Features of the coronavirus disease course in young children
DOI:
https://doi.org/10.14739/2310-1210.2021.5.227539Keywords:
coronavirus disease, young childrenAbstract
The aim. To analyze the features of the coronavirus disease course in young children.
Materials and methods. We analyzed case histories of 60 children aged 0 to 3 years who were hospitalized to the Lviv Regional Children’s Clinical Hospital “OHMATDYT” in the period from April to December 2020 with a diagnosis of coronavirus disease. Out of the 60 children 36 (60 %) were boys and 24 (40 %) were girls. Laboratory studies on the presence of SARS-CoV-2 virus RNA were performed in samples of nasal and pharyngeal swabs by PCR at the State Institution “Lviv Regional Laboratory Center of the Ministry of Health of Ukraine”. Blood and urinary laboratory tests were performed on the basis of the Laboratories in Lviv Regional Children’s Clinical Hospital “OHMATDYT”. The result were statistically processed using Excel software from Microsoft Office 2019 packages. Quantitative characteristics were given as M ± m (arithmetic mean ± standard deviation of the arithmetic mean).
Results. It was found that 40% of children under 1 year old and only 15% from 1 to 3 years old were hospitalized on the first day of the disease. Parents of sick children in 51 (85 %) cases confirmed the presence of contact with infected family members. The analysis of the disease clinical manifestations showed that during the disease course, most children with coronavirus disease had the following clinical manifestations: fever, runny nose, cough, abdominal pain, diarrhea, and general weakness. Lymphopenia, which is the most common laboratory finding in adults with COVID-19, was found only in 28 % of children hospitalized to the Regional Children’s Clinical Hospital “OHMATDYT”. The presence of complications in the form of pneumonia was observed in 5 children, which amounted to 8.3 %. The average duration of inpatient treatment for children under 1 year of age was 7 days, and it was 6 days for children between 1 and 3 years of age.
Conclusions. It was found that 85% of child inpatients were in contact with family members in whom the presence of SARS-CoV-2 infection was confirmed. The main manifestations of coronavirus disease were fever ˃38 °C and general weakness in more than 55% of children aged 0 to 3 years. The level of leukocytes within the age norm was observed in 46.6% of children, leukopenia– in 35.0%, and lymphopenia– in 28.3%. The course of the disease among young children was mild, and only 8.3% of children had the moderately severe course, complicated by pneumonia.
References
Bhuiyan, M. U., Stiboy, E., Hassan, M. Z., Chan, M., Islam, M. S., Haider, N., Jaffe, A., & Homaira, N. (2021). Epidemiology of COVID-19 infection in young children under five years: A systematic review and meta-analysis. Vaccine, 39(4), 667-677. https://doi.org/10.1016/j.vaccine.2020.11.078
Simon, A. K., Hollander, G. A., & McMichael, A. (2015). Evolution of the immune system in humans from infancy to old age. Proceedings of the Royal Society B: Biological Sciences, 282(1821), Article 20143085. https://doi.org/10.1098/rspb.2014.3085
Wu, Z., & McGoogan, J. M. (2020). Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA, 323(13), 1239-1242. https://doi.org/10.1001/jama.2020.2648
