Clinical Profile and Risk Factors for Severe Disease in 402 Children Hospitalized with SARS-CoV-2 from India: Collaborative Indian Pediatric COVID Study Group

Kana Ram Jat, Jhuma Sankar, Rashmi Ranjan Das, Vinod H. Ratageri, Bharat Choudhary, Javeed Iqbal Bhat, Baijayantimala Mishra, Sushma Bhatnagar, Bijayini Behera, Bashir Ahmad Charoo, Jagdish P. Goyal, Aditya Kumar Gupta, Krishna Mohan Gulla, Rani Gera, Shivanand Illalu, S. K. Kabra, Daisy Khera, Balbir Kumar, Rakesh Lodha, Anant MohanPankaj Kumar Mohanty, Amit Kumar Satapathy, Kuldeep Singh, Amitabh Singh, Sumant Vinayak Sharma, Pawan Tiwari, Anjan Trikha, Prakash K. Wari

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22 Scopus citations

Abstract

There is a lack of large multicentric studies in children with COVID-19 from developing countries. We aimed to describe the clinical profile and risk factors for severe disease in children hospitalized with COVID-19 from India. Methods: In this multicentric retrospective study, we retrieved data related to demographic details, clinical features, including the severity of disease, laboratory investigations and outcome. Results: We included 402 children with a median (IQR) age of 7 (2-11) years. Fever was the most common symptom, present in 38.2% of children. About 44% had underlying comorbidity. The majority were asymptomatic (144, 35.8%) or mildly symptomatic (219, 54.5%). There were 39 (9.7%) moderate-severe cases and 13 (3.2%) deaths. The laboratory abnormalities included lymphopenia 25.4%, thrombocytopenia 22.1%, transaminitis 26.4%, low total serum protein 34.7%, low serum albumin 37.9% and low alkaline phosphatase 40%. Out of those who were tested, raised inflammatory markers were ferritin 58.9% (56/95), c-reactive protein 33.3% (41/123), procalcitonin 53.5% (46/ 86) and interleukin-6 (IL-6) 76%. The presence of fever, rash, vomiting, underlying comorbidity, increased total leucocyte count, thrombocytopenia, high urea, low total serum protein and raised creactive protein was factors associated with moderate to severe disease. Conclusion: Fever was the commonest symptom. We identified additional laboratory abnormalities, namely lymphopenia, low total serum protein and albumin and low alkaline phosphatase. The majority of the children were asymptomatic or mildly symptomatic. We found high urea and low total serum protein as risk factors for moderate to severe disease for the first time.

Original languageEnglish (US)
Article numberfmab048
JournalJournal of Tropical Pediatrics
Volume67
Issue number3
DOIs
StatePublished - Jun 1 2021

All Science Journal Classification (ASJC) codes

  • General Medicine

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