Pediatric COVID-19: infants are at greatest risk for severe disease

  • Dong Y & et al
  • Pediatrics
  • 17 Mar 2020

  • curated by Liz Scherer
  • Clinical Essentials
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • Although children of all ages may develop COVID-19, infants are especially susceptible to severe disease, as are children with comorbid respiratory or immunocompromising conditions.
  • Editorial notes the "major role" of children in community-based transmission.

Why this matters

  • WHO offers technical guidance on home care.
  • Clinicians should ensure parents/caregivers are counseled on isolating children with mild symptoms from the rest of the household. 

Key results

  • 2143 children.
    • Median age 7 (interquartile range, 2-13) years.
    • 56.6% (1213) boys.
  • 34.1% (731) laboratory-confirmed COVID-19; 65.9% (1412) suspected disease. 
    • 4.4% (94) asymptomatic.
    • 50.9% (1091) mild.
    • 38.8% (831) moderate severity.
  • Severe, critical case rates by age group:
    • 1-5 years: 7.3%. 
    • 6-10 years: 4.2%.
    • 11-15 years: 4.1%. 
    • ≥16 years: 3.0%.
  • Median time from illness onset to diagnosis: 2 (range, 0-42) days. 
    • Most cases diagnosed 1 week after illness onset.
  • Most pediatric cases in China concentrated in Hubei province, surrounding areas.

Study design

  • Nationwide cohort assessing epidemiology, transmission patterns of pediatric patients with COVID-19 reported to Chinese CDC from January 16 to February 8, 2020.
  • Funding: Science and Technology Commission of Shanghai Municipality.

Limitations

  • Temporal data on clinical characteristics lacking.
  • Some missing confounders (e.g., exposure history, related incubation period).
  • Ongoing cases.