COVID-19 in children ranging from asymptomatic to a multi-system inflammatory disease: A single-center study

Saudi Med J. 2021 Mar;42(3):299-305. doi: 10.15537/smj.2021.42.3.20200625.

Abstract

Objectives: To identify clinical and laboratory characteristics of the Saudi children with confirmed COVID-19.

Methods: Eighty-eight children (0-14 years) with COVID-19 who were admitted to Prince Sultan Military Medical City (PSMMC), Riyadh, Saudi Arabia from April to June 2020 were recruited.

Results: Mean age was 5.74 ± 4.7 years with 41 (49.4%) males and 42 (50.6%) females. The length of hospital stay (LOS) ranged from 1 to 17 days. The main source of infection was infected family members. Mean values of C-reactive protein (CRP), serum ferritin, and lactate dehydrogenase (LDH) were noticeably above normal. Degree of severity and length of stay was significantly correlated with lymphopenia (r= -0.36; p=0.001), whereas it was positively correlated with absolute neutrophil count and with high inflammatory markers, such as CRP, LDH, and others.

Conclusions: Identifying the clinical and laboratory characteristics of the Saudi children with confirmed COVID-19 will improve understanding of this disease's presentation and will help put rapid and proper management strategies into place to face this pandemic. A high index of suspicion is needed for cases presenting with multi-system inflammatory disease, which represented 5.7% of the included study population.

Keywords: COVID-19; MIS-c; Multisystem inflammatory disease; Saudi Arabia; children; pediatric.

MeSH terms

  • Adolescent
  • Asymptomatic Infections
  • Biomarkers / blood
  • C-Reactive Protein / metabolism
  • COVID-19 / complications
  • COVID-19 / diagnosis*
  • COVID-19 / epidemiology
  • COVID-19 / therapy
  • Child
  • Child, Preschool
  • Female
  • Ferritins / blood
  • Humans
  • Infant
  • Infant, Newborn
  • L-Lactate Dehydrogenase / blood
  • Length of Stay
  • Lymphopenia / complications
  • Male
  • Pandemics
  • Retrospective Studies
  • SARS-CoV-2
  • Saudi Arabia / epidemiology
  • Severity of Illness Index
  • Systemic Inflammatory Response Syndrome / complications
  • Systemic Inflammatory Response Syndrome / diagnosis*
  • Systemic Inflammatory Response Syndrome / epidemiology
  • Systemic Inflammatory Response Syndrome / therapy

Substances

  • Biomarkers
  • C-Reactive Protein
  • Ferritins
  • L-Lactate Dehydrogenase

Supplementary concepts

  • pediatric multisystem inflammatory disease, COVID-19 related