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The Coronavirus Disease 2019 (COVID-19) in Children: A Study in an Iranian Children’s Referral Hospital

Authors Mahmoudi S, Mehdizadeh M, Shervin Badv R, Navaeian A, Pourakbari B, Rostamyan M, Sharifzadeh Ekbatani M, Eshaghi H, Abdolsalehi MR, Alimadadi H, Movahedi Z, Mamishi S

Received 20 April 2020

Accepted for publication 16 July 2020

Published 31 July 2020 Volume 2020:13 Pages 2649—2655


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 4

Editor who approved publication: Professor Suresh Antony

Shima Mahmoudi,1 Mehrzad Mehdizadeh,2,3 Reza Shervin Badv,3 Amene Navaeian,4 Babak Pourakbari,1 Maryam Rostamyan,4 Meisam Sharifzadeh Ekbatani,3 Hamid Eshaghi,4 Mohammad Reza Abdolsalehi,4 Hosein Alimadadi,5 Zahra Movahedi,6 Setareh Mamishi1,4

1Tehran University of Medical Sciences, Tehran, Iran; 2School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; 3Pediatrics Center of Excellence, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran; 4Department of Infectious Diseases, Pediatrics Center of Excellence, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran; 5Tehran University of Medical Sciences, Tehran, Iran; 6Department of Pediatric Infectious Disease, Faculty of Medicine, Qom University of Medical Sciences, Qom, Iran

Correspondence: Setareh Mamishi Department of Infectious Diseases
Pediatrics Center of Excellence, Children’s Medical Center Hospital, Keshavarz Boulevard, Tehran, Iran
Tel/ Fax +98- 21- 6642- 8996

Background: Despite the worldwide spread of the coronavirus disease 2019 (COVID-19), the epidemiological and clinical patterns of the COVID-19 infection remain largely unclear, particularly among children. In this study, we explored the epidemiological characteristics, clinical patterns, and laboratory and imaging findings of pediatric patients with COVID-19.
Materials and Methods: From March 7 to March 30, 2020, there were a total of 35 patients who had confirmed COVID-19 infection by laboratory virus nucleic acid test (RT-PCR) assay with throat swab samples or typical chest CT manifestation compatible with COVID-19, in addition to a history of close contact with suspected or confirmed SARS‐CoV‐2 in family members. Information recorded included demographic data, medical history, exposure history, underlying comorbidities, symptoms, signs, laboratory findings and radiologic assessments, severity of disease, treatment, and mortality.
Results: The median age of the patients was 7.5 years (IQR=4– 11; range=4 months to 15 years). A total of 63% were male. Cough was present in 80% of the patients, followed by fever (77%), nausea or vomiting (29%), diarrhea (26%), shortness of breath (29%), headache (20%), and myalgia (14%). Lymphopenia was present in 43% of the patients, thrombocytopenia in 9%, neutopenia in 8%, and leucopenia in 26%. We reported severe pneumonia in 40% of the hospitalized patients and 18 (51%) had underlying diseases. Of 35 patients, 11 had positive RT-PCR results (31%). The chest CT images of 24 patients (69%) suggested COVID-19, while their RT-PCR assays from throat swab samples were negative.
Conclusion: This study demonstrates different clinical findings of pediatrics compared to the previous reports of children. Since a high rate of false negative RT-PCR test was observed, early detection of children with COVID-19 infection by CT is conducive to reasonable management and early treatment.

Keywords: COVID-19, children, severe pneumonia, Iran

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