The Epidemiological Characteristics of 1304 Children with Confirmed COVID-19 in Hubei

Abstract

Background: The outbreak of Coronavirus Disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has wildly spread in Europe and the United States. Local human-to-human-transmission indicates the strong infectivity of SARS-CoV-2 and about 80% of the cluster transmission of COVID-19 occurred in families in China. Children as special population are susceptible to SARS-COV-2 at all ages. The epidemiological characteristics and non-pharmacological interventions of pediatric COVID-19 patients in Hubei by 5 periods according to key events and interventions were discussed.Methods: A retrospective study was conducted on the epidemiological characteristics of pediatric COVID-19 patients in Hubei Province from January to May,2020, including patients’ age, sex, residential location, severity classification, date of onset of symptoms and date of diagnosed.Findings: By 24:00 hours on April 21th, 2020, a total number of 68128 confirmed cases were registered, of which 1304 were pediatric confirmed cases, median age was 9.01 years old (intertitles range:3.43-13.84 years). 756 (57.98%) were male and 548 (42.02%) were female. The number of cases account for 2.68%, 8.67%, 23.85%, 25.08%, 27.07%, 12.65% in neonates, infants, 1-5 years old, 6-10 years old, 11-15 years old and >15 years old respectively.226 (17.33%) were asymptomatic, 637 (48.85%) were mild cases and 396 (30.37%) were moderate cases. There were 42 severe cases and 3 critical cases, accounting for 3.22% and 0.23%.The total rate of confirmed cases is 534 per million in Wuhan and 118 per million in non-Wuhan in children. Thirty patients of severe and critical COVID-19 cases have onset of symptoms before February 12th, 2020 . The average daily rate of pediatric confirmed cases of children in Hubei Province is 0.67 per million (first phase), 2.90 per million (second phase), 4.28 per million (third phase), 0.25 per million (fourth phase),0.04 per million (fifth phase) and 0.03 per million (sixth phase).Statistically significant difference was found in different epidemic phases with a sharp decrease in the fourth phase. Interpretation: The proportion of pediatric COVID-19 is lower than that of adults and people in all ages are susceptible including newborns. Pediatric COVID-19 cases are less severe and the rate of confirmed cases are much lower than those in adults in Hubei. There are four keys points to control the epidemic outbreak quickly in children: 1) The centralized quarantine of patients, which protects children from being infected; 2) The community and city lockdown and the limit of social activity, which protects the elder children; 3) The public intervention, such as wearing face mask and hand hygiene, which protects the infants; 4) The compulsory monitored body temperature to investigate and isolate the potential patients in time. Funding: 1.Tongji hospital of Tongji medical college, Huazhong University of Science and Technology No.XXGZBDYJ0052.Major Special Science and Technology Project of Hubei Province under Grant No. 2020AEA0093.Application foundation frontier project of Wuhan No.2020020601012228Declaration of Interest: All the authors, including Liru Qiu, Yue Zhao, Wenhua Liu, Xi Sun, Pik-to Cheung, Sainan Shu, Yan Hao, Yu Chen, Yan Liu, Menaka Dhuromsingh,Jianhua Zhou, Feng Fang,Qin Ning and Xiaoping Luo declare no competing interests.Ethical Approval: All data analysis in this case were approved by the Ethical Committee of TongjiHospital of Huazhong University of Science & Technology (China) (TJC20200359)