Red flags of poor prognosis in pediatric cases of COVID-19: the first 6610 hospitalized children in Iran

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BMC Pediatrician. 2021 Dec 10;21(1):563. doi: 10.1186/s12887-021-03030-2.


INTRODUCTION: The clinical course of COVID-19, effective therapeutic regimen and poor prognosis risk factors in pediatric cases are still under investigation and no approved vaccine has been introduced for them.

METHODS: This cross-sectional study evaluated various aspects of COVID-19 infection in hospitalized COVID-19-positive children (≺ 18 years old with laboratory-confirmed COVID-19 infection, using the National COVID-19 Registry for all admitted COVID-19 positive cases from February 19 to November 13, 2020, in Iran.

RESULTS: We evaluated 6610 hospitalized children. Fifty-four percent (3268) were male and a third of them were infants under 1 year of age. The mortality rate in the total number of children hospitalized was 5.3% and significantly higher in children with underlying comorbidities (14.4%) (OR: 3.6 [2.7-4.7]). Chronic kidney disease (OR: 3.42 [1.75-6.67]), Cardiovascular disease (OR: 3.2 [2.09-5.11]), chronic lung diseases (OR: 3.21 [1.59-6.47]) and diabetes mellitus (OR: 2.5 [1.38-4.55]), resulted in higher death rates in hospitalized COVID-19 children. Fever (41%), cough (36%) and shortness of breath (27%) were the most common symptoms in hospitalized children, and shortness of breath was associated with an almost three-fold higher death rate in children with COVID-19 infection (OR: 2, 65). [2.13-3.29]).

CONCLUSION: Iran has a relatively high COVID-19 mortality among hospitalized children. Pediatricians should consider children with dyspnoea, infants 1 year and children with underlying comorbidities as risk groups for hospitalization, ICU admission and death.

PMID:34893036 | DOI: 10.1186/s12887-021-03030-2

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