Children with SARS-CoV-2 infection during the novel coronaviral disease (COVID-19) outbreak in Iran: an alarming concern for severity and mortality of the disease

• Published in: BMC infectious diseases Vol. 22; no. 1; p. 382
• Main Authors: Mamishi, Setareh, Pourakbari, Babak, Mehdizadeh, Mehrzad, Navaeian, Amene, Eshaghi, Hamid, Yaghmaei, Bahareh, Hosseinpour Sadeghi, Reihaneh, Poormohammadi, Shiva, Mahmoudieh, Yasmine, Mahmoudi, Shima
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 15.04.2022; BioMed Central; BMC
• Subjects: Abdomen; Adolescent; Cardiovascular diseases; Child; Children; Coronaviruses; COVID-19; COVID-19 - complications; Data collection; Demographic aspects; Diarrhea; Disease; Disease Outbreaks; Epidemics; Epidemiology; Female; Fever; Hospitalization; Hospitals; Humans; Illnesses; Immunology; Infections; Iran; Iran - epidemiology; Male; Medical laboratories; MIS-C; Mortality; Neurological disorders; Patients; Pediatric research; Pediatrics; Polymerase chain reaction; Public health; Respiratory diseases; SARS-CoV-2; Severe acute respiratory syndrome; Severe acute respiratory syndrome coronavirus 2; Severity; Systemic Inflammatory Response Syndrome - epidemiology; Variables; Viral diseases; Iran; COVID-19; MIS-C; SARS-CoV-2; Severity; Mortality
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-022-07200-0

The rapid worldwide spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections led to public health crises globally and the number of pediatric patients with Coronavirus Disease 2019 (COVID-19) is still rising. The aim of this study was to describe the epidemiological, clinical, laboratory, and imaging features of hospitalized patients with COVID-19 at an Iranian referral pediatrics hospital and to compare these parameters between hospitalized patients with and without severe disease, multisystem inflammatory syndrome in children (MIS-C) and children with acute COVID-19, as well as deceased and discharged cases. This study included hospitalized children and adolescents (≤ 18 years) with suspected COVID-19 who had positive results for SARS-CoV-2. Among the 262 patients with suspected COVID-19, 142 confirmed COVID-19 cases were included in the study. A total of 11 children were diagnosed as MIS-C. The majority of the cases with MIS-C were male, (n = 9, 82%) which is significantly higher than children (n = 61, 47%) with acute COVID-19 (P = 0.03). Fifty patients (35%) were shown to have a more severe form of COVID-19. Ninety percent of the cases (n = 45) with severe COVID-19 had comorbidities that was significantly higher than cases with non-severe or mild disease (n = 41, 45%; P < 0.0001). A mortality rate of 10% was reported (n = 14). Ninety-three percent of the deceased cases (n = 13) had comorbidities that were significantly higher than discharged patients (n = 73, 57%; P = 0.009). The increasing number of children with severe COVID-19 is cause for great concern. Underlying diseases, mainly cardiovascular diseases, cancer, and malignancies, are associated with greater risk of development of severe COVID-19 and even death in children. On the other hand, pediatric patients with MIS-C usually develop a milder form of the disease. However, evaluation specific immunological responses in children to explore the delayed inflammatory syndrome are highly recommended.