COVID-19 Accounts for Small Number of Respiratory Infections in Wuhan Children

By Reuters Staff

March 13, 2020

(Reuters Health) - A retrospective analysis of children hospitalized in central Wuhan for a respiratory infection found the COVID-19 virus accounted for only 1.6% of the cases.

The 366 children were hospitalized between January 7 and January 15. Twenty-three (6.3%) were found to be infected with influenza A, 20 (5.5%) had influenza B and 6 (1.6%) had SARS-CoV-2, which causes COVID-19 disease.

All 6 had moderate-to-severe disease and had been completely healthy before their illness. All experienced high fever, cough and swollen tonsils. Four of the 6 had vomiting. Four had pneumonia.

Early reports out of Wuhan had noted the lack of children amid the infected.

But the new report, published online by The New England Journal of Medicine, shows that the deadly disease can infect them, and the symptoms can be serious.

None of the children died. One, a 3-year-old female, was admitted to the intensive care unit. She was one of 4 with pneumonia, specifically patchy ground-glass opacities in both lungs.

None of the 6 had direct exposure to the seafood market thought to be the epicenter of the outbreak and none of the children had any links to each other.

Intriguingly, one child, another 3-year-old female, lived outside Wuhan in the Yangxin area of Huangshi and was ultimately transferred to Wuhan for treatment. She fell ill on January 2, and neither she nor her family had traveled outside the city in the month before she became sick. She lived more than 100 kilometers or so from the other 5 cases.

"We have not identified the source of infection for this patient," said the medical team, led by Weiyong Liu of Tongji Hospital of Huazhong University of Science and Technology in Wuhan.

The oldest of the 6 was a 7-year-old female who spent 7 days in the hospital. The youngest was age 1; he spent 5 days hospitalized.

The time from symptom onset to hospitalization was typically 5 days. Duration of hospitalization ranged from 7 to 10 days, except for the girl who went to the ICU, who was hospitalized for 13 days.

"Laboratory investigations showed that the levels of lymphocytes, white cells, and neutrophils were below the normal range in six, four, and three patients, respectively," the doctors reported.

Treatment included antivirals, antibiotics and supportive care. The girl admitted to the ICU received pooled immune globulin from healthy donors.

SOURCE: The New England Journal of Medicine, online March 12, 2020.