J Pediatr Infect Dis 2021; 16(02): 047-052
DOI: 10.1055/s-0040-1721511
Original Article

Evaluation of the Clinical Features of 81 Patients with COVID-19: An Unpredictable Disease in Children

Hayrettin Temel
1   Department of Pediatrics, School of Medicine, Istanbul Medipol University, Istanbul, Turkey
,
Mehmet Gündüz
1   Department of Pediatrics, School of Medicine, Istanbul Medipol University, Istanbul, Turkey
,
Hüseyin Arslan
2   Department of Pediatric Chest Diseases, School of Medicine, Istanbul Medipol University, Istanbul, Turkey
,
Füsun Ünal
2   Department of Pediatric Chest Diseases, School of Medicine, Istanbul Medipol University, Istanbul, Turkey
,
Emine Atağ
2   Department of Pediatric Chest Diseases, School of Medicine, Istanbul Medipol University, Istanbul, Turkey
,
Murat Cömert
1   Department of Pediatrics, School of Medicine, Istanbul Medipol University, Istanbul, Turkey
,
Mehmet Sait Doğan
3   Department of Pediatric Radiology, School of Medicine, Istanbul Medipol University, Istanbul, Turkey
,
Remzi Erkesim
1   Department of Pediatrics, School of Medicine, Istanbul Medipol University, Istanbul, Turkey
,
Mesut Okur
4   Department of Pediatrics, School of Medicine, Istanbul Medipol University, Istanbul, Turkey
,
Sedat Öktem
5   Department of Pediatric Chest Diseases, School of Medicine, Istanbul Medipol University, Istanbul, Turkey
,
Ayşe İstanbullu Tosun
6   Department of Medical Microbiology, School of Medicine, Istanbul Medipol University, Istanbul, Turkey
› Author Affiliations

Abstract

Objective Data on the prognosis of clinical features of pediatric patients affected by the coronavirus disease 2019 (COVID-19) pandemic is insufficient. This study aimed to examine the clinical, laboratory, and radiology findings of pediatric patients diagnosed with COVID-19.

Methods A total of 81 pediatric patients with a confirmed diagnosis of COVID-19 who were admitted to the pediatric clinics of our tertiary care hospital in Istanbul between March 22 and May 1, 2020, were included in the study.

Results Of the patients, 40 (49.6%) were boys and 41 (50.6%) were girls. The mean age of the patients was 9.3 ± 5.5 years (range: 1 month–16 years). The most common symptoms were cough (28.4%) and fever (25.9%). A total of 26 patients (32.1%) had pharyngeal erythema. There was no significant difference between age groups in terms of symptoms, findings, clinical picture, history of contact, and clinical course (p > 0.001 for each). Abnormal findings were observed in seven (8.6%) patients on chest X-ray, and in four patients (4.9%) on thorax computed tomography. Only three of the patients were hospitalized and all of them discharged with healing.

Conclusion The present study is the most comprehensive study on children diagnosed with COVID-19 in our country, which showed that the COVID-19 picture was mild in pediatric patients, but the signs and symptoms in children were not specific to the disease. Our findings also showed that the rate of asymptomatic infection in children was high and that it was difficult to recognize COVID-19 in children.



Publication History

Received: 30 May 2020

Accepted: 30 October 2020

Article published online:
16 December 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • References

