Journal Article

Phenotypic Variation in Disease Severity Among Hospitalized Pediatric Patients With COVID-19: Assessing the Impact of COVID-19 in the EPICO Study

Gutierrez-Tobar, Iván, Ramírez Varela, Andrea, García García, Sonsoles, Moreno-Lopez, Sergio, Africano, Martha, Soriano-Arandes, Antoni, Herrero, Blanca, Fumado, Victoria, Vásquez-Hoyos, Pablo, Mejía, Luz Marina, Mesa, Andrés Camilo, Calleja, Lourdes, Bachiller Tuta, William Ricardo, Becerra, Natalia, Pérez Camacho, Paola Marsela, Vivas Trochez, Rosalba, David, María Camila, Melendo, Susana, Gutiérrez, Mónica Paola, Baquero, Olga Lucía, Mesa-Rubio, María Lucía, Restrepo-Gualteros, Sonia, Álvarez-Moreno, Carlos, Galvis Diaz, Clara Esperanza, Sossa-Alarcón, María Camila, Gastesi, Irati, Piñeros, Juan Gabriel, Beltrán-Arroyave, Claudia, Friedrich, Gabriela, Tagarro García, Alfredo, Navarro-Ramirez, Luis Miguel, Ortegon, Luz Yessenia, Gómez Pastrana, Irene, Grasa, Carlos, Nieto, José Manuel, Moraleda, Cinta, Díaz-Díaz, Alejandro, Vanegas, Melisa Naranjo, Rodriguez, Paula

2025

Overview

To characterize the clinical phenotypes of SARS-CoV-2 infection in hospitalized children as part of the EPICO multicenter cohort study. We included hospitalized children with confirmed SARS-CoV-2 infection from Colombian and Spanish institutions to assess disease evolution and outcomes. Cluster analysis was performed to identify clinical phenotypes. A total of 2318 patients were included (55% male, 36% infants). Five phenotype clusters emerged: Cluster 1 (26.5%): infants without comorbidities, low PICU admissions and mortality; Cluster 2 (18.5%): respiratory comorbidities, high microorganism co-detection and mortality; Cluster 3 (11.5%): fever, gastrointestinal symptoms, high PICU admissions; Cluster 4 (32%): mild unspecific symptoms, low mortality; Cluster 5 (11.3%): adolescents without comorbidities, low co-detection and hospitalization rates. Findings were consistent across both countries. Identifying clinical phenotypes of SARS-CoV-2 in children may improve risk stratification and guide future management strategies.

• Publisher: Frontiers Media SA,Frontiers Media S.A
• Subject: Adolescent / Asymptomatic / Child / Child, Preschool / Clinical outcomes / Cluster Analysis / Clustering / Cohort analysis / Cohort Studies / Colombia - epidemiology / Comorbidity / COVID-19 / COVID-19 - epidemiology / COVID-19 - mortality / COVID-19 - physiopathology / Disease / Emergency medical care / Epidemiology / Female / Hospitalization / Hospitalization - statistics & numerical data / Humans / Illnesses / Immunoglobulins / Infant / Infections / inpatients / Literature reviews / Male / Multisystem inflammatory syndrome in children / Pediatrics / Phenotype / Population / Public Health Archive / SARS-CoV-2 / SARS-CoV-2 variants / Severe acute respiratory syndrome coronavirus 2 / Severity of Illness Index / Spain - epidemiology