Features of COVID-19 in teenagers. Clinical cases
Keywords:SARS-CоV-2, epidemiological features, clinical features, adolescents, children
Coronavirus infection in childhood is a common disease and has a number of features of the clinical course. There remain quite a lot of problems related to the variety of clinical symptoms, the severity of the course and treatment tactics in different age categories.
Purpose - to study the epidemiological and clinical features of the coronavirus disease COVID-19 in adolescents compared to the younger age group in order to predict the severity of the course and determine treatment tactics.
Materials and methods. A single-center retrospective open cohort study of 188 patients under the age of 18 hospitalized in the infectious disease department of the Chernivtsi Regional Children’s Clinical Hospital with a confirmed respiratory infection caused by SARS-CоV-2 was conducted. This cohort of patients is divided into 2 clinical groups. The Group I consisted of children aged 12 to 18 years (43 children), the Group II included children aged 0 to 11 years (145 patients).
Results. Epidemiologically, extrafamilial sources of infection prevail in adolescence in the range of 44.2% (n=19), which is explained by greater social activity compared to children from birth to 11 years of age. For the 1st observation group, symptoms of damage to the lower respiratory tract are more characteristic, in particular, cough 81.4% (n=23), shortness of breath 51.1% (n=22), hypoxemia 14.2% (n=6) and symptoms of associated with intoxication syndrome (general weakness, asthenia 97.6% (n=42), decreased appetite, refusal to eat 74.4% (n=32), myalgia 11.6% (n=5), headache 14,2% (n=6)). The severity of the course of the coronavirus infection in adolescence is due to the dominance of lower respiratory tract lesions with the development of pneumonia in 58.2% (n=25) of cases, which required longer and more intensive treatment.
Conclusions. The share of adolescents hospitalized due to COVID-19 was 22.9% (n=43), among them with a severe degree of impairment of the general condition - 16.4% (n=7), which is due to the predominance of damage to the lower respiratory tract with the development of pneumonia in 58.2% (n=25) of cases. This cohort of patients is characterized by a longer intoxication syndrome, the epidemiological role of family contacts with regard to COVID-19 decreases, and the value of unidentified non-familial sources of infection increases - 44.2% (n=19).
The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the institution mentioned in the work. Informed consent of parents or their guardians was obtained for conducting research.
No conflict of interests was declared by the authors.
Alsohime F, Temsah MH, Al-Nemri AM, Somily AM, AlSubaiea S. (2020). COVID-19 infection prevalence in pediatric population: Etiology, clinical presentation, and outcome. J Inf Public Health. 13 (12): 1791-1796. https://doi.org/10.1016/j.jiph.2020.10.008; PMid:33127335 PMCid:PMC7574780
Cai J, Xu J, Lin D, Yang Z, Xu L, Qu Z et al. (2020). A Case Series of children with 2019 novel coronavirus infection: clinical and epidemiological features. Clin Infect Dis. 28: 28.
Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y et al. (2020). Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 395: 507-513. https://doi.org/10.1016/S0140-6736(20)30211-7; PMid:32007143
Cui X, Zhao Z, Zhang T, Guo W, Guo W, Zheng J et al. (2021). A systematic review and metaanalysis of children with coronavirus disease 2019 (COVID-19). J Med Virol. 93 (2): 1057-1069. https://doi.org/10.1002/jmv.26398; PMid:32761898 PMCid:PMC7436402
Cui Y, Tian M, Huang D, Wang X, Huang Y, Fan L et al. (2020). A 55-Day-Old Female Infant infected with COVID 19: presenting with pneumonia, liver injury, and heart damage. J Infect Dis. 17: 17.
Dadgar S, Mahmoudinia M, Akbari A et al. (2022). Placental infection with SARS-CoV-2, analysis of 16 cases and literature review. Arch Gynecol Obstet. 305: 1359-1367 https://doi.org/10.1007/s00404-021-06372-5; PMid:35088195 PMCid:PMC8794612
Huang C, Wang Y, Li X, Ren L, Zhao J. (2020). Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 395: 497-506. https://doi.org/10.1016/S0140-6736(20)30183-5; PMid:31986264
Lu X, Zhang L, Du H, Zhang J, Li YY, Qu J, Zhang W, Wang Y, Bao S. (2020). SARS-CoV-2 infection in children. N Engl J Med. 382: 1663-1665. https://doi.org/10.1056/NEJMc2005073; PMid:32187458 PMCid:PMC7121177
Ludvigsson JF. (2020). Systematic review of COVID-19 in children shows milder cases and a better prognosis than adults. Acta Paediatr. 109: 1088-1095. https://doi.org/10.1111/apa.15270; PMid:32202343 PMCid:PMC7228328
MOZ Ukrainy. (2022). Chernivetskyi oblasnyi tsentr kontroliu ta profilaktyky khvorob MOZ Ukrainy. URL: http://www.guchernses.gov.ua.
Ong SWX, Tan YK, Chia PY, Lee TH, Ng OT, Wong MSY, Marimuthu K. (2020). Air, surface environmental, and personal protective equipment contamination by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from a symptomatic patient. JAMA. 323 (16): 1610-1612. https://doi.org/10.1001/jama.2020.3227; PMid:32129805 PMCid:PMC7057172
Wardell H, Campbell JI, VanderPluym C, Dixit A. (2020). Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Febrile Neonates. J Pediatric Infect Dis Soc. 9 (5): 630-635. https://doi.org/10.1093/jpids/piaa084; PMid:32645175 PMCid:PMC7454701
Young BE, Ong SWX, Kalimuddin S. (2020). Epidemiologic features and clinical course of patients infected with SARS-CoV-2 in Singapore. JAMA. 323 (15): 1488-1494. https://doi.org/10.1001/jama.2020.3204; PMid:32125362 PMCid:PMC7054855
Zhao S, Ling K, Yan H, Zhong L, Peng X, Yao S, Huang J, Chen X. (2020). Anesthetic Management of Patients with COVID 19 Infections during Emergency Procedures. J Cardiothorac Vasc Anesth. 34 (5): 1125-1131. https://doi.org/10.1053/j.jvca.2020.02.039; PMid:32178954 PMCid:PMC7102598
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