbidity is an important factor for hospitalization, and mortality is high upon admission to critical care units.

COVID‐19 in childhood: Transmission, clinical presentation, complications and risk factors

“…7 In Italy, 5.9% (10/168) of study participants had co-infections, 16 while in Perú, M. pneumoniae was found in 10% (9/91) of participants. 53 In Latin America, 3.4% (14/409) of participants tested positive for a viral co-infection, although no significant association was found between co-infections and ICU admission or mechanical respiratory support. 22 In contrast, in Europe, 5% (29/582) of participants tested positive for a viral coinfection and patients with one or more viral co-infections were more likely to have signs or symptoms of upper or lower respiratory tract infection at presentation.…”

“…50 Older children were more likely to present with respiratory distress than infants (44% vs. 7%). 17 Less common symptoms include seizures 16,50,53 and loss of taste and smell. 4,17 A study of 2143 (731 laboratory-confirmed) pediatric cases reported to the Chinese Center for Disease Control and Prevention found that 94.1% of cases could be classified as asymptomatic, mild, or moderate.…”

“…18,50 Several studies noted that COVID-19 positive patients had elevated blood markers indicative of inflammation. 17,19,50,51,53 One study reported that 38.8% (47/121) of participants had high concentrations of the inflammatory marker C-reactive protein (CRP). 16 Moreover, children with more serious symptoms were found to have significantly higher CRP levels than those with a milder presentation.…”

“…Older children were more likely to present with respiratory distress than infants (44% vs. 7%) 17 . Less common symptoms include seizures 16,50,53 and loss of taste and smell 4,17 …”

Distinct Characteristics of COVID-19 Infection in Children

“…Clinical characteristics among COVID-19 pediatrics patients in different countries(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38).…”