Epidemiology and Clinical Presentation of Children Hospitalized with SARS-CoV-2 Infection in Suburbs of Paris

Background: Understanding the clinical presentation of SARS-CoV-2 infection and prognosis in children is a major issue. Children often present mild symptoms, and some severe forms require paediatric intensive care, with in some cases a fatal prognosis. Our aim was to identify the epidemiological characteristics, clinical presentation and prognosis of children with coronavirus disease 2019 (Covid-19) hospitalized in Paris suburb hospitals. Methods: In this prospective, observational, multicentre study, we included children hospitalized in one of the 23 paediatric departments of Paris suburb hospitals from March 23 to May 10, 2020, during the national lockdown in France with confirmed SARS-CoV-2 infection (positive RNA test on a nasopharyngeal swab) or highly suspected infection (clinical, biological and/or radiological data features suggestive for SARS-CoV-2 infection). Findings: A total of 192 children were included for confirmed (n=157) or highly suspected (n=35) SARS-CoV-2 infection. The median age was 1 year [interquartile range 0.125-11], with sex ratio 1.3:1. Fever was recorded in 147 (76.6%) children and considered poorly tolerated in 29 (15.1%). The symptoms ranged from rhinorrhoea (34.4%), gastrointestinal (35.5%) to respiratory distress (25%); only 10 (5.2%) children had anosmia and 5 (2.6%) had chest pain. An underlying condition was identified in almost 30% of the children in our study. Overall, 24 (12.5%) children were admitted to paediatric intensive care; 12 required mechanical ventilation and 3 died. Interpretation: For children in Paris suburbs, most cases of Covid-19 showed mild or moderate clinical expression; however, one-eighth of children were admitted to paediatric intensive care and 3 died. Funding Statement: None. Declaration of Interests: The authors have no potential conflicts of interest to disclose. Ethics Approval Statement: The study was approved by the institutional review board of the French society for respiratory medicine (Societe de Pneumologie de Langue Francaise) (#CEPRO 2020-033).