Frontiers in Pediatrics (May 2021)
Epidemiological, Clinical, and Laboratory Features of Children With COVID-19 in Turkey
- Adem Karbuz,
- Gulsen Akkoc,
- Tugba Bedir Demirdag,
- Dilek Yilmaz Ciftdogan,
- Arife Ozer,
- Deniz Cakir,
- Selda Hancerli Torun,
- Eda Kepenekli,
- Tugba Erat,
- Nazan Dalgic,
- Sare Ilbay,
- Ayse Karaaslan,
- Emine H. Erdeniz,
- F. Deniz Aygun,
- S. Elmas Bozdemir,
- Nevin Hatipoglu,
- Melike Emiroglu,
- Zumrut Sahbudak Bal,
- Ergin Ciftci,
- Gulsum Iclal Bayhan,
- Zeynep Gokce Gayretli Aydin,
- Sevliya Ocal Demir,
- Omer Kilic,
- Mustafa Hacimustafaoglu,
- Dicle Sener Okur,
- Semra Sen,
- Aysun Yahsi,
- Hacer Akturk,
- Benhur Cetin,
- Murat Sutcu,
- Manolya Kara,
- Hatice Uygun,
- Tugce Tural Kara,
- Gulay Korukluoglu,
- Ozlem Akgun,
- Gülnihan Üstündağ,
- Mevsim Demir Mis,
- Enes Sali,
- Ozge Kaba,
- Nurhayat Yakut,
- Orhan Kılıc,
- M. Kemal Kanik,
- Ceren Cetin,
- Adem Dursun,
- Muharrem Cicek,
- Esra Kockuzu,
- Esra Sevketoglu,
- Gulsum Alkan,
- Gizem Guner Ozenen,
- Erdal İnce,
- Zekiye Baydar,
- Ahmet Kagan Ozkaya,
- Husnu Fahri Ovali,
- Seher Tekeli,
- Solmaz Celebi,
- Birgul Cubukcu,
- Alkan Bal,
- Fidan Khalilova,
- Mehmet Kose,
- Halil Ugur Hatipoglu,
- Tahir Dalkiran,
- Mehmet Turgut,
- Ayse Basak Altas,
- Hatice Nilgün Selcuk Duru,
- Ahu Aksay,
- Sevcan Saglam,
- Mehpare Sari Yanartas,
- Zeynep Ergenc,
- Yasemin Akin,
- Yeter Duzenli Kar,
- Sabit Sahin,
- Sadiye Kubra Tuteroz,
- Nimet Melis Bilen,
- Halil Ozdemir,
- Mine Cidem Senoglu,
- Burcu Pariltan Kucukalioglu,
- Gulser Esen Besli,
- Yalcin Kara,
- Cansu Turan,
- Burcu Selbest Demirtas,
- Aydın Celikyurt,
- Yasemin Cosgun,
- Murat Elevli,
- Aslihan Sahin,
- Serife Bahtiyar Oguz,
- Ayper Somer,
- Bulent Karadag,
- Recep Demirhan,
- Hatice Turk Dagi,
- Zafer Kurugol,
- Esra Cakmak Taskin,
- Aysegul Sahiner,
- Edanur Yesil,
- Yildiz Ekemen Keles,
- Remzi Sarikaya,
- Ela Erdem Eralp,
- Ferda Ozkinay,
- Hatice Kubra Konca,
- Songul Yilmaz,
- Yasemin Gokdemir,
- Gul Arga,
- Seval Ozen,
- Fevziye Coksuer,
- Goksel Vatansever,
- Hasan Tezer,
- Ates Kara
Affiliations
- Adem Karbuz
- Division of Pediatric Infectious Diseases, Okmeydani Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
- Gulsen Akkoc
- Division of Pediatric Infectious Diseases, Istanbul Haseki Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
- Tugba Bedir Demirdag
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Gazi University, Ankara, Turkey
- Dilek Yilmaz Ciftdogan
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Izmir Tepecik Training and Research Hospital, University of Health Sciences, Izmir, Turkey
- Arife Ozer
- Division of Pediatric Infectious Diseases, Van Training and Research Hospital, University of Health Sciences, Van, Turkey
- Deniz Cakir
- Division of Pediatric Infectious Diseases, Umraniye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
- Selda Hancerli Torun
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Istanbul University, Istanbul, Turkey
- Eda Kepenekli
- Division of Pediatric Infectious Diseases, Faculty of Medicine, Pendik Training and Research Hospital, Marmara University, Istanbul, Turkey
- Tugba Erat
- Division of Pediatric Infectious Diseases, Sanliurfa Training and Research Hospital, Şanlıurfa, Turkey
- Nazan Dalgic
- 0Division of Pediatric Infectious Diseases, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
- Sare Ilbay
- 1Department of Pediatric Infectious Diseases, Faculty of Medicine, Hacettepe University, Ankara, Turkey
- Ayse Karaaslan
