Clinical and epidemiological characteristics of children with SARS-CoV-2 infection: case series in Sinaloa

  1. Giordano Pérez Gaxiola
  2. Rosalino Flores Rocha
  3. Julio César Valadez Vidarte
  4. Melissa Hernández Alcaraz
  5. Gilberto Herrera Mendoza
  6. Miguel Alejandro Del Real Lugo

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Abstract

Background

The SARS-CoV-2 virus may affect both adults and children. Although the disease, named COVID-19, has a lower prevalence in infancy and has been described as mild, the clinical characteristics may vary and there is a possibility of complications.

Objectives

To describe the clinical and epidemiological characteristics of pediatric cases confirmed in the state of Sinaloa, Mexico, during the first three months of the pandemic, and of children admitted with COVID-19 to a secondary hospital.

Methods

This case series includes all patients with SARS-CoV-2 infection confirmed by PCR testing, identified in the state epidemiological surveillance system between March 1 and May 31, 2020. Confirmed patients admitted to the Sinaloa Pediatric Hospital (HPS) during the same dates are also described.

Results

Fifty one children with SARS-CoV-2 were included, 10 of the admitted to HPS. The median age was 10 years. The more frequent symptoms were fever (78%), cough (67%) and headache (57%). Most cases were mild or asymptomatic. Three patients with comorbidities died. Only 4 of 10 patients identified in HPS had been admitted with the diagnosis of possible COVID-19.

Conclusions

SARS-CoV-2 infection in children was mostly mild or asymptomatic, but with a wide range of clinical presentations.

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  1. ScreenIT

    SciScore for 10.1101/2020.07.07.20146332: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Analysis was done using Microsoft Excel version 16.37.
    Microsoft Excel
    suggested: (Microsoft Excel, RRID:SCR_016137)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    This study has weaknesses. First, we could only contact 70% of patients in the two week follow up despite calling by phone two times and sending messages using WhatsApp. Second, the reporting of symptoms at the moment of diagnosis was subjective, although since it is an acute disease recall bias is less likely. Third, data from laboratory and imaging tests was limited to patients in HPS and were ordered by attending physicians. The findings could have varied in children that were not hospitalized or in the few that were admitted to other institutions. Although the majority of patients in this series had no symptoms, or mild or moderate disease, the possibility of complications exist, mainly in children with comorbidities (11,17,18). The three patients that died had concomitant pathologies. The proportion of severe or critical disease should remain low in the next months of the pandemic but considering that cases are still increasing this may represent a logistical challenge for pediatric and general hospitals. The two positive neonates also highlight that, although infrequent, neonatal infection may develop and should be considered in hospital with maternal wards. Fortunately, though, the burden of COVID-19 in pediatric wards should be less than what the influenza virus annually causes (16).

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2020.07.07.20146332v1 on medRxiv