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COVID-19 clinical features in primary care: COVIDPAP study
Marta Carballal-Mariño1, Josep Vicent Balaguer-Martínez2, César García-Vera3
1Centro de Atención Primaria "Cerceda-Culleredo", A Coruña, Spain.
Insights
Pediatric COVID-19 is generally mild, with many asymptomatic cases and few hospitalizations. The household is the primary transmission setting, suggesting school closures should be a last resort.
Area of Science:
- Pediatric infectious diseases
- Epidemiology of viral infections
- Community health
Background:
- Previous COVID-19 studies primarily focused on hospitalized or emergency patients.
- Commonly reported symptoms in earlier studies included fever and cough.
- Limited data existed on the clinical presentation of pediatric COVID-19 in community settings.
Purpose of the Study:
- To define the clinical characteristics of coronavirus disease 2019 (COVID-19) in children within the community setting in Spain.
- To analyze transmission patterns and symptom prevalence across different pediatric age groups.
Main Methods:
- A descriptive and analytical observational study was conducted.
- Included 10,021 pediatric cases (0-14 years) from primary care centers in Spain (May 2020 - April 2021).
- Diagnostics utilized PCR, rapid antigen tests, or positive IgG serology.
Main Results:
- 43.2% of pediatric COVID-19 cases were asymptomatic.
- Rhinorrhea (<2 years), fever (3-8 years), and headache (>9 years) were the most frequent symptoms.
- Households accounted for 64.9% of transmissions; only 18 patients were hospitalized, with no deaths.
Conclusions:
- Pediatric COVID-19 is predominantly a mild illness with a high rate of asymptomatic infections.
- The household is the main transmission setting, not schools.
- School closures should be considered a last resort intervention for managing the pandemic in children.
Objectives:
In Spain, the tools to diagnose COVID-19 were available in primary care from May 2020. Previously most studies described inpatients or patients in A&E departments, and fever and cough were the most frequent symptoms. This study aims to define the clinical picture of the pediatric COVID-19 in the community.
Methods:
A descriptive and analytical observational study was performed including pediatric cases (0-14years) from 255 pediatricians, proportionally distributed to its population, from primary health centers in Spain, from 12th May 2020 to 30th April 2021. Diagnostics were made by PCR detection of viral RNA, rapid antigen detection test or positive IgG serology.
Results:
There were 10,021 positive children included, 48.4% women, mean age 8,04±4.17years. Infection was detected due to contact tracing (70.9%), compatible symptoms (18.8%). Household was the main source of transmission (64.9%), followed by school setting (10%) or unknown (9.9%). We did not find any significant differences in the incidence between holidays and school terms. 43.2% of the children were asymptomatic. Most frequent symptoms are rhinorrhea in <2years, fever in 3-8years and headache in >9years. An exhaustive description of objective and subjective symptoms by age is made. 18 patients were hospitalized, one with multisystem inflammatory syndrome in children. There were no deaths.
Conclusions:
pediatric COVID-19 is a mild disease, with a large number of asymptomatic cases, with very few hospital admissions and deaths. The main setting for transmission is the household, and school closures should be a last resource measure during the COVID-19 pandemic. A specific clinical picture of pediatric COVID-19 was not found.
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