COVID-19 Infection In Children Research Articles

Comparison of clinical characteristics of COVID-19 between children and adult

The aim of the study was to evaluate and compare the clinical characteristics of COVID-19 infection in children and adult. This observational cross-sectional study was conducted in multiple corona dedicated hospitals, situated in Dhaka, Bangladesh from April 2020 to January 2021. Data of COVID -19 positive hospitalized patients were collected in a pre-tested question- naire during hospital stay with proper protective measures. Clinical characteristics of the COVID-19 positive hospitalized children and adult patients were evaluated. Approval was taken from institutional review board of respective institutes. Statistical analyses of the results were obtained by using SPSS-25. In this study the male-to-female ratio was 1:1.6 and 2.8:1 in child and adult patients respectively. More than three quarter (75.4%) of subjects had family members affected before the illness in the child group and more than half (50.9%) cases in the adult group. History of contact or exposure with any symptomatic case was present in 61.4% cases in the adult group but only 14% in the child group. The mean duration of illness was less (9.1}8.6 days) in the child group than in the adult group (14.8}9.5 days). The difference was statistically significant (p<0.05) between the two groups. The most common symptoms in the child group were fever (71.9%), cough (77.2%) and runny nose (52.6%) whereas in the adult group most common symptoms were fatigue, excessive tiredness, or lethargy (80.7%), cough (77.2%) and anosmia (70.3%). There were statistically significant (p<0.05) differences in symp- toms between the two groups. Raised body temperature was (>1010 F) was found in the majori- ty (86.0%) subjects' in the child group than in the adult group where it was 50.9%. The mean SPo2 without oxygen was 96.8}1.2% in the child group and 92.8}5.7% in the adult group. Ten (17.5%) subjects had a symptom-free total illness in the child group and 3(5.3%) in the adult group. The difference in temperature, SPo2 without oxygen, consciousness, and symptom-free total illness were statistically significant (p<0.05) between the two groups. In adult group 94.7% patient required hospital admission according to guideline, but in child group only 40.3% actually needed hospitalization, rest of the children got admitted along with family member or due to other diseases. Fever, cough and runny nose were more frequent symptoms in children however, fever, fatigue, excessive tiredness, anorexia, nausea, vomiting, anosmia, diarrhoea and body ache were more common in adult patients. These differences were statistically signifi- cant. In comparison to COVID-19 infected adult cases, infected children had higher oxygen saturation (without additional oxygen) by pulse oximeter. BSMMU J 2022; 15(1): 35-42

COVID-19 and Dysphagia in Children: A Review.

Coronavirus (COVID-19) infection usually causes mild symptoms in children. However, serious complications may occur as a result of both acute infection or in association with the multisystem inflammatory syndrome (MIS-C). Dysphagia may develop as a sequela of COVID-19. We review the limited data on dysphagia associated with COVID-19 infection in children. Children can develop acute respiratory distress syndrome (ARDS) due to severe COVID-19 infection leading to endotracheal intubation and mechanical ventilation. These children can possibly develop post-intubation dysphagia. Screening for the presence of dysphagia, in an effort to minimize aspiration, in children with active COVID-19 infection must be done carefully to reduce the risk of transmission of the virus. Those children diagnosed with persistent dysphagia after COVID-19 infection has resolved will need further evaluation and management by pediatric subspecialists experienced in treating children with this condition. We recommend, this evaluation and treatment be done by a pediatric aerodigestive team.

