Epidemiology and Clinical Characteristics of sars-cov-2 Infection in Kuwait: Results of a National Registry

Background: The first COVID-19 case was reported in Kuwait in February 2020, and the pandemic rapidly spread in the country. To better understand the impact of COVID-19 on children, a pediatric registry was established, recording all cases of severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) in children, focusing on disease presentation, complications, severity of the disease and early outcomes.

Methods: A retrospective, national-level, cohort study was performed and included all children aged ≤ 12 years with a confirmed SARS-CoV-2 infection by polymerase chain reaction (PCR) in Kuwait between February 24th to December 31st, 2020. Cases were identified through reviewing national electronic SARS-CoV-2 testing, hospital admission records, and medical transfer services. During the study period infected children were identified through symptomatic testing, contact tracing, routine screening upon hospitalization, and screening before and after travel. Children who were older than 12 years at the time of sample collection or had equivocal RT-PCR result were excluded. Also, patients who had positive SARS-CoV-2 specific antibodies without documentation of positive SARS-CoV-2 RT-PCR were excluded in the analysis. Patient demographics, medical history, SARS-CoV-2 testing, signs and symptoms, therapeutic and medical intervention, complications, laboratory tests and outcome were obtained using The Kuwait Pediatric COVID-19 Registry (PCR-Q8). Descriptive analysis was performed.

Results: During the study period, a total of 14,322 children aged ≤12 were diagnosed with SARS-CoV-2 infection in Kuwait. The first pediatric case was reported in March 2020. The monthly number of cases peaked during the summer of 2020 (July-September), and this was followed by a rapid decline during the beginning of winter of 2020 (figure 1). The median age was 7.6 years (IQR 4.1-10.5) and half were male. Less than one-third (29.4%) were symptomatic (table 1). The number of children with pre-existing comorbidities was 228 (1.59%); the most common comorbidities were asthma (54, 0.37%), chronic neurological disorder (29, 0.2%) and acquired/congenital heart disease (25, 0.17%). The number of hospitalized children was 1599 (11.2%). The most common symptoms of those who were hospitalized were fever (39.8%), cough (17.6%), runny nose (11.1%) and diarrhea (8.4%). A total of 32 children were admitted to intensive care (0.22%), and 5 deaths were recorded (0.035%).

Conclusion: Overall, the pediatric COVID-19 registry has invaluable information about the effect of COVID-19 on children in Kuwait. Such information can guide clinical practices for better understanding and management of COVID-19 in children.