Document Type : original article
Authors
Pediatric Respiratory Disease Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Abstract
Background: This study aimed to investigate the clinical characteristics of children diagnosed with COVID-19 in Dr. Masih Daneshvari Hospital from September 2021 to September 2022 to provide insights into the diagnosis and effective management of COVID-19 infection in children.
Methods: In this cross-sectional study, 70 children (under 18 years old) with COVID-19, meeting the study's inclusion criteria, were enrolled after obtaining informed written consent from their parents, and no charges were imposed on them. Demographic information, including age, gender, and family history of COVID-19 exposure, was recorded for the patients. Clinical manifestations and laboratory findings, including Complete Blood Count (CBC), Erythrocyte Sedimentation Rate (ESR), C - C-reactive protein (CRP), and Lactate Dehydrogenase (LDH), were documented according to standard questionnaires. Finally, the study results were analyzed using SPSS software to enhance the diagnosis and follow-up of children with COVID-19.
Results: Among the 70 study participants, 32 were female (45.7%), and 38 were male (54.3%). Regarding age distribution, 14 cases (20%) were less than six years old, 23 cases (32.9%) aged 6-12 years, and 33 cases (47.1%) aged 12-18 years. Among the participants, 66 (94.3%) tested positive for PCR-COVID, while 4 had negative PCR-COVID results. Common clinical findings in the study population included fever, cough, and lethargy.
Conclusion: In symptomatic patients, laboratory findings are mainly present that can help identify individuals who are severely ill. Overall, COVID-19 disease in children has a lower prevalence and severity than that in adults, and the mortality rate is estimated to be very low.
Keywords
- Zimmermann P, Curtis N. Coronavirus infections in children including COVID-19: an overview of the epidemiology, clinical features, diagnosis, treatment and prevention options in children. The Pediatric infectious disease journal. 2020 May 1;39(5):355-68.
- Ryan KE, Goldfield S, Danchin MH, Russell F. COVID‐19, children and schools: overlooked and at risk. The Medical Journal of Australia. 2021 Mar;214(4):189.
- Viner RM, Ward JL, Hudson LD, Ashe M, Patel SV, Hargreaves D, et al. Systematic review of reviews of symptoms and signs of COVID-19 in children and adolescents. Archives of disease in childhood. 2021 Aug 1;106(8):802-7.
- Irfan O, Muttalib F, Tang K, Jiang L, Lassi ZS, Bhutta Z. Clinical characteristics, treatment and outcomes of paediatric COVID-19: a systematic review and meta-analysis. Archives of disease in childhood. 2021 May 1;106(5):440-8.
- Molteni E, Sudre CH, Canas LS, Bhopal SS, Hughes RC, Antonelli M, et al. Illness duration and symptom profile in symptomatic UK school-aged children tested for SARS-CoV-2. The Lancet Child & Adolescent Health. 2021 Oct 1;5(10):708-18.
- Rahimzadeh G, Ekrami Noghabi M, Kadkhodaei Elyaderani F, Navaeifar MR, Enayati AA, Manafi Anari A, et al. COVID-19 infection in Iranian children: a case series of 9 patients. Journal of Pediatrics Review. 2020 Apr 10;8(2):139-44.
- Armin S, Mirkarimi M, Pourmoghaddas Z, Tariverdi M, Jafrasteh A, Marhamati N, et al. Iranian pediatric COVID‐19 epidemiology and clinical characteristics. Canadian Journal of Infectious Diseases and Medical Microbiology. 2021;2021(1):4914371.
- Xia W, Shao J, Guo Y, Peng X, Li Z, Hu D. Clinical and CT features in pediatric patients with COVID‐19 infection: different points from adults. Pediatric pulmonology. 2020 May;55(5):1169-74.
- Steinberger S, Lin B, Bernheim A, Chung M, Gao Y, Xie Z, et al. CT features of coronavirus disease (COVID-19) in 30 pediatric patients. American Journal of Roentgenology. 2020 May 1:1303-11.
- Mahmoudi S, Mehdizadeh M, Shervin Badv R, Navaeian A, Pourakbari B, Rostamyan M, et al. The coronavirus disease 2019 (COVID-19) in children: a study in an Iranian Children’s Referral Hospital. Infection and drug resistance. 2020 Jul 31:2649-55.
