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. 2024 Feb 23:12:1325562.
doi: 10.3389/fped.2024.1325562. eCollection 2024.

Clinical characteristics of 4,520 paediatric patients infected with the SARS-CoV-2 omicron variant, in Xi'an, China

Jingwei Yue  1 , Jin Cao  2 , Lin Liu  1 , Li Yin  1 , Mingyue Li  1
Affiliations

Clinical characteristics of 4,520 paediatric patients infected with the SARS-CoV-2 omicron variant, in Xi'an, China

Jingwei Yue et al. Front Pediatr. .

Abstract

Background and objective: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has broad tissue tropism and high transmission, which are likely to perpetuate the pandemic. The study aim to analyze the clinicopathogenic characteristics in paediatric patients.

Methods: In this single-centre study, we retrospectively included all confirmed cases infected by SARS-CoV-2 infection at Xi'an Children's Hospital, China, from 1 December to 31 December 2022. The demographic, clinical, laboratory, and radiological features of the patients were analysed.

Results: A total of 4,520 paediatric patients with SARS-CoV-2 omicron variant infections were included. Of these, 3,861 (85.36%) were outpatients, 659 (14.64%) were hospitalised patients, and nine patients (0.20%) died. Of the nine patients who died, five were diagnosed with acute necrotising encephalopathy (ANE). The most common symptoms were fever in 4,275 (94.59%) patients, cough in 1,320 (29.20%) patients, convulsions in 610 (13.50%) patients, vomiting in 410 (9.07%) patients, runny nose/coryza in 277 (6.13%) patients, hoarseness of voice in 273 (6.04%) patients. A blood cell analysis showed a slight elevation of monocytes (mean: 11.14 ± 0.07%). The main diagnoses for both outpatients and inpatients were respiratory infection with multisystem manifestations.

Conclusions: A high incidence of convulsions is a typical characteristic of children infected with SARS-CoV-2. Five of the nine COVID-19 fatalities were associated with ANE. This indicates that nervous system damage in children with SARS-CoV-2 infection is more significant.

Keywords: COVID-19; SARS-CoV-2; acute necrotizing encephalopathy; coronavirus; omicron.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Characteristics of main diagnoses and concomitant symptoms in outpatients. (A) Constituent ratio of main diagnoses in outpatients; (B) upper respiratory tract infection (URTI) with concomitant symptoms. (C) Bronchitis with concomitant symptoms. (D) Pneumonia with concomitant symptoms.
Figure 2
Figure 2
The main diagnostic composition of hospitalised patients. The abscissa is the diagnosis and accompanying symptoms. The ordinate is the frequency of the patients.
Figure 3
Figure 3
The main diagnosis of the 9 patients who died. ANE: acute necrotizing encephalopathy.
Figure 4
Figure 4
Brain nuclear magnetic resonance (MRI) of acute necrotizing encephalopathy. (A) Bilateral thalamic symmetrical damage in T2- weighted and T2-weighted flair (red arrow). Brain stem and cerebellum injured in T2- weighted (black arrow). The cerebral cortex was extensively oedematous with significant damage to the left parietal cortex (yellow arrow) in T2-weighted flair. External and internal capsule injury in T2-weighted flair (white arrow). (B) Bilateral thalamic symmetrical damage in T2-weighted flair (red arrow). Periventricular white matter damage in T2-weighted flair (yellow arrow). Centrum semiovale damaged in T2-weighted flair (black arrow). Basal ganglia damaged in T2-weighted flair and T1-weighted (white arrow).
Figure 5
Figure 5
A heat map of Spearman's correlation analyses between lab findings with clinical diagnoses. *, correlation; **, Significant correlation. AST, aspartate aminotransferase; ALT, alanine aminotransferase; CK-MB, creatine kinase isoenzyme; PCT, procalcitonin; CRP, hypersensitive C-reactive protein; Monocytes%, percentage of monocytes; ANE, acute necrotizing encephalopathy.
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