Respiratory and non-respiratory manifestations in children admitted with COVID 19 in Rio de Janeiro city, Brazil

  1. AR Araujo da Silva
  2. CGB Fonseca
  3. JLPS Miranda
  4. BV Travassos
  5. CR Baião
  6. KD Silva
  7. LBAE dos Santos
  8. MMR de Britto
  9. PALS Cerqueira
  10. SNB Pereira
  11. RBJ Rios
  12. CS Vieira
  13. IA Leal
  14. NC Martins
  15. LMAC de Carvalho
  16. AB Pereira
  17. CH Teixeira

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Abstract

Introduction

COVID 19 is still a challenge in pediatrics due to variety of symptoms and different presentations

Aim

To describe clinical, laboratorial and treatment of confirmed COVID-19 pediatric admitted in hospitals.

Methods

A retrospective study was conducted in children (0-18 years), admitted between March and November 15, 2020, with confirmed COVID-19 by reverse transcription polymerase chain reaction or serological tests. Clinical data about symptoms, laboratorial exams and treatments were analysed. Patients were evaluated according predominant (PRS) or non-predominant respiratory symptoms (non-PRS)

Results

Sixty-four patients were evaluated, being the median age 5.6 years. Forty-seven (73.4%) children were admitted with PRS and 17 (26.4%) with non-PRS. The main symptoms in the PRS group were fever in 74.5% of children and cough in 66%; and fever in 76.5% and edema/cavitary effusion in 29.4% in the non-PRS group. The median of C-reactive protein (in mg/dl) was 2.5 in the PRS group and 6.1 in the non-PRS group. Antibiotics were used in 85.1% of the PRS group and 94.1% of non-group. Comorbidity was present in 30/47 (63.8%) of PRS group and 8/17 (47.1%) of non-PRS group (p=0.22). Length of stay until 7 days in patients with comorbidity was present in 27/64 (42.1%) and more than 7 days in 11/64 (17.1%) (p= 0.2)

Conclusion

Non-PRS represented more than one quarter of admitted patients. Fever was the main symptom detected, elevated CRP was frequent and antibiotics were commonly prescribed. Comorbidity was found in both groups and his presence was not associated with a longer length of stay.

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  1. ScreenIT

    SciScore for 10.1101/2020.12.29.20248994: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board StatementIRB: Ethical aspects: The study was approved by the Ethical Committee of Federal Fluminense University, process number 4.100.232, June 20, 2020.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.

    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:
    But even with this limitation all admitted patients were tested to COVID-19 with RT-PCR or serology in cases of patients with more than 10 days of symptoms. Despite the study being conducted in two large pediatric hospitals of Rio de Janeiro city that could be considered a limitation, results could represent a representative panel of metropolitan areas of state, due to many patients being referred to admission from periferic hospitals. Another limitation was evaluation of only admitted patients that excluded children managed in ambulatory settings with mild disease.

    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 10.1101/2020.12.29.20248994v1 on medRxiv