Epidemiologic trends and characteristics of SARS-CoV-2 infections among children in the United States

Abstract

Purpose of review To review the epidemiological characteristics and clinical features associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections among children in the United States. Recent findings In the United States, the majority of SARS-CoV-2 infections in children have been mild illnesses, with those 5–17 years of age having the highest frequency. Specifically, the incidence of SARS-CoV-2 in children is two times higher in adolescents (12–17 years) than younger school-aged children (5–11 years). Despite the higher case counts in older children, 10% of pediatric hospitalizations have been in infants less than one year. In addition, severe respiratory and renal complications, hospitalization, and even death have been documented in children. Summary Clinical manifestations of SARS-CoV-2 infection in children range from asymptomatic to severe respiratory distress, with mild nonspecific symptoms being the most commonly reported. The broad clinical presentation and the frequency of asymptomatic or minimally symptomatic infections in children pose challenges for controlling and detecting SARS-CoV-2. However, severe disease has been noted in children with associated medical complications and death. Thus, additional active surveillance and research is needed to understand the burden children contribute to the SARS-CoV-2 pandemic in the United States.

Mental Health–Related Emergency Department Visits in Adolescents Before and During the COVID-19 Pandemic: A Multicentric Retrospective Study

“…Although we did not see an increase in the overall number of mental health–related ED visits, the observed increase in the proportion of mental health–related ED visits aligns with reported increases in prevalence of mood, anxiety, and eating disorder symptoms in the general population [ [15] , [16] , [17] , [18] ]. Youth have been less affected by medical complications of COVID-19 [ 19 ], and have been less likely to present to the ED for other reasons since the beginning of the pandemic [ 13 ]. This could be owing to youth having fewer opportunities to contract other infections and injuries and could explain the increase in proportion of mental health–related visits without an overall increase in visit numbers.…”

The Alpha Variant (B.1.1.7) of SARS-CoV-2 in Children: First Experience from 3544 Nucleic Acid Amplification Tests in a Cohort of Children in Germany

“…Our data suggest that younger children between the age of 0–12 years are more likely to be tested positive for SARS-CoV-2, because of the occurrence of the Alpha variant (median 8.6 years (min 0.0 years; max 17.8 years)). An epidemiological review comprising data from March–October 2020 in the United States showed that the SARS-CoV-2 incidence was two times higher in adolescents (12–17 years) than in younger children (5–11 years) [ 24 ]. This period does not include the Alpha lineage with high certainty, even though testing for Alpha had not been established then.…”

Distinct Characteristics of COVID-19 Infection in Children

“…Children of all ages are susceptible to COVID-19 (19). Despite the higher incidence of COVID-19 in older children, infants (<1 year) seem to be the most vulnerable due to a high hospitalization rate (20). The average incubation period for COVID-19 in children is about 6.5 days, which is longer than the 5.4 days reported in adults (21).…”