Abstract
Background and Objective: Compared with adult patients infected with
severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), children
have a higher proportion of re-detectable positive (RP) in the recovery
period.The underlying risk factors remain unknown.We aimed to identify
the early risk factors for RP, and to provide a basis for early clinical
prediction and risk stratification. Methods: A retrospective analysis
was performed on all pediatric cases diagnosed with coronavirus disease
2019 (COVID-19). Results: 14 of 38 (36.8%) pediatric patients were
RP.Children have a significantly higher percentage of RP (OR[95%CI]
4.84[2.21-10.59];P=.000).Compared with control group (n=24),RP group
(n=14) had more family cluster infections
(1.59[1.1-2.3];P=.030),while age ([7.2±4.8] vs
[7.6±5.1]),and percentage of male gender (35.7% vs 45.8%), fever
(21.4% vs 45.8%),respiratory or digestive symptoms (71.4% vs 50%),
asymptom (28.6% vs 33.3%), computed tomography positive findings
(85.7% vs 83.3%) and co-infection (7.1% vs 8.3%) were statistically
nonsignificant.The laboratory data of RP group had a relatively higher
white blood cell count (WBC) (7.5[5.1-9.8] vs
4.8[4.4-7.5];P=.009) and longer plasma prothrombin time (PT)
([12.6±0.7] vs [12.1±0.5];P=.023),while neutrophil percentage
and count, lymphocyte percentage and count, hemoglobin,
platelets,erythrocyte sedimentation rate,high sensitivity C-reactive
protein, interleukin 6,procalcitonin, activated partial thromboplastin
time ([37.5±4.6] vs [34.2±5.1]; P=.057),fibrinogen,antithrombin
III and D-dimer showed no statistical difference. Conclusions:Family
cluster infection,higher WBC and longer PT are the main risk factors for
RP in the recovered COVID-19 children.Early activation of coagulation
and WBC may be involved in SARS-CoV-2 clearance.