Coronavirus Disease 2019 (COVID-19) in adolescents: An update on current clinical and diagnostic characteristics
Keywords:
Coronavirus Disease 2019, COVID-19, clinical and diagnostic characteristics, children, adolescentsAbstract
The current outbreak of infections with SARS-CoV-2 is defined as Coronavirus Disease 2019 (COVID-19). The clinical symptoms of COVID-19 include fever, fatigue, cough, breathing difficulty that may lead to respiratory distress; a small population of patients may have diarrhea, nausea or vomiting. The highest infection rate occurs in adults; however, neonates, children, and adolescents can also be infected. As the outbreak continues to spread worldwide, attention has switched toward determinants of clinical manifes- tations and disease severity. The situation surrounding the outbreak is rapidly evolving and the information and recommendations are changing as new information becomes available. This paper summarises the cur- rent findings (April 3,2020) from a systematic literature review on the current knowledge of COVID-19 in adolescents (10-19 years according to the WHO definition) and reports the preliminary epidemiological data stated by the Italian National Institute of Health.
References
Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, Zhao X, Huang B, Shi W, Lu R, Niu P, Zhan F, Ma X, Wang D, Xu W, Wu G, Gao GF, Tan W; China Novel Coronavirus Investigating and Research Team. N Engl J Med. 2020;382:727–373.
Su S,Wong G, ShiW, Liu J, Lai ACK, Zhou J, Liu W, Bi Y, Gao GF. Epidemiology, genetic recombination, and pathogenesis of coronaviruses. Trends Microbiol. 2016;24:490–502.
Cui J, Li F, Shi ZL. Origin and evolution of pathogenic coronaviruses. Nat Rev Microbiol. 2019;17:181–192.
World Health Organization. Director-General's remarks at the media briefing on 2019-nCoV on 11 February 2020. https://www.who.int/dg/speeches/detail/who-director-general-s-remarks-at-the-media-briefing-on-2019-ncov-on-11-february-2020 (Accessed on February 12, 2020).
World Health Organization. Coronavirus disease 2019 (COVID-19) situation report–51. Geneva, Switzerland: World Health Organization; 2020. https://www.who.int/docs/default-source/ coronaviruse/ situation-reports.
Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, Ren R, Leung KSM, Lau EHY, Wong JY, Xing X, Xiang N, Wu Y, Li C, Chen Q, Li D, Liu T, Zhao J, Li M, Tu W, Chen C, Jin L, Yang R, Wang Q, Zhou S, Wang R, Liu H, Luo Y, Liu Y, Shao G, Li H, Tao Z, Yang Y, Deng Z, Liu B, Ma Z, Zhang Y, Shi G, Lam TTY, Wu JTK, Gao GF, Cowling BJ, Yang B, Leung GM, Feng Z. Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia. N Engl J Med. 2020;382:1199–1207.
Zhang H, Kang Z, Gong H, Xu D, Wang J, Li Z, Cui X, Xiao J, Meng T, Zhou W, Liu J, Xu H. The digestive system is a potential route of 2019-nCov infection: a bioinformatics analysis based on single-cell transcriptomes. bioRxiv. 2020.01.30.927806; doi: https://doi.org/10.1101/2020.01.30.927806.
Zhang W, Du RH, Li B, Zheng XS, Yang XL, Hu B, Wang YY, Xiao GF, Yan B, Shi ZL, Zhou P. Molecular and serological investigation of 2019-nCoV infected patients: implication of multiple shedding routes. Emerg Microbes Infect. 2020;9:386-389.
To KK, Tsang OT, Chik-Yan Yip C, Chan KH, Wu TC, Chan JMC, Leung WS, Chik TSH, Choi CYC, Kandamby DH, Lung DC,Tam AR, Poon RWS, Fung AYF, Hung IFN, Cheng VC, Chan JFW, Yuen KY. Consistent detection of 2019 novel coronavirus in saliva.[published online ahead of print, 2020 Feb 12]. Clin Infect Dis. 2020;ciaa149. doi:10.1093/cid/ciaa149.
Xia J, Tong J, Liu M, Shen Y, Guo D. Evaluation of coronavirus in tears and conjunctival secretions of patients with SARS-CoV-2 infection. J Med Virol. 2020;10.1002/jmv.25725. doi:10.1002/ jmv.25725.
