Paediatric Nephrology Centre of Excellence, Department of Paediatrics, King Abdulaziz University, Jeddah, Saudi Arabia.
Paediatric Nephrology Centre of Excellence, Department of Paediatrics, King Abdulaziz University, Jeddah, Saudi Arabia.
J Infect Public Health. 2021 Apr;14(4):543-549. doi: 10.1016/j.jiph.2021.01.011. Epub 2021 Jan 18.
The COVID-19 global pandemic caused by severe acute respiratory syndrome coronavirus 2 infection, warranted attention for whether it has unique manifestations in children. Children tend to develop less severe disease with a small percentage present with clinical manifestations of paediatric multisystem inflammatory syndrome and have poor prognosis. We studied the characteristics of COVID-19 in children requiring hospitalisation in the Kingdom of Saudi Arabia and assessed the clinical presentation and the risk factors for mortality, morbidity, and paediatric intensive care (PICU) admission.
We conducted a retrospective analysis of COVID-19 patients under 15 years hospitalised at three tertiary academic hospitals between 1 March and 30 June 2020.
Eighty-eight children were enrolled (>20% were infants). Seven (8%) were in critical condition and required PICU admission, and 4 (4.5%) died of which 3 met the full diagnostic criteria of multi-system inflammatory syndrome and had a high Paediatric Risk of Mortality (PRISM) score at the time of admission. The initial polymerase chain reaction (PCR) test result was positive for COVID-19 in most patients (97.7%), and the remaining two patients had positive result in the repeated confirmatory test. In a subset of patients (20 subjects), repeated PCR testing was performed until conversion to negative result, and the average duration for conversion was 8 (95% CI: 5.2-10.5) days Children requiring PICU admission presented with signs of respiratory distress, dehydration, and heart failure. Most had fever (71.4%) and tonsillitis; 61.4% were discharged within 7 days of hospitalisation. Risk factors for mortality included skin rash, hypotension, hypoxia, signs of heart failure, chest radiograph suggestive of acute respiratory distress syndrome, anaemia, leucocytosis, hypernatraemia, abnormal liver enzymes, and high troponin I, and risk factors for prolonged hospitalisation (>7 days) included the presence of comorbidities, leucopaenia, hyponatraemia, and elevated C-reactive protein.
The majority of hospitalised children had a brief febrile illness and made a full recovery, but a minority had severe disease.
由严重急性呼吸综合征冠状病毒 2 感染引起的 COVID-19 全球大流行引起了人们的关注，因为它是否在儿童中有独特的表现。儿童往往病情较轻，一小部分表现为儿科多系统炎症综合征的临床症状，预后较差。我们研究了沙特阿拉伯住院的 COVID-19 患儿的特点，并评估了死亡率、发病率和儿科重症监护（PICU）入院的临床特征和危险因素。
我们对 2020 年 3 月 1 日至 6 月 30 日期间在三家三级学术医院住院的 15 岁以下 COVID-19 患儿进行了回顾性分析。
共纳入 88 例患儿（>20%为婴儿）。7 例（8%）病情危急，需要 PICU 入院，4 例（4.5%）死亡，其中 3 例符合多系统炎症综合征的全部诊断标准，入院时小儿死亡风险评分（PRISM）较高。大多数患儿的初始聚合酶链反应（PCR）检测结果为 COVID-19 阳性（97.7%），其余 2 例患儿在重复确认试验中结果阳性。在部分患儿（20 例）中，重复进行 PCR 检测，直至结果转为阴性，平均转换时间为 8 天（95%CI：5.2-10.5）。需要 PICU 入院的患儿表现出呼吸窘迫、脱水和心力衰竭的迹象。大多数有发热（71.4%）和扁桃体炎；61.4%的患儿在住院 7 天内出院。死亡的危险因素包括皮疹、低血压、缺氧、心力衰竭体征、胸片提示急性呼吸窘迫综合征、贫血、白细胞增多、高血钠、肝酶异常和高肌钙蛋白 I，住院时间延长（>7 天）的危险因素包括合并症、白细胞减少、低血钠和 C 反应蛋白升高。
大多数住院患儿发热短暂，病情完全恢复，但少数患儿病情严重。
