Background: To identify the clinical findings and outcomes of children with coronavirus disease 2019 (COVID-19) and factors predicting reverse transcription polymerase chain reaction (RT-PCR) positivity.
Methods: The data were analyzed retrospectively for suspected and confirmed pediatric COVID-19 patients between March 20 and May 31, 2020.
Results: There were 404 children, of them, 176 (43.6%) patients were confirmed to have COVID-19, and 228 (56.4%) were considered suspected cases. Confirmed cases were less symptomatic on admission (67.6%-95.6%). Cough (44.9%), fever (38.1%), sore throat (18.5%), and smell-taste loss (12.7%) were the most common symptoms. Confirmed cases had a 92.6% identified history of contact with COVID-19. Close contact with COVID-19 positive family members and sore throat increased the RT-PCR positivity 23.8 and 5.0 times, respectively; while positivity decreased by 0.4 times if fever was over 38 °C. Asymptomatic and mild cases were categorized as "group 1" (n = 153); moderate, severe, and critical cases as "group 2" (n = 23) in terms of disease severity. Group 2 cases had higher C-reactive protein (40.9%-15.9%) and procalcitonin (22.7%-4.9%) levels and had more frequent lymphopenia (45.5%-13.1%). Out of 23 cases, 19 had abnormal chest radiograph findings; of them, 15 patients underwent chest computed tomographies (CTs), and all had abnormal findings. However, 26.0% of them needed respiratory support, and no patient required invasive ventilation.
Conclusions: Children with COVID-19 have a milder clinical course and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) rarely causes severe disease in children. Contact history with COVID-19 and sore throat are the most important predictors for RT-PCR positivity. Consequently, the role of asymptomatic children in the contamination chain must be fully established and considered for the control of pandemic.
Keywords: COVID-19; SARS-CoV-2; children; clinical characteristics.
© 2021 Japan Pediatric Society.