Clinical Characteristics and Mortality Profile of COVID-19 Patients Aged less than 20 years Old in Pernambuco – Brazil

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  • 1 Instituto de Medicina Integral Prof. Fernando Figueira, Recife, Brazil;
  • 2 Faculdade Pernambucana de Saúde, Recife, Brazil;
  • 3 Universidade de Pernambuco, Recife, Brazil;
  • 4 Instituto Federal de Pernambuco, Garanhuns, Brazil;
  • 5 Instituto Ageu Magalhães - Fiocruz PE, Recife, Brazil

COVID-19 in children and adolescents has low frequency, severity, and fatality rate all over the world. A cross-sectional study was conducted to assess the epidemiological and clinical aspects of COVID-19 in patients younger than 20 years in Pernambuco (Brazil), with cases confirmed by reverse-transcriptase–PCR SARS-CoV-2 between 13 February and June 19, 2020, reported on information systems. Data regarding age (< 30 days, 1–11 months, 1–4 years, 5–9 years, 10–14 years, and 15–19 years), gender, color/race, symptoms, pregnancy or puerperium, comorbidities, hospitalization, and death were investigated. Fatality rate and mortality coefficient were calculated, and a multiple logistic regression analysis was performed to determine if gender, age, and comorbidities were factors associated with death. Of 682 pediatric cases, 52.8% were female, with a mean age of 9 ± 7.2 years. The most frequent symptoms were fever (64.4%), cough (52.4%), and respiratory distress (32.4%). Hospitalization was reported in 46.2% of cases, mainly among neonates (80.3%) and infants (73.8%). Thirty-eight deaths were notified, and a fatality rate of 5.6% (95% CI: 3.9–7.3) was found, with higher fatality rates among neonates 11.5% (7 of 61) and 9.5% (8 of 84) infants. The mortality coefficient was 10.9 per 100,000 inhabitants < 1 year of age, whereas comorbidities (Odds ratio [OR] = 14.13, 95% CI: 6.35–31.44), age < 30 days (OR = 5.17, 95% CI: 1.81–14.77), and age 1–11 months (OR = 3.28, 95% CI: 1.21–8.91) were independent factors associated with death. The results demonstrate the vulnerability of neonates and infants with severe conditions, need hospitalization, and high fatality rate, indicating the necessity to adapt public health policies for these age-groups.

Author Notes

Address correspondence to Gabrielle R. Sena, IMIP - Instituto de Medicina Integral Prof. Fernando Figueira - Directoria de Ensino - Pos Graduacao stricto sensu, Rua dos Coelhos, 300 Boa Vista, Recife PE 50070-550, Brazil. E-mail: gabriellesena8@gmail.com

Authors’ addresses: Gabrielle R. Sena, Instituto de Medicina Integral Prof. Fernando Figueira, Recife, Brazil, Faculdade Pernambucana de Saúde, Recife, Brazil, and Universidade de Pernambuco, Recife, Brazil, E-mail: gabriellesena8@gmail.com. Tiago P. F. Lima, Instituto de Medicina Integral Prof. Fernando Figueira, Recife, Brazil, and Instituto Federal de Pernambuco, Garanhuns, Brazil, E-mail: tiagopessoalim@gmail.com. Suely A. Vidal, Maria do Carmo M. B. Duarte, Mecneide M. Lins, Leuridan C. Torres, and Maria Julia G. Mello, Instituto de Medicina Integral Prof. Fernando Figueira, Recife, Brazil, E-mails: suelyarruda@hotmail.com, mcduarte2010@gmail.com, mecneide.mendes@gmail.com, leuridan.torres@imip.org.br, and mjuliagmello@gmail.com. Patrícia G. M. Bezerra and Eduardo J. Fonseca Lima, Instituto de Medicina Integral Prof. Fernando Figueira, Recife, Brazil, and Faculdade Pernambucana de Saúde, Recife, Brazil, E-mails: pmvbezerra@gmail.com and eduardojorge@imip.org.br. Cynthia Braga, Lívia B. de Andrade, and Jurema T. O. Lima, Instituto de Medicina Integral Prof. Fernando Figueira, Recife, Brazil, and Instituto Ageu Magalhães - Fiocruz PE, Recife, Brazil, E-mails: cynthiabraga27@gmail.com, ftliviabandrade@gmail.com, and jurematsales@gmail.com.

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