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2023, Number 6

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Acta Pediatr Mex 2023; 44 (6)

Clinical-epidemiological characterization of pediatric patients with COVID-19 treated in a regional hospital in El Salvador

Saravia HKC, Flores KE, Oliva MJE, Sánchez GMA, Domínguez QRL

Language: Spanish
References: 53
Page: 419-431
PDF size: 256.04 Kb.


ABSTRACT

Objective: To describe the epidemiological, clinical, laboratory, imaging and treatment characteristics of COVID-19 pediatric cases, confirmed by reverse transcriptasepolymerase chain reaction (RT-PCR) or serology attended in El Salvador.
Material and Method: Cross-sectional and descriptive study of paediatric patients with COVID-19, confirmed by molecular testing or serology, attended between June 1 and December 31, 2020. A code was assigned to each patient to ensure confidentiality.
Results: Seventy-two patients were included, with a predominance in the 1-4 year age group (n = 25). The mean age was 3.4 years; 28 patients were female and 44 were male. Three patients remained asymptomatic, 37 with mild, 22 with moderate, 4 with severe and 6 with critical symptoms. The most common symptoms were: fever, hyporexia, adynamia and cough. The most commonly reported laboratory findings were: anaemia, lymphopenia, elevated lactate dehydrogenase, C-reactive protein and erythrocyte sedimentation rate. Chest radiographs reported pneumonia in 26 patients. The most common treatments were antibiotics and paracetamol. Eleven patients needed supplemental oxygen and seven needed mechanical ventilation. Children under 1 year of age stayed in the hospital twice as long as the other age groups. Six patients developed multisystem inflammatory syndrome. There were seven deaths.
Conclusion: Although the prognosis was favorable in most cases, some patients developed severe or critical illness, dying despite receiving management in intensive care. To reduce these outcomes it is necessary to educate the population so that they seek attention promptly, strengthen health personnel clinical skills for timely identification of the disease, and increase intensive care installed capacity in the event of similar epidemiological phen.


REFERENCES

  1. World Health Organization. Coronavirus disease (COVID-19) pandemic. Geneva (CH): World Health Organization, 2022. https://www.who.int/emergencies/diseases/novel-coronavirus-2019 adgroupsurvey{adgroupsurvey}&gclid=Cj0KCQjwhLKUBhDiARIsAMaTLnEW8xXi4_sywpOtmPBzMd0YAKD8FwcGpmlSVjCuU7BEAFV3-Rk5ax-AaArajEALw_wcB

  2. World Health Organization. WHO Coronavirus (COVID-19)Dashboard. Geneva (CH): World Health Organization, 2022.https://covid19.who.int/?gclid=Cj0KCQjwlOmLBhCHARIsAGiJg7mwYVOy6SDAWogC5R3qu85k9QODCcxHQrrspmostTPJjsganhJBb68aAng_EALw_wcB

  3. Dong Y, Mo X, Hu Y, Qi X, Jiang F, Jiang Z, et al. Epidemiologyof COVID-19 among children in China. Pediatrics 2020; 145(6): e20200702. doi: 10.1542/peds.2020-0702

  4. Shen KL, Yang YH, Jiang RM, Wang TY, Zhao DC, Jiang Y, et al.Updated diagnosis, treatment, and prevention of COVID-19in children: experts' consensus statement (condensed versionof the second edition). World J Pediatr 2020; 16 (3):232-39. doi: 10.1007/s12519-020-00362-4

  5. Tagarro A, Epalza C, Santos M, Sanz-Santaeufemia FJ, OtheoE, Moraleda C, et al. Screening and severity of CoronavirusDisease 2019 (COVID-19) in children in Madrid, Spain.JAMA Pediatr 2020; e201346. doi: 10.1001/jamapediatrics.2020.1346

  6. Son MB. COVID-19: Multisystem inflammatory syndromein children (MIS-C) management and outcome. Alphenaan den Rijn, (NL): UpToDate; 2023. https://www.uptodate.com/contents/covid-19-multisystem-inflammatorysyndrome-in-children-mis-c-management-and-outcome

  7. Bhowmick R, Gulla KM. Pediatric Acute Respiratory DistressSyndrome in COVID-19 Pandemic: Is it the Puzzle ofthe Century? Indian J Crit Care Med 2022; 26 (3): 264-65.doi:10.5005/jp-journals-10071-24175