- 2Division of Pediatric Infectious Diseases, Kartal Dr. Lutfi Kırdar Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
- Emine H. Erdeniz
- 3Division of Pediatric Infectious Diseases, Erzurum Training and Research Hospital, Erzurum, Turkey
- F. Deniz Aygun
- 4Division of Pediatric Infectious Diseases, Istanbul Kanuni Sultan Süleyman Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
- S. Elmas Bozdemir
- 5Division of Pediatric Infectious Diseases, Dortcelik Children's Training and Research Hospital, Bursa, Turkey
- Nevin Hatipoglu
- 6Division of Pediatric Infectious Diseases, Bakirkoy Sadi Konuk Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
- Melike Emiroglu
- 7Department of Pediatric Infectious Diseases, Faculty of Medicine, Selcuk University, Konya, Turkey
- Zumrut Sahbudak Bal
- 8Department of Pediatric Infectious Diseases, Faculty of Medicine, Ege University, Izmir, Turkey
- Ergin Ciftci
- 9Department of Pediatric Infectious Diseases, Faculty of Medicine, Ankara University, Ankara, Turkey
- Gulsum Iclal Bayhan
- 0Department of Pediatric Infectious Diseases, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey
- Zeynep Gokce Gayretli Aydin
- 1Department of Pediatric Infectious Diseases, Faculty of Medicine, Farabi Hospital, Karadeniz Technical University, Trabzon, Turkey
- Sevliya Ocal Demir
- 2Division of Pediatric Infectious Diseases, Goztepe Training and Research Hospital, Istanbul Medeniyet University, Istanbul, Turkey
- Omer Kilic
- 3Department of Pediatric Infectious Diseases, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
- Mustafa Hacimustafaoglu
- 4Department of Pediatric Infectious Diseases, Faculty of Medicine, Uludag University, Bursa, Turkey
- Dicle Sener Okur
- 5Division of Pediatric Infectious Diseases, Denizli Hospital, Denizli, Turkey
- Semra Sen
- 6Department of Pediatric Infectious Diseases, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
- Aysun Yahsi
- 7Division of Pediatric Infectious Diseases, Samsun Training and Research Hospital, University of Health Sciences, Samsun, Turkey
- Hacer Akturk
- 8Department of Pediatric Infectious Diseases, Faculty of Medicine, Koc University, Istanbul, Turkey
- Benhur Cetin
- 9Department of Pediatric Infectious Diseases, Faculty of Medicine, Erciyes University, Kayseri, Turkey
- Murat Sutcu
- 0Department of Pediatric Infectious Diseases, Faculty of Medicine, Istinye University, Istanbul, Turkey
- Manolya Kara
- 1Division of Pediatric Infectious Diseases, Necip Fazil Training and Research Hospital, University of Health Sciences, Kahramanmaraş, Turkey
- Hatice Uygun
- 2Department of Pediatric Infectious Diseases, Faculty of Medicine, Adıyaman University, Adıyaman, Turkey
- Tugce Tural Kara
- 3Department of Pediatric Infectious Diseases, Faculty of Medicine, Akdeniz University, Antalya, Turkey
- Gulay Korukluoglu
- 4Public Health Institutions of Turkey, Director of Virology Department, Ankara, Turkey
- Ozlem Akgun
- 5Division of Pediatrics, Istanbul Haseki Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
- Gülnihan Üstündağ
- 6Division of Pediatric Infectious Diseases, Izmir Tepecik Training and Research Hospital, University of Health Sciences, Izmir, Turkey
- Mevsim Demir Mis
- 7Van Training and Research Hospital, University of Health Sciences, Van, Turkey
- Enes Sali
- Division of Pediatric Infectious Diseases, Umraniye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
- Ozge Kaba
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Istanbul University, Istanbul, Turkey
- Nurhayat Yakut
