Clinical and transmission dynamics characteristics of 406 children with coronavirus disease 2019 in China: A review

Abstract

Objective: Chinese pediatricians are working on the front line to fight COVID-19. They have published a great amount of first-hand clinical data. Collecting their data and forming a large sample for analysis is more conducive to the recognition, prevention and treatment of coronavirus disease 2019 in children. The epidemic prevention and control experience of Chinese pediatricians should be shared with the world.

Methods: By searching Chinese and English literature, the data of 406 children with COVID-19 in China were analyzed.

Results: It was found that the clustered incidence of children's families is a dynamic transmission feature; the incidence is low; asymptomatic infections and mild cases account for 44.8%, with only 7 cases of critical illness; laboratory examination of lymphocyte counts is not reduced, as it is for adults; chest CT findings are less severe than those for adults. These presentations are the clinical features of COVID-19 in children. Only 55 of the 406 cases were tested by anal swab for virus nucleic acid, 45 of which were positive, accounting for 81.8% of stool samples.

Conclusion: There are more children than adults with asymptomatic infections, milder conditions, faster recovery, and a better prognosis. Some concealed morbidity characteristics also bring difficulties to the early identification, prevention and control of COVID-19. COVID-19 screening is needed in the pediatric fever clinic, and respiratory and digestive tract nucleic acid tests should be performed. Efforts should be made to prevent children from becoming a hidden source of transmission in kindergartens, schools or families. Furthermore, China's experience in treating COVID-19 in children has led to faster recovery of sick children.

Keywords: Children; China; Clinical Characteristics; Coronavirus disease 2019; Transmission Ddynamics.

Fig. 1

Severely ill type. Male, 1 year and 1 month. CT showed a diffuse ground-glass shadow and consolidation in the right lung, showing unilateral white lung manifestations, with air bronchial signs.

Fig. 2

CT showed that the shape of the left lower lobe lesion was perpendicular to the chest wall and parallel to the bronchial vascular bundle (fine ↑). The basal lesions in the right lower lobe were located under the pleura, with uneven density and visible halo signs (thick ↓) .

Fig. 3

CT shows the subpleural ground glass shadow outside the middle lobe of the right lung (↑).