Subscribe to RSS
Evaluation of Childhood COVID-19 Cases: A Retrospective Analysis
Objective This study aims to evaluate the demographic, epidemiological, and clinical features of novel coronavirus disease 2019 (COVID-19) cases aged between 0 and 18 years.
Methods The demographic characteristics of the patients, admission symptoms, contact and travel histories, clinical onset duration, symptoms, treatments, laboratory findings, radiological images, and polymerase chain reaction (PCR) negation times were evaluated in a retrospective manner. Thirty-eight children (19 boys and 19 girls) were included in the study.
Results The mean age of the patients was 10.36 ± 5.59 years. The average admission times of the patients after the onset of the symptoms was determined as 1.84 ± 2.02 days. Thirteen (34.2%) patients were observed as asymptomatic. The most common identified symptoms were fever, cough, and fatigue (55.2, 34.2, and 13.2%, respectively). Febrile convulsions, myalgia, dizziness, and diarrhea were the least common symptoms. Also, 25-hydroxyvitamin D3 (vitamin D3) levels were low and aspartate aminotransferase (AST) values were higher in the moderate group than the mild group and the relationships were statistically significant (p = 0.044and 0.027). Ferritin levels of the patients with ground glass opacity (GGO) were found statistically and significantly higher than the patients without GGO (p = 0,031). There was more than one lobe and segment involvement in five patients, the average number of affected lobes and segments was 3.8 and 8.8, respectively. High-resolution computed tomography of the 24 patients showed that; GGO in five (20.8%), consolidation + GGO (mixed) in three (12.5%), consolidation (alone) in one, subpleural linear opacities in three (12.5%), and pavement stone opacities in one (4.2%) patient. COVID-19, which is seen less frequently in children, may pose a risk in infants and young children.
Conclusion Especially high ferritin levels may present with lung involvement and low vitamin D levels may worsen the aggravation of the lung involvement. There is a great need for further research on this subject.
Received: 18 June 2020
Accepted: 13 December 2020
25 February 2021 (online)
© 2021. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
- 1 Wang C, Horby PW, Hayden FG, Gao GF. A novel coronavirus outbreak of global health concern. Lancet 2020; 395 (10223): 470-473
- 2 Johns Hopkins University and Medicine. COVID-19 Dashboard by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHS). Accessed January 14, 2021 at: https://coronavirus.jhu.edu/map.html
- 3 Wu JT, Leung K, Leung GM. Nowcasting and forecasting the potential domestic and international spread of the 2019-nCoV outbreak originating in Wuhan, China: a modelling study. Lancet 2020; 395 (10225): 689-697
- 4 Li Q, Guan X, Wu P. et al. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med 2020; 382 (13) 1199-1207
- 5 Lu Q, Shi Y. Coronavirus disease (COVID-19) and neonate: what neonatologist need to know. J Med Virol 2020; 92 (06) 564-567
- 6 Huynh J, Li S, Yount B. et al. Evidence supporting a zoonotic origin of human coronavirus strain NL63. J Virol 2012; 86 (23) 12816-12825
- 7 Chan JF, Kok KH, Zhu Z. et al. Genomic characterization of the 2019 novel human-pathogenic coronavirus isolated from a patient with atypical pneumonia after visiting Wuhan. Emerg Microbes Infect 2020; 9 (01) 221-236
- 8 Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72314 cases from the Chinese Center for Disease Control and Prevention. JAMA 2020; 323 (13) 1239-1242
- 9 Wu Q, Xing Y, Shi L. et al. Coinfection and other clinical characteristics of COVID-19 in children. Pediatrics 2020; 146 (01) e20200961
- 10 World Health Organisation. Coronavirus disease (COVID-19) Situation Report – 128. Accessed May 27, 2020 at: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200527-covid-19-sitrep-128.pdf?sfvrsn=11720c0a_2
- 11 Turkish Ministry of Health. Daily Corona Virus Table of Turkey. 2020 , Accessed May 27, 2020 at: https://covid19.saglik.gov.tr/
- 12 Dong Y, Mo Z, Hu Y. et al. Epidemiology of COVID-19 among children in China. Pediatrics 2020; 145 (06) e20200702 DOI: 10.1542/peds.2020-0702.
- 13 Dong Y, Mo X, Hu Y. et al. Epidemiological characteristics of 2143 pediatric patients with 2019 coronavirus disease in China. J Emerg Med 2020; 58 (04) 712-713 DOI: 10.1016/j.jemermed.2020.04.006.
