Pucarelli-Lebreiro Giuliana, Venceslau Marianna Tavares, Cordeiro Catherine Crespo, Maciel Fernanda Queiroz, Anachoreta Thiago Dias, de Abreu Thalita Fernandes, Frota Ana Cristina Cisne, Castiñeiras Terezinha Marta Pereira Pinto, da Costa Analucia Mendes, Lopes Adriana Cristina da Luz, Campos Ludmila Nascimento Rodrigues, Calvano Luiza Maria, Guimaraes Maria Angelica Arpon Marandino, Hofer Cristina Barroso
Department of Pediatric Infectious Diseases, Instituto de Puericultura Pediatria Martagão Gesteira, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
Department of Preventive Medicine, University Hospital Clementino Fraga Filho, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
Front Pediatr. 2022 Jul 18;10:934648. doi: 10.3389/fped.2022.934648. eCollection 2022.
The coronavirus disease-2019 (COVID-19) clinical manifestations in children and adolescents are diverse, despite the respiratory condition being the main presentation. Factors such as comorbidities and other respiratory infections may play a role in the initial presentation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. This study aims to describe the epidemiological aspects, clinical, and laboratory manifestations of pediatric patients admitted to a tertiary pediatric hospital in Rio de Janeiro, diagnosed with COVID-19, and compare these with other viral conditions during the first year of the SARS-CoV-2 pandemic.
All patients under 18 years of age that were admitted with upper airway infection were enrolled and followed up for 30 days. The main dependent variable was the laboratorial diagnosis of SARS-CoV-2, and independent variables were studied through logistic regression.
A total of 533 patients were recruited, and 105 had confirmed SARS-CoV-2 infection. Detection of other viruses occurred in 34% of 264 tested participants. Six patients died (two in SARS-CoV-2 infected group). The variables independently associated with COVID-19 were older age (OR = 1.1, 95% CI = 1.0-1.1), lower leukocytes count at entry (OR = 0.9, 95% CI = 0.8-0.9), and contact with suspected case (OR = 1.6, 95% CI = 1.0-2.6). Patients with COVID-19 presented higher odds to be admitted in an intensive care unit (OR = 1.99, 95% CI = 1.08-3.66).
Even during the SARS-CoV-2 pandemic, several other respiratory viruses were present in admitted pediatric patients. Variables associated with COVID-19 infection were older age, lower leukocytes count at entry, and a domiciliary suspect contact. Although patients with COVID-19 were more frequently admitted to ICU, we did not observe higher mortality in this group.
尽管呼吸道症状是主要表现，但2019冠状病毒病（COVID-19）在儿童和青少年中的临床表现多种多样。合并症和其他呼吸道感染等因素可能在严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染的初始表现中起作用。本研究旨在描述里约热内卢一家三级儿科医院收治的确诊COVID-19的儿科患者的流行病学、临床和实验室表现，并在SARS-CoV-2大流行的第一年将这些表现与其他病毒感染情况进行比较。
纳入所有因上呼吸道感染入院的18岁以下患者，并随访30天。主要因变量是SARS-CoV-2的实验室诊断，通过逻辑回归研究自变量。
共招募了533名患者，其中105名确诊感染SARS-CoV-2。在264名接受检测的参与者中，34%检测出其他病毒。6名患者死亡（2名在SARS-CoV-2感染组）。与COVID-19独立相关的变量包括年龄较大（比值比[OR]=1.1，95%置信区间[CI]=1.0-1.1）、入院时白细胞计数较低（OR=0.9，95%CI=0.8-0.9）以及与疑似病例接触（OR=1.6，95%CI=1.0-2.6）。COVID-19患者入住重症监护病房的几率更高（OR=1.99，95%CI=1.08-3.66）。
即使在SARS-CoV-2大流行期间, 入院的儿科患者中也存在几种其他呼吸道病毒。与COVID-19感染相关的变量包括年龄较大、入院时白细胞计数较低以及家庭中有疑似接触者。尽管COVID-19患者更频繁地入住重症监护病房，但我们并未观察到该组的死亡率更高。
