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COVID-19 in Children, Pregnancy and Neonates: A Review of Epidemiologic and Clinical Features.
Pediatr Infect Dis J. 2020 06; 39(6):469-477.PI

Abstract

The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has spread rapidly across the globe. In contrast to initial reports, recent studies suggest that children are just as likely as adults to become infected with the virus but have fewer symptoms and less severe disease. In this review, we summarize the epidemiologic and clinical features of children infected with SARS-CoV-2 reported in pediatric case series to date. We also summarize the perinatal outcomes of neonates born to women infected with SARS-CoV-2 in pregnancy. We found 11 case series including a total of 333 infants and children. Overall, 83% of the children had a positive contact history, mostly with family members. The incubation period varied between 2 and 25 days with a mean of 7 days. The virus could be isolated from nasopharyngeal secretions for up to 22 days and from stool for more than 30 days. Co-infections were reported in up to 79% of children (mainly mycoplasma and influenza). Up to 35% of children were asymptomatic. The most common symptoms were cough (48%; range 19%-100%), fever (42%; 11%-100%) and pharyngitis (30%; 11%-100%). Further symptoms were nasal congestion, rhinorrhea, tachypnoea, wheezing, diarrhea, vomiting, headache and fatigue. Laboratory test parameters were only minimally altered. Radiologic findings were unspecific and included unilateral or bilateral infiltrates with, in some cases, ground-glass opacities or consolidation with a surrounding halo sign. Children rarely needed admission to intensive care units (3%), and to date, only a small number of deaths have been reported in children globally. Nine case series and 2 case reports described outcomes of maternal SARS-CoV-2 infection during pregnancy in 65 women and 67 neonates. Two mothers (3%) were admitted to intensive care unit. Fetal distress was reported in 30% of pregnancies. Thirty-seven percent of women delivered preterm. Neonatal complications included respiratory distress or pneumonia (18%), disseminated intravascular coagulation (3%), asphyxia (2%) and 2 perinatal deaths. Four neonates (3 with pneumonia) have been reported to be SARS-CoV-2 positive despite strict infection control and prevention procedures during delivery and separation of mother and neonates, meaning vertical transmission could not be excluded.

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Authors+Show Affiliations

Zimmermann P
From the Department of Paediatrics, Fribourg Hospital HFR and Faculty of Science and Medicine, University of Fribourg, Switzerland. Department of Paediatrics, The University of Melbourne, Parkville, Australia. Infectious Diseases Research Group, Murdoch Children's Research Institute, Parkville, Australia.
Curtis N
Department of Paediatrics, The University of Melbourne, Parkville, Australia. Infectious Diseases Research Group, Murdoch Children's Research Institute, Parkville, Australia. Infectious Diseases Unit, The Royal Children's Hospital Melbourne, Parkville, Australia.

MeSH

AdolescentBetacoronavirusCOVID-19ChildChild, PreschoolCoinfectionCoronavirus InfectionsCoughFecesFemaleFetal DistressFeverHumansInfantInfant, NewbornInfectious Disease Transmission, VerticalMaleNasopharynxPandemicsPharyngitisPneumonia, ViralPregnancyPremature BirthSARS-CoV-2

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

32398569

Clinical Trial Links

Prevalence of Antibodies Against SARS-CoV-2 Virus That Causes COVID-19 in Tübingen Children

Citation

Zimmermann, Petra, and Nigel Curtis. "COVID-19 in Children, Pregnancy and Neonates: a Review of Epidemiologic and Clinical Features." The Pediatric Infectious Disease Journal, vol. 39, no. 6, 2020, pp. 469-477.
Zimmermann P, Curtis N. COVID-19 in Children, Pregnancy and Neonates: A Review of Epidemiologic and Clinical Features. Pediatr Infect Dis J. 2020;39(6):469-477.
Zimmermann, P., & Curtis, N. (2020). COVID-19 in Children, Pregnancy and Neonates: A Review of Epidemiologic and Clinical Features. The Pediatric Infectious Disease Journal, 39(6), 469-477. https://doi.org/10.1097/INF.0000000000002700
Zimmermann P, Curtis N. COVID-19 in Children, Pregnancy and Neonates: a Review of Epidemiologic and Clinical Features. Pediatr Infect Dis J. 2020;39(6):469-477. PubMed PMID: 32398569.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - COVID-19 in Children, Pregnancy and Neonates: A Review of Epidemiologic and Clinical Features. AU - Zimmermann,Petra, AU - Curtis,Nigel, PY - 2020/5/14/entrez PY - 2020/5/14/pubmed PY - 2020/5/19/medline SP - 469 EP - 477 JF - The Pediatric infectious disease journal JO - Pediatr Infect Dis J VL - 39 IS - 6 N2 - The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has spread rapidly across the globe. In contrast to initial reports, recent studies suggest that children are just as likely as adults to become infected with the virus but have fewer symptoms and less severe disease. In this review, we summarize the epidemiologic and clinical features of children infected with SARS-CoV-2 reported in pediatric case series to date. We also summarize the perinatal outcomes of neonates born to women infected with SARS-CoV-2 in pregnancy. We found 11 case series including a total of 333 infants and children. Overall, 83% of the children had a positive contact history, mostly with family members. The incubation period varied between 2 and 25 days with a mean of 7 days. The virus could be isolated from nasopharyngeal secretions for up to 22 days and from stool for more than 30 days. Co-infections were reported in up to 79% of children (mainly mycoplasma and influenza). Up to 35% of children were asymptomatic. The most common symptoms were cough (48%; range 19%-100%), fever (42%; 11%-100%) and pharyngitis (30%; 11%-100%). Further symptoms were nasal congestion, rhinorrhea, tachypnoea, wheezing, diarrhea, vomiting, headache and fatigue. Laboratory test parameters were only minimally altered. Radiologic findings were unspecific and included unilateral or bilateral infiltrates with, in some cases, ground-glass opacities or consolidation with a surrounding halo sign. Children rarely needed admission to intensive care units (3%), and to date, only a small number of deaths have been reported in children globally. Nine case series and 2 case reports described outcomes of maternal SARS-CoV-2 infection during pregnancy in 65 women and 67 neonates. Two mothers (3%) were admitted to intensive care unit. Fetal distress was reported in 30% of pregnancies. Thirty-seven percent of women delivered preterm. Neonatal complications included respiratory distress or pneumonia (18%), disseminated intravascular coagulation (3%), asphyxia (2%) and 2 perinatal deaths. Four neonates (3 with pneumonia) have been reported to be SARS-CoV-2 positive despite strict infection control and prevention procedures during delivery and separation of mother and neonates, meaning vertical transmission could not be excluded. SN - 1532-0987 UR - https://www.unboundmedicine.com/medline/citation/32398569/COVID_19_in_Children_Pregnancy_and_Neonates:_A_Review_of_Epidemiologic_and_Clinical_Features_ DB - PRIME DP - Unbound Medicine ER -