Clinical and Epidemiological Profile of Children with COVID-19 in a Tertiary Care Center in Tamil Nadu

Abstract

Introduction: Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection, leading to Corona Virus Disease-2019 (COVID-19) has been a recent pandemic and has spread all over India. Many children with SARS-CoV-2 infection wete referred to our tertiary care center from April 2020 to till date. COVID-19 has been an extremely severe infectious disease. However, very few studies have focused on the epidemiological characteristics of this disease in children. Aim: To identify the clinical and epidemiological profile of children with COVID-19 in a tertiary care centre in South India. Materials and Methods: During the recent pandemic of COVID-19, in Chengalpattu district, Tamil Nadu, this cross-sectional study was done in children with SARS-CoV-2 infection, from March 2020 to June 2021 at Paediatric Department, Chengalpattu Medical College Hospital, Tamil Nadu. A total of 191 children who were tested positive for SARS-CoV-2 were admitted to the isolation ward of our institution, as per the Indian Council of Medical Research (ICMR) guidelines and was monitored till discharge or death. The clinical features including fever, cough, diarrhoea, respiratory distress were noted with mean duration of symptoms. Laboratory parameters like leucocytosis/leucopenia, thrombocytosis/thrombocytopenia, c-reactive protein (CRP), D-dimer (D fragments of protein fibrin) and serum ferritin were noted. Results: Among the total study population of 191 children, 108 (56.54%) children were of age group between 5 years to 12 years. Majority of children, 136 (71.2%), were asymptomatic and the disease has more incidence in boys than girls {104 (54.45) % vs. 87 (45.55%)}. Eight (4.19%) children had comorbid illness. A total of 166 (86.91%) children were infected with SARS-CoV-2 during first wave and 25 (13.09%) children were infected during second wave. Among the study population of 55 (28.8%) symptomatic children, fever was the predominant symptom in 27 (14.14%) children followed by fever with cough in 10 (5.23%) children. Mean duration of symptoms were 4.5±1.3 days. The CRP was elevated in 13 (6.80%) of children. Out of 11 (5.79%) children who required oxygen and ventilator support, 6 (3.14%) required only oxygen. Three children had features suggestive of Multisystem Inflammatory Syndrome in Children (MIS-C) of which one child died. Conclusion: In the present study, most of the children were asymptomatic. The prevalence of symptomatic COVID-19 was low in children. The incidence of severe COVID-19 infection in this study was very low. The most severe form of the disease was MIS-C. Mortality is low in the present study group and it occurs in patients with underlying disease or morbid obesity.