Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2025 Mar 18:70:1607246.
doi: 10.3389/ijph.2025.1607246. eCollection 2025.

Phenotypic Variation in Disease Severity Among Hospitalized Pediatric Patients With COVID-19: Assessing the Impact of COVID-19 in the EPICO Study

María Camila Sossa-Alarcón #  1 , Mónica Paola Gutiérrez #  1 , Natalia Becerra #  1 , Luz Yessenia Ortegon #  1 , María Camila David #  1 , Melisa Naranjo Vanegas  2   3 , Gabriela Friedrich  2 , Pablo Vásquez-Hoyos  4   5 , María Lucía Mesa-Rubio  1 , Luis Miguel Navarro-Ramirez  2   6 , Sergio Moreno-Lopez  2 , Olga Lucía Baquero  7 , Luz Marina Mejía  8 , Juan Gabriel Piñeros  1 , Sonia Restrepo-Gualteros  1 , Carlos Álvarez-Moreno  5   9 , Alejandro Díaz-Díaz  10   11 , Iván Gutierrez-Tobar  7   12   13 , Andrés Camilo Mesa  14 , William Ricardo Bachiller Tuta  15   16 , Clara Esperanza Galvis Diaz  17 , Martha Africano  18   19 , José Manuel Nieto  20 , Paola Marsela Pérez Camacho  21   22 , Claudia Beltrán-Arroyave  23   24 , Rosalba Vivas Trochez  25 , Irati Gastesi  26 , Cinta Moraleda  26 , Alfredo Tagarro García  26   27 , Blanca Herrero  28 , Lourdes Calleja  28 , Carlos Grasa  29 , Paula Rodriguez  29 , Susana Melendo  30 , Antoni Soriano-Arandes  30 , Irene Gómez Pastrana  26 , Sonsoles García García  26 , Victoria Fumado  31 , Andrea Ramírez Varela  32   33   34
Affiliations
Multicenter Study

Phenotypic Variation in Disease Severity Among Hospitalized Pediatric Patients With COVID-19: Assessing the Impact of COVID-19 in the EPICO Study

María Camila Sossa-Alarcón et al. Int J Public Health. .

Erratum in

  • Corrigendum: Phenotypic Variation in Disease Severity Among Hospitalized Pediatric Patients With COVID-19: Assessing the Impact of COVID-19 in the EPICO Study.
    Sossa-Alarcón MC, Gutiérrez MP, Becerra N, Ortegon LY, David MC, Vanegas MN, Friedrich G, Vásquez-Hoyos P, Mesa-Rubio ML, Navarro-Ramirez LM, Moreno-Lopez S, Baquero OL, Mejía LM, Piñeros JG, Restrepo-Gualteros S, Álvarez-Moreno C, Díaz-Díaz A, Gutierrez-Tobar I, Mesa AC, Bachiller Tuta WR, Galvis Diaz CE, Africano M, Nieto JM, Pérez Camacho PM, Beltrán-Arroyave C, Vivas Trochez R, Gastesi I, Moraleda C, Tagarro García A, Herrero B, Calleja L, Grasa C, Rodriguez P, Melendo S, Soriano-Arandes A, Gómez Pastrana I, García García S, Fumado V, Ramírez Varela A. Sossa-Alarcón MC, et al. Int J Public Health. 2025 Apr 22;70:1608555. doi: 10.3389/ijph.2025.1608555. eCollection 2025. Int J Public Health. 2025. PMID: 40331043 Free PMC article.

Abstract

Objective: To characterize the clinical phenotypes of SARS-CoV-2 infection in hospitalized children as part of the EPICO multicenter cohort study.

Methods: We included hospitalized children with confirmed SARS-CoV-2 infection from Colombian and Spanish institutions to assess disease evolution and outcomes. Cluster analysis was performed to identify clinical phenotypes.

Results: A total of 2318 patients were included (55% male, 36% infants). Five phenotype clusters emerged: Cluster 1 (26.5%): infants without comorbidities, low PICU admissions and mortality; Cluster 2 (18.5%): respiratory comorbidities, high microorganism co-detection and mortality; Cluster 3 (11.5%): fever, gastrointestinal symptoms, high PICU admissions; Cluster 4 (32%): mild unspecific symptoms, low mortality; Cluster 5 (11.3%): adolescents without comorbidities, low co-detection and hospitalization rates. Findings were consistent across both countries.

Conclusion: Identifying clinical phenotypes of SARS-CoV-2 in children may improve risk stratification and guide future management strategies.

Keywords: COVID-19; SARS-CoV-2 variants; cluster analysis; inpatients; pediatrics.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they do not have any conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Flowchart of Epidemiological Study of COVID-19 in Children of the Spanish Society of Pediatrics (EPICO) cohort study and Institutions included (EPICO Study. Bogotá, Colombia, 2021).
FIGURE 2
FIGURE 2
Clinical Phenotypes in Epidemiological Study of COVID-19 in Children of the Spanish Society of Pediatrics (EPICO) Cohort study (EPICO Study. Bogotá, Colombia, 2021).
See this image and copyright information in PMC

References

    1. World Health Organization. WHO Director-General’s Remarks at the Media Briefing on 2019-nCoV on 11 February 2020 (2020). Available online at: https://www.who.int/director-general/speeches/detail/who-director-genera... (July 12, 2023).
    1. Cobos-Carrascosa E, Ballesteros Á, Aguilera-Alonso D, Mesa JM, García-Sánchez P, Navarro I, et al. Manifestations and Clinical Phenotypes Are Not Specific Enough to Predict SARS-CoV-2 Infection in Symptomatic Children. Acta Paediatr Int J Paediatrics (2022) 1–4. 10.1001/jamanetworkopen.2021.43151 - DOI - PMC - PubMed
    1. Nikolopoulou GB, Maltezou HC. COVID-19 in Children: Where Do We Stand? Arch Med Res (2022) 53(1):1–8. 10.1016/j.arcmed.2021.07.002 - DOI - PMC - PubMed
    1. Parri N, Lenge M, Cantoni B, Arrighini A, Romanengo M, Urbino A, et al. COVID-19 in 17 Italian Pediatric Emergency Departments. Pediatrics (2020) 146(6):e20201235. 10.1542/peds.2020-1235 - DOI - PubMed
    1. Irwin M, Lazarevic B, Soled D, Adesman A. The COVID-19 Pandemic and its Potential Enduring Impact on Children. Curr Opin Pediatr (2022) 34(1):107–15. 10.1097/MOP.0000000000001097 - DOI - PMC - PubMed

Publication types

LinkOut - more resources