tetano
Editor, Senior Moderator
J Med Virol
. 2021 Jul 27.
doi: 10.1002/jmv.27237. Online ahead of print.
Evaluation of predictors of severe-moderate COVID-19 infections at children: a review of 292 children
Aybüke Akaslan Kara[SUP] 1 [/SUP], Elif Böncüoğlu[SUP] 1 [/SUP], Elif Kıymet[SUP] 1 [/SUP], Kamile Ötiken Arıkan[SUP] 1 [/SUP], Şahika Şahinkaya[SUP] 1 [/SUP], Mine Düzgöl[SUP] 1 [/SUP], Ela Cem[SUP] 1 [/SUP], Mİray Çelebi[SUP] 1 [/SUP], Hasan Ağın[SUP] 2 [/SUP], Süleyman Nuri Bayram[SUP] 1 [/SUP], Behzat Özkan[SUP] 3 [/SUP], İlker Devrim[SUP] 1 [/SUP]
Affiliations
Abstract
Background: Although underlying disease is associated with a severe course in adults and laboratory abnormalities have been widely reported, there are not sufficient data on the clinical course of COVID-19 in children with pre-existing comorbid conditions and on laboratory findings. We aimed to describe the independent risk factors for estimating the severity of the COVID-19 in children METHODS: All children between one month to 18 years old who were hospitalized during the period of March 11 - December 31, 2020 resulting from COVID-19 were included in the study. Patients were categorized into mild (group 1) and moderate+severe/critically (group 2) of severity based on the criteria. Demographic characteristics, comorbidities, and laboratory variables between two groups were compared.
Results: A total of 292 children confirmed to have COVID-19 infection were included in the study. Most common associated diseases were obesity (5.1%) and asthma bronchiale (4.1%). We observed that disease progressed more severely in patients with underlying diseases, especially obesity and asthma bronchiale (for patients with obesity odds ratio [OR] 9.1, 95% confidence interval [CI] 1.92 to 43.28, p= 0.005 and for patients with asthma bronchiale OR 4.1, 95% CI 1.04 to 16.80, p= 0.044). In group 2 patients, presence of lymphopenia and hypoalbuminemia, and also elevation in serum levels of C-reactive protein, procalcitonin, and uric acid were detected and these results were statistically significantly (p values; p<0.001, p=0.046, p=0.006, p=0,045, p<0.001, respectively). The strongest predictor of moderate-severe COVID-19 infections at the children was uric acid, with an odds ratio of 1.6 (95% CI 1.14 to 2.13, p= 0.005) and lymphocyte with an odds ratio of 0.7 (95% CI 0.55 to 0.88, p = 0.003).
Conclusions: Although children are less susceptible to COVID-19, pre-existing comorbid condition can predispose to severe disease. In addition, lymphopenia and high uric acid are indicators that COVID-19 infection may progress more severe. This article is protected by copyright. All rights reserved.
Keywords: Coronavirus < Virus classification; Lymphocyte < Immune responses; Pandemics < Epidemiology.
. 2021 Jul 27.
doi: 10.1002/jmv.27237. Online ahead of print.
Evaluation of predictors of severe-moderate COVID-19 infections at children: a review of 292 children
Aybüke Akaslan Kara[SUP] 1 [/SUP], Elif Böncüoğlu[SUP] 1 [/SUP], Elif Kıymet[SUP] 1 [/SUP], Kamile Ötiken Arıkan[SUP] 1 [/SUP], Şahika Şahinkaya[SUP] 1 [/SUP], Mine Düzgöl[SUP] 1 [/SUP], Ela Cem[SUP] 1 [/SUP], Mİray Çelebi[SUP] 1 [/SUP], Hasan Ağın[SUP] 2 [/SUP], Süleyman Nuri Bayram[SUP] 1 [/SUP], Behzat Özkan[SUP] 3 [/SUP], İlker Devrim[SUP] 1 [/SUP]
Affiliations
- PMID: 34314067
- DOI: 10.1002/jmv.27237
Abstract
Background: Although underlying disease is associated with a severe course in adults and laboratory abnormalities have been widely reported, there are not sufficient data on the clinical course of COVID-19 in children with pre-existing comorbid conditions and on laboratory findings. We aimed to describe the independent risk factors for estimating the severity of the COVID-19 in children METHODS: All children between one month to 18 years old who were hospitalized during the period of March 11 - December 31, 2020 resulting from COVID-19 were included in the study. Patients were categorized into mild (group 1) and moderate+severe/critically (group 2) of severity based on the criteria. Demographic characteristics, comorbidities, and laboratory variables between two groups were compared.
Results: A total of 292 children confirmed to have COVID-19 infection were included in the study. Most common associated diseases were obesity (5.1%) and asthma bronchiale (4.1%). We observed that disease progressed more severely in patients with underlying diseases, especially obesity and asthma bronchiale (for patients with obesity odds ratio [OR] 9.1, 95% confidence interval [CI] 1.92 to 43.28, p= 0.005 and for patients with asthma bronchiale OR 4.1, 95% CI 1.04 to 16.80, p= 0.044). In group 2 patients, presence of lymphopenia and hypoalbuminemia, and also elevation in serum levels of C-reactive protein, procalcitonin, and uric acid were detected and these results were statistically significantly (p values; p<0.001, p=0.046, p=0.006, p=0,045, p<0.001, respectively). The strongest predictor of moderate-severe COVID-19 infections at the children was uric acid, with an odds ratio of 1.6 (95% CI 1.14 to 2.13, p= 0.005) and lymphocyte with an odds ratio of 0.7 (95% CI 0.55 to 0.88, p = 0.003).
Conclusions: Although children are less susceptible to COVID-19, pre-existing comorbid condition can predispose to severe disease. In addition, lymphopenia and high uric acid are indicators that COVID-19 infection may progress more severe. This article is protected by copyright. All rights reserved.
Keywords: Coronavirus < Virus classification; Lymphocyte < Immune responses; Pandemics < Epidemiology.