Particularities of respiratory manifestations of COVID-19 infection in children

Introduction. COVID-19 infection is common in the pediatric population, presenting a variety of respiratory manifestations and complications.
 Material and methods. The study included 64 children from the COVID-19 section, IMSP IMC, with a mean age of 2,04±0,4 years (variations 1 day-17 years), divided into 5 age groups: 0-1 month, 1-12 months, 1-3 years, 3-7 years, >7 years. The methodology of the study is expected to assess the significance of clinical manifestations in the COVID-19 infection episode.
 Results. With 21 cases, this study discovered a higher frequency of the disease in infants. The nosological expression of the infection was dominated by pneumonia and unique cases of infection in four children with upper respiratory infections. Every evolution was presented by 11 children, the moderate form being the dominant one. An almost constant sign in the children in the study was a febrile syndrome, which in 31 cases was > 38,0oC. Every second child showed catarrhal respiratory signs, cough, and cyanosis in 66,1% of the children, chest circulation in 32,1% of the cases, wheezing in 6. COVID-19 infection in hospitalized children resulted in respiratory complications in 81,3% of cases and toxic infections – 23,4%.
 Conclusions. COVID-19 infection in hospitalized children occurs mainly with pneumonia and only in unique cases of nasopharyngitis, with the constant presence of catarrhal respiratory signs, dyspnea, and fever, but also a susceptibility to develop severe forms and complications.

Pediatric COVID-19 Vestibular Neuritis.

Introduction With the number of COVID cases in children increasing, the variation in presentation seen in pediatric patients compared with adults has become more apparent. The typical adult presentation of COVID-19 infection, generally associated with acute respiratory symptoms, seems to differ from that seen in children, many of whom are initially asymptomatic. Case Presentation In this case, a previously healthy female adolescent presented with insidious onset nausea and weight loss, but a broad gastrointestinal workup was unrevealing. The delayed development of vertiginous symptoms later led to the identification of prior, asymptomatic COVID-19 infection as the suspected etiology of her presenting gastrointestinal symptoms. Conclusion This case highlights the notion that COVID-19 infection in children may have a delayed manifestation in the absence of acute respiratory systems. Given this, COVID should be included in the differential diagnosis early on in an effort to limit the risks and costs associated with broad, unrevealing workups.

Clinical Characteristics, Laboratory Findings, Management, and Outcome of Severe Coronavirus Disease 2019 in Children at a Tertiary Care Center in Riyadh, Saudi Arabia: A Retrospective Study.

BackgroundNumerous studies worldwide have reported COVID-19 in children; however, the clinical symptoms and consequences of COVID-19 in children have only been reported in a few studies in Saudi and gulf region. Therefore, we aimed to investigate the clinical features and outcomes of COVID-19 infection in children and the therapeutic interventions used.MethodsThis retrospective cohort study included 96 patients with confirmed severe acute respiratory syndrome coronavirus 2 infection aged ≤14 years who were admitted to a tertiary governmental care hospital in Riyadh, Saudi Arabia between March 2020 and November 2020. Data on children with COVID-19, including demographics, comorbidities, symptoms, imaging and laboratory results, therapies, and clinical outcomes, were analyzed.ResultsOf 96 children admitted with a confirmed diagnosis of COVID-19, 63.8% were aged ≤ 3 years, 52.1% were male, 56.2% had an unknown source of infection, and 51% had no comorbidities. Most cases had severe infection (71.88%) as they required oxygen, 10.42% of whom were critical. The most common symptoms were respiratory-related (98%), and the common physical sign was fever (49%). High D-dimer (90.7%) and C-reactive protein (72.09%) levels were found in most cases. Oxygen (71.88%) was the most commonly used treatment. Most patients were discharged home and fully recovered (97.92%). We reported two deaths (2.08%).ConclusionsOur findings showed that the majority of the admitted children with COVID-19 were ≤3 years of age (52.1%) and infected with an unknown source (56.2%). Moreover, the majority of the cases had severe COVID-19 infection as they required oxygen (71.88%), although they had favorable outcomes. However, some cases were critical and resulted in death. Future studies will be crucial to better understand the disease spectrum and potential therapeutic options for COVID-19 in children.

