Pediatric COVID-19 Infection: Do Clinical Features and Hematological Parameters Predict the Need for ICU Admission?

Abstract

Background: The world is facing the new pandemic caused by SARS-COV2. The confrontation of this new pandemic necessitates study and analysis of the clinical and laboratory finding in such entity. Objectives: To discuss the clinical and hematological findings in pediatric patients with SARS-CoV-2 infection and to correlate these characters with the need for ICU admission. Patients and methods: This was a hospital record-based study, in which the clinical features and laboratory findings of 29 pediatric patients with confirmed COVID-19 infection were obtained from the medical records of admitted pediatric patients. Results: This study included 29 pediatric patients with confirmed COVID-19 infection. Six cases (20.7%) were admitted to pediatric ICU. The most common presenting symptoms were cough in 23 cases (79.3%) and fever in 19 cases (65.5%). There was a significant association between tachypnea and ICU admission; as 5 out of 6 ICU cases (83.3%) had tachypnea compared to none 0/23 (0.0%) of the non ICU patients (P < 0.001). The frequencies of lymphopenia and thrombocytopenia were higher among ICU patients (100.0% and 50.0% respectively) than the non ICU ones (39.1% and 8.7% respectively) (P < 0.05 for both). The median values of lymphocytes and platelets counts were significantly lower in ICU patients than those of non ICU patients (P=0.002 and 0.007 respectively). CRP values were higher in ICU patients compared to non ICU patients (P=0.011). Conclusion: Decreased lymphocyte count, thrombocytopenia and elevated CRP can be stood out as discriminative laboratory indices for early ICU admission.