A multicenter retrospective study of clinical features, laboratory characteristics, and outcomes of 166 hospitalized children with coronavirus disease 2019 (COVID‐19): A preliminary report from Iranian Network for Research in Viral Diseases (INRVD)

Abstract

Background The objectives of this study were to analyze the clinical features and laboratory profiles and risk factors associated with critical illness of children with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). Methods One hundred and sixty‐six coronavirus disease 2019 (COVID‐19) Iranian pediatric patients were recruited through a collaborative research network between March and May 2020. Demographics, clinical, laboratory, and radiological results were obtained from patient files. Results Of 166 patients, 102 (61%) and 64 (39%) were males and females, respectively. Ninety‐six (57.8%) and 70 (42.2%), had moderate and severe conditions, respectively. Thirty (18%) of patients died. The common symptoms were fever (73%), cough (54%), and shortness of breath, headache decrease in neutrophil and platelet counts; increase values in lactate dehydrogenase, decrease in the blood pH and HCO3 were significantly associated with the disease severity. 54% and 56% of patients showed abnormal radiographic appearance in Chest X‐ray and in chest computed tomography scan, respectively. Sixty‐one (36.7%) of patients were referred to intensive care unit (ICU). The coexistence of comorbidity was the main factor associated with ICU admission, shock, arrhythmia, acute kidney injury, acute respiratory distress syndrome, acute cardiac injury, and death. Conclusions We describe a higher than previously recognized rate of COVID‐19 mortality in Iranian pediatric patients. Epidemiological factors, such as the relatively high case fatality rate in the country and the presence of underlying diseases were the main factors for the high death rate.

Covid-19 Disease in Pediatric Emergency Room: The Dilemma of Cycle Threshold Value

“…Abnormal findings were found at a rate of 33-54% in studies examining the results of chest radiography [8, 16]. In our study, this rate was found to be 14%.…”

“…However, it is noteworthy that it is significantly higher in hospitalized patients. Abnormal findings were found at a rate of 33-54% in studies examining the results of chest radiography [8,16]. In our study, this rate was found to be 14%.…”

“…When analyzing the symptoms, the most common symptoms were fever and cough, similar to our study. [7][8][9][10][11][12][13][14][15][16]. In a study assessing data for 1734 children aged 5-17 in the United Kingdom, however, it was found that the most common symptoms were headache (62%) and fatigue(55%) [17].…”

Coronavirus Disease 2019 in Pediatric Emergency Room: The Dilemma of Cycle Threshold Value

“…Previous studies have reported rates of CXR abnormalities of 33 to 54%, 8,18 compared with 15% in our study. In a previous Turkish pediatric study, Böncüoğlu et al found that abnormal CT findings correlated with elevated CRP levels.…”

“…8,9,[11][12][13][14][15] As in our study, the most common symptoms are usually reported to be fever and cough. 8,9,[11][12][13][14][15][16][17][18] However, in a UK study of 1,734 children, the most common symptoms were headache (62%) and fatigue (55%). 19 SARS-CoV-2 infections in children have different paths and are less severe than in adults in terms of clinical manifestations.…”