Analysis of Epidemiological and Clinical Characteristics of Children with Mild COVID-19 and Discussion on the Clinical Significance of SARS-CoV-2 Antibody
15 Pages Posted: 9 Apr 2020More...
Background: COVID-19 cases in children are gradually increasing with limited information. Epidemiological and clinical characteristics of children with mild disease in Wuchang Shelter Hospital were analysed.
Methods: Patients (aged ≤18 years) diagnosed with mild COVID-19 in Wuchang Shelter Hospital in Wuhan were included. Demographic, clinical, laboratory, and radiological data during their hospitalisation and isolation period were collected. Retrospective analysis was performed.
Findings: Overall, 1124 patients with mild COVID-19 were admitted, of whom 13 were children (1•16%) and residents of Wuhan with a median age of 16 years (53•8% male). The source of infection was unknown in 30•8% of children. Four patients (30•8%) had abnormal lung computed tomography (CT) findings. Six children (46•2%) had not symptoms with normal CT. During hospitalisation, two SARS-CoV-2 nucleic acid tests were negative shown in 11 patients, and they were discharged from the hospital. Four times SARS-CoV-2 nucleic acid tests of two children (15.4%) were positive and they transferred to another hospital, leading to loss of follow-up. The SARS-CoV-2 IgM and IgG tests were performed at least once in 8 children, 6 of their SARS-CoV-2 IgM were within the normal reference value and the IgG increased. A dynamic increasing trend of SARS-CoV-2 IgG was showed in 2 children; Twice SARS-CoV-2 IgM and IgG tests were within the normal reference values in 2 children. Among the 11 follow-up children, one had positive results for two SARS-CoV-2 nucleic acids tests at isolation.
Interpretation: Children accounted for 1•16 % of mild cases. Some children had uncertain contact history and no clinical symptoms. The etiological diagnosis of children was more important than clinical diagnosis. Disappearance of clinical manifestations of children and the SARS-CoV-2 nucleic acid test with positive result were not parallel. SARS-CoV-2 had long detoxification time, and SARS-CoV-2 cases with positive results appeared again. The production regularity of SARS-CoV-2 IgM and IgG in children and their effect on the body remain unknown.
Funding Statement: None.
Declaration of Interests: None.
Ethics Approval Statement: This case series was approved by the institutional ethics board of the Second Xiangya Hospital of Central South University (No. LYF2020060). All patients agreed that their medical materials could be quoted and published by doctors.
Keywords: COVID-19; SARS-CoV-2; Children; Antibody
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