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COVID-19 in Childhood: Transmission, Clinical Presentation, Complications and Risk Factors
  • Melissa Siebach,
  • Giovanni Piedimonte,
  • Sylvia Ley
Melissa Siebach
Tulane University School of Public Health and Tropical Medicine
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Giovanni Piedimonte
Tulane University School of Medicine
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Sylvia Ley
Tulane University School of Public Health and Tropical Medicine
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Abstract

Children less than 18 years of age account for an estimated 500,000 to 1.5 million global SARS-CoV-2 cases. Lower prevalence of COVID-19 among children, in addition to higher numbers of mild and asymptomatic cases, continues to provide challenges in determining appropriate prevention and treatment courses. Here, we summarize the current evidence on the transmission, clinical presentation, complications and risk factors in regards to SARS-CoV-2 in children and highlight crucial gaps in knowledge going forward. Based on current evidence, children are rarely the primary source of secondary transmission in the household or in child care and school settings and are more likely to contract the virus from an adult household member. Higher transmission rates are observed in older children (10-19 years old) compared to younger children (<10 years old). While increasing incidence of COVID-19 in neonates raises the suspicion of vertical transmission, it is unlikely that breast milk is a vehicle for transmission from mother to infant. The vast majority of clinical cases of COVID-19 in children are mild, but there are rare cases that have developed complications such as multisystem inflammatory syndrome in children (MIS-C), which often presents with severe cardiac symptoms requiring intensive care. Childhood obesity is associated with a higher risk of infection and a more severe clinical presentation. Although immediate mortality rates among children are low, long-term respiratory and developmental implications of the disease remain unknown in this young and vulnerable population.

Peer review status:Published

10 Nov 2020Submitted to Pediatric Pulmonology
11 Nov 2020Submission Checks Completed
11 Nov 2020Assigned to Editor
13 Nov 2020Reviewer(s) Assigned
26 Dec 2020Review(s) Completed, Editorial Evaluation Pending
28 Dec 2020Editorial Decision: Revise Major
09 Jan 20211st Revision Received
11 Jan 2021Submission Checks Completed
11 Jan 2021Assigned to Editor
11 Jan 2021Reviewer(s) Assigned
19 Feb 2021Review(s) Completed, Editorial Evaluation Pending
20 Feb 2021Editorial Decision: Accept
Jun 2021Published in Pediatric Pulmonology volume 56 issue 6 on pages 1342-1356. 10.1002/ppul.25344