Pediatric coronavirus disease 2019 (COVID-19): An insight from west of Iran

Abstract

OBJECTIVE: To study the clinical, laboratory, and radiological characteristics of the pediatric patients infected with the newemerging 2019 coronavirus virus (SARS-CoV-2) in Hamadan and Sanandaj, west of Iran.METHODS: A descriptive study was conducted in Hamadan and Kurdistan province between March 1 to April 15, 2020.Medical records of the children diagnosed as probable or confirmed cases of COVID-19 disease were extracted and analyzedin this study. We followed the WHO Guideline for the case definition of the patients.RESULTS: Thirty patients admitted to the wards specified for COVID-19 diseases. Nineteen (63%) patients categorizedas confirmed by Real-Time Reverse-Transcriptase Polymerase Chain Reaction (RT-PCR) and 11 (37%) patients as probableaccording to Computed Tomography (CT) findings of the chest. Sixteen (53.3%) cases were female, the youngest patientwas one day old, and the oldest patient was 15 years old. 11 (36.7%) cases had a definite history of close contact. Themost common symptoms were fever, cough, and dyspnea, and the most common sign was tachypnea. None of our patientspresented with a runny nose. Lymphopenia and marked elevation of the C-reactive Protein observed in four (13.3%) and 12(40%) cases, respectively. There were 10 (33.3%) cases with normal chest X-rays. Ground-Glass Opacities (GGOs) were themost common CT findings (19, 73.1%). All but one of the patients discharged without sequala. An 11-yrs-old girl expiredwith a fulminant pneumonia.CONCLUSION: COVID-19 is not uncommon in children and could have different presentations. Concomitant use of RT-PCRand chest CT scans in symptomatic cases recommended as a modality of choice to diagnose the disease. Routine laboratorytests, like many other viral infections, may not show significant or specific changes. The superimposed bacterial infectionseems not the determinant of clinical outcomes as most patients had a negative evaluation by specific laboratory tests forbacterial infections; got improved dramatically with a short or no antibiotic therapy.