Clinical and transmission dynamics characteristics of 406 children with coronavirus disease 2019 in China: A review

• Published in: The Journal of infection 2020-08, Vol.81 (2), p.e11-e15
• Main Authors: Zhen-Dong, Yang, Gao-Jun, Zhou, Run-Ming, Jin, Zhi-Sheng, Liu, Zong-Qi, Dong, Xiong, Xie, Guo-Wei, Song
• Format: Article
• Language: English
• Subjects: Adolescent; Betacoronavirus; Child; Child, Preschool; Children; China; China - epidemiology; Clinical Characteristics; Coronavirus disease 2019; Coronavirus Infections - diagnosis; Coronavirus Infections - epidemiology; Coronavirus Infections - pathology; Coronavirus Infections - transmission; COVID-19; Female; Humans; Infant; Infant, Newborn; Lung - diagnostic imaging; Lung - pathology; Male; Pandemics; Pneumonia, Viral - diagnosis; Pneumonia, Viral - epidemiology; Pneumonia, Viral - pathology; Pneumonia, Viral - transmission; Review; SARS-CoV-2; Transmission Ddynamics
• ISSN: 0163-4453; 1532-2742
• DOI: 10.1016/j.jinf.2020.04.030

•This article analyzes the demographic, epidemiological, clinical, laboratory and CT image data of 406 children with COVID-19.•The clustered incidence of children's families is a dynamic transmission feature. There are more children than adults with asymptomatic infections, with milder conditions, faster recovery, and a better prognosis. These characteristics are the clinical features of children with COVID-19.•Only 55 of the 406 cases were tested by anal swab virus for nucleic acid, 45 of which were positive, accounting for 81.8% of stool samples.•Some concealed morbidity characteristics also bring difficulties to the early identification, prevention and control of COVID-19.•Efforts should be made to prevent children from becoming a hidden source of transmission in kindergartens, schools or families. Chinese pediatricians are working on the front line to fight COVID-19. They have published a great amount of first-hand clinical data. Collecting their data and forming a large sample for analysis is more conducive to the recognition, prevention and treatment of coronavirus disease 2019 in children. The epidemic prevention and control experience of Chinese pediatricians should be shared with the world. By searching Chinese and English literature, the data of 406 children with COVID-19 in China were analyzed. It was found that the clustered incidence of children's families is a dynamic transmission feature; the incidence is low; asymptomatic infections and mild cases account for 44.8%, with only 7 cases of critical illness; laboratory examination of lymphocyte counts is not reduced, as it is for adults; chest CT findings are less severe than those for adults. These presentations are the clinical features of COVID-19 in children. Only 55 of the 406 cases were tested by anal swab for virus nucleic acid, 45 of which were positive, accounting for 81.8% of stool samples. There are more children than adults with asymptomatic infections, milder conditions, faster recovery, and a better prognosis. Some concealed morbidity characteristics also bring difficulties to the early identification, prevention and control of COVID-19. COVID-19 screening is needed in the pediatric fever clinic, and respiratory and digestive tract nucleic acid tests should be performed. Efforts should be made to prevent children from becoming a hidden source of transmission in kindergartens, schools or families. Furthermore, China's experience in treating COVID-19 in children has led to faster re