Time for an updated #tweetorial on SARS-CoV-2 infection in children!
#FOAMped #FOAMed #PedsICU #PedsID #IDtwitter
Children consistently make up <2% of confirmed COVID-19 cases. These are usually ascertained by testing sick people in hospital
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)
Iceland tested 6% of their whole population. In community testing (random), 0/848 of children <10yrs were positive
Japanese contact tracing data found lower attack rate in kids
Seems they catch it less
Age distribution of the cases with novel coronavirus disease (COVID-19) is rather different from that of influenza. We examined the age distribution of COVID-19 cases in Japan from January to March,...https://doi.org/10.1101/2020.04.17.20053157
Household transmission is now the most common mode, and children appear to rarely be the index case (5-10%)
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...
Essentially all reported cases in newborns so far very mild disease needed limited support!
Previous studies described the clinical features of Covid-19 in adults and infants under 1 year of age. Little is known about features, outcomes and intrauterine transmission potential in newborn...https://erj.ersjournals.com/content/early/2020/04/01/13993003.00697-2020
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
So what about kids with comorbidities/immunosuppression?
But higher rates of resp/cardiac comorbidity in admitted children in US (23%)
In this preliminary description of pediatric U.S. COVID-19 cases, relatively few children with COVID-19 are hospitalized, and fewer children than adults experience fever, cough, or shortness of ...https://journals.lww.com/jpgn/Abstract/publishahead/COVID_19_and_Paediatric_Inflammatory_Bowel.96116.aspx
For a comprehensive review of the literature, check out the @DFTBubbles rapid review page here