The Relationship Between Age, Sex, and Comorbidities with the Degree of Coronavirus Disease 2019 (Covid-19) in Children at the Hajj Adam Malik Central General Hospital in Medan
Main Article Content
Coronavirus Disease 2019 (COVID-19) has significantly impacted various age groups, including children. The severity of COVID-19 in pediatric patients is influenced by multiple factors, such as age, gender, and the presence of comorbidities. This study analyzes the relationship between these factors and the severity of COVID-19 in children at the Haji Adam Malik Central General Hospital Medan. Using a cross-sectional analytical observational design with a retrospective approach, the study utilizes secondary data from patient medical records to assess demographic characteristics, comorbidities, and the severity of COVID-19 in pediatric cases. The research was conducted from March 2024 to July 2024, focusing on pediatric patients diagnosed with COVID-19 during the study period. The results show that there is no significant relationship between age and sex with the severity of the disease. However, comorbidities such as heart and blood vessel disorders, gastrointestinal and urinary tract diseases, and nervous system disorders were found to significantly influence the severity of COVID-19, with children having these comorbidities experiencing higher severity and mortality rates. The study emphasizes the importance of understanding the relationship between comorbidities and the severity of COVID-19 in children, offering valuable insights for healthcare providers in improving management and treatment strategies for pediatric COVID-19 patients.
Keywords:
COVID-19, Children, Age, Gender, Comorbidities, Severity, SARS-CoV-2, Pediatric Health
Ai T, Yang Z, Hou H, Zhan C, Che C, Lv W, et al. Correlation of Chest CT and RT?PCR Testing for Coronavirus Disease 2019 (COVID?19) in China: A Report of 1014 cases. Radiology. 2020;296(2):32-40
Felicia FV. Manifestasi Klinis Infeksi COVID-19 pada Anak. CDK-287. 2020;47(6):420-3.
Martin B, DeWitt PE, Russell S, Anand A, Bradwell KR, Bremer C, et al. Characteristics, Outcomes, and Severity Risk Factors Associated with SARS-CoV-2 Infection Among Children in the US National COVID Cohort Collaborative. JAMA Netw Open. 2022;5(2):2143151:1-8.
Hu B, Guo H, Zhou P, Shi ZL. Characteristics of SARS-CoV-2 and COVID-19. Nature reviews microbiology. 2021;19(3):141-54
Sari AP and Butar-Butar F. Faktor-Faktor yang berhubungan dengan kematian pasien dengan penyakit COVID-19 di RSUD Drs. H. Amri Tambunan Deli Serdang. TROPHICO. 2022:1-11.
Cucinotta D, Vanelli M. WHO declares COVID-19 a Pandemic. Acta Biomed. 2020;91(1):157–60
Pulungan AB. The COVID-19 Pandemic and Asia-Pacific Children. President of The Asia Pacific Pediatric Association. Asia Pac J Paediatr Child Health. 2020;3:1-15
American Academy of Pediatrics and Children’s Hospital Association. Children and COVID-19 : State Data Report. 2020:1-5
Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospital-Ized Patients With 2019 Novel Coronaviruseinfected Pneumonia Inwuhan, China. JAMA 2020;323(11):1061-9.
Henry BM, Benoit SW, Oliveira MHS, Hsieh WC, Benoit J, Ballout RA, et al. Laboratory Abnormalities in Children With Mild and Severe Coronavirus Disease 2019 (COVID-19): A pooled analysis and review. Clin Biochem. 2020; 81: 1–8.
Lu X, Zhang L, Du H, Zhang J, Li YY, Qu J, et al. SARS-CoV-2 Infection in Children. N Engl J Med. 2020;382:1663-5
Wang X, Fang X, Cai Z. Comorbid Chronic Diseases and Acute Organ Injuries Are Strongly Correlated With Disease Severity and Mortality Among COVID-19 Patients: A Systemic Review And Metaanalysis.2020;19:2402961
Gotzinger F, Santiago-Garcia B, Noguera-Julian A, Lanaspa M, Lancella L, Carducci FIC, et al. COVID-19 in children and adolescents in europe: A Multinational, Multicenter Cohort Study. Lancet Child Adolesc Health.2020;4(9):653-61
Shekerdemien LS, Mahmood NR, Wolfe KK, Riggs BJ, Ross CE, McKiernan CA et al. Characteristics and Outcomes of Children With Coronavirus Disease 2019 (COVID-19) Infection Admitted to US and Canadian Pediatric Intensive Care Units. JAMA Pediatr. 2020;174(9):868-73.