Analysis of clinicolaboratory profile and outcome in COVID-19 positive pediatric patients

COVID-19 infection in children has important public health, social, and economic implications, and even though children may have considerably milder symptoms than individuals >18 years of age, those infected seem to have the same levels of circulating virus in their body and may be as infectious as adults. The objective is to study clincolaboratory profile and outcome in COVID-19 positive pediatrics patients. This hospital based prospective observational study was conducted in the department of Pediatrics , Government Medical College , Haldwani Uttarakhand. COVID 19 Positive Pediatric patient from birth to 18 years from September 2020 to September 2021 were enrolled in the study. Referred patients were 1 in moderate, 3 in severe and 1 in MIS-C group. Expired patients mostly belong to severe category. 1 patient expired due to celphos poisoning and was diagnosed as covid-19 on routine sampling. In conclusion these laboratory findings and clinical features should raise strong suspicion of COVID-19 infection and severity and could be used as a useful predictor for planning treatment in children with moderate to severe illness.

176 COVID-19 infection risk in patients with non-syndromic orofacial clefts during pandemic in Puerto Rico

OBJECTIVES/GOALS: Patients with nsCL/P are prone to infections due to their open like wound cleft and immune system susceptibility. COVID-19 affected nsCL/P patients access to care and treatment delays. This study will determine COVID-19 infection risk between children with nsCL/P compared to those unaffected. METHODS/STUDY POPULATION: Retrospective cohort of children 5 years old and under with nsCL/P (exposed group) and children without nsCL/P (unaffected group); matched by age and gender. Participants will be selected from ongoing case-control study (n=500), School of Dental Medicine, and Pediatric University Hospital. Power analysis will calculate minimum sample size (power=0.80 alpha=0.05). Exclusion criteria: syndromic clefts, patients without diagnosis information and with history of co-morbidity. Other bacterial and viral infections present at the time of COVID-19 diagnosis, sex, age, geographic location, COVID-19 vaccination status and others will be considered as possible cofounders. Descriptive statistics, Chi-square, Odds Ratios at 95% confidence intervals and multiple logistic regression will be estimated. RESULTS/ANTICIPATED RESULTS: We hypothesize that we will identify an increased risk of COVID-19 infection in children with nsCL/P than in those unaffected or children without nsCL/P. Children with nsCL/P will also have an increased risk of symptoms and complications of COVID-19 infection than those unaffected. DISCUSSION/SIGNIFICANCE: Knowing the increased risk of COVID-19 infection in children with nsCL/P will aid to prioritize treatment. If a higher risk of COVID-19 infection is found, it will generate a need to modify elective surgery status to semi-elective; minimizing delayed treatments, unnecessary hospitalizations, complications and increased cost of treatment.

The COVID-19 pandemic in a paediatric population: A health care perspective.

SARS-CoV-2, a member of the coronaviridae family, has caused a deadly pandemic known as the Coronavirus disease 2019, (COVID-19). Paediatric patients get infected by direct exposures or airborne droplets, mostly from households with a cluster of infection or a history of exposure to outbreak areas. COVID-19 is contagious in children (those under the age of 18), with an average incubation time of around 6.5 days. Paediatric patients account for less than 5% of total COVID-19 patients worldwide, and hence studies involving such subjects are unlikely in the near future. As a result, there are inadequate data about COVID-19 infection in children. Therefore, we present this systematic review to understand the epidemiology, clinical features, diagnostic outcomes, and available options for the management of COVID-19 in paediatric populations in order to advise clinical and public health policy choices for safety of children worldwide.

COVID-19 Infection in Children: Diagnosis and Management.

