'Coronavirus symptoms, outcomes in children decoded'
London, Apr 23: Most children with COVID-19 may exhibit only mild symptoms, if any, requiring only supportive care, with good prognosis and full recovery possible within one to two weeks, according to a review of studies, which presents the clinical manifestation of the disease in the young people.
The research, published in the Journal of the American Medical Association, assessed 18 studies with a total of 1,065 participants from China and Singapore, who were mostly pediatric patients with the novel coronavirus infection.
According to the researchers, including those from the University of Pavia in Italy, most pediatric patients with SARS-CoV-2 infection presented with fever, dry cough, and fatigue, or were asymptomatic. They said only one infant presented with pneumonia, complicated by shock and kidney failure, and was successfully treated with intensive care.
Most pediatric patients were hospitalised, and symptomatic children received mainly supportive care with no deaths reported in the age range of 0 to 9 years, the scientists noted in the study.
The researchers believe that defining the clinical characteristics and severity of the disease in large cohorts of patients is an urgent need. While data are available for adult patients with COVID-19, limited reports analyse pediatric patients infected with SARS-CoV-2, they said.
In this context, the current review study of COVID-19 in children and adolescents sheds light on the clinical features, diagnostic tests, current therapeutic management, and prognosis. Fever and cough were the main symptoms, the researchers said, adding that both were reported in six of the included studies. Only one case of a 13-month-old infant reported severe symptoms.
The scientists said this patient developed vomiting, diarrhoea, fever, and pneumonia, complicated by shock with metabolic acidosis and kidney failure that required intensive care and assisted ventilation. Among the two studies which presented gastrointestinal complications from COVID-19, vomiting was described as the primary clinical manifestation.
Except for the single case of severe infection, none of the included patients required oxygen or assisted ventilation, the scientists noted. They said in general, the patients had a good medical outcome, however, one death was reported in the age range of 10 to 19 years.
Based on the analysis, the scientists said pediatric patients acquired infections mainly through close contact with their parents or other family members. Citing a case study, they added that COVID-19 infection might affect newborns who acquired the infection from the mother, suggesting a possible perinatal-peripartum transmission. However, they said larger studies need to be conducted to confirm this.
The scientists added that there were a few limitations to their analysis method. They said the research occurred over a brief 3-month period with nearly all the studies from Chinese reports, as European and US studies in children with COVID-19 were not available, at the time this review was conducted. So the review research could not assess possible clinical, diagnostic, and therapeutic differences, and compare pediatric results with data from adults with SARS-CoV-2 infection, the researchers noted in the study.
The scientists were also unable to evaluate any possible correlation between viral burden and clinical symptoms. They said the lack of data on pediatric patients require further epidemiologic and clinical studies to identify possible preventive and therapeutic strategies.