COVID-19 clinical and epidemiological characteristics in children in Latvia: descriptive retrospective cohort study

To characterise the clinical and epidemiological features of acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection of children in Latvia at the outpatient and hospital setting. The retrospective cohort study was conducted from March to December 2020 and totally 123 SARS-CoV-2 positive children (0-18 years of age) were enrolled in the study. All patients were evaluated in a face-to-face visit according to a specially designed study protocol which consisted of 95 questions divided into 8 sections. Descriptive statistics were used to present the data. The mean age of patients included in the study was 10.2 years. Boys get infected more often than girls – gender distribution was – boys 57% (n=80) and girls – 43% (n=53). 61% (n=70) of all patients were adolescents, aged 10 – 18 years. 74% (n=92) of patients were in contact with a known Covid-19 patient, e.g. in their household or educational institution. Children are most likely to get infected by known Covid-19 positive patients, at home (30%) and in educational establishments (17%). The most common symptom of SARS-CoV-2 infection in our paediatric population in Latvia was increased temperature 83% (n=96). Most frequently – febrile temperature in 46% (n=57) cases; subfebrile temperature 34% (n=42). Tiredness 46% (n=53), cough 35% (n=40), rhinorrhoea 35%(n=40) and headache 33% (n=38) were also other prominent symptoms. Symptoms of SARS-CoV-2 infection in children overlap with seasonal infectious diseases. It is difficult for children to detect symptoms like fatigue, headache and anosmia/ageusia themselves and therefore caregivers should pay attention to these signs when evaluating children with febrile illness.