HHS: Few Adverse Events in Hospitals Were Reported to State Adverse Event Reporting Systems

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Coronavirus Disease 2019 (COVID-19) in Children and / or Adolescents: A Meta-Analysis

  1. Observational studies on PubMed, Scopus and Web of Science databases describing COVID-19 in children and / or adolescents up to 11 April 2020 were analyzed.
  2. 19 studies included a total of 2,855 children and / or adolescents with COVID-19.
  3. Approximately 47% of subjects had fever, 37% cough, 4% diarrhea, 2% nasal congestion, 1% dyspnoea, and 0% abdominal pain.

Subjects presented mild symptoms in 79% of cases, only 4% were critical. Among those with computed tomography pneumonia, 26.4% had unilateral involvement, 16% bilateral involvement, and 9% interstitial pneumonia.

The authors conclude that children and / or adolescents tend to have an often mild course with good prognosis. 11 June 2020.

Clinical Microbiology and Infection

Low risk for SARS-CoV2 symptomatic infection and early complications in pediatric patients during the ongoing CoVID19 epidemics in Lombardy The authors agree with data already reported in China, supporting the hypothesis that clinically evident CoVID-19 is less frequent and milder in the pediatric population.

The data presented, collected in the context of an organized surveillance program, corroborates previous observations and underscores the need to better understand the clinical spectrum of CoVID-19 in the pediatric population. CoVID-19 affects children and young people less severely, in contrast to other potent viral pandemics, including influenza A. June 3, 2020. European Journal of Pediatrics.

Clinical Microbiology and InfectionCharacteristic of COVID-19 Infection in Pediatric Patients:Early Findings From Two Italian Pediatric Research NetworksIn this descriptive study, the researchers examine 130 children with confirmed COVID-19 diagnosed in 28 centers (mainly hospital) in 10 Italian regions during the first months of the pandemic.

Of these, 67 (51.5%) had a relative with COVID-19, while 34 (26.2%) had comorbidities with the most frequent chronic respiratory, cardiac or neuromuscular diseases. Overall 98 (75.4%) had asymptomatic or mild disease, 11 (8.5%) moderate disease, 11 (8.5%) severe disease, and 9 (6.9%) were critically ill with neonates less than 6 months of age with an increased risk of critical illness severity (OR 5.6, 95% CI 1.3 to 29.1).

  • This descriptive case series in children with COVID-19, which mainly includes hospital-enrolled cases, suggests that COVID-19 may have a non-negligible rate of severe presentations in selected pediatric populations with a relatively high rate of comorbidities. Further studies are needed to further understand presentation and outcomes in children with special needs.
  • Of the case series, mostly diagnosed at the hospital level and with a relatively high rate (26.2%) of co-morbidities, about three-quarters had asymptomatic disorder or mild illness. However, 57.7% were hospitalized (75 children), 11.5% needed respiratory support (15 children), and 6.9% were treated in an intensive care unit ( 9 children).

May 19, 2020. The Lancet Child and Adolescent Health.Gastrointestinal features in children with COVID-19: an observation of varied presentation in eight children
The article reports on eight children with COVID-19 and symptoms of atypical appendicitis that required hospitalization.

The authors highlight that while clinical examination should guide decision making and ultrasound is often the only diagnostic imaging modality to rule out appendicitis, transverse imaging was required for differential diagnosis in 4 of 8 patients.

All children underwent imaging to confirm terminal ileitis and no surgery was required. The authors emphasize the importance of abdominal imaging and a COVID-19 test in children prior to surgery given this unusual presentation in children and adolescents.