Clinical features and follow‐up of pediatric patients hospitalized for COVID‐19

Abstract

Objective This report summarizes the clinical features and 1‐month follow‐up observations for pediatric patients who were hospitalized with coronavirus disease 2019 (COVID‐19) in Wuhan Women and Children's Hospital. Methods The 1‐month follow‐up data included clinical manifestations and results from serum severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) IgG and IgM tests, reverse‐transcription polymerase chain reaction (RT‐PCR) for SARS‐CoV‐2, lung computed tomography (CT) scans, and laboratory tests. Results Between January 20 and March 15, 2020, 127 patients aged 0–15 years were hospitalized for COVID‐19 treatment, including 3 severe cases and 124 mild or moderate cases. The main therapies included inhalation of aerosolized interferon‐α (122/127) and additional antiviral drugs (28/127). Among the 81 patients who had pneumonia at admission, 35 with right lobe pneumonia had the longest hospital stay (mean 14.5 ± 7 days); 17 with left lobe pneumonia had the highest creatine kinase (154 ± 106 U/L) and creatine kinase myocardial band (CK‐MB, 43 ± 48 U/L) levels; and 29 with bilateral pneumonia had the highest white blood cell counts (8.3 ± 4 × 109/L). Among the 46 patients who were successfully followed up 1 month after discharge, two notable findings were right lobe pneumonia in 22% (95% confidence interval [CI]: 11%–37%) of patients and persistently elevated serum creatine kinase and CK‐MB levels. The median duration of elevated CK‐MB was 45 days. The mean concentrations of serum SARS‐CoV‐2 IgG and IgM in 41 patients were 8.0 ± 7.5 and 98 ± 40 ng/ml, respectively. At follow‐up, four patients retested positive for SARS‐CoV‐2. Conclusions The involvement of different lung lobes in patients with COVID‐19 was associated with variations in the persistence of pneumonia and elevation of CK‐MB levels and body temperature.

Clinical and Laboratory Characteristics of Pediatric COVID-19 Population—A Bibliometric Analysis

“…In the study [ 59 , 62 ], COVID-19 pediatric patients had lower severity of illness (clinical profile and outcomes) than children with influenza: lymphocyte count and D-dimer were lower in influenza A patients than in COVID-19, and the severity index of pneumonia (CRP, PCT (procalcitonin)) was lower in COVID-19 than influenza A. Ground-glass opacity was more common in COVID-19 patients than in influenza A patients, and consolidation was more frequent in influenza A patients [ 62 ]. The study [ 63 ], reporting results of 1-month follow-up of clinical features, highlighted the association between involvement of different lung lobes and persistence of pneumonia, elevation of creatinine kinase and CK-MB isoenzyme levels, and body temperature. The study [ 16 ] suggests that the gastrointestinal tract may shed the virus and fecal–oral transmission may be possible (persistently positive real-time RT–PCR tests of rectal swabs after their nasopharyngeal testing had become negative).…”

Clinical and Laboratory Profile, Management and Outcome of Pediatric SARS-CoV-2 Infection Admitted at the Philippine General Hospital

“…46,47 Liver dysfunction is likely secondary to the use of hepatotoxic drugs, hypoxia-induced liver injury, systemic inflammation, and multi-organ failure. 48 Cardiac complications occur due to cardiac strain from hypoxia and respiratory failure, direct effect of SARS-CoV-2 on the heart, result of inflammation and cytokine storm, metabolic derangements, or consequences of drugs used for treatment. [49][50][51] Several theories have been postulated to explain why COVID-19 presents mildly in children and why complications are less common.…”

The Predictors of Pneumonia in Children with COVID-19

“…Pneumonia was detected in 81 (65.8%) out of 123 children who underwent CT of the lung in a study from China. Right lung involvement was observed in 17 (13%) of these 81 children, left lung involvement in 35 (28%), and bilateral pulmonary involvement in 29 (23%) 13 . In the present study, pulmonary involvement was detected in 41 (27.1%) patients assessed by means of chest X-ray and/or CT.…”