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Pediatr Infect Dis J. The Risk of Children Hospitalized With Severe COVID-19 in Wuhan

tetano

Editor, Senior Moderator
Pediatr Infect Dis J. 2020 May 6. doi: 10.1097/INF.0000000000002739. [Epub ahead of print]
The Risk of Children Hospitalized With Severe COVID-19 in Wuhan.


Wang Y[SUP]1,[/SUP][SUP]2[/SUP], Zhu F[SUP]3,[/SUP][SUP]4[/SUP], Wang C[SUP]3,[/SUP][SUP]4[/SUP], Wu J[SUP]5[/SUP], Liu J[SUP]6[/SUP], Chen X[SUP]7[/SUP], Xiao H[SUP]2[/SUP], Liu Z[SUP]7[/SUP], Wu Z[SUP]6[/SUP], Lu X[SUP]8[/SUP], Ma J[SUP]7[/SUP], Zeng Y[SUP]9[/SUP], Peng H[SUP]6[/SUP], Sun D[SUP]7[/SUP].

Author information




Abstract

BACKGROUND:

Novel coronavirus disease (COVID-19) is spreading globally. Little is known about the risk factors for the clinical outcomes of COVID-19 in children.
METHODS:

A retrospective case-control study was taken in children with severe acute respiratory syndrome coronary virus-2 infection in Wuhan Children's Hospital. Risk factors associated with the development of COVID-19 and progression were collected and analyzed.
RESULTS:

Eight out of 260 children diagnosed with severe COVID-19 pneumonia were included in the study. Thirty-five children with COVID-19 infection matched for age, sex and date of admission, and who classified as non-severe type, were randomly selected from the hospital admissions. For cases with severe pneumonia caused by COVID-19, the most common symptoms were dyspnea (87.5%), fever (62.5%) and cough (62.5%). In laboratory, white blood cells count was significantly higher in severe children than non-severe children. Levels of inflammation bio-makers such as hsCRP, IL-6, IL-10 and D-dimer elevated in severe children compared with non-severe children on admission. The level of total bilirubin and uric acid clearly elevated in severe children compared with non-severe children on admission. All of severe children displayed the lesions on chest CT, more lung segments were involved in severe children than in non-severe children, which was only risk factor associated with severe COVID-19 pneumonia in multivariable analysis.
CONCLUSIONS:

More than 3 lung segments involved were associated with greater risk of development of severe COVID-19 in children. Moreover, the possible risk of the elevation of IL-6, high total bilirubin and D-dimer with univariable analysis could identify patients to be severe earlier.



PMID:32384397DOI:10.1097/INF.0000000000002739
 
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