Epidemiological, Clinical, and Laboratory Features of Children With COVID-19 in Turkey

• Main Authors: Adem Karbuz, Gulsen Akkoc, Tugba Bedir Demirdag, Dilek Yilmaz Ciftdogan, Arife Ozer, Deniz Cakir, Selda Hancerli Torun, Eda Kepenekli, Tugba Erat, Nazan Dalgic, Sare Ilbay, Ayse Karaaslan, Emine H. Erdeniz, F. Deniz Aygun, S. Elmas Bozdemir, Nevin Hatipoglu, Melike Emiroglu, Zumrut Sahbudak Bal, Ergin Ciftci, Gulsum Iclal Bayhan, Zeynep Gokce Gayretli Aydin, Sevliya Ocal Demir, Omer Kilic, Mustafa Hacimustafaoglu, Dicle Sener Okur, Semra Sen, Aysun Yahsi, Hacer Akturk, Benhur Cetin, Murat Sutcu, Manolya Kara, Hatice Uygun, Tugce Tural Kara, Gulay Korukluoglu, Ozlem Akgun, Gülnihan Üstündağ, Mevsim Demir Mis, Enes Sali, Ozge Kaba, Nurhayat Yakut, Orhan Kılıc, M. Kemal Kanik, Ceren Cetin, Adem Dursun, Muharrem Cicek, Esra Kockuzu, Esra Sevketoglu, Gulsum Alkan, Gizem Guner Ozenen, Erdal İnce, Zekiye Baydar, Ahmet Kagan Ozkaya, Husnu Fahri Ovali, Seher Tekeli, Solmaz Celebi, Birgul Cubukcu, Alkan Bal, Fidan Khalilova, Mehmet Kose, Halil Ugur Hatipoglu, Tahir Dalkiran, Mehmet Turgut, Ayse Basak Altas, Hatice Nilgün Selcuk Duru, Ahu Aksay, Sevcan Saglam, Mehpare Sari Yanartas, Zeynep Ergenc, Yasemin Akin, Yeter Duzenli Kar, Sabit Sahin, Sadiye Kubra Tuteroz, Nimet Melis Bilen, Halil Ozdemir, Mine Cidem Senoglu, Burcu Pariltan Kucukalioglu, Gulser Esen Besli, Yalcin Kara, Cansu Turan, Burcu Selbest Demirtas, Aydın Celikyurt, Yasemin Cosgun, Murat Elevli, Aslihan Sahin, Serife Bahtiyar Oguz, Ayper Somer, Bulent Karadag, Recep Demirhan, Hatice Turk Dagi, Zafer Kurugol, Esra Cakmak Taskin, Aysegul Sahiner, Edanur Yesil, Yildiz Ekemen Keles, Remzi Sarikaya, Ela Erdem Eralp, Ferda Ozkinay, Hatice Kubra Konca, Songul Yilmaz, Yasemin Gokdemir, Gul Arga, Seval Ozen, Fevziye Coksuer, Goksel Vatansever, Hasan Tezer, Ates Kara
• Format: Article
• Language: English
• Published: Frontiers Media S.A. 2021-05-01
• Series: Frontiers in Pediatrics
• Subjects: COVID-19; pediatric; epidemiology; laboratory findings; disease severity
• Online Access: https://www.frontiersin.org/articles/10.3389/fped.2021.631547/full

Objectives: The aim of this study is to identify the epidemiological, clinical, and laboratory features of coronavirus disease 2019 (COVID-19) in children.Methods: A retrospective study was conducted by pediatric infectious disease specialists from 32 different hospitals from all over Turkey by case record forms. Pediatric cases who were diagnosed as COVID-19 between March 16, 2020, and June 15, 2020 were included. Case characteristics including age, sex, dates of disease onset and diagnosis, family, and contact information were recorded. Clinical data, including the duration and severity of symptoms, were also collected. Laboratory parameters like biochemical tests and complete blood count, chest X-ray, and chest computed tomography (CT) were determined.Results: There were 1,156 confirmed pediatric COVID-19 cases. In total, male cases constituted 50.3% (n = 582) and females constituted 49.7% (n = 574). The median age of the confirmed cases was 10.75 years (4.5–14.6). Of the total cases, 90 were younger than 1 year of age (7.8%), 108 were 1–3 years of age (9.3%), 148 were 3–6 years of age (12.8%), 298 were 6–12 years of age (25.8%), 233 were 12–15 years of age (20.2%), and 268 cases were older than 15 years of age (23.2%). The most common symptom of the patients at the first visit was fever (50.4%) (n = 583) for a median of 2 days (IQR: 1–3 days). Fever was median at 38.4°C (38.0–38.7°C). The second most common symptom was cough (n = 543, 46.9%). The other common symptoms were sore throat (n = 143, 12.4%), myalgia (n = 141, 12.2%), dyspnea (n = 118, 10.2%), diarrhea (n = 112, 9.7%), stomachache (n = 71, 6.1%), and nasal discharge (n = 63, 5.4%). When patients were classified according to disease severity, 263 (22.7%) patients were asymptomatic, 668 (57.7%) patients had mild disease, 209 (18.1%) had moderate disease, and 16 (1.5%) cases had severe disease. One hundred and forty-nine (12.9%) cases had underlying diseases among the total cases; 56% of the patients who had severe disease had an underlying condition (p < 0.01). The need for hospitalization did not differ between patients who had an underlying condition and those who do not have (p = 0.38), but the need for intensive care was higher in patients who had an underlying condition (p < 0.01). Forty-seven (31.5%) of the cases having underlying conditions had asthma or lung disease (38 of them had asthma).Conclusions: To the best of our knowledge, this is one of the largest pediatric data about confirmed COVID-19 cases. Children from all ages appear to be susceptible to COVID-19, and there is a significant difference in symptomatology and laboratory findings by means of age distribution.