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BIBTEX RIS

Differences in children and adolescents with SARS-CoV-2 infection: a cohort study in a Brazilian tertiary referral hospital

2021; Elsevier BV; Volume: 76; Linguagem: Inglês

10.6061/clinics/2021/e3488

1980-5322

Heloísa Helena de Sousa Marques, Maria Fernanda Bádue Pereira, Angélica Carreira dos Santos, Thais T. Fink, Camila Sanson Yoshino de Paula, Nadia Litvinov, Cláudio Schvartsman, Artur Figueiredo Delgado, Maria Augusta Bento Cicaroni Gibelli, Werther Brunow de Carvalho, Vicente Odone Filho, Uenis Tannuri, Magda Carneiro‐Sampaio, Sandra Josefina Ferraz Ellero Grisi, Alberto José da Silva Duarte, Leila Antonângelo, Rossana Pulcineli Vieira Francisco, Thelma Suely Okay, Linamara Rizzo Battistella, Carlos Roberto Ribeiro de Carvalho, Alexandra Brentani, Clóvis A. Silva, Adriana Pasmanik Eisencraft, Alfio Rossi, Alice Lima Fante, Aline Pivetta Corá, Amelia Gorete A. de Costa Reis, Ana Paula Scoleze Ferrer, Anarella Penha Meirelles de Andrade, Andréia Watanabe, Angelina Maria Freire Gonçalves, Aurora Rosaria Pagliara Waetge, Camila Altenfelder Silva, Carina Ceneviva, Carolina dos Santos Lázari, Deipara Monteiro Abellan, Emilly Henrique dos Santos, Éster Cerdeira Sabino, Fabíola Roberta Marim Bianchini, Flávio Ferraz de Paes Alcantara, Gabriel Frizzo Ramos, Gabriela Nunes Leal, Isadora Souza Rodriguez, João Renato Rebello Pinho, Jorge David Avaizoglou Carneiro, José Albino da Paz, Juliana Carvalho Ferreira, Juliana Ferreira Ferranti, Juliana Caires de Oliveira Achili Ferreira, Juliana Valéria de Souza Framil, Katia Regina da Silva, Kelly Aparecida Kanunfre, Karina Lucio de Medeiros Bastos, Karine Vusberg Galleti, Lílian Maria Cristófani, Lisa Suzuki, Lúcia Maria Arruda Campos, Maria Beatriz de Moliterno Perondi, Maria de Fátima Rodrigues Diniz, Maria Fernanda Mota Fonseca, Mariana Nutti de Almeida Cordon, Mariana Pissolato, Marina Silva Peres, Marlene Pereira Garanito, Marta Imamura, Mayra de Barros Dorna, Michele Luglio, Mussya Cisotto Rocha, Nádia Emi Aikawa, Natália Viu Degaspare, Neusa Keico Sakita, Nicole Lee Udsen, Paula Gobi Scudeller, Paula Vieira de Vincenzi Gaiolla, Rafael da Silva Giannasi Severini, Regina Maria Rodrigues, Ricardo Katsuya Toma, Ricardo Iunis Citrangulo de Paula, Patrícia Palmeira, Silvana Forsait, Sylvia Costa Lima Farhat, Tânia Miyuki Shimoda Sakano, Vera Hermina Kalika Koch, Vilson Cobello,

Respiratory viral infections research

To compare demographic/clinical/laboratory/treatments and outcomes among children and adolescents with laboratory-confirmed coronavirus disease 2019 (COVID-19).This was a cross-sectional study that included patients diagnosed with pediatric COVID-19 (aged <18 years) between April 11, 2020 and April 22, 2021. During this period, 102/5,951 (1.7%) of all admissions occurred in neonates, children, and adolescents. Furthermore, 3,962 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection samples were processed in patients aged <18 years, and laboratory-confirmed COVID-19 occurred in 155 (4%) inpatients and outpatients. Six/155 pediatric patients were excluded from the study. Therefore, the final group included 149 children and adolescents (n=97 inpatients and 52 outpatients) with positive SARS-CoV-2 results.The frequencies of sore throat, anosmia, dysgeusia, headache, myalgia, nausea, lymphopenia, pre-existing chronic conditions, immunosuppressive conditions, and autoimmune diseases were significantly reduced in children and adolescents (p<0.05). Likewise, the frequencies of enoxaparin use (p=0.037), current immunosuppressant use (p=0.008), vasoactive agents (p=0.045), arterial hypotension (p<0.001), and shock (p=0.024) were significantly lower in children than in adolescents. Logistic regression analysis showed that adolescents with laboratory-confirmed COVID-19 had increased odds ratios (ORs) for sore throat (OR 13.054; 95% confidence interval [CI] 2.750-61.977; p=0.001), nausea (OR 8.875; 95% CI 1.660-47.446; p=0.011), and lymphopenia (OR 3.575; 95% CI 1.355-9.430; p=0.010), but also had less hospitalizations (OR 0.355; 95% CI 0.138-0.916; p=0.032). The additional logistic regression analysis on patients with preexisting chronic conditions (n=108) showed that death as an outcome was significantly associated with pediatric severe acute respiratory syndrome (SARS) (OR 22.300; 95% CI 2.341-212.421; p=0.007) and multisystem inflammatory syndrome in children (MIS-C) (OR 11.261; 95% CI 1.189-106. 581; p=0.035).Half of the laboratory-confirmed COVID-19 cases occurred in adolescents. Individuals belonging to this age group had an acute systemic involvement of SARS-CoV-2 infection. Pediatric SARS and MIS-C were the most important factors associated with the mortality rate in pediatric chronic conditions with COVID-19.