Clinical profile, risk factors and outcomes of pediatric COVID-19: a retrospective cohort multicentre study in Saudi Arabia

Albuali, Waleed H.; Alghamdi, Amal; Aldossary, Shaikha J; Alharbi, Saleh; Majed, Sami I Al; Alenizi, Ahmed; Lardhi, Amer A.; Al-Turki, Shams A; AlSanea, Abdulaziz S; Bubshait, Dalal; Kobeisy, Sumayyah Ahmed Nezar; Herzallah, Noor H; Alqarni, Wejdan A; AlHarbi, Abeer H; Albuali, Hamad W; Aldossary, Bader J; Al-Qurashi, Faisal Othman; Yousef, Abdullah A

doi:10.1136/bmjopen-2021-053722

Cited by 10 publications

(18 citation statements)

References 45 publications

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“…This lower tendency to accept the vaccine in younger children may be attributed to the higher parental perceived risk versus benefit in this age group. This is comparable to the literature that showed that the COVID-19 course is more severe in both infants and teenagers [ 28 , 29 , 30 ]. Among 57 studies with 21,549 patients that were included in the meta-analysis, Harwood et al found that compared with children aged one to four years, infants had increased odds of admission to critical care and death.…”

Section: Discussionsupporting

confidence: 90%

In-Person Schooling Amidst Children’s COVID-19 Vaccination: Exploring Parental Perceptions Just after Omicron Variant Announcement

et al. 2022

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Background: The SARS-CoV-2 Omicron spread fast globally and became the predominant variant in many countries. Resumption of public regular life activities, including in-person schooling, presented parents with new sources of worry. Thus, it is important to study parental worry about the Omicron variant, willingness to vaccinate their children, and knowledge about school-based COVID-19 precautionary measures. Methods: A national, cross-sectional, pilot-validated online questionnaire targeting parents in the Kingdom of Saudi Arabia (KSA) was distributed between 31 December 2021, and 7 January 2022. The survey included sociodemographic, COVID-19 infection data, parental and children vaccination status, attitudes towards booster vaccine, parents’ Omicron-related perceptions and worries, and attitude towards in-person schooling. Results: A total of 1340 participants completed the survey, most (65.3%) of whom were mothers. Of the parents, 96.3% either received two or three doses of the COVID-19 vaccine. Only 32.1% of the parents were willing to vaccinate their young children (5–11 years of age). In relation to their children 12–18 years of age, 48% had already had them vaccinated, 31% were planning to vaccinate them, and 42.8% were willing to administer a booster dose. Only 16% were more worried about the Omicron variant compared to the Delta variant. Residents of western KSA were more worried about Omicron compared to Delta. Parents worried about the Omicron variant and male participants were significantly less aware of school-based COVID-19 precautionary measures. Parents with post-graduate degrees and those having more children were significantly more inclined to send their children to school even if COVID-19 outbreaks could occur in schools, while parents who were more worried about the Omicron variant and were more committed to infection prevention measures were significantly less inclined to do so. Conclusions: Overall, parents had lower worry levels about the Omicron variant compared to the Delta variant. They had a higher willingness to vaccinate their older children compared to the younger ones. In addition, our cohort of parents showed high willingness to send their children to schools and trusted the school-based preventative measures. These findings can inform policy makers when considering school related decisions during the current or future public health crises.

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Section: Discussionsupporting

confidence: 90%

In-Person Schooling Amidst Children’s COVID-19 Vaccination: Exploring Parental Perceptions Just after Omicron Variant Announcement

et al. 2022

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“…These cases featured in Literature during the first pandemic waves when severe forms of diseases in children were also registered, with an incidence rate of approximately 1 to 5000 cases of COVID-19 [ 14 , 35 ]. The first cases were documented in USA and Italy, both in previously healthy children as well as in those with comorbidities [ 36 , 37 , 38 , 39 , 40 , 41 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical and Evolutionary Features of SARS-CoV-2 Infection (COVID-19) in Children, a Romanian Perspective

