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Initial Observations of COVID-19 in US Children
Rabia Agha1, Tsoline Kojaoghlanian2, Jeffrey R Avner3
1Division of Pediatric Infectious Diseases and ragha@maimonidesmed.org.
Insights
Most children infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) showed no respiratory symptoms. Universal testing identified many pediatric COVID-19 cases, highlighting varied presentations and potential missed diagnoses.
Area of Science:
- Pediatric Infectious Diseases
- Viral Respiratory Illnesses
Background:
- Coronavirus disease (COVID-19) impacts children differently than adults.
- Limited data exist on the clinical presentation of COVID-19 in pediatric populations.
Purpose of the Study:
- To detail the clinical presentation and outcomes of pediatric inpatients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.
- To understand disease variability in children during widespread local transmission.
Main Methods:
- Retrospective chart review of pediatric inpatients (0-18 years) admitted over a 4-week period.
- Inclusion criteria: positive polymerase chain reaction (PCR) test for SARS-CoV-2 from nasopharyngeal specimens.
Main Results:
- Clinical data were analyzed for 22 pediatric patients.
- Most children presented without typical respiratory symptoms suggestive of COVID-19.
- Many cases were identified through universal screening rather than symptom-based testing.
Conclusions:
- Pediatric COVID-19 presentation is highly variable.
- Targeted testing strategies may miss infections in children due to atypical symptoms.
- Universal testing aids in identifying asymptomatic or mildly symptomatic pediatric cases.
Abstract:
Coronavirus disease (COVID-19) has affected children differently from adults worldwide. Data on the clinical presentation of the infection in children are limited. We present a detailed account of pediatric inpatients infected with severe acute respiratory syndrome coronavirus 2 virus at our institution during widespread local transmission, aiming to understand disease presentation and outcomes. A retrospective chart review was performed of children, ages 0 to 18 years, with a positive polymerase chain reaction test for severe acute respiratory syndrome coronavirus 2 on nasopharyngeal specimens admitted to our hospital over a 4-week period. We present clinical data from 22 patients and highlight the variability of the presentation. In our study, most children presented without respiratory illness or symptoms suggestive of COVID-19; many were identified only because of universal testing. Because children may have variable signs and symptoms of COVID-19 infection, targeted testing may miss some cases.
