More signs that coronavirus takes less of a toll on children

Kinling Lo

Children infected with the new coronavirus tend to recover from the illness, with most showing at worst mild symptoms, according to two small-scale studies by Chinese researchers.

The studies appear to support earlier research that the coronavirus takes less of a physical toll on children than older people.

But a specialist also cautioned that the studies were small and the mild symptoms might have led to fewer children being tested.

“We still do not understand why there are so few children among the confirmed cases worldwide,” Ben Cowling, a public health professor from the University of Hong Kong, said.

“We don’t yet know how common are infections in children and whether children can spread infection.”

In a paper published in the journal Nature Medicine on Friday, researchers from the Guangzhou Women and Children’s Medical Centre, in the southern Chinese province of Guangdong, examined the cases of 10 infected children – six boys and four girls ranging in age from two months to 15 years.

The 10 were among 745 children tested for the virus between January 22 and February 20.

The children had been tested because they either had close contact with diagnosed patients or were part of a family with an outbreak in the previous two weeks.

Five of these children had a cough, four had a sore throat, three had diarrhoea and two had nasal congestion and a runny nose – symptoms similar to that of a cold or a flu.

“Chest X-rays lacked definite signs of pneumonia, a defining feature of the infection in adult cases,” the paper said.

All of the children recovered and none required respiratory support or treatment in an intensive care unit.

But the researchers also found that the virus continued to appear in faecal samples long after nose and throat swabs no longer show evidence of an infection. Rectal swab testing might be a more effective way to determine how long to quarantine children, the researchers said.

Meanwhile, another Chinese study looked at the cases of six children who tested positive for the coronavirus and hospitalised in Wuhan, the central Chinese city where the disease was first detected.

The six were among 366 children admitted with respiratory infections to Tongji Hospital from January 7 to January 15, according to the study published in the New England Journal of Medicine on Thursday.

The six children, aged one to seven, all recovered in a median 7½ days after hospital admission, with the most seriously ill child taking 13 days to recover and requiring admission to a paediatric intensive care unit.

Children may be just as vulnerable to coronavirus as adults, study finds

Nevertheless, four of the six patients had pneumonia, with radiographic assessments and CAT scans showing typical viral pneumonia patterns in the children.

In Guangdong, the chest X-rays of the 10 children were “either normal or showed only coarse lung markings without unilateral or bilateral pneumonia. Chest CAT scans showed isolated or multiple patchy ground-glass opacities in five patients but were within normal ranges in the other five.”

In a report published on February 28, a World Health Organisation team sent to China said that from data available “it is not possible to determine the extent of infection among children, what role children play in transmission, whether children are less susceptible or if they present differently clinically – [that is] generally milder presentations”.

Yet the report also noted that the disease in children appeared to be relatively rare and mild with roughly 2.4 per cent of the total cases report among individuals aged under 19 years and only 2.5 per cent would develop severe reactions, while 0.2 per cent have recorded critical disease.

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