The majority of children with COVID-19 in 26 countries fared well clinically compared to adults during the first four months of the pandemic, a newly released study shows.
Majority of children with COVID-19 fared well clinically compared to adults during the first four months of the pandemic
Researchers from the Long School of Medicine at The University of Texas Health Science Center at San Antonio prepared the study, which is the largest systematic review to date of children and young adults with COVID-19. EClinicalMedicine, a journal of The Lancet, on June 26 published the results, which cover studies published between Jan. 24 and May 14.
Among the findings:
- 19% of the pediatric population with COVID-19 had no symptoms.
- 21% exhibited patchy lesions on lung X-rays.
- 5.6% suffered from co-infections, such as flu, on top of COVID-19.
- 3.3% were admitted to intensive care units.
- Seven deaths were reported.
“Our data is compiled from 131 studies and encompasses 7,780 patients who span the pediatric age spectrum,” said study senior author Alvaro Moreira, MD, MSc, assistant professor of pediatrics at UT Health San Antonio and a fellowship-trained neonatologist.
“In the study we report the most common symptoms, quantify laboratory findings and describe imaging characteristics of children with COVID-19,” Dr. Moreira said. “Furthermore, we summarize treatments that were administered and offer an initial glimpse of a handful of patients who met the U.S. Centers for Disease Control and Prevention (CDC) criteria for multi system inflammatory syndrome in children.”
Symptoms
The most frequent symptoms, similar to the adult population, were fever and cough. Those were found in 59% and 56% of the pediatric population.
In 233 individuals, a past medical history was noted, and among this group, 152 were children with compromised immune systems or who had underlying respiratory or cardiac disease.
The number of children with excellent outcomes surprised the research team. “Although we are hearing about severe forms of the disease in children, this is occurring in very rare circumstances,” Dr. Moreira said.
The majority of journal articles were from China. The largest study that was included was a case series of 2,572 patients reported by the U.S. CDC COVID-19 team.
Laboratory measures that were consistently abnormal in pediatric COVID-19 patients included inflammatory markers such as creatine kinase, interleukin-6 and procalcitonin.
Few severe cases
Thankfully, only a small number of patients met inclusion for multisystem inflammatory syndrome in children. Their disease paralleled the extreme forms of COVID-19 seen in adults.
“Children with systemic inflammation had a significant decrease in the amount of lymphocytes in their blood,” Dr. Moreira said. “COVID-positive children who didn’t have the extreme form of the disease had 42% lymphocytes in their blood, versus 11% in children with the multisystem syndrome.”
Lymphocytes are one of the main types of immune cells in the body.
Kidney failure was seen in nine pediatric patients, liver failure also in nine and shock in 19. Mechanical ventilation was required by 42 patients.
Study does not take into consideration a new surge of patients in New York, England and Italy
The study does not take into consideration a new surge of patients in New York, England and Italy where specialists are now starting to see children with multisystem inflammatory syndrome, Dr. Moreira said.
In addition to Dr. Moreira, the team consists of two study co-first authors who are medical students in the Long School of Medicine; a pediatric intensive care fellow at Texas Children’s Hospital in Houston; undergraduate students from Texas A&M, The University of Texas at San Antonio and Cottey College; a student accepted into the McGovern Medical School at UTHealth in Houston; and a San Antonio high school student.
1. Ansel Hoang, Kevin Chorath, Axel Moreira, Mary Evans, Finn Burmeister-Morton, Fiona Burmeister, Rija Naqvi, Matthew Petershack, Alvaro Moreira. COVID-19 in 7780 pediatric patients: A systematic review. EClinicalMedicine, 2020; 100433 DOI: 10.1016/j.eclinm.2020.100433
Razi Berry is the founder and publisher of the journal Naturopathic Doctor News & Review, which has been in print since 2005, and the premier consumer-faced website of naturopathic medicine, NaturalPath. She is the host of The Love is Medicine Project docuseries, The Natural Cancer Prevention Summit, The Heart Revolution-Heal, Empower and Follow Your Heart, and the popular 10-week Sugar Free Summer program. From a near death experience as a young girl that healed her failing heart, to later overcoming infertility and chronic fatigue syndrome and fibromyalgia through naturopathic medicine, Razi has lived the mind/body healing paradigm. Her projects uniquely capture the tradition and philosophy of naturopathy: The healing power of nature, the vital life force in every living thing and the undeniable role that science and mind/body medicine have in creating health and overcoming dis-ease. You can follow Razi on social media: Facebook at Razi Berry, Instagram at Razi.Berry and join the Love is Medicine group to explore the convergence of love and health. Look for more, and listen to more Love is Medicine podcast episodes here.