Clinical features and outcome of Covid-19 in individuals without Comorbidities. Do children have the advantage?
Objective: Information regarding clinical characteristics and the natural course of COVID-19 amongst individuals without comorbidities is scarce. We therefore conducted a retrospective observational study to decipher the disease profile in two different age groups, middle-aged (40-59 years) and children (up to 12 years).
Method: Study was conducted by reviewing the medical records of all patients in the desired age groups and excluding all those with preexisting illness (called comorbidities).
Result: A total of 154 and 27 patients were enrolled and studied in the middle-aged adults and children group respectively. Males dominated in both groups with a sex ratio of 2.9 in adults and 1.7 in children. Most of the children (92.5%) had a history of exposure from an infected family member, while in the adult group history of contact was present in 71.4% of patients. 62.9% of children had an asymptomatic infection which was significantly higher than 22.8% in adults. Cough and fever were the most common symptoms in both age groups, but adults were more likely to have respiratory complaints when compared with children.11 (7.1%) patients in the adult group had severe disease while in the children group none had severe disease. Similarly in the adult group 11 patients required ICU admission, but none in the children group. The mean duration of RTPCR positivity was similar in both groups. There was 1 (0.6%) expiry in the adult group whereas none in children.
Conclusion: Healthy individuals in both middle-aged and children group tend to have milder disease and both harbour the virus for the almost same duration but adults are more symptomatic in comparison to children and hence children are more likely to be potential asymptomatic carrier and transmitter of infection.
Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, Davidson KW; et al. Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area. JAMA. 2020 May 26;323(20):2052-2059. doi: 10.1001/jama.2020.6775. Erratum in: JAMA. 2020 May 26;323(20):2098.
Bajgain KT, Badal S, Bajgain BB, Santana MJ. Prevalence of comorbidities among individuals with COVID-19: A rapid review of current literature. Am J Infect Control. 2021 Feb;49(2):238-246. doi: 10.1016/j.ajic.2020.06.213. Epub 2020 Jul 10.
Götzinger F, Santiago-García B, Noguera-Julián A, Lanaspa M, Lancella L, Calò Carducci FI, et al. COVID-19 in children and adolescents in Europe: a multinational, multicentre cohort study. Lancet Child Adolesc Health. 2020 Sep;4(9):653-661. doi: 10.1016/S2352-4642(20)30177-2. Epub 2020 Jun 25.
Rao S, Gavali V, Prabhu SS, Mathur R, Dabre LR, Prabhu SB, Bodhanwala M. Outcome of Children Admitted With SARS-CoV-2 Infection: Experiences From a Pediatric Public Hospital. Indian Pediatr. 2021 Apr 15;58(4):358-362. doi: 10.1007/s13312-021-2196-4. Epub 2021 Jan 11.
Revised guidelines on clinical management of Covid 19. Govt of India, MoHFW,DGHS(EMR Division) 31st March 2020 p 18 .Available at www.mohfw.gov.in
Mohan A, Tiwari P, Bhatnagar S, Patel A, Maurya A, Dar L, et al. Clinico-demographic profile & hospital outcomes of COVID-19 patients admitted at a tertiary care centre in north India. Indian J Med Res. 2020 Jul & Aug;152(1 & 2):61-69. doi: 10.4103/ijmr.IJMR_1788_20.
Sarangi B, Reddy VS, Oswal JS, Malshe N, Patil A, Chakraborty M, et al. Epidemiological and Clinical Characteristics of COVID-19 in Indian Children in the Initial Phase of the Pandemic. Indian Pediatr. 2020 Oct 15;57(10):914-917. doi: 10.1007/s13312-020-1994-4. Epub 2020 Jul 28.
Gupta N, Ish P, Kumar R, Dev N, Yadav SR, Malhotra N, et al. Evaluation of the clinical profile, laboratory parameters and outcome of two hundred COVID-19 patients from a tertiary centre in India. Monaldi Arch Chest Dis. 2020 Nov 9;90(4). doi: 10.4081/monaldi.2020.1507..
Guo CX, He L, Yin JY, Meng XG, Tan W, Yang GP, et al. Epidemiological and clinical features of pediatric COVID-19. BMC Med. 2020 Aug 6;18(1):250. doi: 10.1186/s12916-020-01719-2.
Meena J, Yadav J, Saini L, Yadav A, Kumar J. Clinical Features and Outcome of SARS-CoV-2 Infection in Children: A Systematic Review and Meta-analysis. Indian Pediatr. 2020 Sep 15;57(9):820-826. doi: 10.1007/s13312-020-1961-0. Epub 2020 Jun 24.
Banerjee S, Guha A, Das A, Nandi M, Mondal R. A Preliminary Report of COVID-19 in Children in India. Indian Pediatr. 2020 Oct 15;57(10):963-964. doi: 10.1007/s13312-020-2004-6. Epub 2020 Jul 28.
Ruan PS, Xu HQ, Wu JH, Song QF, Qiu HY. COVID-19 in Children: Clinical Characteristics and Follow-Up Study. SN Compr Clin Med. 2020 Sep 3:1-4. doi: 10.1007/s42399-020-00502-x. Epub ahead of print.
Wang P, Sha J, Meng M, Wang C, Yao Q, Zhang Z, et al. Risk factors for severe COVID-19 in middle-aged patients without comorbidities: a multicentre retrospective study. J Transl Med. 2020 Dec 7;18(1):461. doi: 10.1186/s12967-020-02655-8.
Young BE, Ong SWX, Kalimuddin S, Low JG, Tan SY, Loh J, et al. Epidemiologic Features and Clinical Course of Patients Infected With SARS-CoV-2 in Singapore. JAMA. 2020 Apr 21;323(15):1488-1494. doi: 10.1001/jama.2020.3204. Erratum in: JAMA. 2020 Apr 21;323(15):1510.
Gombar S, Chang M, Hogan CA, Zehnder J, Boyd S, Pinsky BA, et al. Persistent detection of SARS-CoV-2 RNA in patients and healthcare workers with COVID-19. J Clin Virol. 2020 Aug;129:104477. doi: 10.1016/j.jcv.2020.104477. Epub 2020 May 30.
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