Epidemiological and Clinical Characteristics of 74 Children Infected with SARS-CoV-2 in Family Clusters in Wuhan, China

Background: The outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is ongoing globally. Limited data are available for children with SARS-CoV-2 infection.To describe the epidemiological and clinical characteristics of SARS-CoV-2 infection among children in family clusters. Methods: A retrospective case study was conducted in one designated hospital for children with SARS-CoV-2 infection in Wuhan. The study covered 74 children who were admitted to hospital with laboratory confirmed SARS-CoV-2 infection. The data was collected from 28th of January 2020, to 3rd of March 2020. Findings: Out of the 74 children with laboratory confirmed SARS-CoV-2 infection, the median age was 5.8 years (IQR, 1.1-9.8), with no notable variation based on gender. All of children had a direct exposure to at least one family member with confirmed SARS-CoV-2 infection. Most common symptoms were cough in 41(55.4%) and fever in 38 (51.4%). 40 (54.1%) children had typical patterns of viral pneumonia on CT including ground-glass opacity, patchy consolidation and interstitial abnormalities. 17 (23.0%) children were classified as asymptomatic carriers, with neither symptoms nor radiological findings. No fatal events occurred. 68 (91.9%) children recovered fully and showed negative results on RT-PCR assay by nasopharyngeal swabs during our observation period. Contrast to the negative in nasopharyngeal swab, 34% of the anal swabs showed continued positive result. The mean hospitalization days of the children discharged after full recovery was 10.0 (8.0-13.0) days. The mean hospitalization days of the still hospitalized children 13.5 (10.3-16.0) days. Interpretation: Within the family clusters that had SARS-CoV-2 infection, children had mild or even asymptomatic illness. Although CT being highly sensitive, it should be avoided in follow-up of the disease in consideration of the radiological hazards and limited clinical benefits from mild illness in children. Furthermore, it is recommended that both nasopharyngeal and anal swabs should be confirmed negative from the viral load prior to declaring fully recovery as a standard for quarantine. Funding Statement: National Key Research and Development Program of China (No.2016YFC1306202); Wuhan Clinical Medical Research Center for Children’s Neural Disease (No. 2014-160);HUST COVID-19 Rapid Response Call (No. 2020kfyXGYJ0).Declaration of Interests: The authors declare no conflicts of interest. Ethics Approval Statement: This study was approved by the Ethics Committee of Wuhan Children’s Hospital of Tongji Medical College of Huazhong University of Science and Technology. The requirement for informed patient consent was waived by the ethics committee due to retrospective case study and the emergency nature of the COVID-19 infection outbreak.