Characteristics and Management of Children With COVID-19 in Turkey

Abstract

Aims: Limited data about disease management strategies are available for pediatric patients with coronavirus disease-2019, particularly in Turkey. This study aimed to share the data on patients aged under 18 years in our country to be beneficial for understanding the disease course in children. Methods: A retrospective review of the medical records of pediatric patients aged under 18 years who were confirmed as coronavirus disease-2019 between March 11, and June 23, 2020, and were admitted to our hospitals was conducted. Results: A total of 220 pediatric patients with coronavirus disease-2019 were evaluated, of which 48.2% were boys, with a median age of 10 years, and 9.5% had underlying diseases. Patients were classified according to severity, with the percentages of asymptomatic, mild, moderate, and critical/severe cases determined to be 25.5%, 45%, 26.8%, and 2.7%, respectively. Extracorporeal membrane oxygenation was required in two patients (0.9%) and mechanical ventilation in three (1.4%). Targeted therapies were used in six patients (2.7%), with hydroxychloroquine being the most commonly used agent either alone (one patient) or in combination with favipiravir (five patients). Two patients (0.9%) died, and nine (4.1%) were still hospitalized during the study period. Conclusion: Although the disease course of coronavirus disease-2019 seems to be mild in children, critical illness is significant, and the treatment strategy primarily should consist of supportive care according to our preliminary observations.

Multisystem inflammatory syndrome in children during the COVID-19 pandemic in Turkey: first report from the Eastern Mediterranean

“…The emerging infection due to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), named COVID-19, commonly has led a mild upper respiratory illness in children [ 1 – 4 ]. For instance, a study of 220 children with confirmed COVID-19 from Turkey, including our hospital, reported that 66% of cases presented with an asymptomatic and mild disease course, whereas 2.7% of the pediatric cases had a severe disease [ 5 ]. In the beginning of May 2020, a report of eight pediatric cases with a severe hyperinflammation as well as the involvement of several organs was published from London [ 6 ].…”

Demographic, clinical, and laboratory features of COVID‐19 in children: The role of mean platelet volume in predicting hospitalization and severity

“…It has been considered that bacterial infections in some of our suspected patients can be the reason for higher mean values of CRP and PCT than confirmed COVID‐19 patients. In Turkey, Cura et al 26 evaluated 220 pediatric COVID‐19 cases and reported that 17.8% of patients had increased CRP, 2.3% increased PCT, 8.4% neutropenia, 13.5% lymphopenia, and 0.9% had thrombocytopenia. In our study, 14.3% of confirmed COVID‐19 patients had neutropenia, 25.9% patients lymphopenia, and 4.4% thrombocytopenia.…”

COVID-19 in children: A single center experience from Istanbul, Turkey

“…The large pediatric series from China showed that only 0.6% of the patients progressed to ARDS or multiple organ dysfunction (4) . In two pediatric studies from Turkey, dyspnea or tachypnea were observed less than 5% of the patients (18,19) . Similarly, the majority of our patients (81%) had mild disease.…”

“…In Turkey, schools were closed immediately after the detection of the first case in the country, and home isolation for children had been implemented starting from the beginning of the outbreak. In different pediatric studies reported from Turkey, exposure has been reported in 90-99% (18,19) . Similarly, in our case series, the source of infection in almost all children with COVID-19 was a household member or an immediate family mem- ber.…”