Coronavirus in children: Observations from Wuhan, China

In a Letter to the Editor, published on March 18, 2020 in the New England Journal of Medicine (NEJM), researchers from China and the United States provide a report on the coronavirus infection in children hospitalized in Wuhan, China between Jan. 28 and Feb. 26, 2020. Kent Pinkerton, professor of pediatrics at the UC Davis School of Medicine, co-authored this study.

Kent Pinkerton Kent Pinkerton

The letter, titled "SARS-CoV-2 Infection in Children," presents the findings from an observational study, with valuable insights on the manifestations of the infection in children under the age of 15.

The researchers recruited all of the children who presented to Wuhan Children's Hospital, the only children's hospital testing for coronavirus in Wuhan, for possible severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. They assessed and tested 1,391 children and found 171 (12.3%) to be infected with coronavirus. From those infected, 104 (60.8%) were males.

Coronavirus in children

Symptoms varied in their manifestations and intensity: 16% showed no infection symptoms, 19% had upper respiratory tract infection and 65% exhibited pneumonia. Upon admission to the hospital, 29% of the children had tachypnea, a respiratory rate higher than the upper limit of the normal range, and 42% presented with tachycardia, a pulse rate higher than the upper limit of the normal range.

The study also found children infected with SARS-CoV-2 have similar, but milder symptoms compared to those seen in adults.

"Among the 171 children infected with coronavirus, there was a single death of a 10-month-old infant with multiple organ failure," Pinkerton said.

Yet, the researchers voiced the need to determine the transmission potential of these younger patients, especially the asymptomatic, to guide the development of measures to control the ongoing pandemic.

"Even those children who showed no infection symptoms can be highly contagious with the ability to transmit the virus to other children and to hospital staff," Pinkerton said. "This re-enforces the critical need to practice shelter-in-place and social distancing for everyone."

Lu at al. (2020). SARS-CoV-2 Infection in Children. New England Journal of Medicine. DOI: 10.1056/NEJMc2005073

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