How COVID-19 affects pediatric patients

New insights into the clinical and epidemiological characteristics of pediatric patients with coronavirus disease 2019 (COVID-19) could facilitate early identification and intervention in suspected patients, according to a study publishing on June 16, 2020 in the open-access journal PLOS Medicine by Xihui Zhou of the First Affiliated Hospital of Xi'an Jiaotong University, China and colleagues.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has spread rapidly worldwide. Early identification and intervention are necessary for effective control of the epidemic in both adults and children. But relatively little is known about the clinical and epidemiological characteristics of pediatric patients. Zhou and colleagues addressed this gap in knowledge to provide insight into the early diagnosis and assessment of COVID-19 in children. The researchers collected and analyzed the clinical data of 34 pediatric COVID-19 patients in four hospitals in China from January 27 to February 23.

Patients presented with mild (18%) or moderate (82%) forms of COVID-19, and the most common initial symptoms were fever (76%) and cough (62%), which recovered within three or four days after treatment. In contrast to observations in adult patients, pediatric cases showed a higher proportion of fever, vomiting (12%), and diarrhea (12%) on admission. Chest computed tomographic (CT) scans revealed high-density patchy shadows with a late-onset pattern in lung-lobule lesions in 28 patients (82%). By contrast, only 3% of pediatric patients showed features called ground-glass opacities—hazy opacities that do not obscure the underlying bronchial structures or pulmonary vessels—which are typically seen in adults with COVID-19. The clinical presentations were not as severe as the signs observed in the CT images, and the recovery of lesions in lobules lagged behind that of the main symptoms. According to the authors, the findings offer valuable insight into the early diagnosis and epidemic control of COVID-19 in children.