- Purwati NH, Noprida D, Agustia W, Imroatun T, Sarini S, Sahariah S, et al. Impact of age and gender on the incidence of COVID-19 in children at Pasar Rebo hospital, Jakarta. KnE Life Sciences. 2022 Feb 7:460-6.
- Wanga V. Characteristics and Clinical Outcomes of Children and Adolescents Aged 18 Years Hospitalized with COVID-19—Six Hospitals, United States, July–August 2021. MMWR. Morbidity and Mortality Weekly Report. 2021;70.
- Armin S, Fahimzad SA, Rafiei Tabatabaei S, Mansour Ghanaiee R, Marhamati N, Ahmadizadeh SN, et al. COVID‐19 Mortality in Children: A Referral Center Experience from Iran (Mofid Children’s Hospital, Tehran, Iran). Canadian Journal of Infectious Diseases and Medical Microbiology. 2022;2022(1):2737719.
- Butt AA, Dargham SR, Loka S, Shaik RM, Chemaitelly H, Tang P, et al. Coronavirus disease 2019 disease severity in children infected with the omicron variant. Clinical Infectious Diseases. 2022 Jul 1;75(1):e361-7.
- Clark M, Walker B, Bennett E, Herrick A, Kenny S, Gent N. Clinical characteristics of SARS-CoV-2 omicron infection in children under one year. Available at SSRN 4013461. 2022.
- Sheng JF, Shao L, Wang YL. Clinical features of children with coronavirus disease 2019 caused by Delta variant infection. Zhongguo Dang dai er ke za zhi= Chinese Journal of Contemporary Pediatrics. 2021 Dec 1;23(12):1267-70.
- McClenaghan E, Cosgriff R, Brownlee K, Ahern S, Burgel PR, Byrnes CA, et al. The global impact of SARS-CoV-2 in 181 people with cystic fibrosis. Journal of cystic fibrosis. 2020 Nov 1;19(6):868-71.
- Jung A, Orenti A, Dunlevy F, Aleksejeva E, Bakkeheim E, Bobrovnichy V, et al. Factors for severe outcomes following SARS-CoV-2 infection in people with cystic fibrosis in Europe. ERJ open research. 2021 Oct 1;7(4).
- Brown LB, Spinelli MA, Gandhi M. The interplay between HIV and COVID-19: summary of the data and responses to date. Current Opinion in HIV and AIDS. 2021 Jan 1;16(1):63-73..
- Najafinejad M, Cheraghali F, Aghcheli B, Rajabi A, Barati L, Naziri H, et al. COVID-19 in pediatrics: demographic, clinical, laboratory, and radiological characteristics of infected patients with SARS-CoV-2. Frontiers in pediatrics. 2022 Jan 13;9:808187.
- Saleh M, Alkofide A, Alshammari A, Siddiqui K, Owaidah T. Changes in hematological, clinical and laboratory parameters for children with COVID-19: single-center experience. Journal of Blood Medicine. 2021 Sep 4:819-26.
- Itelman E, Wasserstrum Y, Segev A, Avaky C, Negru L, Cohen D, et al. Clinical characterization of 162 COVID-19 patients in Israel: preliminary report from a large tertiary center. The Israel Medical Association Journal: IMAJ. 2020 May 1;22(5):271-4.
- Boribong BP, LaSalle TJ, Bartsch YC, Ellett F, Loiselle ME, Davis JP, et al. Neutrophil profiles of pediatric COVID-19 and multisystem inflammatory syndrome in children. Cell Reports Medicine. 2022 Dec 20;3(12).
- Ravichandran S, Tang J, Grubbs G, Lee Y, Pourhashemi S, Hussaini L, et al. SARS-CoV-2 immune repertoire in MIS-C and pediatric COVID-19. Nature Immunology. 2021 Nov;22(11):1452-64.
- Chen R, Yu YL, Li W, Liu Y, Lu JX, Chen F, et al. Gastrointestinal symptoms associated with unfavorable prognosis of COVID-19 patients: a retrospective study. Frontiers in medicine. 2020 Nov 11;7:608259.
- Zhang C, Gu J, Chen Q, Deng N, Li J, Huang L, et al. Clinical and epidemiological characteristics of pediatric SARS-CoV-2 infections in China: A multicenter case series. PLoS medicine. 2020 Jun 16;17(6):e1003130.
- Dong Y, Mo X, Hu Y, Qi X, Jiang F, Jiang Z, et al. Epidemiology of COVID-19 among children in China. Pediatrics. 2020 Jun 1;145(6).
)