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Differences in Clinical Features and Laboratory Results between Adults and Children with SARS-CoV-2 Infection
Xiaoli Li1, Yan Rong1, Peiyan Zhang2
1Department of Respiratory and Critical Care Medicine, Shenzhen Hospital, Southern Medical University, Shenzhen 518101, China.
Insights
Children infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) often experience mild or asymptomatic illness and show family clustering. Early testing and chest CT scans are recommended for asymptomatic children in exposed families, with attention to potential liver damage.
Area of Science:
- Virology and Infectious Diseases
- Pediatric Medicine
- Epidemiology
Background:
- Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections are typically less prevalent and milder in children compared to adults.
- The underlying reasons for lower prevalence and severity in pediatric populations remain largely unelucidated.
- Limited studies exist on the specific clinical characteristics of SARS-CoV-2 infection in children.
Purpose of the Study:
- To compare the epidemiological and clinical features of SARS-CoV-2 infection between adult and pediatric patient cohorts.
- To identify distinct patterns or risk factors associated with COVID-19 in children.
- To inform diagnostic and management strategies for pediatric SARS-CoV-2 cases.
Main Methods:
- Retrospective analysis of 52 patients (38 adults, 14 children) diagnosed with Coronavirus Disease 2019 (COVID-19).
- Comparison of epidemiological exposure history, clinical classification, symptoms, chest CT findings, and duration of viral shedding.
- Statistical analysis of laboratory indicators including neutrophil and lymphocyte counts, platelet levels, and liver enzymes (AST, ALT).
Main Results:
- Children exhibited a higher proportion of mild/asymptomatic infections (35.71%) compared to adults (23.68%).
- Family clustering was a more significant mode of transmission in children (50%) than in adults (23.68%).
- Adults showed significantly higher neutrophil percentages, while children had lower lymphocyte and platelet counts and altered liver enzyme profiles, suggesting potential liver damage risk in pediatric cases.
Conclusions:
- Children with SARS-CoV-2 often present with family clustering and a higher likelihood of mild or asymptomatic disease.
- Routine nucleic acid testing and chest CT are advised for asymptomatic children in high-risk families.
- Increased vigilance for liver damage is warranted in pediatric COVID-19 patients, despite less common reductions in lymphocytes and platelets.
Abstract:
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children accounts for a small proportion of all infections and is usually mild or asymptomatic. There are few studies on the clinical characteristics of SARS-CoV-2 infection in children, and the causes of the low prevalence in children remain unclear. Herein, we compared the epidemiological and clinical characteristics of SARS-CoV-2 infection between adults and children. Fifty-two patients with Coronavirus Disease 2019 (COVID-19) were retrospectively analyzed, including 38 adults and 14 children. Their clinical information such as epidemiological exposure history, laboratory indicators, chest computed tomography (CT) performance, and number of SARS-CoV-2 positive days were analyzed and compared. In children, 5 (35.71%) had mild COVID-19 and 9 (64.29%) had common type, while, in adults, 9 (23.68%) cases were mild, and 29 (76.32%) were common COVID-19. Among them, family clustering infection accounted for 50% (7/14) of child cases and 23.68% (9/36) of adult cases. Epidemiological exposure history, clinical classification, clinical symptoms, chest CT manifestations, and number of SARS-CoV-2-positive days were not significantly different between children and adults. However, the percentage of neutrophils in adults was significantly higher than that in children (P < 0.05). The percentage and absolute value of lymphocytes, platelet counts, aspartate aminotransferase, and aspartate aminotransferase/alanine aminotransferase in adults were lower than those in children (P < 0.05). Conclusively, children infected with SARS-CoV-2 show the characteristics of family clustering, and the proportion of mild and asymptomatic infections is higher. For families with a history of epidemiological exposure, routine SARS-CoV-2 nucleic acid testing and chest CT examination should be performed in asymptomatic children to determine whether they are infected. Unlike adults, although the reduction of lymphocytes and platelets in children is not common, it is necessary to be alert to the increased risk of liver damage in children.
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