Coinfection and Other Clinical Characteristics of COVID-19 in Children

Abstract

BACKGROUND AND OBJECTIVES: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a newly identified pathogen that mainly spreads by droplets. Most published studies have been focused on adult patients with coronavirus disease 2019 (COVID-19), but data concerning pediatric patients are limited. In this study, we aimed to determine epidemiological characteristics and clinical features of pediatric patients with COVID-19. METHODS: We reviewed and analyzed data on pediatric patients with laboratory-confirmed COVID-19, including basic information, epidemiological history, clinical manifestations, laboratory and radiologic findings, treatment, outcome, and follow-up results. RESULTS: A total of 74 pediatric patients with COVID-19 were included in this study. Of the 68 case patients whose epidemiological data were complete, 65 (65 of 68; 95.59%) were household contacts of adults. Cough (32.43%) and fever (27.03%) were the predominant symptoms of 44 (59.46%) symptomatic patients at onset of the illness. Abnormalities in leukocyte count were found in 23 (31.08%) children, and 10 (13.51%) children presented with abnormal lymphocyte count. Of the 34 (45.95%) patients who had nucleic acid testing results for common respiratory pathogens, 19 (51.35%) showed coinfection with other pathogens other than SARS-CoV-2. Ten (13.51%) children had real-time reverse transcription polymerase chain reaction analysis for fecal specimens, and 8 of them showed prolonged existence of SARS-CoV-2 RNA. CONCLUSIONS: Pediatric patients with COVID-19 presented with distinct epidemiological, clinical, and radiologic characteristics from adult patients. Nearly one-half of the infected children had coinfection with other common respiratory pathogens. It is not uncommon for pediatric patients to have prolonged fecal shedding of SARS-CoV-2 RNA during the convalescent phase.

Immunopathological similarities between COVID-19 and influenza: Investigating the consequences of Co-infection

“…On the other hand, co-infection can increase the severity of symptoms of both diseases in these cases, in which managing of this state is essential and critical in certain groups such as pregnant women, the elderly, and even children. Studies reported a high SARS-CoV-2 and influenza virus co-infection rate in children that highpoints the importance of COVID-19 screening, particularly during the prevalence of seasonal influenza and other respiratory disorders [ 22 ].…”

Emergency high ligation in a suspected COVID-19 pediatric patient with incarcerated inguinal hernia: a case report

“…High fever in our patient could be caused by ileus complications due to uid sequestration to the third cavity which results in dehydration and may be accompanied by bacterial translocation [10]. It might be also caused by the body's reaction to the SARS-CoV-2 infection [11][12][13]. In addition, shortness of breath in our patient might be caused by abdominal distension due to bowel dilatation [14] or by SARS-CoV-2 infection of the lungs [15].…”

Gastrointestinal symptoms and fecal nucleic acid testing of children with 2019 coronavirus disease: a systematic review and meta-analysis

“…Thirteen reports included in the present study described fecal nucleic acid examination ( Table 2), The positive rate of fecal nucleic acid testing in COVID-19 patients was 85.8% (91/106). In reports from China 19,27,29,34,41,52 , the positive rate of all stool samples tested was close to or reached 100%. Additionally, 71.2% (52/73) were still positive for fecal nucleic acid after the respiratory tract specimens turned negative, 45.2% (33/73) were fecal nucleic acid-positive one week after the respiratory tract specimen was nucleic acid-negative, and 34.2% (25/73) were fecal nucleic acid-positive two weeks after a respiratory tract nucleic acid negative test.…”