EPIDEMIOLOGICAL AND CLINICAL CHARACTERISTICS OF PEDIATRIC COVID-19 IN THE TERTIARY CARE SYSTEM IN THAILAND: COMPARATIVE DELTA AND PRE-DELTA ERA Pediatric COVID-19 in Thailand during pre-Delta and Delta era
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Keywords
Pediatric, COVID-19, SARS-CoV-2, Delta
Abstract
Background: Few studies had focused on the epidemiological and clinical characteristics of pediatric COVID-19 (SARS-CoV-2) during Delta and pre-Delta eras in Asia, despite it being a pandemic.
Objective: To study the epidemiological and clinical characteristics of three waves of pediatric COVID-19 infections in a tertiary-care setting in Thailand.
Methods: This retrospective study reviewed all PCR-confirmed pediatric (0-18 years of age) COVID-19 infections between January 13th, 2020 and October 31st, 2021, in a tertiary care system, Thailand.
Results: There were 1,019 patients, aged 0.02 - 18 years, median age of 9.2 years, with no gender differences. Asymptomatic cases accounted for 35.7%, of which 18.9% had abnormal chest X-ray findings. The majority of cases were classified as having mild clinical symptoms, with only 0.8 and 0.4% developing severe and critical illness, respectively. There were no deaths. The Delta dominant group appeared more transmissible, but we did not see any difference in disease severity. Upper respiratory tract symptoms were predominant, while few cases had lower respiratory signs. The sensitivity and specificity of dyspnea symptoms to predict pneumonia (abnormal chest X-ray) were 14% and 95%, respectively, with a likelihood ratio 3.37. The overall prognosis was good, with only 0.01 % needing respiratory equipment. All cases showed clinical improvement with a decent recovery.
Conclusion: Pediatric COVID-19 during Delta era appeared generally more transmissible but benign. One-fifth of cases had pneumonia, but few cases needed respiratory support. Prevention remains important for disease control.
Keywords: Pediatric, COVID-19, SARS-CoV-2, Delta, Epidemiology
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Chanapai Chaiyakulsil, Faculty of Medicine, Thammasat University.
Department of Pediatric
Paskorn Sritipsukho, Center of Excellence in Applied Epidemiology, Thammasat University
Department of Pediatric, Faculty of Medicine, Thammasat University.
Phakatip Sinlapamongkolkul, Faculty of Medicine, Thammasat University.
Department of Pediatric
Utairat Chaumrattanakul, Faculty of Medicine, Thammasat University
Department of Radiology
Auchara Tangsathapornpong, Center of Excellence in Applied Epidemiology, Thammasat University
Department of Pediatric, Faculty of Medicine, Thammasat University.
Pornumpa Bunjoungmanee, Faculty of Medicine, Thammasat University.
Department of Pediatric
Patcharapa Thaweekula, Faculty of Medicine, Thammasat University.
Department of Pediatric
Amolchaya Kwankuac, Faculty of Medicine, Thammasat University.
Department of Radiology
Onsuthi Pharadornuwata, Faculty of Medicine, Thammasat University.
Department of Pediatric
Tananya Lokanuwatsatiena, Faculty of Medicine, Thammasat University.
Department of Pediatric
Pichaya Tantiyavarong, Faculty of Medicine, Thammasat University.
Department of Clinical Epidemiology
Pakarat Pranudomrata, Faculty of Medicine, Thammasat University.
Department of Pediatric
Chatchai Mingmalairak, Faculty of Medicine, Thammasat University.
Department of Surgery