PC3044: Clinical Characteristics of Children with COVID-19 Infection in an Outpatient Pediatric Center

Background: According to the American Academy of Pediatrics State-Level Data Report, over 12.9 million children have tested positive for COVID-19 as of April 14, 2022 with 7.9 million of these cases reported since September 2021. Though precautionary measures such as masks show significant infection reduction within schools, COVID-19 has still spread rapidly within the pediatric cohort. Rapid testing in an outpatient setting holds the potential to aid in controlling pandemic outbreaks such as COVID-19 by mitigating spread among young individuals through early detection and diagnosis of COVID-19.

Methods: This is a retrospective descriptive study describing clinical characteristics of COVID-19 infection in children < 18 years of age presenting to Florida Pediatric Group (FPG) from July 1, 2020 through March 31, 2022. These patients presented with either symptoms or recent exposure. All patients that tested positive for the first time at FPG using the Quidel Sofia SARS Antigen Fluorescent Immunoassay test were included. Patients with previous recent COVID-19 diagnosis who came to FPG for retesting were excluded.

Results: Approximately 5600 patients < 18 years old were tested for COVID-19 infection during the study period. A total of 394 patients tested positive for COVID-19 for the first time, satisfying inclusion and exclusion criteria. 194 of these patients (49.2%) presented during the Omicron variant surge in Florida (December 6, 2021 - March 31, 2022). There were 45 (11.4%) asymptomatic and 349 (88.6%) symptomatic cases. Positive children presented with the following symptoms; fever (206, 52.3%), cough (186, 47.2%), coryza (142, 36.0%), headache (110, 27.9%), sore throat (107, 27.2%), myalgia (39, 9.9%), abdominal pain (32, 8.1%), vomiting (23, 5.8%), ear ache/infection (16, 4.1%), diarrhea (14, 3.6%), nausea (12, 3.1%), conjunctivitis/eye pain (8, 2.0%), loss of taste (7, 1.8%), chest discomfort (6, 1.5%), and loss of smell (4, 1.0%). Results of the antigen tests were obtained 15 minutes after nasopharyngeal swabbing.

Conclusion: Given the significant proportion of asymptomatic children with COVID-19, the wide variety of symptoms, and the rapid spread of the infection, diagnosing children suspected of COVID-19 through rapid antigen testing holds the potential to assist in controlling the pandemic by providing a fast and relatively inexpensive test in an outpatient setting. This data shows how an outpatient pediatric primary care office is effective in early diagnosis of COVID-19 infection to assist parents and the school system in rapid identification, contact tracing, and isolation of these positive patients.