Nagwan Y Saleh1, Hesham M Aboelghar1, Sherif S Salem1, Reda A Ibrahem2, Fatma O Khalil3, Ahmed S Abdelgawad4, Asmaa A Mahmoud5. 1. Department of Pediatrics, Faculty of Medicine, Menoufia University, Shebin Elkom, Egypt. 2. Department of Public Health and community Medicine, Faculty of Medicine, Menoufia University, Shebin Elkom, Egypt. 3. Department of Clinical and Molecular Microbiology and Immunology, National Liver Institute, Menoufia University, Shebin Elkom, Egypt. 4. Department of Clinical Pathology, National Liver Institute, Menoufia University, Shebin Elkom, Egypt. 5. Department of Pediatrics, Faculty of Medicine, Menoufia University, Shebin Elkom, Egypt. asmaasoliman50@gmail.com.
Abstract
BACKGROUND: Emergence of 2019-nCoV attracted global attention and WHO declared COVID-19 a public health emergency of international concern. Therefore we aimed to explore the severity and atypical manifestations of COVID-19 among children. METHODS: This is an observational cohort study conducted on 398 children with confirmed COVID-19 by using real-time reverse transcriptase polymerase chain reaction assay for detection of 2019-nCoV nucleic acid during the period from March to November 2020. Patients were subdivided regarding the severity of COVID-19 presentation into Group I (Non-severe COVID-19) was admitted into wards and Group II (Severe COVID-19) admitted into the PICU. RESULTS: Non- severe cases were 295cases (74.1%) and 103cases (25.9%) of severe cases. There was a significant difference between age groups of the affected children (P < 0.001) with a median (0-15 years). Boys (52%) are more affected than girls (48%) with significant differences (P < 0.001). 68.6%of confirmed cases had contact history to family members infected with COVID-19. 41.7% of severe patients needed mechanical ventilation. Death of 20.4% of severe cases. In COVID-19 patients, fever, headache, fatigue and shock were the most prominent presentations (95, 60.3, 57.8, and 21.8% respectively). 3.5% of children were manifested with atypical presentations; 1.25% manifested by pictures of acute pancreatitis, 1.25% presented by manifestations of deep venous thrombosis and 1.0% had multisystem inflammatory syndrome (MIS-C). Multivariate regression analysis showed that COVID-19 severity in children was significantly higher among children with higher levels of D-dimer, hypoxia, shock and mechanical ventilation. CONCLUSION: Most children had a non-severe type of COVID-19 and children with severe type had higher levels of D-dimer, hypoxia, shock and mechanical ventilation.
BACKGROUND: Emergence of 2019-nCoV attracted global attention and WHO declared COVID-19 a public health emergency of international concern. Therefore we aimed to explore the severity and atypical manifestations of COVID-19 among children. METHODS: This is an observational cohort study conducted on 398 children with confirmed COVID-19 by using real-time reverse transcriptase polymerase chain reaction assay for detection of 2019-nCoV nucleic acid during the period from March to November 2020. Patients were subdivided regarding the severity of COVID-19 presentation into Group I (Non-severe COVID-19) was admitted into wards and Group II (Severe COVID-19) admitted into the PICU. RESULTS: Non- severe cases were 295cases (74.1%) and 103cases (25.9%) of severe cases. There was a significant difference between age groups of the affected children (P < 0.001) with a median (0-15 years). Boys (52%) are more affected than girls (48%) with significant differences (P < 0.001). 68.6%of confirmed cases had contact history to family members infected with COVID-19. 41.7% of severe patients needed mechanical ventilation. Death of 20.4% of severe cases. In COVID-19patients, fever, headache, fatigue and shock were the most prominent presentations (95, 60.3, 57.8, and 21.8% respectively). 3.5% of children were manifested with atypical presentations; 1.25% manifested by pictures of acute pancreatitis, 1.25% presented by manifestations of deep venous thrombosis and 1.0% had multisystem inflammatory syndrome (MIS-C). Multivariate regression analysis showed that COVID-19 severity in children was significantly higher among children with higher levels of D-dimer, hypoxia, shock and mechanical ventilation. CONCLUSION: Most children had a non-severe type of COVID-19 and children with severe type had higher levels of D-dimer, hypoxia, shock and mechanical ventilation.
Authors: John S Bradley; Carrie L Byington; Samir S Shah; Brian Alverson; Edward R Carter; Christopher Harrison; Sheldon L Kaplan; Sharon E Mace; George H McCracken; Matthew R Moore; Shawn D St Peter; Jana A Stockwell; Jack T Swanson Journal: Clin Infect Dis Date: 2011-10 Impact factor: 9.079
Authors: D Wang; X L Ju; F Xie; Y Lu; F Y Li; H H Huang; X L Fang; Y J Li; J Y Wang; B Yi; J X Yue; J Wang; L X Wang; B Li; Y Wang; B P Qiu; Z Y Zhou; K L Li; J H Sun; X G Liu; G D Li; Y J Wang; A H Cao; Y N Chen Journal: Zhonghua Er Ke Za Zhi Date: 2020-04-02
Authors: John Kubale; Angel Balmaseda; Aaron M Frutos; Nery Sanchez; Miguel Plazaola; Sergio Ojeda; Saira Saborio; Roger Lopez; Carlos Barilla; Gerald Vasquez; Hanny Moreira; Anna Gajewski; Lora Campredon; Hannah E Maier; Mahboob Chowdhury; Cristhiam Cerpas; Eva Harris; Guillermina Kuan; Aubree Gordon Journal: JAMA Netw Open Date: 2022-06-01