COVID-19 Disease in Presenting to the Pediatric Emergency Department: A Multicenter Study of 8886 Cases.

Autor: Duman M; Division of Pediatric Emergency Care, Department of Pediatrics, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey. Electronic address: mduman@deu.edu.tr., Şık N; Division of Pediatric Emergency Care, Department of Pediatrics, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey., Tekşam Ö; Hacettepe University Ihsan Dogramaci Children's Hospital, Ankara, Turkey., Akça H; Ankara City Hospital, Department of Pediatric Emergency Medicine, Ankara, Turkey., Kurt F; Ankara City Hospital, Department of Pediatric Emergency Medicine, Ankara, Turkey., Çağlar AA; Ankara City Hospital, Department of Pediatric Emergency Medicine, Ankara, Turkey., Yıldız LA; Ankara City Hospital, Department of Pediatric Emergency Medicine, Ankara, Turkey., Taşar MA; University of Health Sciences, Ankara Training and Research Hospital, Pediatric Emergency Department, Ankara, Turkey., Fidancı İ; University of Health Sciences, Ankara Training and Research Hospital, Pediatric Emergency Department, Ankara, Turkey., Yayla BCC; University of Health Sciences, Ankara Training and Research Hospital, Pediatric Emergency Department, Ankara, Turkey., Yılmaz D; Division of Pediatric Emergency Care, Department of Pediatrics, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey., Güngör E; Hacettepe University Ihsan Dogramaci Children's Hospital, Ankara, Turkey., Demir Ş; Aydın Gynecology and Childhood Hospital, Pediatric Emergency Department, Aydın, Turkey., Çokuğraş H; Cerrahpasa Faculty of Medicine, İstanbul University-Cerrahpasa, Istanbul, Turkey., Cebeci SO; Cerrahpasa Faculty of Medicine, İstanbul University-Cerrahpasa, Istanbul, Turkey., Önal P; Cerrahpasa Faculty of Medicine, İstanbul University-Cerrahpasa, Istanbul, Turkey., Saz EU; Ege University Faculty of Medicine, Izmir, Turkey., Yurtseven A; Ege University Faculty of Medicine, Izmir, Turkey., Uysalol M; Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Division of Pediatric Emergency, Istanbul, Turkey., Yıldız R; Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Division of Pediatric Emergency, Istanbul, Turkey., Gümüş S; Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Division of Pediatric Emergency, Istanbul, Turkey., Bal A; Manisa Celal Bayar University Faculty of Medicine, Hafsa Sultan Hospital, Manisa, Turkey., Bayturan SŞ; Manisa Celal Bayar University Faculty of Medicine, Hafsa Sultan Hospital, Manisa, Turkey., Zengin N; Manisa Celal Bayar University Faculty of Medicine, Hafsa Sultan Hospital, Manisa, Turkey., Atik S; Manisa Celal Bayar University Faculty of Medicine, Hafsa Sultan Hospital, Manisa, Turkey., Çiftdoğan DY; Pediatric Emergency Medicine Clinic, University of Health Sciences, Tepecik Education and Research Hospital, Izmir, Turkey., Berksoy E; Pediatric Emergency Medicine Clinic, University of Health Sciences, Tepecik Education and Research Hospital, Izmir, Turkey., Çiçek A; Pediatric Emergency Medicine Clinic, University of Health Sciences, Tepecik Education and Research Hospital, Izmir, Turkey., Şahin S; Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey., Kızıl MC; Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey., Kara Y; Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey., Apa H; Dr. Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital, Izmir, Turkey., Ulusoy E; Dr. Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital, Izmir, Turkey., Kara AA; Dr. Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital, Izmir, Turkey., Yesil E; Mersin City Training and Research Hospital, Mersin, Turkey., Erdem M; Mersin City Training and Research Hospital, Mersin, Turkey., Turan C; Mersin City Training and Research Hospital, Mersin, Turkey., Arslanoglu S; Istanbul Medeniyet University Faculty of Medicine, Goztepe Prof Dr Suleyman Yalcin City Hospital, Istanbul, Turkey., Duyu M; Istanbul Medeniyet University Faculty of Medicine, Goztepe Prof Dr Suleyman Yalcin City Hospital, Istanbul, Turkey., Besli GE; Istanbul Medeniyet University Faculty of Medicine, Goztepe Prof Dr Suleyman Yalcin City Hospital, Istanbul, Turkey., Arslan