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DOI: 10.1055/s-0041-1729630
Should We Perform Laboratory and Radiographic Evaluations for All Children with COVID-19?: A Single-Center Experience
Funding None.![](https://www.thieme-connect.de/media/10.1055-s-00033103/202101/lookinside/thumbnails/10-1055-s-0041-1729630_2000101-1.jpg)
Abstract
Background The diagnostic and treatment strategies for children are limited because of the small number of children with COVID-19. A large proportion of infected children are asymptomatic or have mild symptoms. We report our experience regarding clinical characteristics, laboratory, radiologic findings, and outcomes of children with COVID-19.
Materials and Methods This retrospective single-center study was conducted on children with COVID-19. The data on epidemiologic characteristics, clinical features, laboratory, and radiologic findings of patients were extracted from the hospital information management system records, and patients' forms filled upon admission.
Results The median age of children was 121 months, 46.8% of the patients were females and 53.2% were males. Of the 581 children assessed, a total of 222 (38.2%) had positive test results; 69 of them (31.1%) were asymptomatic. The median absolute lymphocyte and eosinophil counts were statistically significantly lower in symptomatic children (p = 0.001; p = 0.02). Neutrophil lymphocyte ratio was statistically significantly higher in the symptomatic children (p = 0.001). Of 72 computed tomography scans, 35 (48.6%) were normal, and only 29 (40%) were consistent with classic/probable/indeterminate COVID-19 predominant pattern.
Conclusion Our results showed a few laboratory abnormalities in asymptomatic polymerase chain reaction positive children; therefore, unnecessary investigation might be avoided and clinicians should consider clinical symptoms.
Note
Approval was received from the Ethical Committee of the institution (B.10.1.TKH.4.34.H.GP.0.0.1/139).
Publication History
Received: 28 November 2020
Accepted: 16 March 2021
Article published online:
01 June 2021
© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
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References
- 1 WHO/2019-nCoV/Situation Report-99.. Geneva, Switzerland: World Health Organization. Accessed April 28, 2020 at: URL: https://www.who.int/docs/default–source/coronaviruse/situation–reports
- 2 Castagnoli R, Votto M, Licari A. et al. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children and adolescents: a systematic Review. JAMA Pediatr 2020; 174 (09) 882-889
- 3 Dong Y, Mo X, Hu Y. et al. Epidemiology of COVID-19 among children in China. Pediatrics 2020; 145 (06) e20200702
- 4 Lu X, Zhang L, Du H. et al; Chinese Pediatric Novel Coronavirus Study Team. SARS-CoV-2 infection in children. N Engl J Med 2020; 382 (17) 1663-1665
- 5 CDC COVID-19 Response Team. Coronavirus disease 2019 in children - United States, February 12-April 2, 2020. MMWR Morb Mortal Wkly Rep 2020; 69 (14) 422-426
- 6 Zheng F, Liao C, Fan QH. et al. Clinical characteristics of children with coronavirus disease 2019 in Hubei, China. Curr Med Sci 2020; 40 (02) 275-280
- 7 Chang TH, Wu JL, Chang LY. Clinical characteristics and diagnostic challenges of pediatric COVID-19: A systematic review and meta-analysis. J Formos Med Assoc 2020; 119 (05) 982-989
- 8 Hasan A, Mehmood N, Fergie J. Coronavirus Disease (COVID-19) and Pediatric Patients: A Review of Epidemiology, Symptomatology, Laboratory and Imaging Results to Guide the Development of a Management Algorithm. Cureus 2020; published online March 31, 2020. DOI 10.7759/cureus.7485. Association 2020; published online April 2020. https://doi.org/10.1016/j.jfma.2020.04.007
- 9 Kocabaş E, Ersöz D, Karakoç F. et al. Turkish Thoracic Society Consensus report on diagnosis and treatment of community acquired pneumonia in children. Turk Thorac J 2009; 10 (Suppl. 02) 3-28
- 10 British Society of Thoracic Imaging. Thoracic Imaging in COVID 19 Infection Guidance for the Reporting Radiologist Version 2. Accessed March 16, 2020 from: URL https://www.bsti.org.uk/standards-clinical-guidelines/clinical-guidelines/bsti-covid-19-guidance-for-the-reporting-radiologist/
- 11 Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA 2020; •••: 323(13):1239-42
- 12 Tagarro A, Epalza C, Santos M. et al. Screening and severity of coronavirus disease 2019 (COVID-19) in children in Madrid, Spain. JAMA Pediatr 2020; DOI: 10.1001/jamapediatrics.2020.1346.
- 13 Korean Society of Infectious D. Korean Society of Pediatric Infectious D, Korean Society of E, Korean Society for Antimicrobial T, Korean Society for Healthcare-associated Infection C, Prevention, et al. Report on the Epidemiological Features of Coronavirus Disease 2019 (COVID-19) Outbreak in the Republic of Korea from January 19 to March 2, 2020. J Korean Med Sci 2020; 35: e112
- 14 Wang W, Xu Y, Gao R. et al. Detection of SARS-CoV-2 in different types of clinical specimens. JAMA 2020; 323 (18) 1843-1844
- 15 Sethuraman N, Jeremiah SS, Ryo A. Interpreting diagnostic tests for SARS-CoV-2. JAMA 2020; 323 (22) 2249-2251 DOI: 10.1001/jama.2020.8259.
- 16 Brodin P. Why is COVID-19 so mild in children?. Acta Paediatr 2020; 109 (06) 1082-1083
- 17 Pediatric Intensive Care Society. PICS Statement: Increased number of reported cases of novel presentation of multi-system inflammatory disease. Accessed April 27, 2020 at: URL: https://picsociety.uk/wpcontent/uploads/2020/04/PICS-statement-re-novel-KD-C19-presentation-v2-27042020.pdf
- 18 Shen KL, Yang YH, Jiang RM. et al. Updated diagnosis, treatment and prevention of COVID-19 in children: experts' consensus statement (condensed version of the second edition). World J Pediatr 2020; 24: 1-8
- 19 Du W, Yu J, Wang H. et al. Clinical characteristics of COVID-19 in children compared with adults in Shandong Province, China. Infection 2020; 48 (03) 445-452
- 20 Garofalo R, Kimpen JL, Welliver RC, Ogra PL. Eosinophil degranulation in the respiratory tract during naturally acquired respiratory syncytial virus infection. J Pediatr 1992; 120 (01) 28-32
- 21 Phipps S, Lam CE, Mahalingam S. et al. Eosinophils contribute to innate antiviral immunity and promote clearance of respiratory syncytial virus. Blood 2007; 110 (05) 1578-1586
- 22 Guan WJ, Ni ZY, Hu Y. et al; China Medical Treatment Expert Group for Covid-19. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med 2020; 382 (18) 1708-1720
- 23 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
- 24 Meng H, Xiong R, He R. et al. CT imaging and clinical course of asymptomatic cases with COVID-19 pneumonia at admission in Wuhan, China. J Infect 2020; 81 (01) e33-e39
- 25 Tuncer T, Karaci M, Boga A, Durmaz H, Guven S. QT interval evaluation associated with the use of hydroxychloroquine with combined use of azithromycin among hospitalised children positive for coronavirus disease 2019. Cardiol Young 2020; 30 (10) 1482-1485