MMWR Provides Preliminary US Data on COVID-19 Pediatric Cases

Data on the epidemiology and clinical characteristics of pediatric cases of COVID-19 in the United States are now emerging.

People under the age of 18 make up about 22% of the US population. Based on data from China, US health officials anticipated that pediatric coronavirus disease 2019 (COVID-19) cases may be less severe and consist of different symptoms than cases in adults.

As the United States now has highest number of confirmed COVID-19 cases, the clinical characteristics of pediatric cases in the United States are now emerging.

An early release of the US Centers for Disease Control and Prevention’s (CDC) Morbidity and Mortality Weekly Report (MMWR) contained a preliminary description of pediatric cases of COVID-19 in the United States. The authors of the report explain that few children with COVID-19 are hospitalized, and fewer children than adults experience fever, shortness of breath, or cough.

The article was written by CDC's COVID-19 response team.

The authors analyzed data from 149,760 laboratory confirmed COVID-19 cases that occurred from February 12 through April 2, 2020 across all 50 states.

Among 149,082 cases for which age information was available, 2572 (1.7%) were among people younger than 18 years of age. Symptomatic data were available for 9.4%, underlying condition data for 13%, and hospitalization status for 33%.

Of the pediatric patients with available data, 73% had fever, shortness of breath, or cough. Comparatively, 93% of adults experienced one of those symptoms. These preliminary findings suggest that children with COVID-19 may not report fever or cough as frequently as adult patients do.

Of all pediatric patients, 5.7% were confirmed to have been hospitalized. Out of the pediatric patients for whom hospitalization status was known, 20% were hospitalized. This is lower than the percentages hospitalized among all those with known hospitalization status (33%).

“Whereas most COVID-19 cases in children are not severe, serious COVID-19 illness resulting in hospitalization still occurs in this age group,” the authors wrote.

A total of 3 deaths were reported among pediatric cases included in the analysis, but reviews to confirm COVID-19 as the cause of death are ongoing.

The median age of COVID-19 cases in children was 11 years. About a third (32%) of reported cases occurred in children between 15-17, followed by those in children 10-14 (27%). Children between 5 to 9 years of age made up 15% of cases, children aged less than a year made up another 15% of cases, and children aged 1 through 4 made up 11% of cases.

Sex was known for 2490 of the pediatric COVID-19 cases. Of these cases, 1408 (57%) occurred in male children. Among adult cases, 75,450 (53%) occurred in males.

Among 184 cases with known exposure information, 168 were associated with the household or community and only 16 were associated with travel.

Another recent MMWR also confirmed Chinese reporting on underlying health conditions leading to susceptibility to severe infections. It appears the clinical characteristics in the United States are consistent with those seen around the world in terms of risk groups, based on the preliminary data.