Phenotypic Variation in Disease Severity Among Hospitalized Pediatric Patients With COVID-19: Assessing the Impact of COVID-19 in the EPICO Study.

IF 2.4 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH International Journal of Public Health Pub Date : 2025-03-18 eCollection Date: 2025-01-01 DOI:10.3389/ijph.2025.1607246

María Camila Sossa-Alarcón, Mónica Paola Gutiérrez, Natalia Becerra, Luz Yessenia Ortegon, María Camila David, Melisa Naranjo Vanegas, Gabriela Friedrich, Pablo Vásquez-Hoyos, María Lucía Mesa-Rubio, Luis Miguel Navarro-Ramirez, Sergio Moreno-Lopez, Olga Lucía Baquero, Luz Marina Mejía, Juan Gabriel Piñeros, Sonia Restrepo-Gualteros, Carlos Álvarez-Moreno, Alejandro Díaz-Díaz, Iván Gutierrez-Tobar, Andrés Camilo Mesa, William Ricardo Bachiller Tuta, Clara Esperanza Galvis Diaz, Martha Africano, José Manuel Nieto, Paola Marsela Pérez Camacho, Claudia Beltrán-Arroyave, Rosalba Vivas Trochez, Irati Gastesi, Cinta Moraleda, Alfredo Tagarro García, Blanca Herrero, Lourdes Calleja, Carlos Grasa, Paula Rodriguez, Susana Melendo, Antoni Soriano-Arandes, Irene Gómez Pastrana, Sonsoles García García, Victoria Fumado, Andrea Ramírez Varela

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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.

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住院小儿COVID-19患者疾病严重程度的表型变异：在EPICO研究中评估COVID-19的影响

目的：作为EPICO多中心队列研究的一部分，探讨住院儿童SARS-CoV-2感染的临床表型。方法：我们纳入了来自哥伦比亚和西班牙机构的确诊SARS-CoV-2感染的住院儿童，以评估疾病演变和结局。进行聚类分析以确定临床表型。结果：共纳入2318例患者（男性55%，婴幼儿36%）。出现了5个表型集群：集群1(26.5%)：无合并症的婴儿，PICU入院率和死亡率低；第2组（18.5%）：呼吸道合并症、高微生物共检率和死亡率；群集3(11.5%)：发热、胃肠道症状、PICU高住院率；第4组（32%）：轻度非特异性症状，低死亡率；第5组（11.3%）：青少年无合并症，低共检率和住院率。两国的调查结果是一致的。结论：明确儿童SARS-CoV-2的临床表型可改善风险分层，指导未来的治疗策略。

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来源期刊

International Journal of Public Health 医学-公共卫生、环境卫生与职业卫生

CiteScore

4.20

自引率

2.20%

发文量

269

审稿时长

12 months

期刊介绍： The International Journal of Public Health publishes scientific articles relevant to global public health, from different countries and cultures, and assembles them into issues that raise awareness and understanding of public health problems and solutions. The Journal welcomes submissions of original research, critical and relevant reviews, methodological papers and manuscripts that emphasize theoretical content. IJPH sometimes publishes commentaries and opinions. Special issues highlight key areas of current research. The Editorial Board''s mission is to provide a thoughtful forum for contemporary issues and challenges in global public health research and practice.