Clinical features of severe pediatric patients with coronavirus disease 2019 in Wuhan: a single center’s observational study

Flash survey on severe acute respiratory syndrome coronavirus-2 infections in paediatric patients on anticancer treatment

“…The possibility that more severe disease associated with immunosenescence, along with an increased risk of severe disease in adults with cancer, and a single case report of a critically ill child who developed COVID-19 during myelosuppressive chemotherapy, has raised the concern that COVID-19 among immunosuppressed children might be a much more severe illness than is seen in otherwise healthy children. 2,[8][9][10] This is consistent with data for other coronaviruses, which do cause more severe infections in immunocompromised children. 11 To evaluate this, we used a flash survey to determine whether there was current evidence that pediatric patients with cancer in SARS-CoV-2 affected areas had been tested for this virus or had developed severe COVID-19 disease.…”

“…The mild disease experienced by the three children in this study is in direct contrast to the only previously published case of which we are aware. An 8 year old child undergoing myelosuppressive chemotherapy for T-cell acute lymphoblastic leukemia in ALL in a Wuhan hospital developed respiratory failure over the course of 3 weeks, eventually requiring mechanical ventilation; the patient had not recovered at the time of the report 8 (and included in 3,9 ). During the course of that patient's disease, CRP and IL-6 were only mildly elevated but ferritin levels were high (6417-15,758 ug/L).…”

A meta-analysis on the role of children in SARS-CoV-2 in household transmission clusters

“…3 The current consensus is that clinical symptoms of COVID-19 are, on average, milder in children (although severe infections can still occur). [4][5][6][7][8] Such observations are consistent with the lower incidence of severe disease amongst children following infection with other coronaviruses including severe acute respiratory distress syndrome (SARS) or Middle East respiratory syndrome (MERS). 9,10 However, this lower incidence of clinical symptoms (and therefore lower incidence of detected disease) raises concerns that children could be an important source of SARS-CoV-2 in household transmission clusters.…”

Managing Asthma during Coronavirus Disease-2019: An Example for Other Chronic Conditions in Children and Adolescents

“…Symptoms of COVID-19 can be similar to those of worsening asthma, or an asthma exacerbation. Dry cough and shortness of breath, commonly seen in asthma, are among the most common presenting symptoms of COVID-19 in case series of children admitted to the hospital in China, as well as in available CDC data in the U.S. (10)(11)(12) Fever, a common presenting symptom of COVID-19, may help differentiate COVID-19 from an asthma exacerbation, although fever can be present in other virus-triggered asthma exacerbations as well. (3,10-12) Other less common symptoms of COVID-19, better described in the adult population, may help differentiate COVID-19 from asthma and include myalgia, confusion headache, pharyngitis, rhinorrhea, loss of sense of smell and taste, diarrhea, nausea and vomiting.…”

“…(19) Although there is a paucity of literature on pediatric risk factors, the case series to date from Wuhan on hospitalized pediatric cases don't list asthma as a pre-existing risk factor for morbidity or mortality. (10,11) It is further reassuring that children appear to be at lower risk of COVID-19 morbidity and mortality than the adult population in general, although severe infection still can occur. (13,20) The CDC morbidity and mortality report notes that among the 149,082 reported U.S. cases of COVID-19 for which age is known, only 2572 (1.7%) occurred in In summary, based on available information to date, it is unclear whether there is a significantly increased risk of COVID-19 morbidity among asthmatic children.…”