March 12, 2020

Clinical Characteristics of 6 Children From Wuhan With COVID-19 in the Early Phase of the Outbreak

By Denise Baez

A study published in The New England Journal of Medicine showed that coronavirus disease 2019 (COVID-19) occured in children in the early phase of the outbreak in Wuhan, China, causing moderate-to-severe respiratory illness.

From January 7, 2020, to January 15, 2020, a total of 366 hospitalised children and adolescents aged 16 years and younger were enrolled in a retrospective study of respiratory infections at 3 branches of Tongji Hospital, which are located 14 km to 34 km from one another in central Wuhan.

Influenza A virus was detected in 23 (6.3%) patients, influenza B virus was detected in 20 (5.5%), and SARS-CoV-2, the virus that causes COVID-19, was detected in 6 (1.6%) patients.

The dates of illness onset in the 6 patients with COVID-19 were between January 2, 2020, and January 8, 2020, and the patients were hospitalised between January 7, 2020, and January 13, 2020.

The children were aged 1 to 7 years (4 female, 2 male). Common clinical characteristics included high fever (all 6 six patients), cough (all 6 patients), and vomiting (in 4 patients).

Four children had pneumonia, as assessed radiographically, with CT scans of the chest showing typical viral pneumonia patterns. Chest CT findings were available for 5 patients. One patient showed normal findings, 3 patients showed patch shadows in both lungs, and 1 patient showed patch ground-glass opacities in both lungs.

Laboratory investigations showed that the levels of lymphocytes, white cells, and neutrophils were below the normal range in 6, 4, and 3, patients, respectively.

All patients were treated with oseltamivir and 4 patients also received glucocorticoids. Only 1 child needed supplemental oxygen. One child was admitted to the paediatric intensive care unit and received pooled immune globulin from healthy donors.

Duration of fever was 3 to 11 days and duration of hospitalisation was 5 to 13 days.

All children recovered after hospitalisation.

“Our findings indicate that SARS-CoV-2 infections in children were occurring early in the epidemic,” wrote Weiyong Liu, PhD, Tongji Hospital of Huazhong University of Science and Technology, Wuhan, China, and colleagues.

The researchers said that none of the patients or their family members had had direct exposure to Huanan Seafood Wholesale Market or to one another.

Of note, one of the children in the study resided outside Wuhan. This patient had illness onset on January 2, 2020. The patient and her family were residents of the Yangxin area of Huangshi and had not traveled outside the city in the month before illness onset. The researchers have not identified the source of infection for this patient.

Informed consent was obtained from the parents or guardians of the children with COVID-19 for the publication of their clinical data.


SOURCE: The New England Journal of Medicine
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