P COVID

Clinical Presentation and Features of SARS-CoV-2 Infection in Children

F. Bruder Stapleton, MD reviewing Lu X et al. N Engl J Med 2020 Mar 18

Among 171 confirmed cases, common symptoms were cough, pharyngeal erythema and fever, while 16% were asymptomatic.

To identify the clinical features and short-term outcomes of SARS-CoV-2 infection in children, researchers described cases treated in Wuhan, China, the epicenter of the current pandemic.

Of 1391 children assessed between January 28 and February 26, 2020, 171 children (12%) were confirmed to have SARS-CoV-2 infection: 60% were boys, the median age was 7 years, and age ranged from 1 day to 15 years. Twenty-seven (16%) of the confirmed cases were asymptomatic without pneumonia. Clinical features included the following:

• The most common symptoms were cough (49%) and fever (42%).
• Fever >39o C occurred in 9% of confirmed cases.
• Less-common features were diarrhea, fatigue, rhinorrhea, vomiting, and nasal congestion.
• Pneumonia was present in 111 children, including 12 who were asymptomatic.
• Blood tests were unremarkable except for lymphopenia in 6 children.
• Computed tomography (CT) appearance of pneumonia included a ground-glass opacity in 33% of cases.
• Three children required intensive care with mechanical ventilation; all had a chronic underlying health condition.
• One 10-month-old child died after 4 weeks of hospitalization.