Impact of Prexisting Comorbidities on Pediatric Emergency Admissions during Covid-19 Pandemic - Abstract
1.1. Aim: To document the clinical profile and outcome of children below 18 years of age with SARS-CoV-2 infection with relation to pre-existing comorbidities.
1.2. Methods: Prospective, observational study at the Emergency Department of a tertiary care children’s hospital in South India from May 2020 to April 2021. Details regarding demography, clinical presentation, history of contact with positive SARS-CoV-2 patients, preexisting comorbidities, emergency management, the requirement of intensive care treatment, diagnosis at discharge, and outcome were analyzed for all SARS-CoV-2 positive children who required emergency care.
1.3. Results: A total of 196 children were positive for SARS-CoV-2 and 109 children among them required emergency management. Among them, 19% were infants, 61% were from 1 to 12 years of age and the remaining 19% were adolescents. The Mean age was 6.3 years. There were 23 children (21.1%), with preexisting comorbidities. Fever was the most common presenting complaint in children in both groups. 26.1% of children with comorbidities and 9.3% of children without comorbidities had severe presenting symptoms which was statistically highly significant. The mean duration of stay was 7 days in children with comorbidities 3 days in children without comorbidities which was also statistically significant. 34.7% of children with preexisting comorbidities and 12.7% of previously healthy children required intensive care management. We observed Multisystem Inflammatory Syndrome in Children (MIS-C), only in children without comorbidities (8.2%). Nearly 2/3rd of children with COVID pneumonia required assisted ventilation. Mortality was less than 1% which was attributed to the preexisting malignancy and not because of the severity of SARS-CoV-2 infection.
1.4. Conclusion: SARS-CoV-2 infection in admitted children presents with great clinical variability. Supportive therapy is recommended in the majority of children with SARSCoV-2 infection. Preexisting comorbidity does not seem to increase the severity of COVID-19, however, we emphasize the importance of emergency management and intensive monitoring for a better prognosis.