CORONAVIRUS DISEASE 2019 IN A TERTIARY PEDIATRIC CENTER IN PORTUGAL

  1. Tiago Milheiro Silva
  2. Ana Margarida Garcia
  3. Catarina Gouveia
  4. Flora Candeias
  5. Maria João Brito

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Abstract

Objectives

Describe the demographic, clinical, laboratory, and imaging features of SARS-CoV-2 infected children at a tertiary pediatric center in Portugal during the first 6 months of the COVID-19 pandemic.

Design

Single center, descriptive study of pediatric patients, who had a confirmed SARS-CoV-2 infection from March 7 to September 20, 2020.

Setting

Tertiary Pediatric referral center.

Patients

18 years or younger.

Main outcome measures

Incidence, mortality, age of infection, clinical characteristics, treatment prescribed and outcome.

Results

A total of 300 patients were included with a median age of 5 years (IQR 1-11) and in 67% a contact was identified (co-habitant in 52.7%). 56 (18.7%) had pre-existing medical conditions. A mode of three days mediated symptom appearance to diagnose. The most common symptoms were fever (55.7%), cough (38.3%), and nasal congestion (24%). 23% of the patients were admitted due to complications related to COVID-19 and 2% required intensive care. We used drugs with antiviral activity in 9% of the patients, immunomodulatory medication with corticosteroids in 3.3%, and intravenous immunoglobulin in 1.7%. Two (0.6%) children died and 2.3% reported short-term sequelae.

Conclusions

COVID-19 is usually a mild disease in children, but a small proportion of patients develop severe and critical disease. Fatal outcomes were rare overall and exclusive of severe previous medical conditions. Suspecting and diagnosing COVID-19 in children based on their symptoms without epidemiologic information and virus testing is very challenging. Our data also reflect the uncertainties regarding specific treatment options, highlighting that additional data on antiviral and immunomodulatory drugs are urgently needed.

Article activity feed

  1. ScreenIT

    SciScore for 10.1101/2021.08.16.21262100: (What is this?)

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

    Table 1: Rigor

    EthicsConsent: All antiviral therapies were administered after informed consent was signed by parents or caretakers and approval by the pharmacy commission of our hospital was obtained.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Antibodies
    SentencesResources
    The cases were diagnosed by real-time reverse transcription–polymerase chain reaction (rRT-PCR) in a combined nasopharyngeal and oropharyngeal swab or respiratory secretions or by the confirmation of antibodies to SARS-CoV-2.
    SARS-CoV-2
    suggested: None

    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: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    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.

    Results from scite Reference Check: We found no unreliable references.

    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 10.1101/2021.08.16.21262100 on medRxiv