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What We Should Know About SARS-CoV-2 Infection in Children
26 Pages Posted: 9 Apr 2020
More...Abstract
Background: The SARS-CoV-2 has been responsible for over 300,000 infections worldwide, however, epidemiological and clinical data of infected children are limited.
Methods: We conducted a retrospective, multi-center study,and followed up with all children from the families with SARS-CoV-2 infected members in Zhejiang Province.We compared the epidemiological data between children and adults in the same families and analyzed the clinical characteristics andviral excretion time in pediatric cases.
Findings: By February 29, 2020, 1298 cases from 883 families were confirmed with SARS-CoV-2 infection and 314 of which were children-families. Incidence of infection in children contacts was13·2% (43/325, 95%CI 9·5-16·9), which was lower than that in adult contacts (21·2%, 108/ 510, 95%CI 17·6-24·7). The mean age of 43 pediatric cases was 8·2 years and mean incubation period was 9·1 days. The peak of pediatric cases was two weeks later than that of adult cases. Forty (93·0%) were family clustering. Thirty-three children had COVID-19 (20 pneumonia) with mild symptoms and 10 were asymptomatic.The most common symptoms were fever (63·6%, 21/33) and cough (36·4%, 12/33). Four asymptomatic children had abnormal findings on chest CT. Fecal SARS-CoV-2 RNA detection was positive in 91·4% (32/35) cases and some children had viral excretion time over 60 days. Viral clearance time was not different among the groups treated with different antiviral regiments. No subsequent infection was observed in family contacts of fecal-viral-excreting children.
Interpretation: Children have lower susceptibility of SARS-CoV-2 infection, milder clinical symptoms, longer incubation and fecal viral excretion time. Antiviral treatment did not improve the symptoms or shorten the time of viral excretion. Positive results of fecal SARS-CoV-2RNA detection were not used as indication for hospitalization or quarantine.
Funding Statement: This work was supported by Zhejiang University Special Scientific Research fund for COVID-19 Prevention and Control, and funding from Ruian Science and Technology Bureau (MS2020023).
Declaration of Interests: The authors have no conflicts of interest to declare.
Ethics Approval Statement: The study was approved by both the institutional ethics board of Zhejiang Provincial CDC (T-043-R) and ethics commission of all designated hospitals for recruiting COVID-19 patients. Oral consents were obtained from the guardians of children.
Keywords: SARS-CoV-2; COVID-19; Epidemiological characteristics; Clinical symptoms; Children; Viral excretion
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