Coronavirus – COVID-19! We are being inundated with information and opinions about the virus. Finally, there is a report about children and COVID-19 that was released this week as a “pre-publication” article in a very respected medical journal, Pediatrics (read the full article). This pre-publication is an early release to get the information out sooner than what it would typically take.
The article was written by pediatricians from Shanghai and describes the epidemiology of children under the age of 18 who had COVID-19. According to the report, there were 2,143 Chinese children infected. 34.1% had positive laboratory tests, and the remainder were suspected cases. There was no discrepancy between boys and girls.
I think we will find different information with American children as we may have tighter research methodologies so we know who is included in our study and who is not. However, I think this report gives us great insight into COVID-19 that applies to our children. The main findings from this study include the following breakdowns:
- 4.4% of the patients were asymptomatic (no symptoms)
- 50.9% had mild symptoms (cold symptoms, fever, sore throat, runny nose, cough, sneezing, stomach pain, vomiting, or diarrhea)
- 38.8% had moderate symptoms (same as above but worse, with pneumonia and wheeze, but no need for extra oxygen or shortness of breath)
- 5.9% had severe or critical symptoms (same as above, but after 1 week they develop worsening shortness of breath, need for oxygen, etc.; critical is when they are in acute respiratory distress syndrome, shock, heart failure, kidney failure, sepsis, etc.)
Only one child died out of the 2,143 kids diagnosed with COVID-19. However, there was significant variation in how the virus affected children of different ages. These are the percentages of severe/critical cases by age group:
- 10.6% of cases in infants under 1 year of age were critical
- 7.3% of cases in children 1-5 years old were critical
- 3-4% of all other children’s cases were critical
The reported percentage of adults who get severe symptoms is 18.5%. So children under 1 year of age are at a higher risk than other children, but still less than adults. Why the disease is less severe in children is not known. The authors suggest that it may have to do with a receptor called angiotensin converting enzyme II (ACE2). Perhaps children have a lower function of ACE2 and are not having as much viral activity.
Here are a couple more notes regarding this report:
- The age range of children infected with the virus was 1 day old to 18 years old
- They were unable to report on the incubation period in this study
Please be aware that I am following this infection closely and writing blog posts for my general pediatrics practice as well. These can be found at www.northatlantapeds.com/blog/