COVID-19: pediatric cases occurred early in Wuhan outbreak

  • Liu W & al.
  • N Engl J Med
  • 12 Mar 2020

  • curated by Liz Scherer
  • Clinical Essentials
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Takeaway

  • SARS-CoV-2 infections in children were occurring early in the epidemic, according to retrospective data in a small number of COVID-19 cases in Wuhan, China.

Why this matters

  • Despite limited case data describing COVID-19 clinical characteristics and disease spectrum in children, evidence suggests that infections may cause moderate-to-severe respiratory illnesses in some but that recovery is likely. 

Key results

  • 366 hospitalized children.
  • Most frequently detected pathogens: influenza A (6.3%, n=23), influenza B (5.5%, n=20), and SARS-CoV-2 (1.6%, n=6).
  • COVID-19 patients (n=6): 
    • Median age, 3 years (range 1-7).
    • Illness onset: January 2-8, 2020.
    • Hospitalizations: January 7-13, 2020.
  • Most common clinical characteristics: high fever (>39℃, all), cough (all), vomiting (n=4).
  • Labs: below normal lymphocytes (all), low white cells (n=4), low neutrophils (n=3).
  • Pneumonia (n=4), with patchy ground glass opacities (both lungs, n=1) or patchy shadows (both lungs, n=3) on CT.
  • 1 patient admitted to ICU and administered pooled immunoglobulins; all patients received empirical antivirals, antibiotics, supportive therapy. 
  • 100% recovery, post-hospitalization (median, 7.5 [5-13] days).
  • No patients, family members had Wuhan market contact.

Study design

  • Retrospective case analysis of respiratory infections in hospitalized, Chinese children (aged ≤16 years old), 7-15 January, 2020.
  • Funding: Ministry of Science and Technology of China.

Limitations

  • Small case numbers.
  • Retrospective.