Clinical Characteristics of Children with Coronavirus Disease 2019 in Hubei, China

Abstract

Since December 2019, COVID-19 has occurred unexpectedly and emerged as a health problem worldwide. Despite the rapidly increasing number of cases in subsequent weeks, the clinical characteristics of pediatric cases are rarely described. A cross-sectional multicenter study was carried out in 10 hospitals across Hubei province. A total of 25 confirmed pediatric cases of COVID-19 were collected. The demographic data, epidemiological history, underlying diseases, clinical manifestations, laboratory and radiological data, treatments, and outcomes were analyzed. Of 25 hospitalized patients with COVID-19, the boy to girl ratio was 1.27:1. The median age was 3 years. COVID-19 cases in children aged <3 years, 3-6 years, and ≥6-years patients were 10 (40%), 6 (24%), and 9 (36%), respectively. The most common symptoms at onset of illness were fever (13 [52%]), and dry cough (11 [44%]). Chest CT images showed essential normal in 8 cases (33.3%), unilateral involvement of lungs in 5 cases (20.8%), and bilateral involvement in 11 cases (45.8%). Clinical diagnoses included upper respiratory tract infection (n=8), mild pneumonia (n=15), and critical cases (n=2). Two critical cases (8%) were given invasive mechanical ventilation, corticosteroids, and immunoglobulin. The symptoms in 24 (96%) of 25 patients were alleviated and one patient had been discharged. It was concluded that children were susceptible to COVID-19 like adults, while the clinical presentations and outcomes were more favorable in children. However, children less than 3 years old accounted for majority cases and critical cases lied in this age group, which demanded extra attentions during home caring and hospitalization treatment.

Clinical Manifestations of Children with COVID-19: a Systematic Review

“…3,11,26,27,29,[31][32][33][34][35][36][37]13,[39][40][41][42]45,16,[19][20][21][22][23][24] Co-infections with other pathogens were reported in 5 studies. 12,13,16,19,34 Two patients were reported with influenza A, 5 with influenza B, 3 with respiratory syncytial virus (RSV), 1 with cytomegalovirus, 7 with Mycoplasma pneumoniae and 1 with Enterobacter aerogenes.…”

Managing Asthma during Coronavirus Disease-2019: An Example for Other Chronic Conditions in Children and Adolescents

“…Symptoms of COVID-19 can be similar to those of worsening asthma, or an asthma exacerbation. Dry cough and shortness of breath, commonly seen in asthma, are among the most common presenting symptoms of COVID-19 in case series of children admitted to the hospital in China, as well as in available CDC data in the U.S. (10)(11)(12) Fever, a common presenting symptom of COVID-19, may help differentiate COVID-19 from an asthma exacerbation, although fever can be present in other virus-triggered asthma exacerbations as well. (3,10-12) Other less common symptoms of COVID-19, better described in the adult population, may help differentiate COVID-19 from asthma and include myalgia, confusion headache, pharyngitis, rhinorrhea, loss of sense of smell and taste, diarrhea, nausea and vomiting.…”

“…(19) Although there is a paucity of literature on pediatric risk factors, the case series to date from Wuhan on hospitalized pediatric cases don't list asthma as a pre-existing risk factor for morbidity or mortality. (10,11) It is further reassuring that children appear to be at lower risk of COVID-19 morbidity and mortality than the adult population in general, although severe infection still can occur. (13,20) The CDC morbidity and mortality report notes that among the 149,082 reported U.S. cases of COVID-19 for which age is known, only 2572 (1.7%) occurred in In summary, based on available information to date, it is unclear whether there is a significantly increased risk of COVID-19 morbidity among asthmatic children.…”

Recent progress and challenges in drug development against COVID-19 coronavirus (SARS-CoV-2) - an update on the status

“…The most prominent examples of this in history is smallpox, which had a minor effect on children but was catastrophic in adults [33,34]. Children recover quickly and in general, completely while it severe complications to include death result in adults [35].…”

“…Presently, children appear to be the least affected by the consequences of the disease and the number of infected children (under 19 years old) has not exceed 2% of all infected people in the world and there are no deaths under the age of 9 years [34]. Scientists cannot fully explain this phenomenon but there are some medical theories that may explain.…”