Clinico-etiological profile of hospitalized paediatric patients: COVID-19 and non-COVID-19 in a district hospital of Northern India during lockdown period

Ramanjot Kaur, Sadbhavna Pandit, Neeraj Dhawan


Background: With the sudden outbreak of coronavirus pandemic in 2020, there is a paucity of data on the clinical and epidemiological profile of COVID positive paediatric patients. Objective of the study was a retrospective analysis of both COVID-19 and non-COVID-19 cases admitted to a district Hospital of Northern India.

Methods: A retrospective cross-sectional study was conducted in the Pediatric Emergency Department of Government Multi-speciality Hospital, Chandigarh from 22 March 2020 till 30 November 2020.

Results: A total of 842 children were enrolled. Among neonates, 33% had sepsis as the major admitting diagnosis and SARI in children less than 1 year (excluding neonates) (33.5%) and in the 1-5 years age group (37.3%). In children more than 5 years, acute febrile illnesses were the main admitting diagnosis (50.4%). 204 patients (24.2%) were tested for COVID-19. 62 children (30.4%) were found to be positive. Asymptomatic children (74.2%) dominated the COVID-19 positive group. The most common symptom included fever (87.5%) with no reported mortality. Atypical symptoms (56.1%) were more common than respiratory symptoms. The majority of children had mild COVID-19 symptoms (62.6%). The unusual presentation of COVID-19 was in the form of acute appendicitis (6.2%) and renal vein thrombosis (6.2%) in the symptomatic group.

Conclusions: For children with COVID-19, most of them were infected via family clustering, were asymptomatic, and had mild symptoms with an overall good prognosis. However, for atypical cases, a high suspicion of COVID-19 associated multisystem inflammatory syndrome should be kept in mind for early diagnosis.


Paediatric, COVID-19, SARS-CoV-2, Risk factors, Severity, Clinico-etiological profile

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Wang C, Horby PW, Hayden FG, Gao GF. A novel coronavirus outbreak of global health concern. Lancet. 2020;395(10223):470-3.

Kandel N, Chungong S, Omaar A, Xing J. Health security capacities in the context of COVID-19 outbreak: an analysis of International Health Regulations annual report data from 182 countries. Lancet. 2020;395(10229):1047-53.

Xu Y, Li X, Zhu B, Liang H, Fang C, Gong Y, et al. Characteristics of pediatric SARS-CoV-2 infection and potential evidence for persistent fecal viral shedding. Nat Med. 2020;26(4):502-5.

Lu R, Zhao X, Li J, Niu P, Yang B, Wu H, et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet. 2020;395(10224):565-74.

Gupta N, Praharaj I, Bhatnagar T, Vivian TJW, Giri S, Chauhan H, et al. Severe acute respiratory illness surveillance for coronavirus disease 2019, India, 2020. Indian J Med Res. 2020;151(2):236-40.

Meena J, Yadav J, Saini L, Yadav A, Kumar J. Clinical Features and Outcome of SARS-CoV-2 Infection in Children: A Systematic Review and Meta-analysis. Indian Pediatr. 2020;57(9):820-6.

Qiu H, Wu J, Hong L, Luo Y, Song Q, Chen D. Clinical and epidemiological features of 36 children with coronavirus disease 2019 (COVID-19) in Zhejiang, China: an observational cohort study. Lancet Infect Dis. 2020;20(6):689-96.

Wu Z, Googan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020;323(13):1239-42.

Zimmermann P, Curtis N. Coronavirus infections in children including covid-19: an overview of the epidemiology, clinical features, diagnosis, treatment and prevention options in children. Pediatr Infect Dis J. 2020;39(5):355-68.

Bunyavanich S, Do A, Vicencio A. Nasal gene expression of angiotensin-converting enzyme 2 in children and adults. JAMA. 2020;323(23):2427-9.

Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708-20.

Kosmeri C, Koumpis E, Tsabouri S, Siomou E, Makis A. Hematological manifestations of SARS-CoV-2 in children. Pediatr Blood Cancer. 2020;67(12):28745.

Zeng L, Xia S, Yuan W, Yan K, Xiao F, Shao J, et al. Neonatal early-onset infection with sars-cov-2 in 33 neonates born to mothers with COVID-19 in Wuhan, China. JAMA Pediatr. 2020;174(7):722-5.

Dong Y, Mo X, Hu Y, Qi X, Jiang F, Jiang Z, et al. Epidemiology of COVID-19 among children in China. Pediatrics. 2020;145(6):20200702.