Spectrum of SARS-CoV-2-Related Clinical Syndromes in Children: A Year in the Life

Clin Pediatr (Phila). 2022 Feb;61(2):188-193. doi: 10.1177/00099228211064655. Epub 2021 Dec 3.

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has a wide pediatric clinical spectrum. Initial reports suggested that children had milder symptoms compared with adults; then diagnosis of multisystem inflammatory syndrome in children (MIS-C) emerged. We performed a retrospective cohort study of hospitalized patients at a children's hospital over 1 year. Our objectives were to study the demographic and clinical profile of pediatric SARS-CoV-2-associated diagnoses. Based on the clinical syndrome, patients were classified into coronavirus disease 2019 (COVID-19; non-MIS-C) and MIS-C cohorts. Among those who tested positive, 67% were symptomatic. MIS-C was diagnosed in 24 patients. Both diagnoses were more frequent in Caucasians. Both cohorts had different symptom profiles. Inflammatory markers were several-fold higher in MIS-C patients. These patients had critical care needs and longer hospital stays. More COVID-19 patients had respiratory complications, while MIS-C cohort saw cardiovascular involvement. Health care awareness of both syndromes is important for early recognition, diagnosis, and prompt treatment.

Keywords: COVID-19; Multi-system inflammatory syndrome in children; SARS-CoV-2.

MeSH terms

  • Adolescent
  • COVID-19 / classification
  • COVID-19 / complications*
  • COVID-19 / epidemiology
  • COVID-19 / physiopathology*
  • Child
  • Child, Preschool
  • China / epidemiology
  • Cohort Studies
  • Female
  • Humans
  • Male
  • Retrospective Studies
  • Syndrome*
  • Systemic Inflammatory Response Syndrome / classification
  • Systemic Inflammatory Response Syndrome / epidemiology
  • Systemic Inflammatory Response Syndrome / physiopathology

Supplementary concepts

  • pediatric multisystem inflammatory disease, COVID-19 related