Covid en niños
Epidemiology of Pediatric Patients With COVID-19 in China
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- Among 731 laboratory-confirmed cases of children with COVID-19 and 1412 suspected cases, over 90% of all patients had asymptomatic, mild, or moderate disease. The median time from onset of illness to a diagnosis of the disease was 2 days. At the early onset of COVID-19, it spread rapidly from the Hubei province to other provinces in China, then gradually decreased over time. More children in the Hubei province were infected than in any other province.
- There was no significant age or gender difference among children infected with COVID-19. The clinical manifestations of disease among children were noticeably less severe than in adults. However, younger patients, in particular, infants, were susceptible to more severe infection.
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As I noted in another commentary, children's infection with COVID-19 may be less about a high risk of harm to the children themselves, but rather their possible roles as vectors of disease transmission to others. So what do we know about the epidemiology of COVID-19 in children?
This study examined 2143 pediatric patients with COVID-19, of which about a third were laboratory-confirmed, with the rest being suspected cases. They found that over 90% were asymptomatic, mild, or moderate cases. The spread of disease was found to be very rapid early on, but the decline was rather gradual, albeit steady. Notably, this data also made the case for human-to-human transmission since children were not likely to visit the seafood market at which the first human cases were thought to have originated.
Transmission seemed to radiate from where the illness began in Hubei Province, although it's unclear to me whether this reflects a relative lack of longer-distance travel amongst children in China. However, even then, social factors can alter that — the one province in which there was higher spread was the rather distant Heilongjiang province, perhaps attractive because of a well-known Ice Sculpture Festival in Harbin, the capital of the province.
Notably, there is some brief exploration of why children seem less affected: they speculate that since angiotensin converting enzyme II (ACE2) is the cell receptor for SARS-CoV, that COVID-19 may also target ACE2…which is less mature and functional in children versus adults. They also speculate that the much higher rate of respiratory infections in children vs adults may yield higher levels of antibody that may offer some crossover protection. However, this is a summary of available hypotheses provided by the authors, and certainly not a study testing any of these concepts
OBJECTIVES
To identify the epidemiological characteristics and transmission patterns of pediatric patients with COVID-19 in China.
METHODS
Nationwide case series of 2143 pediatric patients with COVID-19 reported to the Chinese Center for Disease Control and Prevention from January 16 to February 8, 2020 were included. The epidemic curves were constructed by key dates of disease onset and case diagnosis. Onset-to-diagnosis curves were constructed by fitting a log-normal distribution to data on both onset and diagnosis dates.
RESULTS
There were 731 (34.1%) laboratory-confirmed cases and 1412 (65.9%) suspected cases. The median age of all patients was 7 years (interquartile range: 2-13), and 1213 cases (56.6%) were boys. Over 90% of all patients were asymptomatic, mild, or moderate cases. The median time from illness onset to diagnoses was 2 days (range: 0 to 42 days). There was a rapid increase of disease at the early stage of the epidemic and then there was a gradual and steady decrease. Disease rapidly spread from Hubei Province to surrounding provinces over time. More children were infected in Hubei province than any other province.
CONCLUSIONS
Children at all ages appeared susceptible to COVID-19, and there was no significant gender difference. Although clinical manifestations of children's COVID-19 cases were generally less severe than those of adults' patients, young children, particularly infants, were vulnerable to infection. The distribution of children's COVID-19 cases varied with time and space, and most of the cases concentrated in Hubei province and surrounding areas. Furthermore, this study provides strong evidence for human-to-human transmission.
Epidemiological Characteristics of 2143 Pediatric Patients With 2019 Coronavirus Disease in China
Pediatrics 2020 Mar 16;[EPub Ahead of Print], Y Dong, X Mo, Y Hu, X Qi, F Jiang, Z Jiang, S TongSkin Care Physicians of Costa Rica
Clinica Victoria en San Pedro: 4000-1054
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posted by dermatica at
March 29, 2020
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