Clinical Profile and Short-term Outcome of Paediatric COVID-19 in the First, Second and Third Wave of the Pandemic in IndiaAn Observational Study

Abstract

Introduction: There has been adequate evidence that children are less likely to contract the Coronavirus Disease-2019 (COVID19) infection and less likely to experience a deadly course of the disease in the paediatric group. The majority of the time, they exhibit moderate respiratory symptoms, like fever, dry cough and exhaustion. They were all free of COVID-19 pneumonia. Aim: To compare the clinical features and short-term outcomes of COVID-19 in children during May 2020 to April 2022. Materials and Methods: The present analytical observational study was conducted in the Department of Paediatrics, Chettinad Hospital, Chennai, Tamil Nadu, India, from March 2020 to March 2022. The study population included Reverse TranscriptionPolymerase Chain Reaction (RT-PCR) positive COVID-19 children between age groups of one month and 18 years age. A sample size of 102, 90 and 98 were included from first, second and third wave, respectively. Kruskal-Wallis test and Analysis of Variance (ANOVA) test were used were used for statistical analysis. Results: In the study population, the mean age in the wave 1, wave 2 and wave 3 was 9.1±5.25 years, 9.3±4.99 years and 9.2±5.12 years, respectively. Males were more affected in all the phases than females. The most common symptoms in all the three waves were cough, myalgia and fever. Fever was the predominant symptom reported in all three waves (74.8% in wave 1, 80.6% in wave 2 and 75% in wave 3). Between the COVID19 waves, baseline investigations such as Alanine Transaminase (ALT) and Aspartate Transaminase (AST) (p-value=0.001, 0.02) showed significant differences. C-reactive Protein (CRP) was non reactive in (81.55%) in wave 1, (85.07%) in wave 2 and (65.3%) in wave 3. (p-value=0.029). Conclusion: The present study results conclude that the presenting features of COVID-19 in children were mild, and the outcome was good. The first, second and third waves had considerable differences in clinical findings and short-term outcomes among COVID-19-affected children.