Pediatric COVID-19: clinical characteristics and prognostic outcomes

To analyze the clinical characteristics of pediatric coronavirus disease 2019 (COVID-19) and provide direction for clinical treatment and nursing. Children under 18 years old admitted to the First Affiliated Hospital of Xiamen University were collected due to testing positive for COVID-19 from the outbreak of COVID-19 to January 2023. Patient data, including age, vaccination history, admission symptoms, clinical progression, and treatment outcomes, were extracted from the database. From April 2020 to January 2023, 237 children under 18 years old with COVID-19-positive result in the pediatric ward were collected. All cases achieved hospital discharge without mortality. Among them, 17.72% were under 1 year old, 27.00% were 1-4 years old, 34.60% were 5-10 years old, and 20.68% were over 10 years old. Male predominance was observed (63.29%, sex ratio 1.72:1), the prevalence rate of children of all ages is also similar in sexual distinction (P = 0.739). Additionally, 53.16% of patients have mild symptoms; the proportion of asymptomatic COVID-19 positive children over 10 years old is higher than that of other age groups. The proportion of respiratory symptoms of children under 1 year old is significantly higher than other age groups (88.09%, P < 0.01). Convulsions manifested universally in 23 confirmed pediatric COVID-19 cases (aged 2 months-11 years). Pediatric COVID-19 infections generally manifest mild symptoms; however, infants under 1 year old exhibit more severe respiratory symptoms, necessitating escalated ventilatory support. Additionally, male children demonstrate higher susceptibility to infection compared with females across all pediatric age groups, carrying clinical and public health implications for epidemic response.

According to a review of 72,314 cases by the China Center for Disease Control and Prevention (CDC), less than 1% of the cases occurred in children under the age of 10 years, with the vast majority being children. If children are indeed infected with severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), the vast majority of people will have mild diseases that do not require hospitalization. Therefore, the available data on coronavirus disease 2019 (COVID-19) in infants are still limited. This article collects the cases of children who have been hospitalized because of positive tests since the outbreak of COVID-19, analyzes, and understands how COVID-19 influences children, which can help us better interpret and respond to public health measures.