A Comparison Between Chinese Children Infected with Coronavirus Disease-2019 and with Severe Acute Respiratory Syndrome 2003

doi:10.1016/j.jpeds.2020.06.041

Observational Study

. 2020 Sep:224:30-36.

doi: 10.1016/j.jpeds.2020.06.041. Epub 2020 Jun 18.

A Comparison Between Chinese Children Infected with Coronavirus Disease-2019 and with Severe Acute Respiratory Syndrome 2003

Xiaoli Xiong¹, Gilbert T Chua², Shuiqing Chi³, Mike Yat Wah Kwan⁴, Wilfred Hing Sang Wong², Aifen Zhou⁵, Chi Chiu Shek⁴, Keith T S Tung², Huan Qin⁶, Rosa S Wong², Xue Li⁷, Peng Chen⁸, Shuai Li³, Celine S Chui⁷, Winnie W Y Tso², Marco H K Ho², Ian C K Wong⁹, Godfrey C F Chan², Yu Lung Lau², Kenneth K Y Wong¹⁰, Patrick H Y Chung¹⁰, Hui Li¹¹, Paul K H Tam¹², Shao-Tao Tang³, Patrick Ip¹³

Affiliations

¹ Department of Integrated Chinese and Western Medicine, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
² Department of Pediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China.
³ Department of Pediatric Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
⁴ Department of Pediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong SAR, China.
⁵ Department of Maternal Healthcare, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
⁶ Institute of Maternal and Child Health, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan.
⁷ Department of Pediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China; Center for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong SAR, China.
⁸ Department of Respiratory Medicine, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
⁹ Center for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong SAR, China; Research Department of Practice and Policy, UCL School of Pharmacy, University College, London, UK.
¹⁰ Division of Pediatric Surgery, Department of Surgery, The University of Hong Kong, Hong Kong SAR, China.
¹¹ Department of Hematology, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
¹² Division of Pediatric Surgery, Department of Surgery, The University of Hong Kong, Hong Kong SAR, China; Dr. Li Dak Sum Research Center, The University of Hong Kong-Karolinska Institute Collaboration in Regenerative Medicine, The University of Hong Kong, China.
¹³ Department of Pediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China. Electronic address: patricip@hku.hk.

PMID: 32565097
PMCID: PMC7301144
DOI: 10.1016/j.jpeds.2020.06.041

Observational Study

A Comparison Between Chinese Children Infected with Coronavirus Disease-2019 and with Severe Acute Respiratory Syndrome 2003

Xiaoli Xiong et al. J Pediatr. 2020 Sep.

. 2020 Sep:224:30-36.

doi: 10.1016/j.jpeds.2020.06.041. Epub 2020 Jun 18.

Authors

Affiliations

¹ Department of Integrated Chinese and Western Medicine, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
² Department of Pediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China.
³ Department of Pediatric Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
⁴ Department of Pediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong SAR, China.
⁵ Department of Maternal Healthcare, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
⁶ Institute of Maternal and Child Health, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan.
⁷ Department of Pediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China; Center for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong SAR, China.
⁸ Department of Respiratory Medicine, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
⁹ Center for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong SAR, China; Research Department of Practice and Policy, UCL School of Pharmacy, University College, London, UK.
¹⁰ Division of Pediatric Surgery, Department of Surgery, The University of Hong Kong, Hong Kong SAR, China.
¹¹ Department of Hematology, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
¹² Division of Pediatric Surgery, Department of Surgery, The University of Hong Kong, Hong Kong SAR, China; Dr. Li Dak Sum Research Center, The University of Hong Kong-Karolinska Institute Collaboration in Regenerative Medicine, The University of Hong Kong, China.
¹³ Department of Pediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China. Electronic address: patricip@hku.hk.

PMID: 32565097
PMCID: PMC7301144
DOI: 10.1016/j.jpeds.2020.06.041

Abstract

Objectives: To compare the clinical and laboratory features of severe acute respiratory syndrome 2003 (SARS) and coronavirus disease 2019 (COVID-19) in 2 Chinese pediatric cohorts, given that the causative pathogens and are biologically similar.

Study design: This is a cross-sectional study reviewing pediatric patients with SARS (n = 43) and COVID-19 (n = 244) who were admitted to the Princess Margaret Hospital in Hong Kong and Wuhan Children's Hospital in Wuhan, respectively. Demographics, hospital length of stay, and clinical and laboratory features were compared.

