COVID-19 in Children at the National Teaching Hospital of Cotonou: Epidemiology, Clinic, and Therapy

Objective: The description of COVID-19 in children has evolved over time. We report here its epidemiological, clinical and evolutionary aspects in a hospital setting in sub-Saharan Africa. Methods: The study was prospective cross sectional, from January 1 to June 30, 2021. It included all children from 1 month to 18 years of age, admitted to the pediatric emergency ward of the CNHU HKM of Cotonou, tested positive for SARS-CoV-2 by RT-PCR on nasopharyngeal swabs. At admission, screening of children was targeted, based on symptoms common in children with COVID-19 according to the literature. Results: A total of 93 children were screened during the period, among which 18 were positive for SARS-CoV-2. The hospital frequency was 2% (18/895). The median age was 11 months. The most common symptoms were fever, cough, and shortness of breath. Half of the children had comorbidities, including heart disease, sickle cell disease, and nephrotic syndrome. The moderate form was the most frequent with pneumonia (10/18). The severe form was present in 2 children. Malaria was associated in 2 cases. The evolution was favorable in 17 children, after a mean hospitalization time of 5.81±2.74 days. One 4-month-old infant, with suspected multisystem inflammatory syndrome (MIS-C) died. Conclusion: The evolution of COVID-19 in children is benign, but severe forms are possible. A systematic screening should be proposed to all febrile children admitted to the emergency room.