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Marques HHS, Pereira MFB, Santos ACD, et al. Differences in children and adolescents with SARS-CoV-2 infection: a cohort study in a Brazilian tertiary referral hospital. Clinics (Sao Paulo). 2021;76:e3488doi: 10.6061/clinics/2021/e3488.
Marques, H. H. S., Pereira, M. F. B., Santos, A. C. D., Fink, T. T., Paula, C. S. Y., Litvinov, N., Schvartsman, C., Delgado, A. F., Gibelli, M. A. B. C., Carvalho, W. B., Odone Filho, V., Tannuri, U., Carneiro-Sampaio, M., Grisi, S., Duarte, A. J. D. S., Antonangelo, L., Francisco, R. P. V., Okay, T. S., Batisttella, L. R., Carvalho, C. R. R., Brentani, A. V. M., Silva, C. A., Eisencraft, A. P., Rossi Junior, A., Fante, A. L., Cora, A. P., Reis, A. G. A. C., Ferrer, A. P. S., Andrade, A. P. M., Watanabe, A., Gonçalves, A. M. F., Waetge, A. R. P., Silva, C. A., Ceneviva, C., Lazari, C. D. S., Abellan, D. M., Santos, E. H. D., Sabino, E. C., Bianchini, F. R. M., Alcantara, F. F. P., Ramos, G. F., Leal, G. N., Rodriguez, I. S., Pinho, J. R. R., Carneiro, J. D. A., Paz, J. A., Ferreira, J. C., Ferranti, J. F., Ferreira, J. O. A., Framil, J. V. S., Silva, K. R. D., Kanunfre, K. A., Bastos, K. L. M., Galleti, K. V., Cristofani, L. M., Suzuki, L., Campos, L. M. A., Perondi, M. B. M., Diniz, M. F. R., Fonseca, M. F. M., Cordon, M. N. A., Pissolato, M., Peres, M. S., Garanito, M. P., Imamura, M., Dorna, M. B., Luglio, M., Rocha, M. C., Aikawa, N. E., Degaspare, N. V., Sakita, N. K., Udsen, N. L., Scudeller, P. G., Gaiolla, P. V. V., Severini, R. D. S. G., Rodrigues, R. M., Toma, R. K., Paula, R. I. C., Palmeira, P., Forsait, S., Farhat, S. C. L., Sakano, T. M. S., Koch, V. H. K., & Cobello Junior, V. (2021). Differences in children and adolescents with SARS-CoV-2 infection: a cohort study in a Brazilian tertiary referral hospital. Clinics (Sao Paulo, Brazil), 76e3488. https://doi.org/10.6061/clinics/2021/e3488
Marques, Heloisa Helena de Sousa, et al. "Differences in children and adolescents with SARS-CoV-2 infection: a cohort study in a Brazilian tertiary referral hospital." Clinics (Sao Paulo, Brazil) vol. 76 (2021): e3488. doi: https://doi.org/10.6061/clinics/2021/e3488
Marques HHS, Pereira MFB, Santos ACD, Fink TT, Paula CSY, Litvinov N, Schvartsman C, Delgado AF, Gibelli MABC, Carvalho WB, Odone Filho V, Tannuri U, Carneiro-Sampaio M, Grisi S, Duarte AJDS, Antonangelo L, Francisco RPV, Okay TS, Batisttella LR, Carvalho CRR, Brentani AVM, Silva CA, Eisencraft AP, Rossi Junior A, Fante AL, Cora AP, Reis AGAC, Ferrer APS, Andrade APM, Watanabe A, Gonçalves AMF, Waetge ARP, Silva CA, Ceneviva C, Lazari CDS, Abellan DM, Santos EHD, Sabino EC, Bianchini FRM, Alcantara FFP, Ramos GF, Leal GN, Rodriguez IS, Pinho JRR, Carneiro JDA, Paz JA, Ferreira JC, Ferranti JF, Ferreira JOA, Framil JVS, Silva KRD, Kanunfre KA, Bastos KLM, Galleti KV, Cristofani LM, Suzuki L, Campos LMA, Perondi MBM, Diniz MFR, Fonseca MFM, Cordon MNA, Pissolato M, Peres MS, Garanito MP, Imamura M, Dorna MB, Luglio M, Rocha MC, Aikawa NE, Degaspare NV, Sakita NK, Udsen NL, Scudeller PG, Gaiolla PVV, Severini RDSG, Rodrigues RM, Toma RK, Paula RIC, Palmeira P, Forsait S, Farhat SCL, Sakano TMS, Koch VHK, Cobello Junior V. Differences in children and adolescents with SARS-CoV-2 infection: a cohort study in a Brazilian tertiary referral hospital. Clinics (Sao Paulo). 2021 Nov 26;76:e3488. doi: 10.6061/clinics/2021/e3488. eCollection 2021. PMID: 34852143; PMCID: PMC8595603.
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Clinics (Sao Paulo). 2021 Nov 26;76:e3488. doi: 10.6061/clinics/2021/e3488. eCollection 2021.

Differences in children and adolescents with SARS-CoV-2 infection: a cohort study in a Brazilian tertiary referral hospital.

