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PHENOTYPIC VARIATION IN DISEASE SEVERITY AMONG HOSPITALIZED PEDIATRIC PATIENTS WITH COVID-19: ASSESSING THE IMPACT OF COVID-19 IN THE EPICO STUDY
  • +36
  • María Camila Sossa,
  • Mónica Paola Gutiérrez,
  • Natalia Becerra,
  • Luz Yessenia Ortegon,
  • María Camila David,
  • Pablo Vasquez-Hoyos,
  • María Lucia Mesa-Rubio,
  • ALFREDO TAGARRO,
  • Juan Gabriel Piñeros,
  • Melisa Sofía Naranjo Vanegas,
  • Olga Lucía Baquero Castañeda,
  • Sonia Restrepo-Gualteros,
  • Clara Galvis,
  • Martha Africano,
  • CINTA MORALEDA,
  • Gabriela Friedrich,
  • Blanca Herrero,
  • Carlos Grasa,
  • Antoni Soriano-Arandes,
  • Luis Miguel Navarro Ramirez,
  • Sergio Moreno-Lopez,
  • Alejandro Díaz-Díaz,
  • Carlos Alvarez-Moreno,
  • Luz Marina Mejía,
  • Iván Gutierrez-Tobar,
  • Andrés Camilo Mesa,
  • William Ricardo Bachiller Tuta,
  • José Manuel Nieto,
  • Paola Marcela Pérez Camacho,
  • Claudia Beltrán-Arroyave,
  • Rosalba Vivas Trochez,
  • Irati Gastegi,
  • Paula Rodriguez-Molino,
  • Susana Melendo,
  • Irene Gómez Pastrana,
  • Sonsoles García García,
  • Victoria Fumadó,
  • Lourdes Calleja,
  • Andrea Ramirez
María Camila Sossa
Hospital Universitario de la Fundacion Santa Fe de Bogota

Corresponding Author:[email protected]

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Mónica Paola Gutiérrez
Hospital Universitario de la Fundacion Santa Fe de Bogota
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Natalia Becerra
Hospital Universitario de la Fundacion Santa Fe de Bogota
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Luz Yessenia Ortegon
Hospital Universitario de la Fundacion Santa Fe de Bogota
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María Camila David
Hospital Universitario de la Fundacion Santa Fe de Bogota
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Pablo Vasquez-Hoyos
Red colaborativa pediátrica de Latinoamérica (LaRed Network
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María Lucia Mesa-Rubio
Hospital Universitario de la Fundacion Santa Fe de Bogota
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ALFREDO TAGARRO
Hospital Universitario 12 de Octubre Centro de Investigacion Biomedica
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Juan Gabriel Piñeros
Hospital Universitario de la Fundacion Santa Fe de Bogota Bogota, CO
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Melisa Sofía Naranjo Vanegas
Universidad de los Andes Facultad de Medicina
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Olga Lucía Baquero Castañeda
Clinica Infantil Colsubsidio
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Sonia Restrepo-Gualteros
Hospital Universitario de la Fundacion Santa Fe de Bogota
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Clara Galvis
Hospital Militar Central
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Martha Africano
Universidad Industrial de Santander Facultad de Ciencias
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CINTA MORALEDA
Hospital Universitario 12 de Octubre Centro de Investigacion Biomedica
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Gabriela Friedrich
Universidad de los Andes Facultad de Medicina Santiago, CL
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Blanca Herrero
Hospital Infantil Universitario Nino Jesus Servicio de Cuidados Intensivos Pediatricos
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Carlos Grasa
Hospital Universitario La Paz Hospital Infantil
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Antoni Soriano-Arandes
Hospital Universitario Vall D´Hebron
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Luis Miguel Navarro Ramirez
Universidad de los Andes Facultad de Medicina Santiago, CL
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Sergio Moreno-Lopez
Universidad de los Andes Facultad de Medicina
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Alejandro Díaz-Díaz
Universidad Nacional de Colombia Facultad de Medicina Bogota, CO
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Carlos Alvarez-Moreno
Universidad Nacional de Colombia
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Luz Marina Mejía
Instituto de Ortopedia Infantil Roosevelt Bogota, CO 110001
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Iván Gutierrez-Tobar
Clinica Colsanitas SA Bogota, CO 111176
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Andrés Camilo Mesa
Hospital Infantil San José Bogotá, CO
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William Ricardo Bachiller Tuta
Fundación Universitaria de Ciencias de la Salud Bogota, CO
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José Manuel Nieto
Hospital Regional de la Orinoquía Yopal, CO
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Paola Marcela Pérez Camacho
Fundacion Valle del Lili Centro de Investigaciones Clinicas Cali, CO
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Claudia Beltrán-Arroyave
Universidad de Antioquia, Clínica del Rosario Medellin, CO
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Rosalba Vivas Trochez
Clínica SOMA Medellin, CO
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Irati Gastegi
Hospital Universitario 12 de Octubre Centro de Investigacion Biomedica Madrid, ES 28041
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Paula Rodriguez-Molino
Hospital Universitario La Paz
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Susana Melendo
Hospital Universitario Vall D´Hebron, Department of Pediatrics Barcelona, ES
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Irene Gómez Pastrana
Hospital Universitario 12 de Octubre Centro de Investigacion Biomedica Madrid, ES 28041
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Sonsoles García García
Hospital Universitario 12 de Octubre Centro de Investigacion Biomedica Madrid, ES 28041
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Victoria Fumadó
Hospital Universitario Sant Joan de Deu, Department of Pediatrics Barcelona, ES
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Lourdes Calleja
Hospital Infantil Universitario Nino Jesus Servicio de Cuidados Intensivos Pediatricos Madrid, ES 28009
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Andrea Ramirez
School of Medicine, Universidad de los Andes, Bogota, Colombia, FETP, Instituto Nacional de Salud, Bogota DC. Colombia
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Abstract

Background: SARS-CoV-2 infection has been extensively documented since the onset of the pandemic, particularly in the adult population. However, there is a lack of evidence describing the phenotypic manifestations of the disease in the pediatric population. We aimed to characterize the clinical phenotypes of SARS-CoV-2 infection in hospitalized children. Methods: The EPICO study is a multicenter cohort conducted between April 2020- November 2021, involving 55 institutions in Spain and 13 institutions in Colombia. Hospitalized children aged 29 days to 17 years with confirmed SARS-CoV-2 infection were included to determine the disease´s evolution, severity factors, and outcomes. Cluster analysis was conducted to characterize clinical phenotypes. Results: A total of 2318 patients from Colombian and Spanish institutions were included. The population was 55% male, with infants being the largest group (36%). Five distinct phenotype clusters emerged, differing significantly in clinical and epidemiological characteristics. Cluster 1 (26.57%) consisted of infants without comorbidities, with low PICU admission and mortality rates. Cluster 2 (18.5%) had respiratory comorbidities, high co-detection, and mortality rates. Cluster 3 (11.51%) showed fever, gastrointestinal symptoms, and high PICU admission. Cluster 4 (32.09%) had mild unspecific symptoms and low mortality. Cluster 5 (11.3%) included adolescents without comorbidities, with low co-detection and hospitalization rates. Comparable findings were observed in both countries. Conclusion: Our study successfully identified distinct patterns of clinical and epidemiological characteristics associated with SARS-CoV-2 infection in hospitalized pediatric patients. These findings may help shape future guidelines and improve risk stratification in children.