Hag AD, Nugraha AP, Anggy F, Damayanti F, Wibisana IKGA, Widhiani NPV, Syifa RRDM, et al. Faktor-Faktor Terkait Tinggi Keparahan Infeksi Coronavirus Disease 2019 (COVID-19): Sebuah Kajian Literatur. JIMKI. 2021;9(1):48-55.
Prastyowati A. Mengenal Karakteristik Virus SARS-CoV-2 Penyebab Penyakit COVID-19 sebagai Dasar Upaya untuk Pengembangan Obat Antivirus dan Vaksin. BioTrends. 2020;11(1):1-10.
Graff K, Smith C, Silveira L, Jung S, Curran-Hays S, Jarjour J, Carpenter L, et al. Risk Factors for Severe COVID-19 in Children. Pediatr Infect Dis J. 2021;40:137-45.
Swann OV, Holden KA, Turtle L, Pollock L, Fairfield CJ, Drake TM, Seth S, et al. Clinical Characteristics of Children and Young People Admitted to Hospital with COVID-19 in United Kingdom: Prospective Multicentre Observational Cohort Study. BMJ. 2020;370
Muharramah DH and Prihartono N. Obesity and Severity COVID-19: Literature Review Study. Jurnal Epidemiologi Kesehatan Komunitas. 2021;6(2):323-32.
Negara INAK, Budhitresna AAG, Sari NLPEK. Hubungan antara Komorbiditas dengan Derajat Keparahan Infeksi COVID-19 di Rumah Sakit Sanjiwani Gianyar. AMJ. 2022;2(1):13-20.
Shereen MA, Khan S, Kazmi A, Bashir N, Siddique R. COVID-19 Infection: Emergence, Transmission, and Characteristics of Human Coronaviruses. Journal of Advanced Research. 2020;24:91-8.
Prastyowati A. Mengenal Karakteristik Virus SARS-CoV-2 Penyebab Penyakit COVID-19 sebagai Dasar Upaya untuk Pengembangan Obat Antivirus dan Vaksin. BioTrends. 2020;11(1):1-10.
Minggu RB, Rumbajan JM, Turalaki GLA. Struktur Genom Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). Jurnal Biomedik. 2021;13(2):233-40.
Zhang L, Liu Y. Potential Interventions for Novel Corona Virus in China: A Systematic Review. J Med Virol. 2020;92 (5):479-90
Li Y, Guo F, Cao Y, Li L, Guo Y. Insight into COVID?2019 for pediatricians. Pediatr Pulmonol. 2020;55(5):1?4.
Wu Z, McGoogan JM. Characteristics of and Important Lessons From The Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of A Report of 72 314 Cases From The Chinese Center For Disease Control and Prevention. JAMA. 2020;323(13):1239–42
Korean Society of Infection Disease. Report on the Epidemiological Features of Coronavirus Disease 2019 (COVID-19) Outbreak in the Republic Korea From January 19 To March 2, 2020. J Korean Med Sci. 2020;35(10):112.
Lu X, Zhang L, Du H, Zhang J, Li YY, Qu J, et al. SARS-CoV-2 Iinfection in Children. N Engl J Med. 2020;382(17):1663?65
Dong Y, Mo X, Hu Y, Qi X, Jiang F, Jiang Z, et al. Epidemiology of COVID-19 Among Children in China,”. Pediatrics. 2020;145(6):20200702.
Xu XW, Wu XX, Jiang XG, Xu KJ, Ying LJ, Ma CL, et al. Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARS-Cov-2) outside of Wuhan, China: retrospective case series. BMJ. 2020;368:606.
Xia W, Shao J, Guo Y, Peng X, Li Z, Hu D. Clinical and CT features in pediatric patients with COVID?19 infection: different points from adults. Ped Pulmonol. 2020;55:1169–74
De Wilde AH, Snijder EJ, Kikkert M, van Hemert MJ. Host factors in coronavirus replication. Curr Top Microbiol Immunol. 2018;419:1-42.
