A Comparison Between Chinese Children Infected with Coronavirus Disease-2019 and with Severe Acute Respiratory Syndrome 2003

• Published in: The Journal of pediatrics Vol. 224; pp. 30 - 36
• Main Authors: Xiong, Xiaoli, Chua, Gilbert T., Chi, Shuiqing, Kwan, Mike Yat Wah, Sang Wong, Wilfred Hing, Zhou, Aifen, Shek, Chi Chiu, Tung, Keith T.S., Qin, Huan, Wong, Rosa S., Li, Xue, Chen, Peng, Li, Shuai, Chui, Celine S., Tso, Winnie W.Y., Ho, Marco H.K., Wong, Ian C.K., Chan, Godfrey C.F., Lau, Yu Lung, Wong, Kenneth K.Y., Chung, Patrick H.Y., Li, Hui, Tam, Paul K.H., Tang, Shao-tao, Ip, Patrick
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-09-2020
• Subjects: Adolescent; Asymptomatic Infections; Betacoronavirus; Child; Child, Preschool; children; China - epidemiology; Chinese; Coronavirus Infections - diagnosis; Coronavirus Infections - epidemiology; COVID-19; Cross-Sectional Studies; Female; Hong Kong; Hospitalization; Humans; Infant; Length of Stay; Male; Original; Pandemics; Pneumonia, Viral - diagnosis; Pneumonia, Viral - epidemiology; Retrospective Studies; SARS; SARS Virus; SARS-CoV-2; Severe Acute Respiratory Syndrome - diagnosis; Severe Acute Respiratory Syndrome - epidemiology; Hong Kong; China; COVID-19; ACE2; CT; LOS; SARS-CoV-2; children; SARS-CoV; SARS; Chinese; NPA
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2020.06.041

To compare the clinical and laboratory features of severe acute respiratory syndrome 2003 (SARS) and coronavirus disease 2019 (COVID-19) in 2 Chinese pediatric cohorts, given that the causative pathogens and are biologically similar.
This is a cross-sectional study reviewing pediatric patients with SARS (n = 43) and COVID-19 (n = 244) who were admitted to the Princess Margaret Hospital in Hong Kong and Wuhan Children's Hospital in Wuhan, respectively. Demographics, hospital length of stay, and clinical and laboratory features were compared.
Overall, 97.7% of patients with SARS and 85.2% of patients with COVID-19 had epidemiologic associations with known cases. Significantly more patients with SARS developed fever, chills, myalgia, malaise, coryza, sore throat, sputum production, nausea, headache, and dizziness than patients with COVID-19. No patients with SARS were asymptomatic at the time of admission, whereas 29.1% and 20.9% of patients with COVID-19 were asymptomatic on admission and throughout their hospital stay, respectively. More patients with SARS required oxygen supplementation than patients with COVID-19 (18.6 vs 4.7%; P = .004). Only 1.6% of patients with COVID-19 and 2.3% of patients with SARS required mechanical ventilation. Leukopenia (37.2% vs 18.6%; P = .008), lymphopenia (95.4% vs 32.6%; P < .01), and thrombocytopenia (41.9% vs 3.8%; P < .001) were significantly more common in patients with SARS than in patients with COVID-19. The duration between positive and negative nasopharyngeal aspirate and the length in hospital stay were similar in patients with COVID-19, regardless of whether they were asymptomatic or symptomatic, suggesting a similar duration of viral shedding.
Children with COVID-19 were less symptomatic and had more favorable hematologic findings than children with SARS.