Clinical characteristics of 30 children with severe acute SARS‐CoV‐2 infection

Abstract Background To describe the characteristics of pediatric patients with severe COVID‐19 in China and identify the clinical variables associated with cardiovascular involvement, severe neurological complications, and disease prognosis. Methods A retrospective surveillance study were conducted from December 1 to 31, 2022, in Guangzhou Women and Children's Medical Center. Clinical and laboratory characteristics were abstracted by medical record review and were further analyzed according to different manifestations. Results A total of 30 children (median age, 27.5 months; 36.7% female) met the criteria for the diagnosis of severe COVID‐19. The top five presented symptoms were fever, convulsions, cough, polypnea, and fatigue. Compared with shock absent patients, the cardiovascular involved patients had different laboratory features, including elevated aspartate aminotransferase (AST), lactic acid levels, and abnormalities in coagulation parameters. Higher levels of alanine aminotransferase, AST, lactic dehydrogenase, creatinine, lactic acid, and abnormal coagulant function were more common in patients with severe neurological complications and patients who died during hospitalization. Higher lymphocyte counts and serum sodium concentrations were also observed in non‐survivors. Conclusion Severe COVID‐19 pediatric patients had varied clinical characteristics. Laboratory features associated with cardiovascular involvement, severe neurological complications, and adverse outcomes may facilitate early identification of the severe patients.