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Pediatric COVID-19 Symptoms Differ From Those Seen in Adults

Fever and respiratory symptoms common but not considered a hallmark of the disease in children

MONDAY, June 15, 2020 (HealthDay News) -- Clinical manifestations of COVID-19 in children differ widely from adult cases, according to a review published online June 3 in Pediatric Pulmonology.

Tiago H. de Souza, M.D., Ph.D., from the State University of Campinas in Brazil, and colleagues conducted a systematic literature review to identify studies that describe the clinical, laboratorial, and radiological characteristics of children with COVID-19.

The researchers identified 38 studies (1,124 cases) and found that 14.2 percent of children were asymptomatic, 36.3 percent had mild symptoms, 46.0 percent had moderate symptoms, 2.1 percent had severe symptoms, and 1.2 percent of cases were critical. Fever was the most common symptom (47.5 percent), followed by cough (41.5 percent), nasal symptoms (11.2 percent), diarrhea (8.1 percent), and nausea/vomiting (7.1 percent). Pneumonia was diagnosed in 36.9 percent of children, while 10.9 percent were diagnosed with upper airway infections. Just over one in 10 children had a reduced lymphocyte count (12.9 percent). Nearly two-thirds of cases exhibited abnormalities on computed tomography (63 percent), including ground glass opacities, patchy shadows, and consolidations. Only one death was reported.

"The vast majority of children with COVID-19 have a favorable clinical course and their clinical manifestations differ widely from adult cases. Fever and respiratory symptoms should not be considered a hallmark of COVID-19 in children," the authors write. "Therefore, pediatricians should have a high level of clinical suspicion to diagnose children infected with severe acute respiratory syndrome coronavirus 2, as the majority of pediatric cases are asymptomatic or mild."

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