• Murat Duman, Nihan Şık, Özlem Tekşam, Halise Akça, Funda Kurt, ÇağlarAyla AkcaAAAnkara City Hospital, Department of Pediatric Emergency Medicine, Ankara, Turkey., Leman Akcan Yıldız, Medine Ayşin Taşar, İlknur Fidancı, YaylaBurcu Ceylan CuraBCCUniversity of Health Sciences, Ankara Training and Research Hospital, Pediatric Emergency Department, Ankara, Turkey., Durgül Yılmaz, Emre Güngör, Şule Demir, Haluk Çokuğraş, Sinem Oral Cebeci, Pınar Önal, Eylem Ulaş Saz, Ali Yurtseven, Metin Uysalol, Raif Yıldız, Süheyla Gümüş, Alkan Bal, Semra Şen Bayturan, Neslihan Zengin, Sinem Atik, Dilek Yılmaz Çiftdoğan, Emel Berksoy, Alper Çiçek, Sabiha Şahin, Mahmut Can Kızıl, Yalçın Kara, Hurşit Apa, Emel Ulusoy, Aybüke Akaslan Kara, Edanur Yesil, Meltem Erdem, Caner Turan, Sertac Arslanoglu, Muhterem Duyu, Gulser Esen Besli, Gazi Arslan, Ayşe Tolunay Oflu, Mehmet Çeleğen, Ebru Buldu, İbrahim Etem Pişkin, Hakan Kardeş, Hayri Levent Yılmaz, Dinçer Yıldızdaş, Gamze Gökulu, Pınar Çay, Utku Özer, Okşan Derinöz Güleryüz, Özlem Çolak, and GüneysuSongül TomarSTGazi University, Faculty of Medicine, Department of Pediatric Emergency, Ankara, Turkey..
• Division of Pediatric Emergency Care, Department of Pediatrics, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey. Electronic address: mduman@deu.edu.tr.
• Am J Emerg Med. 2022 Sep 1; 59: 133140133-140.

BackgroundThe aim was to evaluate the epidemiological, clinical, laboratory, and radiologic data of children with SARS-CoV-2 positivity by polymerase chain reaction (PCR) together with treatment strategies and clinical outcomes and to evaluate cases of multisystem inflammatory syndrome in children (MIS-C) in this population.MethodsThis was a multicenter retrospective observational cohort study performed in the pediatric emergency departments of 19 tertiary hospitals. From March 11, 2020, to May 31, 2021, children who were diagnosed with confirmed nasopharyngeal/tracheal specimen SARS-CoV-2 PCR positivity or positivity for serum-specific antibodies against SARS-CoV-2 were included. Demographics, presence of chronic illness, symptoms, history of contact with SARS-CoV-2 PCR-positive individuals, laboratory and radiologic investigations, clinical severity, hospital admissions, and prognosis were recorded.ResultsA total of 8886 cases were included. While 8799 (99.0%) cases resulted in a diagnosis of SARS-CoV-2 with PCR positivity, 87 (1.0%) patients were diagnosed with MIS-C. Among SARS-CoV-2 PCR-positive patients, 51.0% were male and 8.5% had chronic illnesses. The median age was 11.6 years (IQR: 5.0-15.4) and 737 (8.4%) patients were aged <1 year. Of the patients, 15.5% were asymptomatic. The most common symptoms were fever (48.5%) and cough (30.7%) for all age groups. There was a decrease in the rate of fever as age increased (p < 0.001); the most common age group for this symptom was <1 year with the rate of 69.6%. There was known contact with a SARS-CoV-2 PCR-positive individual in 67.3% of the cases, with household contacts in 71.3% of those cases. In terms of clinical severity, 83 (0.9%) patients were in the severe-critical group. There was hospital admission in 1269 (14.4%) cases, with 106 (1.2%) of those patients being admitted to the pediatric intensive care unit (PICU). Among patients with MIS-C, 60.9% were male and the median age was 6.4 years (IQR: 3.9-10.4). Twelve (13.7%) patients presented with shock. There was hospital admission in 89.7% of these cases, with 29.9% of the patients with MIS-C being admitted to the PICU.ConclusionMost SARS-CoV-2 PCR-positive patients presented with a mild clinical course. Although rare, MIS-C emerges as a serious consequence with frequent PICU admission. Further understanding of the characteristics of COVID-19 disease could provide insights and guide the development of therapeutic strategies for target groups.Copyright © 2022 Elsevier Inc. All rights reserved.

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