441 - Clinical Characteristics of Pediatric SARS-CoV-2 Infection and Coronavirus Disease 2019 (COVID-19) in Kuwait

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Presenting Author(s)

Danah Y. Alsharrah

Pediatric Resident
Department of Pediatrics, Farwaniyah Hospital, Ministry of Health, Kuwait
Kuwait City, Hawalli, Kuwait
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Co-Author(s)

FA

Fatemah Al-Haddad

pediatric resident
Department of Pediatrics, Farwaniyah Hospital, Ministry of Health, Kuwait
Kuwait city, Al Farwaniyah, Kuwait
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
SA

Sarah Aljamaan

Pediatric Resident
Department of Pediatrics, Farwaniyah Hospital, Ministry of Health, Kuwait
Kuwait City, Al Farwaniyah, Kuwait
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
MA

Muneera Al-Yaseen

Pediatric Resident
Department of Pediatrics, Mubarak Hospital, Ministry of Health, Kuwait
Kuwait city, Hawalli, Kuwait
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
NA

Nahar Al-Mutairi

Pediatric Assistant Registrar
Department of Pediatrics, Jahra Hospital, Ministry of Health, Kuwait
Kuwait City, Al Jahra, Kuwait
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
MA

Mariam Ayed

specialist neonatologist
Department of Pediatrics, Farwaniyah Hospital, Ministry of Health, Kuwait
Kuwait City, Al Farwaniyah, Kuwait
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
JP

Jesse Papenburg

Pediatric ID specialist and medical microbiologist
Departments of Pediatrics and Medical Microbiology, McGill University Health Centre, Montreal, QC, Canada
Montreal, Quebec, Canada
Disclosure: AbbVie (Consultant, Scientific Research Study Investigator, Research Grant or Support, Speaker's Bureau)BD Diagnostics (Research Grant or Support)Cepheid (Speaker's Bureau)MedImmune (Scientific Research Study Investigator)Sanofi Pasteur (Scientific Research Study Investigator)Seegene (Research Grant or Support, Speaker's Bureau)
MA

Mohammad Alghounaim

Pediatric ID specialist and medical microbiologist
Department of Pediatrics, Amiri Hospital, Ministry of Health, Kuwait
Kuwait City, Al Asimah, Kuwait
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Background: Clinical presentation of coronavirus disease-2019 (COVID-19) ranges from asymptomatic to severe and life threatening. National-level registries found that children, generally, have less severe disease when compared to adults. However, most asymptomatically infected children will not present to hospital and may be missed. We aimed to describe the clinical characteristics in pediatric COVID-19 patients in Kuwait, and to estimate the potential duration of viral shedding.

Methods: A retrospective cohort study was performed in Jaber Alahmad Hospital (JAH) from Feb. 29th to Apr. 30th, 2020. During the study period and as part of the public health measures to contain COVID-19, all SARS-CoV-2 infected patients 1 month-18 years old, regardless of symptoms, were hospitalized at JAH, and were included. Demographics, clinical data, and laboratory results were collected. Polymerase chain reaction (PCR) negativity was defined as having two consecutive negative PCR results from a respiratory specimen. Descriptive statistics and multivariable regression analyses were performed.

Results: A total of 134 pediatric SARS-CoV-2 infections were identified. Of those, 91 patients (67.9%) were asymptomatic, the remaining cases had mild COVID-19 illness and mild pneumonia. The median age was 8.8 years (IQR: 4.7-12.4), 55.2% were males, and 89.5% were healthy. Cough and fever were the most commonly reported symptoms. The median duration to PCR negativity was 15 days (IQR: 13-19) for symptomatic patients and 15.5 days (IQR: 14-21) for asymptomatic patients. Predictors for symptoms included abnormal procalcitonin (aOR 6.6; 95% CI 1.48 -29.3) , C-reactive protein (aOR 9.10; 95% CI 1.29-32.13), and X-ray finding of pneumonia ( aOR 6.44; 95% CI 1.29-32.13 ).

Conclusion: Asymptomatic SARS-CoV-2 infection is very common in children. Among symptomatic patients, the disease seems to be mild. Children exhibit substantial duration of viral shedding, as measured by PCR positivity, regardless of symptoms.