Chan JF, Yuan S, Kok KH, To KK, Chu H, Yang J, Xing F, Liu J, Yip CC, Poon RW, Tsoi HW, Lo SK, Chan KH, Poon VK, Chan WM, Ip JD, Cai JP, Cheng VC, Chen H, Hui CK, Yuen KY. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet. 2020;395:514–523.
Bai Y, Yao L, Wei T, Tian F, Jin DY, Chen L, Wang M. Presumed Asymptomatic Carrier Transmission of COVID-19 [published online ahead of print, 2020 Feb 21]. JAMA. 2020;e202565. doi:10.1001/jama. 2020.2565.
Zou L, Ruan F, Huang M, Liang L, Huang H, Hong Z, Yu J, Kang M, Song Y, Xia J, Guo Q, Song T, He J, Yen HL, Peiris M, Wu J. SARS-CoV-2 Viral Load in Upper Respiratory Specimens of Infected Patients. N Engl J Med. 2020;382:1177-1179.
Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, Wang B, Xiang H, Cheng Z, Xiong Y, Zhao Y, Li Y, Wang X, Peng Z.Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus- infected pneumonia in Wuhan, China. [published online ahead of print, 2020 Feb 7]. JAMA. 2020;e201585. doi:10.1001/jama.2020.1585.
Gao WJ, Li LM. [Advances on Presymptomatic or Asymptomatic Carrier Transmission of COVID-19]. Zhonghua Liu Xing Bing Xue Za Zhi. 2020;41(0):485–488. doi:10.3760/cma.j.cn112338-20200228-00207. [Article in Chinese].
Rothe C, Schunk M, Sothmann P, Bretzel G, Froeschl G, Wallrauch C, Zimmer T,Thiel V, Janke C, Transmission of 2019-nCoV Infection from an Asymptomatic Contact in Germany. N Engl J Med. 2020;382:970–971.
Wei WE, Li Z, Chiew CJ, Yong SE, Toh MP,Lee VJ . Presymptomatic transmission of SARS-CoV-2: Singapore, January 23 –March 16, 2020. MMWR Morb Mortal Wkly Rep. ePub: 1 April 2020. DOI: http://dx.doi.org/ 10.15585/ mmwr.mm6914e1.
Yu P, Zhu J, Zhang Z, Han Y. A familial cluster of infection associated with the 2019 novel coronavirus indicating possible person-to-person transmission during the incubation period. J Infect Dis. 2020;jiaa077. doi:10.1093/infdis/jiaa077.
Chan JF, Yuan S, Kok KH, To KK, Chu H, Yang J, Xing F, Liu J, Yip CC, Poon RW, Tsoi HW, Lo SK, Chan KH, Poon VK, Chan WM, Ip JD, Cai JP, Cheng VC, Chen H, Hui CK, Yuen KY A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet. 2020;395(10223):514-523.
Dahl E. Coronavirus (Covid-19) outbreak on the cruise ship Diamond Princess. Int Marit Health. 2020 71:5–8.
Dashraath P, Jing Lin Jeslyn W, Mei Xian Karen L, Li Min L, Sarah L, Biswas A, Arjandas Choolani M, Mattar C, Lin SL.Coronavirus Disease 2019 (COVID-19) Pandemic and Pregnancy [published online ahead of print, 2020 Mar 23]. Am J Obstet Gynecol. 2020;S0002-9378(20)30343-4. doi:10.1016/ j.ajog.2020. 03. 021.
Zeng L, Xia S, Yuan W, Yan K, Xiao F, Shao J, Zhou W. Neonatal Early-Onset Infection With SARS-CoV-2 in 33 Neonates Born to Mothers With COVID-19 in Wuhan, China. JAMA Pediatr. 2020 Mar 26. https://jamanetwork.com/journals/jamapediatrics/fullarticle/2763787.
Zeng H, Xu C, Fan J, Tang Y, Deng Q, Zhang W, Long X. Antibodies in Infants Born to Mothers With COVID-19 Pneumonia. JAMA. Published online March 26, 2020. doi:10.1001/jama.2020.4861.
Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, Liu L, Shan H, Lei CL, Hui DSC, Du B, Li LJ, Zeng G, Yuen KY, Chen RC, Tang CL, Wang T, Chen PY, Xiang J, Li SY, Wang JL, Liang ZJ, Peng YZ, Wei L, Liu Y, Hu YH, Peng P, Wang JM, Liu JY, Chen Z, Li G, Zheng ZJ, Qiu SQ, Luo J, Ye CJ, Zhu SY, Zhong NS. Clinical characteristics of 2019 novel coronavirus infection in China. medRxiv. 2020 Feb 9. https:
//doi.org/10.1101/2020.02.06.20020974.
Centers for Disease Control and Prevention. Interim Guidelines for Collecting, Handling, and Testing Clinical Specimens from Persons Under Investigation (PUIs) for Coronavirus Disease 2019 (COVID-19). February 14, 2020. https://www.cdc.gov/coronavirus/2019-nCoV/lab/guidelines-clinical-specimens.html (Accessed on March 15, 2020).
Xie X, Zhong Z, Zhao W, Zheng C, Wang F, Liu J. Chest CT for Typical 2019-nCoV Pneumonia: Relationship to Negative RT-PCR Testing [published online ahead of print, 2020 Feb 12]. Radiology. 2020;200343. doi:10.1148/radiol.2020200343.Coronavirus disease 2019 (COVID-19)
Ai T, Yang Z, Hou H, Zhan C, Chen C, Lv W, Tao Q, Sun Z, Xia L. Correlation of Chest CT and RT-PCR Testing in Coronavirus Disease 2019 (COVID-19) in China: A Report of 1014 Cases.[published online ahead of print, 2020 Feb 26]. Radiology. 2020;200642. doi:10.1148/radiol.2020200642.
Henry BM, Oliveira MH. Preliminary epidemiological analysis on children and adolescents with novel coronavirus disease 2019 outside Hubei Province, China: an observational study utilizing crowdsourced data
medRxiv. 2020.03.01.20029884; doi: https://doi.org/10.1101/2020.03.01.20029884.
Liao J, Fan S Sr, Chen J, Wu J, Xu S, Guo Y, Li C, Zhang X, Wu C, Mou H, Song C, Li F, Wu G, Zhang J, Guo L, Liu H, Lv J, Xu L, Lang C. Epidemiological and clinical characteristics of COVID-19 in adolescents and young adults.medRxiv. 2020.03.10.20032136; doi: https://doi.org/10.1101/ 2020.03. 10. 20032136.
Rodriguez-Morales AJ, Cardona-Ospina JA, Gutiérrez-Ocampo E, Villamizar-Peñaa R, Holguin-Riveraa Y, Escalera-Antezanai JP, Alvarado-Arnezi LE, Bonilla-Aldanaa K, Franco-Paredesd C, Henao-Martinez AF, Paniz-Mondolfid A, Lagos-Grisalesa GJ, Ramírez-Vallejoa E, Suárezc JA, Zambranos LI, Villamil-Gómezc WE, Balbin-Ramone GJ, Rabaanw AA, Harapan H, Dhamaaa K, Nishiura H, Kataokaac H, Ahmadad T, Sahaf R, On behalf of the Latin American Network of Coronavirus Disease 2019-COVID-19 Research (LANCOVID-19). Clinical, laboratory and imaging features of COVID-19: A systematic review and meta-analysis [published online ahead of print, 2020 Mar 13]. Travel Med Infect Dis. 2020;101623. doi:10.1016/ j.tmaid.2020.101623.
Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020;10.1001/jama.2020.2648. doi:10.1001/jama.2020.2648.
Korean Society of Infectious Diseases; Korean Society of Pediatric Infectious Diseases; Korean Society of Epidemiology; Korean Society for Antimicrobial Therapy; Korean Society for Healthcare-associated Infection Control and Prevention; Korea Centers for Disease Control and Prevention. Report on the epidemiological features of coronavirus disease 2019 (COVID-19) outbreak in the Republic of Korea from January 19 to March 2, 2020. J Korean Med Sci. 2020;35(10):e112. Published 2020 Mar 16. doi:10.3346/ jkms.2020.35.e112.
Korea Centers for Disease Control and Prevention. The update of COVID-19 in Korea as of March 2. http://ncov.mohw.go.kr/. Updated 2020. Accessed March 2, 2020.
