COVID-19 Disease in Presenting to the Pediatric Emergency Department: A Multicenter Study of 8886 Cases - 04/08/22
: Prof., Nihan Şık, MD a, Özlem Tekşam b : Prof., Halise Akça c : Assoc. Prof., Funda Kurt c : Assoc. Prof., Ayla Akca Çağlar, MD c, Leman Akcan Yıldız, MD c, Medine Ayşin Taşar d : Prof., İlknur Fidancı, MD d, Burcu Ceylan Cura Yayla, MD d, Durgül Yılmaz a : Prof., Emre Güngör, MD b, Şule Demir, MD e, Haluk Çokuğraş f : Prof., Sinem Oral Cebeci, MD f, Pınar Önal, MD f, Eylem Ulaş Saz g : Prof., Ali Yurtseven g : Assoc. Prof., Metin Uysalol h : Assoc. Prof., Raif Yıldız, MD h, Süheyla Gümüş, MD h, Alkan Bal i : Assoc. Prof., Semra Şen Bayturan i : Assoc. Prof., Neslihan Zengin, MD i, Sinem Atik, MD i, Dilek Yılmaz Çiftdoğan j : Prof., Emel Berksoy j : Assoc. Prof., Alper Çiçek, MD j, Sabiha Şahin k : Prof., Mahmut Can Kızıl, MD k, Yalçın Kara, MD k, Hurşit Apa l : Prof., Emel Ulusoy l : Assoc. Prof., Aybüke Akaslan Kara, MD l, Edanur Yesil, MD m, Meltem Erdem, MD m, Caner Turan, MD m, Sertac Arslanoglu n : Prof., Muhterem Duyu, MD n, Gulser Esen Besli, MD n, Gazi Arslan, MD o, Ayşe Tolunay Oflu p : Assoc. Prof., Mehmet Çeleğen, MD p, Ebru Buldu, MD p, İbrahim Etem Pişkin q : Prof., Hakan Kardeş, MD q, Hayri Levent Yılmaz r : Prof., Dinçer Yıldızdaş r : Prof., Gamze Gökulu, MD r, Pınar Çay, MD r, Utku Özer, MD r, Okşan Derinöz Güleryüz s : Prof., Özlem Çolak, MD s, Songül Tomar Güneysu, MD s
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Abstract |
Background |
The aim was to evaluate the epidemiological, clinical, laboratory, and radiologic data of children with SARS-CoV-2 positivity by polymerase chain reaction (PCR) together with treatment strategies and clinical outcomes and to evaluate cases of multisystem inflammatory syndrome in children (MIS-C) in this population.
Methods |
This was a multicenter retrospective observational cohort study performed in the pediatric emergency departments of 19 tertiary hospitals. From March 11, 2020, to May 31, 2021, children who were diagnosed with confirmed nasopharyngeal/tracheal specimen SARS-CoV-2 PCR positivity or positivity for serum-specific antibodies against SARS-CoV-2 were included. Demographics, presence of chronic illness, symptoms, history of contact with SARS-CoV-2 PCR-positive individuals, laboratory and radiologic investigations, clinical severity, hospital admissions, and prognosis were recorded.
Results |
A total of 8886 cases were included. While 8799 (99.0%) cases resulted in a diagnosis of SARS-CoV-2 with PCR positivity, 87 (1.0%) patients were diagnosed with MIS-C. Among SARS-CoV-2 PCR-positive patients, 51.0% were male and 8.5% had chronic illnesses. The median age was 11.6 years (IQR: 5.0–15.4) and 737 (8.4%) patients were aged <1 year. Of the patients, 15.5% were asymptomatic. The most common symptoms were fever (48.5%) and cough (30.7%) for all age groups. There was a decrease in the rate of fever as age increased (p < 0.001); the most common age group for this symptom was <1 year with the rate of 69.6%. There was known contact with a SARS-CoV-2 PCR-positive individual in 67.3% of the cases, with household contacts in 71.3% of those cases. In terms of clinical severity, 83 (0.9%) patients were in the severe-critical group. There was hospital admission in 1269 (14.4%) cases, with 106 (1.2%) of those patients being admitted to the pediatric intensive care unit (PICU). Among patients with MIS-C, 60.9% were male and the median age was 6.4 years (IQR: 3.9–10.4). Twelve (13.7%) patients presented with shock. There was hospital admission in 89.7% of these cases, with 29.9% of the patients with MIS-C being admitted to the PICU.
Conclusion |
Most SARS-CoV-2 PCR-positive patients presented with a mild clinical course. Although rare, MIS-C emerges as a serious consequence with frequent PICU admission. Further understanding of the characteristics of COVID-19 disease could provide insights and guide the development of therapeutic strategies for target groups.
Le texte complet de cet article est disponible en PDF.Keywords : Children, COVID-19, SARS-CoV-2, Infection, Pandemic
Abbreviations : COVID-19, WHO, MIS-C, SARS-CoV-2, PCR, CRP, BNP, IL-6, CT, EF, SD, IQR, RSV, PICU, AST, ALT, LDH, PT, INR
Plan
Vol 59
P. 133-140 - septembre 2022 Retour au numéro
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