- Division of Pediatric Infectious Diseases, Faculty of Medicine, Pendik Training and Research Hospital, Marmara University, Istanbul, Turkey
- Orhan Kılıc
- 8Division of Pediatrics, Sanliurfa Training and Research Hospital, Şanlıurfa, Turkey
- M. Kemal Kanik
- 0Division of Pediatric Infectious Diseases, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
- Ceren Cetin
- 2Division of Pediatric Infectious Diseases, Kartal Dr. Lutfi Kırdar Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
- Adem Dursun
- 9Division of Pediatrics, Erzurum Training and Research Hospital, Erzurum, Turkey
- Muharrem Cicek
- 0Division of Pediatrics, Istanbul Kanuni Sultan Süleyman Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
- Esra Kockuzu
- 1Division of Pediatrics, Dortcelik Children's Training and Research Hospital, Bursa, Turkey
- Esra Sevketoglu
- 2Division of Pediatric Intensive Care, Bakirkoy Sadi Konuk Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
- Gulsum Alkan
- 7Department of Pediatric Infectious Diseases, Faculty of Medicine, Selcuk University, Konya, Turkey
- Gizem Guner Ozenen
- 8Department of Pediatric Infectious Diseases, Faculty of Medicine, Ege University, Izmir, Turkey
- Erdal İnce
- 9Department of Pediatric Infectious Diseases, Faculty of Medicine, Ankara University, Ankara, Turkey
- Zekiye Baydar
- 3Department of Pediatrics, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey
- Ahmet Kagan Ozkaya
- 4Department of Pediatric Emergency, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
- Husnu Fahri Ovali
- 5Department of Pediatrics, Goztepe Training and Research Hospital, Istanbul Medeniyet University, Istanbul, Turkey
- Seher Tekeli
- 6Department of Pediatrics, Faculty of Medicine, Eskisehir Osmangazi University, Eskişehir, Turkey
- Solmaz Celebi
- 4Department of Pediatric Infectious Diseases, Faculty of Medicine, Uludag University, Bursa, Turkey
- Birgul Cubukcu
- 7Denizli Hospital, Denizli, Turkey
- Alkan Bal
- 8Department of Pediatric Emergency, Faculty of Medicine, Manisa Celal Bayar University, Manisa, Turkey
- Fidan Khalilova
- 9Department of Pediatrics, Faculty of Medicine, Koc University, Istanbul, Turkey
- Mehmet Kose
- 0Department of Pediatric Pulmonology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
- Halil Ugur Hatipoglu
- 1Department of Pediatrics, Faculty of Medicine, Istinye University, Istanbul, Turkey
- Tahir Dalkiran
- 2Division of Pediatric Intensive Care, Necip Fazıl Training and Research Hospital, University of Health Sciences, Kahramanmaraş, Turkey
- Mehmet Turgut
- 2Department of Pediatric Infectious Diseases, Faculty of Medicine, Adıyaman University, Adıyaman, Turkey
- Ayse Basak Altas
- 4Public Health Institutions of Turkey, Director of Virology Department, Ankara, Turkey
- Hatice Nilgün Selcuk Duru
- 5Division of Pediatrics, Istanbul Haseki Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
- Ahu Aksay
- 6Division of Pediatric Infectious Diseases, Izmir Tepecik Training and Research Hospital, University of Health Sciences, Izmir, Turkey
- Sevcan Saglam
- 7Van Training and Research Hospital, University of Health Sciences, Van, Turkey
- Mehpare Sari Yanartas
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Istanbul University, Istanbul, Turkey
- Zeynep Ergenc
- Division of Pediatric Infectious Diseases, Faculty of Medicine, Pendik Training and Research Hospital, Marmara University, Istanbul, Turkey
- Yasemin Akin
- 3Division of Pediatrics, Kartal Dr. Lutfi Kırdar Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
- Yeter Duzenli Kar
