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2023

ANUÁRIO DO HOSPITAL
DONA ESTEFÂNIA

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COVID-19 PNEUMONIA IN CHILDREN: WHAT SHOULD WE EXPECT AFTERWARDS?

Inês Ferrão Fernandes1; Ana Pereira Lemos1; Ana Margarida Garcia1, Tiago Milheiro Silva1, Rita Valsassina1, Catarina Gouveia1, Maria João Brito1

1 - Unidade de Infecciologia, Área de Pediatria Médica, Hospital Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa

- Poster, ESPID 2022

BACKGROUND: SARS-CoV-2 infection causes a spectrum of manifestations, ranging from asymptomatic to severe respiratory and extra-pulmonary symptoms. Current data shows that prolonged symptom duration is common not only in adults with COVID-19, but also among children.
METHODS: Descriptive cohort study, including children with COVID-19 pneumonia between April 2020 and December 2021. We describe the maintenance or occurrence of new symptoms and organic lesions after discharge. Statistics: SPSS 26® (p<0,05).
RESULTS: Of a total of 398 patients with SARS-CoV-2 infection, 60 (15%) had COVID-19 pneumonia, with median age 4,67 years (IQR 11,58). 26 (43%) had comorbidities, mainly obesity. Admission occurred in average on the 5 th day of disease. Symptoms were cough (45), fever (44), dyspnea (41) and hypoxemia (37). Disease was classified as mild (4), moderate (18), severe (30) and critical (8). Complications arouse in 72% of patients: respiratory insufficiency (38), ARDS (1), pneumothorax (1), septic shock (1), cardiogenic shock (1) and heart failure (1). Therapeutical approach included remdesivir (18), corticosteroids (27), oxygen (32), high-flow oxygen therapy (3), non-invasive ventilation (2) and invasive ventilation (1). Coinfections occurred in 25 (42%) of cases. Follow up appointment was made in 47 patients (78%). 11/47 (23%) maintained cough (5), fatigue (4), chest pain (2) and dyspnea (1), 16/24 had alterations in chest x-ray after an average of 3 months and 4/47 have abnormal pulmonary function testing. No statistically significant association was found between maintenance of symptoms in the follow-up evaluation.
CONCLUSIONS: Our children experience similar long-term post-recovery sequelae and the main symptoms resemble those described in adults. COVID-19 pneumonia is associated with morbidity during acute period and long-term evolution. Investigation regarding the pathophysiology of long-COVID is necessary to ensure patients receive appropriate follow-up and treatment.

Palavras Chave: COVID-19; Pneumonia; SARS-CoV-2