Epidemiological and Clinical Characteristics of COVID-19 in Indian Children in the Initial Phase of the Pandemic

Abstract

Objective To assess the epidemiological and clinical characteristics of pediatric inpatients with COVID-19, early in the pandemic. Methods Clinical and laboratory profile and outcomes were studied for children (aged 1 month — 18 years) presenting between 1 April, 2020 and 20 May, 2020 with positive nasopharyngeal swab for SARS-CoV-2 by RT-PCR. Results 50 children (56% male) with median (IQR) age of 6 (2–12) years were included. Majority (56%) were from families belonging to Kuppuswamy upper lower socioeconomic class. 45 (90%) had positive household contact, and 33 (66%) had overcrowding at home. 29 (58%) children were asymptomatic while 20 (40%) had mild symptoms. Fever, cough, and sore throat were the most common symptoms. High C-reactive protein levels were seen in 15 (30%) children. There was no mortality. Conclusion The disease burden appears high in lower socio-economic group with majority having a positive household contact. Milder disease pattern in the pediatric age group is reiterated.

Clinical Profile, Hospital Course and Outcome of Children with COVID-19

“…Another observation was that the median (IQR) time for RT-PCR to become negative in the present cohort was 16 (12)(13)(14)(15)(16)(17)(18)(19) d, a finding similar to the report from Delhi on adult patients [24]. Studies on virological assessment of hospitalized patients with COVID-19 showed persistence of SARS-CoV-2 RNA in nasopharyngeal samples for a duration of about 2 wk [25,26].…”

“…Gastrointestinal symptoms were the next common manifestations. Observational studies across the world have reported similar frequency of symptoms [13][14][15][16]. A systematic review of 27 studies showed fever to be present in half (41%-58%) followed by cough (39%-51%) and rapid breathing (6%-17%).…”

“…In a large pediatric study from China, the proportion of severe and critical cases were 10.6% and 7.3% for ˂1 and 1-5 y age groups as compared to 3%-4% for older children [4]. In common with adults, underlying 15 (11)(12)(13)(14)(15)(16)(17)(18)(19)(20) a also received invasive mechanical ventilation comorbidities increases the risk for severe disease and intensive care admission in children [21]. In a brief report from UK, 4 out of 5 (80%) children with comorbidities had multiorgan involvement [22].…”

“…Demographic and clinical characteristics of children with At the time of writing, 29 (94%) were discharged, 1 (3%) is still admitted to hospital for ongoing management of comorbidities after being tested negative for SARS-CoV-2 and 1 (3%) died. Median (IQR) length of hospital stay in survivors was 15(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) d(Table 3). Follow-up RT-PCR before discharge was performed in 17 children and the median (IQR) duration to RT-PCR negativity was 16(12)(13)(14)(15)(16)(17)(18)(19) d. One child tested negative only after 35 d of hospitalization.…”

Paediatric COVID-19: Milder Presentation—A Silver Lining in Dark Cloud

“…In our study, all children were from lower socioeconomic class, all had positive close family member at home that was COVID-19 positive. A similar pattern was seen in other studies [ 6 , 7 ]. All children were from a containment zone and all had exposure to a positive household contact.…”