Characteristics and Outcome of Children Admitted with Sars- Cov-2 Infection: Experiences from a Pediatric Public Hospital in Western India  

Abstract

BackgroundSARS-CoV-2 infection in children is asymptomatic or mildly symptomatic. Clinical characteristics and outcome of children admitted with COVID 19, especially with underlying illnesses, has not been studied. ObjectiveTo study the clinical characteristics and outcome of children admitted, with SARS-CoV-2 infection, to a paediatric multispecialty hospital in Mumbai, the epicentre of the COVID19 pandemic in India. Design and SettingRetrospective observational study of medical records of 969 children admitted between 19 March and 7 August 2020.ParticipantsClinico-demographic characteristics and outcome of COVID 19 positive children admitted during the study period. Variables compared between children who were previously healthy (Group I) and children with co-morbidity (Group II).Main outcomeCOVID 19 disease severity characterisation and factors predicting outcome as discharge or death was studied.Results123 (71M) tested SARS-CoV-2-positive by RT-PCR with median age of presentation of 3 years [IQR 0.7– 6 years]. 47 (38%) had co-morbidities and were more severely affected (p = 0.0146). MIS-C/ KD was common in Group I. Thirty nine (31.7 %) needed intensive care. Fourteen (11.4%) died. Male sex, respiratory manifestation, pulseox saturation <94% at admission, need for ventilation, inotrope, hospital stay of <10 days were independent mortality predictors. Regression analysis revealed oxygen saturation <94% at admission (OR 35.9, 95% CI 1.5-856) and hospital stay <10 days (OR 9.1, 95% CI 1.04 -99.1) as predictors of mortality.ConclusionCOVID 19 in children although considered mild, presence of co-morbidities causes severe disease. Pulseox saturation <94% on admission, hospital stay <10days are predictors of mortality.