Screening of COVID-19 in children admitted to the hospital for acute problems: preliminary data
Keywords:
COVID-19, children, emergency, respiratory and gastrointestinal symptomsAbstract
Background: The new Coronavirus identified in Whuan at the end of 2019 (SARS-CoV-2) belongs to the Beta Coronavirus genus and is responsible for the new Coronavirus 2019 pandemia (COVID-19). Infected children may be asymptomatic or present fever, dry cough, fatigue or gastrointestinal symptoms. The CDC recommends that clinicians should decide to test patients based on the presence of signs and symptoms compatible with COVID-19. Material and methods: 42 children (the majority < 5 years of age) were referred, to our Pediatric Department, as possible cases of COVID-19 infection. Blood analysis, chest X-ray, and naso-oropharyngeal swab specimens for viral identification of COVID-19 were requested. Results: None of the screened children resulted positive for COVID-19 infection. At first presentation, the most frequent signs and symptoms were: fever (71.4%), fatigue (35.7%) and cough (30.9%). An high C-reactive protein value and abnormalities of chest X-ray (bronchial wall thickening) were detected in 26.2% and 19% of patients, respectively. Almost half of patients (45.2%) required hospitalization in our Pediatric Unit and one patient in Intensive Care Unit. Conclusions: Testing people who meet the COVID-19 suspected case definition criteria is essential for clinical management and outbreak control. Children of all ages can get COVID-19, although they appear to be affected less frequently than adults, as reported in our preliminary survey. Further studies are needed to confirm our observations.
References
Zhu N, Zhang D, Wang W, et al. China Novel Coronavirus Investigating and Research Team. N Engl J Med. 2020;382:727–373.
Task force COVID-19 del Dipartimento Malattie Infettive e Servizio di Informatica, Istituto Superiore di Sanità. Epidemia COVID-19, Aggiornamento Nazionale: 9 aprile 2020.
Cai J, Xu J, Lin D, et al. A Case Series of children with 2019 novel coronavirus infection: clinical and epidemiological features. [published online ahead of print, 2020 Feb 28]. Clin Infect Dis. 2020; ciaa198. doi:10.1093/cid/ciaa198.
The Society of Pediatrics of Hubei Medical Association, The Society of Pediatrics of Wuhan Medical Association, Hubei Pediatric Medical Quality Control Center. Suggestions on the diagnosis and treatment of novel coronavirus infection in children in Hubei province. CJCP. 2020;22:96–99.
Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet . 2020;395:497-506.
Ludvigsson JF. Systematic review of COVID-19 in children show milder cases and a better prognosis than adults. [published online ahead of print, 2020 Mar 23]. Acta Paediatr. 2020;10.1111/ apa.15270. doi:10.1111/apa.15270.
Lu X, Zhang L, Du H, et al. SARS-CoV-2 Infection in Children [published online ahead of print, 2020 Mar 18]. N Engl J Med. 2020;NEJMc2005073. doi:10.1056/NEJMc2005073
World Health Organization. Global surveillance for COVID-19 caused by human infection with COVID-19 virus. Interim guidance 20 March 2020.pp.1-20.https://www.who.int/emergencies/ diseases/novel-coronavirus-2019/technical-guidance/surveillance-and-case-definitions.
Zhang Y. The Epidemiological Characteristics of an Outbreak of 2019 Novel Coronavirus
Diseases (COVID-19) — China, 2020. Chinese J Epidemiol. (by The Novel Coronavirus
Pneumonia Emergency Response Epidemiology Team) 2020.
Livingston E, Bucher K. Coronavirus Disease 2019 (COVID-19) in Italy. JAMA. 2020 doi:
1001/jama.2020.4344 [published Online First: 2020/03/18].
Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19) — United
States, February 12–March 16, 2020. (CDC COVID-19 Response Team). Morbidity and Mortality
Weekly Report March 18, 2020 2020;69.
Dong Y, Mo X, Hu Y, et al. Epidemiological Characteristics of 2143 Pediatric Patients With 2019 Coronavirus Disease in China. Pediatrics. 2020;e20200702. doi:10.1542/peds.2020-0702.
Kroumpouzos G, Gupta M, Jafferany M, et al. COVID-19: A Relationship to Climate and Environmental Conditions? Dermatol Ther. 2020;e13399.
Després VR, Huffman JA, Burrows SM, et al. Primary biological aerosol particles in the atmosphere: a review. Tellus B: Chemical and Physical Meteorology. 2012; 64:1. Anal Bioanal Chem (2016) 408:6337–6348
Fang F, Luo XP. Facing the pandemic of 2019 novel coronavirus infections: the pediatric perspectives. Zhonghua Er Ke Za Zhi. 2020;58:81-85.
Li W, Moore MJ, Vasilieva N, et al. Angiotensin-convertingenzyme 2 is a functional receptor for the SARS coronavirus. Nature. 2003;426: 450-454.
Zhou P, Yang X, Wang X, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020;579:270-273.
Kroumpouzos G, Gupta M, Jafferany M, et al. COVID-19: A Relationship to Climate and Environmental Conditions? Dermatol Ther. 2020;e13399.
Després VR, Huffman JA, Burrows SM, et al. Primary biological aerosol particles in the atmosphere: a review. Tellus B: Chemical and Physical Meteorology 2012;64:15598–15656.
Downloads
Published
Issue
Section
License
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Transfer of Copyright and Permission to Reproduce Parts of Published Papers.
Authors retain the copyright for their published work. No formal permission will be required to reproduce parts (tables or illustrations) of published papers, provided the source is quoted appropriately and reproduction has no commercial intent. Reproductions with commercial intent will require written permission and payment of royalties.