Phenotypic Variation in Disease Severity Among Hospitalized Pediatric Patients With COVID-19: Assessing the Impact of COVID-19 in the EPICO Study

Abstract

COVID-19; Inpatients; Pediatrics

COVID-19; Pacientes hospitalizados; Pediatría

COVID-19; Pacients hospitalitzats; Pediatria

Objective: To characterize the clinical phenotypes of SARS-CoV-2 infection in hospitalized children as part of the EPICO multicenter cohort study. Methods: We included hospitalized children with confirmed SARS-CoV-2 infection from Colombian and Spanish institutions to assess disease evolution and outcomes. Cluster analysis was performed to identify clinical phenotypes. Results: A total of 2318 patients were included (55% male, 36% infants). Five phenotype clusters emerged: Cluster 1 (26.5%): infants without comorbidities, low PICU admissions and mortality; Cluster 2 (18.5%): respiratory comorbidities, high microorganism co-detection and mortality; Cluster 3 (11.5%): fever, gastrointestinal symptoms, high PICU admissions; Cluster 4 (32%): mild unspecific symptoms, low mortality; Cluster 5 (11.3%): adolescents without comorbidities, low co-detection and hospitalization rates. Findings were consistent across both countries. Conclusion: Identifying clinical phenotypes of SARS-CoV-2 in children may improve risk stratification and guide future management strategies.

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This study was fund by the Pediatrics Department at the Universidad de los Andes and Fundación Santa Fe de Bogotá and Pan American Health Organization. The sponsors were not directly involved in the study, meaning that they had no role in the study design, data collection, and report writing.