First Pediatric Case of Coronavirus Disease 2019 in Korea

Abstract

The large outbreak of coronavirus disease 2019 (COVID-19) that started in Wuhan, China has now spread to many countries worldwide. Current epidemiologic knowledge suggests that relatively few cases are seen among children, which limits opportunities to address pediatric specific issues on infection control and the children's contribution to viral spread in the community. Here, we report the first pediatric case of COVID-19 in Korea. The 10-year-old girl was a close contact of her uncle and her mother who were confirmed to have COVID-19. In this report, we present mild clinical course of her pneumonia that did not require antiviral treatment and serial viral test results from multiple specimens. Lastly, we raise concerns on the optimal strategy of self-quarantine and patient care in a negative isolation room for children.

Keywords: COVID-19; Children; Coronavirus; SARS-CoV-2.

Fig. 1. Diagram showing how the family members of the first pediatric patient with COVID-19 were in self-quarantine at home. The patient lived with her parents and her cousin, while her aunt and uncle lived upstairs. Her uncle was quarantined in his room but shared meals at her house (grey table) until he was confirmed with COVID-19. The remaining five family members had been placed in self-quarantine without sharing meals in the dining table (white table). The patient and her mother stayed in the same room until her mother's diagnosis. Individuals in black indicate the confirmed cases and bold line means a quarantine room. The actual floor plan may be different.

COVID-19 = coronavirus disease 2019.

Fig. 2. Serial viral test results of multiple specimens and chest imaging of the patient. (A) Serial viral test results of the RNA-dependent RNA polymerase region of the ORF1b gene on real-time reverse transcription polymerase chain reaction are shown for multiple specimens according to the onset of symptoms. (B) Chest X-ray shows no infiltrations on admission, day 3 since symptom onset. (C) Chest CT performed on the fourth day since symptom onset demonstrates patchy nodular consolidations with peripheral ground glass opacities in subpleural areas of the right lower lobe in axial and sagittal views of CT.

CT = computed tomography, SARS-CoV-2 = severe acute respiratory syndrome coronavirus 2.