Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Dec;14(6):776-785.
doi: 10.1007/s11684-020-0820-7. Epub 2020 Oct 27.

Clinical manifestations and pathogen characteristics in children admitted for suspected COVID-19

Xiaofang Cai  1 , Hanlan Jiang  1 , Simin Zhang  1 , Shengying Xia  1 , Wenhui Du  1 , Yaoling Ma  1 , Tao Yu  2 , Wenbin Li  3
Affiliations

Clinical manifestations and pathogen characteristics in children admitted for suspected COVID-19

Xiaofang Cai et al. Front Med. 2020 Dec.

Abstract

Coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has spread around the world. However, approaches to distinguish COVID-19 from pneumonia caused by other pathogens have not yet been reported. We retrospectively analyzed the clinical data of 97 children with probable COVID-19. A total of 13 (13.4%) patients were confirmed positive for SARS-CoV-2 infection by nucleic acid RT-PCR testing, and 41 (42.3%) patients were found to be infected with other pathogens. Notably, no pathogen was detected in 43 (44.3%) patients. Among all patients, 25 (25.8%) had familial cluster exposure history, and 52 (53.6%) had one or more coexisting conditions. Fifteen (15.5%) patients were admitted or transferred to the PICU. In the 11 confirmed COVID-19 cases, 5 (45.5%) and 7 (63.6%) were positive for IgM and IgG against SARS-CoV-2, respectively. In 22 patients with suspected COVID-19, 1 (4.5%) was positive for IgG but negative for IgM. The most frequently detected pathogen was Mycoplasma pneumonia (29, 29.9%). One patient with confirmed COVID-19 died. Our results strongly indicated that the detection of asymptomatic COVID-19 or coexisting conditions must be strengthened in pediatric patients. These cases may be difficult to diagnose as COVID-19 unless etiologic analysis is conducted. A serologic test can be a useful adjunctive diagnostic tool in cases where SARS-CoV-2 infection is highly suspected but the nucleic acid test is negative.

Keywords: coronavirus disease 2019; emergency; pediatrics; retrospective investigation; severe acute respiratory syndrome coronavirus 2.

PubMed Disclaimer

Conflict of interest statement

Xiaofang Cai, Hanlan Jiang, Simin Zhang, Shengying Xia, Wenhui Du, Yaoling Ma, Tao Yu, and Wenbin Li declare that they have no conflicts of interest. All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Oral consent was obtained from the legal guardians in this study.

References

    1. Zhou M, Zhang X, Qu J. Coronavirus disease 2019 (COVID-19): a clinical update. Front Med. 2020;14(2):126–135. doi: 10.1007/s11684-020-0767-8. - DOI - PMC - PubMed
    1. Xu J, Chen Y, Chen H, Cao B. 2019 novel coronavirus outbreak: a quiz or final exam? Front Med. 2020;14(2):225–228. doi: 10.1007/s11684-020-0753-1. - DOI - PMC - PubMed
    1. Wang Y, Wang Y, Chen Y, Qin Q. Unique epidemiological and clinical features of the emerging 2019 novel coronavirus pneumonia (COVID-19) implicate special control measures. J Med Virol. 2020;92(6):568–576. doi: 10.1002/jmv.25748. - DOI - PMC - PubMed
    1. Lai CC, Shih TP, Ko WC, Tang HJ, Hsueh PR. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): the epidemic and the challenges. Int J Antimicrob Agents. 2020;55(3):105924. doi: 10.1016/j.ijantimicag.2020.105924. - DOI - PMC - PubMed
    1. Zhang Z, Liu S, Xiang M, Li S, Zhao D, Huang C, Chen S. Protecting healthcare personnel from 2019-nCoV infection risks: lessons and suggestions. Front Med. 2020;14(2):229–231. doi: 10.1007/s11684-020-0765-x. - DOI - PMC - PubMed