292 - The Relationship between Clinical Characteristics and COVID-19 Infection in Children in an Outpatient Pediatric Center

During the COVID-19 pandemic, the US healthcare system was overwhelmed leading to hospital overcrowding and difficulty obtaining COVID-19 testing. Moreover, the most common signs and symptoms suggestive of COVID infection are shared with a wide variety of viral and bacterial infections, making diagnosis difficult without confirmed COVID-19 testing. Therefore, rapid testing in an outpatient setting holds the potential to aid in controlling pandemics such as COVID-19 by mitigating spread among individuals through early detection and diagnosis while relieving the testing burden on emergency departments and urgent care centers. 

Objective: This is a retrospective case control matched study to examine clinical characteristics of COVID-19 infection in children  < 18 years of age presenting to Florida Pediatric Group (FPG) from July, 2020 to April, 2022.

Design/Methods:

Each COVID-19 positive patient was age, gender, and time of testing matched to a patient testing negative for COVID-19. All patients presented with either symptoms and/or recent exposure. All patients testing positive for the first time at FPG using the Quidel Sofia SARS Antigen Fluorescent Immunoassay test were included. Previously COVID-19 positive patients who came for retesting were excluded. Data was analyzed by t test for continuous variables and Chi Square test for dichotomous variables.

Results:

A total of 5600 children were tested, of them 390 COVID-19 positive were matched to 390 negative patients. There was no significant difference between the groups for abdominal pain, chest discomfort, conjunctivitis, coryza, cough, decreased feeding, diarrhea, ear ache/pulling, dizziness, lethargy/weakness, rash, sore throat, vomiting, nausea, weight loss, loss of taste, and loss of smell as seen in the attached table. COVID-19 patients had significantly higher incidence of fever, myalgia, headache, and have higher exposure to COVID positive family members. COVID-19 negative patients had significantly higher wheezing, diarrhea, and asymptomatic presentation.

Conclusion(s): The wide variety of symptoms, the striking similarity between positive and negative patients, and the rapid spread of the infection, reinforces that diagnosing children suspected of COVID-19 through rapid antigen testing holds the potential to assist in controlling the pandemic by providing a fast and relatively inexpensive test in an outpatient setting. An outpatient pediatric primary care office can be effective in early diagnosis of COVID-19 infection to assist parents and the school system in rapid identification, contact tracing, and isolation of these positive patients.