et al. 2022

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Background: Given the potential for additional development to clarify a better knowledge of generally influence of COVID-19 upon the pediatric population, the clinical symptoms of SARS-CoV-2 infection in children and adolescents are still being explored. Morbidity in children is characterized by a variable clinical course. Our study’s goal was to compare clinical aspects of 230 pediatric patients who analyzed positive for SARS-CoV-2 and were hospitalized between April 2020 and March 2022. Methods: This retrospective study aimed to compare the clinical characteristics of coronavirus disease 2019, (COVID-19) in two groups of pediatric patients hospitalized in the infectious disease clinical ward IX at the National Institute for Infectious Diseases “Prof. Dr. Matei Bals,” Bucharest, Romania. Clinical characteristics of 88 patients (first group), admitted between April–December 2020 were compared with the second group of 142 children admitted between July 2021 and March 2022. Results: Of 230 children, the median age was 4.5 years, and 53.9% were male. Fever (82.17%) and sore throat (66%) were the most common initial symptoms. Rhinorrhea (42%), cough (34%) and diarrhea (41.74%), with abdominal pain (26%) were also reported in a considerable number of cases. 88 (36.21%) patients (first group) were admitted during the second wave in Romania, mostly aged <5 years old, and experienced digestive manifestations like fever (p = 0.001), and diarrhea (p = 0.004). The second group experienced different clinical signs when compared with the first group, with higher temperature and increased respiratory symptoms analogous to persons who suffer acute respiratory viral infections. The proportion in the second group increased by 23.48% from the first group, and the 0–4 age group for both groups had symptoms for a median interval of 5 days; age (0–4-years old) and length of stay were both proportionally inversely and required longer hospitalization (5 days), for the first group. During study time, the fully vaccinated children for 5–12 years old were 10%, and for 13–18 years old, 14.35% respective. We report two Pediatric Inflammatory Multisystem Syndrome (PIMS) in the second group, with favorable evolution under treatment. Comorbidities (obesity and oncological diseases) were reported in both groups and are risk factors for complications appearing (p < 0.001). All pediatric cases admitted to our clinic evolved favorably and no death was recorded. Conclusions: Clinical characteristics of pediatric patients with COVID-19 are age-related. In the first group, 85.29% of 0–4 years old children experienced digestive symptoms, whereas in the second group 83.78% underwent mild and moderate respiratory symptoms for the 5–12 age range. The potential effects of COVID-19 infection in children older than 5 years should encourage caregivers to vaccinate and improve the prognosis among pediatric patients at risk.

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“…Age groups were determined based on the World Health Organization Guideline on “COVID-19 disease in children and adolescents.” 12 The clinical severity was determined using the classification system proposed by Dong et al and summarized in Table 1 . 13 14 15 16 17 The medical records of parents and siblings were investigated and the source of infection was determined as a household contact if the SARS-CoV-2 RT-qPCR test of a household contact was positive within 5 days' of the case.…”

Section: Methodsmentioning

confidence: 99%

The Impact of Alpha Variant (B.1.1.7), Viral Load, and Age on the Clinical Course of Pediatric COVID-19 Patients

Unalan-Altintop

Celep

Milletli-Sezgin

et al. 2022

J Pediatr Infect Dis

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Objective The research on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mainly consists of adult patients, leaving its impact on children understudied. This study aims to investigate the correlations between viral load, clinical course, age, and Alpha variant (B.1.1.7) in children. Methods The study was conducted on children under the age of 18 years, who were admitted to Amasya University Sabuncuoglu Serefeddin Research and Training Hospital in Turkey between February and April 2021. ΔCt values, which were obtained by real-time polymerase chain reaction (PCR), were analyzed to estimate the viral loads of the patients. Alpha variant (B.1.1.7) positivity was determined by real-time PCR. Results There was no difference between estimated viral loads of different clinical courses (p > 0.05), or between asymptomatic and symptomatic patients (p > 0.05). Viral loads were found to decrease with increasing age (p = 0.002). Also, a higher rate of symptomatic disease was found in children under the age of 4 years (p < 0.05). Alpha variant (B.1.1.7) was not found to be associated with severe disease in children (p > 0.05). Conclusion Our results demonstrate higher viral loads and symptomatic disease in children under the age of 4 years. Alpha variant (B.1.1.7) was not found to be related to disease severity. There has not been a consensus on the vaccination of the pediatric population worldwide. More studies are needed to understand the viral kinetics of SARS-CoV-2 and its severity on children to build effective vaccination strategies in children as public health restrictions are eased.

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Clinical profile, risk factors and outcomes of pediatric COVID-19: a retrospective cohort multicentre study in Saudi Arabia

Cited by 10 publications

References 45 publications

In-Person Schooling Amidst Children’s COVID-19 Vaccination: Exploring Parental Perceptions Just after Omicron Variant Announcement

In-Person Schooling Amidst Children’s COVID-19 Vaccination: Exploring Parental Perceptions Just after Omicron Variant Announcement

Clinical and Evolutionary Features of SARS-CoV-2 Infection (COVID-19) in Children, a Romanian Perspective

The Impact of Alpha Variant (B.1.1.7), Viral Load, and Age on the Clinical Course of Pediatric COVID-19 Patients

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