Limited data are available for pediatric patients with coronavirus disease 2019 (COVID-19), especially with regard to disease management strategies.
Objective
To assess the children with COVID-19.
Method
We conducted a retrospective review of the medical records of pediatric patients on March 11 and May 23, 2020.
Results
We evaluated 77 COVID-19 pediatric patients, of whom 45.5% were male, with a median age of 8 years (interquartile range [IQR] = 2-13), and 6.4% had underlying diseases. Patients were classified according to severity, with the percentages of asymptomatic, mild, moderate, and critical/severe cases determined to be 24.7%, 41.6%, 29.9%, and 3.9%, respectively. Extracorporeal membrane oxygenation and mechanic ventilation were only required for 1 patient. Targeted therapies were used in 3 patients.
Conclusion
The disease course of COVID-19 appears to be milder in children than in adults, and the treatment course primarily consists of supportive care.
LiQGuanXWuP, et al. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med. 2020;382:1199-1207.
3.
WuZMcGooganJM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72314 cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020;323:1239-1242.
4.
CDC COVID-19 Response Team. Coronavirus disease in children—United States, February 12-April 2, 2020. MMWR Morb Mortal Wkly Rep. 2020;69:422-426.
5.
ZimmermannPCurtisN. Coronavirus infections in children including COVID-19: an overview of the epidemiology, clinical features, diagnosis, treatment and prevention options in children. Pediatr Infect Dis J. 2020;39:355-368.
6.
WeiMYuanJLiuYFuTYuXZhangZJ. Novel coronavirus infection in hospitalized infants under 1 year of age in China. JAMA. 2020;323:1313-1314.
7.
DongYMoXHuY, et al. Epidemiology of COVID-19 among children in China. Pediatrics. 2020;145:e20200702.
8.
LuXZhangLDuH, et al; Chinese Pediatric Novel Coronavirus Study Team. SARS-CoV-2 infection in children. N Engl J Med. 2020;382:1663-1665.
9.
XiaWShaoJGuoYPengXLiZHuD. Clinical and CT features in pediatric patients with COVID-19 infection: different points from adults. Pediatr Pulmonol. 2020;55:1169-1174.
10.
ChenAHuangJLiaoY, et al. Differences in clinical and imaging presentation of pediatric patients with COVID-19 in comparison with adults. Radiol Cardiothorac Imaging. 2020;2:e200117.
11.
ShenKLYangYHJiangRM, et al. Updated diagnosis, treatment and prevention of COVID-19 in children: experts’ consensus statement (condensed version of the second edition). World J Pediatr. 2020;16:232-239.
12.
ShekerdemianLSMahmoodNRWolfeKK, et al; International COVID-19 PICU Collaborative. Characteristics and outcomes of children with coronavirus disease 2019 (COVID-19) infection admitted to US and Canadian pediatric intensive care units. JAMA Pediatr. Published online May 11, 2020. doi:10.1001/jamapediatrics.2020.1948
QiuHWuJHongLLuoYSongQChenD. Clinical and epidemiological features of 36 children with coronavirus disease 2019 (COVID-19) in Zhejiang, China: an observational cohort study. Lancet Infect Dis. 2020;20:689-696.
15.
HuangCWangYLiX, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497-506.
16.
BrennerDJHallEJ. Computed tomography—an increasing source of radiation exposure. N Engl J Med. 2007;357:2277-2284.
17.
PascuttiMFErkelensMNNolteMA. Impact of viral infections on hematopoiesis: from beneficial to detrimental effects on bone marrow output. Front Immunol. 2016;7:364.
18.
MaHHuJTianJ, et al. A single-center, retrospective study of COVID-19 features in children: a descriptive investigation. BMC Med. 2020;18:123.
19.
ChenWZhengKILiuSYanZXuCQiaoZ. Plasma CRP level is positively associated with the severity of COVID-19. Ann Clin Microbiol Antimicrob. 2020;19:18.
20.
ZhangJJYLeeKSAngLWLeoYSYoungBE. Risk factors of severe disease and efficacy of treatment in patients infected with COVID-19: a systematic review, meta-analysis and meta-regression analysis. Clin Infect Dis. Published online May 14, 2020. doi:10.1093/cid/ciaa576
21.
WangYZhuFWangC, et al. Children hospitalized with severe COVID-19 in Wuhan. Pediatr Infect Dis J. 2020;39:e91-e94.
22.
TangNBaiHChenXGongJLiDSunZ. Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy. J Thromb Haemost. 2020;18:1094-1099.
23.
KolliasAKyriakoulisKGDimakakosEGaryphalliaPStergiouGSSyrigosK. Thromboembolic risk and anticoagulant therapy in COVID-19 patients: emerging evidence and call for action. Br J Haematol. 2020;189:846-847.
24.
SongWLiJZouNGuanWPanJXuW. Clinical features of pediatric patients with coronavirus disease (COVID-19). J Clin Virol. 2020;127:104377.
25.
CaoBWangYWenD, et al. A trial of lopinavir-ritonavir in adults hospitalized with severe COVID-19. N Engl J Med. 2020;382:1787-1799.
26.
MehraMRDesaiSSRuschitzkaFPatelAN. Hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19: a multinational registry analysis. Lancet. Published online May 22, 2020. doi:10.1016/S0140-6736(20)31180-6
27.
MehraMRDesaiSSKuySHenryTDPatelAN. Cardiovascular disease, drug therapy, and mortality in Covid-19. N Engl J Med. 2020;382:e102.