Results: Overall, 97.7% of patients with SARS and 85.2% of patients with COVID-19 had epidemiologic associations with known cases. Significantly more patients with SARS developed fever, chills, myalgia, malaise, coryza, sore throat, sputum production, nausea, headache, and dizziness than patients with COVID-19. No patients with SARS were asymptomatic at the time of admission, whereas 29.1% and 20.9% of patients with COVID-19 were asymptomatic on admission and throughout their hospital stay, respectively. More patients with SARS required oxygen supplementation than patients with COVID-19 (18.6 vs 4.7%; P = .004). Only 1.6% of patients with COVID-19 and 2.3% of patients with SARS required mechanical ventilation. Leukopenia (37.2% vs 18.6%; P = .008), lymphopenia (95.4% vs 32.6%; P < .01), and thrombocytopenia (41.9% vs 3.8%; P < .001) were significantly more common in patients with SARS than in patients with COVID-19. The duration between positive and negative nasopharyngeal aspirate and the length in hospital stay were similar in patients with COVID-19, regardless of whether they were asymptomatic or symptomatic, suggesting a similar duration of viral shedding.

Conclusions: Children with COVID-19 were less symptomatic and had more favorable hematologic findings than children with SARS.

Keywords: COVID-19; Chinese; SARS; children.

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Figures

**Figure 1**
Age distribution of patients with COVID-19 and patients with SARS.

**Figure 2**
COVID-19 and SARS symptoms comparison. ∗P < .05.

See this image and copyright information in PMC

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References

1. Coronavirus disease (COVID-19) Pandemic: World Health Organization; 2020. https://www.who.int/emergencies/diseases/novel-coronavirus-2019
1. Summary table of SARS cases by country, 1 November 2002 - 7 August 2003: World Health Organization; 2003. https://www.who.int/csr/sars/country/country2003_08_15.pdf?ua=1
1. Lu R., Zhao X., Li J., Niu P., Yang B., Wu H. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet. 2020;395:565–574. - PMC - PubMed
1. Petrosillo N., Viceconte G., Ergonul O., Ippolito G., Petersen E. COVID-19, SARS and MERS: are they closely related? Clin Microbiol Infect. 2020;26:729–734. - PMC - PubMed
1. Lu X., Zhang L., Du H., Zhang J., Li Y.Y., Qu J. SARS-CoV-2 Infection in Children. N Engl J Med. 2020;382:1663–1665. - PMC - PubMed

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[1] Coronavirus disease (COVID-19) Pandemic: World Health Organization; 2020. https://www.who.int/emergencies/diseases/novel-coronavirus-2019

[2] Coronavirus disease (COVID-19) Pandemic: World Health Organization; 2020. https://www.who.int/emergencies/diseases/novel-coronavirus-2019

[3] Summary table of SARS cases by country, 1 November 2002 - 7 August 2003: World Health Organization; 2003. https://www.who.int/csr/sars/country/country2003_08_15.pdf?ua=1

[4] Summary table of SARS cases by country, 1 November 2002 - 7 August 2003: World Health Organization; 2003. https://www.who.int/csr/sars/country/country2003_08_15.pdf?ua=1

[5] Lu R., Zhao X., Li J., Niu P., Yang B., Wu H. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet. 2020;395:565–574. - PMC - PubMed

[6] Lu R., Zhao X., Li J., Niu P., Yang B., Wu H. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet. 2020;395:565–574. - PMC - PubMed

[7] Petrosillo N., Viceconte G., Ergonul O., Ippolito G., Petersen E. COVID-19, SARS and MERS: are they closely related? Clin Microbiol Infect. 2020;26:729–734. - PMC - PubMed

[8] Petrosillo N., Viceconte G., Ergonul O., Ippolito G., Petersen E. COVID-19, SARS and MERS: are they closely related? Clin Microbiol Infect. 2020;26:729–734. - PMC - PubMed

[9] Lu X., Zhang L., Du H., Zhang J., Li Y.Y., Qu J. SARS-CoV-2 Infection in Children. N Engl J Med. 2020;382:1663–1665. - PMC - PubMed

[10] Lu X., Zhang L., Du H., Zhang J., Li Y.Y., Qu J. SARS-CoV-2 Infection in Children. N Engl J Med. 2020;382:1663–1665. - PMC - PubMed

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A Comparison Between Chinese Children Infected with Coronavirus Disease-2019 and with Severe Acute Respiratory Syndrome 2003

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A Comparison Between Chinese Children Infected with Coronavirus Disease-2019 and with Severe Acute Respiratory Syndrome 2003

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