key: cord-0881411-3dcctl1c
authors: Ranabothu, Saritha; Onteddu, Sanjeeva; Nalleballe, Krishna; Dandu, Vasuki; Veerapaneni, Karthika; Veerapandiyan, Aravindhan
title: Spectrum of COVID‐19 in Children
date: 2020-06-15
journal: Acta Paediatr
DOI: 10.1111/apa.15412
sha: 731424134768f15a70c0f1d7e442ad39e9bdb5fa
doc_id: 881411
cord_uid: 3dcctl1c

The prevalence of coronavirus disease 2019 (COVID‐19) is lower in children compared to adults. Children contribute to 1‐5% of all COVID‐19 cases (1) . A recent study from China reported that 171(12.3%) of 1391 children with suspected disease had confirmed COVID‐19 infection (2) . As of May 15, 2020, there are 33,241 children with COVID‐19 in the United States (3) . The most common symptoms in children with confirmed and suspected COVID‐19 include fever and cough followed by diarrhea, and abdominal pain.

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The prevalence of coronavirus disease 2019 (COVID-19) is lower in children compared to adults. Children contribute to 1-5% of all COVID-19 cases (1) . A recent study from China reported that 171(12.3%) of 1391 children with suspected disease had confirmed COVID-19 infection (2) . As of May 15, 2020, there are 33,241 children with COVID-19 in the United States (3) . The most common symptoms in children with confirmed and suspected COVID-19 include fever and cough followed by diarrhea, and abdominal pain. A very few children developed critical illness coagulopathy, respiratory failure, shock, and renal injury (4) . Severe manifestations of COVID-19 are reported in children younger than 1 year of age and children with comorbid conditions (4) . The majority of children with COVID-19 in the United States that required hospitalization had one or more underlying medical conditions such as chronic lung disease, cardiovascular disease, and immunosuppression (5) . Despite the available limited information, COVID-19 in children poses a significant challenge due to the atypical/asymptomatic presentations and role in community transmission. Knowledge regarding the clinical characteristics and disease burden in children is critical at this stage of the pandemic for better treatment, control of transmission, and appropriate allocation of healthcare resources. Data regarding organ system-specific involvement of COVID-19 is lacking.

We used TriNetX, a global health collaborative clinical research platform that collects real-time electronic medical record data from various healthcare organizations. Our search criteria included children from 0-18 years of age with a confirmed laboratory diagnosis of COVID-19 from January 20, 2020, to June 10, 2020. We used laboratory codes to identify children with confirmed COVID-19 and to gather information on symptoms and organ system involvement.

We used a time constraint of 1 month in the search criteria for any new diagnoses reported on or

This article is protected by copyright. All rights reserved after the diagnosis of COVID-19. We analyzed the data based on age, demographic distribution, symptoms, and organ system involvement. There were a total of 1353 children in the database that met the aforementioned criteria. Demographics and clinical characteristics of these patients are described in table 1. The most common symptoms include fever and cough. Interestingly, loss of smell/taste sensation was reported only in a minority of children and they were 11 years or older. This might be related to the inability of younger children to express this peculiar symptom. About organ system involvement, the majority of the children We describe the clinical characteristics of children with confirmed COVID-19 based on the data available in the largest database to date. The available information confirms multiple organ system involvement in children with COVID-19 and only minority of children require hospitalization and/or critical care. As this report is based on ICD-10 codes entered from the electronic medical record, one should be cautious about establishing causation. Individual patient-level data including outcomes could not be ascertained due to the nature of this study.

Further systematic studies are needed to better understand the organ system-specific manifestations of COVID-19 in children, management, and clinical outcomes.

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COVID-19 and Kawasaki Disease: Novel Virus and Novel Case. Hosp Pediatr

SARS-CoV-2 Infection in Children

Epidemiological characteristics of 2143 pediatric patients with 2019 coronavirus disease in China

Available from: www.cdc.gov. Table 1: Presentations of children in COVID-19

Thank you to Naveen Nallaballe for his help with analysis. Data for the study were provided by the Arkansas Clinical Data Repository (AR-CDR) maintained by the Department of Biomedical Informatics in the College of Medicine at the University of Arkansas for Medical Sciences (UAMS). The AR-CDR is approved to operate as an enterprise data resource to support research across UAMS. Data in the AR-CDR come from UAMS Electronic Medical Record (EMR), tumor registry, billing, and cancer genomic data and comprise encounters since 05/01/2014.

No funding was secured for this study.

All authors have no conflicts of interest to disclose.

This article is protected by copyright. All rights reserved