番茄社区

A study of six young children in Wuhan, China, hospitalized with COVID-19 coronavirus found that four of them developed pneumonia, with a median hospital stay of seven days.

Clinical data showed abnormal lab results, including low levels of lymphocytes for all six children ages 1 through 7, with six patients presenting with fever and cough, and four of six presenting with vomiting, reported Yingle Liu, PhD, of Wuhan University in Wuhan, China, and colleagues.

Moreover, one child was admitted to the pediatric intensive care unit and received pooled immune globulin, the authors wrote in the .

However, they drew no conclusion about the level of risk of children contracting the infection, and their sample size is admittedly small.

Nevertheless, Liu and colleagues wrote that "our findings indicate that [COVID-19] infections in children were occurring early in the epidemic."

There have been sparse data published about young children and COVID-19 infection in major medical journals. Researchers from Wuhan recently examined a cohort of nine infants, and found mild illness and family clustering.

CDC officials discussed "multiple hypotheses" about why few cases have been seen in children, speculating that infections have occurred but with only "mild illness."

So far, public health recommendations have been based on the experiences of other countries with and China, both of which closed schools. A recent editorial by 番茄社区's Editor-in-Chief Martin Makary, MD, MPH, of Johns Hopkins University, published prior to the NEJM article, stated "all U.S. schools are at risk and may need to be closed."

But infections in children did not seem to figure into , where substantial local transmission was underway. It did not recommend closing schools, but only "social distancing measures," such as canceling large gatherings, postponing athletic contests, and limiting "classroom mixing." Distance learning was recommended only for students "at risk of severe illness."

Liu and colleagues examined data from a larger cohort of 366 hospitalized children age 16 and younger, from Jan. 7 to Jan. 15, 2020. There were 23 testing positive for influenza A, 20 for influenza B, and six for COVID-19.

All six of the COVID-19 cases presented with high fever and cough. Laboratory abnormalities showed lymphocytes were below normal range in all six, while four had low white cell counts and three had low neutrophils.

Children were hospitalized for a median of 7 days, with a range of 5-13 days. Patients were treated with antivirals, antibiotics, and supportive therapies, the authors said.

The authors concluded that their study showed COVID-19 infection "causing moderate-to-severe respiratory illness" in the early phase of the outbreak in hospitalized children.

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