Abstract:
Introduction. Despite spreading worldwide, the clinical and epidemiological patterns of
COVID-19 still remain uncertain, especially among children. Further research is needed to
elucidate the interaction between SARS-CoV-2 virus and the child's body. Currently, there
are few reports on sero-epidemiological analyzes of serum antibodies anti-SARS-CoV-2 in
children, but also how long the antibodies and potential protection persist. Moreover,
knowledge about the factors that affect the time to seropositivity is lacking. To prevent
and control COVID-19 in children, larger studies are needed and the knowledge should be
strengthened to monitor the infection at the population level. The purpose of the paper:
determination of some clinical-epidemiological and evolutionary aspects of COVID-19 in
children hospitalized in PMSI Municipal Clinical Hospital of Contagious Diseases for
Children.
Material and methods. The clinical-epidemiological features of COVID-19 have been
analyzed in 1102 children, hospitalized in Clinical Hospital of Contagious Diseases for
Children during 2020. The case management was in accordance with the requirements of
the National Clinical Protocol, in some children investigations of specific immunity against
SARS-CoV-2 were performed by ELISA method, in paired serum samples. The information
was grouped and analyzed using the Microsoft Excel 2019 program, according to age, sex,
living environment, average length of hospital stay, form of disease, and the results of
serological investigations, using the method of descriptive, cross-sectional
epidemiological study.
Results. The group of pediatric patients with COVID-19 were represented equally by boys
and girls (51.08% vs 48.92%), the age distribution being 0-3 years – 29.13%, 3-7 years -
20.87%, 7-11 years – 16.06% and 11-18 years 33.94%. The urban living environment has
been set at 71.71%, rural – at 28.22% patients. The children were hospitalized on average
of 3.26 (±2.60) days of the disease, the average length of stay was 14.02 (±5.25). Mild
forms were diagnosed in 11.88%, moderate – in 85.29% and severe – in 2.81% of cases,
respectively. The results of specific serological investigations were positive when taking
the first sample in 21.15% IgM and 17.30% IgG, in the second sample the share of
seropositivity was 83.65% IgM and 79.32% for IgG (p<0,001). Seroconversion varied
according to the week of the disease (I, II, III, IV), obvious results after the 2nd and 3rd
week of the disease, both for IgM (18.4%, 85.47%, 81.11% and 100% respectively), as well
as for IgG (14.42%, 81.19%, 76.6% and 100%). All children were recovered, there were
no cases of deaths.
Conclusion. COVID-19 infection in hospitalized children evolved more frequently in
medium (85.29%) and mild (11.88%) forms, middle and preschool students dominated in
the age structure. In general, pediatric patients develop an age-dependent anti-COVID-19
immune response after the 2nd and 3rd week of illness.
Description:
PMSI Municipal Clinical Hospital of Contagious Diseases for Children, Chisinau, Republic of Moldova, Nicolae Testemitanu State University of Medicine and Pharmacy, Republic of Moldova