A recent review of 72,314 cases of COVID-19 found that <1% of cases were in children <10 years of age. The authors were interested in the spectrum of disease in children treated at the Wuhan Children’s Hospital. They included both symptomatic and asymptomatic children with known contact with COVID-19. Of 1391 children assessed and tested, 12.3% were confirmed to have SARS-CoV-2 infection. The median age of infected children was 6.7 years. Fever was present in 41.5% at some time during their illness. Other common signs and symptoms included cough and pharyngeal erythema. 15.8% of cases did not have any symptoms or radiologic features of pneumonia. 12 patients had radiologic features of pneumonia but did not have any symptoms of infection. Three children required intensive care and invasive mechanical ventilation; all had pre-existing conditions (hydronephrosis, leukaemia [on maintenance chemotherapy] and intussusception). Lymphopenia (lymphocyte count <1.2 × 10^9/L) was present in 3.5% patients. The most common radiologic finding was bilateral ground-glass opacity (32.7%). By the time of writing there had been one death of a 10-month-old child with intussusception who died 4 weeks after admission. 21 patients were in a stable condition on the general wards and 149 had been discharged. Therefore most infected children do appear to have a milder clinical course, with asymptomatic infections not being uncommon.
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