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Published on: December 19, 2020
Clinical and laboratory characteristics of children with SARS-CoV-2 infection
Emel Berksoy1, Ali Kanik2, Alper Çiçek1
1Pediatric Emergency Department, İzmir Tepecik Education and Research Hospital, İzmir, Turkey.
Insights
This study of pediatric COVID-19 cases found that most children infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) experienced mild symptoms. Laboratory findings in SARS-CoV-2 positive children showed lower inflammatory markers compared to negative cases.
Area of Science:
- Pediatric Infectious Diseases
- Virology
- Epidemiology
Background:
- Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in late 2019, causing the COVID-19 pandemic.
- Understanding the clinical presentation and characteristics of SARS-CoV-2 infection in children is crucial for effective management.
Purpose of the Study:
- To describe the demographic, clinical, radiological, and laboratory findings of children suspected of SARS-CoV-2 infection.
- To compare characteristics between SARS-CoV-2-positive and SARS-CoV-2-negative pediatric patients.
- To assess the severity spectrum of COVID-19 in a pediatric cohort.
Main Methods:
- Retrospective analysis of 422 children (0-18 years) admitted to a pediatric emergency department.
- Comparison of clinical and laboratory data between SARS-CoV-2-positive and negative groups.
- Assessment of viral coinfections using nasopharyngeal polymerase chain reaction testing.
Main Results:
- SARS-CoV-2 infection was confirmed in 18.4% of children; fever and cough were most common.
- Asymptomatic and mild cases constituted the majority (85.9%) of SARS-CoV-2 positive children.
- SARS-CoV-2 positive patients exhibited lower white blood cell counts and inflammatory markers (LDH, d-dimer, procalcitonin).
- Isolated rhinorrhea was significantly more common in SARS-CoV-2 negative children (p=0.0014).
Conclusions:
- COVID-19 in children typically presents with mild symptoms, with a low incidence of severe or critical illness.
- Distinct laboratory findings, including lower inflammatory markers, may aid in differentiating pediatric SARS-CoV-2 infection.
- Rhinorrhea as an isolated symptom is unlikely to indicate SARS-CoV-2 infection in children.
Abstract:
We describe the demographic, clinical, radiological, and laboratory findings of 422 children (0-18 year-of-age) suspected of having severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection admitted to a pediatric emergency department between March 23, and July 23, 2020. We compared the characteristics of SARS-CoV-2-positive patients to SARS-CoV-2-negative patients. SARS-CoV-2 infection was confirmed in 78 (18.4%). Fever (51.2%) and cough (43.5%) were the most commonly reported signs in the SARS-CoV-2-positive patients. Isolated rhinorrhea (7.2%) was reported only in the SARS-CoV-2-negative group (p = .0014). Patients with SARS-CoV-2 infection were classified according to severity, with the percentages of asymptomatic, mild, moderate, severe, and critical cases determined to be 29.5%, 56.4%, 12.9%, 1.2%, and 0%, respectively. Of the 422 children, 128 (30.3%) underwent nasopharyngeal polymerase chain reaction testing for other respiratory viral pathogens; 21 (16.4%) were infected with viral pathogens other than SARS-CoV-2. Only one patient (4.7%) with confirmed coronavirus disease 2019 (COVID-19) disease was coinfected with respiratory syncytial virus and rhinovirus. The results indicate lower median white blood cell, neutrophil, and lymphocyte counts, lower lactate dehydrogenase, d-dimer, and procalcitonin levels in the SARS-CoV-2-positive group (p ≤ .001). Our findings confirm that COVID-19 in children has a mild presentation. In our cohort, no patient with SARS-CoV-2 infection had isolated rhinorrhea.
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