International Journal of Public Health (Mar 2025)

Phenotypic Variation in Disease Severity Among Hospitalized Pediatric Patients With COVID-19: Assessing the Impact of COVID-19 in the EPICO Study

  • María Camila Sossa-Alarcón,
  • Mónica Paola Gutiérrez,
  • Natalia Becerra,
  • Luz Yessenia Ortegon,
  • María Camila David,
  • Melisa Naranjo Vanegas,
  • Melisa Naranjo Vanegas,
  • Gabriela Friedrich,
  • Pablo Vásquez-Hoyos,
  • Pablo Vásquez-Hoyos,
  • María Lucía Mesa-Rubio,
  • Luis Miguel Navarro-Ramirez,
  • Luis Miguel Navarro-Ramirez,
  • Sergio Moreno-Lopez,
  • Olga Lucía Baquero,
  • Luz Marina Mejía,
  • Juan Gabriel Piñeros,
  • Sonia Restrepo-Gualteros,
  • Carlos Álvarez-Moreno,
  • Carlos Álvarez-Moreno,
  • Alejandro Díaz-Díaz,
  • Alejandro Díaz-Díaz,
  • Iván Gutierrez-Tobar,
  • Iván Gutierrez-Tobar,
  • Iván Gutierrez-Tobar,
  • Andrés Camilo Mesa,
  • William Ricardo Bachiller Tuta,
  • William Ricardo Bachiller Tuta,
  • Clara Esperanza Galvis Diaz,
  • Martha Africano,
  • Martha Africano,
  • José Manuel Nieto,
  • Paola Marsela Pérez Camacho,
  • Paola Marsela Pérez Camacho,
  • Claudia Beltrán-Arroyave,
  • Claudia Beltrán-Arroyave,
  • Rosalba Vivas Trochez,
  • Irati Gastesi,
  • Cinta Moraleda,
  • Alfredo Tagarro García,
  • Alfredo Tagarro García,
  • Blanca Herrero,
  • Lourdes Calleja,
  • Carlos Grasa,
  • Paula Rodriguez,
  • Susana Melendo,
  • Antoni Soriano-Arandes,
  • Irene Gómez Pastrana,
  • Sonsoles García García,
  • Victoria Fumado,
  • Andrea Ramírez Varela,
  • Andrea Ramírez Varela,
  • Andrea Ramírez Varela

DOI
https://doi.org/10.3389/ijph.2025.1607246
Journal volume & issue
Vol. 70

Abstract

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ObjectiveTo characterize the clinical phenotypes of SARS-CoV-2 infection in hospitalized children as part of the EPICO multicenter cohort study.MethodsWe included hospitalized children with confirmed SARS-CoV-2 infection from Colombian and Spanish institutions to assess disease evolution and outcomes. Cluster analysis was performed to identify clinical phenotypes.ResultsA total of 2318 patients were included (55% male, 36% infants). Five phenotype clusters emerged: Cluster 1 (26.5%): infants without comorbidities, low PICU admissions and mortality; Cluster 2 (18.5%): respiratory comorbidities, high microorganism co-detection and mortality; Cluster 3 (11.5%): fever, gastrointestinal symptoms, high PICU admissions; Cluster 4 (32%): mild unspecific symptoms, low mortality; Cluster 5 (11.3%): adolescents without comorbidities, low co-detection and hospitalization rates. Findings were consistent across both countries.ConclusionIdentifying clinical phenotypes of SARS-CoV-2 in children may improve risk stratification and guide future management strategies.

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