Clinical and transmission dynamics characteristics of 406 children with coronavirus disease 2019 in China: A review

Abstract

Objective: Chinese pediatricians are working on the front line to fight COVID-19. They have published a great amount of first-hand clinical data. Collecting their data and forming a large sample for analysis is more conducive to the recognition, prevention and treatment of coronavirus disease 2019 in children. The epidemic prevention and control experience of Chinese pediatricians should be shared with the world. Methods: By searching Chinese and English literature, the data of 406 children with COVID-19 in China were analyzed. Results: It was found that the clustered incidence of children's families is a dynamic transmission feature; the incidence is low; asymptomatic infections and mild cases account for 44.8%, with only 7 cases of critical illness; laboratory examination of lymphocyte counts is not reduced, as it is for adults; chest CT findings are less severe than those for adults. These presentations are the clinical features of COVID-19 in children. Only 55 of the 406 cases were tested by anal swab for virus nucleic acid, 45 of which were positive, accounting for 81.8% of stool samples. Conclusion: There are more children than adults with asymptomatic infections, milder conditions, faster recovery, and a better prognosis. Some concealed morbidity characteristics also bring difficulties to the early identification, prevention and control of COVID-19. COVID-19 screening is needed in the pediatric fever clinic, and respiratory and digestive tract nucleic acid tests should be performed. Efforts should be made to prevent children from becoming a hidden source of transmission in kindergartens, schools or families. Furthermore, China's experience in treating COVID-19 in children has led to faster recovery of sick children.

Clinical and laboratory characteristics of SARS-CoV2-infected paediatric patients in Jordan: serial RT-PCR testing until discharge

“…The patients were admitted regardless of their symptoms. None of the children developed serious complications which is consistent with reports of a milder course in paediatric patients in general [6,8,18].…”

SARS-CoV-2 in children: spectrum of disease, transmission and immunopathological underpinnings

“…To date, there are no published data confirming faecal-oral transmission of SARS-CoV-2, despite detectable virus genetic material documented in the stool of paediatric patients. 53,54 Isolated case reports have suggested transmission from symptomatic children to household contacts, 10,11 however these are rare. Simultaneously, other case reports support an absence of transmission even amongst symptomatic children, including one paediatric index case for whom not one of 172 contacts tested positive for SARS-CoV-2.…”

“…[4][5][6] Furthermore, if children do acquire SARS-CoV-2, the vast majority experience mild disease not requiring hospitalisation, 3,[7][8][9] and as SARS-CoV-2 disseminates globally and chains of transmission are becoming increasingly recognised, children do not appear to be efficient transmitters of infection. [10][11][12][13] There are a number of hypotheses postulated to explain children's lower risk of being infected by, and affected by, SARS-CoV-2. These include differences in viral kinetics, a mucosal burden of competing pathogens, and alterations in their immune response including vascular susceptibility to SARS-CoV-2 infection.…”

Chest CT in COVID-19 pneumonia: A review of current knowledge

“…There are often no CT abnormalities [40]. In case of lung involvement, ground glass is the predominant sign [40,41]. The "halo sign" is found more frequently than in adults [39,41].…”

“…In case of lung involvement, ground glass is the predominant sign [40,41]. The "halo sign" is found more frequently than in adults [39,41]. Coinfections, especially viral, are also more frequent [42].…”