Centers for Disease Control and Prevention. Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19). MMWR. 2020; 69:1-4
Zhu N, Zhang D, Wang W. China Novel Corona virus Investigating and Research Team. A novel corona virus from patients with pneumonia in China,2019.N Engl J Med. 2020;382(8):727-33.
Zaki AM, van Boheemen S, Bestebroer TM, Osterhaus AD, Fouchier RA. Isolation of A Novel Corona Virus From A Man With Pneumonia in Saudi Arabia. N Engl J Med. 2012;367(19):1814-20
Lu R, Zhao X, Li J. Genomic Characterisation and Epidemiology of 2019 Novel Coro Navirus: Implications For Virus Origins and Receptor Binding. Lancet. 2020;395(10224):565-74
Hoffmann M, Kleine-Weber H, Schroeder S. SARS-CoV-2 Cell Entry Depends on ACE2 and TMPRSS2 and is Blocked by A Clinically Proven Protease Inhibitor. Cell. 2020;181(2):271-80.
Sungnak W, Huang N, Bécavin C HCA Lung Biological Network. SARS-CoV-2 Entry Factors are Highly Expressed in Nasal Epithelial Cells Together With Innate Immune Genes. Natmed. 2020;26(5): 681-7
Zou X, Chen K, Zou J, Han P, Hao J, Han Z. Single-cell RNA-seq Data Analysis on the Receptor ACE2 Expression Reveals the Potential Risk of Different Human Organs Vulnerable to 2019-Ncov Infection. Front Med. 2020;14(2):185-92
Mancia G, Rea F, Ludergnani M, Apolone G, Corrao G. Renin-angiotensin-aldosterone System Blockers and the Risk of COVID-19. N Engl J Med. 2020;382(25):2431-40
Xu Z, Shi L, Wang Y. Pathological Findings of COVID-19 Associated with Acute Respiratory Distress Syndrome. Lancet Respir Med. 2020;8(4): 420-2
Tang N, Li D, Wang X, Sun Z. Abnormal Coagulation Parameters are Associated with Poor Prognosis in Patients with Novel Corona Virus Pneumonia. J Thromb Haemost. 2020;18(4):844-7.
Thachil J, Tang N, Gando S. ISTH Interim Guidance on Recognition and Management of Coagulopathy in COVID-19. J Thromb Haemost. 2020;18(5):1023-6
Klok FA, Kruip MJHA, vander Meer NJM. Incidence of Thrombotic Complications in Critically Ill ICU Patients with COVID-19. Thromb Res.2020;191: 145-147
Dashraath P, Wong JLJ, Lim MXK. Corona Virus Disease 2019 (COVID-19) Pandemic and Pregnancy. AmJ Obstet Gynecol. 2020;222(6): 521-31
Chen H, Guo J, Wang C. Clinical Characteristics and Intrauterine Vertical Transmission Potential of COVID-19 Infection in Nine Pregnant Women: A Retrospective Review of Medical Records. Lancet.2020;395(10226):809-15
Felicia FV. Manifestasi Klinis Infeksi COVID-19 pada Anak. CDK-287. 2020;47(6):420-3.
Martin B, DeWitt PE, Russell S, Anand A, Bradwell KR, Bremer C, et al. Characteristics, Outcomes, and Severity Risk Factors Associated with SARS-CoV-2 Infection Among Children in the US National COVID Cohort Collaborative. JAMA Netw Open. 2022;5(2):2143151:1-8.
Hu B, Guo H, Zhou P, Shi ZL. Characteristics of SARS-CoV-2 and COVID-19. Nature reviews microbiology. 2021;19(3):141-54
Sari AP and Butar-Butar F. Faktor-Faktor yang berhubungan dengan kematian pasien dengan penyakit COVID-19 di RSUD Drs. H. Amri Tambunan Deli Serdang. TROPHICO. 2022:1-11.
Cucinotta D, Vanelli M. WHO declares COVID-19 a Pandemic. Acta Biomed. 2020;91(1):157–60
Pulungan AB. The COVID-19 Pandemic and Asia-Pacific Children. President of The Asia Pacific Pediatric Association. Asia Pac J Paediatr Child Health. 2020;3:1-15
American Academy of Pediatrics and Children’s Hospital Association. Children and COVID-19 : State Data Report. 2020:1-5
Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospital-Ized Patients With 2019 Novel Coronaviruseinfected Pneumonia Inwuhan, China. JAMA 2020;323(11):1061-9.
