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Araya Satdhabudha
Chanapai Chaiyakulsil
Paskorn Sritipsukho
Phakatip Sinlapamongkolkul
Utairat Chaumrattanakul
Auchara Tangsathapornpong
Pornumpa Bunjoungmanee
Patcharapa Thaweekula
Amolchaya Kwankuac
Onsuthi Pharadornuwata
Tananya Lokanuwatsatiena
Pichaya Tantiyavarong
Pakarat Pranudomrata
Chatchai Mingmalairak


Pediatric, COVID-19, SARS-CoV-2, Delta


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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