Purpose of ReviewDue to the rapidly changing landscape of COVID-19, the purpose of this review is to provide a concise and updated summary of pediatric COVID-19 diagnosis and management.Recent FindingsThe relative proportion of pediatric cases have significantly increased following the emergence of the Omicron variant (from < 2% in the early pandemic to 25% from 1/27 to 2/3/22). While children present with milder symptoms than adults, severe disease can still occur, particularly in children with comorbidities. There is a relative paucity of pediatric data in the management of COVID-19 and the majority of recommendations remain based on adult data.SummaryFever and cough remain the most common clinical presentations, although atypical presentations such as “COVID toes,” anosmia, and croup may be present. Children are at risk for post-infectious complications such as MIS-C and long COVID. Nucleic acid amplification tests through respiratory PCR remain the mainstay of diagnosis. The mainstay of management remains supportive care and prevention through vaccination is highly recommended. In patients at increased risk of progression, interventions such as monoclonal antibody therapy, PO Paxlovid, or IV remdesivir × 3 days should be considered. In patients with severe disease, the use of remdesivir, dexamethasone, and immunomodulatory agents (tocilizumab, baricitinib) is recommended. Children can be at risk for thrombosis from COVID-19 and anticoagulation is recommended in children with markedly elevated D-dimer levels or superimposed clinical risk factors for hospital associated venous thromboembolism.

Characteristics of Nutrients and Microbiological Dadih Puding as Food Supplementation for Children with Sars-Cov-2 Infection

The Severe Acute Respiratory Syndrome Corona Virus-2 (SARS-CoV-2) that cause COVID-19 global pandemic is a devastating disease causing thousands of victims every day. Therefore, there must be a certain effort to reduce the risk of the disease progress, including improvement of individual immune system like the probiotic supplementation. Meanwhile, dadih is a dairy product obtained from fermented buffalo milk contains various nutrients for human body, especially probiotics that beneficial for reducing the risk of COVID-19 infection in children. The aim of the study was to determine the nutritional and microbiological content of dadih pudding as additional supplementation in children confirmed positive for COVID-19. The study design was True Experiment using Completely Randomized Design (CRD). It consisted of four formulas. They were F0 as the standard formula, then F1, F2, and F3 as the treatment formula by adding dadih 50, 60, 70, and 80 grams, respectively. This study was initiated with the analysis of biochemical nutritional value at a laboratory in Padang Research Center and Industry Standardization. Besides, it also determined the number of total Acid Lactic Bacterial quantification which was analyzed at microbiology laboratory, Agricultured Technology Faculty, Universitas Andalas. Nutrients and lactic acid bacteria in dadih pudding are potential as food supplementation, especially for children with COVID-19 infection. It is strongly recommended to give probiotic dadih to children in order to counter oxidative stress and inflammation, and the setting of COVID-19.Â

Outcomes of COVID-19 in children with cancer – Report from the Indian Pediatric Oncology Group (InPOG) COVID-19 registry in India

IntroductionThe clinical outcomes of COVID-19 infection in children with cancer have been variable worldwide. Therefore, we aimed to collect data from all regions in India through a national collaborative study and identify factors that cause mortality directly related to COVID-19 infection. MethodsData was collected prospectively on children across India on cancer therapy and diagnosed with COVID-19 infections from 47 centers from April 2020 to October 2021. Information was recorded on the demographics, the number of children that required intervention, and the outcome of the infection. In addition, we analyzed the impact of the delta variant in 2021. ResultsA total of 659 children were studied, of whom 64% were male and 36% were female. The data from the eastern region was sparse, and this was a collection bias. COVID-19 infection was predominantly seen in children less than five years. The delta variant had a higher impact in the southern region, and this was statistically significant. Of the 659 children, 30 children died (4.5%), however only 7 of the deaths were directly attributed to COVID-19 infection (1%). ConclusionThe study reports the largest nationally representative cohort of children with cancer and COVID-19 to date in India. We identified demographic and clinical factors associated with increased all-cause mortality in patients with cancer. Complete characterization of the cohort has provided further insights into the effects of COVID-19 on cancer outcomes. The low mortality allows us to recommend that specific cancer treatments be continued without delays in therapy.