Henry BM, Benoit SW, Oliveira MHS, Hsieh WC, Benoit J, Ballout RA, et al. Laboratory Abnormalities in Children With Mild and Severe Coronavirus Disease 2019 (COVID-19): A pooled analysis and review. Clin Biochem. 2020; 81: 1–8.
Lu X, Zhang L, Du H, Zhang J, Li YY, Qu J, et al. SARS-CoV-2 Infection in Children. N Engl J Med. 2020;382:1663-5
Wang X, Fang X, Cai Z. Comorbid Chronic Diseases and Acute Organ Injuries Are Strongly Correlated With Disease Severity and Mortality Among COVID-19 Patients: A Systemic Review And Metaanalysis.2020;19:2402961
Gotzinger F, Santiago-Garcia B, Noguera-Julian A, Lanaspa M, Lancella L, Carducci FIC, et al. COVID-19 in children and adolescents in europe: A Multinational, Multicenter Cohort Study. Lancet Child Adolesc Health.2020;4(9):653-61
Shekerdemien LS, Mahmood NR, Wolfe KK, Riggs BJ, Ross CE, McKiernan CA et al. Characteristics and Outcomes of Children With Coronavirus Disease 2019 (COVID-19) Infection Admitted to US and Canadian Pediatric Intensive Care Units. JAMA Pediatr. 2020;174(9):868-73.
Hag AD, Nugraha AP, Anggy F, Damayanti F, Wibisana IKGA, Widhiani NPV, Syifa RRDM, et al. Faktor-Faktor Terkait Tinggi Keparahan Infeksi Coronavirus Disease 2019 (COVID-19): Sebuah Kajian Literatur. JIMKI. 2021;9(1):48-55.
Prastyowati A. Mengenal Karakteristik Virus SARS-CoV-2 Penyebab Penyakit COVID-19 sebagai Dasar Upaya untuk Pengembangan Obat Antivirus dan Vaksin. BioTrends. 2020;11(1):1-10.
Graff K, Smith C, Silveira L, Jung S, Curran-Hays S, Jarjour J, Carpenter L, et al. Risk Factors for Severe COVID-19 in Children. Pediatr Infect Dis J. 2021;40:137-45.
Swann OV, Holden KA, Turtle L, Pollock L, Fairfield CJ, Drake TM, Seth S, et al. Clinical Characteristics of Children and Young People Admitted to Hospital with COVID-19 in United Kingdom: Prospective Multicentre Observational Cohort Study. BMJ. 2020;370
Muharramah DH and Prihartono N. Obesity and Severity COVID-19: Literature Review Study. Jurnal Epidemiologi Kesehatan Komunitas. 2021;6(2):323-32.
Negara INAK, Budhitresna AAG, Sari NLPEK. Hubungan antara Komorbiditas dengan Derajat Keparahan Infeksi COVID-19 di Rumah Sakit Sanjiwani Gianyar. AMJ. 2022;2(1):13-20.
Shereen MA, Khan S, Kazmi A, Bashir N, Siddique R. COVID-19 Infection: Emergence, Transmission, and Characteristics of Human Coronaviruses. Journal of Advanced Research. 2020;24:91-8.
Prastyowati A. Mengenal Karakteristik Virus SARS-CoV-2 Penyebab Penyakit COVID-19 sebagai Dasar Upaya untuk Pengembangan Obat Antivirus dan Vaksin. BioTrends. 2020;11(1):1-10.
Minggu RB, Rumbajan JM, Turalaki GLA. Struktur Genom Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). Jurnal Biomedik. 2021;13(2):233-40.
Zhang L, Liu Y. Potential Interventions for Novel Corona Virus in China: A Systematic Review. J Med Virol. 2020;92 (5):479-90
Li Y, Guo F, Cao Y, Li L, Guo Y. Insight into COVID?2019 for pediatricians. Pediatr Pulmonol. 2020;55(5):1?4.
