COVID-19 in children: A single center experience from Istanbul, Turkey

Objective: We aimed to evaluate the demographic, epidemiological, and clinical characteristics of children with coronavirus disease‐2019 (COVID-19), and to determine variations of the clinical presentation of the disease by age. Method: A total of 104 confirmed COVID-19 patients aged between 0-18 years were retrospectively analyzed. The study period was between March 15, 2020 and July 1, 2020. A confirmed COVID-19 was defined as a child who has positive real-time reverse transcription-polymerase chain reaction (rRT-PCR). The patients were analyzed in terms of demographic, epidemiological, clinical, laboratory and imaging features, and clinical outcomes. Results: The median age (inter-quartile range) of the patients was 11.8 (8.4) years, and 53 (51%) were male. Ninety-eight (94%) of the patients had an epidemiological risk factor. The most frequent symptoms were cough (62%), fever (42%), and fatigue (33%). Seven patients (7%) were asymptomatic, 84 (81%) were mild, 9 (9%) were moderate, and 4 (4%) were in severe or critical condition. Ninety-eight (94%) of the patients underwent a chest x-ray, and 12% had pneumonia. The patients younger than 5 years were more likely to have fever (p = 0.019), rhinorrhea (p = 0.041), and diarrhea (p = 0.035). Muscle/join pain (26%), loss of smell/taste (20%), and headache (19%) were striking extra-pulmonary symptoms in older patients. Only 8% of the patients were hospitalized, and 4% were admitted to the intensive care unit. No death occurred. Conclusion: The most of the pediatric COVID-19 cases have mild symptoms without pneumonia. They may not present with fever or cough which are considered characteristic symptoms of the disease and the frequency of signs and symptoms may vary by age. Children younger than 5 years old are more likely to have fever, rhinorrhea, and diarrhea. School-age children and adolescents may present with extra-pulmonary symptoms such as muscle/join pain, smell/taste loss, and headache.