563 - Characterization of Pediatric Patients Presenting for COVID-19 Testing in an Outpatient Setting

Poster Number: 563
Publication Number: 563.240

Anoosha Kasanagottu, St. Christopher's Hospital for Children, Philadelphia, PA, United States; Brian Novi, St. Christopher's Hospital for Children, Philadelphia, PA, United States; Uma Raman, St. Christopher's Hospital for Children, Philadelphia, PA, United States; Morgan Sutter, St. Christopher's Hospital for Children, Philadelphia, PA, United States; Brandon M. Blount, St. Christopher's Hospital for Children, Philadelphia, PA, United States; Kelly Courts, St. Christopher's Hospital, Philadelphia, PA, United States; Eric D. Thompson, St. Christopher's Hospital for Children, Philadelphia, PA, United States; Rita P. Guevara, St. Christopher's Hospital for Children, Philadelphia, PA, United States; Vanessa Durand, St. Chr, Philadelphia, PA, United States; Renee Turchi, St. Christopher's Hospital for Children, Philadelphia, PA, United States; Emily Souder, St Christopher's Hospital for Children, Philadelphia, PA, United States; Hans B. Kersten, St. Christopher's Hospital for Children, Philadelphia, PA, United States

Background: Despite the large number of pediatric patients presenting with concern for COVID-19 infection and requesting testing, there is still a need for research describing pediatric symptomatology, which is often milder, and more variable than adults.

Objective: Characterize the symptoms and risk factors of patients presenting to an outpatient urban pediatric clinic to inform decision-making algorithms for pediatric COVID-19 testing.

Design/Methods: Retrospective chart review of 349 children who presented to St. Christopher’s Hospital for Children’s for screening or testing for COVID-19 between March and December of 2020 were included. Demographic data (including race, ethnicity, and language), reason for testing, symptoms, and SARS-CoV-2 PCR results were extracted both electronically and via manual chart review into a REDCap database. Frequency data was obtained and analyzed utilizing SPSS and Excel for analysis.

Results: Of the 349 charts reviewed, 22.6% of subjects tested positive for COVID-19. The most common etiologies for testing included: positive exposure (66.5%), cough (19.5%), pre-operative screenings (9.2%), fever (8.6%), daycare requirements (5.7%), and travel (3.2%). The most common site of exposure was households (37.8%). Of COVID-19 positive subjects; 78.2% had known exposure, 60.3% symptomatic; the most common symptoms cough (38%), fever (19%), rhinorrhea (17.7%) and congestion (17.7%). Of COVID-19 negative subjects, 46.8% were symptomatic. Cough (p=0.03), lack of taste or smell (p < 0.01), chills (p=0.04), and headache (p < 0.01) were associated with a positive COVID-19 test, while rhinorrhea, sore throat, abdominal pain and fever were not associated with a positive or negative test (p >0.05). Home exposure (p < 0.01) and school exposure (p=0.02) were associated with a negative result.  Of those exposed, 25% were positive while those who were symptomatic, 29% were positive. There was no statistically significant difference between rates of positivity, rates of exposure, reasons for testing, or symptomatology when subgroups were compared by language or by race ( >0.05).Conclusion(s): COVID-19 positivity in an urban pediatric sample was not associated with being symptomatic, or having a home or school exposure. Cough, lack of taste and smell, headache, and chills were most strongly associated with COVID-19 positivity, though not the most prevalent symptoms in COVID-positive patients. This data confirms variability in presentations of COVID-19 infection, thus requiring physicians to maintain a high index of suspicion. Further review could further inform decision making.
Anoosha Kasanagottu CVAnoosha Kasanagottu_CV.pdf