The intriguing features of COVID-19 in children and its impact on the pandemic

Sáfadi, Marco Aurélio Palazzi

doi:10.1016/j.jped.2020.04.001

Cited by 70 publications

(79 citation statements)

References 28 publications

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“…After a few months of the virus disseminating around the world, official epidemiological data from the infected countries were published, as well as literature reports from medical teams in charge of COVID-19 patients. Even though there are only a few explanations for this observation to date, it rapidly became evident that the proportion of infected children, either symptomatic or not, was dramatically lower than that of adults [ 2 ]. Moreover, children harbored far less severe forms of the disease [ 3 , 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

The Wide Spectrum of COVID-19 Clinical Presentation in Children

Nathan

Prévost

Sileo

et al. 2020

JCM

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Background: Ten months after its appearance in December 2019, SARS-CoV-2 has infected more than 25 million patients worldwide. Because children were first identified as potential spreaders of the virus, schools were closed in several countries. However, it rapidly became evident that the number of hospitalized children infected by SARS-CoV-2 was dramatically lower than that of adults. To date, only hypotheses have been raised to explain this difference, so it is of great importance to describe the presentation of this disease among children. Here, we describe a wide spectrum of COVID-19 manifestation in children in a dedicated pediatric unit in France. Methods: Patients hospitalized with COVID-19 who were diagnosed on the basis of either positive SARS-CoV-2 RT-PCR in nasopharyngeal swabs and/or typical aspects in chest-computed tomography (CT) were included between March and May 2020 in Paris. Results: Twenty-three patients were included on the basis of positive RT-PCR (n = 20) and/or typical aspects in CT (n = 4). The median age was 4.9 years [0.1–17.6]. Patients were grouped by age (<2 years old: n = 14, 61%; 2–10 years old: n = 2, 9%; >10 years old: n = 7, 30%). Overweight or obesity was reported in only three patients. At presentation, the most frequent symptom in the overall cohort was fever (n = 18, 78%), followed by acute rhinitis (n = 9, 64%) and cough (n = 7, 50%) in the under 2-year-old group and cough (n = 4, 57%), fatigue, dyspnea and abdominal pain (n = 3, 43% each) in the over 10-year-old group. Five patients required ICU treatment, four of whom were aged >10 years, two presented with acute myocarditis, and two were sickle cell disease patients who presented with acute chest syndrome. Discussion and conclusion: The youngest patients seem to present milder forms of COVID-19 without the need for ICU treatment and with a shorter length of hospitalization. More severe evolutions were observed in teenagers, with, however, favorable outcomes. Given the context of closed schools and confinement, the infection of these children suggests intra-familial transmission that needs to be further assessed. This description might help to understand the intriguing differences in COVID-19 severity across age-classes.

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Section: Introductionmentioning

confidence: 99%

The Wide Spectrum of COVID-19 Clinical Presentation in Children

Nathan

Prévost

Sileo

et al. 2020

JCM

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“…However, some studies suggest that incubation may take up to 24 days, which is higher than the WHO statistics. The number of reproductions (R0) for SARS-CoV-2 is estimated by current studies between 2 and 3, indicating that the epidemic potential of this disease is higher than SARS with R0 = 0.8 and MERS with R0 = 0.69 [24], [25], [26]. Recent data suggest that COVID-19 has a mortality rate of between 2.3 and 3 [18], [27].…”

Section: Epidemiologymentioning

confidence: 95%

“…Recent data suggest that COVID-19 has a mortality rate of between 2.3 and 3 [18], [27]. We need to be careful in calculating the case fatality rate of COVID-19 (currently at a global rate of up to 5%), authenticating that these rates will be lower after setting the denominator to reflect the exact number of individuals who acquired the infection [26].…”

Section: Epidemiologymentioning

confidence: 99%

COVID-19 in Children: A Narrative Review

Razavi

Davoodi

Shojaei

et al. 2020

Open Access Maced J Med Sci

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BACKGROUND: In December 2019, coronavirus (CoV) disease 2019 (COVID-19) was detected in Wuhan, China, which is known as severe acute respiratory syndrome CoV 2 (Severe acute respiratory syndrome [SARS]-CoV-2). AIM: This study attempted a narrative review of the researches about COVID-19 in children. METHODS: We searched all articles between 2000 and April 2020 in PubMed, Scopus, and ScienceDirect related to COVID-19 in children, using the following terms: “COVID-19,” “coronavirus,” “SARS-CoV-2” in combination with “pediatrics,” or “children.” RESULTS: The most common method of transmitting the disease to children was through close contact with family members through respiratory droplets. Coinfection is common in pediatric with COVID-19 infection. One of the most important transmission routes is oral feces. The severity of the disease was mild or asymptomatic in most children. The most common clinical symptoms were fever and cough, and gastrointestinal symptoms were more common in children than in adults. Infants and preschoolers had more severe clinical symptoms than older children. The most common radiographic findings from the lungs were bilateral ground-glass opacity. Increased procalcitonin and lactate dehydrogenase should be considered in children. The use of intravenous immunoglobulin, lopinavir/ritonavir, and oseltamivir, along with oxygen therapy, had the greatest effect on improving children’s conditions. CONCLUSIONS: The most important way to prevent this disease in children is to follow the health tips of family members. Although the number of children with the disease is low, children are vulnerable to infection. Antiviral medications along with the use of muscle relaxants and oxygen therapy have a great impact on children’s condition.

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“…Fortunately, children have a predominantly benign course, with mild symptoms or even no symptoms, and there is almost no reported mortality (16,17). However, children may play a major role in community-based viral transmission, especially in the home environment (11).…”

Section: ' Introductionmentioning

confidence: 99%

“…Some hypotheses have been discussed to explain the better clinical evolution of COVID-19 in children, such as the lower systemic inflammatory response and the release of proinflammatory cytokines; as well as the lower virus concentration in the respiratory tract, probably related to the difference in the expression of angiotensin-converting enzyme receptor 2 in the respiratory tract of children than that of adults (16,17).…”

Section: ' Introductionmentioning

confidence: 99%

Diagnostic value of volumetric capnography in patients with chronic cough variant asthma

Sun

Yang

Gong

et al. 2020

Clinics

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Pediatric gastroenterologists, family members, and caregivers of patients with inflammatory bowel disease (IBD) are on alert; they are all focused on implementing prophylactic measures to prevent infection by severe acute respiratory syndrome coronavirus 2, evaluating the risks in each patient, guiding them in their treatment, and keeping IBD in remission. To face the current issues of the coronavirus disease pandemic, we have developed a synthesis of the main recommendations of the literature directed at pediatric gastroenterologists in control of patients with pediatric IBD and adapted to the national reality. ' CLINICAL MANIFESTATIONS Clinical manifestations of COVID-19 include the same symptoms as those found in other flu-like syndromes, for example, headache, fever, cough, coryza, odynophagia, myalgia, and anorexia (11). Throughout the evolution of the pandemic and the increase in case descriptions, diarrhea, vomiting, and anorexia

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The intriguing features of COVID-19 in children and its impact on the pandemic

Cited by 70 publications

References 28 publications

The Wide Spectrum of COVID-19 Clinical Presentation in Children

The Wide Spectrum of COVID-19 Clinical Presentation in Children

COVID-19 in Children: A Narrative Review

Diagnostic value of volumetric capnography in patients with chronic cough variant asthma

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