METHODS: This is a prospective observational analytical study involving children 1 month to 18 years old, hospitalized with COVID-19-positive and negative SARI during the pandemic. All eligible patients were enrolled after obtaining informed parental consent. Their clinical manifestations, investigations, and outcomes were documented on a predesigned case record form. A nasopharyngeal swab sample for COVID-19 reverse transcription polymerase chain reaction was sent, and results were noted.
RESULTS: From May 2020 to July 2021, 267 children were hospitalized with a diagnosis of SARI. Out of these, 146 (54.7%) were boys and 78.7% were under five years of age. Other presentations included fever and cough, breathlessness, nausea, vomiting, diarrhea, rash, seizures, and altered sensorium. Twenty-eight patients (10.5%) tested positive for COVID-19. COVID-19 patients were similar in terms of demographic characteristics and presenting symptoms to non-COVID-19 patients but had a lower absolute lymphocyte count (p = 0.019) and higher serum alanine transaminase levels (p = 0.013). Acute respiratory distress syndrome (OR, 4.3; 95% CI, 1.8-10.0), shock (OR, 3.9; 95% CI, 1.9-7.9), and need for intensive care unit admission (OR, 9.9; 95% CI, 6.9-14) were more common in COVID-19 SARI patients. Death occurred in 18% of COVID-19 and 9% of non-COVID-19 patients (p = 0.07). SARI nonsurvivors had significantly lower blood pH and platelet counts than survivors.
CONCLUSIONS: Comparison of COVID-19-positive and negative SARI patients showed subtle differences between the two groups, with COVID-19-positive children having an increased severity of illness. Also, laboratory evidence of multiorgan dysfunction at admission was associated with higher mortality.
方法:这是一项前瞻性观察性分析研究,涉及1个月至18岁的儿童,大流行期间因COVID-19阳性和阴性SARI住院。所有符合条件的患者均在获得父母知情同意后进行登记。他们的临床表现,调查,结果记录在预先设计的病例记录表上.发送了用于COVID-19逆转录聚合酶链反应的鼻咽拭子样本,并注意到结果。
结果:从2020年5月至2021年7月,267名儿童因诊断为SARI而住院。在这些中,146(54.7%)为男孩,58.7%为5岁以下。其他演讲包括发烧和咳嗽,呼吸困难,恶心,呕吐,腹泻,皮疹,癫痫发作,和改变的感官。28名患者(10.5%)的COVID-19检测呈阳性。COVID-19患者的人口统计学特征和症状与非COVID-19患者相似,但绝对淋巴细胞计数较低(p=0.019),血清丙氨酸转氨酶水平较高(p=0.013)。急性呼吸窘迫综合征(OR,4.3;95%CI,1.8-10.0),shock(OR,3.9;95%CI,1.9-7.9),以及重症监护病房入院的需要(或者,9.9;95%CI,6.9-14)在COVID-19SARI患者中更为常见。18%的COVID-19患者和9%的非COVID-19患者死亡(p=0.07)。SARI非幸存者的血液pH和血小板计数明显低于幸存者。
结论:COVID-19阳性和阴性SARI患者的比较显示两组之间存在细微差异,COVID-19阳性儿童的疾病严重程度增加。此外,入院时多器官功能障碍的实验室证据与较高的死亡率相关.