Coronavirus disease in children: A multicentre study from the Kingdom of Saudi Arabia

The COVID-19 global pandemic caused by severe acute respiratory syndrome coronavirus 2 infection, warranted attention for whether it has unique manifestations in children. Children tend to develop less severe disease with a small percentage present with clinical manifestations of paediatric multisys...

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Bibliographic Details
Published in:	Journal of infection and public health Vol. 14; no. 4; pp. 543 - 549
Main Authors:	Kari, Jameela A., Shalaby, Mohamed A., Albanna, Amr S., Alahmadi, Turki S, Sukkar, Samaher A., MohamedNur, Hanan A.H., AlGhamdi, Manar S., Basri, Afnan H., Shagal, Reem A., Alnajar, Abeer, Badawi, Mazen, Safdar, Osama Y., Zaher, Zaher F., Temsah, Mohamad-Hani, Alhasan, Khalid A.
Format:	Journal Article
Language:	English
Published:	England Elsevier Ltd 01-04-2021 The Author(s). Published by Elsevier Ltd on behalf of King Saud Bin Abdulaziz University for Health Sciences Elsevier
Subjects:	Child Child, Preschool Children COVID-19 COVID-19 - diagnosis COVID-19 - epidemiology Epidemiology Female Hospitalization Humans Infant Male Retrospective Studies SARS-CoV-2 Saudi Arabia Saudi Arabia - epidemiology Systemic Inflammatory Response Syndrome Tertiary Care Centers - statistics & numerical data Saudi Arabia COVID-19 Saudi Arabia SARS-CoV-2 Children Epidemiology
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Summary:	The COVID-19 global pandemic caused by severe acute respiratory syndrome coronavirus 2 infection, warranted attention for whether it has unique manifestations in children. Children tend to develop less severe disease with a small percentage present with clinical manifestations of paediatric multisystem inflammatory syndrome and have poor prognosis. We studied the characteristics of COVID-19 in children requiring hospitalisation in the Kingdom of Saudi Arabia and assessed the clinical presentation and the risk factors for mortality, morbidity, and paediatric intensive care (PICU) admission. We conducted a retrospective analysis of COVID-19 patients under 15 years hospitalised at three tertiary academic hospitals between 1 March and 30 June 2020. Eighty-eight children were enrolled (>20% were infants). Seven (8%) were in critical condition and required PICU admission, and 4 (4.5%) died of which 3 met the full diagnostic criteria of multi-system inflammatory syndrome and had a high Paediatric Risk of Mortality (PRISM) score at the time of admission. The initial polymerase chain reaction (PCR) test result was positive for COVID-19 in most patients (97.7%), and the remaining two patients had positive result in the repeated confirmatory test. In a subset of patients (20 subjects), repeated PCR testing was performed until conversion to negative result, and the average duration for conversion was 8 (95% CI: 5.2–10.5) days Children requiring PICU admission presented with signs of respiratory distress, dehydration, and heart failure. Most had fever (71.4%) and tonsillitis; 61.4% were discharged within 7 days of hospitalisation. Risk factors for mortality included skin rash, hypotension, hypoxia, signs of heart failure, chest radiograph suggestive of acute respiratory distress syndrome, anaemia, leucocytosis, hypernatraemia, abnormal liver enzymes, and high troponin I, and risk factors for prolonged hospitalisation (>7 days) included the presence of comorbidities, leucopaenia, hyponatraemia, and elevated C-reactive protein. The majority of hospitalised children had a brief febrile illness and made a full recovery, but a minority had severe disease.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 The first two authors contributed equally to the paper.
ISSN:	1876-0341 1876-035X
DOI:	10.1016/j.jiph.2021.01.011