As we try to predict what will happen here in the US with COVID-19, its natural to look at the experience in China, where the epidemic began. In a study published in the journal Pediatrics, we learn about how the pandemic affected children.
The study looked at information about 2,143 children with COVID-19 infections that were reported to Chinas Centers for Disease Control from January 16 to February 8 of this year. Of the infections, about a third were confirmed with a laboratory test for COVID-19. The others were diagnosed based on symptoms and the results of other tests, such as x-rays.
The best news in this study is that 90% of the children had illness that was asymptomatic, mild, or moderate as opposed to severe or critical. While 4.4% were reported as asymptomatic, given that only a third had laboratory testing, its very likely that the actual number of asymptomatic infections in children during that time period was higher. Only one child died.
In adults, it appears that more like 80% have mild to moderate infections. We dont know why children appear to have milder disease overall. Its likely a combination of factors related to body chemistry, immune function, and even social factors such as how children are cared for and spend their days. But whatever the reason, its good news.
However, there is a part of the study we need to pay attention to: younger children are at higher risk of running into trouble. Among children less than a year old, 10.6% had severe or critical disease. For children ages 1 to 5, that number was still high at 7.3%. It dropped to 4.2% for 6-to-10-year-olds, 4.1% for 11-to-15-year-olds, and 3% for those 16 and older. Interestingly, the only child who died was 14 years old.
Its not really surprising that the youngest children, especially infants, are more vulnerable. In most epidemics, such as influenza, its the very young and the very old that have the highest risk.
How can we use this information? Aside from all the advice already given to parents about hand washing, social distancing, and maintaining healthy habits, parents of young children should take extra care.
Be especially careful about who has contact with your young children
Be particularly watchful should young children get sick
Call your doctor for advice rather than bringing your child in for mild or moderate illness (theres nothing your doctor can do at the office, and you are just adding the risk of more exposures). However, you should absolutely seek medical care if your child has
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For more information on coronavirus and COVID-19, see the Harvard Health Publishing Coronavirus Resource Center.
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