Red Flags of Poor Prognosis in Pediatric Cases of Covid-19: The First 6610 Hospitalized Children in Iran Publisher Pubmed



Madani S¹ ; Shahin S¹ ; Yoosefi M¹ ; Ahmadi N¹ ; Ghasemi E¹ ; Koolaji S¹ ; Mohammadi E¹ ; Mohammadi Fateh S^{1, 2} ; Hajebi A¹ ; Kazemi A¹ ; Pakatchian E¹ ; Rezaei N^{1, 2} ; Jamshidi H³ ; Larijani B² Show All Authors Show Affiliations
Source: BMC Pediatrics Published:2021

Abstract

Introduction: COVID-19 clinical course, effective therapeutic regimen, and poor prognosis risk factors in pediatric cases are still under investigation and no approved vaccinehas been introduced for them. Methods: This cross-sectional study evaluated different aspect of COVID-19 infection in hospitalized COVID-19 positive children (≺18 years oldwith laboratory confirmed COVID-19 infection, using the national COVID-19 registry for all admitted COVID-19 positive cases from February 19 until November 13,2020, in Iran. Results: We evaluated 6610 hospitalized children. Fifty-four percent (3268) were male and one third of them were infants younger than 1 year. Mortality rate in total hospitalized children was 5.3% and in children with underlying co-morbidities (14.4%) was significantly higher (OR: 3.6 [2.7-4.7]). Chronic kidney disease (OR: 3.42 [1.75-6.67]), Cardiovascular diseases (OR: 3.2 [2.09-5.11]), chronic pulmonary diseases (OR: 3.21 [1.59-6.47]), and diabetes mellitus (OR: 2.5 [1.38-4.55]), resulted in higher mortality rates in hospitalized COVID-19 children. Fever (41%), cough (36%), and dyspnea (27%) were the most frequent symptoms in hospitalized children and dyspnea was associated with near three times higher mortality rate among children with COVID-19 infection (OR: 2.65 [2.13-3.29]). Conclusion: Iran has relatively high COVID-19 mortality in hospitalized children. Pediatricians should consider children presenting with dyspnea, infants≺ 1 year and children with underlying co-morbidities, as high-risk groups for hospitalization, ICU admission, and death. © 2021, The Author(s).