Epidemiology of COVID-19 Among Children in China
Tóm tắt
To identify the epidemiological characteristics and transmission patterns of pediatric patients with the 2019 novel coronavirus disease (COVID-19) in China.
Nationwide case series of 2135 pediatric patients with COVID-19 reported to the Chinese Center for Disease Control and Prevention from January 16, 2020, to February 8, 2020, were included. The epidemic curves were constructed by key dates of disease onset and case diagnosis. Onset-to-diagnosis curves were constructed by fitting a log-normal distribution to data on both onset and diagnosis dates.
There were 728 (34.1%) laboratory-confirmed cases and 1407 (65.9%) suspected cases. The median age of all patients was 7 years (interquartile range: 2–13 years), and 1208 case patients (56.6%) were boys. More than 90% of all patients had asymptomatic, mild, or moderate cases. The median time from illness onset to diagnoses was 2 days (range: 0–42 days). There was a rapid increase of disease at the early stage of the epidemic, and then there was a gradual and steady decrease. The disease rapidly spread from Hubei province to surrounding provinces over time. More children were infected in Hubei province than any other province.
Children of all ages appeared susceptible to COVID-19, and there was no significant sex difference. Although clinical manifestations of children’s COVID-19 cases were generally less severe than those of adult patients, young children, particularly infants, were vulnerable to infection. The distribution of children’s COVID-19 cases varied with time and space, and most of the cases were concentrated in Hubei province and surrounding areas. Furthermore, this study provides strong evidence of human-to-human transmission.
Từ khóa
Tài liệu tham khảo
Li, 2020, Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia, N Engl J Med, 382, 1199, 10.1056/NEJMoa2001316
Huang, 2020, Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China [published correction appears in Lancet 2020;395(10223):496], Lancet, 395, 497, 10.1016/S0140-6736(20)30183-5
Tan, 2020, A novel coronavirus genome identified in a cluster of pneumonia cases — Wuhan, China 2019−2020, China CDC Weekly, 2, 61, 10.46234/ccdcw2020.017
Lu, 2020, Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding, Lancet, 395, 565, 10.1016/S0140-6736(20)30251-8
Zhu, 2020, A novel coronavirus from patients with pneumonia in China, 2019, N Engl J Med, 382, 727, 10.1056/NEJMoa2001017
WHO. WHO director-general’s statement on IHR Emergency Committee on Novel Coronavirus (2019-nCoV). Available at: https://www.who.int/dg/speeches/detail/who-director-general-s-statement-on-ihr-emergency-committee-on-novel-coronavirus-(2019-ncov). Accessed March 3, 2020
WHO. Coronavirus disease 2019 (COVID-19): situation report – 42. Available at: https://www.who.int/docs/default-source/coronaviruse/20200302-sitrep-42-covid-19.pdf?sfvrsn=d863e045_2. Accessed March 3, 2020
Fang, 2020, Recommendations for the diagnosis, prevention and control of the 2019 novel coronavirus infection in children (first interim edition), Zhonghua Er Ke Za Zhi, 145, e20200834
Shen, 2020, Diagnosis, treatment, and prevention of 2019 novel coronavirus infection in children: experts’ consensus statement, World J Pediatr, 10.1007/s12519-020-00343-7
Chan, 2020, A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster, Lancet, 395, 514, 10.1016/S0140-6736(20)30154-9
Wang, 2020, Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China, JAMA, 10.1001/jama.2020.1585
Phan, 2020, Importation and human-to-human transmission of a novel coronavirus in Vietnam, N Engl J Med, 382, 872, 10.1056/NEJMc2001272
The Novel Coronavirus Pneumonia Emergency Response Epidemiology Team, 2020, The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) -China, 2020, China CDC Weekly, 2, 113, 10.46234/ccdcw2020.032
de Wilde, 2018, Host factors in coronavirus replication, Curr Top Microbiol Immunol, 419, 1
National Health Commission of the People's Republic of China . Update on COVID-19 epidemic situation as of 24:00 on March 25. Available at: http://www.nhc.gov.cn/xcs/yqtb/202003/f01fc26a8a7b48debe194bd1277fdba3.shtml. Accessed March 26, 2020
South China Agricultural University . South China Agricultural University finds pangolin may be a potential intermediate host for a new coronavirus. Available at: https://scau.edu.cn/2020/0207/c1300a219015/page.htm. Accessed March 3, 2020
Cyranoski, Did pangolins spread the China coronavirus to people? [published online ahead of print February 7, 2020], Nature
Li, 2003, Angiotensin-converting enzyme 2 is a functional receptor for the SARS coronavirus, Nature, 426, 450, 10.1038/nature02145
Zhou, 2020, A pneumonia outbreak associated with a new coronavirus of probable bat origin, Nature, 579, 270, 10.1038/s41586-020-2012-7
Wrapp, 2020, Cryo-EM structure of the 2019-nCoV spike in the prefusion conformation, Science, 367, 1260, 10.1126/science.abb2507
Fang, 2020, Facing the pandemic of 2019 novel coronavirus infections: the pediatric perspectives [published online ahead of print February 2, 2020], Zhonghua Er Ke Za Zhi, 58, E001
Guan, Clinical characteristics of coronavirus disease 2019 in China [published online ahead of print February 28, 2020], N Engl J Med.