Abstract
The wide spectrum of COVID-19 symptoms complicates the selection of target groups for screening. We aimed to compare data of children screened for COVID-19 at the pediatric emergency department in Vilnius between different phases throughout 1 year (Phase I: March–May, 2020; Phase II: June–September, 2020; and Phase III: October, 2020–February, 2021) and to evaluate the possible predictors of the disease. SARS-CoV-2 PCR tests were positive for 2.7% of tested children (248/9,238), significantly higher during the Phase III (5.5%) compared with the Phase I (0.6%, p = 0.000) and Phase II (0.3%, p = 0.000). Infants and teenagers (12–17 years) accounted for a larger proportion of COVID-19 patients (24.6 and 26.2%, respectively) compared to other age groups: 1–2 years (18.9%), 3–6 years (14.9%), and 7–11 years (15.3%). There were more COVID-19 cases among children with a known SARS-CoV-2 exposure compared to those who did not declare any contact (18.2 vs. 1.1%, p = 0000). When symptoms were adjusted for age, gender and known exposure to SARS-CoV-2, we found that fever (OR 2.66; 95% CI 1.89–3.81), pharyngitis (OR 1.35; 95% CI 1.01–1.80), headache (OR 1.81; 95% CI 1.09–2.90), and anosmia/ageusia (OR 6.47; 95% CI 1.61–22.47) were the most significant predictors.Conclusion: Although high numbers of testing were maintained throughout the year, the positive test results were significantly higher during the Phase III. Age (<1 year, 12–17 years), a history of exposure to SARS-CoV-2 and some symptoms, such as fever, pharyngitis, headache and anosmia/ageusia could aid in targeting groups for screening for COVID-19 in children.
Highlights
The global spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection caused more than 110 million cases with over 2.4 million deaths worldwide between late December 2019 and February 2021 [1]
Children were screened for SARS-CoV-2 according to the recommendations of the Ministry of Health, which changed several times according to the epidemiological situation of COVID-19 in the country
During the first year of the COVID-19 pandemic in Lithuania, 9,238 children were screened for SARS-CoV-2 at the pediatric emergency department in Vilnius
Summary
The global spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection caused more than 110 million cases with over 2.4 million deaths worldwide between late December 2019 and February 2021 [1]. During this approximate one-year period almost two hundred thousand (200,000) cases of the coronavirus disease 2019 (COVID-19) were diagnosed in Lithuania, including over fourteen thousand (14,000) children. Pediatric Inflammatory Multisystem Syndrome (PIMS), following COVID-19, must be differentiated from various bacterial and viral infections as well as Kawasaki disease [8] This lack of specificity of signs or symptoms makes screening for identification of SARS-CoV-2 infection in children challenging
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