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Vulnerability of Children to SARS CoV-2 Infection: A Three-Center Retrospective Cohort Study of 106 Pediatric Patients in China
20 Pages Posted: 30 Jun 2020
More...Abstract
Background: COVID-19 has spread to virtually all countries, and is still increasing rapidly. However, pediatric cases are uncommon and their epidemiological and clinical characteristics have yet to be systematically profiled.
Methods: This is a retrospective cohort study on 106 pediatric COVID-19 cases admitted to 3 nationally designated pediatric treatment hospitals in China. Epidemiological, clinical, radiological, and laboratory data were collected and compared between adults and children and between infants and older children.
Findings: The median age was five years (Range: 1d–18y). Seventy-one cases (67%) were symptomatic at diagnosis; common symptoms included fever (46%) and cough (33%). 78(75%) had a chest CT alteration. Common treatments included antiviral drugs (92%), antibiotics (36%) and corticosteroids (27%). Abnormal changes were common in blood cells, coagulation function, and various biomarkers. Adult cases were 2-10 times as likely as children cases to have symptoms (P≤0.015), radiological alterations (P≤0.0001), abnormal changes in laboratory examinations (P≤0.0024), and therapies for more severe conditions such as oxygen therapy and admission to intensive care unit (P≤0.054). Contrary to the expectation from the children-adult difference that younger age is a potential protector, a disproportionately large number of infant cases in children and infant were more severe than older children (P≤0.05), suggesting infants be more vulnerable to the infection than older children.
Interpretation: SARS CoV-2 infection in children was clinically milder than adults. Infants were, however, more likely to get clinically more severe than older children. More attention should be given to prevention and treatment of the infection in infants.
Funding Statement: The National Key Research and Development Program of China (2019YFB1404803) and Guangzhou Regenerative Medicine Guangdong Laboratory (2020GZR110306001).
Declaration of Interests: All authors declare no competing interests.
Ethics Approval Statement: This study was approved by the ethics committee of Guangzhou Women and Children’s Medical Center, Wuhan Children’s Hospital, and the Third People's Hospital of Shenzhen, and followed the principles of the Declaration of Helsinki. Written consent was obtained from the parents or guardians of the included children.
Keywords: SARS-CoV-2; Covid-19; Pediatric; Infants; Adults
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