Management and Clinical Characteristics in Children with SARS-CoV-2 Infection: Experience in a highly complex public hospital in the city of Sao Paulo

Vieira, R. S. R.; Aguiar, E. L. d.; Verlangieri, H. A. R.; Evangelista, N. M. d. A.; Otsuka, M.; Sarrubbo, S. A. B.

Objective: Faced with the SARS-CoV-2 epidemic, the real impact of the disease on children and adolescents and the behavior of the disease in this population are questioned. This study aims to assess the clinical characteristics of children and adolescents with SARS-CoV-2 infection and the effectiveness of the measures adopted at the institution. Methods: This is a prospective study carried out from 11/04/2020 to 19/06/2020. Investigated 346 patients between zero and eighteen years old, with analysis of patients diagnosed with COVID-19 confirmed by RT-PCR, obtained from a nasopharynx and oropharynx swab, attended at a highly complex public pediatric hospital in the city of Sao Paulo. Protocols for clinical management and treatment of cases of SARS-CoV-2 infection were adopted during the assistance and implementation of a preoperative screening protocol. They were evaluated according to sex, age, epidemiology, presence of comorbidities, clinical manifestations, therapy used, need for hospitalization in the ward and ICU, use of mechanical ventilation (MV) and evolution. Results: 66 confirmed patients with COVID 19 were identified. Median age was 7 years old, with the male gender predominant (2:1). 27 patients (40.9%) had contact with symptomatic respiratory individuals, comorbidity occurred in 50 cases (75.8%). Main clinical manifestations were: fever, 37 patients (56.1%); cough, 23 (34.8%); respiratory distress in 10 (15.2%) and gastrointestinal symptoms in 24 (36.4%). 38 patients (57.6%) received antibiotics and 13 (19.7%) received corticotherapy. 37 patients (56.1%) required hospitalization, eight (19.5%) in the ICU and six (75%) requiring MV. One death occurred and others with good evolution. Conclusion: This study corroborates the perception that the pediatric patient has a more benign manifestation, even in the presence of comorbidities, requiring the screening of surgical patients. The protocol adopted by the institution proved to be effective, with no contamination being observed among patients or between patients and collaborators. Keywords: Coronavirus Infections, Study Characteristics, Pediatric