485. Pediatrics Institutional COVID-19 Review

Abstract

Background. Corona virus disease (COVID-19) caused by SARS-COV2 represents global public health concern, with varied severity of illness in different ages and racial groups. This study aims to describe clinical presentation and outcomes in children aged 0-18 years in a community hospital setting in the United States. Methods. This is a retrospective medical record review of pediatric patients (0-18 years) admitted to Saint Barnabas Medical Center between March 2020-August 2020 with confirmed diagnosis of COVID-19 infection. Diagnosis of COVID-19 infection is based on ICD-10 diagnosis code from the coding abstract data of the hospital, and data analysis is based on retrospective chart review using electronic medical records for the patients included in the study. Patient data include demographics (age, sex, race), pre-existing conditions, presenting symptoms, treatments used and outcomes. Findings. We identified 27 cases of pediatric COVID-19 patients at Saint Barnabas Medical Center during period of March 2020-August 2020. Fever (74%) was the most frequent symptom identified, followed by cough (44%), nausea/vomiting (30%), abdominal pain (19%), headache (19%), diarrhea (15%), shortness of breath (15%), red eyes (15%), rash (11%), chest pain (4%), and loss of taste/smell (4%). 13 out of 27 patients had imaging with chest X-ray, and 7 (54%) had findings of lung infiltrates or opacities. 6 of 27 patients had echocardiogram, and 4 (67%) had positive echocardiogram findings. 11 of 27 patients had some comorbid condition. 17 of 27 (63%) received no treatment. 3 patients (11%) were treated with IVIG + steroids, 2 (7%) received steroids only, 2 (7%) received Remdesivir, 1 (4%) received HCQ, and 1 (4%) received Tocilizumab along with IVIG+ steroids. Only 3 of 27 patients (11%) required supplemental oxygen treatment. No deaths were reported. Of 27 patients, 11 (41%) received inpatient care in general pediatrics, 10 (37%) received care only in ER, 4 (15%) received ICU level of care, and 2 (7%) received care in newborn nursery. Of 27 patients, 17 (63%) were female, and 10 (37%) were male. Race distribution was 48% black, 22% white, 4 % Asian Indian, and 26% others/unknown. Age distribution was 41% aged >15 yrs, 19% aged 6-10 yrs, 15% aged 1-5 yrs, 11% aged 11-15 yrs, 11% newborn, and 4% 0-1 yr. Interpretation. This review supports findings from other studies in children showing overall good prognosis in children diagnosed with COVID-19 infection. This study also shows that there is some racial component involved as black children were infected twice as much as white children. However, it requires more longitudinal studies to confirm these findings, and better understand symptomatology and disease course in children with COVID-19 infection.