Clinical characteristics of pediatric SARS-CoV-2 infection and coronavirus disease 2019 (COVID-19) in Kuwait

Affiliations

01 May 2021

-

doi: 10.1002/jmv.26684


Abstract

Clinical presentation of coronavirus disease-2019 (COVID-19) ranges from asymptomatic to severe and life-threatening. National-level registries found that children, generally, have less severe disease when compared with adults. However, most asymptomatically infected children will not present to hospital and may be missed. We aimed to describe the clinical characteristics in pediatric COVID-19 patients in Kuwait, and to estimate the potential duration of viral shedding. A retrospective cohort study was performed in Jaber Alahmad Hospital (JAH) from February 29 to April 30, 2020. During the study period and as part of the public health measures, all severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected patients from 1 month to 18 years old, regardless of symptoms, were hospitalized at JAH, and were included. Polymerase chain reaction (PCR) negativity was defined as having two consecutive negative PCR results from a respiratory specimen. Descriptive statistics and multivariable regression analyses were performed. We found that 67.9% (95% CI, 59.4%-75.3%) of 134 SARS-CoV-2-infected children were asymptomatic. Median PCR positivity was 15 days and did not vary with symptoms. Among patients who had laboratory investigations and chest imaging, symptomatic infection was associated with elevated C-reactive protein and procalcitonin, and radiographic pneumonia. Asymptomatic SARS-CoV-2 infection is very common in children. Among symptomatic patients, the disease seems to be mild. Children exhibit substantial duration of viral shedding, regardless of symptoms.

Keywords: SARS coronavirus


Figures


Similar articles

Dynamic profile of SARS-CoV-2 infection among hospitalized patients in Kuwait: a descriptive study.

Madi N, Al-Awadhi E, Al-Assaf F.BMC Infect Dis. 2021 Aug 5;21(1):758. doi: 10.1186/s12879-021-06504-x.PMID: 34353284 Free PMC article.

SARS-CoV-2 Clinical Characteristics and Viral Shedding in Kuwait.

Alghounaim M, Caya C, Alothman K, Alhasawi A, Papenburg J.Med Princ Pract. 2022;31(1):93-97. doi: 10.1159/000521408. Epub 2021 Dec 9.PMID: 34883487 Free PMC article.

Symptomatic Infection is Associated with Prolonged Duration of Viral Shedding in Mild Coronavirus Disease 2019: A Retrospective Study of 110 Children in Wuhan.

Lu Y, Li Y, Deng W, Liu M, He Y, Huang L, Lv M, Li J, Du H.Pediatr Infect Dis J. 2020 Jul;39(7):e95-e99. doi: 10.1097/INF.0000000000002729.PMID: 32379191 Free PMC article.

Human and novel coronavirus infections in children: a review.

Rajapakse N, Dixit D.Paediatr Int Child Health. 2021 Feb;41(1):36-55. doi: 10.1080/20469047.2020.1781356. Epub 2020 Jun 25.PMID: 32584199 Review.

Prolonged viral shedding in feces of pediatric patients with coronavirus disease 2019.

Xing YH, Ni W, Wu Q, Li WJ, Li GJ, Wang WD, Tong JN, Song XF, Wing-Kin Wong G, Xing QS.J Microbiol Immunol Infect. 2020 Jun;53(3):473-480. doi: 10.1016/j.jmii.2020.03.021. Epub 2020 Mar 28.PMID: 32276848 Free PMC article. Review.


Cited by

Clinical Characteristics, Outcomes and Prognostic Factors for Critical Illness in Hospitalized COVID-19 Patients in Saudi Arabia: A Retrospective Cohort Study.

El-Kady AM, Aldakheel FM, Allemailem KS, Almatroudi A, Dbas Alharbi R, Al Hamed H, Alsulami M, Alshehri WA, El-Ashram S, Kreys E, Mohamed K, Al-Megrin WAI, Elshabrawy HA.Int J Gen Med. 2022 Aug 31;15:6945-6963. doi: 10.2147/IJGM.S374090. eCollection 2022.PMID: 36068791 Free PMC article.

Risk factors for disease severity and mortality of children with Covid-19: A study at a Vietnamese Children's hospital.

Nguyen PNT, Thuc TT, Hung NT, Thinh LQ, Minh NNQ, Duy DQ, Nhut TM, Linh NBY, Tuan TM, Giang NHL, Tuyen VTM.J Infect Chemother. 2022 Oct;28(10):1380-1386. doi: 10.1016/j.jiac.2022.06.010. Epub 2022 Jun 20.PMID: 35738340 Free PMC article.

Clinical and epidemiological characteristics of children with COVID-19 in Selangor, Malaysia.

See KC, Tan LP, Ong LT, Lee PY.IJID Reg. 2022 Mar;2:63-69. doi: 10.1016/j.ijregi.2021.11.012. Epub 2021 Dec 5.PMID: 35721419 Free PMC article.

The Pediatric COVID-19 Registry in Kuwait: Methodology and Results of Pilot Phase.

