Epidemiology, clinical features, and outcomes of coronavirus disease among children in Al-Madinah, Saudi Arabia

Abstract

Background and Objective: Coronavirus disease (COVID-19) is milder with favorable outcomes in children than in adults. However, detailed data regarding COVID-19 in children from Saudi Arabia are scarce. This study aimed to describe COVID-19 among children in Al-Madinah, Saudi Arabia. Methods: This retrospective observational study included children <14 years old hospitalized with COVID-19 between May 1, 2020 and July 31, 2020. Clinical data, COVID-19 disease severity, and outcomes were collected. The total number of presenting symptoms and signs were computed by counting those recorded upon presentation. The Kruskal-Wallis non-parametric test was used to compare the number of symptoms and signs across all levels of COVID-19 severity. Result: Overall, 106 patients met the inclusion criteria; their ages ranged from 2 weeks to 13 years. Most patients were ≤12 months of age (43.4%). Bronchial asthma was the most common comorbidity (9.4%). Among 99 symptomatic patients, fever was the most common symptom (84.8%); seven patients (7%) were diagnosed with febrile seizure. Most COVID-19 cases were mild (84%); one patient (0.94%) was in critical condition and one patient (0.94%) met the Multisystem Inflammatory Syndrome in children criteria. The mean number of symptoms and signs in children with severe or critical COVID-19 was significantly higher than that in children with mild cases or non-severe pneumonia (P < .001). One patient died owing to COVID-19 (0.94%). Conclusions: COVID-19 mortality in children is rare; however, while most children exhibit mild disease with favorable outcomes, children with chronic lung disease may be at higher risk for severe disease.

Prevalence and Outcome of Management of Respiratory Distress Syndrome: A Systematic Review

“…According to our study results, respiratory distress syndrome prevalence rates in Saudi Arabia ranged between 5.1% in Jeddah and highest 84% in Al-Madinah [11,12]. Saudi Arabia had a comparable prevalence of respiratory distress syndrome in several studies, 56%, 60%, 20% [13][14][15] also 8% of the cases admitted to the PICU unit.…”

“…(2020) [12] Al-Madinah Twenty-nine (27%) of the 106 patients had at least one pre-existing ailment, with bronchial asthma being the most prevalent (9.4%). In terms of COVID-19 disease severity, the majority of cases (84%), including one patient (0.94%), satisfied the MIS-C criteria.…”

Prognosis of COVID-19 in the middle eastern population, knowns and unknowns

“…Indeed, the laboratory findings showed that among hospitalized patients, lymphocytopenia and leukopenia, in addition to elevated levels of ferritin, D-dimer, and C-reactive proteins, were encountered (Almoosa et al, 2020;Alnajjar et al, 2021;Mosalli et al, 2021;Shahin et al, 2021). The mortality rate was very low in the infected children of this country, with this latter not exceeding four deaths among all reports (Almoosa et al, 2020;Alnajjar et al, 2021;Alshengeti et al, 2021;Asseri et al, 2021;Hijazi et al, 2021;Kari et al, 2021b;Mosalli et al, 2021;AlGhamdi et al, 2022). Interestingly, in one study, it was found that 21% of hospitalized children infected with SARS-CoV-2 developed acute kidney injury.…”

“…A substantial portion were asymptomatic ( Ahmad et al, 2021 ; Almuzaini et al, 2021 ; Hijazi et al, 2021 ) with this rate ranging from 27.9% ( Mosalli et al, 2021 ) to 54.6% ( Alharbi et al, 2021 ). Among symptomatic ones, the most common reported symptoms were fever, cough, runny nose, and shortness of breath ( Harbi et al, 2020 ; Ahmad et al, 2021 ; Alharbi et al, 2021 ; Alshengeti et al, 2021 ; Mosalli et al, 2021 ; Shahin et al, 2021 ; AlGhamdi et al, 2022 ). Gastrointestinal symptoms were also described but to a lesser extent ( Almoosa et al, 2020 ; Alharbi et al, 2021 ; Almuzaini et al, 2021 ; Alnajjar et al, 2021 ; Shahin et al, 2021 ).…”

“…Moeller et al, conducted a multicenter study across 174 centers in Europe, found that children with chronic respiratory conditions might be at a higher risk of experiencing a severe form of COVID-19 ( Moeller et al, 2020 ). In hospitalized COVID-19 children, the majority were admitted to the general ward and did not require intensive care ( Alshengeti et al, 2021 ; Asseri et al, 2021 ; Almuzaini et al, 2021 ; Alnajjar et al, 2021 ; Hijazi et al, 2021 ; Kari et al, 2021b ; AlGhamdi et al, 2022 ). On the other hand, those that needed intensive care had more frequent shortness of breath, higher absolute neutrophil counts and ferritin levels, and lower oxygen saturation, and albumin levels compared to those admitted to the general ward in the hospital ( Asseri et al, 2021 ).…”