Coronavirus disease 2019 in young people – United States, February 12 to April 2, 2020

As of April 2, 2020, the coronavirus disease 2019 (COVID-19) pandemic has caused more than 890,000 cases and more than 45,000 deaths worldwide, totaling 239,279 cases and 5,443 deaths in the United States. United States. [1,2] In the United States, 22% of the population is made up of infants, youth, and adolescents under the age of 18 (youth). [3] Data from China suggests that pediatric cases of COVID-19 may be less severe than adult cases and that children may experience other symptoms than adults; [4,5] however, features of the disease in pediatric patients in the United States have not been described. Data from 149,760 laboratory-confirmed cases of COVID-19 in the United States that occurred between February 12 and April 2, 2020, were analyzed. Of the 149,082 (99. 6%) reported cases in which known age, 2,572 (1. 7%) were under 18 years of age. Data were available for a small proportion of patients on many vital variables, including symptoms (9. 4%), background conditions (13%), and hospital prestige (33%). Of those with information, 73% of pediatric patients had symptoms of fever, cough, or shortness of breath, compared to 93% of adults aged 18 to 64 years in the same period; 5. 7% of all pediatric patients, or 20% of those with known hospitalization status, were hospitalized, which is lower than hospitalization rates among all adults aged 18 to 64 years (10% ) or those whose prestige of hospitalization is known (33%). . Three deaths were reported among the pediatric cases included in this analysis. These data support previous findings that children with COVID-19 may not have reported fever or cough as adults. [4] While most cases of COVID-19 in youth are not severe, severe cases of COVID-19 that result in hospitalization still occur in this age group. Social distancing and daily preventive behaviors remain vital for all age groups, as patients with less severe illness and those without symptoms likely play a critical role in disease transmission. [6, 7]

Data on COVID-19 cases were reported to CDC across 50 states, the District of Columbia, New York City, and 4 U. S. territories. Jurisdictions voluntarily report knowledge of laboratory-confirmed cases in a standardized case report form. Data submitted to CDC is initial and may be updated through fitness departments as more information becomes available. At the time of this analysis, the characteristics of interest were only available for a minority of cases, adding the prestige of hospitalization (33%), the presence of pre-existing underlying medical conditions (13%), and symptoms (9. 4%). . Due to the high percentage of instances with unawareness and the fact that instances with severe outcomes are more likely to have inpatient or intensive care unit (ICU) prestige, the percentages of inpatients, summing those admitted to ICU, were estimated over a range, for which the lower bound denominator included instances with known or unknown hospitalization or ICU prestige, and the upper bound included only instances with known hospitalization or extensive care prestige. For other features, percentages were calculated from the number of instances with known data for that feature. The demographics of COVID-19 cases were evaluated between cases in youth over 18 years of age and adults over 18 years of age. Because the clinical severity of COVID-19 is greater in older adults ≥65 years than in younger age groups, [8] clinical characteristics, summing symptoms and hospitalizations, were evaluated in adults older than 18 to 64 years and in comparison with pediatric instances. No statistical comparison was made due to the high percentage of lack of knowledge.

As of April 2, 2020, information was available on 149,760 cases of COVID-19 in the U. S. Older than 18 years ≥and 146,510 (98%) in adults older than 18 years, totaling 113,985 (76%) older than 18 years. Of the 2,572 pediatric cases, 850 (33%) were reported in New York; 584 (23%) from the rest of New York State; 393 (15%) from New Jersey; and the remaining 745 (29%) from other jurisdictions. The distribution of pediatric case reporting jurisdictions was similar to that of adult reporting jurisdictions aged 18 years and older, with a decrease in the percentage of adult cases reported in New York State (14). %). The first pediatric case of COVID-19 in the United States was reported to CDC on March 2, 2020; Since March 5, pediatric instances have been reported daily (Figure 1).

Figure 1.

COVID-19 cases in youth* under 18 years of age, as of date of notification to CDC (N=2549)† — United States, February 24 to April 2, 2020§ *Includes infants, youth, and adolescents. †Excludes 23 cases in youth younger than 18 years without reporting dates. § Report date as of February 24, 2020; Reported instances include all instances that evolved as of February 12, 2020.