Qabazard S, Al-Abdulrazzaq D, Al-Kandari H, Ayed M, Alanezi A, Al-Shammari N, Alharbash Z, Al-Khabbaz M, Kalander K, Bin-Hassan S, Alfraij A, Alghounaim M, Alsaeid K, Al-Hashemi H.Med Princ Pract. 2022;31(5):471-479. doi: 10.1159/000524756. Epub 2022 May 20.PMID: 35598599 Free PMC article.

Comparison between SARS-CoV-2 positive and negative pneumonia in children: A retrospective analysis at the beginning of the pandemic.

Zhamankulov A, Rozenson R, Morenko M, Akhmetova U, Tyo A, Poddighe D.World J Exp Med. 2022 Mar 20;12(2):26-35. doi: 10.5493/wjem.v12.i2.26. eCollection 2022 Mar 20.PMID: 35433317 Free PMC article.


KMEL References


References

  1.  
    1. Bunyavanich S, Do A, Vicencio A. Nasal gene expression of angiotensin‐converting enzyme 2 in children and adults. JAMA. 2020;323:2427. 10.1001/jama.2020.8707 - DOI - PMC - PubMed
  2.  
    1. Lu X, Zhang L, Du H, et al. SARS‐CoV‐2 infection in children. N Engl J Med. 2020;382(17):1663‐1665. 10.1056/NEJMc2005073 - DOI - PMC - PubMed
  3.  
    1. Lu Y, Li Y, Deng W, et al. Symptomatic infection is associated with prolonged duration of viral shedding in mild coronavirus disease 2019: a retrospective study of 110 children in Wuhan. Pediatr Infect Dis J. 2020;39(7):e95‐e99. 10.1097/INF.0000000000002729 - DOI - PMC - PubMed
  4.  
    1. Children and COVID‐19 : State Data Report: American Academy of Pediatrics and the Children's Hospital Association. July 16, 2020. https://downloads.aap.org/AAP/PDF/AAP%20and%20CHA%20-%20Children%20and%2.... Accessed July 24, 2020.
  5.  
    1. Souza TH, Nadal JA, Nogueira RJN, Pereira RM, Brandao MB. Clinical manifestations of children with COVID‐19: a systematic review. Pediatr Pulmonol. 2020;55:1892‐1899. 10.1002/ppul.24885 - DOI - PMC - PubMed
  6.  
    1. Götzinger F, Santiago‐García B, Noguera‐Julián A, et al. COVID‐19 in children and adolescents in Europe: a multinational, multicentre cohort study. Lancet Child Adolesc Health. 2020;4:653‐661. 10.1016/S2352-4642(20)30177-2 - DOI - PMC - PubMed
  7.  
    1. Sun D, Li H, Lu X‐X, et al. Clinical features of severe pediatric patients with coronavirus disease 2019 in Wuhan: a single center's observational study. World Journal of Pediatrics. 2020;16:1‐9. - PMC - PubMed
  8.  
    1. Lu Y, Li Y, Deng W, et al. Symptomatic infection is associated with prolonged duration of viral shedding in mild coronavirus disease 2019: a retrospective study of 110 children in Wuhan. Pediatr Infect Dis J. 2020;39(7):e95‐e99. - PMC - PubMed
  9.  
    1. World Health Organization . Clinical management of severe acute respiratory infection when COVID‐19 is suspected: Interim guidance V1.2. April 2, 2020. Available from https://www.who.int/publications/i/item/clinical-management-of-covid-19
  10.  
    1. Lanzkowsky P. Hematological Reference Values: Lanzkowsky's Manual of Pediatric Hematology and Oncology. 6th ed. Amsterdam: Elsevier; 2016:709‐728. AP. Appendix 1. http://www.sciencedirect.com/science/book/9780128013687
  11.  
    1. Chao JY, Derespina KR, Herold BC, et al. Clinical characteristics and outcomes of hospitalized and critically ill children and adolescents with coronavirus disease 2019 (COVID‐19) at a Tertiary Care Medical Center in New York City. J Pediatr. 2020;223:14‐19. 10.1016/j.jpeds.2020.05.006 - DOI - PMC - PubMed
  12.  
    1. Cruz AT, Zeichner SL. COVID‐19 in children: initial characterization of the pediatric disease. Pediatrics. 2020;145(6):e20200834. 10.1542/peds.2020-0834 - DOI - PubMed
  13.  
    1. Dong Y, Mo X, Hu Y, et al. Epidemiology of COVID‐19 among children in China. Pediatrics. 2020;145(6):e20200702. 10.1542/peds.2020-0702 - DOI - PubMed
  14.  
    1. Han MS, Choi EH, Chang SH, et al. Clinical characteristics and viral RNA detection in children with coronavirus disease 2019 in the Republic of Korea [published online ahead of print August 28, 2020]. JAMA Pediatr. 2020. 10.1001/jamapediatrics.2020.3988 - DOI - PMC - PubMed
  15.  
    1. Papenburg J, Fontela PS, Freitas RR, Burstein B. Inappropriate antibiotic prescribing for acute bronchiolitis in US emergency departments, 2007‐2015. J Pediatric Infect Dis Soc. 2019;8(6):567‐70. 10.1093/jpids/piy131 - DOI - PubMed