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Differences in children and adolescents with SARS-CoV-2 infection: a cohort study in a Brazilian tertiary referral hospital.

Authors :
Marques HHS
Pereira MFB
Santos ACD
Fink TT
Paula CSY
Litvinov N
Schvartsman C
Delgado AF
Gibelli MABC
Carvalho WB
Odone Filho V
Tannuri U
Carneiro-Sampaio M
Grisi S
Duarte AJDS
Antonangelo L
Francisco RPV
Okay TS
Batisttella LR
Carvalho CRR
Brentani AVM
Silva CA
Eisencraft AP
Rossi Junior A
Fante AL
Cora AP
Reis AGAC
Ferrer APS
Andrade APM
Watanabe A
Gonçalves AMF
Waetge ARP
Silva CA
Ceneviva C
Lazari CDS
Abellan DM
Santos EHD
Sabino EC
Bianchini FRM
Alcantara FFP
Ramos GF
Leal GN
Rodriguez IS
Pinho JRR
Carneiro JDA
Paz JA
Ferreira JC
Ferranti JF
Ferreira JOA
Framil JVS
Silva KRD
Kanunfre KA
Bastos KLM
Galleti KV
Cristofani LM
Suzuki L
Campos LMA
Perondi MBM
Diniz MFR
Fonseca MFM
Cordon MNA
Pissolato M
Peres MS
Garanito MP
Imamura M
Dorna MB
Luglio M
Rocha MC
Aikawa NE
Degaspare NV
Sakita NK
Udsen NL
Scudeller PG
Gaiolla PVV
Severini RDSG
Rodrigues RM
Toma RK
Paula RIC
Palmeira P
Forsait S
Farhat SCL
Sakano TMS
Koch VHK
Cobello Junior V
Source :
Clinics (Sao Paulo, Brazil) [Clinics (Sao Paulo)] 2021 Nov 26; Vol. 76, pp. e3488. Date of Electronic Publication: 2021 Nov 26 (Print Publication: 2021).
Publication Year :
2021

Abstract

Objectives: To compare demographic/clinical/laboratory/treatments and outcomes among children and adolescents with laboratory-confirmed coronavirus disease 2019 (COVID-19).<br />Methods: This was a cross-sectional study that included patients diagnosed with pediatric COVID-19 (aged <18 years) between April 11, 2020 and April 22, 2021. During this period, 102/5,951 (1.7%) of all admissions occurred in neonates, children, and adolescents. Furthermore, 3,962 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection samples were processed in patients aged <18 years, and laboratory-confirmed COVID-19 occurred in 155 (4%) inpatients and outpatients. Six/155 pediatric patients were excluded from the study. Therefore, the final group included 149 children and adolescents (n=97 inpatients and 52 outpatients) with positive SARS-CoV-2 results.<br />Results: The frequencies of sore throat, anosmia, dysgeusia, headache, myalgia, nausea, lymphopenia, pre-existing chronic conditions, immunosuppressive conditions, and autoimmune diseases were significantly reduced in children and adolescents (p<0.05). Likewise, the frequencies of enoxaparin use (p=0.037), current immunosuppressant use (p=0.008), vasoactive agents (p=0.045), arterial hypotension (p<0.001), and shock (p=0.024) were significantly lower in children than in adolescents. Logistic regression analysis showed that adolescents with laboratory-confirmed COVID-19 had increased odds ratios (ORs) for sore throat (OR 13.054; 95% confidence interval [CI] 2.750-61.977; p=0.001), nausea (OR 8.875; 95% CI 1.660-47.446; p=0.011), and lymphopenia (OR 3.575; 95% CI 1.355-9.430; p=0.010), but also had less hospitalizations (OR 0.355; 95% CI 0.138-0.916; p=0.032). The additional logistic regression analysis on patients with preexisting chronic conditions (n=108) showed that death as an outcome was significantly associated with pediatric severe acute respiratory syndrome (SARS) (OR 22.300; 95% CI 2.341-212.421; p=0.007) and multisystem inflammatory syndrome in children (MIS-C) (OR 11.261; 95% CI 1.189-106. 581; p=0.035).<br />Conclusions: Half of the laboratory-confirmed COVID-19 cases occurred in adolescents. Individuals belonging to this age group had an acute systemic involvement of SARS-CoV-2 infection. Pediatric SARS and MIS-C were the most important factors associated with the mortality rate in pediatric chronic conditions with COVID-19.

Details

Language :
English
ISSN :
1980-5322
Volume :
76
Database :
MEDLINE
Journal :
Clinics (Sao Paulo, Brazil)
Publication Type :
Academic Journal
Accession number :
34852143
Full Text :
https://doi.org/10.6061/clinics/2021/e3488