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\begin{document}

\title{PHENOTYPIC VARIATION IN DISEASE SEVERITY AMONG HOSPITALIZED PEDIATRIC
PATIENTS WITH COVID-19: ASSESSING THE IMPACT OF COVID-19 IN THE EPICO
STUDY}



\author[1]{María Camila Sossa}%
\author[1]{Mónica Paola Gutiérrez}%
\author[1]{Natalia Becerra}%
\author[1]{Luz Yessenia Ortegon}%
\author[1]{María Camila David}%
\author[2]{Pablo Vasquez-Hoyos}%
\author[1]{María Lucia Mesa-Rubio}%
\author[3]{ALFREDO TAGARRO}%
\author[4]{Juan Gabriel Piñeros}%
\author[5]{Melisa Sofía Naranjo Vanegas}%
\author[6]{Olga Lucía Baquero Castañeda}%
\author[1]{Sonia Restrepo-Gualteros}%
\author[7]{Clara  Galvis}%
\author[8]{Martha Africano}%
\author[3]{CINTA MORALEDA}%
\author[9]{Gabriela Friedrich}%
\author[10]{Blanca Herrero}%
\author[11]{Carlos Grasa}%
\author[12]{Antoni Soriano-Arandes}%
\author[9]{Luis Miguel Navarro Ramirez}%
\author[5]{Sergio Moreno-Lopez}%
\author[13]{Alejandro Díaz-Díaz}%
\author[14]{Carlos Alvarez-Moreno}%
\author[15]{Luz Marina Mejía}%
\author[16]{Iván Gutierrez-Tobar}%
\author[17]{Andrés Camilo Mesa}%
\author[18]{William Ricardo Bachiller Tuta}%
\author[19]{José Manuel Nieto}%
\author[20]{Paola Marcela Pérez Camacho}%
\author[21]{Claudia Beltrán-Arroyave}%
\author[22]{Rosalba Vivas Trochez}%
\author[23]{Irati Gastegi}%
\author[24]{Paula Rodriguez-Molino}%
\author[25]{Susana Melendo}%
\author[23]{Irene Gómez Pastrana}%
\author[23]{Sonsoles García García}%
\author[26]{Victoria Fumadó}%
\author[27]{Lourdes Calleja}%
\author[28,29]{Andrea Ramirez}%
\affil[1]{Hospital Universitario de la Fundacion Santa Fe de Bogota}%
\affil[2]{Red colaborativa pediátrica de Latinoamérica (LaRed Network}%
\affil[3]{Hospital Universitario 12 de Octubre Centro de Investigacion Biomedica}%
\affil[4]{Hospital Universitario de la Fundacion Santa Fe de Bogota Bogota, CO}%
\affil[5]{Universidad de los Andes Facultad de Medicina}%
\affil[6]{Clinica Infantil Colsubsidio}%
\affil[7]{Hospital Militar Central}%
\affil[8]{Universidad Industrial de Santander Facultad de Ciencias}%
\affil[9]{Universidad de los Andes Facultad de Medicina Santiago, CL}%
\affil[10]{Hospital Infantil Universitario Nino Jesus Servicio de Cuidados Intensivos Pediatricos}%
\affil[11]{Hospital Universitario La Paz Hospital Infantil}%
\affil[12]{Hospital Universitario Vall D´Hebron}%
\affil[13]{Universidad Nacional de Colombia Facultad de Medicina Bogota, CO}%
\affil[14]{Universidad Nacional de Colombia}%
\affil[15]{Instituto de Ortopedia Infantil Roosevelt Bogota, CO 110001}%
\affil[16]{Clinica Colsanitas SA Bogota, CO 111176}%
\affil[17]{Hospital Infantil San José Bogotá, CO}%
\affil[18]{Fundación Universitaria de Ciencias de la Salud Bogota, CO}%
\affil[19]{Hospital Regional de la Orinoquía Yopal, CO}%
\affil[20]{Fundacion Valle del Lili Centro de Investigaciones Clinicas Cali, CO}%
\affil[21]{Universidad de Antioquia, Clínica del Rosario Medellin, CO}%
\affil[22]{Clínica SOMA Medellin, CO}%
\affil[23]{Hospital Universitario 12 de Octubre Centro de Investigacion Biomedica Madrid, ES 28041}%
\affil[24]{Hospital Universitario La Paz}%
\affil[25]{Hospital Universitario Vall D´Hebron, Department of Pediatrics Barcelona, ES}%
\affil[26]{Hospital Universitario Sant Joan de Deu, Department of Pediatrics Barcelona, ES}%
\affil[27]{Hospital Infantil Universitario Nino Jesus Servicio de Cuidados Intensivos Pediatricos Madrid, ES 28009}%
\affil[28]{School of Medicine, Universidad de los Andes, Bogota, Colombia}%
\affil[29]{FETP, Instituto Nacional de Salud, Bogota DC. Colombia}%


\vspace{-1em}



  
  \date{June 18, 2024}


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\selectlanguage{english}
\begin{abstract}
\textbf{Background:} SARS-CoV-2 infection has been extensively
documented since the onset of the pandemic, particularly in the adult
population. However, there is a lack of evidence describing the
phenotypic manifestations of the disease in the pediatric population. We
aimed to characterize the clinical phenotypes of SARS-CoV-2 infection in
hospitalized children. \textbf{Methods:} The EPICO study is a
multicenter cohort conducted between April 2020- November 2021,
involving 55 institutions in Spain and 13 institutions in Colombia.
Hospitalized children aged 29 days to 17 years with confirmed SARS-CoV-2
infection were included to determine the disease\selectlanguage{ngerman}´s evolution, severity
factors, and outcomes. Cluster analysis was conducted to characterize
clinical phenotypes. \textbf{Results:} A total of 2318 patients from
Colombian and Spanish institutions were included. The population was
55\% male, with infants being the largest group (36\%). Five distinct
phenotype clusters emerged, differing significantly in clinical and
epidemiological characteristics. Cluster 1 (26.57\%) consisted of
infants without comorbidities, with low PICU admission and mortality
rates. Cluster 2 (18.5\%) had respiratory comorbidities, high
co-detection, and mortality rates. Cluster 3 (11.51\%) showed fever,
gastrointestinal symptoms, and high PICU admission. Cluster 4 (32.09\%)
had mild unspecific symptoms and low mortality. Cluster 5 (11.3\%)
included adolescents without comorbidities, with low co-detection and
hospitalization rates. Comparable findings were observed in both
countries. \textbf{Conclusion:} Our study successfully identified
distinct patterns of clinical and epidemiological characteristics
associated with SARS-CoV-2 infection in hospitalized pediatric patients.
These findings may help shape future guidelines and improve risk
stratification in children.%
\end{abstract}\selectlanguage{ngerman}%



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