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Ok a few things have been moving in the world of paediatric #COVIDー19 literature

Time for an updated #tweetorial on SARS-CoV-2 infection in children!

#FOAMped #FOAMed #PedsICU #PedsID #IDtwitter

So there are fewer cases in children. How much fewer?

Children consistently make up <2% of confirmed COVID-19 cases. These are usually ascertained by testing sick people in hospital


COVID-19 is less severe in children, but often is it severe?

From a Chinese cohort 0.6% needed PICU but lots of community testing involved…

US CDC data has 2% of admissions in PICU (limited data)…

So why aren't we seeing kids with COVID-19? Is it because they're not getting it, or just not sick enough to go to hospital?

Iceland tested 6% of their whole population. In community testing (random), 0/848 of children <10yrs were positive…

Also in Italy, where a town screened 70% of its residents. Of the general population, 2.6% were positive. Of children <10yrs, 0%.…

Japanese contact tracing data found lower attack rate in kids…

Seems they catch it less

So are they not the super spreaders we thought?

Household transmission is now the most common mode, and children appear to rarely be the index case (5-10%)……

OK but when they DO get symptoms, what does it look like?

Cough and fever much less frequent than in adults (both ~50% of cases) with about 10% having GI symptoms

No reports of anosmia or rashes as yet...

Neonates - can't trust 'em right? What about with COVID-19?

Essentially all reported cases in newborns so far very mild disease needed limited support!…

How about vertical/intrauterine transmission? This is complicated

ALL swabs of placenta/amniotic fluid/vaginal fluid negative so far

But some babies have been IgM +ve positive at birth. IgM doesn't cross the placenta so implies infection…

Now we know SARS-CoV-2 serology is not great so far, and IgM has high cross-reactivity, so remains to be seen whether this will be born out in future research.

So what about kids with comorbidities/immunosuppression?

Numbers are small, but all reported cases mild so far in children with IBD…

And cancer…

But higher rates of resp/cardiac comorbidity in admitted children in US (23%)…

That's all, thanks for reading!

For a comprehensive review of the literature, check out the @DFTBubbles rapid review page here…

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