One of 149,082 U.S. cases of COVID-19 reported as of April 2, 2020, for which age was known, 2,572 (1.7%) occurred in patients aged <18 years. In comparison, persons aged <18 years accounts for 22% of the U.S. inhabitants. Comparatively few pediatric COVID-19 cases were hospitalized (5.7percent –20%; including 0.58%–2.0% admitted to an ICU), consistent with previous reports that COVID-19 illness often might have a moderate class among younger patients. Hospitalization was most common among pediatric patients aged <1 year old and those with underlying conditions. Additionally, 73 percent of children for whom symptom information was known reported the attribute COVID-19 signs and symptoms of cough, fever, or shortness of breath.
A second report indicated that although pediatric COVID-19 patients rarely have acute outcomes, the disease may be more acute among babies.
During this preliminary investigation of U.S. pediatric COVID-19 cases, a majority (57 percent ) of patients were men. Some studies have reported a vast majority of COVID-19 cases among males, and an analysis of 44,000 COVID-19 instances in patients of all ages in China reported that a greater case-fatality rate among men than among women. However, the same report, as well as a separate analysis of 2,143 pediatric COVID-19 instances from China, found no substantial difference in the number of cases among females and males. Reasons for any potential gap in COVID-19 incidence or severity between males and females are unknown. In the present evaluation, the predominance of men in all pediatric age groups, including patients aged 1 year old, suggests that biologic factors might play a part in any differences in COVID-19 susceptibility by gender.
First, due to the high workload associated with COVID-19 response activities on local, state, and territorial public health personnel, a vast majority of psychiatric cases were missing data on illness symptoms, severity, or underlying conditions. Data for many variables are unlikely to be lost at random, and therefore, these results have to be interpreted with care. Because of the high proportion of lost data, statistical comparisons couldn’t be conducted. Secondly, because most instances happened only days prior to the publication of the report, the results for many patients is unknown, and this analysis might underestimate the severity of disease or symptoms that manifested later in the duration of disease. In many locations, prioritization of testing for seriously ill patients likely occurs, which would lead to overestimation of the proportion of patients using COVID-19 disease who are hospitalized (such as those treated in an ICU) among all age groups. Finally, this analysis compares the clinical characteristics of pediatric cases (persons aged <18 years) with those of instances among adults aged 18–64 decades. Severe COVID-19 disorder appears to be more common among adults at the high end of this age range, and therefore instances in young adults might be more like those among children than suggested by the present analysis.
Since the amount of COVID-19 cases continues to rise in many regions of the USA, it will be important to accommodate COVID-19 surveillance strategies to keep up the collection of crucial case information without overburdening authority health departments. National surveillance will be complemented by concentrated surveillance programs collecting comprehensive case information on a subset of cases across various health care settings. These systems will offer thorough information on the evolving COVID-19 incidence and risk factors for infection and severe illness. A more systematic and detailed collection of inherent condition information among pediatric patients could be helpful to comprehend which children may be at the highest risk for acute COVID-19 illness.
This preliminary examination of features of COVID-19 disorder among children in the United States suggests that kids don’t always have fever or cough as reported symptoms and signs. Although most cases reported among kids thus far have not been severe, clinicians should keep a high index of suspicion for COVID-19 infection in children and monitor for progression of the disease, particularly among infants and children with underlying conditions. However, these findings must be interpreted with caution because of the high proportion of cases missing data on significant features. Since men with hepatitis and mild illness, including children, are probably playing a part in the transmission and spread of COVID-19 in the community, social distancing and everyday preventive behaviors are recommended for persons of all ages to slow the spread of the virus, protect the health care system from becoming overloaded, and protect older adults and persons of any age with serious underlying health conditions.