Characteristics and Outcomes of Children With COVID-19: Evidence From West Nusa Tenggara Province, Indonesia

Abstract

Background: Globally, COVID-19 is less prevalent in children than adults. However, in Indonesia, the number of infected children is one rise rapidly. Objectives: To describe characteristics and outcomes of children with COVID-19 in West-Nusa-Tenggara Province, Indonesia. Methods: We retrospectively reviewed registries of children with confirmed COVID-19 collected by the Indonesian-Pediatric-Society, West-Nusa-Tenggara. Children diagnosed with COVID-19 by RT-PCR from March 2 to July 12, 2020, were included in the analysis. Results: Of 146 COVID-19-confirmed subjects, 47.9% were symptomatic, 45.2% were aged < 5 years old, 58.2% were male, 54.8% had a history of COVID-19 contact, and 2.7% (n = 4) died. Asymptomatic subjects had older median age (P < 0.01), longer median duration of RT-PCR conversion (P < 0.01) than symptomatic children and 88.2% had a history of COVID-19 contact. Forty-eight (out of 55 hospitalized symptomatic subjects or 87%) were < 5 years old, had younger median age (P < 0.01), and 4 (7.3%) had a history of COVID-19 contact. They also had higher respiratory rate and body temperature (P < 0.01), lower oxygen saturation (P < 0.01), higher white-blood-cell counts (P = 0.01), and lower hemoglobin levels (P = 0.015) compared to the non-hospitalized symptomatic subjects. Forty-three (78%) hospitalized subjects were in severe and critical condition, 49 (89%) were pneumonic, and 28 (51%) had bilateral infiltrates on chest x-ray. All registered deaths were due to acute-respiratory-distress-syndrome. Besides, all deaths were in hospitals without a pediatric-intensive-care-unit. Conclusions: In the present study, we identified both asymptomatic and symptomatic COVID-19 infected children. Most symptomatic COVID-19 cases were in children < 5 years old, presented with severe pneumonia, and few of them had a history of COVID-19 contact.