Coinfection and Other Clinical Characteristics of COVID-19 in Children
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Open Access
- 1 July 2020
- journal article
- research article
- Published by American Academy of Pediatrics (AAP) in PEDIATRICS
- Vol. 146 (1)
- https://doi.org/10.1542/peds.2020-0961
Abstract
Pediatric patients with COVID-19 presented with symptoms distinct from adults and were susceptible to coinfection; persistent fecal shedding of viral RNA was found after respiratory specimens revealed negative results. BACKGROUND AND OBJECTIVES:Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a newly identified pathogen that mainly spreads by droplets. Most published studies have been focused on adult patients with coronavirus disease 2019 (COVID-19), but data concerning pediatric patients are limited. In this study, we aimed to determine epidemiological characteristics and clinical features of pediatric patients with COVID-19.METHODS:We reviewed and analyzed data on pediatric patients with laboratory-confirmed COVID-19, including basic information, epidemiological history, clinical manifestations, laboratory and radiologic findings, treatment, outcome, and follow-up results.RESULTS:A total of 74 pediatric patients with COVID-19 were included in this study. Of the 68 case patients whose epidemiological data were complete, 65 (65 of 68; 95.59%) were household contacts of adults. Cough (32.43%) and fever (27.03%) were the predominant symptoms of 44 (59.46%) symptomatic patients at onset of the illness. Abnormalities in leukocyte count were found in 23 (31.08%) children, and 10 (13.51%) children presented with abnormal lymphocyte count. Of the 34 (45.95%) patients who had nucleic acid testing results for common respiratory pathogens, 19 (51.35%) showed coinfection with other pathogens other than SARS-CoV-2. Ten (13.51%) children had real-time reverse transcription polymerase chain reaction analysis for fecal specimens, and 8 of them showed prolonged existence of SARS-CoV-2 RNA.CONCLUSIONS:Pediatric patients with COVID-19 presented with distinct epidemiological, clinical, and radiologic characteristics from adult patients. Nearly one-half of the infected children had coinfection with other common respiratory pathogens. It is not uncommon for pediatric patients to have prolonged fecal shedding of SARS-CoV-2 RNA during the convalescent phase.This publication has 17 references indexed in Scilit:
- Novel Coronavirus Infection in Hospitalized Infants Under 1 Year of Age in ChinaJAMA, 2020
- Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, ChinaJAMA, 2020
- A Familial Cluster of Infection Associated With the 2019 Novel Coronavirus Indicating Possible Person-to-Person Transmission During the Incubation PeriodThe Journal of Infectious Diseases, 2020
- Diagnosis and treatment of 2019 novel coronavirus infection in children: a pressing issueWorld Journal of Pediatrics, 2020
- Clinical features of patients infected with 2019 novel coronavirus in Wuhan, ChinaThe Lancet, 2020
- Investigating the impact of influenza on excess mortality in all ages in Italy during recent seasons (2013/14–2016/17 seasons)International Journal of Infectious Diseases, 2019
- The developing immune system – from foetus to toddlerActa Paediatrica, 2011
- Children Hospitalized With Severe Acute Respiratory Syndrome-Related Illness in TorontoPEDIATRICS, 2003
- Severe acute respiratory syndrome in children: Experience in a regional hospital in Hong Kong*Pediatric Critical Care Medicine, 2003
- Clinical presentations and outcome of severe acute respiratory syndrome in childrenThe Lancet, 2003