Clinical profile of Covid-19 in children: Study from a Medical College Hospital in Mangalore, Karnataka, India

Introduction: India reported its first case of coronavirus disease 2019 (Covid-19) on 30th January 2020. During the first wave, it was noted that older individuals with comorbidities were mainly affected and in the second wave younger people including children were also affected.

Objectives: To assess the clinico-epidemiological profile, investigations and outcomes in children admitted with Covid-19 to a Medical College Hospital in Mangalore, Karnataka, India and to compare the first and second waves.

Method: In this ambispective descriptive study, all patients below 18 years of age with a confirmed diagnosis of Covid-19 or Multisystem Inflammatory Syndrome in Children (MIS-C), admitted to a Medical College Hospital in Mangalore, Karnataka, India from April 2020 to July 2021 were included. Epidemiological data, symptoms, clinical management and outcomes were noted and the differences between the two waves were assessed.

Results:A total of 64 children (27 from the first wave and 37 from the second wave) were included; 25 (39%) children were exposed to a Covid-19 suspect with parents being the major source. The age groups mainly affected were 1-5 years (30%) and 11-18 years (27%); 56 (87%), 3 (5%) and 5 (8%) had mild, moderate and severe Covid-19 respectively and there was one death; 39 (61%) had fever, 13 (20%) had febrile convulsions and 3 were co-infected with dengue; 25 (40%) children were admitted to the intensive care unit (ICU), of whom 9 had MIS-C, with 5 being severe. Among the admissions, a significantly higher female incidence (OR 2.9, 95% CI 1.02-8.28, p=0.04) was noted in the second wave. ICU admissions were also higher in the second wave (OR-1.7, 95% CI 0.45-4.7, p=0.31) but this was not statistically significant.

Conclusions: Majority of children had no known contact with a Covid-19 suspect and had mild disease. More children were affected in the second wave compared to the first. Fever was the most common complaint with seizures and gastrointestinal complaints being next. The most common age groups affected were 1-5 years and 11-18 years.

Sri Lanka Journal of Child health, 2022; 51(3): 391-396