Management of Children with Severe COVID-19 in a Pediatrics Unit in Istanbul: A Retrospective Study

Abstract

Objective: SARS-CoV-2 is a probable causative agent of severe disease both in children and adults. In this study, we aimed to evaluate the management of hospitalized severe pediatric COVID-19 patients. Methods: Data on the management of 21 children under the age of 18 who were hospital- ized with severe COVID-19 between March 2020 and May 2020 were included in this study. Results: A total of 1109 patients, including 888 outpatients and 221 inpatients, were in- cluded in this study. 91 (41.1%) of the 221 hospitalized children were PCR positive for SARS-CoV-2. 21 (23%) of 91 COVID-19 patients were considered severe COVID-19. 10 (47.6%) were females and 11 (52.4%) were males, with a mean±standard deviation (SD) age of 14.4±2.7 years (range; 9 years–17.6 years). The most prevalent symptoms at admission were fever (80.9%), cough (76.1%), shortness of breath (23.8%) and myalgia (23.8%). 4 (19%) of 21 patients had underlying diseases. 19 (90.4%) patients were in close contact with con- firmed cases in the family. All patients had typical findings on lung computed tomography (CT) and the major CT abnormalities observed were ground-glass opacities. Two patients who needed respiratory support received favipiravir treatment. The mean hospital stay was 7.34±2.65 (5–16) days. Clinical improvement was achieved in all patients. Conclusion: The clinical course of COVID-19 in children is milder and has a better prog- nosis than adults, but it should be kept in mind that severe cases are defined in the pediatric patient group and these patients should be followed closely.