Clinical and laboratory characteristics of children with SARS-CoV-2 infection

Abstract

We describe the demographic, clinical, radiological, and laboratory findings of 422 children (0-18 year-of-age) suspected of having severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection admitted to a pediatric emergency department between March 23, and July 23, 2020. We compared the characteristics of SARS-CoV-2-positive patients to SARS-CoV-2-negative patients. SARS-CoV-2 infection was confirmed in 78 (18.4%). Fever (51.2%) and cough (43.5%) were the most commonly reported signs in the SARS-CoV-2-positive patients. Isolated rhinorrhea (7.2%) was reported only in the SARS-CoV-2-negative group (p = .0014). Patients with SARS-CoV-2 infection were classified according to severity, with the percentages of asymptomatic, mild, moderate, severe, and critical cases determined to be 29.5%, 56.4%, 12.9%, 1.2%, and 0%, respectively. Of the 422 children, 128 (30.3%) underwent nasopharyngeal polymerase chain reaction testing for other respiratory viral pathogens; 21 (16.4%) were infected with viral pathogens other than SARS-CoV-2. Only one patient (4.7%) with confirmed coronavirus disease 2019 (COVID-19) disease was coinfected with respiratory syncytial virus and rhinovirus. The results indicate lower median white blood cell, neutrophil, and lymphocyte counts, lower lactate dehydrogenase, d-dimer, and procalcitonin levels in the SARS-CoV-2-positive group (p ≤ .001). Our findings confirm that COVID-19 in children has a mild presentation. In our cohort, no patient with SARS-CoV-2 infection had isolated rhinorrhea.

Keywords: COVID-19; SARS-CoV-2; children; clinical features.

Figure 1

Flow chart showing imaging findings. *Abnormal CXRs was defined as any patchy consolidation, presence of air‐bronchogram, atelectasis, pleural fluid, flatting of ribs, and any presentation on  CXR except normal finding. ^¥Chest CT compatible with COVID‐19 was defined by the pediatric radiologist as CT features of subpleural lesions with localized infiltration, consolidation with surrounding halo sign, ground‐glass opacity, unilateral or bilateral peripheric pulmonary lesions, and air‐bronchogram sign. Chest CT, computed tomography of the chest; COVID‐19, coronavirus disease 2019; CXR, chest X‐ray; SARS‐CoV‐2, severe acute respiratory syndrome coronavirus 2