Coronavirus in children and infants, what do we know at the moment?

In recent days, the news of the spread of the COVID-19 Virus in Italy, commonly known as Coronavirus, has sparked a series of fears and questions. Let’s try to understand the impact on children and newborns.

Many clear and timely answers can be found in the press releases that are constantly published and updated in the dedicated section of the Ministry of Health website .

We therefore refer you to that section for general questions relating to the current epidemic. Do not inform yourself from uncertain sources. Fake news is circulating and will continue to circulate.

Johns Hopkins University has developed a monitoring system for a few weeks which you can consult here , and which allows you to have a visual idea of ​​the progress of the epidemic in the various countries.

As for questions relating to the Coronavirus in pregnancy or in children, one must refer to the few articles published in recent weeks and which are based on the cases recorded in China.

Obviously, being a virus that has been circulating for a few months, the data collected, especially with regard to pregnancies and children, is very meager, therefore numerically insufficient to be able to draw certain conclusions.

What we know at the moment thanks to this Chinese CDC publication , which is based on about 72,000 cases, is that the 0-9 and 10-19 age groups are very little affected:

Does Coronavirus in children cause milder symptoms?

As we explained a few lines above, there is still little data available, but let’s see together what has been collected so far.

A first study published in the England Journal of Medicine at the end of January which considered the first 425 confirmed cases of Coronavirus, did not report any children under the age of 15. The authors hypothesized that the children for some reason were less likely to be infected or might show milder symptoms.

However, the consideration that the data relating to childhood from China is not so accurate also remains valid.

Guido Gattinara , president of Sitip ( Italian Society of Pediatric Infectious Diseases ) declared that “ A low number of cases among children would be a good thing since they are less likely to wash their hands, cover their mouths and refrain from touching their others, behaviors that can spread germs. If the coronavirus spreads among children, the epidemic could get worse .”

Other data concerning infections in children concern the case of a 10-year-old boy published in the authoritative journal Lancet who took into consideration a family that had been infected by the virus. In this family unit, the 10-year-old boy, who was also positive for the virus, was asymptomatic unlike the other adult members of the family, who presented symptoms of varying degrees of severity.

It therefore seems, data in hand, that very few children are infected with the new coronavirus. And those who test positive for COVID-19 appear to have milder symptoms than adults.

A report published in JAMA   showed that the majority of people infected with the coronavirus are between the ages of 49 and 56.

Most hospitalized patients are often people with an underlying condition , so the severity of the disease can depend on the general health of the person who becomes infected with the virus.

The coronavirus virus in newborns

Nine infants under the age of 1 were infected with the COVID-19 virus and were hospitalized in China between December 8, 2019 and February 6, 2020 (based on data from China’s central government and local health departments) .

In a research letter published in JAMA ,  data from nine infants aged 28 days to 1 year who were hospitalized with a diagnosis of COVID-19 between December 8, 2019 and February 6, 2020 were reviewed.

The children’s ages ranged from 1 month to 11 months, and seven of the 9 children were girls. Among the patients were two children from Beijing, two from Hainan, and one each from the Guangdong, Anhui, Shanghai, Zhejiang and Guizhou areas.

All infected children had at least one infected family member, and the children’s infections occurred after family member infections; seven children either lived in Wuhan or had family members who had visited Wuhan.

One of the children had no symptoms but tested positive for the coronavirus, two others had a diagnosis but lacked information on any symptoms. Fever occurred in four patients, and mild upper respiratory tract symptoms occurred in two children.

None of the children died and none reported serious complications or the need for intensive care or mechanical ventilation .

According to Dr. Wei and his team, the fact that most of the children were girls could suggest that they are more susceptible to the virus than boys, although overall COVID-19 viral infections have been more common in adult men, in particularly those with chronic comorbidities.

Study results are limited by small sample size and lack of symptom data for some patients .

News of February 25, 2020 is that a 17-day-old baby girl healed independently, without the use of drugs. The news comes from the British Daily Mail which cites local Chinese sources.

However, the results confirm that the COVID-19 virus is transmissible to children under the age of 1 , and adults who come into contact with children should take protective measures, including wearing masks , washing hands before contact with children and systematically sterilize toys and crockery.

It’s still too early to say for sure whether children actually have a lower risk, but we’ve seen this before with other infectious diseases.

For example, children younger than 12 who were diagnosed with SARS experienced milder symptoms and fewer hospitalizations than adults.

Children diagnosed with MERS also had a lower mortality rate than adults and generally experienced milder symptoms.

We are still in the very early stages of researching the new coronavirus. Until we have more evidence, no firm conclusions can be drawn about how COVID-19 manifests itself in pregnant women and children.

Time will certainly give more answers than we currently have.

The first data in Italy

Giulio Gallera, Councilor for Wealfare of the Lombardy Region reported the following data on 26 February: “There are 4 positive children in
Lombardy: 2 aged 10, 1 aged 15 and 1 aged 4. Two have been discharged and two are in hospital but are fine. All come from the Codogno area”.

Good habits

Whatever the impact of the virus on children, which is not yet predictable with certainty, it is essential to take the correct precautions to contain the spread of the virus.

The President of the Italian Federation of Pediatricians, Paolo Biasci declared: “ We appeal to parents to avoid taking their children to their family pediatrician’s office or to the emergency room, due to common respiratory symptoms such as cough, cold and fever. To cancel the contagion we must limit the contact between sick and healthy people. In the first instance, the symptoms can be managed with telephone advice and symptomatic drugs suggested by the family pediatrician ”.