Editor's note: For the latest news on coronavirus disease 2019, visit https://www.aappublications.org/news/2020/01/28/coronavirus.
Children remain at lower risk of severe illness due to coronavirus disease 2019 (COVID-19) than adults, but infants were found to be most at risk of hospitalization among pediatric patients, according to preliminary data published today in Morbidity and Mortality Weekly Report (MMWR).
Relatively few U.S. children with COVID-19 are hospitalized, and fewer children than adults experience fever, cough or shortness of breath, according to the report from the Centers for Disease Control and Prevention (CDC).
Pediatrics and New England Journal of Medicine recently published similar findings on children with COVID-19 in China.
The CDC’s COVID-19 Response Team analyzed preliminary data on 149,760 COVID-19 cases occurring from Feb. 12 to April 2 reported from 50 states, the District of Columbia, New York City and four U.S. territories.
Of the 149,082 laboratory-confirmed COVID cases for which age was known, 2,572 (1.7%) were among children under 18 years old. Fifty-seven percent were males.
Most of the reported cases in children came from New York City (33%). The AAP has been monitoring age group data posted by New York City, and patterns are parallel to what is reported in MMWR today. The MMWR-reported pediatric cases also came from New York state (23%), New Jersey (15%) and the rest of the jurisdictions (29%).
Information on symptoms, underlying conditions and hospitalization status was provided for just 9.4%, 13% and 33% of the children with COVID-19, respectively. However, this small proportion of pediatric patients gives a preliminary snapshot of the impact on children in the U.S. outbreak, according to the report. More complete data on hospitalization, symptoms and conditions will be key to track the impact of COVID-19 on children.
Other key points:
- Among pediatric patients, children under age 1 year and children with underlying health conditions were at highest risk of serious illness resulting in hospitalization. Clinicians are urged to maintain a high index of suspicion for COVID-19 infection and monitor these populations for progression of illness.
- Of 95 children under age 1 hospitalized for COVID-19, five children were admitted to an intensive care unit.
- Three pediatric deaths were reported, but the cases are being reviewed to determine if COVID-19 was the likely cause of death.
- Chronic lung disease (including asthma), cardiovascular disease and immunosuppression were the most common underlying health conditions of 345 children of all ages for which information was available.
- Seventy-three percent of children reported fever, cough or shortness of breath compared to 93% of adult patients.
Finally, authors emphasized that social distancing and everyday preventive behaviors for all age groups are crucial, as experts learn more about the role of asymptomatic children and those with mild disease in spreading COVID-19.