Evaluation of predictors of severe‐moderate COVID‐19 infections at children: A review of 292 children
Although the underlying disease is associated with a severe course in adults and laboratory abnormalities have been widely reported, there are not sufficient data on the clinical course of coronavirus disease 2019 (COVID‐19) in children with pre‐existing comorbid conditions and on laboratory finding...
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| Published in: | Journal of medical virology Vol. 93; no. 12; pp. 6634 - 6640 |
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| Main Authors: | , , , , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
London
Wiley Subscription Services, Inc
01-12-2021
John Wiley and Sons Inc |
| Subjects: | |
| Online Access: | Get full text |
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| Summary: | Although the underlying disease is associated with a severe course in adults and laboratory abnormalities have been widely reported, there are not sufficient data on the clinical course of coronavirus disease 2019 (COVID‐19) in children with pre‐existing comorbid conditions and on laboratory findings. We aimed to describe the independent risk factors for estimating the severity of the COVID‐19 in children. All children between 1 month and 18 years old who were hospitalized during the period of March 11–December 31, 2020, resulting from COVID‐19 were included in the study. Patients were categorized into mild (group 1) and moderate + severe/critically (group 2) severity based on the criteria. Demographic characteristics, comorbidities, and laboratory variables between the two groups were compared. A total of 292 children confirmed to have COVID‐19 infection were included in the study. The most common associated diseases were obesity (5.1%) and asthma bronchiale (4.1%). We observed that disease progressed more severely in patients with underlying diseases, especially obesity and asthma bronchiale (for patients with obesity odds ratio [OR] 9.1, 95% confidence interval [CI] 1.92–43.28, p = 0.005 and for patients with asthma bronchiale OR 4.1, 95% CI 1.04–16.80, p = 0.044). In group 2 patients, presence of lymphopenia and hypoalbuminemia, and also an elevation in serum levels of C‐reactive protein, procalcitonin, and uric acid were detected and these results were statistically significant (p values; p < 0.001, p = 0.046, p = 0.006, p = 0.045, p < 0.001, respectively). The strongest predictor of moderate‐severe COVID‐19 infections in the children was uric acid, with an odds ratio of 1.6 (95% CI 1.14–2.13, p = 0.005) and lymphocytes with an odds ratio of 0.7 (95% CI 0.55–0.88, p = 0.003). Although children are less susceptible to COVID‐19, the pre‐existing comorbid condition can predispose to severe disease. In addition, lymphopenia and high uric acid are indicators that COVID‐19 infection may progress more severely.
Highlights
There are not sufficient data on the clinical course of COVID‐19 in children with pre‐existing comorbidities.
Obesity, asthma bronchiale, lymphopenia, and uric acid elevation are indicators that COVID‐19 infection may progress more severely.
We recommend clinicians must be more aware of deterioration in the children with comorbidities and monitor lymphocyte count, and uric acid levels as predictors for severe infection in terms of deterioration. |
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| Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
| ISSN: | 0146-6615 1096-9071 |
| DOI: | 10.1002/jmv.27237 |