Coronavirus Disease 2019 in Children — United States, February 12–April 2, 2020. MMWR Morb Mortal Wkly Rep 2020;69:422–426. DOI: http://dx.doi.org/10.15585/mmwr.mm6914e4external.
As of April 2, 2020, the coronavirus disease 2019 (COVID-19) pandemic has resulted in >890,000 cases and >45,000 deaths worldwide, including 239,279 cases and 5,443 deaths in the United States (1,2). In the United States, 22% of the population is made up of infants, children, and adolescents aged <18 years (children) (3). Data from China suggest that pediatric COVID-19 cases might be less severe than cases in adults and that children might experience different symptoms than do adults (4,5); however, disease characteristics among pediatric patients in the United States have not been described. Data from 149,760 laboratory-confirmed COVID-19 cases in the United States occurring during February 12–April 2, 2020 were analyzed. Among 149,082 (99.6%) reported cases for which age was known, 2,572 (1.7%) were among children aged <18 years. Data were available for a small proportion of patients on many important variables, including symptoms (9.4%), underlying conditions (13%), and hospitalization status (33%). Among those with available information, 73% of pediatric patients had symptoms of fever, cough, or shortness of breath compared with 93% of adults aged 18–64 years during the same period; 5.7% of all pediatric patients, or 20% of those for whom hospitalization status was known, were hospitalized, lower than the percentages hospitalized among all adults aged 18–64 years (10%) or those with known hospitalization status (33%). Three deaths were reported among the pediatric cases included in this analysis. These data support previous findings that children with COVID-19 might not have reported fever or cough as often as do adults (4). Whereas most COVID-19 cases in children are not severe, serious COVID-19 illness resulting in hospitalization still occurs in this age group. Social distancing and everyday preventive behaviors remain important for all age groups as patients with less serious illness and those without symptoms likely play an important role in disease transmission (6,7).
Data on COVID-19 cases were reported to CDC from 50 states, the District of Columbia, New York City, and four U.S territories. Jurisdictions voluntarily report data on laboratory-confirmed cases using a standardized case report form.* Data on cases occurring during February 12–April 2, 2020 and submitted through an electronic case-based COVID-19 surveillance database were reviewed for this report. Data submitted to CDC are preliminary and can be updated by health departments as more data become available. At the time of this analysis, characteristics of interest were available for only a minority of cases, including hospitalization status (33%), presence of preexisting underlying medical conditions (13%), and symptoms (9.4%). Because of the high percentage of cases with missing data and because cases with severe outcomes are more likely to have hospitalization or intensive care unit (ICU) status reported, percentages of patients hospitalized, including those admitted to the ICU, were estimated as a range, for which the denominator for the lower bound included cases with both known and unknown hospitalization or ICU status, and the upper bound included only cases with known hospitalization or ICU status. For other characteristics, percentages were calculated from among the number of cases with known information for that characteristic. Demographics of COVID-19 cases were assessed among cases in children aged <18 years and adults aged ≥18 years. Because clinical severity of COVID-19 is higher among adults aged ≥65 years than in younger age groups (8), clinical features including symptoms and hospitalizations were assessed among adults aged 18–64 years and compared with those among the pediatric cases. Statistical comparisons were not performed because of the high percentage of missing data.
As of April 2, 2020, data on 149,760 laboratory-confirmed U.S. COVID-19 cases were available for analysis. Among 149,082 (99.6%) cases for which patient age was known, 2,572 (1.7%) occurred in children aged <18 years and 146,510 (98%) in adults aged ≥18 years, including 113,985 (76%) aged 18–64 years. Among the 2,572 pediatric cases, 850 (33%) were reported from New York City; 584 (23%) from the rest of New York state; 393 (15%) from New Jersey; and the remaining 745 (29%) from other jurisdictions. The distribution of reporting jurisdictions for pediatric cases was similar to that of reporting jurisdictions for cases among adults aged ≥18 years, except that a lower percentage of adult cases was reported from New York state (14%). The first pediatric U.S. COVID-19 case was reported to CDC on March 2, 2020; since March 5, pediatric cases have been reported daily.
Among all 2,572 COVID-19 cases in children aged <18 years, the median age was 11 years (range 0–17 years). Nearly one third of reported pediatric cases (813; 32%) occurred in children aged 15–17 years, followed by those in children aged 10–14 years (682; 27%). Among younger children, 398 (15%) occurred in children aged <1 year, 291 (11%) in children aged 1–4 years, and 388 (15%) in children aged 5–9 years. Among 2,490 pediatric COVID-19 cases for which sex was known, 1,408 (57%) occurred in males; among cases in adults aged ≥18 years for which sex was known, 53% (75,450 of 143,414) were in males. Among 184 (7.2%) cases in children aged <18 years with known exposure information, 16 (9%) were associated with travel and 168 (91%) had exposure to a COVID-19 patient in the household or community.
Disponível Em: <https://www.cdc.gov/>