Study design
A single-center prospective study was conducted from April 17, 2020 to
September 30, 2020. Visits occurred at Hospital das Clínicas da
Faculdade de Medicina da USP (HCFMUSP) in São Paulo, Brazil. The Ethics
Committee of our Institution approve this study and written consent
assignment was obtained from each patient before inclusion in the study.
We collected 1,566 respiratory samples from 1,044 patients younger than
18 years to assess SARS-CoV-2 infection. Of these, 919 were analyzed
further in search of other respiratory pathogens (ORP). The samples were
collected in pediatric patients with the following clinical findings:
flu-like syndrome in high-risk children (<5 years or
underlying conditions), fever without a source, severe acute respiratory
syndrome (SARS), complete or incomplete Kawasaki Disease (KD), KD shock
syndrome, MAS (macrophage-activating syndrome), gastrointestinal or
neurological signs/symptoms.(4)
We included only patients with laboratory confirmed COVID-19 or ORP. In
patients with high suspicion of COVID-19 but negative RT-PCR (real-time
reverse transcription-polymerase chain reaction), serology was collected
within 14 days of symptom onset. We excluded pre-surgical screenings or
presence of bacterial coinfection.
Patients were divided in two groups: (a) Group 1 - laboratory confirmed
pediatric COVID-19 patients without coinfection of ORP; (b) Group 2 -
other respiratory virus infections, excluding SARS-CoV-2.