Dermatological Manifestations of COVID-19 in Children

ContextThe clinical picture of pediatric severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) infection differs from adults as do the cutaneous manifestations. In this review, we summarize the varied morphological manifestations of SARS-CoV-2 infection in the pediatric population.Evidence acquisitionA comprehensive literature search was conducted (23 September, 2021) across multiple databases (PubMed, EMBASE, MEDLINE and Cochrane) with the relevant keywords. An additional filter of age group between 0–18 years was kept in each of the searches.ResultsChilblains constitute the most common cutaneous manifestation of pediatric coronavirus disease (COVID-19). Other commonly reported manifestations include maculopapular rash, urticaria, erythema multiforme, and papulovesicular eruptions. Majority of children with these manifestations are asymptomatic, highlighting the need to clinically suspect and appropriately manage such patients. A subset of pediatric patients develop severe multisystem involvement termed as multi-system inflammatory syndrome in children (MIS-C) that has varied mucocutaneous manifestations.ConclusionA wide variety of dermatological manifestation of SARS-CoV-2 infection is reported, and both the pediatrician and dermatologist need to be aware of the same to suspect and diagnose COVID-19 infection in children.Electronic Supplementary MaterialSupplementary material is available in the online version of this article at 10.1007/s13312-022-2521-6.

COVID-19 pandemic and kidney disease in children: literature review and own regional observations

Introduction. Currently, the coronavirus infection pandemic caused by the SARS-CoV-2 virus continues around the world. Research data from domestic and foreign authors indicate that the kidneys are a target organ for a new infection, lesions vary from proteinuria and hematuria to acute kidney injury.Aim of the study – to determine the frequency and nature of kidney damage in children with confirmed coronavirus infection.Materials and methods. A retrospective and prospective analysis of cases of confirmed COVID-19 infection in children (n = 441) admitted to the Samara Regional Children’s Infectious Diseases Hospital from March 2020 to July 2021 was carried out. SARSCoV-2 RNA was detected in all patients by a one-step reverse transcription reaction combined with a polymerase chain reaction. The changes in the kidneys that occurred in 57 children were studied. The research results were processed using the Statistica 7.0 software (StatSoft, USA).Results. The involvement of the kidneys in the infectious process was detected in every 8 children with COVID-19 (12.9%), more often in the form of isolated urinary syndrome, the detection rate of which correlated with the severity of the course of coronavirus infection: in severe cases, proteinuria was detected in 31.6% of patients, hematuria – in 21%, acute kidney injury – in 10.5%, diabetic nephropathy – in 5.3%. Kidney damage was combined with damage to the respiratory and gastrointestinal tract, characterized by rapid recovery of urine output and azotemia parameters without special renal therapy. A clinical case of the onset of nephrotic syndrome that developed 2 weeks after suffering a coronavirus infection is described.Conclusions. Children with COVID-19 require kidney function monitoring for early detection and correction in case of impairment. Patients with isolated urinary syndrome in the acute period require long-term observation in order to detect latent renal pathology.

Comparison of COVID-19 Infection in Children During the First and Second Wave.

Concerns have been raised in the media that ‘the third wave’ will severely affect children. Here, an experience of SARS-CoV-2 infection in children is reported. Of the 8,626 SARS-CoV-2 RT-PCR tests performed in children (0–17 y) from March 2020 to July 2021 at the authors' institute, 1470 (17%) were positive, [711/4821 (14.7%) during the first wave (July 2020 to January 2021), and 759/3583 (21.2%) during the second wave (February 2021 to July 2021)]. The children in both waves were similar in presentation (74.1% mildly symptomatic versus 80.2% mildly symptomatic; rest asymptomatic). None of them had COVID pneumonia. Five children died (0.3%), all of a serious primary non-COVID disease. Seventy-three cases of MIS-C during August 2020 to July 2021, with low mortality (2.7%) were also identified. The similarity in COVID-19 infection in children between the first and the second waves seems to suggest that the likelihood of the ‘third wave’ hitting children hard is low.

COVID-19 Infection in Children and Infants: Current Status on Therapies and Vaccines.

