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

  • Dong Y & et al
  • Pediatrics
  • 17 mar. 2020

  • de Liz Scherer
  • Clinical Essentials
El acceso al contenido completo es sólo para profesionales sanitarios registrados. El acceso al contenido completo es sólo para profesionales sanitarios registrados.

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.