Aimen Ch, Attia Bari, Junaid Rashid, Yasin Alvi, Farrah Naz, Nasir Rana, Iqbal Bano, Abid Qureshi, Khalida Aamir, Naureen Akhtar, Shazia Maqbool, Nisar Ahmad, Muhammad Saleem, Masood Sadiq.
Comorbidity and COVID-19 in Children - a Single Center Experience.
Pak Paed J Jan ;44(4):306-13.

Objectives: To describe the epidemiological characteristics, clinical presentation, severity of the disease, and early outcomes of children with COVID-19 in Pakistan with special reference to underlying comorbid conditions. Study Design: Descriptive cross-sectional study. Place and Duration of Study: The Children`s Hospital and The Institute of Child Health, Lahore, from March 15 to July 31, 2020. Material and Methods: We analyzed data on all laboratory-confirmed cases of severe acute respiratory syndrome coronavirus 2 (SARC-COV- 2) infection in children admitted to a single tertiary care center including patient characteristics, clinical course and hospital outcomes with special reference to underlying comorbidity. Results: Of 42 symptomatic children, 19 (45%) had a pre-existing comorbidity, the most common of which was chronic kidney disease (7/19- 37%). The median age was 7.75 years (IQR: 1.3-11.2) with a slight female preponderance (55%). Fever (79%), respiratory symptoms (52%), and gastrointestinal symptoms (14%) were the most common symptoms. No direct or indirect contact with COVID-19 positive person was identified in 12 patients (29%). Patients with pre-existing comorbidity required mechanical ventilation and prolonged intensive care monitoring than those without. There were three fatalities in the groups of 42 (7%) patients, and underlying comorbid conditions were significantly associated with a fatal outcome (p=0.032). Conclusion: COVID-19 in children is generally mild with good outcome. Chronic kidney disease was the commonest co-morbidity and the presence of an underlying co-morbid condition is a risk factor for prolonged hospital stay and a poor outcome.

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