Clinical Manifestations of Patients with COVID Admitted to Tertiary Hospital

Background: Although COVID-19 has affected a substantial number of pediatric patients, severe illness remains relatively uncommon, with most children responding well to supportive care. The clinical presentation in this population is heterogeneous and frequently involves non-respiratory symptoms. However, adolescents and children with underlying medical comorbidities are more susceptible to developing significant respiratory complications.
Objective: This study aimed to investigate the diversity of clinical presentations and imaging findings of COVID-19 among adolescents and children.
Patients and methods: This observational, cross-sectional investigation was carried out between November 2022 and November 2023 at Mansoura University Children’s Hospital, Mansoura, Egypt. All enrolled patients underwent a comprehensive evaluation conducted more than four weeks after their initial COVID-19 diagnosis. The assessment included a structured interview by a senior pediatrician to evaluate the presence of ongoing symptoms and their impact on daily functioning. Radiological investigations comprised echocardiography, chest CT, EEG, and brain MRI.
Results: Multisystem inflammatory syndrome in children (MIS-C) was identified in 22.2% of cases and represented the most frequent presentation of post-COVID syndrome. Other most reported symptoms included increased anxiety and worry (82.9%), fatigue (74.3%), breathlessness (68.6%), and the need to seek medical attention due to symptoms (60.0%). Other frequently reported symptoms were loss of appetite (57.1%), new-onset cough distinct from any pre-COVID cough (51.4%), and chest pain with palpitations (51.4%). Additional complaints included weak physical strength (37.1%), abdominal pain (34.3%), anosmia and headache (28.6%), altered sense of taste (25.7%), joint pain (22.9%), dizziness (17.1%), and diarrhea (11.4%). Notably, 11.4% of children reported that their symptoms had a negative impact on their school performance.
Conclusion: A significant proportion of children experienced long-term physical and neuropsychiatric sequelae following COVID-19, with radiological evidence of persistent organ involvement observed in some cases. These findings underscore the need for structured follow-up and multidisciplinary care for pediatric COVID-19 survivors.