Clinical Characteristics of Suspected COVID-19 in Pediatric Patients

Abstract

Objectives: This study reviews patients aged 21 and younger, who presented to the Ochsner Medical Center’s Pediatric Emergency Department during the COVID-19 pandemic. A retrospective analysis was completed comparing demographics, symptomology, and laboratory analysis between COVID positive and negative patients. Methods: This study examined pediatric patients presenting to the Pediatric Emergency Department at Ochsner Medical Center between March 11 and May 20, 2020. All children included in the study underwent COVID-19 testing via nasopharyngeal swab. Demographic and clinical information was collected through chart review of electronic medical records, and the Fisher Exact Test was utilized in statistical analysis to determine if clinical characteristics influenced COVID-19 test results in a meaningful way. Results: In our experiment, 160 patients were included based on symptomatology consistent with COVID-19 infection, and 22 (13.8%) resulted positive. The following variables significantly influenced the COVID-19 test to result positive: Ages 11-18 (p < 0.001), exposure to sick contact (p < 0.001), neurologic symptoms (p = 0.001), and anosmia (p = 0.009). Characteristics which significantly influenced COVID-19 tests to result negative were ages 1-4 (p = 0.040), and White race (p = 0.048). Within the cohort, 6 COVID positive patients necessitated hospital admission, 3 of whom were admitted to the PICU. All 3 PICU admits displayed symptoms of shock, consistent with Multisystem Inflammatory Syndrome in Children (MIS-C). Conclusion: We found COVID-19 infection rate in children to be 13.8%, which is consistent with national data. We found significant associations between COVID positivity and anosmia, neurologic symptoms, sick contacts and 1118 year-old age group. COVID negativity was significantly associated with 1-4 year-old age group and White race. While long-term effects from COVID19 are not yet known, our study showed overall flu-like symptoms and no deaths. Yet, Black adolescent patients may be at risk for more severe disease. Continued efforts towards studying transmission and prevention of COVID in children are needed.