COVID-19 associated pediatric complications

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Harmeet Kharoud M.D.[2]

Presentations

• Presentation of COVID-19 is less severe in children as compared to adults.
• According to CDC, as of April 2, 2020, 1.7% confirmed cases of COVID-19 were reported in children aged <18 years age among the total number of confirmed cases of COVID-19.
• COVID-19 in children could range from asymptomatic presentation to mild to severe disease.

Symptoms

• Fever and Cough are one of the most common symptoms reported in children.
  • One study showed fever is prevalent in 47.5% of children and cough in 41.5% among the 1124 children with COVID-19.
  • According to the CDC, fever, and cough was reported in 56% and 54% of children with COVID 19
• Dyspnea, nasal congestion, pharyngeal erythema, and sore throat are also common presentations in children.
• Gastrointestinal symptoms-The gastrointestinal manifestation in COVID-19 positive children are diarrhea, vomiting, abdominal pain, nausea, and anorexia.
  • Children can present with gastrointestinal symptoms in the absence of respiratory symptoms.
• Cutaneous Findings

Severity of Disease in Children with COVID-19

• Asymptomatic presentation-
  • A large number of children with COVID-19 are asymptomatic.
  • According to one study 14.2% of children were asymptomatic. Another study showed 18% of asymptomatic children with COVID-19.
• Mild Disease
  • Few numbers of children also present with mild manifestations of COVID-19.
  • A study showed 36.3% of children present with a mild form of the disease.
• Severe
  • 2.1% of children present with a severe form of COVID-19 disease.
  • Children with underlying comorbidities are more susceptible to getting severe COVID-19 disease.