Childhood COVID-19: a multicentre retrospective study

Abstract

Objectives: To investigate the clinical and epidemiological characteristics of paediatric patients with coronavirus disease-19 (COVID-19).

Methods: Paediatric patients diagnosed with COVID-19 between January 15 and March 15, 2020, from seven hospitals in Zhejiang Province, China, were collected retrospectively and analysed.

Results: Thirty-two children with COVID-19, ranging in age from 3 months to 18 years, were enrolled. Family aggregation occurred in 87.5% of infant and preschool-aged children (7/8), and also school-aged children (14/16), but in only 12.5% (1/8) of adolescents (p < 0.05, p < 0.001). Most of these patients had mild symptoms: mainly fever (20/32) followed by cough (10/32) and fatigue (4/32). The average durations of viral RNA in respiratory samples and gastrointestinal samples were 15.8 d and 28.9 d, respectively. Detox duration in faeces decreased with age: 39.8 d, 27.5 d and 20.4 d in infants and preschool children, school children, and adolescents respectively (p_{0-6, -18} <0.01, p_{0-6, -14} <0.05). Pneumonia was found in 14 children, but there was no statistical significance in the incidence of pneumonia between different age groups. Thirty patients were treated with antiviral drugs, and all patients were stable and gradually improved after admission.

Conclusions: Most children with COVID-19 had a mild process and a good prognosis. More attention should be paid to investigation of household contact history in the diagnosis of COVID-19 in young children. Viral RNA lasts longer in the gastrointestinal system than in the respiratory tract, especially in younger children.

Keywords: Child; Coronavirus disease-19; Diagnosis; Outcome; Treatment.

Fig. 1

Comparison of respiratory (RT) and gastrointestinal (GI) samples for the detection of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) RNA. (A) RNA duration in respiratory and digestive tracts between different age groups. (B) The dynamic change of SARS-CoV-2 RNA in the respiratory tracts of six typical patients (different colour for each patient). (C) The dynamic change in SARS-CoV-2 RNA in the digestive tracts of five typical patients (different colour for each patient).