  8. Kornitzer J. A Systematic Review of Characteristics Associatedwith COVID-19 in Children with Typical Presentationand with Multisystem Inflammatory Syndrome. Int J EnvironRes Public Health 2021; 18 (16): 8269. doi:10.3390/ijerph18168269

  9. Antoon JW, Hall M, Howard LM, Herndon A, FreundlichKL, Grijalva CG. COVID-19 and Acute Neurologic Complicationsin Children. Pediatrics 2022; 150 (5): e2022058167.doi:10.1542/peds.2022-058167

  10. Hoang A. COVID-19 in 7780 pediatric patients: A systematicreview. EClinicalMedicine 2020; 24: 100433. doi: 10.1016/j.eclinm.2020.100433

  11. Bustos BR, Padilla PO. El tiempo de llene capilar prolongadoes predictor de una saturación venosa central deoxígeno disminuida. Rev Chil Pediatría 2014; 85 (5): 539-45.doi:10.4067/S0370-41062014000500003

  12. Jain S, Iverson LM. Glasgow Coma Scale. In: StatPearls.Treasure Island (FL): StatPearls Publishing, 2022.

  13. Ministerio de Salud. Lineamientos técnicos para la atenciónintegral de personas con COVID-19. Segunda edición. Ministeriode Salud, 2020. http://asp.salud.gob.sv/regulacion/pdf/lineamientos/lineamientos_tecnicos_atencion_integral_codiv19_segunda_edicion_adenda_acuerdo_1949.pdf

  14. Acevedo L, Piñeres-Olave BE, Niño-Serna LF, Vega LM,Gomez IJA, Chacón S, et al. Mortality and clinical characteristicsof multisystem inflammatory syndrome in children(MIS-C) associated with covid-19 in critically ill patients: anobservational multicenter study (MISCO study). BMC Pediatr2021; 21 (1): 516. doi: 10.1186/s12887-021-02974-9

  15. Gonzalez-Dambrauskas S, Vasquez-Hoyos P, CamporesiA, Cantillano EM, Dallefeld S, Dominguez-Rojas J, et al.Critical Coronavirus and Kids Epidemiological (CAKE) StudyInvestigators. Paediatric critical COVID-19 and mortality ina multinational prospective cohort. Lancet Reg Health Am2022: 100272. doi: 10.1016/j.lana.2022.100272

  16. Feldstein LR, Rose EB, Horwitz SM, Collins JP, NewhamsMM, Son MBF, et al. Multisystem Inflammatory Syndromein U.S. Children and Adolescents. N Engl J Med 2020; 383(4): 334-46. doi:10.1056/NEJMoa2021680

  17. Rubens JH, Akindele NP, Tschudy MM, Sick-Samuels AC.Acute covid-19 and multisystem inflammatory syndromein children. BMJ 2021: n385. doi:10.1136/bmj.n385

  18. American Academy of Pediatrics. Children and COVID-19:State-Level Data Report. Itasca (IL): American Academy ofPediatrics; 2022. https://www.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/children-and-covid-

  19. 19-state-level-data-report/19. Dewi R, Kaswandani N, Karyanti MR, Setyanto DB, PudjiadiAH, Hendarto A, et al. Mortality in children with positiveSARS-CoV-2 polymerase chain reaction test: Lessonslearned from a tertiary referral hospital in Indonesia. Int JInfect Dis 2021; 107: 78-85. doi: 10.1016/j.ijid.2021.04.019

  20. Whittaker E, Bamford A, Kenny J, Kaforou M, Jones CE,Shah P, et al. Clinical characteristics of 58 children with apediatric inflammatory multisystem syndrome temporallyassociated with SARS-CoV-2. JAMA 2020; 324 (3): 259. doi:10.1001/jama.2020.10369

  21. Ouldali N, Pouletty M, Mariani P, Beyler C, Blachier A,Bonacorsi S, et al. Emergence of Kawasaki disease relatedto SARS-CoV-2 infection in an epicentre of the FrenchCOVID-19 epidemic: a time-series analysis. Lancet ChildAdolesc Health 2020; 4 (9): 662-8. doi: 10.1016/S2352-4642(20)30175-9

  22. Swann OV, Holden KA, Turtle L, Pollock L, Fairfield CJ, DrakeTM, et al. Clinical characteristics of children and youngpeople admitted to hospital with Covid-19 in United Kingdom:prospective multicentre observational cohort study.BMJ 2020; m3249. doi: 10.1136/bmj.m3249

