Abstract

Background

Age disparities in infection rates, clinical symptoms, and death rates during the COVID-19 pandemic were evident. However, there is insufficient evidence regarding the costs and outcomes of child cases and their associated factors.

Objective

This study aimed to investigate hospitalization costs and clinical characteristics/outcomes and their associated factors in Iranian children with COVID-19.

Methods

This retrospective descriptive-analytical study included children aged ≤18 years who were infected with COVID-19 and hospitalized for more than 24 hours. Hospitalization costs and death as outcome were the primary variables. Clinical data were obtained from a COVID-19 registry system in Iran, covering the years 2020-2021. Data analysis was performed using descriptive statistics and the generalized linear models (GLM) regression by employing STATA 15 software.

Results

A total of 698 children under 18 years old were included. Fever (75.2%), dry cough (43.0%), and vomiting (36.0%) were the most common symptoms. About 5.7% of the cases resulted in death. The mean hospitalization costs per patient were $2,820. Comorbidities and intensive care unit (ICU) admissions were factors associated with death, and age, ICU admissions, and comorbidities were factors associated with cost.

Conclusion

During epidemics, due to unknown clinical features and hidden symptoms, all age groups should be considered. Early diagnostic tests should be performed to reduce the spread of the virus, ensure timely treatment, and reduce medical costs after the appearance of initial symptoms.

Keywords: COVID-19, Children, Direct medical costs, Clinical outcome.
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