The most common clinical and laboratory findings in adolescents with COVID-19 are
- incubation period in adolescents and young adults is longer than in older patients
- than young adults, adolescents are less likely to be overweight / obese, smoke and drink alcohol
- no serious cases were observed and there is a higher probability of asymptomatic cases (14.3% vs 6.3%)
- adolescent and young adult patients with COVID-19 have different symptom patterns and a lower incidence of abnormal laboratory findings. Inflammatory markers of C-reactive protein (CRP) and procalcitonin (PCT) are elevated in 13.6% and 10.6% of cases, respectively
- ground glass opacity was found in 50% of adolescents compared with 68.8% of young adults
- Compared to young adults, adolescent patients received less oxygen therapy and fewer days of persistent fever
- fewer teenagers developed severe complications.
May 11, 2020. Clinical Infectious Diseases. SARS-CoV-2 (COVID-19): What do we know about children? A systematic review
The authors conducted a rapid systematic review and narrative summary of all literature related to SARS-CoV-2 in pediatric populations. The search terms also included SARS-CoV and MERS-CoV. The search was carried out in some MEDLINE databases, MedRxiv, among the WHO resources and in the COVID-19 19 resource centers of eleven major journals and publishers.
English abstracts of Chinese language papers were included. From the initial 1657 documents 105 complete articles were evaluated for admissibility.
Of these 24 are COVID-19 related studies included in the review
- Children appear to be less affected by the disease than adults by the rates observed in large epidemiological studies.
- This may be due to the fact that children are often asymptomatic or have mild symptoms, so they do not attract the doctor’s attention, are not tested and therefore counted among positive cases.
Data on clinical outcomes are sparse from the studies reviewed, but include several reports of asymptomatic infection and a milder course of disease in young children, although radiological abnormalities are noted.
Severe cases are not reported in detail and there is little data relating to transmission. 11 May 2020. JAMA.
Characteristics and Outcomes of Children With Coronavirus Disease 2019 (COVID-19) Infection Admitted to US and Canadian Pediatric Intensive Care Units
In this cross-sectional study of 46 North American PICUs, between March 14 and April 3, 2020, 48 children were admitted to 14 pediatric intensive care units (PICUs) in the United States and none in Canada.
A total of 40 children (83%) had pre-existing underlying medical conditions, 35 (73%) had respiratory symptoms, and 18 (38%) required invasive ventilation, and the hospital mortality rate was 4.2%.
This study shows that COVID-19 can lead to a significant disease burden in children, but confirms that severe disease is less frequent and that early hospital outcomes in children are better than in adults.