A score system for prolonged virus shedding in pediatric patients with COVID-19

Qian Liu¹, Xiaohong Liu², Yan Zheng³, Yong Zhang¹

¹Department of Cardiology, Wuhan Women and Children Medical Care Center, Wuhan, China - ²Department of Oncology, Renmin Hospital of Wuhan University, Wuhan, China - ³Department of Respiratory, Wuhan Women and Children Medical Care Center, Wuhan, China

Introduction: To develop a risk score system for for prolonged virus clearance in pediatric patients with coronavirus disease 2019 (COVID-19).

Methods: Data were retrospective collected from hospitalized with confirmed COVID-19 in our hospital. LASSO regression analysis was applied to identify clinical features statistically related to prolonged virus shedding and then we established an score system for delayed virus clearance in pediatric patients.

Results: A total of 183 pediatric patients with confirmed COVID-19 were finally included in this study and the median duration of SARS-CoV-2 :virus shedding was 11 days (IQR, 8.0–16.0 days) with a longest one 33 days. Five factors (body mass index, serum IgA, d-dimer, time from illness onset to first medical visitation and fever) were selected by the LASSO regression analysis for the construction of the score system. The score system showed well-calibrated, clinical useful and had good discriminative ability, Moreover, patients with score ≥14 points (the best cutoff score) had a significantly delayed SARS-CoV-2 RNA clearance compared with patients with score <14 points (HR=1.870, 95%CI=1.357-2.577, P<0.0001).

Conclusions: A simple-to-use score system that uses clinical parameters was developed for prolonged virus shedding in pediatric COVID-19 patients. The score system can help physicians to evaluate the risk of transmission and guide decisions regarding isolation.