key: cord-1002301-jvhrp51s authors: Yu, H.; Cai, Q.; Dai, X.; Liu, X.; Sun, H. title: The clinical and epidemiological features and hints of 82 confirmed COVID-19 pediatric cases aged 0-16 in Wuhan, China date: 2020-03-18 journal: nan DOI: 10.1101/2020.03.15.20036319 sha: 80933ff78d5e77a162d75a2a826e9c84cec43020 doc_id: 1002301 cord_uid: jvhrp51s Although COVID-19 pediatric patients just account for 1% of the overall cases, they are nonnegligible invisible infection sources. We quantitatively analyzed the clinical and epidemiological features of 82 confirmed cases aged 0-16 admitted to Wuhan Children's Hospital, which are expected to shed some lights onto the pediatric diagnosis and therapy. The outbreak of COVID-19 epidemic has attracted worldwide attentions since Dec., 2019, especially in Wuhan. The confirmed children just account for 1% of the overall confirmed cases. Although most of them have mild cases, they are still invisible infection sources of COVID-19 apt to be ignored. This study was carried out on Feb. 1-20, 2020 at Wuhan Children's Hospital, the sole designated hospital for COVID-19 children patients. The participants consisted of 813 children receiving COVID-19 nucleic acid detection. We obtained epidemiological, clinical laboratory, and outcome data. The study was approved by Wuhan Children's Hospital Ethics Committee, and official informed consent was obtained from guardians involved before enrollment when data were collected retrospectively. Take throat-swab, anal-swab or urine specimens at admission, and implement real-time RT-PCR (Wuhan Huada Medical Technology Co., Ltd.). We described symptoms on admission; laboratory results; chest radiography and CT findings; treatment received for COVID-19 and clinical outcomes. Totally 812 children received COVID-19 nucleic acid detection. Therein, 82 (10.99 %) were infected with COVID-19. 74 (90.24%) had a history of exposure to confirmed or suspected family members. All the children lived in Wuhan. As shown in Table 1 , 51 boys and 31 girls were infected with COVID-19 with minimal and maximal ages being 3 days after birth and 16 years, respectively. Male infection rate (62.20%) is higher than female (37.8%), demonstrating the opposite to All rights reserved. No reuse allowed without permission. the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint (which was not peer-reviewed) is . https://doi.org/10.1101/2020.03.15.20036319 doi: medRxiv preprint [1] . Children over 6-age have the highest infection rate (42.68%). On admission, most had fever or cough. Most have mild clinical symptoms with 8 no symptoms. 8 critically ill cases was found with 4 children and 4 infants. On admission, leucocytes were above (resp. below) normal in 21 (25.61%) patients (resp. 4 (4.88%)). The percentage of lymphocytes were above (resp. below) normal range in 48 (58.54%) patients (resp. 16 (19.51%)). Activated partial thromboplastin time (APTT) were above (resp. below) normal range in 9 (9/49, 18.37%) patients (resp. 3 (3/49, 6.12%)). Albumin were below normal range in 30(36.59%). γ Glutamyl transpeptidase were above normal range in 27(32.93%). 30 (36.59%) had myocardial damage. Elevation of lactate dehydrogenase (LDH) in 15 (18.29%). Regarding chest X-ray and CT, 30 (36.59%), 38 (46.34%) and 18 (21.95%) patients showed bilateral, unilateral, multiple mottling and groundglass opacity pneumonia, respectively. 1 (1.22%) was found pleural effusion occurred. 2 (2.44%) had normal chest CTs. All patients were treated in isolation and interferon atomization therapy. Most were given antibiotic or antiviral treatment. 6 (6.10%) children received nasal catheter oxygen therapy. Only 8 was transferred to ICU and given intensive care. 3 had serious complications. Till Feb. 20, 60 (73.17%) patients had been discharged whereas others still in hospital. Two discharged. The mean hospital stay was 11.2 day. From the clinical and treatment data collected in 82 hospitalized COVID-19 patients under 16-age, it surfaces that the juvenile case size is much smaller than the adult counterparts [2, 3] due to milder symptoms. Accordingly, they are apt to be ignored as potential infection resources of COVID-19. The laboratory results and clue are highlighted below, which might be beneficial for diagnosis and therapy for pediatric patients. Most patients had a history of exposure to COVID-19 pneumonia confirmed or suspected family members, and children over 6-age have the highest infection rate. Opposite to [1] , male proportion is higher than female. Most have fever or cough on admission. Most have mild symptoms. Discharged rate is 73.17%. Mean hospital stay was 11.2 days. Zero death rate. Among inspected clinical features, the most important indexes for COVID-19 are CT pneumonia, lymphocytes, APTT, Albumin, γ Glutamyl transpeptidase, LDH. The study was limited to a small number of patients from a single center in Wuhan. Further studies from multiple centers on a larger cohort would be beneficial to further validate the proposed route as well as understand of the disease. All rights reserved. No reuse allowed without permission. the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint (which was not peer-reviewed) is All rights reserved. No reuse allowed without permission. the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint (which was not peer-reviewed) is . https://doi.org/10.1101/2020.03.15.20036319 doi: medRxiv preprint Novel coronavirus infection in hospitalized infants under 1 year of age in China Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study Coronavirus infections more than just the common cold H. Yu is a diagnostic technician of the clinical laboratory in Wuhan Children's Hospital. All rights reserved. No reuse allowed without permission. the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.The copyright holder for this preprint (which was not peer-reviewed) is . https://doi.org/10.1101/2020.03.15.20036319 doi: medRxiv preprint