Objectives: The aim of this study is to identify the epidemiological, clinical, and laboratory features of coronavirus disease 2019 (COVID-19) in children.Methods: A retrospective study was conducted by pediatric infectious disease specialists from 32 different hospitals from all over Turkey by case record forms. Pediatric cases who were diagnosed as COVID-19 between March 16, 2020, and June 15, 2020 were included. Case characteristics including age, sex, dates of disease onset and diagnosis, family, and contact information were recorded. Clinical data, including the duration and severity of symptoms, were also collected. Laboratory parameters like biochemical tests and complete blood count, chest X-ray, and chest computed tomography (CT) were determined.Results: There were 1,156 confirmed pediatric COVID-19 cases. In total, male cases constituted 50.3% (n = 582) and females constituted 49.7% (n = 574). The median age of the confirmed cases was 10.75 years (4.5–14.6). Of the total cases, 90 were younger than 1 year of age (7.8%), 108 were 1–3 years of age (9.3%), 148 were 3–6 years of age (12.8%), 298 were 6–12 years of age (25.8%), 233 were 12–15 years of age (20.2%), and 268 cases were older than 15 years of age (23.2%). The most common symptom of the patients at the first visit was fever (50.4%) (n = 583) for a median of 2 days (IQR: 1–3 days). Fever was median at 38.4°C (38.0–38.7°C). The second most common symptom was cough (n = 543, 46.9%). The other common symptoms were sore throat (n = 143, 12.4%), myalgia (n = 141, 12.2%), dyspnea (n = 118, 10.2%), diarrhea (n = 112, 9.7%), stomachache (n = 71, 6.1%), and nasal discharge (n = 63, 5.4%). When patients were classified according to disease severity, 263 (22.7%) patients were asymptomatic, 668 (57.7%) patients had mild disease, 209 (18.1%) had moderate disease, and 16 (1.5%) cases had severe disease. One hundred and forty-nine (12.9%) cases had underlying diseases among the total cases; 56% of the patients who had severe disease had an underlying condition (p < 0.01). The need for hospitalization did not differ between patients who had an underlying condition and those who do not have (p = 0.38), but the need for intensive care was higher in patients who had an underlying condition (p < 0.01). Forty-seven (31.5%) of the cases having underlying conditions had asthma or lung disease (38 of them had asthma).Conclusions: To the best of our knowledge, this is one of the largest pediatric data about confirmed COVID-19 cases. Children from all ages appear to be susceptible to COVID-19, and there is a significant difference in symptomatology and laboratory findings by means of age distribution.

Objective: We aimed to describe the infectivity of adult and pediatric COVID-19 patients in the presence of viral shedding and anti-SARS-CoV-2 antibody response. Materials and Methods:A total of 408 consequent samples from eleven adults and five pediatric patients with SARS-CoV-2 infection were included. Reverse transcription-polymerase chain reaction (RT-PCR) and viral culture were performed for the samples obtained every other day from saliva, nasopharynx, feces, serum, urine, and tear. Anti-SARS-CoV-2 antibodies were measured. Results:The median duration of RNA shedding in all specimens was 7 (2-15) days in adults and 5 (3-19) days in children. The median duration from symptom onset to admission was three days. The viral RNA was positive in 44.7 % of the nasopharynx and 37.6% of saliva samples up to 16 days in adults and 19 days in children. We detected the latest viral culture positivity in the nasopharynx on day eight of symptoms. The viral RNA was found in 6.1% of feces, 4.4% of serum, 4.3 % of tear, 2.9% of urine. The earliest seroconversion was the seventh day for adults and the eighth day for children. On the 14th day, total antibody positivity was 78% in adults and 80% in children. After seroconversion, the viral RNA was still detected in the nasopharynx and saliva of three patients; however, the infectious virus was not present. Conclusion:The infectivity of a positive patient is low after eight days of symptoms. The risk of fecal-oral transmission is very low, and strict hand hygiene measures could be preventive.

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Introduction: Roseola infantum is always considered to be among the differential diagnosis of young patients with fever and leukopenia whom to be strictly isolated with the preliminary diagnosis of COVID-19 until otherwise proven during the pandemic.Results: Human herpes virus-6 (HHV-6) polymerase chain reaction (PCR) blood test was performed in 4 of 7 patients with a clinical diagnosis of roseola infantum and all found to be HHV-6 PCR positive. The most striking laboratory finding in all patients was leukopenia. HHV-6 PCR tests were found to be positive. Severe acute respiratory syndrome coronavirus-2 testing were found to be negative in all patients. Conclusion:During the peak of the pandemic, children continued to present with fever because of viral infections other than COVID-19.

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