The COVID19 pandemic has caused a great impact globally which has led to over 106 million confirmed cases and 2.3 million deaths as of Feb 2021. A study was conducted to describe and compare the characteristics and outcomes of hospitalized children with SARS- CoV-2 or Multisystem Inflammatory Syndrome (MIS) in three countries namely Canada, Iran, and Costa Rica. 15 pediatric hospitals entered asymptomatic and symptomatic subjects up to 17 years of age, from Feb to November 2020 with a laboratory-confirmed diagnosis of SARS-Co-V-2 infection or with MIS-C (Multisystem Inflammatory Syndrome).
The SARS-Co-V-2 in children were classified as mild, severe, and critical cases. Mild SARS-Co-V-2 in children was classified as children who were symptomatic but did not require supplemental O2 support. The severe disease was defined as the need for supplemental O2 due to COVID19 or MIS-C without either death or admission to ICU. The critical disease was defined as death or admission of ICU of children affected with SARS-Co-V-2
Of 211 patients included, 103 had a presumptive diagnosis of COVID19 or MIS-C at admission while 108 were admitted with other diagnoses. These 108 patients out of 211 were diagnosed with COVID19 on admission but were initially not suspected of having COVID-19. 81 had the mild or asymptomatic disease and eight later were thought to have been infected at a hospital. Children with MIS-C were more likely to show fever, gastrointestinal symptoms, myalgia, conjunctivitis, and rash than those without MIS-C.
In conclusion, approximately half of the children with SARS-Co-V-2 or MIS-C diagnosed during hospitalization were admitted with other diagnoses. Half of all children with COVID-19 are thought to have other conditions before admission, and two-thirds have no or mild symptoms. About 16% were admitted to the ICU, and half of these were put on mechanical ventilation. The study shows that four deaths occurred.
Only a few patients required oxygen supplementation or admission to the ICU. It was concluded that neonates and children with comorbidities and those with chest X-rays compatible with COVID19 were at a higher rate of requiring supplemental O2 or ICU admission during the SARS-Co-V-2 hospitalization.
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