Abstract
This prospective multicenter cohort study aimed to analyze the epidemiological and clinical characteristics of coronavirus disease 2019 (COVID-19) in children. The study, based on the pediatric part of the Polish SARSTer register, included 1283 children (0 to 18 years) who were diagnosed with COVID-19 between 1 March 2020 and 31 December 2020. Household contact was reported in 56% of cases, more frequently in younger children. Fever was the most common symptom (46%). The youngest children (0–5 years) more frequently presented with fever, rhinitis and diarrhea. Teenagers more often complained of headache, sore throat, anosmia/ageusia and weakness. One fifth of patients were reported to be asymptomatic. Pneumonia was diagnosed in 12% of patients, more frequently in younger children. During the second wave patients were younger than during the first wave (median age 53 vs. 102 months, p < 0.0001) and required longer hospitalization (p < 0.0001). Significantly fewer asymptomatic patients were noted and pneumonia as well as gastrointestinal symptoms were more common. The epidemiological characteristics of pediatric patients and the clinical presentation of COVID-19 are age-related. Younger children were more frequently infected by close relatives, more often suffered from pneumonia and gastrointestinal symptoms and required hospitalization. Clinical courses differed significantly during the first two waves of the pandemic.
Highlights
Due to the rapid spread and enormous burden of coronavirus disease 2019 (COVID19), the World Health Organization declared it a pandemic in March 2020 [1]
This study presents our experience with COVID-19 in 1283 patients from 14 pediatric hospital settings in Poland
Children aged 0–5 years accounted for a high proportion of our patients (45%), to preliminary data from Italy [9], but other authors reported a higher prevalence among older children [8,11,16]
Summary
Due to the rapid spread and enormous burden of coronavirus disease 2019 (COVID19), the World Health Organization declared it a pandemic in March 2020 [1]. From the beginning of the pandemic, available observations suggested that pediatric populations are less affected than adults, with a lower incidence and milder clinical course of the disease [3,4,5,6] Many reports, including both observational studies [7,8,9,10,11,12] and systematic reviews [13,14,15,16], address the epidemiological and clinical characteristics of pediatric patients with COVID-19, most of which were published in the first months of the pandemic, providing valuable information about the novel disease in children. The number of pediatric cases grows, and answering some critical questions should become easier, e.g., which children are more vulnerable to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, whether any factors can predict a more severe clinical course and whether the disease remained the same and had the same clinical picture during subsequent waves of the pandemic
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