Clinical Severity and Predictors of Outcome among Children and Adolescents Hospitalized with Covid-19

Abstract

Objectives: To analyze the clinical, demographic, and epidemiological spectrum and their association with clinical severity and predictors of outcome, in children hospitalized with COVID-19, in a public reference hospital for COVID-19 in a State in Northeastern Brazil, between April 2020 and April 2021. Method: A retrospective cross-sectional study was conducted by analyzing the electronic medical records of children and adolescents. In the statistical analysis, we adopted a significance level of 5% and employed the chi-square test and Fisher’s exact test. Results: Of the 165 patients seen in the emergency room with clinically suspected COVID-19, 117 were admitted and confirmed by rapid serologic test or RT-PCR for SARS-CoV-2. The median age was 3 years 5 months. The weight-for-age in children under 10 years of age was adequate in 64.1% of them. The predominant symptoms were cough, fever, and dyspnea. There was pneumonia diagnosis in 53.8% of patients, and interstitial pulmonary infiltrate was the most frequent alteration (50.4%). There was an association between ethnicity (black or brown) and greater severity of the disease. Asthma was the most prevalent comorbidity, followed by diabetes mellitus, both were statistically associated with disease severity. The favorable outcome of hospital discharge within 14 days was associated with adequate weight. Conclusions: Black and brown ethnicity and the comorbidities of asthma and diabetes mellitus were determinants of severity while age-appropriate weight was a predictor of favorable outcome in COVID-19.