Epidemiological and clinical features of pediatric COVID-19

Abstract

Background: COVID-19 is an extremely severe infectious disease. However, few studies have focused on the epidemiological and clinical characteristics of pediatric COVID-19. This study conducted a retrospective review of the epidemiological and clinical features of COVID-19 in children. Methods: A retrospective study was conducted on children with a definite diagnosis of COVID-19 in mainland China using the web crawler technique to collect anonymous COVID-19 updates published by local health authorities. Results: Three hundred forty-one children aged 4 days to 14 years with a median age of 7 years were included. Sixty-six percent of pediatric patients were infected via family members with COVID-19. The median incubation period was 9 days (interquartile range, 6 to 13). Asymptomatic cases accounted for 5.9%, of which 30% had abnormal chest radiologic findings. A majority of pediatric COVID-19 cases showed mild to moderate clinical features, and only a few developed severe or critical diseases (0.6% and 0.3%, respectively). Fever (77.9%) and cough (32.4%) were the predominant presenting symptoms of pediatric COVID-19. The pediatric patients had fewer underlying diseases and complications than adults. The treatment modalities for pediatric COVID-19 patients were not as complex as those of adult COVID-19 patients. The overall prognosis of pediatric COVID-19 was benign with a decent recovery. The median time from onset to cure was 16 days (interquartile range, 13 to 21). Conclusions: Compared to adults, COVID-19 in children has distinct features of epidemiology and clinical manifestations. The findings from this study might help to guide the development of measures to prevent and treat this ongoing global pandemic. Trial registration: Chinese Clinical Trial Registry (chictr.org.cn) identifier: ChiCTR2000030464.

Epidemiological and Clinical Characteristics of COVID-19 in Children: A Systematic Review and Meta-Analysis

“…In addition, 26% of pediatric cases showed normal chest radiological imaging on admission, which also makes it difficult to identify the suspected cases. Consistent with the findings of Guo et al (20), our results revealed that the pooled mean incubation period in children was 9.57 days, which was longer than adults (4 days) (21). This might be explained by children being less likely to be tested for coronavirus infection due to the proxy reports of symptoms in younger children, especially at pre-school age.…”

Síndrome respiratória aguda grave por COVID-19 em crianças e adolescentes no Brasil: perfil dos óbitos e letalidade hospitalar até a 38ᵃ Semana Epidemiológica de 2020

“…9 A recent study highlighted that the main form of COVID-19 infection in children (4 days to 14 years old) was through family groups, and that standing out among the clinical characteristics were long incubation periods, fever and coughing. 16 The same study found that 30% of asymptomatic children had post-infection lung damage. 16 Although hospital lethality was greater among children under 1 year old, they were closely followed by adolescents aged 15-19 years old.…”

“…16 The same study found that 30% of asymptomatic children had post-infection lung damage. 16 Although hospital lethality was greater among children under 1 year old, they were closely followed by adolescents aged 15-19 years old. It is possible that among adolescents hospitalized with COVID-19, pre-existing chronic conditions may have been associated with worsening of the clinical picture and with high death and lethality frequency in the group studied.…”

Salient Conclusive Remarks on Epidemiology and Clinical Manifestations of Pediatric COVID-19: Narrative Review

“…Although limited data in the literature regarding the vertical transmission of the SARS-CoV-2 from infected pregnant mother to the fetus are available, some epidemiological studies in this context concluded that this means of transmission is unlikely to exist (42,43). As per the virus source to the children, another comprehensive study included a considerable number of Chinese children with definite COVID-19 indicated that most of them acquired the infection from the familial sources (69). As a general important epidemiological note, the sources and transmission modes of the virus for pediatric COVID-19 is considered extremely important for understanding the role of children in the dynamics of the pandemic as they may become a sizable factor in the disease spread in many parts of the world (70).…”

“…The incubation period of COVID-19 in pediatric patients was appraised and discussed in several studies. It had been estimated as 5-6 days in some reports (43, 51) and 9-11 days in others (9,52,69). An overwhelming data retrieved from the literature revealed that the asymptomatic nature of COVID-19 among many infected children worldwide was observed (55)(56)(57).…”