Background

In December 2019, a new coronavirus was identified and named SARS-CoV2. COVID-19 is a multisystemic disease caused by SARS-CoV-2. Pediatric patients represent only approximately 1% of total cases and usually present with less severe symptoms.

As of December 8, 2020, 6.623.911 cases were detected in Brazil and 177.317 deaths occurred.

This study describes the characteristic of children with COVID-19 and other respiratory viruses during the 2020 pandemic.

Methods

We analyzed clinical and laboratory data of patients aged 0-17 seeking care in the emergency department submitted to Real Time Reverse Transcriptase Polymerase Chain Reaction (RT-PCT) for SARS-CoV-2. This was a single center study conducted in a private hospital in São Paulo, Brazil from February 25th to May 21st of 2020.

Laboratory results and clinical data were collected through patients' files. Viral testing was conducted by the hospital's laboratory independently from the research. Disease severity and Multisystem Inflammatory Syndrome (MIS-C) were defined according to World Health Organization criteria.

Results

We identified 885 patients submitted to RT-PCR for SARS-CoV-2, with 4.1% positive. 124 patients were included in the study, eight of them positive for SARS-CoV-2 and 38 positive for other respiratory pathogens. Cough (n=7, 87.5%) and fever (n=6, 75%) were the most common symptoms. Headache was significantly more common in children with COVID-19 (50%, p=0.03). No cases of MIS-C and no deaths were identified. No patients needed mechanical ventilation. There was one co-detection (SARS-CoV-2, Influenza B and HCoV-NL63). Disease severity was similar in children with COVID-19 and other respiratory viruses.

Conclusions

COVID-19 cannot be distinguished from other viral illnesses in the pediatric population. Other respiratory viruses were more frequent in children during the pandemic. Level of suspicion must always be high even in asymptomatic patients.