Clinical Characteristics of Pediatric COVID‐19 and Predictors of PCR Positivity

Arslan, Gazi; Aktürk, Hüseyin; Duman, Murat

BACKGROUND: To identify the clinical findings and outcomes of children with COVID‐19 and factors predicting RT‐PCR positivity. METHODS: The data retrospectively analyzed for suspected and confirmed pediatric COVID‐19 patients between March 20 and May 31, 2020. RESULTS: There were 404 children, of them, 176 (43.6%) patients were confirmed to have COVID‐19 which were less symptomatic on admission (67.6% to 95.6%). Cough (44.9%), fever (38.1%), sore throat (18.5%), and smell‐taste loss (12.7%) were the most common symptoms. Confirmed cases had 92.6% identified history of contact with COVID‐19. Close contact with COVID‐19 positive family members and coughs increased the RT‐PCR positivity 23.8 and 5.0 times, respectively; while positivity decreased by 0.4 times if fever was over 38°C. Asymptomatic and mild cases were categorized as ‘group 1’ (n=153), moderate, severe and critical cases as ’group 2’ (n=23) in terms of disease severity. Group 2 cases had higher C‐reactive protein (40.9% to 15.9%) and procalcitonin (22.7% to 4.9%) levels and had more frequent lymphopenia (45.5% to 13.1%). Out of 23 cases, 19 had abnormal chest x‐ray findings; of them, 15 patients underwent chest CTs, and all had abnormal findings. However, 26.0% of them needed respiratory support, and no patient required invasive ventilation. CONCLUSION: Children with COVID‐19 have milder clinical course and SARS‐CoV‐2 rarely causes severe disease in children. Contact history with COVID‐19 and sore throat are the most important predictors for RT‐PCR positivity. Consequently, the role of asymptomatic children in the contamination chain must be fully established and considered for the control of pandemic.