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Jiande Chen, Department of Respiratory Medicine, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Respiratory Medicine, Shanghai Children’s Medical Center Gui Zhou Hospital, Shanghai Jiao Tong University School of Medicine, Guiyang, Guizhou, ChinaFollow
Qiuyu Tang, Department of Respiration, Fujian Branch of Shanghai Children’s Medical Centre Affiliated to Shanghai Jiao Tong University School of Medicine (Fujian Children’s Hospital; Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University), Fuzhou, Fujian, China
Dong Wang, Infection Department, Fujian Branch of Shanghai Children’s Medical Centre Affiliated to Shanghai Jiao Tong University School of Medicine (Fujian Children’s Hospital; Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University), Fuzhou, Fujian, China
Shuhua Yuan, Department of Respiratory Medicine, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
Jilei Lin, Department of Respiratory Medicine, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
Fengquan He, HongHe MCH, HongHe Hani and Yi Autonomous Prefecture Maternal and Child Health Hospital, Yunnan, China
Yong Yin, Department of Respiratory Medicine, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China

Abstract

Objective: The omicron variant of coronavirus disease 2019 (COVID-19) has caused a global epidemic in 2022. Our aim was to investigate the symptom spectrum and risk factors for fever in pediatric patients with omicron infection. Methods: From April 8, 2022, to May 17, 2022, this prospective observational study included pediatric patients who attended the child-parent sections of the Fangcang shelter hospitals with laboratory-confirmed COVID-19. Patient data were collected from questionnaires. The risk factors for prolonged fever and high fever were identified by univariate and multivariate analyses. Results: In total, 1,541 pediatric patients were included. The most common symptoms associated with Omicron infection were those affecting the upper respiratory tract. However, gastrointestinal symptoms such as vomiting (11.2%) and diarrhea (7.3%), and lower respiratory symptoms such as wheeze (2.8%), polypnea (2.1%), and chest tightness (2.1%) were present in a non-negligible proportion of cases. The use of antipyretic medicine was independent risk factor for prolonged fever (odds ratio (OR) 1.475, 95% confidence interval (CI): 1.010-2.155, P=0.044) and high fever (OR 3.254, 95% CI: 2.339-4.527, P<0.001). COVID-19 vaccination (OR 0.515, 95% CI: 0.347-0.764, P=0.001) was independently associated with a decreased risk for high fever. Conclusions: In addition to upper respiratory tract infection symptoms, recognition should be given to gastrointestinal and lower respiratory symptoms caused by omicron. Antipyretic administration to manage fever in pediatric patients with the Omicron variant should be undertaken with caution. COVID-19 vaccination may help mitigate high fever.

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