![]() ![]() Critical disease, including respiratory failure, acute respiratory distress syndrome, and, less commonly, shock, may occur in children with COVID-19. 13,22 The signs and symptoms of COVID-19 may overlap significantly with those of influenza and other respiratory and enteric viral infections. 21 The most common signs and symptoms of COVID-19 in hospitalized children are fever, nausea/vomiting, cough, shortness of breath, and upper respiratory symptoms. Although the true incidence of asymptomatic SARS-CoV-2 infection is unknown, a small study reported that 45% of children who underwent surveillance testing at the time of hospitalization for a non-COVID-19 indication had asymptomatic infection. The signs and symptoms of SARS-CoV-2 infection in symptomatic children may be similar to those in adults however, a greater proportion of children may be asymptomatic or have only mild illness when compared with adults. 20 The study also found that children who identified as Black or as mixed or other races/ethnicities had significantly more hospitalizations than children who identified as White. 13 A study in England reported that children who identified as Asian were more likely than children who identified as White to be hospitalized for COVID-19 and to be admitted to an ICU. 19 In a large United Kingdom study, admission to critical care was independently associated with hospitalized children who self-reported as being of Black ethnicity. ![]() study of children with COVID-19 who were hospitalized between April and September 2020 reported an association between race/ethnicity and disease severity. From 2020 to 2021, Black/African American children with COVID-19 in the United States were 2 times more likely to be hospitalized and 5 times more likely to be admitted to the ICU than White children. 6-17Ĭhildren from some racial and ethnic groups experience disproportionate rates of COVID-19-related hospitalization, which may be a result of barriers to accessing health care and economic and structural inequities. Although only a small percentage of children with COVID-19 will require medical attention, the percentage of intensive care unit (ICU) admissions among hospitalized children is comparable to that for hospitalized adults with COVID-19. The data on the pathogenesis and clinical spectrum of SARS-CoV-2 infection in children are still limited compared to the data for adults. ![]() 1-4 According to a report from the CDC, by February 2022, approximately 75% of children and adolescents had serologic evidence of prior SARS-CoV-2 infection. Epidemiologyĭata from the Centers for Disease Control and Prevention (CDC) demonstrate that SARS-CoV-2 infection and severe disease and death due to COVID-19 occur less often in children than in adults. MIS-C refers to the postinfectious inflammatory condition. Throughout this section, COVID-19 refers to the acute, primarily respiratory illness due to infection with SARS-CoV-2. This section also includes information on risk factors for severe COVID-19, vertical transmission, and infants born to a birth parent with SARS-CoV-2 infection. This section provides an overview of the epidemiology and clinical spectrum of disease, including COVID-19, multisystem inflammatory syndrome in children (MIS-C), and post-COVID conditions. See Guidelines Development for more information. Data on the prevalence of post-COVID conditions in children are limited but suggest that younger children may have fewer persistent symptoms than older children and adults.Įach recommendation in the Guidelines receives a rating for the strength of the recommendation (A, B, or C) and a rating for the evidence that supports it (I, IIa, IIb, or III).The majority of children with MIS-C do not have underlying comorbidities. Many patients with MIS-C require intensive care management. A small subset of children and young adults with SARS-CoV-2 infection may develop multisystem inflammatory syndrome in children (MIS-C).Vertical transmission of SARS-CoV-2 appears to be rare, but suspected or probable cases of vertical transmission have been described. ![]()
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