Clinical characteristics of pediatric COVID-19 infection in patients aged under 15 years visiting Charoenkrung Pracharak Hospital
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Abstract
Objectives: To study the clinical presentation and treatment outcomes of pediatric SARS-CoV-2 infection and differentiate across three variants in Bangkok Metropolitan Hospitals.
Materials and Methods: This retrospective study reviewed pediatric patients under 15 years old with confirmed SARS-CoV-2 infection from January 2020 to June 2022. The SARS-CoV-2 variants were defined on the basis of the epidemic curve provided by the Department of Disease Control.
Results: A total of 895 pediatric SARS-CoV-2 infection cases were enrolled, of which 55.8% were male. The mean age (SD) was 7.35 (± 4.6) years old, and 4.7% of patients had underlying diseases, with respiratory diseases being the most common (2.6%). Household contact cases accounted for 65.8% of the total. Clinical presentations included upper respiratory symptoms (cough 55.9%, rhinorrhea 37.8%, sputum 13.2%, sore throat 23.1%), fever (57%), and extra-pulmonary tract symptoms (e.g., gastrointestinal symptoms such as diarrhea 10.2% and nausea/vomiting 8.4%) and seizure 3.7%, with 13.5% showing no symptoms. The disease spectrum included asymptomatic 8.8%, mild severity 55 %, moderate severity 34.9% and severe severity 1.3%. Comparing the three periods; pre-Delta, Delta, and Omicron variants; high-grade fever and seizures predominated in Omicron, while anosmia and loss of taste were notable in Delta, while the pre-Delta period predominantly had asymptomatic cases. Chest x-rays of the patients revealed abnormalities in 38.5% of cases. Abnormal chest radiography showed that interstitial infiltration was 76.8% and patchy infiltration or ground glass opacity were 29.8%. Favipiravir was prescribed to 83.3% of children with symptomatic COVID-19 and/or risk factors. Disease progression was observed in 4.9% of cases, with 1.3% requiring oxygen therapy, and none needing mechanical ventilation. Overall, all patients fully recovered, with no mortality reported.
Conclusion: Pediatric COVID-19 infection generally has a favorable prognosis in children. Although respiratory symptoms are the most common presentation, each period may have different predominant symptoms. Overall, patients typically experience full recovery.
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