Clinical risk profile associated with SARS-CoV-2 infection and complications in the emergency area of a pediatric COVID-19 center

Víctor B. Olivar-López, Departamento de Urgencias. Hospital Infantil de México Federico Gómez, Mexico City, Mexico
Ana Leyva-Barrera, Departamento de Urgencias, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
Briceida López-Martínez, Subdirección de Servicios Auxiliares y Diagnóstico, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
Israel Parra-Ortega, Departamento de Laboratorio Clínico, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
Horacio Márquez-González, Servicio de Investigación Clínica, Hospital Infantil de México Federico Gómez, Ciudad de México, México

Background: In February 2020, the disease caused by the novel coronavirus (SARS-CoV-2), was classified as a pandemic. In the pediatric population, coronavirus disease (COVID)-19 has a reported mortality of less than 6% in complicated cases; however, the clinical characteristics and severity are not the same as those presented in the adult population. This study aimed to describe the clinical manifestations of patients younger than 18 years old and their association with the confirmation of the test and outcomes. Methods: We conducted an analytical cross-sectional study of symptoms suggestive for SARS-CoV-2 infection. All subjects with a confirmatory test for SARS-CoV-2 were included. Initial symptoms, history of influenza vaccination, and previous contact were documented, and mortality and the requirement for assisted mechanical ventilation were identified. The proportions of the variables were compared with the χ2 test. The odds ratio for a positive test and the requirement of intubation was calculated. Results: Of a total of 510 subjects, 76 (15%) were positive for SARS-CoV-2. The associated symptoms were chest pain, sudden onset of symptoms, and general malaise. The variable most associated with contagion was the exposure to a relative with a confirmed diagnosis of COVID-19. Infants and subjects without the influenza vaccine showed an increased risk for respiratory complications. Conclusions: The frequency of positivity in the test was 15% (infants and adolescents represented 64% of the confirmed cases), and the associated factors identified were contact with a confirmed case, sudden onset of symptoms, and chest pain.

Keywords: Coronavirus disease-19. Pediatric. Emergency medical care. Endotracheal intubation. Mexico.