Perfil das internações por Covid-19 em crianças e adolescentes no Brasil

Abstract

INTRODUCTION: COVID 19 (coronavirus disease 2019), was discovered in samples collected from patients with unknown pneumonia in the city of Wuhan, China, in late 2019. It quickly spread around the world, being declared a pandemic state by the World Health Organization (WHO) in March of the following year. In this same month, there was already community transmission of the disease throughout Brazil. It is considered an infectious disease that can cause symptoms such as fever, dry cough, fatigue, dyspnea, and some patients can also present pain, nasal congestion, headache, conjunctivitis, sore throat, loss of smell and taste, among others. In more severe cases patients can develop pneumonia and Severe Acute Respiratory Syndrome (SARS). Children and teenagers infected with the virus can in most cases present asymptomatic, mild or moderate forms of the disease, however, they are also capable of developing various clinical and severe manifestations, and deaths can occur. The lack of information and inconsistency of data when it comes to severity and comorbidities of children related to the disease, becomes a factor that hinders the detection of risk factors for complications and mortality in this age group. OBJECTIVE: To describe the profile and temporal variation of hospitalizations of children and teenagers with COVID-19 in Brazil. METHOD: This is a descriptive cross-sectional study, conducted based on data from the Department of Informatics of the Unified Health System (DATASUS), to trace the profile of hospitalizations of children and teenagers with COVID-19 in Brazil. Hospitalizations of children under the age of nine (9) years and teenagers aged ten (10) to nineteen (19) years, residing in Brazil, who tested positive for COVID-19, between March 2020 to December 2021, were analyzed. Data available at DATASUS, with information about the profile of hospitalizations of children and teenagers with COVID-19, were inserted into the study in order to bring more updated data about the profile of hospitalizations of the age group with the disease. We excluded adults (20 to 59 years) and the elderly (over 60 years), data from months after December 2021, data from other countries, and diagnoses that do not make up the profile of COVID-19. For analysis, descriptive statistics (frequency and mean) were used, and the percentage of hospitalizations and diagnoses of COVID-19 in children and adolescents was calculated. Since this is secondary and public domain data, the present study does not have ethical and moral implications because it does not present information that can identify children/adolescents hospitalized for measles in Brazil. Thus, it does not require review and approval by the Research Ethics Committee. RESULTS: During the study period (2020-2021), the records of 16,678 cases of children and teenagers hospitalized for COVID-19 according to SIVEP-Gripe were evaluated. There was a predominance in children under one year old (32.7%). In teenagers, there was a higher frequency among those aged 15 to 19 years (25%). Males were predominant in those hospitalized for the disease (51.3%), and the race/color brown had the highest percentage (62.1%). The most prominent regions were the Southeast (33.3%) and Northeast (28.5%). 8.2% of the cases died, and in the criterion for closure of the disease, the laboratory test was the most predominant (88.8%). The year with more days of hospitalization was 2020 with 8.1%, followed by 2021, with an increase in the average number of ICU days (2.5%). SARS participated in the hospitalization of children and adolescents, especially for SARS unspecified in 2020 (71.8%) of cases with hospitalizations, and in that same year there were more cases of COVID - 19 (18.2%). It is noteworthy, that in 2021 the data of hospitalizations for COVID-19 without information were the majority (99.5%). CONCLUSION: The results presented in this study will contribute to information about the profile of hospitalizations of children and adolescents for COVID-19 in Brazil. A fundamental health promotion action to control the pandemic and collective effort for the immunization of children. However, vaccine hesitancy and Fake News may delay successful vaccination strategies.