Pediatric Patients with SARS-CoV-2 Infection: Clinical Characteristics in the United States from a Large Global Health Research Network

Background Few reports have been published on the clinical presentation of pediatric patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) We aim to shed more light on the clinical presentation of pediatric patients infected with coronavirus disease 2019 (COVID-19), and also potential risk factors for more severe clinical case presentation Methods We used a large global health research network to gather clinical data extracted from the electronic medical records of pediatric patients aged < 18 years with confirmed SARS-CoV-2 from January 1, 2020 to May 7, 2020 Clinical symptoms at presentation, hospitalization status, associated co-morbidities, and treatments received were reviewed Results A total of 627 patients with COVID-19 diagnosis (334 were outpatient, 293 were inpatient) were included from a total of 20 organizations across the United States The mean age of patients was seven years, 48% were females Inpatients were younger than outpatients (mean age of 5 6 years vs 8 2 years, p<0 001) Sixty-one percent of patients in the inpatient group were < 5 years of age vs 44% in the outpatient group Amongst 293 inpatients, 90% (n=265) were non-severe and 10% (n=28) were classified as severe The percentage of patients <5 years was higher in severe inpatients vs non-severe (71% vs 60% ) Significantly more patients with a severe illness vs non-severe illness had a history of co-morbidity including non-congenital heart disease (50% vs 11%, p<0 001) and disease of the respiratory system (86% vs 53%, p<0 001) Conclusion Clinicians should closely monitor young children with underlying conditions and COVID-19, as they may be more likely to be hospitalized and have a higher severity of the disease