Differences in children and adolescents with SARS-CoV-2 infection: a cohort study in a Brazilian tertiary referral hospital

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de Sousa Marques, Heloisa Helena ^[1] ; Badue Pereira, Maria Fernanda ^[1] ; dos Santos, Angelica Carreira ^[1] ; Fink, Thais Toledo ^[1] ; Yoshino de Paula, Camila Sanson ^[1] ; Litvinov, Nadia ^[1] ; Schvartsman, Claudio ^[1] ; Delgado, Artur Figueiredo ^[1] ; Bento Cicaroni Gibelli, Maria Augusta ^[1] ; de Carvalhol, Werther Brunow ^[1] ; Odone Filho, Vicente ^[1] ; Tannuri, Uenis ^[1] ; Carneiro-Sampaio, Magda ^[1] ; Grisi, Sandra ^[1] ; da Silva Duarte, Alberto Jose ^[1] ; Antonangelo, Leila ^[1] ; Vieira Francisco, Rossana Pucineli ^[1] ; Okay, Thelma Suely ^[1] ; Batisttella, Linamara Rizzo ^[1] ; Ribeiro de Carvalho, Carlos Roberto ^[1] ; Maria Brentani, Alexandra Valeria ^[1] ; Silva, Clovis Artur ^[1] ; Grp, HC-FMUSP Pediat COVID Study

Afiliação do(s) autor(es)

^[1] Hosp Clin HCFMUSP, Fac Med, Sao Paulo, SP - Brazil

• Tipo de documento: Artigo Científico
• Fonte: Clinics; v. 76, 2021.
• Citações Web of Science: 1

Resumo

OBJECTIVES: To compare demographic/clinical/laboratory/treatments and outcomes among children and adolescents with laboratory-confirmed coronavirus disease 2019 (COVID-19). METHODS: This was a cross-sectional study that included patients diagnosed with pediatric COVID-19 (aged <18 years) between April 11, 2020 and April 22, 2021. During this period, 102/5,951 (1.7%) of all admissions occurred in neonates, children, and adolescents. Furthermore, 3,962 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection samples were processed in patients aged <18 years, and laboratory-confirmed COVID-19 occurred in 155 (4%) inpatients and outpatients. Six/155 pediatric patients were excluded from the study. Therefore, the final group included 149 children and adolescents (n=97 inpatients and 52 outpatients) with positive SARS-CoV-2 results. RESULTS: The frequencies of sore throat, anosmia, dysgeusia, headache, myalgia, nausea, lymphopenia, pre-existing chronic conditions, immunosuppressive conditions, and autoimmune diseases were significantly reduced in children and adolescents (p<0.05). Likewise, the frequencies of enoxaparin use (p=0.037), current immunosuppressant use (p=0.008), vasoactive agents (p=0.045), arterial hypotension (p<0.001), and shock (p=0.024) were significantly lower in children than in adolescents. Logistic regression analysis showed that adolescents with laboratory-confirmed COVID-19 had increased odds ratios (ORs) for sore throat (OR 13.054; 95% confidence interval [CI] 2.750-61.977; p=0.001), nausea (OR 8.875; 95% CI 1.660-47.446; p=0.011), and lymphopenia (OR 3.575; 95% CI 1.355-9.430; p=0.010), but also had less hospitalizations (OR 0.355; 95% CI 0.138-0.916; p=0.032). The additional logistic regression analysis on patients with preexisting chronic conditions (n=108) showed that death as an outcome was significantly associated with pediatric severe acute respiratory syndrome (SARS) (OR 22.300; 95% CI 2.341-212.421; p=0.007) and multisystem inflammatory syndrome in children (MIS-C) (OR 11.261; 95% CI 1.189-106. 581; p=0.035). CONCLUSIONS: Half of the laboratory-confirmed COVID-19 cases occurred in adolescents. Individuals belonging to this age group had an acute systemic involvement of SARS-CoV-2 infection. Pediatric SARS and MIS-C were the most important factors associated with the mortality rate in pediatric chronic conditions with COVID-19. (AU)

• Processo FAPESP: 15/03756-4 - Avaliação da relevância dos níveis sanguíneos de drogas utilizadas em doenças autoimunes reumatológicas no acompanhamento da segurança, eficácia e aderência à terapêutica
• Beneficiário: Eloisa Silva Dutra de Oliveira Bonfá
• Modalidade de apoio: Auxílio à Pesquisa - Temático