Ok a few things have been moving in the world of paediatric #COVIDー19 literature

Time for an updated #tweetorial on SARS-CoV-2 infection in children!

#FOAMped #FOAMed #PedsICU #PedsID #IDtwitter

COVID-19 is less severe in children, but often is it severe?

From a Chinese cohort 0.6% needed PICU but lots of community testing involved

US CDC data has 2% of admissions in PICU (limited data)

So why aren't we seeing kids with COVID-19? Is it because they're not getting it, or just not sick enough to go to hospital?

Iceland tested 6% of their whole population. In community testing (random), 0/848 of children <10yrs were positive


So are they not the super spreaders we thought?

Household transmission is now the most common mode, and children appear to rarely be the index case (5-10%)



OK but when they DO get symptoms, what does it look like?

Cough and fever much less frequent than in adults (both ~50% of cases) with about 10% having GI symptoms

No reports of anosmia or rashes as yet...

How about vertical/intrauterine transmission? This is complicated

ALL swabs of placenta/amniotic fluid/vaginal fluid negative so far

But some babies have been IgM +ve positive at birth. IgM doesn't cross the placenta so implies infection


Now we know SARS-CoV-2 serology is not great so far, and IgM has high cross-reactivity, so remains to be seen whether this will be born out in future research.

So what about kids with comorbidities/immunosuppression?

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