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Comparison of the Clinical and Laboratory Features of COVID-19 in Children During All Waves of the Epidemic: A Single Center Retrospective Study

  • Sunbok Suh (Department of Pediatrics, Busan Medical Center) ;
  • Hyungsu Kim (Department of Pediatrics, Busan Medical Center)
  • Received : 2023.11.08
  • Accepted : 2023.12.20
  • Published : 2024.04.25

Abstract

Purpose: Since the start of the coronavirus disease 2019 (COVID-19) pandemic, various variants of concern have emerged. We divided the representative COVID-19 mutation period into four waves and aimed to analyze the clinical and laboratory features of children with COVID-19 from pre-mutation wave to the middle of omicron wave. Methods: We retrospectively reviewed the medical records of hospitalized patients aged ≤19 years with laboratory confirmed COVID-19. Clinical and laboratory findings during pre-mutation (February 1st 2020 to September 30th 2020), alpha/beta (October 1st 2020 to May 31st 2021), delta (June 1st 2021 to October 31st 2021), and omicron (November 1st 2021 to May 31st 2022) waves were compared. Results: Among total 827 patients, 163 (19.7%) were asymptomatic, and the frequency of fever and cough was 320 (38.7%) and 399 (48.2%), respectively. The proportion of fever ≥38.5℃ was observed to be high during the omicron wave in the age group under 12 years. Lymphopenia was observed highly in the omicron wave in the age group under 12 years, and in the delta wave in the age group older than 12 years. Neutropenia was highly observed in the delta wave in the 0-4 years age group. Conclusions: There were distinct characteristics during all epidemic waves of COVID-19. Children with COVID-19 had more frequent persistent fever during delta wave and children during the omicron wave had a higher peak fever.

목적: 코로나19 판데믹이 시작된 이후, 다양한 주요 변이 바이러스가 출현했다. 코로나 19 판데믹 기간 동안 대표적인 주요 변이 바이러스 유행 시기를 네 가지로 나누고, 네 가지의 주요 변이 바이러스 시기로부터 임상적 그리고 혈액학적 검사의 특징을 파악하고자 하였다. 방법: 코로나19 확진으로 입원한 19세 이하 환자의 의무기록을 후향적으로 분석하였다. 변이전시기(2020년 2월 1일-2020년 9월 30일), 알파와 베타 변이 시기(2020년 10월 1일-2021년 5월 31일), 델타 변이 시기(2021년 6월 1일-2021년 10월 31일), 오미크론 변이 시기(2021년 11월 1일-2022년 5월 31일)를 비교하였다. 결과:대상환자 827명중에서 163명(19.7%)가무증상이었고, 발열과기침의빈도는각각 320명(38.7%), 399명(48.2%)이었다. 38.5℃ 이상의 발열이 있었던 경우는 12세 미만인 경우에 오미크론 변이 시기에 높게 관찰되었다. 혈액학적 검사에서 백혈구 감소증, 임파구 감소증 그리고 호중구 감소증은 각각 33%, 30.2%, 24.9%로 관찰되었다. 결론: 코로나 19의 주요 변이 바이러스 우세 시기에 다른 특징들이 있었다. 델타 변이 시기에 4일 이상의 발열이 지속되는 경우가 더 많았고, 오미크론 변이 시기에는 38.5℃ 이상의 발열을 가지는 경우가 많았다.

Keywords

Acknowledgement

This work was supported by Public Medical Research Institute, Busan Medical Center.

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