Clinical Profile and Short-Term Outcome of Children with Acute SARS-CoV-2 Infection During the First and Second Waves of the Pandemic

Abstract

Objectives: To compare the clinical profile and short-term outcome of children admitted with acute SARS-CoV-2 infection during the first and second waves of the Coronavirus Disease (COVID-19).

Methods: This retrospective study was conducted in a tertiary care setting. A retrospective medical record review of all pediatric patients admitted with confirmed SARS-CoV-2 infection between March 2020 and September 2021 was conducted. Patients' demographic data, pre-existing comorbidities, mode of presentation, and clinical course in the hospital were noted. The outcome measures were in-hospital mortality, need for intensive care, and invasive mechanical ventilation, duration of ICU, and hospital stay.

Results: One thousand and twenty-four children were recruited, 592 of the first wave and 432 of the second wave. In the second wave, more children were admitted with respiratory distress (OR = 3.38) and neurological manifestations (OR = 4.61). There was a higher requirement of intensive care (OR = 4.2) and invasive mechanical ventilation (OR = 4.17). In-hospital mortality of the second wave was also increased (1.4% vs. 0.1%), but the difference was not statistically significant. Children with neurological comorbidities (OR = 8.73), malnutrition (OR = 3.01), and preterm babies (OR = 6.8) were associated with severe COVID.

Conclusion: The clinical profile of the second wave of COVID-19 in children was different from the first wave, with more respiratory distress and neurological manifestations at presentation. In the second wave, a significant increase in the incidence of severe infections requiring ICU care was observed.

Keywords: COVID-19; Comorbidities; Mortality; Neurological manifestations; Severe COVID.