- 14 Shen KL, Yang YH. Diagnosis and treatment of 2019 novel coronavirus infection in children: a pressing issue. World J Pediatr 2020; 16 (03) 219-221
- 15 Kam KQ, Yung CF, Cui L. et al. A well infant with coronavirus disease 2019 with high viral load. Clin Infect Dis 2020; 71 (15) 847-849
- 16 Miller A, Reandelar MJ, Fasciglione K. et al. Correlation between universal BCG vaccination policy and reduced morbidity and mortality for COVID-19: an epidemiological study. Med Rxiv 2020; DOI: 10.1101/2020.03.24.20042937.
- 17 Kleinnijenhuis J, Quintin J, Preijers F. et al. Long-lasting effects of BCG vaccination on both heterologous Th1/Th17 responses and innate trained immunity. J Innate Immun 2014; 6 (02) 152-158
- 18 Arts RJW, Moorlag SJCFM, Novakovic B. et al. BCG vaccination protects against experimental viral infection in humans through the induction of cytokines associated with trained immunity. Cell Host Microbe 2018; 23 (01) 89-100.e5
- 19 Wardhana. Datau EA, Sultana A, Mandang VV, Jim E. The efficacy of Bacillus Calmette-Guerin vaccinations for the prevention of acute upper respiratory tract infection in the elderly. Acta Med Indones 2011; 43 (03) 185-190
- 20 Nankabirwa V, Tumwine JK, Mugaba PM, Tylleskär T, Sommerfelt H. PROMISE- EBF Study Group. Child survival and BCG vaccination: a community based prospective cohort study in Uganda. BMC Public Health 2015; 15 (01) 175
- 21 de Wit E, van Doremalen N, Falzarano D, Munster VJ. SARS and MERS: recent insights into emerging coronaviruses. Nat Rev Microbiol 2016; 14 (08) 523-534
- 22 Imai Y, Kuba K, Rao S. et al. Angiotensin-converting enzyme 2 protects from severe acute lung failure. Nature 2005; 436 (7047): 112-116
- 23 Liu Y, Yang Y, Zhang C. et al. Clinical and biochemical indexes from 2019-nCoV infected patients linked to viral loads and lung injury. Sci China Life Sci 2020; 63 (03) 364-374
- 24 Guo J, Huang Z, Lin L, Lv J. Coronavirus disease 2019 (COVID-19) and cardiovascular disease: a viewpoint on the potential influence of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers on onset and severity of severe acute respiratory syndrome coronavirus 2 infection. J Am Heart Assoc 2020; 9 (07) e016219
- 25 Xie X, Chen J, Wang X, Zhang F, Liu Y. Age- and gender-related difference of ACE2 expression in rat lung. Life Sci 2006; 78 (19) 2166-2171
- 26 Kong J, Zhu X, Shi Y. et al. VDR attenuates acute lung injury by blocking Ang-2-Tie-2 pathway and renin-angiotensin system. Mol Endocrinol 2013; 27 (12) 2116-2125
- 27 Tsujino I, Ushikoshi-Nakayama R, Yamazaki T, Matsumoto N, Saito I. Pulmonary activation of vitamin D3 and preventive effect against interstitial pneumonia. J Clin Biochem Nutr 2019; 65 (03) 245-251
- 28 Martineau AR, Jolliffe DA, Hooper RL. et al. Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data. BMJ 2017; 356: i6583
- 29 Panarese A, Shahini E. Letter: COVID-19, and vitamin D. Aliment Pharmacol Ther 2020; 51 (10) 993-995
- 30 McCartney DM, Byrne DG. Optimisation of vitamin D status for enhanced Immuno-protection against Covid-19. Ir Med J 2020; 113 (04) 58
- 31 Xia W, Shao J, Guo Y, Peng X, Li Z, Hu D. Clinical and CT features in pediatric patients with COVID-19 infection: Different points from adults. Pediatr Pulmonol 2020; 55 (05) 1169-1174
- 32 Li W, Cui H, Li K, Fang Y, Li S. Chest computed tomography in children with COVID-19 respiratory infection. Pediatr Radiol 2020; 50 (06) 796-799
- 33 Zhou B, She J, Wang Y. Utility of ferritin, procalcitonin, and C-reactive protein in severe patients with 2019 novel coronavirus disease. Research Square 2020; DOI: 10.21203/rs.3.rs-18079/v1.
- 34 Liu T, Zhang J, Yang Y. et al. The potential role of IL-6 in monitoring severe case of coronavirus disease 2019. medRxiv 2020; DOI: 10.1101/2020.03.01.20029769.