Since the beginning in December 2019, the SARS-CoV-2 outbreak appeared to affect mostly the adult population, sparing the vast majority of children who only showed mild symptoms. The purpose of this investigation is to assess the status on the mechanisms that give children and infants this variation in epidemiology compared to the adult population and its impact on therapies and vaccines that are aimed towards them. A literature review, including in vitro studies, reviews, published guidelines and clinical trials was performed. Clinical trials concerned topics that allowed a descriptive synthesis to be produced. Four underlying mechanisms were found that may play a key role in providing COVID-19 protection in babies. No guidelines are available yet for therapy due to insufficient data; support therapy remains the most used. Only two vaccines are approved by the World Health Organization to be used in children from 12 years of age, and there are currently no efficacy or safety data for children below the age of 12 years. The COVID-19 clinical frame infection is milder in children and adolescents. This section of the population can act as vectors and reservoirs and play a key role in the transmission of the infection; therefore, vaccines are paramount. More evidence is required to guide safely the vaccination campaign.

Racial, ethnic and socioeconomic disparities in SARS-CoV-2 infection amongst children.

COVID-19 disproportionately affects racial and ethnic minority populations, but comparatively few epidemiologic studies have been performed on children as compared to adults. To characterise factors associated with SARS-CoV-2 infections amongst children from Chicago, Illinois, USA. A test-negative case-control study of children tested for SARS-CoV-2 (0-18years) at three medical centres of the Rush University System for Health between 12March and 7 December 2020 was conducted. Of 8462 children, 1,302 tested positive by real-time PCR or rapid (NAAT) testing. Infection with SARS-CoV-2 was analysed as the outcome variable; effects of predictors were assessed by logistic regression analysis. A Paediatric Risk Score Index with a concordance index of 72% of accuracy was created to predict SARS-CoV-2 infection. The median age of cases was 13years. On multivariable analysis, factors associated with SARS-CoV-2 infection were being Hispanic/Latinx (odds ratio [OR] 2.45, 95% CI 1.99, 3.03); Black/African-American (OR 1.31, 95% CI 1.03, 1.66); overweight/obese (OR 1.27, 95% CI 1.02, 1.58); older age, 10-14years (OR 1.70, 95% CI 1.39, 2.08), 15-18years (OR 2.06, 95% CI 1.71, 2.47); from households with income <$50,000 (OR 1.36, 95% CI 1.17, 1.60); or residing in predominantly minority neighbourhoods (OR 1.45, 95% CI 1.17, 1.80). Infections were higher during the second "fall" wave (5 October 2020 onward) compared with the first "spring" wave (OR 2.30, 95% CI 2.01, 2.63). Within Chicago, racial/ethnic minority neighbourhoods had striking positivity rates, as high as 39% in majority Hispanic/Latinx West Lawn neighbourhood. In suburban Chicago, highest positivity rates (20%-28%) were in zip codes within Hispanic/Latinx communities. Infection with SARS-CoV-2 is more likely amongst children of Hispanic/Latinx ethnicity, Black/African-American race, aged 10-18years, who are overweight/obese, from lower income households, and from minority neighbourhoods. Future studies should focus on the prevention of COVID-19 infection in children of highest risk.

Per oral endoscopic myotomy (POEM) in a COVID-19 patient

Background: SARS-COV2 pandemic had a great impact on our life. Changes had been done to accommodate the current situation. Infection control measures in the endoscopy units had entirely changed. Also, prioritizations of different procedures had changed especially in the lockdown time. Peroral Endoscopic Myotomy (POEM) is considered a low priority endoscopic procedure. Case presentation: We report a 12-year-old child complaining of dysphagia and weight loss who was diagnosed as Type II achalasia. She underwent POEM. According to our Egyptian protocol; COVID-19 was excluded pre-procedural. After POEM, immediately post-procedural chest X-ray was done as usual, and it showed a shadow in the right lung base. Accordingly, HRCT of the chest was done and it showed bilateral asymmetrical patchy areas of ground-glass opacities in the posterior segments of both lower lung lobes (CO-RADS 4). PCR for COVID-19 was positive. Conclusion: We report a very unique COVID-19 case that raises many challengeable issues and shows a useful message about the risk of silent COVID-19 infection in children during the endoscopy. Keywords: achalasia; Poem; 3rd Space endoscopy; COVID-19.