  • 1 Hasan A, Mehmood N, Fergie J. Coronavirus disease (COVID-19) and pediatric patients: a review of epidemiology, symptomatology, laboratory and imaging results to guide the development of a management algorithm. Cureus 2020; 12 (03) e7485
  • 2 Zimmermann P, Curtis N. Coronavirus infections in children including COVID-19: an overview of the epidemiology, clinical features, diagnosis, treatment and prevention options in children. Pediatr Infect Dis J 2020; 39 (05) 355-368
  • 3 Hatipoglu N. The “New” problem of humanity: new coronavirus [2019-NCOV / COVID-19] disease. Med J Bakirkoy 2020; 16: 1-8
  • 4 Tezer H, Bedir Demirdağ T. Novel coronavirus disease (COVID-19) in children. Turk J Med Sci 2020; 50 (SI-1): 592-603
  • 5 Brodin P. Why is COVID-19 so mild in children?. Acta Paediatr 2020; 109 (06) 1082-1083
  • 6 Cristiani L, Mancino E, Matera L. et al. Will children reveal their secret? The coronavirus dilemma. Eur Respir J 2020; 55 (04) 2000749
  • 7 Castagnoli R, Votto M, Licari A. et al. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children and adolescents: a systematic review. JAMA Pediatr 2020; 174 (09) 882-889
  • 8 Hong H, Wang Y, Chung HT, Chen CJ. Clinical characteristics of novel coronavirus disease 2019 (COVID-19) in newborns, infants and children. Pediatr Neonatol 2020; 61 (02) 131-132
  • 9 Dong Y, Mo X, Hu Y. et al. Epidemiology of COVID-19 among children in China. Pediatrics 2020; 145 (06) e20200702
  • 10 Choi SH, Kim HW, Kang JM, Kim DH, Cho EY. Epidemiology and clinical features of coronavirus disease 2019 in children. Clin Exp Pediatr 2020; 63 (04) 125-132
  • 11 Lu X, Zhang L, Du H. et al; Chinese Pediatric Novel Coronavirus Study Team. SARS-CoV-2 infection in children. N Engl J Med 2020; 382 (17) 1663-1665
  • 12 Society of Pediatrics, Chinese Medical Association. Editorial Board, Chinese Journal of Pediatrics. [Recommendations for the diagnosis, prevention and control of the 2019 novel coronavirus infection in children (first interim edition)] ZhonghuaErKeZaZhi 2020; 58 (03) 169-174
  • 13 Han YN, Feng ZW, Sun LN. et al. A comparative-descriptive analysis of clinical characteristics in 2019-coronavirus-infected children and adults. J Med Virol 2020
  • 14 Feng K, Yun YX, Wang XF. et al. [Analysis of CT features of children with 2019 novel coronavirus infection]. ZhonghuaErKeZaZhi 2020; 58: 275-278
  • 15 Tan YP, Tan BY, Pan J, Wu J, Zeng SZ, Wei HY. Epidemiologic and clinical characteristics of 10 children with coronavirus disease 2019 in Changsha, China. J Clin Virol 2020; 127: 104353
  • 16 Jiehao C, Jin X, Daojiong L. et al. A case series of children with 2019 novel coronavirus infection: clinical and epidemiological features. Clin Infect Dis 2020; 71 (06) 1547-1551
  • 17 Shen Q, Guo W, Guo T. et al. Novel coronavirus infection in children outside of Wuhan, China. Pediatr Pulmonol 2020; 55 (06) 1424-1429
  • 18 Sun D, Li H, Lu XX. et al. Clinical features of severe pediatric patients with coronavirus disease 2019 in Wuhan: a single center's observational study. World J Pediatr 2020; 16 (03) 251-259
  • 19 Bai K, Liu W, Liu C. et al. Clinical analysis of 25 COVID-19 infections in children. Pediatr Infect Dis J 2020; 39 (07) e100-e103
  • 20 Wang D, Ju XL, Xie F. et al. [Clinical analysis of 31 cases of 2019 novel coronavirus infection in children from six provinces (autonomous region) of northern China]. Zhonghua Er Ke Za Zhi 2020; 58 (04) 269-274
  • 21 Xia W, Shao J, Guo Y, Peng X, Li Z, Hu D. Clinical and CT features in pediatric patients with COVID-19 infection: Different points from adults. Pediatr Pulmonol 2020; 55 (05) 1169-1174
  • 22 Li H, Chen K, Liu M, Xu H, Xu Q. The profile of peripheral blood lymphocyte subsets and serum cytokines in children with 2019 novel coronavirus pneumonia. J Infect 2020; 81 (01) 115-120
  • 23 Zheng F, Liao C, Fan QH. et al. Clinical characteristics of children with coronavirus disease 2019 in Hubei, China. Curr Med Sci 2020; 40 (02) 275-280
  • 24 Qiu H, Wu J, Hong L, Luo Y, Song Q, Chen D. Clinical and epidemiological features of 36 children with coronavirus disease 2019 (COVID-19) in Zhejiang, China: an observational cohort study. Lancet Infect Dis 2020; 20 (06) 689-696
  • 25 Garazzino S, Montagnani C, Donà D. et al Italian SITIP-SIP Pediatric Infection Study Group, Italian SITIP-SIP SARS-CoV-2 paediatric infection study group*. Multicentre Italian study of SARS-CoV-2 infection in children and adolescents, preliminary data as at 10 April 2020. Euro Surveill 2020; 25 (18) 2000600
  • 26 Du W, Yu J, Wang H. et al. Clinical characteristics of COVID-19 in children compared with adults in Shandong Province, China. Infection. 2020; 48 (03) 445-452
  • 27 Chiotos K, Hayes M, Kimberlin DW. et al. Multicenter initial guidance on use of antivirals for children with COVID-19/SARS-CoV-2. J Pediatric Infect Dis Soc 2020; piaa045
  • 28 Gautret P, Lagier JC, Parola P. et al. Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial. Int J Antimicrob Agents 2020; 56 (01) 105949
  • 29 Wu Q, Xing Y, Shi L. et al. Coinfection and other clinical characteristics of COVID-19 in children. Pediatrics 2020; 146 (01) e20200961