# Risk Factors and Clinical Features of Deterioration in 739 COVID‐19 Affected Children Aged Under 14 Years in Zhuhai, China: A Multicenter, Retrospective Study

## TL;DR

This study analyzed 739 children with COVID-19 in China to identify risk factors and clinical features linked to disease severity.

## Contribution

The study identifies specific risk factors and clinical indicators for severe SARS-CoV-2 infection in children under 14.

## Key findings

- Fever and cough were the most common symptoms in children with SARS-CoV-2.
- Young age, underlying conditions, and certain lab markers were linked to severe infection.
- Most children improved with treatment, and no deaths were reported.

## Abstract

To retrospectively analyze the clinical characteristics of children with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection, this study involved 739 children with SARS‐CoV‐2 infection who were admitted to multiple medical institutions in Zhuhai City from December 15, 2022 to January 24, 2023. Epidemiological and clinical data were collected and analyzed using statistical methods to understand the disease characteristics. The onset and progression of SARS‐CoV‐2 infection in children were significantly associated with age distribution, basic illness, vaccination status, exposure history, and family clustering. The most common clinical symptoms were fever (91.7%) and cough (81.6%). Laboratory findings indicated elevated neutrophil count, neutrophil‐to‐lymphocyte ratio, platelet‐to‐lymphocyte ratio, prothrombin time, and procalcitonin, creatine kinase, D‐dimer, and IL‐6 levels, along with decreased lymphocyte count, platelet count, and lymphocyte‐to‐monocyte ratio. Lung computed tomography (CT) showed imaging changes strongly linked to severe infection. After receiving anti‐inflammatory, symptomatic, supportive, and antipathogen therapies, 74% of the children displayed clinical symptomatic relief, 26% of the children were cured and discharged, and there were no fatalities. In Zhuhai, children infected with SARS‐CoV‐2 commonly exhibit family‐based transmission, with fever and cough as the predominant symptoms. Factors, such as young age, basic illness, specific laboratory markers, and patchy exudative changes on lung CT scans, served as critical indicators of severe infection. Early detection and monitoring of these factors, along with timely vaccination against novel coronavirus, can mitigate disease severity and prevent progression.

Seven hundred and thirty‐nine children infected with SARS‐CoV‐2 in Zhuhai tend to have close‐contact aggregated morbidity within the family, with fever and cough as the main manifestations. Low age, underlying disease, some laboratory indicators, and patchy exudative changes on CT of the lungs are the windsocks of the severity of the infection.