Clinical Analysis of 25 COVID-19 Infections in Children

Abstract

Background: To describe the characteristics of clinical manifestations of children with 2019 novel coronavirus (2019-nCoV) infection in Chongqing. Methods: All 25 children with laboratory-confirmed 2019-nCoV infection by real-time reverse transcription-PCR (RNA-PCR) were admitted from the 4 designated treatment hospitals of 2019-nCoV in Chongqing from January 19 to March 12, 2020. Clinical data and epidemiologic history of these patients were retrospectively collected and analyzed. Results: The diagnosis was confirmed through RNA-PCR testing. Among the 25 cases, 14 were males and 11 were females. The median age was 11.0 (6.3–14.5) years (range 0.6–17.0 years). All children were related to a family cluster outbreak, and 7 children (28%) with a travel or residence history in Hubei Province. These patients could be categorized into different clinical types, including 8 (32%) asymptomatic, 4 (16%) very mild cases and 13 (52%) common cases. No severe or critical cases were identified. The most common symptoms were cough (13 cases, 52%) and fever (6 cases, 24%). The duration time of clinical symptoms was 13.0 (8.0–25.0) days. In the 25 cases, on admission, 21 cases (84%) had normal white blood cell counts, while only 2 cases (8%) more than 10 × 109/L and 2 cases (8%) less than 4 × 109/L, respectively; 22 cases(88%) had normal CD4+ T lymphocyte counts, while in the remaining 3 cases(8%) this increased mildly; 23 cases had normal CD8+ T lymphocyte counts, while in the remaining 2 cases (8%) CD8+ T lymphocyte counts were mildly increased as well. All Lymphocyte counts were normal. There were no statistical differences of lab results between the groups of asymptomatic cases, mild cases and common cases. There were only 13 cases with abnormal CT imaging, most of which were located in the subpleural area of the bottom of the lung. All patients were treated with interferon, 6 cases combined with Ribavirin, and 12 cases combined with lopinavir or ritonavir. The days from onset to RNA turning negative was 15.20 ± 6.54 days. There was no significant difference of RNA turning negative between the groups of interferon, interferon plus ribavirin and interferon plus lopinavir or ritonavir treatment. All the cases recovered and were discharged from hospital. Conclusions: The morbidity of 2019-nCoV infection in children is lower than in adults and the clinical manifestations and inflammatory biomarkers in children are nonspecific and milder than that in adults. RNA-PCR test is still the most reliable diagnostic method, especially for asymptomatic patients.

Occurrence and transmission potential of asymptomatic and presymptomatic SARS-CoV-2 infections: A living systematic review and meta-analysis

“…The remaining studies, in hospital settings, included adult patients only (15 studies, n = 3,228) [27,39,45,52,53,56,57,64,80,83,89,92,103,107,114], children only (10 studies, n = 285) [40][41][42]59,84,87,98,99,104,106], or adults and children (10 studies, n = 1,518) [54,67,77,79,86,88,96,102,109,112] (Table 1, Fig 1). The types of hospital and clinical severity of patients differed, including settings in which anyone with SARS-CoV-2 infection was admitted for isolation and traditional hospitals.…”

Clinical characteristics and evolution of pediatric patients with acute leukemia and SARS-COV2 virus infection in a third level hospital in Mexico

“… Media p Value aPTT Alive 29.9 s (28.5–30.5sec) Deadc35.75 s (30.7–40.9 s) 0.010 D-Dimer Alive 407 ng/mL (289–562 ng/mL) Dead 4180 ng/mL (582–11183 ng/mL). 0.010 AST Alive18.4 U/L [ [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] ] Dead162.4 U/L (1.1–813 U/L) 0.035 ALT Alive70.8 U/L (6.6–362.3 U/L) Dead 121.2 U/L (20–427 U/L) 0.041 AST: aspartateaminotransferase, ALT: alanineaminotransferase. …”

Clinical Characteristics of Pediatric Inflammatory Multisystem Syndrome Associated With COVID-19

“…Although clinical manifestations and in ammatory biomarkers in most of the children are nonspeci c and milder than that in adults (16), but children with COVID-19 infection may present symptoms similar to Kawasaki disease and in ammatory syndromes. So, PIMS should be considered in patients with fever and rash, seizure, cough, tachypnea, and gastrointestinal symptoms such as vomiting, diarrhea, and abdominal pain.…”