Journal of Clinical and Diagnostic Research. 2023 Jun, Vol-17(6): SC15-SC18 15 15 DOI: 10.7860/JCDR/2023/60141.18038 Original Article Paediatrics Section Clinical Profile and Short-term Outcome of Paediatric COVID-19 in the First, Second and Third Wave of the Pandemic in India- An Observational Study SAI SWAROOP ARCHAKA 1 , ALEXANDER MANNU 2 , VINOTH GNANA CHELLAIYAN 3 INTRODUCTION The risk of COVID-19 infection is universal. Based on previous literature, there does not appear to be an age limit for COVID-19 susceptibility. According to recent research, children represent for a tiny percentage of COVID-19 occurrences as compared to adults [1,2]. Although COVID-19, Severe Acute Respiratory Syndrome (SARS), and Middle East Respiratory Disease (MERS) are all caused by a coronavirus and can cause severe respiratory distress, COVID-19 has its unique epidemiological and clinical characteristics. COVID-19 has a prolonged incubation time, high infectivity, unusual clinical signs, and a significant fatality rate in elderly adults [3,4]. According to some reports, children are at higher risk to contract SARS-CoV-2, although they had minimal symptoms and a milder sickness, as well as a lesser case-fatality rate compared to adults [5-7]. Because many of the early investigations in China were conducted in adult facilities, the number of children reported was limited [8]. The number of paediatric children infected with COVID- 19 is expected to grow rapidly, if it has not already, due to the fast global spread of SARS-CoV-2 infection [9]. The report by Max Planck Institute for Demographic Research (MPIDR) coverage database suggested that among 3.7 million deaths, over 13,400 (0.4%) were recognised in paediatrics and adolescents under 20 years of age. Specifically, the epidemiological and clinical manifestations of COVID-19 in the 0-14 years paediatric population until now are not completely described [10]. The devastating second wave of COVID-19 in India peaked during the May 2021 primary, fueled by B1 617 lineage variations, particularly the delta variant [5]. It is probable that the clinical aspects of each wave will alter based on the variants that dominate the waves [11,12]. The current research was conducted to compare the clinical manifestations and short- term aftermaths of COVID-19 in children during the first wave, second wave and third wave. MATERIALS AND METHODS The present analytical observational study was conducted in the Department of Paediatrics, Chettinad Hospital, Chennai, Tamil Nadu, India, from March 2020 to March 2022. The Institutional Ethics Committee had approved the study (IEC number: IHEC- II/0437/22). The study population included RT-PCR positive COVID-19 children between age groups from one month to 18 years age. The children with incomplete record of data were excluded. First COVID-19 wave was from March 2020 to October 2020, second wave was from April 2021 to September 2021 and third wave was from December 2021 to March 2022 [13,14]. The sample included in the first wave was 103 subjects and 90 subjects in the second wave and 98 subjects in the third wave. The data was collected regarding demographical, clinical symptoms and signs, including daily vital parameters, laboratory measurements, imaging findings, management, and outcome. All children were monitored for their vitals from admission till discharge and parameters includes temperature, heart rate, respiratory rate and Capillary Refilling Time (CRT). A complete haemogram, CRP, Keywords: Capillary refilling time, Coronavirus disease-2019, Fever, Myalgia ABSTRACT Introduction: There has been adequate evidence that children are less likely to contract the Coronavirus Disease-2019 (COVID- 19) infection and less likely to experience a deadly course of the disease in the paediatric group. The majority of the time, they exhibit moderate respiratory symptoms, like fever, dry cough and exhaustion. They were all free of COVID-19 pneumonia. Aim: To compare the clinical features and short-term outcomes of COVID-19 in children during May 2020 to April 2022. Materials and Methods: The present analytical observational study was conducted in the Department of Paediatrics, Chettinad Hospital, Chennai, Tamil Nadu, India, from March 2020 to March 2022. The study population included Reverse Transcription- Polymerase Chain Reaction (RT-PCR) positive COVID-19 children between age groups of one month and 18 years age. A sample size of 102, 90 and 98 were included from first, second and third wave, respectively. Kruskal-Wallis test and Analysis of Variance (ANOVA) test were used were used for statistical analysis. Results: In the study population, the mean age in the wave 1, wave 2 and wave 3 was 9.1±5.25 years, 9.3±4.99 years and 9.2±5.12 years, respectively. Males were more affected in all the phases than females. The most common symptoms in all the three waves were cough, myalgia and fever. Fever was the predominant symptom reported in all three waves (74.8% in wave 1, 80.6% in wave 2 and 75% in wave 3). Between the COVID- 19 waves, baseline investigations such as Alanine Transaminase (ALT) and Aspartate Transaminase (AST) (p-value=0.001, 0.02) showed significant differences. C-reactive Protein (CRP) was non reactive in (81.55%) in wave 1, (85.07%) in wave 2 and (65.3%) in wave 3. (p-value=0.029). Conclusion: The present study results conclude that the presenting features of COVID-19 in children were mild, and the outcome was good. The first, second and third waves had considerable differences in clinical findings and short-term outcomes among COVID-19-affected children.