Clinical and Epidemiological Features of Pediatric COVID‐19: A Retrospective Study
Mohammadreza Mirkarimi, Solmaz Heidari, Ahmad Shamsizadeh, Kia Tahouri, Mohsen Alisamir, Mohammadreza Fathi, Shooka Mohammadi
Health Science Reports, doi:10.1002/hsr2.70181
Background and Aims: There is a demand for additional data regarding the impact of coronavirus disease 2019 on the pediatric population. This study sought to determine the clinical and epidemiological features of pediatric COVID-19 in Iran. Methods: A retrospective study was performed to assess medical records of children with COVID-19 admitted to Abuzar Hospital in Ahvaz (Iran). Their clinical and demographic data were recorded. Results: In this study, 600 medical records of pediatric COVID-19 patients were evaluated. Over 50% of them were boys. Mild, moderate, and severe manifestations of COVID-19 were identified in 250, 200, and 150 children, respectively. Patients with severe or moderate COVID-19 had substantially higher levels of various inflammatory markers (C-reactive protein (CRP), fibrinogen, and D-dimer), alanine transaminase (ALT), creatine kinase (CPK), blood urea nitrogen (BUN), neutrophils, lactate dehydrogenase (LDH), aspartate aminotransferase (AST), creatinine (Cr), bilirubin, and gamma-glutamyl transferase (GGT) compared to children with mild COVID-19 (p < 0.001); they also had lower levels of lymphocytes, hemoglobin (Hb), and vitamin D than patients with mild COVID-19 (p < 0.001). In addition, children with severe or moderate COVID-19 had a notably higher incidence of fever or dry cough and longer hospital stays than those with mild COVID-19 (p < 0.001). The prevalence of malnutrition and anemia in patients was 50.6% and 31.5%, respectively. A significant proportion of children who were underweight and stunted experienced moderate to severe COVID-19. Furthermore, there was a considerably higher prevalence of malnutrition, anemia, and vitamin D insufficiency, or deficiency in children with moderate-to-severe COVID-19 compared to patients with mild COVID-19 (p < 0.001).
Conclusion: The outcomes of this study revealed a significantly higher prevalence of malnutrition, anemia, vitamin D insufficiency or deficiency, elevated liver and kidney function test results, and increased inflammatory markers in children with moderate to severe COVID-19 compared to those with mild COVID-19.
| Introduction Coronavirus disease 2019 (COVID-19) is a highly pathogenic, contagious, and easily transmissible infection [1] . The outbreak of COVID-19 has created a global public health challenge and an emerging threat [2] . The majority of children with COVID-19 experienced less severe COVID-19 disease progression and had better outcomes than adults [3, 4] . The global prevalence of pediatric deaths and severe cases was approximately 0.3% and 0.6%-5%, respectively [5] . At the population level, children comprise a small percentage of COVID-19 infections, and they are typically acquired through adult contact [6, 7] .
Author Contributions Mohammadreza Mirkarimi: conceptualization, data curation, investigation, methodology, project administration, resources, supervision, writing-review and editing. Solmaz Heidari: data curation, methodology, project administration, supervision, writing-review and editing, resources. Ahmad Shamsizadeh: project administration, writing-review and editing, supervision. Kia Tahouri: data curation, investigation, writing-review and editing. Mohsen Alisamir: conceptualization, data curation, writingreview and editing, project administration, supervision, investigation, methodology, resources. Mohammadreza Fathi: writing-review and editing, supervision, project administration. Shooka Mohammadi: writing-review and editing, writing-original draft, formal analysis, data curation.
Ethics Statement The medical ethics committee of Ahvaz Jundishapur University of Medical Sciences (AJUMS) approved the protocol of the study (IR.AJUMS.REC.1399.821).
Conflicts of Interest The authors declare no conflicts of interest.
Standard of Reporting The STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) checklist has been followed in this study.
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