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The Age-Related Course of COVID-19 in Pediatric Patients-1405 Cases in a Single Center
Lidia Stopyra1,2, Aleksandra Kowalik3, Justyna Stala1
1Department of Infectious Diseases and Pediatrics, Zeromski Specialist Hospital in Krakow, 30-931 Kraków, Poland.
Insights
Age influences pediatric COVID-19 severity, with infants and toddlers showing distinct symptoms and hospitalization patterns. Adolescents experienced more severe disease courses, highlighting age-specific risks in children.
Area of Science:
- Pediatrics
- Infectious Diseases
- Epidemiology
Background:
- Age is a key COVID-19 risk factor in adults, but its role in pediatric disease remains less understood.
- Understanding pediatric COVID-19 characteristics is crucial for effective management and public health strategies.
Purpose of the Study:
- To analyze the clinical characteristics of COVID-19 in pediatric patients across different age groups.
- To identify age-specific patterns in symptoms, comorbidities, and disease severity in children.
Main Methods:
- Prospective study of 1405 pediatric COVID-19 patients from March 2020 to April 2022.
- Categorization into three age groups: infants, toddlers (1-5 years), and children (5-18 years).
- Analysis of demographic data, symptoms, comorbidities, laboratory findings, and hospitalization outcomes.
Main Results:
- Male predominance in infants and toddlers; female predominance in older children.
- Higher comorbidity rates in older children (5-18 years).
- Increased proportion of infants and toddlers hospitalized over time; 74% of hospitalized children were under five.
- Distinct symptom profiles: upper respiratory in infants/toddlers, lower respiratory/gastroenterocolitis in older children.
- Elevated ALT, CK, LDH, and D-dimers most pronounced in infants.
- Adolescents showed a higher incidence of severe disease courses.
- Median hospitalization was 3-4 days, longest for infants.
Conclusions:
- Pediatric COVID-19 presents varied characteristics across age groups, with significant differences in symptoms and disease severity.
- Infants and toddlers represent a substantial and increasing proportion of hospitalized pediatric COVID-19 cases.
- Adolescents are more prone to severe disease, underscoring the need for age-tailored clinical approaches and monitoring.
Abstract:
Since the beginning of the pandemic, many reports have pointed to age as the most important risk factor for severe COVID-19 in adults, but this relationship is less clear in children. Between March 2020 and April 2022, 1405 pediatric COVID-19 patients were included in our prospective study, which aimed to analyze the disease's characteristics in three age groups: infants, toddlers (1-5 years), and children (5-18 years). We observed male prevalence of the disease in infants and toddlers compared to female prevalence in children. Comorbidities appeared most often in children. In the first pandemic wave, the vast majority of pediatric patients were children, but later, the percentage of infant and toddler patients increased significantly. A total of 74% of hospitalized children were younger than five years. Upper respiratory tract symptoms were most common in infants and toddlers, and lower respiratory tract symptoms and gastroenterocolitis were more common in children. Neurological symptoms appeared similarly in all age groups. The activities of ALT, CK, and LDH were the most elevated in infants, along with D-dimers. The median length of hospitalization fluctuated between three and four days and was highest in infants. Severe courses were more common in adolescents.
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