COVID-19 in Brazilian children and adolescents: findings from 21 hospitals

Liu, P. M. F.; de Melo, M. d. C. B.; Diniz, L. M. O.; Dias, C. d. S.; Costa, A. S. d. M.; Farace, B. L.; da Silva, C. T. C. A.; Anschau, F.; Aranha, F. G.; Nascimento, G. F.; Duani, H.; Costa, J. H. S. M.; Ruschel, K. B.; Nogueira, M. C. A.; de Oliveira, N. R.; Pozza, R.; Francisco, S. C.; Lage, T. M.; Ramires, Y. C.; Pereira, D. N.; Reis, Z. S. N.; Chatkin, J. M.; Marcolino, M. S.

Introduction: Children and adolescents with Covid-19 have been shown lower mortality less intense symptoms when compared to adults, but studies in Brazil have been based on the compulsory notifying system only. Objective: To analyse clinical, laboratory, radiological characteristics and outcomes of hospitalized patients under 20 years with Covid-19. Methods: Cases series of hospitalized patients with confirmed Covid-19 under 20 years, obtained from a cohort study in 37 hospitals from five states of Brazil. Results: From 36 patients, 20 (55.5%) were adolescentes, 20 (55.5%) were male, 18 (50.0%) had comorbidities, 2 were pregnant and in 7 (19.4%), initial symptoms occurred during hospitalization for other causes, of whom 3 were possibly infected in the hospital. Fever (61.1%), dyspnea (33.3%) and neurological symptoms (33.0%) were the most common complaints. C-reactive protein was higher than 50mg/L in 16.7% and D-dimer was above the reference limit in 22.2%. Chest X-rays were performed in 20 (55.5%) patients, 9 had abnormalities, and chest tomography in 5. Hospital length of stay ranged from 1-40 days (median 5 [interquartile range 3-10]), 16 (44.4%) needed intensive therapy, 6 (16.7%) required mechanical ventilation and one patient (2.8%) died. Conclusion: In case series patients under 20 years from hospitals from 5 states of Brazil, comorbidities were frequent, and most common symptoms were fever, dyspnea and neurological symptoms. Forty-four percent required intensive therapy, showing that the disease was not as mild as it was expected, and one patient died.