İlknur FİDANCI, Medine TAŞAR, Burcu CURA YAYLA, Kübra AYKAÇ, Bahar AKINTUĞ, Mustafa Berkay KILIÇ, Gökçe İŞCAN

Çocuk Acil Servisimize Başvuran COVİD 19 hastalar

Amaç: Çocuk Acil Servisimize başvuran COVİD 19 PCR testi + olan hastaları başvuru semptomları, klinik, labaratuar ve radyolojik bulgularıyla birlikte değerlendirmeyi amaçladık. Gereç ve yöntem: Çalışma üçüncü basamak Çocuk Acil Servise Mart 2020- Ocak 2021 tarihleri arasında başvuran hastalarda yapıldı. Verilerin analizinde SPSS 26 V kullanıldı. Bulgular: Çalışmaya 1007 COVİD 19 PCR + hasta dahil edildi. Bunlardan 512(%50.8) si kız, 495(%49.2) i erkek cinsiyetteydi, yaş ortancası 171 ay(min-max:2-226) idi. Hastaların sınıflamasında 818(%81) hasta asemptomatik, 106(%10.5) hasta hafif, 77(%7.6) hasta orta, 6(%0,5) hasta ağır klinikteydi. En sık görülen semptom ateş(%45.6), öksürük(%38.3) ve boğaz ağrısıydı(%26.7). Yaş gruplarına göre bakıldığında 120 ay üstü grupta ateş (p<0,01), kusma ve ishal(p=0.010) anlamlı derecede yüksekti. Hastaların %74,3 üne akciğer grafisi çekildi, %1,06 sı anormal olarak değerlendirildi. Bu durum orta ağırlıktaki grupta daha çok görüldü.(p<0.01). Sadece 20(1.9)hastaya bilgisayarlı tomografi çekildi, bununda 8(0.8) tanesi anormal olarak raporlandı. CRP yüksekliği hastaların %28.9 unda, lökopeni %38.5 unda, lenfopeni %25.2 sinde görülen en yaygın görülen laboratuar bulgularıydı. CRP, Prokalsitonin ve Troponin değerleri ağır grupta yüksekti.(p<0.019; p<0.003, p<0.013). Hastaların %10.3 hastanede yatarak tedavi aldı. Sonuç: COVİD 19 çocuklarda her ne kadar asemptomatik ve hafif semptomlarla seyretse de komorbid hastalığı olan grupta ağır seyredebileceği ve ölümlerin görülebileceği unutulmamalı, asemptomatiklerin bulaş açısından tespiti özellikle yaşlı ve altta yatan hastalığı olan erişkinleri korumak için önemlidir.

Anahtar Kelimeler:

covid 19, çocuk acil, çocuk

COVID 19 Patients Who Applied To Our Pediatric Emergency Department

Objective: We aimed to evaluate COVID 19 PCR test positive patients who admitted to our Pediatric Emergency Department, together with their admission symptoms, clinical, laboratory and radiological findings. Method: The study was conducted in patients admitted to Pediatric Emergency Department between March 2020 and January 2021. SPSS 26 V was used in the analysis of the data. Results: 1007 COVID 19 PCR + patients were included in the study. Of these, 512 (50.8%) were female, 495 (49.2%) were male, and the median age was 171 months (min-max: 2-226). In the disease classification of patients, 818 (81%) patients were asymptomatic. The most common symptoms were fever (45.6%), cough (38.3%) and sore throat (26.7%). According to age groups, fever (p<0.01), vomiting and diarrhea (p=0.010) were significantly higher in the group over 120 months of age.Chest X-ray was taken in 74.3% of the patients, 1.06% of them were evaluated as abnormal. This situation was seen more in the moderate group (p<0.01). CRP elevation was the most common laboratory finding in 28.9% of patients, leukopenia in 38.5%, and lymphopenia in 25.2% of patients. CRP, procalcitonin and troponin values were higher in the severe group (p<0.019; p<0.003, p<0.013). 10.3% of the patients received inpatient treatment. Conclusion: Although COVID 19 progresses with asymptomatic and mild symptoms in children, it should be borne in mind that in rare cases, there may be severe course and death. It is important to detect asymptomatic cases in terms of transmission, especially to protect the elderly and adults with underlying disease.

Keywords:

