Abstract
Clinical Spectrum and Atypical Presentation of COVID-19 in Hospitalized Children below 14 Years in a Tertiary Care Hospital: Prospective Observational Study
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Background: Since December, 2019, an outbreak of coronavirus disease 2019 (COVID-19) has spread globally. India is now 2nd worst affected country after USA. In central India, a very little is known about the clinical spectrum and severity of COVID-19 in children.
Objectives: To assess the clinical characteristics of hospitalized COVID-19 infected children below 14 years of age and to describe atypical presentations of COVID 19 in children.
Design: Prospective observational study.
Setting: Tertiary care centre and a dedicated covid hospital in central India.
Participants: All the children less than 14years admitted with the laboratory conformed diagnosis of COVID-19 between 14th April to 30th October 2020 were enrolled in this study.
Results: 45 children were admitted with COVID-19. The most common symptom were fever 17(37%), cough 8(17.7%), breathing difficulty 5 (11%), nausea and vomiting 4(8.8%) and seizure 4(8.8%). 10 (22.2%) children admitted in the hospital needed critical care. 23 (51%) children were asymptomatic, 8(17%) children were having mild symptoms, 4 (8.8%) had moderate disease and 10 children were admitted with severe/critical disease {Septic shock with respiratory failure 4(8.8%), Guillain barre syndrome 1(2%), Encephalitis 2(4%), Kawasaki disease 1(2%), ARDS 2(4%)}. 3 (6.6%) children died in the hospital of age group between 2-3 months and remaining 42(93.3%) children discharged successfully.
Conclusion: Our study shows that Pediatrics patients with COVID-19 have a simple transmission mode, either by close contact with infected adults or by exposure to epidemic areas. Early identification and management of severe disease as described n our case study can lead to significant change in their outcome (66.6% survival among critically ill children on mechanical ventilator).
Keywords: COVID 19, Children, Clinical features
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