Centers for Disease Control and Prevention COVID-19 Response Team. Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19) — United States, February 12–March 16, 2020. MMWR. 2020;69:1-4.
Italian National Institute of Health (ISS) bulletin data -April 2, 2020. https://www. iss.it/ coronavirus.
Cereda D , Tirani M, Rovida F, Demicheli V, Ajelli M, Poletti P, Trentini F, Guzzetta G, Marziano V, Barone A, Magoni M, Deandrea S, Diurno G, Lombardo M, Faccini M, Pan A, Bruno R, Pariani E, Grasselli G, Piatti A, Gramegna M, Baldanti F, Melegaro A, Merler S. The early phase of the COVID-19 outbreak in Lombardy, Italy. Submitted on 20 Mar 2020. arXiv:2003.09320v1.
CDC COVID-19 Response Team. Coronavirus Disease 2019 in Children — United States, February 12–April 2, 2020. MMWR Morb Mortal Wkly Rep. 2020; 69:1-5.
Cai J, Xu J, Lin D, Yang Z, Xu L, Qu Z, Zhang Y, Zhang H, Jia R, Liu P, Wang X, Ge Y, Xia A, Tian H, Chang H, Wang C, Li J, Wang J, Zeng M. 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.
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.
Dong Y, Mo X, Hu Y, Qi X, Jiang F, Jiang Z, Tong S. Epidemiological Characteristics of 2143 Pediatric Patients With 2019 Coronavirus Disease in China. Pediatrics. 2020;e20200702. doi:10.1542/peds.2020-0702
Henry BM, Oliveira MH. Preliminary epidemiological analysis on children and adolescents with novel coronavirus disease 2019 outside Hubei Province, China: an observational study utilizing crowdsourced data
medRxiv. 2020.03.01.20029884; doi: https://doi.org/10.1101/2020.03.01.20029884.
Liao J, Fan S Sr, Chen J, Wu J, Xu S, Guo Y, Li C, Zhang X, Wu C, Mou H, Song C, Li F, Wu G, Zhang J, Guo L, Liu H, Lv J, Xu L, Lang C. Epidemiological and clinical characteristics of COVID-19 in adolescents and young adults.medRxiv. 2020.03.10.20032136; doi: https://doi.org/10.1101/ 2020.03. 10. 20032136.
Extance A. Covid-19 and long term conditions: what if you have cancer, diabetes, or chronic kidney disease? BMJ. 2020 Mar 25;368:m1174. doi: 10.1136/bmj.m1174.
World Health Organization. Clinical management of severe acute respiratory infection (SARI) when COVID-19 disease is suspected. March 2020 [internet publication].
Hartmann-Boyce J, Hobbs R. Inhaled steroids in asthma during the COVID-19 outbreak. March 2020. Centre for Evidence-Based Medicine [internet publication].
Qiu H, Wu J, Hong L, Luo Y, Song Q, Chen D. Clinical and epidemiological features of 36 children with coronavirus disease 2019 (COVID-19) in Zhejiang, China: an observational cohort study [published online ahead of print, 2020 Mar 25]. Lancet Infect Dis. 2020;S1473-3099(20)30198-5. doi:10.1016/S1473-3099 (20)30198-5.
Lu H. Drug treatment options for the 2019-new coronavirus (2019-nCoV). Biosci Trends. 2020;14:69–71.
Wang M, Cao R, Zhang L, Yang X, Liu J, Xu M, Shi Z, Hu Z, Zhong W, Xiao G.. Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro. Cell Res. 2020;30:269–271.
Grohskopf LA, Alyanak E, Broder KR, Walter EB, Fry AM, Jernigan DB. Prevention and control of seasonal influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices—United States, 2019–20 influenza season. MMWR Recomm Rep. 2019;68 (No. RR-3). https://doi.org/10.15585/mmwr.rr6803a1.
Choe YJ, Choi EH. Are We Ready for Coronavirus Disease 2019 Arriving at Schools? J Korean Med Sci. 2020;35(11):e127. Published 2020 Mar 23. doi:10.3346/jkms.2020.35.e127
Centers for Disease Control and Prevention. Considerations for school closure. https://www.cdc.gov/ coronavirus/2019-ncov/downloads/considerations-for-school-closure.pdf. Updated 2020. Accessed March 14, 2020.
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