Symptom clusters helping the assessment of SARS-COV-2-infected children: Amiens cohort versus European data

BACKGROUND: Since December 2019, the novel coronavirus (SARS-CoV-2) pandemic, caused >240 million cases and >5 million deaths. Given the current wider dissemination of pediatric cases, it is important to address questions regarding the clinical picture in children or if there are clinical patterns that may help us identify in an early stage what can be the prognosis and help clinicians with patient management. The study aimed to investigate in a French monocentric cohort and other European cohorts the presence of symptom clusterization and its possible connection to illness categories to help medical first-line screening and orientation in the pediatric emergency department (ED). METHODS: We conducted a retrospective cohort study describing clinical, laboratory, and radiological characteristics of SARS-CoV-2-infected children admitted to pediatric ED to assess the presence of symptom clustering. A scoping review of the literature was performed to further investigate symptom clusters. RESULTS: Of 1086 tested children, 48 tested positive to SARS-CoV-2. The clinical, laboratory, and radiological characteristics of our sample were fully described. Two distinct clusters of clinical phenotypes were identified as well as their potential association with illness categories in SARS-CoV-2-infected children. Comparison with similar European cohorts highlights how symptoms coming from the mucocutaneous-enteric, and the respiratory clusters are associated with a more severe clinical picture. CONCLUSIONS: This study promotes the importance to identify early prognostic patterns to help clinicians in the decision process, especially in COVID-19 pediatric patients.