The different clinical characteristics of corona virus disease cases between children and their families in China - the character of children with COVID-19

Abstract

This study aims to analyze the different clinical characteristics between children and their families infected with severe acute respiratory syndrome coronavirus 2. Clinical data from nine children and their 14 families were collected, including general status, clinical, laboratory test, and imaging characteristics. All the children were detected positive result after their families onset. Three children had fever (22.2%) or cough (11.2%) symptoms and six (66.7%) children had no symptom. Among the 14 adult patients, the major symptoms included fever (57.1%), cough (35.7%), chest tightness/pain (21.4%), fatigue (21.4%) and sore throat (7.1%). Nearly 70% of the patients had normal (71.4%) or decreased (28.6%) white blood cell counts, and 50% (7/14) had lymphocytopenia. There were 10 adults (71.4%) showed abnormal imaging. The main manifestations were pulmonary consolidation (70%), nodular shadow (50%), and ground glass opacity (50%). Five discharged children were admitted again because their stool showed positive result in SARS-CoV-2 PCR. COVID-19 in children is mainly caused by family transmission, and their symptoms are mild and prognosis is better than adult. However, their PCR result in stool showed longer time than their families. Because of the mild or asymptomatic clinical process, it is difficult to recognize early for pediatrician and public health staff.

Keywords: Coronavirus; children; clinical characteristics; corona virus diseases-19 (COVID-19); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Figure 1:

Chest CT images of a case 7 and case 8 (one pair of 11 month old twins) patient upon admission, who had no symptom. (A) Transverse chest CT images showed pulmonary consolidation and ground glass opacity (case 7 on 7 February). (B) Showed marked improvement after 5 days (case 7 on 13 February). (C) Lung CT of case 8 – the case 7’s younger brother on admission day (case 8 on 7 February).

Figure 2.

Lung computed tomography (CT) images of case 7 and case 8’s families. (A) The CT of their grandpa, who was 72-year-old and admitted for symptoms of high fever for 3 days. (B) CT scan of case their father, a 38-year-old patient admitted for symptoms of high fever, shortness of breath and fatigue for 10 days on his admission day. (C) Lung CT image of their mother, a 32-year-old female patient admitted for positive result of PCR (C). (D) Chest CT of the twins’ grandma, 65 years old and had fever, dry cough and chest pain for 6 days before admission.