Clinical features
The clinical presentation of COVID-19 in neonates and children is
typically mild and exhibits similarities across different countries
(Shen K et al.,2020 ; Zhu H et al.2020). Children most frequently
require hospitalization due to symptoms such as fever and respiratory
issues, including cough, sore throat, facial flushing, nasal congestion,
rapid breathing or difficulty breathing (tachypnea/dyspnea), and an
elevated heart rate (tachycardia) (Tagarro A et al., 2021; Parri N et
al., 2020). In rare instances, neurological symptoms such as seizures,
dystonia, and altered mental status have also been documented (Dugue R
et al., 2020).
COVID-19 severity categories, encompassing asymptomatic infections,
mild, moderate, severe, and critical cases, were defined based on
clinical features, laboratory tests, and X-ray imaging criteria, (Dong Y
et al., 2020). While lymphocytopenia was observed frequently in adults
with severe COVID-19 and correlated with adverse outcomes, this is not
typically the case in children, likely due to the higher percentage of
lymphocytes in individuals of that particular age group (Henry BM et
al.,2020; Li H et al. 2020). On the other hand, adults displayed
significantly elevated levels of D-Dimer, ferritin, and coagulopathy,
whereas these manifestations were rarely observed in children, (Sun D et
al.; 2020).
The majority of these laboratory irregularities observed in children
lack specificity. It was noted that 69.2% of children had leukocyte
counts within the normal range, and instances of neutrophilia or
neutropenia were infrequent (occurring in less than 5% of cases).
Platelet counts exhibited variability across different studies,
generally trending higher than the normal range. Additionally,
C-reactive protein levels were elevated in 13.6% of cases, while
procalcitonin levels were increased in 10.6% of cases ( Henry BM et
al., 2020).