  23. Cifuentes MP, Rodriguez-Villamizar LA, Rojas-Botero ML,Alvarez-Moreno CA, Fernández-Niño JA. Socioeconomicinequalities associated with mortality for COVID-19 inColombia: a cohort nationwide study. J Epidemiol CommunityHealth 2021; 75 (7): 610-15. doi:10.1136/jech-2020-216275

  24. Mena GE, Martinez PP, Mahmud AS, Marquet PA, BuckeeCO, Santillana M. Socioeconomic status determinesCOVID-19 incidence and related mortality in Santiago,Chile. Science 2021; 372 (6545): eabg5298. doi:10.1126/science.abg5298

  25. Zampieri FG, Skrifvars MB, Anstey J. Intensive care accessibilityand outcomes in pandemics. Intensive Care Med2020; 46 (11): 2064-66. doi:10.1007/s00134-020-06264-3

  26. Silva LL. Emergency care gap in Brazil: geographical accessibilityas a proxy of response capacity to tackle COVID-19. Front Public Health 2021; 9: 740284. doi:10.3389/fpubh.2021.740284

  27. Levy M, Recher M, Hubert H, Javouhey E, Fléchelles O,Leteurtre S, et al. Multisystem Inflammatory Syndromein children by COVID-19 vaccination status of adolescentsin France. JAMA 2022; 327 (3): 281-83. doi: 10.1001/jama.2021.23262

  28. Payne AB, Gilani Z, Godfred-Cato S, Belay ED, Feldstein LR,Patel MM, et al. Incidence of multisystem inflammatorysyndrome in children among US persons infected withSARS-CoV-2. JAMA Netw Open 2021; 4 (6): e2116420. doi:10.1001/jamanetworkopen.2021.16420

  29. Feldstein LR, Tenforde MW, Friedman KG, Newhams M,Rose EB, Dapul H, et al. Characteristics and outcomes of USchildren and adolescents with Multisystem InflammatorySyndrome in Children (MIS-C) compared with severe acuteCOVID-19. JAMA 2021; 325 (11): 1074-87. doi: 10.1001/jama.2021.2091

  30. Centers for Disease Control and Prevention. Informationfor Healthcare Providers about Multisystem InflammatorySyndrome in Children (MIS-C) [Internet].Atlanta (GA): Centers for Disease Control and Prevention;2021. https://www.cdc.gov/mis/mis-c/hcp/index.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fmis%2Fhcp%2Findex.html

  31. Centers for Disease Control and Prevention. COVID-19Response Team. Coronavirus disease 2019 in children.United States, February 12-April 2, 2020. Morbidity andMortality Weekly Report 422 MMWR 2020; 69 (14): 422-6. https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6914e4-H.pdf

  32. Seth S, Rashid F, Khera K. An overview of the COVID‐19complications in paediatric population: A pandemic dilemma.Int J Clin Pract 2021; 75 (9). doi:10.1111/ijcp.14494

  33. Siebach MK, Piedimonte G, Ley SH. COVID‐19 in childhood:transmission, clinical presentation, complicationsand risk factors. Pediatr Pulmonol 2021; 56 (6): 1342-56.doi:10.1002/ppul.25344

  34. Siracusa L, Cascio A, Giordano S, Medaglia AA, Restivo GA,Pirrone I, et al. Neurological complications in pediatricpatients with SARS-CoV-2 infection: a systematic review ofthe literature. Ital J Pediatr 2021; 47 (1): 123. doi:10.1186/s13052-021-01066-9

  35. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinicalcharacteristics of 138 hospitalized patients with 2019 novelcoronavirus-infected pneumonia in Wuhan, China. JAMA2020; 323 (11): 1061-69. doi: 10.1001/jama.2020.1585

  36. Kelada M, Anto A, Dave K, Saleh SN. The role of sex in therisk of mortality from COVID-19 amongst adult patients:a systematic review. Cureus 2020; 12 (8): e10114. doi:10.7759/cureus.10114

  37. Lu X, Zhang L, Du H, Zhang J, Li YY, Qu J, et al. SARS-CoV-2infection in children. N Engl J Med 2020; 382 (17): 1663-5.doi: 10.1056/NEJMc2005073

  38. Götzinger F, Santiago-García B, Noguera-Julián A, LanaspaM, Lancella L, Caló Carducci FI, et al. COVID-19 in childrenand adolescents in Europe: a multinational, multicentrecohort study. Lancet Child Adolesc Health. 2020; 4(9):653-661. doi: 10.1016/S2352-4642(20)30177-2

