Clinical and Diagnostic Characteristics of Children with Sars-Cov2 Infection at a Picu in a Tertiary Hospital in Colombia: It Is Better a Two-Step Diagnostic Strategy?

ABSTRACT

BACKGROUND AND AIM: Children affected with COVID-19 infection are less likely to develop severe disease. The burden of disease and allocated resources make diagnosis and management differ among centers. Missed cases could be reduced if a second test is carried out in those with an initial negative assay. AIM: To describe the clinical characteristics, imaging finding and outcomes of COVID-19 disease in children admitted to a Pediatric Intensive Care Unit (PICU). METHOD(S) Retrospective, single-center study in patients (0-18 years) with confirmed COVID-19 infection, during one year of the SARS-CoV-2 outbreak. RESULT(S) Twenty-four patients were included, with respiratory disease (n=12, 52%), sepsis (n=5, 22%), MIS-C (n=4, 17%) and non-Covid related diagnosis (brain trauma, status epilepticus and abdominal mass). Seventeen patients (71%) had an initial positive COVID-19 test. The other seven (29%) were detected with a second RT-PCR. Supportive treatment included vasopressors (n=4), steroids (n=3), dialysis (n=2), high flow nasal cannula (n=3) and mechanical ventilation (n=9). The mean PICU length of stay was 3 days (IQR 1.5-16). Patterns in chest x-rayincluded interstitial (n=11, 50%), alveolar (n=4, 18%) and atelectasis (n=4, 18%). Two patients died (8%), one immunocompromised with sepsis and the other because of intracranial bleeding. CONCLUSION(S) This study describes the clinical and radiological characteristics of severe COVID-19 infection in children and highlights the value of a second diagnostic test to decrease the false negative rate. Further investigation is warranted in order to evaluate the impact of this approach in terms of cost, isolation measures and inpatient infection rates. (Table Presented).