- 9Division of Pediatrics, Erzurum Training and Research Hospital, Erzurum, Turkey
- Sabit Sahin
- 1Division of Pediatrics, Dortcelik Children's Training and Research Hospital, Bursa, Turkey
- Sadiye Kubra Tuteroz
- 7Department of Pediatric Infectious Diseases, Faculty of Medicine, Selcuk University, Konya, Turkey
- Nimet Melis Bilen
- 8Department of Pediatric Infectious Diseases, Faculty of Medicine, Ege University, Izmir, Turkey
- Halil Ozdemir
- 9Department of Pediatric Infectious Diseases, Faculty of Medicine, Ankara University, Ankara, Turkey
- Mine Cidem Senoglu
- 3Department of Pediatrics, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey
- Burcu Pariltan Kucukalioglu
- 4Department of Pediatrics, Kanuni Training and Research Hospital, University of Health Sciences, Trabzon, Turkey
- Gulser Esen Besli
- 5Department of Pediatrics, Goztepe Training and Research Hospital, Istanbul Medeniyet University, Istanbul, Turkey
- Yalcin Kara
- 6Department of Pediatrics, Faculty of Medicine, Eskisehir Osmangazi University, Eskişehir, Turkey
- Cansu Turan
- 4Department of Pediatric Infectious Diseases, Faculty of Medicine, Uludag University, Bursa, Turkey
- Burcu Selbest Demirtas
- 7Denizli Hospital, Denizli, Turkey
- Aydın Celikyurt
- 9Department of Pediatrics, Faculty of Medicine, Koc University, Istanbul, Turkey
- Yasemin Cosgun
- 4Public Health Institutions of Turkey, Director of Virology Department, Ankara, Turkey
- Murat Elevli
- 5Division of Pediatrics, Istanbul Haseki Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
- Aslihan Sahin
- 6Division of Pediatric Infectious Diseases, Izmir Tepecik Training and Research Hospital, University of Health Sciences, Izmir, Turkey
- Serife Bahtiyar Oguz
- 7Van Training and Research Hospital, University of Health Sciences, Van, Turkey
- Ayper Somer
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Istanbul University, Istanbul, Turkey
- Bulent Karadag
- 5Division of Pediatric Pulmonology, Pendik Training and Research Hospital, Marmara University, Istanbul, Turkey
- Recep Demirhan
- 6Division of Thoracic Surgery, Kartal Dr. Lutfi Kırdar Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
- Hatice Turk Dagi
- 7Department of Microbiology, Faculty of Medicine, Selcuk University, Konya, Turkey
- Zafer Kurugol
- 8Department of Pediatric Infectious Diseases, Faculty of Medicine, Ege University, Izmir, Turkey
- Esra Cakmak Taskin
- 9Department of Pediatric Infectious Diseases, Faculty of Medicine, Ankara University, Ankara, Turkey
- Aysegul Sahiner
- 3Department of Pediatrics, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey
- Edanur Yesil
- 4Department of Pediatric Infectious Diseases, Faculty of Medicine, Uludag University, Bursa, Turkey
- Yildiz Ekemen Keles
- 6Division of Pediatric Infectious Diseases, Izmir Tepecik Training and Research Hospital, University of Health Sciences, Izmir, Turkey
- Remzi Sarikaya
- 7Van Training and Research Hospital, University of Health Sciences, Van, Turkey
- Ela Erdem Eralp
- 5Division of Pediatric Pulmonology, Pendik Training and Research Hospital, Marmara University, Istanbul, Turkey
- Ferda Ozkinay
- 8Department of Pediatric Infectious Diseases, Faculty of Medicine, Ege University, Izmir, Turkey
- Hatice Kubra Konca
- 9Department of Pediatric Infectious Diseases, Faculty of Medicine, Ankara University, Ankara, Turkey
- Songul Yilmaz
- 3Department of Pediatrics, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey
- Yasemin Gokdemir
