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Int J Public Health . Phenotypic Variation in Disease Severity Among Hospitalized Pediatric Patients With COVID-19: Assessing the Impact of COVID-1

tetano

Editor, Senior Moderator
Int J Public Health


. 2025 Mar 18:70:1607246.
doi: 10.3389/ijph.2025.1607246. eCollection 2025. Phenotypic Variation in Disease Severity Among Hospitalized Pediatric Patients With COVID-19: Assessing the Impact of COVID-19 in the EPICO Study

María Camila Sossa-Alarcón[SUP] #[/SUP][SUP] 1 [/SUP], Mónica Paola Gutiérrez[SUP] #[/SUP][SUP] 1 [/SUP], Natalia Becerra[SUP] #[/SUP][SUP] 1 [/SUP], Luz Yessenia Ortegon[SUP] #[/SUP][SUP] 1 [/SUP], María Camila David[SUP] #[/SUP][SUP] 1 [/SUP], Melisa Naranjo Vanegas[SUP] 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 [/SUP], Gabriela Friedrich[SUP] 2 [/SUP], Pablo Vásquez-Hoyos[SUP] 3 [/SUP], María Lucía Mesa-Rubio[SUP] 1 [/SUP], Luis Miguel Navarro-Ramirez[SUP] 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 [/SUP], Sergio Moreno-Lopez[SUP] 2 [/SUP], Olga Lucía Baquero[SUP] 4 [/SUP], Luz Marina Mejía[SUP] 5 [/SUP], Juan Gabriel Piñeros[SUP] 1 [/SUP], Sonia Restrepo-Gualteros[SUP] 1 [/SUP], Carlos Álvarez-Moreno[SUP] 6 [/SUP], Alejandro Díaz-Díaz[SUP] 7 [/SUP], Iván Gutierrez-Tobar[SUP] 8 [/SUP], Andrés Camilo Mesa[SUP] 9 [/SUP], William Ricardo Bachiller Tuta[SUP] 10 [/SUP], Clara Esperanza Galvis Diaz[SUP] 11 [/SUP], Martha Africano[SUP] 12 [/SUP], José Manuel Nieto[SUP] 13 [/SUP], Paola Marcela Pérez Camacho[SUP] 14 [/SUP], Claudia Beltrán-Arroyave[SUP] 15 [/SUP], Rosalba Vivas Trochez[SUP] 16 [/SUP], Irati Gastesi[SUP] 17 [/SUP], Cinta Moraleda[SUP] 17 [/SUP], Alfredo Tagarro García[SUP] 17 18 [/SUP], Blanca Herrero[SUP] 19 [/SUP], Lourdes Calleja[SUP] 19 [/SUP], Carlos Grasa[SUP] 20 [/SUP], Paula Rodriguez[SUP] 20 [/SUP], Susana Melendo[SUP] 21 [/SUP], Antoni Soriano-Arandes[SUP] 21 [/SUP], Irene Gómez Pastrana[SUP] 17 [/SUP], Sonsoles García García[SUP] 17 [/SUP], Victoria Fumado[SUP] 22 [/SUP], Andrea Ramírez Varela[SUP] 23 [/SUP]



Affiliations
Abstract

Objective: To characterize the clinical phenotypes of SARS-CoV-2 infection in hospitalized children as part of the EPICO multicenter cohort study.
Methods: We included hospitalized children with confirmed SARS-CoV-2 infection from Colombian and Spanish institutions to assess disease evolution and outcomes. Cluster analysis was performed to identify clinical phenotypes.
Results: A total of 2318 patients were included (55% male, 36% infants). Five phenotype clusters emerged: Cluster 1 (26.5%): infants without comorbidities, low PICU admissions and mortality; Cluster 2 (18.5%): respiratory comorbidities, high microorganism co-detection and mortality; Cluster 3 (11.5%): fever, gastrointestinal symptoms, high PICU admissions; Cluster 4 (32%): mild unspecific symptoms, low mortality; Cluster 5 (11.3%): adolescents without comorbidities, low co-detection and hospitalization rates. Findings were consistent across both countries.
Conclusion: Identifying clinical phenotypes of SARS-CoV-2 in children may improve risk stratification and guide future management strategies.

Keywords: COVID-19; SARS-CoV-2 variants; cluster analysis; inpatients; pediatrics.

 
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