Abstract

Introduction

Discussion

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Data Availability

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Conflicts of Interest

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Abstract

Background. Despite the worldwide spread of Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2), information about the epidemiological and clinical patterns of this infection is still largely unknown in children. In addition, the prevalence of this disease is still very high in some parts of the world, including Iran. Thus, this study aims to evaluate the epidemiological features, laboratory and imaging findings, and the type of treatments in children with novel coronavirus 2019 (COVID-19). Method. This study is conducted from March 2020–March 2021 by using the medical records of hospitalized confirmed COVID-19 children younger than 18 years in five cities of Iran: Tehran, Ahwaz, Isfahan, Bandar-Abbas, and Khorramabad. In addition to demographic and epidemiological data, we also studied clinical signs and treatments. Results. In total 278 confirmed COVID-19 children, the average age was 5.3 years, and 59.4%were boys. A total of 37.8% had an underlying disease, in which the most common was a malignancy. The most common symptoms were fever and cough. In this group of pediatrics, some abnormal laboratory findings have been seen. GGO (Ground-Glass Opacity) had been diagnosed in 58.6% of children. 3.6% needed oxygen therapy with ventilators, and 83.09% had received antibiotic treatments with the majority of ceftriaxone. Also, 10% had got steroids. In this study, the mortality rate was 4.3%. Conclusion. In this study, most of the children who died had an underlying disease, so timely care and action is important in them. Most children admitted to our study received antibiotics and were prescribed antivirals and steroids for a smaller number. Also, a small number of children received oxygen therapy, most of whom were in the age group of 1 to 5 years.

۱٫ Introduction

Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Because of the intensity and alarming level of spread, the World Health Organization (WHO) deemed it a pandemic [1]. The first pandemic infection to occur due to a coronavirus [2], SARS-CoV-2, is a factor that effects all age groups.

COVID-19 has a low incidence of severe cases among children. Children have a milder clinical course than adults [3–۶]. Children and adults have different levels of immune maturity, which may be the reason for differences in the prevalence and type of clinical manifestations of COVID-19 [7]. However, it is also important to note that even mild COVID-19 can cause transmission [8]. According to the work of Gandhi et al., asymptomatic transmission is the Achilles’ heel of this pandemic [9].

In other words, children can cause cluster propagation in the home environment [10]. Furthermore, children with gastrointestinal symptoms can transmit the virus through their feces for weeks, which is dangerous in some places such as kindergartens or elementary schools [11–۱۳].