- 5Division of Pediatric Pulmonology, Pendik Training and Research Hospital, Marmara University, Istanbul, Turkey
- Gul Arga
- 9Department of Pediatric Infectious Diseases, Faculty of Medicine, Ankara University, Ankara, Turkey
- Seval Ozen
- 9Department of Pediatric Infectious Diseases, Faculty of Medicine, Ankara University, Ankara, Turkey
- Fevziye Coksuer
- 9Department of Pediatric Infectious Diseases, Faculty of Medicine, Ankara University, Ankara, Turkey
- Goksel Vatansever
- 8Department of Pediatric Emergency, Faculty of Medicine, Ankara University, Ankara, Turkey
- Hasan Tezer
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Gazi University, Ankara, Turkey
- Ates Kara
- 1Department of Pediatric Infectious Diseases, Faculty of Medicine, Hacettepe University, Ankara, Turkey
- DOI
- https://doi.org/10.3389/fped.2021.631547
- Journal volume & issue
-
Vol. 9
Abstract
Objectives: The aim of this study is to identify the epidemiological, clinical, and laboratory features of coronavirus disease 2019 (COVID-19) in children.Methods: A retrospective study was conducted by pediatric infectious disease specialists from 32 different hospitals from all over Turkey by case record forms. Pediatric cases who were diagnosed as COVID-19 between March 16, 2020, and June 15, 2020 were included. Case characteristics including age, sex, dates of disease onset and diagnosis, family, and contact information were recorded. Clinical data, including the duration and severity of symptoms, were also collected. Laboratory parameters like biochemical tests and complete blood count, chest X-ray, and chest computed tomography (CT) were determined.Results: There were 1,156 confirmed pediatric COVID-19 cases. In total, male cases constituted 50.3% (n = 582) and females constituted 49.7% (n = 574). The median age of the confirmed cases was 10.75 years (4.5–14.6). Of the total cases, 90 were younger than 1 year of age (7.8%), 108 were 1–3 years of age (9.3%), 148 were 3–6 years of age (12.8%), 298 were 6–12 years of age (25.8%), 233 were 12–15 years of age (20.2%), and 268 cases were older than 15 years of age (23.2%). The most common symptom of the patients at the first visit was fever (50.4%) (n = 583) for a median of 2 days (IQR: 1–3 days). Fever was median at 38.4°C (38.0–38.7°C). The second most common symptom was cough (n = 543, 46.9%). The other common symptoms were sore throat (n = 143, 12.4%), myalgia (n = 141, 12.2%), dyspnea (n = 118, 10.2%), diarrhea (n = 112, 9.7%), stomachache (n = 71, 6.1%), and nasal discharge (n = 63, 5.4%). When patients were classified according to disease severity, 263 (22.7%) patients were asymptomatic, 668 (57.7%) patients had mild disease, 209 (18.1%) had moderate disease, and 16 (1.5%) cases had severe disease. One hundred and forty-nine (12.9%) cases had underlying diseases among the total cases; 56% of the patients who had severe disease had an underlying condition (p < 0.01). The need for hospitalization did not differ between patients who had an underlying condition and those who do not have (p = 0.38), but the need for intensive care was higher in patients who had an underlying condition (p < 0.01). Forty-seven (31.5%) of the cases having underlying conditions had asthma or lung disease (38 of them had asthma).Conclusions: To the best of our knowledge, this is one of the largest pediatric data about confirmed COVID-19 cases. Children from all ages appear to be susceptible to COVID-19, and there is a significant difference in symptomatology and laboratory findings by means of age distribution.
Keywords