Pediatric COVID 19 April 30, 2020 • Limited published reports • No clear evidence at this time of vertical transmission from COVID infected mothers • Children less affected than adults • Symptoms in children are similar with fever and cough most reported • May have leukopenia and lymphopenia • Variable chest imaging from normal to ground glass, consolidations, interstitial dis
Epidemiological Characteristics of 2143 Pediatric Patients with 2019 Coronavirus Disease in China Methods: • Retrospective review of 2143 children reported to CCDC from 1/16-2/8/2020 • Series included suspected as well as laboratory confirmed cases Results • 731(34.1%) were lab confirmed; 1412 (65.9%) were suspected cases • Median age 7yrs, similar number of males/females Dong Y et al Pediatrics, April 2020
Epidemiological Characteristics of 2143 Pediatric Patients with 2019 Coronavirus Disease in China Results • 94.1% classified as asymptomatic, mild or moderate • Severe cases <1 10.6% 1-5yrs 7.3% 6-10yrs 4.2% 11-15yrs 4.1% death in 14yo >16yrs 3% More severe disease in suspected than confirmed so were some of infants sick with other viruses? Dong Y et al Pediatrics, April 2020
Coronavirus Disease in Children- United States, February 12-April 2, 2020 • 2572/149,760 (1.7%) lab confirmed COVID 19 cases in US were children <18yrs (22% of popul) • Mostly from NY and NJ • Very limited data reported • Median age 11yrs • Fewer hospitalizations but there were some • 3 deaths (ongoing review to confirm if COVID 19 was likely cause of death) MMWR April 6, 2020
Pediatric COVID 19 April 30, 2020 • Overall much less severe disease, hospitalizations and death in children • Multiple reports of febrile infants with COVID 19 • As US outbreak continues, more unpublished reports of sick adolescents with some of the risk factors that have been associated with severe disease in adults, particularly obesity
Pediatric COVID 19 April 30, 2020 • Maine CDC Pediatric Data (<20yrs) – 25 confirmed cases 2.3% Therapy in Children • Supportive care; Clinical trials for very ill – Chiotos et al J Pediatric ID Society MMC enrolled in studies of 2 drugs • Remdesivir >12yrs;>40kg – iv therapy for up to 10 days • Hydroxycholoroquine >18yrs – placebo controlled oral therapy for 5days
Pediatric COVID 19 April 30, 2020 • Dermatologic manifestations – COVID toes; acute self healing acroischemic lesions reported in fingers/toes of some children during this outbreak (some with +COVID tests) • European reports of multisystem inflammatory state requiring intensive care – Some features of TSS or Kawasaki disease – Not all COVID +
Pediatric COVID 19 April 30, 2020
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