Abstract
Understanding the clinical presentation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and prognosis in children is a major issue. Children often present mild symptoms, and some severe forms require paediatric intensive care, with in some cases a fatal prognosis. Our aim was to identify the epidemiological characteristics, clinical presentation, and prognosis of children with coronavirus disease 2019 (Covid-19) hospitalized in Paris suburb hospitals. In this prospective, observational, multicentre study, we included children hospitalized in paediatric departments of Paris suburb hospitals from 23 March 2020 to 10 May 2020, during the national lockdown in France with confirmed SARS-CoV-2 infection (positive RNA test on a nasopharyngeal swab) or highly suspected infection (clinical, biological, and/or radiological data features suggestive for SARS-CoV-2 infection). A total of 192 children were included for confirmed (n = 157) or highly suspected (n = 35) SARS-CoV-2 infection. The median age was one year old (interquartile range 0.125–11) with a sex ratio 1.3:1. Fever was recorded in 147 (76.6%) children and considered poorly tolerated in 29 (15.1%). The symptoms ranged from rhinorrhoea (34.4%) and gastrointestinal (35.5%) to respiratory distress (25%). Only 10 (5.2%) children had anosmia and five (2.6%) had chest pain. An underlying condition was identified in almost 30% of the children in our study. Overall, 24 (12.5%) children were admitted to paediatric intensive care units, 12 required mechanical ventilation, and three died. For children in Paris suburbs, most cases of Covid-19 showed mild or moderate clinical expression. However, one-eighth of children were admitted to paediatric intensive care units and three died.
Highlights
The discovery of a new form of pneumonia in early December 2019 in Wuhan, Hubei Province, followed by the rapid spread of the disease in China and across all continents, led to the most serious health crisis in the modern world for more than a century
We describe case characteristics, including age, sex, history, co-existing conditions, exposure to SARS-CoV-2, symptoms, biological findings, and imaging patterns, when the case was reported
Among the 205 children who were admitted to paediatric emergency departments in 23 Paris suburb hospitals during the study period, 192 (93.7%) were hospitalized and had available clinical data
Summary
The discovery of a new form of pneumonia in early December 2019 in Wuhan, Hubei Province, followed by the rapid spread of the disease in China and across all continents, led to the most serious health crisis in the modern world for more than a century. Covid-19 results from the infection with the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), a virus that is one of the six coronaviruses already known to infect humans. Four of these (HCoV-NL63, HCoV-229E, HCoV-OC43 and HKU1) usually caused mild common cold-type symptoms in immunocompetent people whereas. SARS-CoV-2 is responsible for an ongoing global pandemic, leading to 4.2 million cases and 286,613 deaths as of 12 May 2020, with France among the main affected countries, with 26,646 deaths to date [2]. The first three Covid-19 cases identified in France were reported on 24 January 2020 in travellers returning from Wuhan, China [3]. By March 23, France had the second highest number of Covid-19 infections and the greatest number of deaths in Europe, which led the French health authorities to initiate a lockdown from 17 March 2020
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