Wu Z, McGoogan JM. Characteristics of and Important Lessons From The Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of A Report of 72 314 Cases From The Chinese Center For Disease Control and Prevention. JAMA. 2020;323(13):1239–42
Korean Society of Infection Disease. Report on the Epidemiological Features of Coronavirus Disease 2019 (COVID-19) Outbreak in the Republic Korea From January 19 To March 2, 2020. J Korean Med Sci. 2020;35(10):112.
Lu X, Zhang L, Du H, Zhang J, Li YY, Qu J, et al. SARS-CoV-2 Iinfection in Children. N Engl J Med. 2020;382(17):1663?65
Dong Y, Mo X, Hu Y, Qi X, Jiang F, Jiang Z, et al. Epidemiology of COVID-19 Among Children in China,”. Pediatrics. 2020;145(6):20200702.
Xu XW, Wu XX, Jiang XG, Xu KJ, Ying LJ, Ma CL, et al. Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARS-Cov-2) outside of Wuhan, China: retrospective case series. BMJ. 2020;368:606.
Xia W, Shao J, Guo Y, Peng X, Li Z, Hu D. Clinical and CT features in pediatric patients with COVID?19 infection: different points from adults. Ped Pulmonol. 2020;55:1169–74
De Wilde AH, Snijder EJ, Kikkert M, van Hemert MJ. Host factors in coronavirus replication. Curr Top Microbiol Immunol. 2018;419:1-42.
Centers for Disease Control and Prevention. Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19). MMWR. 2020; 69:1-4
Zhu N, Zhang D, Wang W. China Novel Corona virus Investigating and Research Team. A novel corona virus from patients with pneumonia in China,2019.N Engl J Med. 2020;382(8):727-33.
Zaki AM, van Boheemen S, Bestebroer TM, Osterhaus AD, Fouchier RA. Isolation of A Novel Corona Virus From A Man With Pneumonia in Saudi Arabia. N Engl J Med. 2012;367(19):1814-20
Lu R, Zhao X, Li J. Genomic Characterisation and Epidemiology of 2019 Novel Coro Navirus: Implications For Virus Origins and Receptor Binding. Lancet. 2020;395(10224):565-74
Hoffmann M, Kleine-Weber H, Schroeder S. SARS-CoV-2 Cell Entry Depends on ACE2 and TMPRSS2 and is Blocked by A Clinically Proven Protease Inhibitor. Cell. 2020;181(2):271-80.
Sungnak W, Huang N, Bécavin C HCA Lung Biological Network. SARS-CoV-2 Entry Factors are Highly Expressed in Nasal Epithelial Cells Together With Innate Immune Genes. Natmed. 2020;26(5): 681-7
Zou X, Chen K, Zou J, Han P, Hao J, Han Z. Single-cell RNA-seq Data Analysis on the Receptor ACE2 Expression Reveals the Potential Risk of Different Human Organs Vulnerable to 2019-Ncov Infection. Front Med. 2020;14(2):185-92
Mancia G, Rea F, Ludergnani M, Apolone G, Corrao G. Renin-angiotensin-aldosterone System Blockers and the Risk of COVID-19. N Engl J Med. 2020;382(25):2431-40
Xu Z, Shi L, Wang Y. Pathological Findings of COVID-19 Associated with Acute Respiratory Distress Syndrome. Lancet Respir Med. 2020;8(4): 420-2
Tang N, Li D, Wang X, Sun Z. Abnormal Coagulation Parameters are Associated with Poor Prognosis in Patients with Novel Corona Virus Pneumonia. J Thromb Haemost. 2020;18(4):844-7.
Thachil J, Tang N, Gando S. ISTH Interim Guidance on Recognition and Management of Coagulopathy in COVID-19. J Thromb Haemost. 2020;18(5):1023-6
Klok FA, Kruip MJHA, vander Meer NJM. Incidence of Thrombotic Complications in Critically Ill ICU Patients with COVID-19. Thromb Res.2020;191: 145-147
Dashraath P, Wong JLJ, Lim MXK. Corona Virus Disease 2019 (COVID-19) Pandemic and Pregnancy. AmJ Obstet Gynecol. 2020;222(6): 521-31
Chen H, Guo J, Wang C. Clinical Characteristics and Intrauterine Vertical Transmission Potential of COVID-19 Infection in Nine Pregnant Women: A Retrospective Review of Medical Records. Lancet.2020;395(10226):809-15
