Acute respiratory disease caused by 2019 novel coronavirus (2019-nCoV) has rapidly spread throughout China. Children and adults show a different clinical course. The purpose of the current study is to comparatively analyze the clinical characteristics of 2019-nCoV infection in children and adults and to explore the possible causes for the discrepancies present. The medical records of 25 adults and 7 children confirmed cases of 2019-2019-nCoV acute respiratory diseases were reviewed retrospectively. All children were family clusters. The total adult patients were differentiated into the local residents of Wuhan, a history of travel to Wuhan and direct contact with people from Wuhan. The numbers were 14 (56%), 10 (40%), and 1 (4%), respectively. The median incubation period of children and adults was 5 days (ranged, 3-12 days) and 4 days (ranged, 2-12 days), respectively. Diarrhoea and/or vomiting (57.1%) were demic by World Health Organiza more common in children, whereas for adults it was myalgia or fatigue (52%). On admission, the percentage of children having pneumonia (5%, 71.4%) was roughly the same as adults (20%, 80%). A total of 20% of adults had leucopoenia, but leukocytosis was more frequently in children (28.6%, P=.014). A higher number of children had elevated creatine kinase isoenzyme (57.1% vs 4%, P=.004). Antiviral therapy was given to all adult patients but to none of the children. In summary, knowledge of these differences between children and adults will not only be helpful for the clinical diagnosis of 2019-nCoV disease, but also for a future discussion on age-specific coronavirus infection. K E Y W O R D S 2019 novel coronavirus, clinical manifestations, comparative analysis, differences between children and adults, laboratory parameters

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Background: Since December 2019, acute respiratory disease (ARD) caused by 2019 novel coronavirus (2019-nCoV) rapidly spread throughout China. Children and adults seemed to differ in the clinical course of the disease. The purpose of the current study is to comparatively analyze the clinical characteristics of children and adult patients with 2019-nCoV infection and to explore the possible causes for the discrepant aspects.Methods: In this retrospective study, the medical records of 32 cases confirmed with 2019-nCoV ARD from Xi'an eighth hospital (Shaanxi, China) from January 31 to February 16, 2020 were reviewed.Results: In all 32 patients contained 7 children and 25 adults. All children were family cluster. For adult patients, local residents of Wuhan, recently travelled to Wuhan, patient contacted with people from Wuhan were 14 (56%), 10 (40%), 1 (4%), respectively. The median incubation period of children and adult was 5 days (range, 3 to 12) and 4 days (range, 2 to 12), respectively. Altogether 10 (40%) adult patients had underlying conditions significantly, but no children had. Fever (Children 71.4% vs. Adult 96%) and cough (Children 71.4% vs. Adult 76%) were the most common symptoms in both groups. The third symptom observed in children was diarrhea and/or vomiting (57.1%), for adult it was myalgia or fatigue (52%). On admission, 5 (71.4%) children patients showed pneumonia roughly the same as adult patients (20, 80%), and that the two group shared a multitude of common imaging characteristics. 20% of adult with leucopoenia, but leukocytosis was significantly more frequently in children (28.6%, P=0.014). More children had elevated creatine kinase isoenzyme (57.1% vs. 4%, P=0.004). All patients were discharged after symptomatic treatment, including oxygen therapy, antiviral treatment, antibiotic treatment. Only one infant was intravenously injected low-dose glucocorticoids.Conclusions: Our results multi-dimensionally demonstrate that children with 2019-nCoV infection present a clinical picture which is often distinct from that of adults. Knowledge of these differences will be helpful for the clinical diagnosis of 2019 novel coronavirus diseases (COVID-19) and for a future discussion on age specific infection case definitions.