Clinical-epidemiological study of COVID-19 infection in hospitalized children

ABSTRACT

Background: Emerging evidence suggests that children are at greater risk of COVID-19 infection than initially predicted. Although studies show a slight evolution in pediatric patients, there is an increased risk in newborns and infants, as immaturity of the respiratory tract and immune system contributes to the development of severe forms in this age group. There is also insufficient information on the role of children in the transmission of the virus, which is important in making public health decisions. Aim(s) To identify the clinical and epidemiological characteristics and transmission patterns of pediatric patients with the Covid-19. Method(s) The study includes 417 children hospitalized in the COVID-19 section of the IMSP Mother and Child Institute in 2021. The mean age was 3.96 +/- 3.97 years. Confirmation of the diagnosis was based on the detection of SARS-CoV- 2 virus by the application of molecular biology tests or rapid tests for the detection of SARS-CoV- 2 antigen. Result(s) More than half of the children were under the age of 5 (58.27% 95% CI, 65.3-74.3), of which newborns accounted for 10.79% 95% CI, 8.1-14.3, and infants up to one year -28.29% 95% CI, 24.1-32.9. Boys prevailed slightly, accounting for 56.83% 95% CI, 51.9-61.6, and 60.67% 95% CI, 55.8-65.4 of children with COVID-19 infection were from urban areas. From the anamnestic data, the mean time from the onset of SARS-CoV- 2 infection to the time of diagnostic was 3.88 +/- 1.98 days. The conditions of transmission of the virus to children included in the study were family contact in 46.04% 95% CI, 41.2-51.0 cases, import cases 6.95% 95% CI, 4.8-9.9, participation in public events in 5.7% 95% CI, 3.8-8.6, contact in children's communities (schools/kindergartens) in 4.31% 95% CI, 2.1-6.9. Also, there were 1.67% 95% CI, 0.7-3.6 newborns of COVID-19 positive mothers with symptomatic forms. The number of hospitalizations was obviously increased in march-april and august-september, confirming the evolution in waves of the SARS-CoV- 2 pandemic. Conclusion(s) Frequent affecting to children up to one year of age is a cause for concern, as infants have a developing immune system and are at risk for bronchopulmonary damage. Family contact is the main source of infection for the pediatric population, so interventions targeting children could have a relatively small impact on reducing the transmission of SARS-CoV- 2 infection.