To Assess The Clinico-Epidemiological Profile and Out Come of Paediatric Patients With Corona Virus Disease 2019 (COVID-19) Infection During The Pandemic at Government Medical College Anantapuramu
To Assess The Clinico-Epidemiological Profile and Out Come of Paediatric Patients With Corona Virus Disease 2019 (COVID-19) Infection During The Pandemic at Government Medical College Anantapuramu
To Assess The Clinico-Epidemiological Profile and Out Come of Paediatric Patients With Corona Virus Disease 2019 (COVID-19) Infection During The Pandemic at Government Medical College Anantapuramu
ISSN No:-2456-2165
Dr. Suhasini MD (Professor and HOD) Dr. N.Praveen Deen Kumar. MD (Assoc Prof), Dr Shankar Narayana MD(Asst Prof),
Table 3: symptoms
<1 year 1.1-6 years 6.1-12 years
Fever 7 17 16
Cough 7 8 8
Cold 4 4 5
Respiratory Distress 6 4 4
G.I Symptoms 6 3 5
Seizures 4 5 2
Sepsis ± Shock 4 2 1
UTI - - 2
Asymptomatic 5 18 23
Table 4:oxygen,MODS,comorbidities
Age Requires O2 Requires MV Requires inotrope support MODS Comorbidities Expired
<1 year 12 2 (2) 10 6 8 2 (2)
1.1-6 years 8 2 7 4 5 2
6.1-12 years 5 1 4 2 10 1
Most of the COVID-19 infections are asymptomatic in Our study shows that pediatrics patients with COVID-19
children as well as adults and many of them are not reported. have a simple transmission mode, either by close contact with
Therefore, we confined our study to symptomatic cases only. infected adults or by exposure to epidemic areas. Most
Pediatric observational studies published early in the spread children are asymptomatic. Atypical or severe manifestations
across China reported similar clinical findings with fever can be seen in 22% of children and require intensive
being the most common symptom followed by cough and sore monitoring. Severe life-threatening illnesses in the form of
throat. In our study too, the main clinical features of COVID- ARDS, GBS, KD and other multisystem involvement are seen
19 in children were fever, cough, nausea, vomiting. Among in these patients. Therefore, it is mandatory in current scenario
critically ill children most common complaints were fever, to have a high degree of suspicion for COVID-19 in children
breathing difficulty and seizures. Four patients out of 10 with admitted in pediatric intensive care units (PICUs) with an
severe COVID-19 in our study presented initially as viral unexplained diagnosis, persistent fever and high levels of
encephalitis and therefore had seizures as a common inflammatory markers.
complaint. The severe disease and critical disease (ARDS,
respiratory failure, shock, myocardial failure, and multiorgan REFERENCES
dysfunction) are less frequent in children (1-3%) as compared
to adults (10- 30%). [1]. Zhui N, Zhang D, wang W, Lix, yang B, Song J et al.
china novel virus investigating and research team. A
A recent meta-analysis has also shown that most of the novel corona virus from patients with pneumonia in
patients have mild to moderate disease (96%) with only 1% of china. N Engl J med. 2020; 382(8):727-733.
all the symptomatic pediatric cases being critically sick. In our [2]. WHO. Corona virus 2019 (Covid 19) situation report-51,
study also, most patients were asymptomatic but 22% had 2020.
atypical or severe disease. Since our study is a hospital-based [3]. Li Q, Guan X, Wu p, Wang X, Zhoul, Tong Y et al.
study, therefore we saw slightly increased number of cases Early transmission dynamics in wuhan, china of novel
with severe/critical disease. Various hypotheses have been corona virus-infected pneumonia. N Engl J Med. 2020;
proposed for the lesser disease severity in children, though a 382(13):1199-1207.
definite answer is still awaited. Similarly, the mortality [4]. Chan JF, Yuan S, Kok KH, To KK, Chu H, Yang J et al.
associated with COVID-19 is much lower in the pediatric A family cluster of pneumonia associated with the 2019
population (less than 1 %) than that reported in adults (5- novel corona virus indicating person to person
15%).However, In a cross-sectional study of 46 North transmission: study of a family cluster. Lancet. 2020;
American pediatric intensive care units (PICUs),between 395(10223):514-523.
March 14 and April 3, 2020, 48 children were admitted to 14 [5]. Lin GT, Zhang YH. Epidemiological investigation of a
PICUs in the US and none in Canada of which 73% presented covid-19 family cluster out break transmitted by a 3-
with respiratory symptoms, and 38% required invasive Month Old Infant. Health Info Sci Syst. 2021, 9.6.
ventilation, and the hospital mortality rate was 4.2%.22 In our [6]. Cheng-Xian Guo, Li He, Yen SY, Meng XG, Tan W,
study the mortality rate was 6.6% as it was a hospital-based Yang GP et al. Epidemiological and clinical features of
study and out of 10 critically ill children, almost all children pediatric covid-19. BMC Med. 2020; 18(1):250.
required inotropic support, 9 required mechanical ventilation [7]. Laner SA, Grantz KH, Br Q, Jones FK, Zheng Q,
and other life supportive treatment. Moredith HR et al. The incubation period of corona virus
disease 2019 (covid-19) from publicly reported
Mortality in our study was only seen in those who died confirmed cases: estimation and application. Ann intern
within 12 hours of admission. Co-morbidities play a major Med. 2020; 172(9):577-582.
role in terms of severity of the disease especially malnutrition [8]. Lu X, Zhang L, Du H, Zhang J, Li YY, Qu S et al.
which is a most seen co-morbidity as a risk factor for severe Chinese paediatric novel corona virus study team. SARS-
COVID-19. In children, malnutrition is known to foster CoV-2 infection in children. N Engl J Med. 2020;
infections; in our study we have seen deaths in younger infants 282(17):1663-1665.
with associated malnutrition as co morbidity. [9]. Xia W, Shao J, Guo Y, Peng X, Li Z, Hu D. Clinical and
CT features in pediatric patients with covid-19 infection:
Four out of 10 patients who developed severe disease different points from adults. Pediatric pulmonol. 2020;
had associated malnutrition therefore can be considered as an 55(5):1169-1174.
important risk factor for severe disease. However more data is [10]. Ludrigsson JF. Systematic reviews of Covid-19 in
needed to clarify the association of malnutrition and other co- children shows milder cases and a better prognosis than
morbid condition with mortality in children with COVID-19. adults. Acta Paediatric. 2020; 109(6):1088-1095.