Among the 2,572 cases of COVID-19 in young people younger than 18 years, the median age is 11 years (range 0 to 17 years). Nearly one-third of reported pediatric cases (813; 32%) occurred in older children aged 15 to 17 years, followed by those in children aged 10 to 14 years (682; 27%). Among younger youth, 3nine8 (1five%) occurred in children under 1 year old, 2nine1 (11%) in 1- to 4-year-olds, and 388 (1five%) in five-year-olds. at age nine. Of the 2,490 pediatric cases of COVID-19 for which sex is known, 1,408 (57%) occurred in males; Of the cases of adults ≥ 18 years of age in whom the sex was known, 53% (7five, 4five0 of 143,414) were men. Among 184 (7. 2%) cases in youth younger than 18 years with known exposure data, 16 (nine %) were travel-related and 168 (nine 1%) had been exposed to a COVID-19 patient. 1nine in the family or community.

Information was obtained on the prestige of hospitalization of 745 (29%) instances in young people under 18 years of age and 35,061 (31%) instances in adults aged 18 to 64 years. Of the young people with COVID-19, 147 (estimated diversity = 5. 7% to 20%) were hospitalized, of whom 15 (0. 58% to 2. 0%) were admitted to an intensive care unit (Figure 2). Among older adults aged 18 to 64 years, the percentages of hospitalized patients (10% to 33%), adding those admitted to the ICU (1. 4% to 4. 5%), were higher. Children younger than one year accounted for the highest percentage (15% to 62%) of hospitalizations among pediatric COVID-19 patients. Of the 95 children under one year of age with recognized hospitalization prestige, 59 (62%) were hospitalized, of which five were admitted to the intensive care unit. with little variation between age teams (Figure 2).

Figure 2.

Nine cases of COVID-1 in youth* under 18 years of age, among those with known hospitalization prestige (N=7fourfive), † by organization of age and hospitalization prestige — United States, February 12 to April 2, 2020 Abbreviation: ICU = extensive care unit. *Includes infants, youth, and adolescents. †Number of young people without hospitalization by age organization: <1 year (303 of 398; 76%); 1 to four years (18nine out of 2nine1; 6five%); five to nine years (27five out of 388; 71%); 10 to 1four years (four66 out of 682; 68%); 15 to 17 years (five nine-four of 813; 73%).

Of the 345 paediatric instances with baseline data, 80 (23%) had at least one baseline condition. The maximum non-unusual background situations were chronic lung disease (adding asthma) (40), cardiovascular disease (25) and immunosuppression (10). ). Of the 295 paediatric instances for which data are available on the prestige of hospitalization and underlying medical situations, 28 out of 37 (77%) hospitalized patients, adding the six patients admitted to an intensive care unit, had one or more underlying medical situations; Of the 258 patients who were not hospitalized, 30 (12%) had background situations. Among the paediatric cases included in this review, three deaths were reported; however, a review of those cases is underway to verify that COVID-19 is the likely cause of death.

*https://www. cdc. gov/coronavirus/2019-ncov/downloads/pui-form. pdf.

*Cases were included in the denominator if they had a known symptomatic state of fever, cough, shortness of breath, nausea/vomiting, and diarrhea. Total number of patients by age group: <18 years (N = 2572), 18–64 years (N = 113,985). †Includes all cases with one or more of these symptoms. People were included if they had data for measured or subjective fever variables and were thought to have fever if 'yes' was indicated for any of the variables. ¶Nose discharge and abdominal pain were less common than other symptoms; Therefore, the percentages with those symptoms are probably underestimated.

CDC COVID-19 Response Team Stephanie Bialek, CDC; Ryan Gierke, CDC; Michelle Hughes, CDC; Lucy A. McNamara, CDC; Tamara Pilishvili, CDC; Tami Skoff, CDC.

Corresponding Lucy A. McNamara for CDC COVID-19 Response Team, eocevent294@cdc. gov, 770-488-7100.

All authors completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. No potential conflicts of interest were disclosed.

What do we already know about this topic?

Data from China suggests that cases of pediatric coronavirus disease 2019 (COVID-19) could be less severe than cases in adults and that children (people younger than 18) might have other symptoms than adults.

What does this bring?

In this initial description of pediatric COVID-19 cases in the United States, few children with COVID-19 are hospitalized and fewer children than adults suffer from fever, cough, or shortness of breath. Serious consequences have been reported in children, totaling 3 deaths.

What are the implications for public practice?

Pediatric patients with COVID-19 may not have a fever or cough. Social distancing and preventive behaviours remain vital for all age groups, as patients with less severe illness and those without symptoms are likely to play a critical role in disease transmission.

Figure 1.

Figure 2.

You’ve already decided on My Alerts

Click on the subject line below to receive emails when new items become available.

Leave a Comment Cancel Reply