COVID-19 Pediatric Experience in a Portuguese Hospital: A Retrospective Clinical Analysis

Abstract

Introduction: Since the World Health Organization announced the coronavirus disease-2019 (COVID-19) as a pandemic, its impact is seen every day. Despite the morbidity affecting the adult population, current evidence suggests that in children, COVID-19 causes
milder symptoms.
Methods: This case series describes COVID-19 pediatric cases, diagnosed at the pediatric emergency department of Hospital de Cascais. A retrospective analysis was carried out, comprising the period from March to October 2020 describing clinical presentation, laboratory findings, treatment and outcome. Clinical data were obtained from the hospital records and the TRACE COVID platform, after informed consent from the caregivers.
Results: A total of 67 children out of 1974 tested (3%), were diagnosed with COVID-19 disease. The median age was six years-old, without gender predominance. Most patients presented with fever (76%) and respiratory symptoms (43%). Headache (30%) and myalgias (10%) were also frequently described. Gastrointestinal symptoms were reported in 43% of children, while only 6% experienced
loss of taste or smell. Diagnostic confirmation was done with reverse transcription polymerase chain reaction (RT – PCR) from nasal and oropharyngeal secretions. Five children (7%) required laboratory testing, and the findings included leukocytosis
and C-reactive protein (CRP) elevation. Three patients (4%) underwent chest radiography and none of them had abnormalities suggesting COVID-19 pneumonia. Disease severity ranged from mild to slightly moderate, with no complication requiring support
treatment nor specific antiviral therapy. Among all patients, only one was transferred to a tertiary hospital; the others were discharged home. Follow-up was possible in 63 children (94%) and they became asymptomatic after a median of five days.
Conclusion: These results are similar to those found in international series and to the only Portuguese study published in 2020, from a tertiary hospital. This retrospective series supports current evidence, which states that children infected with SARS-CoV-2 have a milder clinical course than adults.