SARS-CoV-2 infection in children requiring hospitalization: the experience of Navarra, Spain

World J Pediatr. 2020 Dec;16(6):614-622. doi: 10.1007/s12519-020-00393-x. Epub 2020 Sep 28.

Abstract

Background: Coronavirus disease 2019 in children, or pediatric COVID-19, initially was described as an acute respiratory syndrome similar to the adult presentation but with less severe manifestations.

Methods: We describe the clinical characteristics, disease presentation, treatments and outcomes of all pediatric cases with COVID-19 admitted to the reference hospitals in Navarra, Spain during the first wave of the COVID-19 outbreak (February-May 2020).

Results: We found a low number of hospitalized cases in infants and children compared to adults with a hospitalization ratio of 1:180. Most of these hospitalized cases did not suffer from severe disease. Over 80% of infections reported household contacts, and the mother was the known-contact in 83% of these cases. 72% of hospitalized cases were previously healthy children. We describe how symptoms in pediatric cases are nonspecific and how COVID-19 can be presented with a wide range and variety of symptoms. Respiratory symptoms are not always present, and severe neurological and cardiac features can occur in previously healthy children.

Conclusion: Epidemiological description and case reports will be key to a better recognition and to adequate treatment of pediatric patients with COVID-19.

Keywords: Coronavirus disease 2019; Hospitalization; Severe acute respiratory syndrome coronavirus 2.

MeSH terms

  • Adolescent
  • COVID-19
  • Child
  • Child, Preschool
  • Cohort Studies
  • Combined Modality Therapy
  • Communicable Diseases, Emerging / epidemiology
  • Communicable Diseases, Emerging / prevention & control*
  • Coronavirus Infections / epidemiology*
  • Coronavirus Infections / prevention & control
  • Coronavirus Infections / therapy*
  • Female
  • Follow-Up Studies
  • Hospitalization / statistics & numerical data*
  • Humans
  • Incidence
  • Infant
  • Infection Control / methods*
  • Male
  • Pandemics / prevention & control
  • Pandemics / statistics & numerical data
  • Pneumonia, Viral / epidemiology*
  • Pneumonia, Viral / prevention & control
  • Pneumonia, Viral / therapy*
  • Retrospective Studies
  • Risk Assessment
  • Severity of Illness Index
  • Spain / epidemiology
  • Treatment Outcome