Clinical presentations and outcome of severe acute respiratory syndrome in children

Abstract

Hong Kong has been severely affected by severe acute respiratory syndrome (SARS). Contact in households and health-care settings is thought to be important for transmission, putting children at particular risk. Most data so far, however, have been for adults. We prospectively followed up the first ten children with SARS managed during the early phase of the epidemic in Hong Kong. All the children had been in close contact with infected adults. Persistent fever, cough, progressive radiographic changes of chest and lymphopenia were noted in all patients. The children were treated with high-dose ribavirin, oral prednisolone, or intravenous methylprednisolone, with no short-term adverse effects. Four teenagers required oxygen therapy and two needed assisted ventilation. None of the younger children required oxygen supplementation. Compared with adults and teenagers, SARS seems to have a less aggressive clinical course in younger children.

Children Hospitalized With Severe Acute Respiratory Syndrome-Related Illness in Toronto

“…Our findings are generally consistent with those described for 10 children with probable SARS in Hong Kong. 15 In that cohort, 4 of 5 teenagers required oxygen supplementation, whereas all those younger than 10 years did not.…”

“…None of the children in this cohort, with the exception of a 17.5-year-old girl, developed respiratory distress or required oxygen supplementation, and in most, chest radiograph findings tended to be mild and nonspecific. Similarly, compared with teenagers and adults, 7,8,[13][14][15] laboratory abnormalities such as lymphopenia, thrombocytopenia, and elevation in CPK and liver transaminase levels seemed to be mild in degree in young children. In fact, such abnormalities were observed in similar frequency in probable, suspect, and other cause cases.…”

“…Twenty-five children were admitted to the Hospital for Sick Children with a presumptive diagnosis of suspect or probable SARS between March 14 and June 15,2003. The majority of these admissions occurred between March 24 and April 4 (Fig 1).…”

“…4,5,8,13,14 There is a paucity of pediatric data; a preliminary report out of Hong Kong describing 10 cases of pediatric SARS suggested that younger children may have milder disease than teenagers and adults. 15 The purpose of the present report is to describe the clinical, laboratory, and epidemiologic features of children who were admitted to the Hospital for Sick Children, Toronto, with a presumptive diagnosis of suspect or probable SARS.…”

Síndrome agudo respiratorio severo: un panorama mundial de la epidemia

“…30 Se ha observado que el SARS no solamente ocurre rara vez durante la infancia, sino que llega a manifestarse clínicamente con cuadros clínicos menos agresivos que en adultos. 31 Algunos de los contactos cercanos a casos del SARS desarrollan fiebre sin síntomas respiratorios, sugiriendo Franco-Paredes C y col.…”