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Abstract：
Although the 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 coronavirus disease 2019 (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. All children between 1 month and 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) severity based on the criteria. Demographic characteristics, comorbidities, and laboratory variables between the two groups were compared. A total of 292 children confirmed to have COVID-19 infection were included in the study. The 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] 1.92-43.28, p = 0.005 and for patients with asthma bronchiale OR 4.1, 95% CI 1.04-16.80, p = 0.044). In group 2 patients, presence of lymphopenia and hypoalbuminemia, and also an elevation in serum levels of C-reactive protein, procalcitonin, and uric acid were detected and these results were statistically significant (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 in the children was uric acid, with an odds ratio of 1.6 (95% CI 1.14-2.13, p = 0.005) and lymphocytes with an odds ratio of 0.7 (95% CI 0.55-0.88, p = 0.003). Although children are less susceptible to COVID-19, the 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 severely.
摘要：
尽管潜在的疾病与成人的严重病程有关，并且已经广泛报道了实验室异常，关于已有共患疾病的儿童2019年冠状病毒病(COVID-19)的临床病程和实验室检查结果,没有足够的数据.我们旨在描述评估儿童COVID-19严重程度的独立危险因素。在2020年3月11日至12月31日期间因COVID-19住院的所有1个月至18岁儿童均纳入研究。根据标准将患者分为轻度(组1)和中度+重度/危重(组2)严重程度。人口特征，合并症,比较两组间的实验室变量。共有292名确认感染COVID-19的儿童被纳入研究。最常见的相关疾病是肥胖(5.1%)和支气管哮喘(4.1%)。我们观察到患有基础疾病的患者疾病进展更严重，尤其是肥胖和支气管哮喘(肥胖比值比[OR]9.1,95%置信区间[CI]1.92-43.28,p=0.005,支气管哮喘患者OR4.1,95%CI1.04-16.80,p=0.044).在第2组患者中，存在淋巴细胞减少和低蛋白血症，以及血清C反应蛋白水平的升高，降钙素原,和尿酸检测，这些结果具有统计学意义（p值;p<0.001，p=0.046，p=0.006，p=0.045，p<0.001）。儿童中重度COVID-19感染的最强预测因子是尿酸，比值比为1.6（95％CI1.14-2.13，p=0.005），淋巴细胞比值比为0.7（95％CI0.55-0.88，p=0.003）。尽管儿童不太容易感染COVID-19，但预先存在的合并症可能易患严重疾病。此外,淋巴细胞减少和高尿酸是COVID-19感染可能进展更严重的指标。
