3.4 Clinical presentation of COVID-19 patients
Young patients underwent confirmatory tests for COVID-19 disease by either reverse transcription-polymerase chain reaction (RT-PCR) of nasopharyngeal swab (proportion = 46.5%, 95%CI: 12.9%-80.1%) or anti-SARS-COV-2 IgG analysis (proportion = 69.6%, 95%CI: 48.9%-90.2%) (Table 2B). For the six clinical criteria of Kawasaki disease, fever (proportion = 82.4%, 95%CI: 69.8%-95.1%) and polymorphous maculopapular exanthema (proportion = 63.7%, 95%CI: 53.8%-73.5%) were the most frequent principal features, followed by changes of lips and oral cavity (proportion = 58.1%, 95%CI: 38.6%-77.6%) and bilateral non-purulent conjunctival congestion (proportion = 56.0%, 95%CI: 40.0%-71.9%). Changes of peripheral extremities (proportion = 40.7%, 95%CI: 12.9%-68.5%) and acute non-purulent cervical lymphadenopathy (proportion = 28.5%, 95%CI: 13.9%-43.1%) were the least presenting features (Table 2C). Children presented more often with gastrointestinal symptoms including abdominal pain, nausea, and diarrhea (proportion = 79.4%, 95%CI: 68.1%-90.7%) and shock (proportion = 68.1%, 95%CI: 51.9%-84.3%). Neurocognitive symptoms as headache, irritability, lethargy, or visual change were reported in 31.8% of patients (95%CI: 21.9%-41.8%), while the prevalence of respiratory symptoms as cough and dyspnea accounted for 29.6% (95%CI: 19.6%-39.6%) (Table 2D). Obesity (proportion = 26.0%, 95%CI: 7.1%-44.9%) and asthma (proportion = 14.6%, 95%CI: 6.9%-22.2%) were two comorbid conditions reported in pediatric cases presented with Kawasaki-like features (Table 2E). Abnormal Chest X-ray was observed in 45.5% (95%CI: 24.9%-66.0%), while ECG abnormalities was found in 55.3% of patients (95%CI: 45.1%-65.6%) (Table 2F). Apart of studies reporting ECG findings and asthma, there was evidence of considerable heterogeneity across studies.