The burden of SARS-CoV-2 infection among children in Lagos, Nigeria

ABSTRACT

Introduction/ Background: Most reports are silent on the burden of COVID-19 in paediatric population. Is the incidence and severity of COVID-19 truly low as reported? The objective of this study was to describe the prevalence and clinical features of coronavirus disease among children at a COVID-19 testing centre in Lagos, Nigeria. Methods: This is a retrospective study describing the prevalence and pattern of symptoms of COVID-19 among children at a testing centre in Lagos, Nigeria. Data was collected from the electronic records of individuals (< 18 years) visiting the SARS-CoV-2 testing centre from March 1, 2020, to June 30, 2020. The sociodemographic data, travel history, preexisting comorbidities, clinical symptoms, and outcomes of the qualitative (SARS-CoV-2) RT-PCR results were extracted and analyzed using SPSS software, version 22.0. Results: Three hundred and seven children were screened for SARS-CoV-2 infection and fifty children were found to be positive, giving a prevalence of 16.3%. The median age (interquartile range (IQR)) was 9 (4- 14) years. Seventeen (34.0%) of the SARS-CoV-2- positive children presented with symptoms while the rest were asymptomatic. The common presenting symptoms among those positive for SARS-CoV-2 infection were fever (40.0%), cough (32.9%), sore throat (17.1%), and runny nose (15.7%). Fever and sore throat occurring together was the symptom combination most predictive of SARS-CoV- 2 infection among the population (OR 0.49,95% CI 0.12-1.98 and OR 4.59 95% CI 0.93-22.73). Impact This is the first study to describe the epidemiological and clinical characteristics of children screened for SARS-CoV-2 infection in sub-Saharan Africa. The pattern of symptoms seen in SARS-CoV-2 infections among children is similar to common childhood infections (malaria, acute diarrhea diseases, and respiratory tract infection). Conclusion: Prevalence of paediatric SARS-CoV-2 infection was 16.3%, but majorly of mild disease and was commonly predicated by fever and sore throat symptom combination. There is a need for a high level of suspicion in the management of common febrile diseases in paediatric settings especially in presence of sore throat.