Clinical Characteristics of Children with Coronavirus Disease 2019 in Hubei, China

Abstract

Since December 2019, COVID-19 has occurred unexpectedly and emerged as a health problem worldwide. Despite the rapidly increasing number of cases in subsequent weeks, the clinical characteristics of pediatric cases are rarely described. A cross-sectional multicenter study was carried out in 10 hospitals across Hubei province. A total of 25 confirmed pediatric cases of COVID-19 were collected. The demographic data, epidemiological history, underlying diseases, clinical manifestations, laboratory and radiological data, treatments, and outcomes were analyzed. Of 25 hospitalized patients with COVID-19, the boy to girl ratio was 1.27:1. The median age was 3 years. COVID-19 cases in children aged <3 years, 3.6 years, and ≥6-years patients were 10 (40%), 6 (24%), and 9 (36%), respectively. The most common symptoms at onset of illness were fever (13 [52%]), and dry cough (11 [44%]). Chest CT images showed essential normal in 8 cases (33.3%), unilateral involvement of lungs in 5 cases (20.8%), and bilateral involvement in 11 cases (45.8%). Clinical diagnoses included upper respiratory tract infection (n=8), mild pneumonia (n=15), and critical cases (n=2). Two critical cases (8%) were given invasive mechanical ventilation, corticosteroids, and immunoglobulin. The symptoms in 24 (96%) of 25 patients were alleviated and one patient had been discharged. It was concluded that children were susceptible to COVID-19 like adults, while the clinical presentations and outcomes were more favorable in children. However, children less than 3 years old accounted for majority cases and critical cases lied in this age group, which demanded extra attentions during home caring and hospitalization treatment.

Keywords

SARS-CoV-2 / COVID-19 / coronavirus / children

References

[1] BogochII, WattsA, Thomas-BachliA, et al.. Pneumonia of Unknown Etiology in Wuhan, China: Potential for International Spread Via Commercial Air Travel. J Travel Med, 2020

[2] LuH, StrattonCW, TangYW. Outbreak of Pneumonia of Unknown Etiology in Wuhan China: the Mystery and the Miracle. J Med Virol, 2020

[3] PaulesCI, MarstonHD, FauciAS. Coronavirus Infections-More Than Just the Common Cold. JAMA, 2020

[4] HuiDS, IAE, MadaniTA, et al.. The continuing 2019-nCoV epidemic threat of novel coronaviruses to global health — The latest 2019 novel coronavirus outbreak in Wuhan, China. Int J Infect Dis, 2020, 91: 264-266

[5] ChanJF, KokKH, ZhuZ, et al.. Genomic characterization of the 2019 novel human-pathogenic coronavirus isolated from a patient with atypical pneumonia after visiting Wuhan. Emerg Microbes Infect, 2020, 9(1): 221-236

[6] NationalH C o t P R C. Novel coronavirus (2019-nCoV): situation, 2020

[7] HuangC, WangY, LiX, et al.. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet, 2020

[8] ZhuN, ZhangD, WangW, et al.. A Novel Coronavirus from Patients with Pneumonia in China, 2019. New Engl J Med, 2020

[9] ChenN, ZhouM, DongX, et al.. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet, 2020

[10] WangD, HuB, HuC, et al.. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA, 2020

[11] ChenF, LiuZS, ZhangFR, et al.. Frist case of severe childhood novel coronavirus pneumonia in China. Zhonghua Er Ke Za Zhi, 2020, 58: E005

[12] WeiM, YuanJ, LiuY, et al.. Novel Coronavirus Infection in Hospitalized Infants Under 1 Year of Age in China. JAMA, 2020

[13] Pediatric Branch Of Hubei Medical Association PBOW.. Recommendation for the diagnosis and treatment of novel coronavirus infection in children in Hubei (Trial version 1). Chin J Contemp Pediatr, 2020, 2(22): 96-99

[14] KohD, SngJ. Lessons from the past: perspectives on severe acute respiratory syndrome. Asia Pac J Public Health, 2010, 22(3): 132S-136S

[15] LeungCW, ChiuWK. Clinical picture, diagnosis, treatment and outcome of severe acute respiratory syndrome (SARS) in children. Paediatr Respir Rev, 2004, 5(4): 275-288

[16] ChengVC, LauSK, WooPC, et al.. Severe acute respiratory syndrome coronavirus as an agent of emerging and reemerging infection. Clin Microbiol Rev, 2007, 20(4): 660-694

[17] AlhamlanFS, MajumderMS, BrownsteinJS, et al.. Case characteristics among Middle East respiratory syndrome coronavirus outbreak and non-outbreak cases in Saudi Arabia from 2012 to 2015. Bmj Open, 2017, 7(1): e011865

[18] MorensDM, TaubenbergerJK, FauciAS. Predominant role of bacterial pneumonia as a cause of death in pandemic influenza: implications for pandemic influenza preparedness. J Infect Dis, 2008, 198(7): 962-970

[19] FritzCQ, EdwardsKM, SelfWH, et al.. Prevalence, Risk Factors, and Outcomes of Bacteremic Pneumonia in Children. Pediatrics, 2019, 144(1): e20183090