TY - JOUR T1 - Clinical spectrum and risk factors for complicated disease course in children admitted with SARS-CoV-2 infection JO - Anales de Pediatría (English Edition) T2 - AU - Storch-de-Gracia,Pilar AU - Leoz-Gordillo,Inés AU - Andina,David AU - Flores,Patricia AU - Villalobos,Enrique AU - Escalada-Pellitero,Silvia AU - Jiménez,Raquel SN - 23412879 M3 - 10.1016/j.anpede.2020.07.005 DO - 10.1016/j.anpede.2020.07.005 UR - https://analesdepediatria.org/en-clinical-spectrum-risk-factors-for-articulo-S2341287920301915 AB - IntroductionAt this time there are still major questions about the characteristics of disease caused by the new coronavirus (COVID-19) in children as well as factors associated with the development of severe forms of the disease. Study designRetrospective study including patients under 18 years of age admitted with SARS-CoV-2 infection from March 1 to April 30, 2020. Infection was confirmed by real-time reverse transcriptase polymerase chain reaction (RT-PCR) or antibody testing. We describe the epidemiological and clinical data, laboratory and imaging findings, as well as treatment and outcome in these patients. In light of these findings, patients were classified into two severity groups and then compared. ResultsThirty-nine children were included, with a median age of 9 years (range 12 days–16 years); 23 were boys. Cases with uncomplicated disease course (24) mostly presented to the emergency department (ED) with fever and/or respiratory symptoms without significant alterations in laboratory findings. Of the 15 children with a complicated course, 12 developed shock. In addition to fever, they frequently presented altered appearance, extreme tachycardia, abdominal pain, vomiting, diarrhea, rash, and/or conjunctival hyperemia. They also showed greater lymphopenia (p=0.001), elevated neutrophil/lymphocyte ratio (p=0.001), C-reactive protein (p<0.001), procalcitonin (p=0.001), D-dimer (p<0.001), and ferritin (p<0.001). ConclusionsSARS-CoV-2 infection in admitted children presents with great clinical variability. When provided supportive care, patients with predominant respiratory symptoms without altered laboratory-test results generally have an uncomplicated course. Patients with complicated disease present mainly with fever and abdominal and/or mucocutaneous symptoms. Most develop shock. Elevation of inflammatory markers may allow for early detection and the final outcome is good. ER -