Clinical outcomes of pediatric COVID-19 in a tertiary care center in Bangkok, Thailand

OBJECTIVE: To describe the clinical characteristics and outcomes of pediatric COVID-19 in Thailand, where favipiravir is the mainstay of antiviral treatment. METHODS: We conducted a hospital based observational cohort study of COVID-19 among children. The study included children (age <15 years) with confirmed positive reverse transcriptase-polymerase chain reaction for SARS-CoV-2 from nasopharyngeal swab. RESULTS: From April to July 2021, 416 cases with a median age of 7.1 (interquartile range 2.7–11.6) years were included in the study. The spectrum of disease included 82 (20%) asymptomatic, 232 (56%) mild and 102 (24%) with pneumonia. Abnormal chest x-ray findings included ground-glass opacities (46%), focal infiltrations (27%), perihilar opacities (19%), reticular infiltrations (15%) and other non-specific findings (4%). Only 12 children (3%) required oxygen support. Favipiravir was prescribed to 129 children (31%); 102 patients with pneumonia and 27 patients at risk for disease progression. Pneumonia was more common in age <3 years compared with those aged 3–<12 years (adjusted odds ratio (aOR) 0.30, 95% CI 0.17–0.52), 12–15 years (aOR 0.40, 95% CI 0.21–0.77) and in patients with comorbidities (aOR 2.36, 95% CI 1.09–5.12). CONCLUSIONS: One-fourth of pediatric COVID-19 patients had pneumonia, but few required oxygen support. Off-label use of Favipiravir in pediatric COVID-19 patients in a recent outbreak in Bangkok is reported.