  39. Zhu L, Wang J, Huang R, Liu L, Zhao H, Wu C, et al. Clinicalcharacteristics of a case series of children with coronavirusdisease 2019. Pediatr Pulmonol 2020; 55 (6): 1430-32. doi:10.1002/ppul.24767

  40. Katz J, Guelmann M. Increased prevalence of dysgeusia inpediatric patients diagnosed with COVID-19. Pediatr Dent2021; 43 (4): 282-84. PMID: 34467844

  41. Yan Q, Qiu D, Liu X, Guo X, Hu Y. Prevalence of smell ortaste dysfunction among children with COVID-19 infection:a systematic review and meta-analysis. Front Pediatr 2021;9: 686600. doi: 10.3389/fped.2021.686600

  42. Mania A, Mazur-Melewska K, Lubarski K, Kuczma-NapierałaJ, Mazurek J, Jończyk-Potoczna K, et al. Wide spectrum ofclinical picture of COVID-19 in children -From mild to severedisease. J Infect Public Health 2021; 14 (3): 374-79. doi:10.1016/j.jiph.2020.12.029

  43. Epidemiology Working Group for NCIP Epidemic Response,Chinese Center for Disease Control and Prevention. Theepidemiological characteristics of an outbreak of 2019novel coronavirus diseases (COVID-19) in China. ZhonghuaLiu Xing Bing Xue Za Zhi 2020; 41 (2): 145-51. doi: 10.3760/cma.j.issn.0254-6450.2020.02.003

  44. Kosmeri C, Koumpis E, Tsabouri S, Siomou E, Makis A.Hematological manifestations of SARS‐CoV‐2 in children.Pediatr Blood Cancer 2020; 67 (12). doi:10.1002/pbc.28745

  45. Wardlaw T, Salama P, Johansson EW, Mason E. Pneumonia:the leading killer of children. Lancet 2006; 368 (9541):1048-50. doi: 10.1016/S0140-6736(06)69334-3

  46. Wang Z, Li X, Li D, Li Y. Clinical features of 167 childrenwith the novel influenza A (H1N1) virus infection inXian, China. Turk J Pediatr 2012; 54 (2): 99-104. PMID:22734294

  47. Babyn PS, Chu WC, Tsou IY, Wansaicheong GK, Allen U,Bitnun A, et al. Severe acute respiratory syndrome (SARS):chest radiographic features in children. Pediatr Radiol 2004;34 (1): 47-58. doi: 10.1007/s00247-003-1081-8

  48. Prata-Barbosa A, Lima-Setta F, Santos GRD, Lanziotti VS,de Castro REV, de Souza DC, et al. Pediatric patients withCOVID-19 admitted to intensive care units in Brazil: a prospectivemulticenter study. J Pediatr (Rio J) 2020; 96 (5):582-92. doi: 10.1016/j.jped.2020.07.002

  49. Shekerdemian LS, Mahmood NR, Wolfe KK, Riggs BJ, RossCE, McKiernan CA, et al. Characteristics and outcomes ofchildren with coronavirus disease 2019 (COVID-19) infectionadmitted to US and Canadian pediatric intensive careunits. JAMA Pediatr 2020; 174 (9): 868-73. doi: 10.1001/jamapediatrics.2020.1948

  50. Liu X, Tang J, Xie R, Li W, Chen J, Guo Y, et al. Clinical andepidemiological features of 46 children <1-year-old withcoronavirus disease 2019 in Wuhan, China: a descriptivestudy. J Infect Dis 2020; 222 (8): 1293-97. doi: 10.1093/infdis/jiaa472

  51. Zhang C, Gu J, Chen Q, Deng N, Li J, Huang L, et al. Clinicaland epidemiological characteristics of pediatric SARSCoV-2 infections in China: a multicenter case series.PLoS Med 2020; 17 (6): e1003130. doi: 10.1371/journal.pmed.1003130

  52. Guo CX, He L, Yin JY, Meng XG, Tan W, Yang GP, et al. Epidemiologicaland clinical features of pediatric COVID-19.BMC Med 2020; 18 (1): 250. doi: 10.1186/s12916-020-01719-2

  53. Garazzino S, Montagnani C, Doná D, Meini A, Felici E,Vergine G, et al. Multi-centre Italian study of SARS-CoV-2infection in children and adolescents, preliminary data asat 10 April 2020. Euro Surveill 2020; 25 (18): 2000600. doi:10.2807/1560-7917.ES.2020.25.18.200600




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