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Compared to adults, children with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have predominantly mild or asymptomatic infections, but the underlying immunological differences remain unclear. Here, we describe clinical features, virology, longitudinal cellular, and cytokine immune profile, SARS-CoV-2-specific serology and salivary antibody responses in a family of two parents with PCR-confirmed symptomatic SARS-CoV-2 infection and their three children, who tested repeatedly SARS-CoV-2 PCR negative. Cellular immune profiles and cytokine responses of all children are similar to their parents at all timepoints. All family members have salivary anti-SARS-CoV-2 antibodies detected, predominantly IgA, that coincide with symptom resolution in 3 of 4 symptomatic members. Plasma from both parents and one child have IgG antibody against the S1 protein and virus-neutralizing activity detected. Using a systems serology approach, we demonstrate higher levels of SARS-CoV-2-specific antibody features of these family members compared to healthy controls. These data indicate that children can mount an immune response to SARS-CoV-2 without virological confirmation of infection, raising the possibility that immunity in children can prevent the establishment of SARS-CoV-2 infection. Relying on routine virological and serological testing may not identify exposed children, with implications for epidemiological and clinical studies across the life-span.

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Studies conducted prior to 17 June 2013 were reviewed. We included 10 studies in the analysis, involving a total of 1106 children. When isotonic fluids were used, the sodium level in the body was less likely to be low. One hundred and sixty-nine children per 1000 had low sodium levels in the blood when an isotonic fluid was given, compared with 338 children per 1000 when a hypotonic fluid was used. The results for serious adverse events associated with isotonic or hypotonic fluids were uncertain. This review mainly looked at patients who either had surgery and/or were in intensive care, with most only needing intravenous fluid for less than a day. Quality of the evidence The studies included were generally well conducted and were of a high quality. Isotonic versus hypotonic solutions for maintenance intravenous fluid administration in children (Review)

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IMPORTANCEThe immune response in children with SARS-CoV-2 infection is not well understood. OBJECTIVE To compare seroconversion in nonhospitalized children and adults with mild SARS-CoV-2 infection and identify factors that are associated with seroconversion. DESIGN, SETTING, AND PARTICIPANTSThis household cohort study of SARS-CoV-2 infection collected weekly nasopharyngeal and throat swabs and blood samples during the acute (median, 7 days for children and 12 days for adults [IQR,[4][5][6][7][8][9][10][11][12][13] days) and convalescent (median, 41 [IQR,(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49) days) periods after polymerase chain reaction (PCR) diagnosis for analysis. Participants were

To compare the incidence of hyponatraemia related to isotonic versus hypotonic intravenous fluid administration for maintenance purposes in children and secondarily to assess the change in baseline sodium, rate of hypernatraemia and attributable adverse effects of both fluid types in children. Isotonic versus hypotonic solutions for maintenance intravenous fluid administration in children (Protocol)

Objective: International studies describing COVID-19 in children have shown low proportions of paediatric cases and generally a mild clinical course. We aimed to present early data on children tested for SARS-CoV-2 at a large Australian tertiary children's hospital according to the state health department guidelines, which varied over time. Methods: We conducted a retrospective cohort study at The Royal Children's Hospital, Melbourne, Australia. It included all paediatric patients (aged 0-18 years) who presented to the ED or the Respiratory Infection Clinic (RIC) and were tested for SARS-CoV-2. The 30-day study period commenced after the first confirmed positive case was detected at the hospital on 21 March 2020, until 19 April 2020. We recorded epidemiological and clinical data. Results: There were 433 patients in whom SARS-CoV-2 testing was performed in ED (331 [76%]) or RIC (102 [24%]). There were four (0.9%) who had positive SARS-CoV-2 detected, none of whom were admitted to hospital or developed severe disease. Of these SARS-CoV-2 positive patients, 1/4 (25%) had a comorbidity, which was asthma. Of the SARS-CoV-2 negative patients, 196/429 (46%) had comorbidities. Risk factors for COVID-19 were identified in 4/4 SARS-CoV-2 positive patients and 47/429 (11%) SARS-CoV-2 negative patients. Conclusion: Our study identified a very low rate of SARS-CoV-2 positive cases in children presenting to a tertiary ED or RIC, none of whom were admitted to hospital. A high proportion of patients who were SARS-CoV-2 negative had comorbidities.