G; Derince Training and Research Hospital, Kocaeli, Turkey., Oflu AT; Afyonkarahisar Health Sciences University Faculty of Medicine, Department of Pediatrics, Afyon, Turkey., Çeleğen M; Afyonkarahisar Health Sciences University Faculty of Medicine, Department of Pediatrics, Afyon, Turkey., Buldu E; Afyonkarahisar Health Sciences University Faculty of Medicine, Department of Pediatrics, Afyon, Turkey., Pişkin İE; Zonguldak Bulent Ecevit University Faculty of Medicine, Department of Pediatrics, Zonguldak, Turkey., Kardeş H; Zonguldak Bulent Ecevit University Faculty of Medicine, Department of Pediatrics, Zonguldak, Turkey., Yılmaz HL; Cukurova University, Faculty of Medicine, Adana, Turkey., Yıldızdaş D; Cukurova University, Faculty of Medicine, Adana, Turkey., Gökulu G; Cukurova University, Faculty of Medicine, Adana, Turkey., Çay P; Cukurova University, Faculty of Medicine, Adana, Turkey., Özer U; Cukurova University, Faculty of Medicine, Adana, Turkey., Güleryüz OD; Gazi University, Faculty of Medicine, Department of Pediatric Emergency, Ankara, Turkey., Çolak Ö; Gazi University, Faculty of Medicine, Department of Pediatric Emergency, Ankara, Turkey., Güneysu ST; Gazi University, Faculty of Medicine, Department of Pediatric Emergency, Ankara, Turkey.
Jazyk: angličtina
Zdroj: The American journal of emergency medicine [Am J Emerg Med] 2022 Sep; Vol. 59, pp. 133-140. Date of Electronic Publication: 2022 Jun 09.
DOI: 10.1016/j.ajem.2022.06.015
Abstrakt: Background: The aim was to evaluate the epidemiological, clinical, laboratory, and radiologic data of children with SARS-CoV-2 positivity by polymerase chain reaction (PCR) together with treatment strategies and clinical outcomes and to evaluate cases of multisystem inflammatory syndrome in children (MIS-C) in this population.
Methods: This was a multicenter retrospective observational cohort study performed in the pediatric emergency departments of 19 tertiary hospitals. From March 11, 2020, to May 31, 2021, children who were diagnosed with confirmed nasopharyngeal/tracheal specimen SARS-CoV-2 PCR positivity or positivity for serum-specific antibodies against SARS-CoV-2 were included. Demographics, presence of chronic illness, symptoms, history of contact with SARS-CoV-2 PCR-positive individuals, laboratory and radiologic investigations, clinical severity, hospital admissions, and prognosis were recorded.
Results: A total of 8886 cases were included. While 8799 (99.0%) cases resulted in a diagnosis of SARS-CoV-2 with PCR positivity, 87 (1.0%) patients were diagnosed with MIS-C. Among SARS-CoV-2 PCR-positive patients, 51.0% were male and 8.5% had chronic illnesses. The median age was 11.6 years (IQR: 5.0-15.4) and 737 (8.4%) patients were aged <1 year. Of the patients, 15.5% were asymptomatic. The most common symptoms were fever (48.5%) and cough (30.7%) for all age groups. There was a decrease in the rate of fever as age increased (p < 0.001); the most common age group for this symptom was <1 year with the rate of 69.6%. There was known contact with a SARS-CoV-2 PCR-positive individual in 67.3% of the cases, with household contacts in 71.3% of those cases. In terms of clinical severity, 83 (0.9%) patients were in the severe-critical group. There was hospital admission in 1269 (14.4%) cases, with 106 (1.2%) of those patients being admitted to the pediatric intensive care unit (PICU). Among patients with MIS-C, 60.9% were male and the median age was 6.4 years (IQR: 3.9-10.4). Twelve (13.7%) patients presented with shock. There was hospital admission in 89.7% of these cases, with 29.9% of the patients with MIS-C being admitted to the PICU.
Conclusion: Most SARS-CoV-2 PCR-positive patients presented with a mild clinical course. Although rare, MIS-C emerges as a serious consequence with frequent PICU admission. Further understanding of the characteristics of COVID-19 disease could provide insights and guide the development of therapeutic strategies for target groups.
Competing Interests: Declaration of Competing Interest The authors declare no conflict of interest.
(Copyright © 2022 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: