Seasonal coronaviruses infections in children: do they always cause mild illness?

Area of Science:

• Pediatric infectious diseases
• Respiratory virology
• Public health surveillance

Background:

• Human coronaviruses (HCoVs) cause a spectrum of respiratory illnesses in children, from mild to severe pneumonia.
• Coinfection with other respiratory viruses is common in pediatric HCoV cases.
• Understanding clinical outcomes and risk factors for severe disease is crucial for pediatric respiratory infections.

Purpose of the Study:

• To describe human coronavirus (HCoV) infections in children.
• To determine the clinical status and effects of coinfections in pediatric HCoV cases.
• To identify risk factors for intensive care unit (ICU) admission and need for high oxygen support.

Main Methods:

• A five-year retrospective surveillance study (September 2015 - November 2020).
• Analysis of demographic characteristics, clinical data, laboratory results, and treatment of pediatric patients with HCoV infections confirmed by RT-PCR.
• Comparison of clinical outcomes, including ICU admission and oxygen support, based on coinfection status and patient characteristics.

Main Results:

• Of 2606 children, 98 tested positive for HCoVs, with 81.6% under five years old.
• 70% of HCoV cases involved coinfection with other respiratory viruses, significantly impacting clinical diagnosis.
• Hypoxia and underlying diseases were significantly associated with ICU admission (p=0.003, p=0.004).
• Hypoxia, chest X-ray infiltration, and elevated C-reactive protein were linked to high oxygen support needs (p=0.001, p=0.036, p=0.004).

Conclusions:

• HCoV infections in children can present with severe clinical findings, especially when coinfected with other viral agents.
• Coinfection significantly influences clinical diagnosis and disease severity in pediatric HCoV cases.
• Identifying risk factors like hypoxia and underlying conditions is vital for managing severe HCoV infections in children.