tetano
Editor, Senior Moderator
Adv Clin Exp Med
. 2023 May 16.
doi: 10.17219/acem/163410. Online ahead of print. SARS-COV-2 infections in children: The role of fibrinogen in predicting diagnosis and severity: A retrospective cohort study
Gulsen Akkoc[SUP] 1 [/SUP], Ayşe Ağbaş[SUP] 2 [/SUP], Eralp Göksu[SUP] 3 [/SUP], Sevde Beyaz[SUP] 3 [/SUP], Funda Yıldız[SUP] 3 [/SUP], Elvan Bayramoğlu[SUP] 4 [/SUP], Canan Yolcu[SUP] 5 [/SUP], Senem Ayça[SUP] 6 [/SUP], Nurcihan Çalışkan Dolu[SUP] 7 [/SUP], Kamil Şahin[SUP] 3 [/SUP], Macit Koldaş[SUP] 7 [/SUP], Murat Elevli[SUP] 3 [/SUP]
Affiliations
Background: Evaluating predictors of coronavirus disease 2019 (COVID-19) and severity among children may help clinicians manage the high rate of hospital admissions for suspected cases.
Objectives: This study aimed to evaluate the demographic, clinical and laboratory characteristics of children during the pandemic, and determine the predictors of COVID-19 and moderate-to-severe disease.
Material and methods: This retrospective cohort study included all consecutive COVID-19 cases in patients aged <18 years who presented to the Pediatric Emergency Department at Haseki Training and Research Hospital (Istanbul, Turkey) between March 15 and May 1, 2020, and underwent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction (PCR) analysis of oro-nasopharyngeal swabs (n = 1137).
Results: The frequency of SARS-CoV-2 PCR positivity was 28.6%. The COVID-19 (+) group presented with sore throat, headache and myalgia significantly more frequently than the COVID-19 (-) group. Multivariate logistic regression models showed independent predictors of SARS-CoV-2 positivity as follows: age, contact history, lymphocyte count <1500/mm3, and neutrophil count <4000/mm3. In addition, higher age, neutrophil count and fibrinogen levels were independent predictors of severity. The diagnostic cutoff value for fibrinogen (370.5 mg/dL) had a sensitivity of 53.12, specificity of 83.95, positive predictive value (PPV) of 39.53, and negative predictive value (NPV) of 90.07 for predicting severity.
Conclusions: Symptomatology, whether alone or in combination with other approaches, may be an appropriate strategy to guide the diagnosis and management of COVID-19.
Keywords: COVID-19; SARS-CoV-2 PCR; children; fibrinogen; severity.
. 2023 May 16.
doi: 10.17219/acem/163410. Online ahead of print. SARS-COV-2 infections in children: The role of fibrinogen in predicting diagnosis and severity: A retrospective cohort study
Gulsen Akkoc[SUP] 1 [/SUP], Ayşe Ağbaş[SUP] 2 [/SUP], Eralp Göksu[SUP] 3 [/SUP], Sevde Beyaz[SUP] 3 [/SUP], Funda Yıldız[SUP] 3 [/SUP], Elvan Bayramoğlu[SUP] 4 [/SUP], Canan Yolcu[SUP] 5 [/SUP], Senem Ayça[SUP] 6 [/SUP], Nurcihan Çalışkan Dolu[SUP] 7 [/SUP], Kamil Şahin[SUP] 3 [/SUP], Macit Koldaş[SUP] 7 [/SUP], Murat Elevli[SUP] 3 [/SUP]
Affiliations
- PMID: 37191449
- DOI: 10.17219/acem/163410
Background: Evaluating predictors of coronavirus disease 2019 (COVID-19) and severity among children may help clinicians manage the high rate of hospital admissions for suspected cases.
Objectives: This study aimed to evaluate the demographic, clinical and laboratory characteristics of children during the pandemic, and determine the predictors of COVID-19 and moderate-to-severe disease.
Material and methods: This retrospective cohort study included all consecutive COVID-19 cases in patients aged <18 years who presented to the Pediatric Emergency Department at Haseki Training and Research Hospital (Istanbul, Turkey) between March 15 and May 1, 2020, and underwent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction (PCR) analysis of oro-nasopharyngeal swabs (n = 1137).
Results: The frequency of SARS-CoV-2 PCR positivity was 28.6%. The COVID-19 (+) group presented with sore throat, headache and myalgia significantly more frequently than the COVID-19 (-) group. Multivariate logistic regression models showed independent predictors of SARS-CoV-2 positivity as follows: age, contact history, lymphocyte count <1500/mm3, and neutrophil count <4000/mm3. In addition, higher age, neutrophil count and fibrinogen levels were independent predictors of severity. The diagnostic cutoff value for fibrinogen (370.5 mg/dL) had a sensitivity of 53.12, specificity of 83.95, positive predictive value (PPV) of 39.53, and negative predictive value (NPV) of 90.07 for predicting severity.
Conclusions: Symptomatology, whether alone or in combination with other approaches, may be an appropriate strategy to guide the diagnosis and management of COVID-19.
Keywords: COVID-19; SARS-CoV-2 PCR; children; fibrinogen; severity.