Clinics (Sao Paulo, Brazil)

Heloisa Helena de Sousa Marques, Maria Fernanda Badue Pereira, Angélica Carreira Dos Santos, Thais Toledo Fink, Camila Sanson Yoshino de Paula, Nadia Litvinov, Claudio Schvartsman, Artur Figueiredo Delgado, Maria Augusta Bento Cicaroni Gibelli, Werther Brunow de Carvalho, Vicente Odone Filho, Uenis Tannuri, Magda Carneiro-Sampaio, Sandra Grisi, Alberto José da Silva Duarte, Leila Antonangelo, Rossana Pucineli Vieira Francisco, Thelma Suely Okay, Linamara Rizzo Batisttella, Carlos Roberto Ribeiro de Carvalho, Alexandra Valéria Maria Brentani, Clovis Artur Silva, Adriana Pasmanik Eisencraft, Alfio Rossi Junior, Alice Lima Fante, Aline Pivetta Cora, Amelia Gorete A de Costa Reis, Ana Paula Scoleze Ferrer, Anarella Penha Meirelles de Andrade, Andreia Watanabe, Angelina Maria Freire Gonçalves, Aurora Rosaria Pagliara Waetge, Camila Altenfelder Silva, Carina Ceneviva, Carolina Dos Santos Lazari, Deipara Monteiro Abellan, Emilly Henrique Dos Santos, Ester Cerdeira Sabino, Fabíola Roberta Marim Bianchini, Flávio Ferraz de Paes Alcantara, Gabriel Frizzo Ramos, Gabriela Nunes Leal, Isadora Souza Rodriguez, João Renato Rebello Pinho, Jorge David Avaizoglou Carneiro, Jose Albino Paz, Juliana Carvalho Ferreira, Juliana Ferreira Ferranti, Juliana de Oliveira Achili Ferreira, Juliana Valéria de Souza Framil, Katia Regina da Silva, Kelly Aparecida Kanunfre, Karina Lucio de Medeiros Bastos, Karine Vusberg Galleti, Lilian Maria Cristofani, Lisa Suzuki, Lucia Maria Arruda Campos, Maria Beatriz de Moliterno Perondi, Maria de Fatima Rodrigues Diniz, Maria Fernanda Mota Fonseca, Mariana Nutti de Almeida Cordon, Mariana Pissolato, Marina Silva Peres, Marlene Pereira Garanito, Marta Imamura, Mayra de Barros Dorna, Michele Luglio, Mussya Cisotto Rocha, Nadia Emi Aikawa, Natalia Viu Degaspare, Neusa Keico Sakita, Nicole Lee Udsen, Paula Gobi Scudeller, Paula Vieira de Vincenzi Gaiolla, Rafael da Silva Giannasi Severini, Regina Maria Rodrigues, Ricardo Katsuya Toma, Ricardo Iunis Citrangulo de Paula, Patricia Palmeira, Silvana Forsait, Sylvia Costa Lima Farhat, Tânia Miyuki Shimoda Sakano, Vera Hermina Kalika Koch, Vilson Cobello Junior

Affiliations

  1. Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR.
  2. Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, SP, BR.

PMID: 34852143 PMCID: PMC8595603 DOI: 10.6061/clinics/2021/e3488

Abstract

OBJECTIVES: To compare demographic/clinical/laboratory/treatments and outcomes among children and adolescents with laboratory-confirmed coronavirus disease 2019 (COVID-19).

METHODS: This was a cross-sectional study that included patients diagnosed with pediatric COVID-19 (aged <18 years) between April 11, 2020 and April 22, 2021. During this period, 102/5,951 (1.7%) of all admissions occurred in neonates, children, and adolescents. Furthermore, 3,962 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection samples were processed in patients aged <18 years, and laboratory-confirmed COVID-19 occurred in 155 (4%) inpatients and outpatients. Six/155 pediatric patients were excluded from the study. Therefore, the final group included 149 children and adolescents (n=97 inpatients and 52 outpatients) with positive SARS-CoV-2 results.

RESULTS: The frequencies of sore throat, anosmia, dysgeusia, headache, myalgia, nausea, lymphopenia, pre-existing chronic conditions, immunosuppressive conditions, and autoimmune diseases were significantly reduced in children and adolescents (p<0.05). Likewise, the frequencies of enoxaparin use (p=0.037), current immunosuppressant use (p=0.008), vasoactive agents (p=0.045), arterial hypotension (p<0.001), and shock (p=0.024) were significantly lower in children than in adolescents. Logistic regression analysis showed that adolescents with laboratory-confirmed COVID-19 had increased odds ratios (ORs) for sore throat (OR 13.054; 95% confidence interval [CI] 2.750-61.977; p=0.001), nausea (OR 8.875; 95% CI 1.660-47.446; p=0.011), and lymphopenia (OR 3.575; 95% CI 1.355-9.430; p=0.010), but also had less hospitalizations (OR 0.355; 95% CI 0.138-0.916; p=0.032). The additional logistic regression analysis on patients with preexisting chronic conditions (n=108) showed that death as an outcome was significantly associated with pediatric severe acute respiratory syndrome (SARS) (OR 22.300; 95% CI 2.341-212.421; p=0.007) and multisystem inflammatory syndrome in children (MIS-C) (OR 11.261; 95% CI 1.189-106. 581; p=0.035).

CONCLUSIONS: Half of the laboratory-confirmed COVID-19 cases occurred in adolescents. Individuals belonging to this age group had an acute systemic involvement of SARS-CoV-2 infection. Pediatric SARS and MIS-C were the most important factors associated with the mortality rate in pediatric chronic conditions with COVID-19.

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