SARS-CoV-2 Infection in Children: Transmission Dynamics and Clinical Characteristics

Cao Q, Chen YC, Chen CL, Chiu CH. SARS-CoV-2 infection in children: Transmission dynamics and clinical characteristics. J Formos Med Assoc. 2020 Mar;119(3):670-673. doi: 10.1016/j.jfma.2020.02.009. Epub 2020 Mar 2. PubMed PMID: 32139299; PubMed Central PMCID: PMC7126646.

The emergence and spread of a novel coronavirus (SARS-CoV-2) from Wuhan, China, have become a Public Health Emergency of International Concern, designated by World Health Organization. As of February 26, 2020, the National Health Commission of the People’s Republic of China has received a total of 77,663 confirmed cases from across China.1 As of February 26, 126 confirmed cases were reported from Hong Kong (HK), Macao, and Taiwan, and 1804 from 37 countries worldwide.1 During the previous outbreaks of Severe Acute Respiratory Syndrome (SARS) in HK and Middle East Respiratory Syndrome (MERS) in South Korean, very few pediatric patients were reported, respectively.2,3 Despite a high mortality rate of SARS and MERS in the adults, there were no fatalities in the pediatric patients.2,3 Children appeared to have a milder form of the disease caused by the coronaviruses, including SARS-CoV-2.

The first confirmed pediatric case of SARS-CoV-2 infection was reported in Shenzhen on January 20.4 As of February 10, a total of 398 confirmed pediatric cases and 10,924 adult cases were reported nationwide, excluding the Hubei province (Fig. 1A). The data from Hubei province was incomplete because children were rarely screened for SARS-CoV-2 initially. However, a recent study that analyzed 44,672 laboratory-confirmed cases from across China as of February 11, 2020, only 416 (0.9%) were less than 10 years of age and 549 (1.2%) between 10 and 20 years of age.5 In this outbreak, with the increase in the number of adult contacts who turned out to be the infected, the number of pediatric infections also increased concomitantly. With more diagnostic detection done, the proportion of mild infections mainly in children and young adults became higher.5 The formation of the so-called “second-generation” infections in a short period of time indicates that the virus is highly contagious.

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