BMC Pediatrics (Dec 2021)

Red flags of poor prognosis in pediatric cases of COVID-19: the first 6610 hospitalized children in Iran

  • Sedigheh Madani,
  • Sarvenaz Shahin,
  • Moein Yoosefi,
  • Naser Ahmadi,
  • Erfan Ghasemi,
  • Sogol Koolaji,
  • Esmaeil Mohammadi,
  • Sahar Mohammadi Fateh,
  • Amirali Hajebi,
  • Ameneh Kazemi,
  • Erfan Pakatchian,
  • Negar Rezaei,
  • Hamidreza Jamshidi,
  • Bagher Larijani,
  • Farshad Farzadfar

DOI
https://doi.org/10.1186/s12887-021-03030-2
Journal volume & issue
Vol. 21, no. 1
pp. 1 – 9

Abstract

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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.

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