A longitudinal study of children with COVID-19 in outpatient centers in terms of clinical manifestations, hospitalization, antibiotic prescription, and the number of COVID-19 times

Abstract

Background: A few months after the first description of COVID-19 in China, there was evidence that this serious problem was increasing worldwide. The SARS-CoV-2 virus has several subtypes with different characteristics. The disease is mild in children, and patients with this infection are generally not expected to receive antibiotics. This study aimed to focus on the number of times a person gets sick with COVID-19 and the use of antibiotics due to secondary bacterial infections in outpatient children. Methods: From February 2020 to August 2022, children aged <15 years diagnosed with SARS-CoV-2 infection were studied regarding clinical manifestations, need for hospitalization, antibiotic prescription, and the number of COVID-19 infection times. Results: Of 2448 children with the final diagnosis of COVID-19, 65% were boys, 192 people (7.84%) were infected with COVID-19 twice, 35 (1.43%) three times, 7 (0.29%) four times, and 2 (0.14%) five times, and 143 (5.84%) needed hospitalization. The prevalence of antibiotic use was 17.73% (n = 434); Acute bacterial sinusitis (12.21%) and middle ear infection (8.52%) were the most common known reasons for an antibiotic prescription, respectively. Conclusions: Several subtypes of SARS-CoV-2 have different clinical behaviors in the age group of children. A person may be infected with COVID-19 several times. The use of antibiotics in outpatients is insignificant and mostly limited to acute sinusitis and middle ear infection.