The authors were interested in the epidemiology, clinical and laboratory features of children hospitalised with COVID-19. They conducted a retrospective review of electronic medical records from a tertiary care centre in New York City that included children and adolescents (≤21 years) who had confirmed COVID-19. Of 50 patients, 54% were male and 50% were Hispanic. The median number of days from symptom onset to admission was 2 days. 80% of patients had fever and 64% had respiratory symptoms. 6% of patients only had gastrointestinal symptoms. Obesity (22%) was the the most prevalent comorbidity. 32% of patients needed respiratory support, including 18% who needed mechanical ventilation. One patient died. None of the 14 infants included had severe disease and only one of eight immunocompromised patients did. Obesity was found to be significantly associated with mechanical ventilation in children ≥2 years (67% vs. 20%). Lymphopenia was common upon admission (72%) but did not differ significantly between those with and without severe disease. Those with severe disease had significantly higher C-reactive protein levels (8.978 vs. 0.64 mg/dL) and procalcitonin levels (0.31 vs. 0.17 ng/mL) upon admission. They also had higher peak interleukin 6, ferritin and D-dimer levels during hospitalisation. Hydroxychloroquine was given to 15 patients but could not be completed by three patients. Prolonged test positivity (maximum of 27 days) was seen in four patients. Therefore in this case series, COVID-19 had diverse manifestations in children and adolescents. Infants and immunocompromised patients did not seem to be at increased risk of severe disease.
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