A new study from China found that overall children in China infected with the novel coronavirus showed less severe symptoms of illness than adults. The study, “Epidemiological Characteristics of 2143 Pediatric Patients With 2019 Coronavirus Disease in China,” examined the cases of 731 children with confirmed laboratory-tested cases of the coronavirus and 1,412 children who were suspected of having COVID-19.
Of the 2143 pediatric patients included in the study, only one child died. The victim was a 14-year-old boy from Hubei province. He died on Feb 7, 2020. More than 90% of all pediatric patients, however, were asymptomatic, showing mild or common forms of illness.
Why most of the children’s COVID-19 cases were less severe than adults’ cases is puzzling. This may be related to both exposure and host factors. Children were usually well cared for at home and might have relatively less opportunities to expose themselves to pathogens and/or sick patients. Angiotensin converting enzyme II (ACE2) was known as cell receptor for SARS-CoV. 2019-nCoV has some amino acid homology to SARS-CoV and may be able to use ACE2 as a receptor. Recent evidence indicates that ACE2 is also likely the cell receptor of 2019-nCoV. It is speculated that children were less sensitive to 2019-nCoV because the maturity and function (e.g., binding ability) of ACE2 in children may be lower than that in adults – Epidemiological Characteristics of 2143 Pediatric Patients With 2019 Coronavirus Disease in China
The study also provides strong evidence for human-to-human transmission as children were unlikely to visit the Huanan Seafood Wholesale Market where the early adult patients were reported to obtain 2019-nCoV. The study concluded that, children at all ages appeared susceptible to COVID-19, and there was no significant gender difference.
Although clinical manifestations of children’s COVID-19 cases were generally less severe than those of adults’ patients, young children, particularly infants, were vulnerable to infection – Epidemiological Characteristics of 2143 Pediatric Patients With 2019 Coronavirus Disease in China
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