Analytical Study of COVID 19 in Pediatrics

Abstract Background: The current corona virus disease 2019 (COV-ID-19) pneumonia pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a major global health threat. Since its first identification in Wuhan, China, in December 2019, COVID-19 has spread globally at an accelerated rate with rapid increases in cases and mortality. Aim of Study: Study and analyze the COVID-19-positive and suspected children regarding the patient's clinical, labo-ratory, diagnostic, course and treatment outcome data. Material and Methods: Combined retrospective and pro-spective study was conducted at, Minia General Hospital, Mallawy isolation hospital, Mallawy Chest Hospital and Assiut Al-Azhar University Hospital and Minia University Hospital from April 2020 until October 2021. A total of 117 admitted or outpatient COVID-19 confirmed or suspected pediatric children were enrolled. Results: Age ranged from 0.05 to 18 years with a mean of 9.05±6.06 years, and the age groups from (0-6) years were 42 (35.89%), from (7-12) years were 27 (23.1%) and more than 12 years 48 (41.01). There were 72 (61.54%) males and 45 (38.46%) females. 110 (94%) patients had fever. 109 (93.2%) had running nose. 82 (70%) had sore throat, 111 (95.9%) had cough 33 (28.2%) had diarrhea. 66 (56.4%) of the studied patients were moderate cases, 20 (17.1%) were mild, 24 (20.5%) were Severe and 7 (5.98%) were critical. 2 (1.7%) of the studied patients were asthmatic. Regarding cardiac complications, 1 (0.9) had impending heart failure, 2 (1.7%) arrested while 1 (0.9%) had cardiac thrombosis. Regarding chest CT, 12 (10.3%) had CO-RAD 1 (normal) CT, 1 (0.9%) had CO-RAD 2 (low suspicious) s, 3 (2.6%) had CO-RAD 4 (highly suspicious), 11 (9.4%) had CO-RAD 5 (very high suspicious), 40 (34.2) had CORAD 6 (PCR positive) while chest CT wasn't done on 50 (42.7%) of the studied patients. 113 (96.6%) had antipyretics (Paracetamol). Regarding anticoagulants, 15 (12.8%) had Clexane, 1 (0.85%) had Heparin and 3 (2.6%) had Aspirin. Conclusions: Finally we could conclude that, COVID-19 infection is not uncommon in pediatric patients and most of them are moderate and it presents as either primary, MIS-C, and Kawasaki disease like symptoms, CT chest is highly sensitive in diagnosis of COVID-19 in comparison with X-ray. Most common symptom are fever and cough, Sore throat, runny nose and anosmia. D-dimer high level associated with long stay at hospital. We found that most of the deaths and ICU outcomes related to MIS-C presentation and associated comorbidities. Decreased mortality rate in our study 1.7%, and this is an evidence of the success of the Egyptian protocol in management of COVID-19 cases. Many cases the first presentation is not related to the respiratory system as DKA, seizures, jaundice, so during disease outbreak any symptom is consider COVID-19 until proven otherwise.