TY - JOUR
T1 - Clinical Profile and Risk Factors for Severe Disease in 402 Children Hospitalized with SARS-CoV-2 from India
T2 - Collaborative Indian Pediatric COVID Study Group
AU - Jat, Kana Ram
AU - Sankar, Jhuma
AU - Das, Rashmi Ranjan
AU - Ratageri, Vinod H.
AU - Choudhary, Bharat
AU - Bhat, Javeed Iqbal
AU - Mishra, Baijayantimala
AU - Bhatnagar, Sushma
AU - Behera, Bijayini
AU - Charoo, Bashir Ahmad
AU - Goyal, Jagdish P.
AU - Gupta, Aditya Kumar
AU - Gulla, Krishna Mohan
AU - Gera, Rani
AU - Illalu, Shivanand
AU - Kabra, S. K.
AU - Khera, Daisy
AU - Kumar, Balbir
AU - Lodha, Rakesh
AU - Mohan, Anant
AU - Mohanty, Pankaj Kumar
AU - Satapathy, Amit Kumar
AU - Singh, Kuldeep
AU - Singh, Amitabh
AU - Sharma, Sumant Vinayak
AU - Tiwari, Pawan
AU - Trikha, Anjan
AU - Wari, Prakash K.
N1 - Publisher Copyright:
© The Author(s) [2021]. Published by Oxford University Press. All rights reserved.
PY - 2021/6/1
Y1 - 2021/6/1
N2 - 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.
AB - 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.
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U2 - 10.1093/tropej/fmab048
DO - 10.1093/tropej/fmab048
M3 - Article
C2 - 34152424
AN - SCOPUS:85110265816
SN - 0142-6338
VL - 67
JO - Journal of Tropical Pediatrics
JF - Journal of Tropical Pediatrics
IS - 3
M1 - fmab048
ER -