COVID-19 Induced Secondary Hemophagocytic Lymphohsitocytosis: A Case Series

Hemophagocytic lymphohistiocytosis (HLH) is a lethal and rapidly progressive hyper-inflammatory state that lead to development of fulminant multi-organ failure. HLH is divided into primary or familial HLH (FHL) and secondary HLH (sHLH). It can be triggered by a variety of agent that affect the immune system, infection is a common triggering agent. Recently, Coronavirus disease (COVID-19) has spread all over the world and was declared a pandemic. COVID-19 infection in children can induce serious hyper-inflammatory syndrome termed multisystem inflammatory syndrome (MIS-C). Clinically MIS-C patients present with features that resemble Kawasaki’s disease or toxic shock syndrome and the clinical and laboratory manifestations may also similar to that of secondary hemophagocytic lymphohistiocytosis, or macrophage activation syndrome (MAS).&#x0D; The reported HLH syndrome in children with COVID-19 increased during 2020-2021. In this case series we present two pediatric patient diagnosed as sHLH post- COVID-19 infection with a brief literature review of similar pediatric patients.

Urticarial eruption in COVID-19-positive children: A report of two cases

Recent literature has reported a variety of dermatological manifestations in children and adults associated with COVID-19. Herein, we report urticarial eruptions in two COVID-19-positive children. In the first case, urticaria with angioedema preceded a febrile episode and only partially responded to conventional doses of antihistamines. In the second case, urticaria followed the appearance of fever and upper respiratory symptoms. Both cases recovered completely within two weeks of diagnosis. These cases demonstrate that urticaria and angioedema, precedent or following a febrile illness, with or without respiratory symptoms, may be a presenting symptom of COVID-19 infection in children. A high index of suspicion in such cases helps the early administration of treatment and isolation of the patients to limit the spread of the virus.

Clinical characteristics and outcome of pediatric cases managed during the first wave of the Covid-19 pandemic at Ahmadu Bello University Teaching Hospital, Zaria

Context: Over 161 million cases of COVID-19 have so far been confirmed globally with over 3.3 million deaths. An understanding of the local epidemiological characteristics in the pediatric population is necessary to enable proper planning of mitigation strategies. Aim: To describe the clinical characteristics and outcomes of pediatric patients with COVID-19. Setting and Design: We conducted a retrospective study on cases of COVID-19 diagnosed by the real-time polymerase chain reaction of nasopharyngeal samples and oropharyngeal swabs managed during the first wave of the pandemic at the Ahmadu Bello University Teaching Hospital. The severity of illness was graded based on clinical features as classified by the World Health Organization. Statistical Analysis was carried out using IBM SPSS Version 23 (California, USA). Results: Forty-six children met the above criteria. The median age was 7 yrs (IQR = 3.75-12). There were more females than males with Covid-19 infection (M:F = 1:1.55). A third (32.6%) of children were asymptomatic while half (50%) had only mild symptoms. Although school-aged children aged 6-11 years were the most infected (30.4%), more severe disease was seen in infants (25%) and those with co-morbidities. Nasal discharge, cough, and fever were the most common presentation occurring in 34.8%, 32.6%, and 26.1%, respectively. The case fatality rate was 6.5%, all occurring amongst those with comorbidities. Conclusion: COVID-19 infection in children is largely mild or asymptomatic. Symptoms when present are indistinguishable from symptoms of other common viruses causing upper respiratory tract infections. Severe disease and mortality were observed among infants and children with co-morbidities.