Clinico-pathological and Genomic Characteristics among Children with SARS-CoV-2 Infection

Abstract

Introduction: There is inadequate information on infections with the Severe Acute Respiratory Syndrome Virus 2 (SARS-CoV-2) in children. Their clinical, as well as pathological correlation, is poorly understood. In India, children and adolescents account for 12% of all Coronavirus Disease 2019 (COVID-19) cases reported. Children accounted for roughly 11% of those impacted globally last year. However, this year, we are seeing around 20-40% of youngsters in positive instances over the world. Even babies and infants are testing positive for COVID-19, although their illness is under control and seldom becomes fatal. Children aged 5 to 12 years, on the other hand, are at a higher risk. Aim: To study the clinical, pathological and genomic characteristics among children with SARS-CoV-2 infection. Materials and Methods: This cross-sectional study was conducted among 48 paediatric positive patients for SARS-CoV-2 at Government Institute of Medical Sciences, Noida, Uttar Pradesh, and CSIR-Institute of Genomics and Integrative Biology, New Delhi, India, from 1st April 2021 to 31st May 2021. The laboratory testing was done by the real-time Reverse Transcription-Polymerase Chain Reaction (RT-PCR) method. The patients were classified as mild, moderate, severe, or asymptomatic. Their clinical and pathological findings were recorded in the case sheet. Genomic analyses were done for identifying the genetic variant in the nine selected samples. Data entry and analysis were performed using Statistical Package for Social Sciences (SPSS) version 26.0. Chi-square test was used for categorical variables and the t-test was used for continuous variables. Results: The study group has median age of 12 years. Male:Female ratio was 2:3. Most children had acquired infection from the community and 30% had the moderate illness and were admitted. Serum Glutamic-Oxalacetic Transaminase (SGOT) and Glutamic-Pyruvic Transaminase (SGPT) were raised in six patients. Alkaline Phosphatase (ALP) was raised in 21 patients and bilirubin was raised in two patients. The average duration of hospitalisation was six days (range 2-13 days). No mortality among the 48 paediatric patients studied was identified in the hospital. Delta variant (B.1.617.2) was identified in seven patients with D614, P681R, L452R mutations and B.1.617.2 was identified in two patients. Delta variant was present in the paediatric patients, but it did not prolong the hospital stay or cause mortality. Conclusion: The findings of the study suggest that children may be a potential source of infection in the SARS-CoV-2 pandemic while having an asymptomatic to mild illness.

Keywords

• coronavirus disease 2019
• delta variant
• liver enzymes
• monoclonal antibodies
• severe acute respiratory syndrome virus 2
• spike protein gene