Perfil clínico epidemiológico dos casos de covid-19 em crianças internadas em um Hospital de referência em Macapá

Abstract

Available data on COVID-19 for the pediatric population remains limited, with scant information about the clinical manifestations and characteristics of children severely affected by COVID- 19. Objectives: to describe the clinical-epidemiological characteristics of COVID-19 cases in hospitalized children; and to evaluate the correlation between the symptoms presented and the length of stay. Methods: Cross-sectional study that included patients ≤12 years old, hospitalized with COVID-19 between April 2020 and June 2021, in a pediatric hospital in the northern region of Brazil. Demographic data, origin, clinical status, length of stay in the ward and ICU, use of mechanical ventilation, radiological changes and use of supplemental oxygen were analyzed. Data were analyzed using the SPSS 26.0 program, being presented as mean, standard deviation, frequencies and percentages. To assess the correlation between symptoms and length of stay, the chi-square test of independence and Cramer's V correlation coefficient were used, adopting a significance level of 5%. Results: 48 children with COVID-19 tested by RT-PCR were hospitalized, with a predominance of males (54.2%), most from Macapá. The mean age of the patients was 24 months. The mean duration of hospitalizations was 5 days for those who developed mild symptoms (35.4%) and 10 days for those who developed SARS (64.6%). In 22.9% of the patients there was a need for supplemental oxygen, 2 children (4.2%) were admitted to the ICU and only one case of multisystem inflammatory syndrome (MIS) was confirmed, with November being the month with the highest number of hospitalizations (27%). The main radiological alteration found was bilateral interstitial infiltrate. No deaths were recorded during the study period, but from January to May 2021, there was an 83% increase in confirmed measles cases, and among these, 8% of children also tested positive for COVID-19. There was an association between the presence of respiratory distress and length of stay ≥7 days (p 0.017; Cramer's coefficient 0.4). However, it was not possible to detect an association between the presence of other symptoms and the length of hospital stay. The other symptoms evaluated included fever (p 0.09), cough (p 0.74), sore throat (p 0.07), diarrhea (p 0.47), vomiting (p 0.41), abdominal pain (p 0.49), fatigue (p 1.0) and loss of taste (p 1.0). Conclusion: the predominance of hospitalizations was in males, with evolution to severe cases, but with hospital discharge without intercurrences, with respiratory distress associated with longer hospitalization. The few confirmations by RT-PCR indicate low testing during the virus dissemination phase. Thus, it is essential to know the characteristics of children hospitalized for COVID-19 for better prevention and treatment of the disease.