Most kids infected with the coronavirus develop only mild symptoms and typically recover within two weeks, according to a study published Wednesday in JAMA Pediatrics.
However, it found that some children become seriously ill, including a 13-month-old infant who was admitted to intensive care.
Researchers in Italy analyzed 1,065 Covid-19 patients, mostly in China, under age 19. They analyzed studies published between Dec. 1 and March 3. At least 444 of the patients were younger than age 10, while 553 were ages 10 to 19.
Most children were reported to have mild respiratory symptoms, namely fever, dry cough, and fatigue or were asymptomatic, meaning they produced no symptoms, the researchers said. Many of the children were hospitalized, but most kids with symptoms required only supportive care and didn’t need oxygen or assisted ventilation, they said. No children under age 9 died, but one death was reported in the 10-19 age range.
One 13-month-old infant with Covid-19 did develop severe complications, however. The infant developed vomiting, diarrhea, fever and pneumonia, complicated by shock and kidney failure that required intensive care, the researchers said. One study also described a 30-hour-old newborn who developed breathing problems after acquiring the infection from the mother.
“Unlike adults, children do not seem to be at higher risk of severe illness based on age and sex,” wrote Riccardo Castagnoli, a Ph.D. candidate at the University of Pavia and a lead author of the analysis. “However, at present, no data are available on the role of comorbidities in the severity of pediatric COVID-19.”
The findings appear to be in line with those from the Centers from Disease Control and Prevention and in China, where the disease emerged almost four months ago and has since spread across the globe, infecting more than 2.5 million people.
Earlier this month, the CDC published a report that found that the majority of pediatric patients in the U.S. developed only mild symptoms such as fever or cough, while a few children had been hospitalized or worse after becoming infected.
A recent study published online in the journal Pediatrics looked at 2,143 cases of children with confirmed or suspected Covid-19 that were reported to the Chinese CDC between Jan. 16 and Feb. 8.
That study found that a number of children in China have developed severe or critical disease and one child has died. More than 90% of the cases were asymptomatic, mild or moderate cases. However, nearly 6% of the children’s cases were severe or critical, compared with 18.5% for adults.
Early in the outbreak, researchers and infectious disease experts said the virus appeared to be sparing children while being particularly severe in the elderly and those with underlying health conditions. However, one researcher noted that the apparent lack of children among confirmed coronavirus cases could also be because they are getting infected but developing more mild symptoms that aren’t being reported to health authorities.
“The data is coming out in so many places and so many forms,” Marc Lipsitch, a professor of epidemiology at the Harvard School of Public Health, said in February.
The differences in symptoms among different age groups are seen in other respiratory illnesses as well. The seasonal flu, which infects millions in the U.S. each year, is usually more severe in adults than children.
Thousands of children are hospitalized each year in the U.S. from the flu, but death is rare, according to the CDC. However, 50% to 70% of flu-related hospitalizations in the U.S. occur in people 65 years and older, and 70% to 85% of deaths occur in that age group, the CDC says.
The Italian study came with limitations. The research occurred over a brief three-month period and all but one case came from China, the researchers said. As a result, they could not assess possible differences in diagnostics and therapeutics.
The researchers said further studies are needed, including analysis of data from Europe and the United States.