Multi-organ Presentation of Children with COVID-۱۹ Infection in the North of Iran: A Retrospective Study

Background: COVID-۱۹ can cause various symptoms in children. The aim of the study was evaluation of multi-organ presentation of children with COVID-۱۹ infection in Amirkola Children’s Hospital in Babol, Iran. Materials and Methods: This study was conducted retrospectively and data were extracted from medical records. All children with suspected COVID-۱۹ infection who were referred to Amirkola Children’s Hospital in Babol (north of Iran) from March ۴, ۲۰۲۰ to May ۳۰, ۲۰۲۰ were enrolled. Clinical features of the respiratory and digestive system and Multisystem Inflammatory Syndrome in Children (MIS-c) were assessed. In all children WBC, RBC, Hb, MCV, Lymphocyte, CRP, ESR, ALT, AST, PT, PTT and platelets were also evaluated. Data analysis was conducted with SPSS software version ۱۶.۰. Results: Totally ۳۷ children were recruited to the study. The most common clinical symptoms in children were fever (۸۶.۵%), weakness (۷۵.۷%) anorexia (۷۳%)abdominal pain (۴۸.۶.۹%), diarrhea (۴۵.۹%) nausea and vomiting (۳۷.۸%), cough (۳۲.۴%). About ۶۰% and ۸% of children had Hb and MCV less than normal levels respectively,So that ۸۰% and ۶۰% of children had abnormal elevations in CRP and ESR, respectively. Also, ۳۲% and ۳۵% of them had an increase in ALT and AST levels respectively and about ۴۰% of them hadhypoalbuminemia. Additionally, ۷ of ۳۷ (۱۸.۹%) children had MIS-c. The result of the study demonstrated that ۱۰/۳۷ (۳۲.۴%) of children had pulmonary involvement. Conclusion: In this study gastrointestinal symptoms were more common than respiratory symptoms in children with COVID-۱۹ infection. Also, about one- fifth of children with COVID-۱۹ had MIS-c. Attention to manifestations of organs other than respiratory system in children with COVID-۱۹ infection is necessary.

Keywords:

Children , COVID-۱۹ , gastrointestinal symptoms , Respiratory symptoms