DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20215044

Morbidity, mortality and clinico-laboratory profile of COVID-19 related illness in children: a retrospective observational study from a tertiary care centre in India

Bijoy Patra, Manju Nimesh, Parasdeep Kaur, Sumantha Patil, Hema Gupta, Saria Jilowa, Dheeraj Bahl

Abstract


Background: As India is poised for a third wave of SARS Co-V2 infection with a large unvaccinated pediatric population, it becomes imperative and pertinent for a study to find out its demographic, clinico-laboratory profile, and outcome in children with COVID-19 disease and its related illness.

Methods: This is a retrospective observational study undertaken for Children and Adolescent admitted in the department of pediatrics of a teaching and tertiary care referral hospital, Delhi.

Results: The median age of admitted children with COVID-19 disease was 11 years with an interquartile range 3 to 16 years. The median duration of hospital stay was 10 days (mean: 18±14 days). Mortality was 9/62 (14%). Recovery in non-severe (asymptomatic, mild, moderate) was 41/41 (100%), and in severe and critical illness including MISC was 42.8% (9/21). Mortality in severe and critical patients managed in SARI and COVID ward was 44% (8/18). Death among MISC patient in PICU was 33% (1/3). Difference in CRP rise was significant in severe and non-severe group of COVID-19 (p=0.017).

Conclusions: Even though the morbidity and mortality associated with COVID-19 infection and related illness seems to be miniscule, the infection causes significant illness in the subgroup of children who requires hospitalization and can be fatal in those with comorbidity.


Keywords


Morbidity, Mortality, Clinico-laboratory profile, COVID-19, MISC

Full Text:

PDF

References


Lu H, Stratton CW, Tang YW. Outbreak pneumonia of unknown etiology in Wuhan China: the mystery and the miracle. J Med Viral. 2020;16:54-9.

Zhu N, Zhang D, Wang W. A novel coronavirus from patients with pneumonia in China, 2019. N Eng J Med. 2020;54:44-9.

World Health Organization. Situation reports. Available at: https:// www.who.int/emergencies/diseases/novel-coronavirus-2019/ situation-reports/. Accessed on 13th July 2020.

Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395:507-713.

Qiu H, Wu J, Hong L, Luo Y, Song Q, Chen D. Clinical and epidemiological features of 36 children with coronavirus disease 2019 (COVID-19) in Zhejiang, China: an observational cohort study. Lancet Infect Dis. 2020;20:689-96.

Dong Y, Mo X, Hu Y, Qi X, Jiang F, Jiang Z et al. Epidemiological characteristics of 2143 pediatric patients with 2019 coronavirus disease in China. Pediatrics. 2020;145:e20200702.

Ludvigsson JF. Systematic review of COVID‐19 in children shows milder cases and a better prognosis than adults. Acta Pediatrica. 2020;109:1088-95.

Zimmerman P, Curtis N. Coronavirus infections in children including COVID-19: an overview of the epidemiology, clinical features, diagnosis, treatment, and prevention options in children. Pediatr Infect Dis J. 2020;39:355-68.

Nickbakhsh S, Mair C, Matthews L, Reeve R, Johnson PC, Thorburn F et al. Virus-virus interactions impact the population dynamics of influenza and the common cold. Proceedings National Academy Sci. 2019;116(52):27142-50.

Lee PI, Hu YL, Chen PY, Huang YC, Hsueh PR. Are children less susceptible to COVID-19? J Microbiol Immunol Infect. 2020;53:371-2.

Godfred-Cato S. COVID-19-associated multisystem inflammatory syndrome in children-United States, March-July 2020. MMWR Morb Mortal Wkly Rep. 2020;69(32):1074-80.

Royal college of Pediatrics and Child Health. Guidance-Pediatric multisystem inflammatory syndrome temporally associated with COVID-19, 2020. Available at: https://www.rcpch.ac.uk/resources/guidance-pediatric-multisystem-inflammatory-syndrome- temporally-associated-covid-19. Accessed on September 10th, 2020.

World Health Organization. Multisystem Inflammatory Syndrome in Children and Adolescents With COVID-19. Scientific Brief. WHO website. Published May 15, 2020. Available at: https://www.who.int/publications-detail/multisystem-inflammatory-syndrome-in-children-and-adolescents-with-covid-19. Accessed on January 18th, 2021.

Sarangi B, Reddy VS, Oswal JS, Malshe N, Patil A, Chakraborty M et al. Epidemiological and clinical characteristics of COVID-19 in Indian children in the initial phase of the pandemic. Indian pediatrics. 2020;57(10):914-7.

Panahi L, Amiri M, Pouy S. Clinical characteristics of COVID-19 infection in newborns and pediatrics: systematic review. Arch academic emergency med. 2020;8:1.

Meena J, Yadav J, Saini L, Yadav A, Kumar J. Clinical features, and outcome of SARS-CoV-2 infection in children: A systematic review and meta-analysis. Indian Pediatrics. 2020;57(9):820-6.

Hoang A, Chorath K, Moreira A, Evans M, Burmeister-Morton F, Burmeister F et al. COVID-19 in 7780 pediatric patients: a systematic review. E Clin Med. 2020;24:100433.

Jat KR, Sankar J, Das RR. Clinical profile, and Risk factors for severe disease in 402 Children Hospitalized with SARS-CoV-2 from India: Collaborative Indian Pediatric COVID study group. J Trop Pediatr. 2021;1-11.

Gupta S, Chopra N, Singh A, Gera R, Chellani H, Pandey R et al. Unusual Clinical Manifestations and Outcome of Multisystem Inflammatory Syndrome in Children (MIS-C) in a Tertiary Care Hospital of North India. J Trop Pediatr. 2021;67(1):fmaa127.

Shekerdemian LS, Mahmood NR, Wolfe KK, Riggs BJ, Ross CE, McKiernan CA et al. Characteristics and outcomes of children with coronavirus disease 2019 (COVID-19) infection admitted to US and Canadian pediatric intensive care units. JAMA pediatrics. 2020;174(9):868-73.

Chao JY, Derespina KR, Herold BC, Goldman DL. Clinical characteristics and outcomes of hospitalized and critically ill children and adolescents with coronavirus disease 2019 (COVID-19) at a Tertiary Care Medical Center in New York City. J Pediatr. 2020;223:14-9.

Götzinger F, Santiago-García B, Noguera-Julián A, Lanaspa M. COVID-19 in children and adolescents in Europe: a multinational, multicenter cohort study. Lancet Child Adolescent Health. 2020;4(9):653-61.

Henry BM, Lippi G, Plebani M. Laboratory abnormalities in children with novel coronavirus disease 2019. Clin Chem Lab Med. 2020;58:1135-8.

Yang AP, Liu J, Tao W, Li H. The diagnostic and predictive role of NLR, d-NLR and PLR in COVID-19 patients. Int Immunopharmacol. 2020;84:106504.

Liu H, Liu F, Li J, Zhang T, Wang D, Lan W. Clinical and CT imaging features of the COVID-19 pneumonia: Focus on pregnant women and children. J infect. 2020;80(5):e7-13.