COVID-19 in children: the link in the transmission chain
Alyson A Kelvin，Scott Halperin
Published:March 25, 2020DOI:https://doi.org/10.1016/S1473-3099(20)30236-X
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), emerged from Wuhan, Hubei province, China, in late 2019 and has now reached pandemic status.1 Coronaviruses typically cause mild upper respiratory tract infections;2 however, SARS-CoV-2,3 severe acute respiratory syndrome coronavirus (SARS-CoV),4 and Middle East respiratory syndrome coronavirus (MERS-CoV)5 have all been associated with severe illness and death. Common symptoms reported in adults with COVID-19 are fever, dry cough, and fatigue; severe cases have been associated with dyspnoea and bilateral ground-glass opacities on chest CT.3 In China, the SARS-CoV-2 reproductive number is estimated at 2.6 The combined case-fatality rate is 2% in China,7 and the risk of death is increased significantly in older people (approximately 15%).7 It is noteworthy that infants and children have not been featured prominently in COVID-19 case statistics. An analysis from China has shown that children younger than 10 years account for only 1% of COVID-19 cases,7 similar to the proportion for SARS-CoV and MERS-CoV epidemics.4, 5
