Characteristics and clinical outcomes of COVID-19 in children: a hospital-based surveillance study in Latin America's hardest-hit city

• DOI: 10.1016/j.ijregi.2022.12.003
• Publication Date: 2022-12-15T16:59:38Z
• Authors: Daniel Jarovsky; Giuliana de Freit...; Renata Mazzotti Z...; Thales Araújo de ...; Camila Giuliana A...; Daniella Gregória...; Denis Tadeu Gomes...; Sabrina Bortolin ...; José Cassio de Mo...; Francisco Ivanild...; Flávia Jacqueline...; Marco Aurélio Pal...
• Keywords: 2. Zero hunger; 03 medical and health sciences; 0302 clinical medicine; 11. Sustainability; Coronavirus (COVID-19) Collection; 3. Good health

In 2020, Brazil became the epicentre of the coronavirus disease (COVID-19) pandemic in Latin America, resulting in an unparalleled health catastrophe. Nevertheless, comprehensive clinical reports in Brazilian children are not available.This retrospective, hospital-based, active surveillance study was performed to identify paediatric patients with COVID-19 who presented at a private academic medical centre in a large urban area between March 2020 and March 2021. Clinical and demographic information was analysed for those requiring hospitalization, those with severe illness and those with clinical syndromes.In total, 964 symptomatic cases were evaluated; of these, 17.7% required hospitalization, and 27.5% of hospitalized cases were classified as severe/critical. Acute bronchiolitis and pneumonia were the most common causes of hospitalization among the severe cases. Twenty-seven hospitalized children fulfilled the diagnostic criteria for multi-system inflammatory syndrome (median age 29 months; 85.2% cases were non-severe). A significant co-existing condition was present in 29% of hospitalized children. The risk of hospitalization was higher in children with at least one comorbidity, children aged <2 years and obese children. Increased risk of severe disease was described among those with leukopenia, leukocytosis or any significant comorbidity. No deaths occurred among the study population.Although most children with COVID-19 experienced mild disease, and no deaths occurred among the study population, a significant proportion of cases required hospitalization and developed severe illness. Obesity, young age, underlying comorbidity, leukopenia and leukocytosis were risk factors for hospitalization or severe disease.