Evaluation of the Clinical Features of 81 Patients with COVID-19: An Unpredictable Disease in Children

Abstract

Objective Data on the prognosis of clinical features of pediatric patients affected by the coronavirus disease 2019 (COVID-19) pandemic is insufficient. This study aimed to examine the clinical, laboratory, and radiology findings of pediatric patients diagnosed with COVID-19. Methods A total of 81 pediatric patients with a confirmed diagnosis of COVID-19 who were admitted to the pediatric clinics of our tertiary care hospital in Istanbul between March 22 and May 1, 2020, were included in the study. Results Of the patients, 40 (49.6%) were boys and 41 (50.6%) were girls. The mean age of the patients was 9.3 ± 5.5 years (range: 1 month–16 years). The most common symptoms were cough (28.4%) and fever (25.9%). A total of 26 patients (32.1%) had pharyngeal erythema. There was no significant difference between age groups in terms of symptoms, findings, clinical picture, history of contact, and clinical course (p > 0.001 for each). Abnormal findings were observed in seven (8.6%) patients on chest X-ray, and in four patients (4.9%) on thorax computed tomography. Only three of the patients were hospitalized and all of them discharged with healing. Conclusion The present study is the most comprehensive study on children diagnosed with COVID-19 in our country, which showed that the COVID-19 picture was mild in pediatric patients, but the signs and symptoms in children were not specific to the disease. Our findings also showed that the rate of asymptomatic infection in children was high and that it was difficult to recognize COVID-19 in children.

Computed tomography findings in 3,557 COVID-19 infected children: a systematic review

“…), 5 were from Turkey(66,72,92,99,107), 7 were from Iran(43,69,71,95,97,104,106), 2 were from Italy(87,112), 2 were from Brazil (96,114), 1 was from Egypt (85), 1 was from the Latin America (108), 1 was from France (105), 2 was from the UAE (91,93), 1 was from Portugal(113) and the remained 55 studies were from China. All of them were published in 2020-21.Among the 81 studies, 14 investigated children and adults(36…”

A Single-Center (Sibiu, Romania), Retrospective Study (March–November 2020) of COVID-19 Clinical and Epidemiological Features in Children

“…On laboratory assessment, 53% of patients were noted to have lymphopenia, neutropenia 32.02% (n = 65), and low iron 23.37% (n = 43). In contrast, patients also had monocytosis (n = 90, 44.33%), elevated C-reactive protein (n = 51, 25.12%, a significant inflammatory marker [24] also in COVID- 19), neutrophilia (n = 34, 16.75%), leukocytosis (n = 29, 14.29%), elevated iron (n = 22, 11.96%), and increased number of eosinophils (n = 24, 11.82%).…”

“…In our study, episodes of fever as a symptom (mentioned at the time of hospitalization) were considered. Research in pediatric patients reported fever and cough as the most common symptoms in children diagnosed with COVID-19 with the proportion of fever between 20% and 100%, respectively, and proportion of cough between 11% and 100% [19,[39][40][41][42]. Moreover, research in adult patients reported the fever and cough as the most common symptoms with prevalence of fever at 78% (95% CI 75-81) and prevalence of cough 57% (95% CI 54-60) [43].…”

“…Moreover, research in adult patients reported the fever and cough as the most common symptoms with prevalence of fever at 78% (95% CI 75-81) and prevalence of cough 57% (95% CI 54-60) [43]. A possible explanation of percentual variation may be related to (small) sample size and/or of how fever is defined: temperature measured at the time of admission or measured before or during hospitalization, different levels of temperature (>37 • C or >37.3 • C or >37.5 • C or >38 • C or >39 • C or unmentioned) [12,13,19,40,44]. In the present study, symptoms such as sore throat, rhinorrhea, fatigue, headache, diarrhea, vomiting, myalgia, and abdominal pain, were observed in a lower percentage of patients.…”

“…Studies reporting the results of screening for COVID-19 underlying clinical and epidemiological factors denote that most children appear to have mild or moderate disease or many non-specific symptoms or may by asymptomatic [13,[15][16][17][18][19][20][21].…”