covid 19, pediatric emergency, child,

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Zu ZY, Jiang MD, Xu PP, Chen W, Ni QQ, Lu GM, et al. Coronavirus Disease 2019 (COVID-19): A Perspective from China. Radiology 2020;21:200490.
The Coronavirus Scientific Advisory Board (Turkey). 14 April 2020. [Internet] https://covid19bilgi.saglik.gov.tr/depo/rehberler/COVID-19_Rehberi.pdf Last update:
Chan JF, Yuan S, Kok KH, To KK, Chu H, Yang J, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet 2020;395:514-23.
Wang D, Ju XL, Xie F, Lu Y, Li FY, Huang HH, et al. Clinical analysis of 31 cases of 2019 novel coronavirus infection in children from six provinces (autonomous region) of northern China. Zhonghua Er Ke Za Zhi 2020;58:269-74.
CDC COVID-19 Response Team. Coronavirus Disease 2019 in Children - United States, February 12-April 2, 2020. MMWR Morb Mortal Wkly Rep 2020;69:422-6.
Stokes EK, Zambrano LD, Anderson KN, Marder EP, Raz KM, El Burai Felix S, et al. Coronavirus Disease 2019 Case Surveillance - United States, January 22-May 30, 2020. MMWR Morb Mortal Wkly Rep 2020;19;69:759-65.
de Souza TH, Nadal JA, Nogueira RJN, Pereira RM, Brandão MB. Clinical manifestations of children with COVID-19: A systematic review. Pediatr Pulmonol 2020;55:1892-9.
Dong Y, Mo X, Hu Y, Qi X, Jiang F , Jiang Z, et al. Epidemiological Characteristics of 2143 Pediatric Patients With 2019 Coronavirus Disease in China. Pediatrics 2020;58:712–3.
Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72314 cases from the Chinese center for disease control and prevention. JAMA 2020;323:1239–42.
Ladhani SN, Amin-Chowdhury Z, Davies HG, Aiano F, Hayden I, Lacy J, et al. COVID-19 in children: analysis of the first pandemic peak in England. Arch Dis Child. 2020;105:1180-5.
Lu X, Zhang L, Du H, Zhang J, Li YY, Qu J, et al. SARS-CoV-2 Infection in Children. New Engl J Med 2020;382:1663-5.
Foster CE, Marquez L, Davis AL, Tocco E, Koy TH, Dunn J, et al. A surge in pediatric coronavirus disease 2019 cases: the experience of Texas Children’s Hospital from March to June 2020. J Pediatric Infect Dis Soc 2020;10:593–8.
Jahangir M, Nawaz M, Nanjiani D, Siddiqui MS. Clinical manifestations and outcomes of COVID-19 in the paediatric population: a systematic review. Hong Kong Med J 2021;27:35–45.
Garazzino S, Montagnani C, Donà D, Meini A, Felici E, Vergine G, et al. Multicentre Italian study of SARS-CoV-2 infection in children and adolescents, preliminary data as at April 10 2020. Euro Surveill 2020;25:2000600.
Lu X, Xing Y, Wong GW. COVID-19: lessons to date from China. Arch Dis Child. Forthcoming 2020;105:1146-50.
Cui X, Zhao Z, Zhang T, Guo W, Guo W, Zheng J, et al. A systematic review and meta-analysis of children with coronavirus disease 2019 (COVID-19). J Med Virol 2021;93:1057-69.
Tian Y, Rong L, Nian W, He Y. Review article: gastrointestinal features in COVID-19 and the possibility of faecal transmission. Aliment Pharmacol Ther 2020;51:843-51.
Zheng F, Liao C, Fan Q, Chen HB, Zhao XG, Xie ZG, et al. Clinical characteristics of children with coronavirus disease 2019 in Hubei, China. Curr Med Sci 2020;40:275‐80.
Qiu H, Wu J, Hong L, Luo Y, Song Q, Chen D. Clinical and epidemiological features of 36 children with coronavirus disease 2019 (COVID-19) in Zhejiang, China: an observational cohort study. Lancet Infect Dis 2020;20:689-96.
Ma Y‐L, Xia S‐Y, Wang M, Zhang SM, DU WH, Chen Q. Clinical features of children with SARS‐CoV‐2 infection: an analysis of 115 cases. Chin J Contemp Pediatr 2020;22:290‐3.
Wang XF, Yuan J, Zheng YJ, Chen J, Bao YM, Wang YR, et al. Retracted: Clinical and epidemiological characteristics of 34 children with 2019 novel coronavirus infection in Shenzhen. Zhonghua Er Ke Za Zhi 2020;17;58:E008.
Singh P, Attri K, Mahto D, Kumar V, Kapoor D, Seth A. Clinical Profile of COVID-19 Illness in Children-Experience from a Tertiary Care Hospital. Indian J Pediatr 2022;89:45-51.
Lippi G, Plebani M, Henry BM. Thrombocytopenia is associated with severe coronavirus disease 2019 (COVID-19) infections: A meta-analysis. Clin Chim Acta 2020;506:145-8.
Korkmaz MF, Türe E, Dorum BA, Kılıç ZB. The Epidemiological and Clinical Characteristics of 81 Children with COVID-19 in a Pandemic Hospital in Turkey: an Observational Cohort Study. J Korean Med Sci 2020;35:e236.
Rajapakse N, Dixit D. Human and novel coronavirus infections in children: a review. Paediatr Int Child Health 2021;41:36-55.
Parri N, Lenge M, Cantoni B, Arrighini A, Romanengo M, Urbino A, et al. COVID-19 in 17 Italian pediatric emergency departments. Pediatrics 2020;146:e20201235.
Bao C, Liu X, Zhang H, Li Y, Liu J. Coronavirus disease 2019 (COVID-19) CT findings: a systematic review and metaanalysis. J Am Coll Radiol 2020;17:701–9
Chen A, Huang J, Liao Y, Liu Z, Chen D, Yang C, et al. Differences in Clinical and Imaging Presentation of Pediatric Patients with COVID-19 in Comparison with Adults. Radiol Cardiothor Imaging 2020;2:e200117.
Bozan Ö, Aksel G, Kahraman HA, Giritli Ö, Eroğlu SE. Comparison of PECARN and CATCH clinical decision rules in children with minor blunt head trauma. Eur J Trauma Emerg Surg 2019;45:849-55.
Simsek Uzunoglu S, Akca H. Systematic Review: Clinical Symptoms and Laboratory and Radiology Findings in Children with COVID-19. Niger J Clin Pract 2021;24:1259-67.
Shahid S, Raza M, Junejo S, Maqsood S. Clinical features and outcome of COVID-19 positive children from a tertiary healthcare hospital in Karachi. J Med Virol 2021;93:5988-97.
Maltezou HC, Magaziotou I, Dedoukou X, Eleftheriou E, Raftopoulos V, Michos A, et al. Children and adolescents with SARS-CoV-2 infection: epidemiology, clinical course and viral loads. Pediatr Infect Dis J 2020;39:e388–92.