Clinical characteristics of children with COVID-19 admitted in a tertiary referral center in Perú
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Abstract
Introduction
COVID-19 pandemic represents a big impact on children’s health, this study describes the behavior of the disease in hospitalized pediatric patients in the Instituto Nacional de Salud del Niño San Borja (INSN-SB).
Methods
Retrospective study of patients with confirmed COVID-19 diagnostic between March and July 2020. Demographic, clinic, laboratory, radiology and treatment data were collected and for the analysis descriptive statistics were included.
Results
From a total of 91 patients. 36.3% (33) were female. The age group who was affected the most were school children with a median age of 4 years old (IQR 1-8). Patients who came from Lima represented 61.5%. Previous contact was determined in 30.8% of the cases. PCR results for SARS CoV-2 were positive in 50.6% of the cases and 49.4% in the quick tests. Comorbidity was present in 53.8% of the cases. Most frequent symptoms were fever (39.6%), general discomfort (23.1%), cough (19.8%) and shortness of breath (14.3%). Presence of MIS-C was confirmed in 6 patients. Use of antibiotics represented 76.9% of the cases. The most frequent radiology pattern was bilateral interstitial (57.7%). Comorbidities were present in 68.2% (15/22) of patients in PICU. From a total of 9 deceased patients, 6 were admitted in PICU and 8 presented associated comorbidities.
Conclusions
COVID-19 in children displays mild and moderate clinical manifestations. A great proportion of patients exhibited comorbidities, especially PICU patients and the ones that died.
What is known about the subject
In pediatric patients, the prevalence and severity of COVID-19 are usually low, however, in the presence of MIS-C, greater severity and probability of admission to the PICU is observed.
What this study adds
This study describes the results of complex pediatric patients and the associated comorbidity in LMIC setting that showed greater severity and admission to the ICU.
Microbiological isolates in cultures were low, therefore the initiation of empirical antibiotic therapy is not justified in most cases.
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SciScore for 10.1101/2020.09.18.20186866: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement IACUC: Clinical evaluation was managed by the attending pediatrician according to the institutional care guidelines.
IRB: Ethical approval: The present study was approved by the Institutional Review Board of the INSN-SB with project code PI-429.Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
Software and Algorithms Sentences Resources The statistical analyses were performed using the STATA version 16 program (StataCorp. 2019. Stata Statistical Software: Release 16. STATAsuggested: (Stata, RRID:SCR_012763)StataCorpsuggested: (Stata, RRID:SCR_012763)Results from OddPub: We did not …
SciScore for 10.1101/2020.09.18.20186866: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement IACUC: Clinical evaluation was managed by the attending pediatrician according to the institutional care guidelines.
IRB: Ethical approval: The present study was approved by the Institutional Review Board of the INSN-SB with project code PI-429.Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
Software and Algorithms Sentences Resources The statistical analyses were performed using the STATA version 16 program (StataCorp. 2019. Stata Statistical Software: Release 16. STATAsuggested: (Stata, RRID:SCR_012763)StataCorpsuggested: (Stata, RRID:SCR_012763)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:Our study has some limitations. One limitation was the absence of complete baseline tests proposed for COVID-19, partly explained by the diversity of clinical criteria for the request. Finally, not all patients diagnosed with MIS-C had undergone a serological test for SARS-CoV 2, and only patients with a positive confirmatory test were included in the present study. In conclusion, SARS CoV-2 infection in children presents mild and moderate clinical manifestations, with the presence of comorbidities being an important factor for hospitalization, and high mortality upon admission to the pediatric ICU. In addition, patients presenting diagnostic criteria of MIS-C showed a favorable evolution.
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.
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