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. 2020 Apr 9;57(5):435–442. doi: 10.1007/s13312-020-1819-5

Coronavirus Disease 2019 (COVID-19) in Children - What We Know So Far and What We Do Not

S Balasubramanian 1, Neha Mohan Rao 2,✉, Anu Goenka 3, Marion Roderick 4, Athimalaipet V Ramanan 5
PMCID: PMC7240240  PMID: 32273490

Abstract

Pediatric coronavirus disease-19 (COVID-19) infection is relatively mild when compared to adults, and children are reported to have a better prognosis. Mortality in children appears rare. Clinical features of COVID-19 in children include fever and cough, but a large proportion of infected children appears to be asymptomatic and may contribute to transmission. It remains unclear why children and young adults are less severely affected than older individuals, but this might involve differences in immune system function in the elderly and/or differences in the expression/function of the cellular receptor for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)- Angiotensin converting enzyme 2 (ACE2). Laboratory findings and chest imaging may not be specific in children with COVID-19. Diagnosis is by Reverse transcriptase-Polymerase chain reaction (RT-PCR) testing of upper or lower respiratory tract secretions. This review additionally considers COVID-19 in immunosuppressed children, and also suggests a management algorithm for the few children who appear to present with life threatening infection, including the potential use of antiviral and immunomodulatory treatment. The most significant threat to global child health from SARS-CoV-2 is unlikely to be related to COVID 19 in children, but rather the socio-economic consequences of a prolonged pandemic.

Keywords: SARS-CoV-2, Pandemic, Management, Immunosuppressed

Contributors: SB, AVR- Initiated the preparation of the manuscript;NMR: Substantial contribution to the conception and design of the work, and prepared and finalized the draft; SB, AVR, AG, MR-Substantial contributions to the acquisition, analysis, and interpretation of data for the work, SB, AVR, A G, MR-Revising it critically for important intellectual content;SB, NMR, AG, MR, AVR: Final approval of the version to be published, and agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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Articles from Indian Pediatrics are provided here courtesy of Nature Publishing Group

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