Cui, X., Zhang, T., Zheng, J., Zhang, J., Si, P., Xu, Y., Guo, W., Liu, Z., Li, W., Ma, J., Dong, C., Shen, Y., Cai, C., & He, S. (2020). Children with coronavirus disease 2019: A review of demographic, clinical, laboratory, and imaging features in pediatric patients. Journal of Medical Virology, 92(9), 1501-1510. https://doi.org/10.1002/jmv.26023
Lu, X., Zhang, L., Du, H., Zhang, J., Li, Y. Y., Qu, J., Zhang, W., Wang, Y., Bao, S., Li, Y., Wu, C., Liu, H., Liu, D., Shao, J., Peng, X., Yang, Y., Liu, Z., Xiang, Y., Zhang, F., Silva, R. M., … Chinese Pediatric Novel Coronavirus Study Team. (2020). SARS-CoV-2 Infection in Children. The New England Journal of Medicine, 382(17), 1663-1665. https://doi.org/10.1056/NEJMc2005073
Lee, P. I., Hu, Y. L., Chen, P. Y., Huang, Y. C., & Hsueh, P. R. (2020). Are children less susceptible to COVID-19? Journal of Microbiology, Immunology and Infection, 53(3), 371-372. https://doi.org/10.1016/j.jmii.2020.02.011
Dong, Y., Mo, X., Hu, Y., Qi, X., Jiang, F., Jiang, Z., & Tong, S. (2020). Epidemiology of COVID-19 Among Children in China. Pediatrics, 145(6), Article e20200702. https://doi.org/10.1542/peds.2020-0702
Márquez-Aguirre, M. P., Gutiérrez-Hernández, A., Lizárraga-López, S. L., Muñoz-Ramírez, C. M., Ventura-Gómez, S. T., Zárate-Castañón, P. M. S., González-Mercado, L. A., López-Alamilla, A. A., Palma-Pérez, R., & Reyes-Hernández, A. (2020). Clinical spectrum of COVID-19 in the pediatric patient. Acta Pediátrica de México, 41(S1), 64-71. https://www.medigraphic.com/cgi-bin/new/resumenI.cgi?IDARTICULO=94518
Huang, C., Wang, Y., Li, X., Ren, L., Zhao, J., Hu, Y., Zhang, L., Fan, G., Xu, J., Gu, X., Cheng, Z., Yu, T., Xia, J., Wei, Y., Wu, W., Xie, X., Yin, W., Li, H., Liu, M., Xiao, Y., … Cao, B. (2020). Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet, 395(10223), 497-506. https://doi.org/10.1016/S0140-6736(20)30183-5
Guan, W. J., & Zhong, N. S. (2020). Clinical Characteristics of Covid-19 in China. The New England Journal of Medicine, 382(19), 1859-1862. https://doi.org/10.1056/NEJMc2005203
Parri, N., Lenge, M., Buonsenso, D., & Coronavirus Infection in Pediatric Emergency Departments (CONFIDENCE) Research Group. (2020). Children with Covid-19 in Pediatric Emergency Departments in Italy. The New England Journal of Medicine, 383(2), 187-190. https://doi.org/10.1056/NEJMc2007617
Steinman, J. B., Lum, F. M., Ho, P. P., Kaminski, N., & Steinman, L. (2020). Reduced development of COVID-19 in children reveals molecular checkpoints gating pathogenesis illuminating potential therapeutics. Proceedings of the National Academy of Sciences of the United States of America, 117(40), 24620-24626. https://doi.org/10.1073/pnas.2012358117
Carsetti, R., Quintarelli, C., Quinti, I., Piano Mortari, E., Zumla, A., Ippolito, G., & Locatelli, F. (2020). The immune system of children: the key to understanding SARS-CoV-2 susceptibility? The Lancet. Child & Adolescent Health, 4(6), 414-416. https://doi.org/10.1016/S2352-4642(20)30135-8
Brodin, P. (2020). Why is COVID-19 so mild in children? Acta Paediatrica, 109(6), 1082-1083. https://doi.org/10.1111/apa.15271
Shen, K., Yang, Y., Wang, T., Zhao, D., Jiang, Y., Jin, R., Zheng, Y., Xu, B., Xie, Z., Lin, L., Shang, Y., Lu, X., Shu, S., Bai, Y., Deng, J., Lu, M., Ye, L., Wang, X., Wang, Y., Gao, L., … Global Pediatric Pulmonology Alliance. (2020). Diagnosis, treatment, and prevention of 2019 novel coronavirus infection in children: experts' consensus statement. World Journal of Pediatrics, 16(3), 223-231. https://doi.org/10.1007/s12519-020-00343-7
Downloads
Published
How to Cite
Issue
Section
License
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)