ABSTRACT
We like to share some ideas on the publication “Clinical and laboratory profile of children with COVID-19 admitted at a tertiary care hospital in Karnataka, Southern India”1. Sahana KS, et al1 concluded that “Presence of undernutrition and elevated C-reactive protein were associated with severe illness”. In this study, some laboratory parameters were studied and there might be important confounding effects. As Sahana KS, et al1 noted, some children have nutritional problems which might affect some laboratory parameters such as ferritin and haemoglobin. Additionally, a nutrition risk screening (NRS) score should be applied. In a previous report, NRS score was a good predictor for clinical outcome in cases with sepsis and it might be applicable to cases with COVID-192. Finally, the treatment given to different children might be different and it can result in different clinical outcomes. Those cases with atypical presentation may have received additional medications and it can affect both clinical outcome and clinical parameters. For example, steroids can affect the platelet count and might help to improve the clinical outcome. © 2018. Intertax. All rights reserved.
ABSTRACT
Objectives: To assess the clinical characteristics, laboratory parameters and outcomes in paediatric patients with COVID-19. Method: Case records of all paediatric patients admitted with COVID-19 were included in the study. Data regarding mode of presentation, presence of comorbid conditions, severity of COVID-19, laboratory investigations and management were noted. Results: A total of 32 children was admitted with COVID-19 infection in our institute. COVID-19 infection was mild in 16 (50%) patients, moderate in 6 (18.8%) and severe in 10 (31.3%). Ages of the children ranged from 6 months to 16 years with a mean age of 10.75 years. Of them 17 (53%) were boys and 15 (47%) were girls. Pre-existing comorbidities were present in 8 (25%) children. Respiratory symptoms were the commonest presenting complaints, being observed in 18 (59%) cases. Atypical presentation of COVID-19 (other than respiratory) was seen in 31% of cases. Presence of undernutrition and elevated C-reactive protein (CRP) were associated with severe Covid-19 illness (p<0.05). Eleven (34%) cases required intensive care and mechanical ventilation was required in 2 (6.3%) cases. Out of the 32 cases only 1 patient expired giving a case fatality rate of 3.1%. Conclusions: Atypical presentation of COVID-19 with varied manifestations involving systems other than respiratory was observed in children as a separate entity from hyper-inflammatory syndrome. Presence of undernutrition and elevated CRP was associated with severe illness. © 2021,Sri Lanka Journal of Child Health. All rights reserved.