· Children and adolescents (0 to 18 years) contributed 1- 10% of laboratory confirmed cases of COVID-19 globally.
· Children have been reported to have milder symptoms of COVID-19 and have shown better prognosis as compared to adults.
· Severe cases presenting as a multisystem inflammatory syndrome in children (MIS-C) has been reported in some pediatric cases of COVID-19. Many of these children meet the criteria for complete or incomplete Kawasaki disease, but different clinical presentations of this inflammatory disorder are being reported.
· Underlying medical conditions and comorbidities such as such as sickle cell disease, immunocompromised condition, obesity, cancer, cardiovascular disease, and asthma have been associated with severity and complications from COVID-19 infection in pediatric patients.
· Although rare, death from COVID-19 in children have been reported, with a case fatality rate of less than 0.5%.
Asamoah, G; Muhajarine, N; Dalidowicz, M; Ellsworth, C; Howell-Spooner, B. What is the disease progression and epidemiology of COVID-19 in pediatric populations? 2020 Jul 27; Document no.: EOC072102 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 17 p. (CEST rapid review report)
Pediatric cases of COVID-19 constitute between 1% to 10% of all confirmed cases of COVID-19; variation exists by jurisdiction.
Few case reports exist of confirmed child-to-other transmission. Contact tracing studies suggest that children are unlikely to be transmitters of the disease. Households are the most likely environments for transmission.
A recent large South Korean contact tracing study however (in pre-print) found that household COVID-19 transmission rates for children age 10-19 were significantly higher than in adults; transmission rates for children age 0-9 were relatively low.
AUGUST 7th, 2020 UPDATE: No new studies examining secondary attack rates of pediatric index cases were found. Studies continue to suggest low transmission from pediatric cases, and high proportion of pediatric cases being asymptomatic to mildly symptomatic.
MARCH 9th, 2021 UPDATE: Variants of Concerns are an emerging threat, but literature on pediatric prevalence and transmissibility is sparse. The British variant seems more transmissible (secondary attack rate higher) but follows the same age-related distribution of cases seen earlier in the pandemic.
Sulaiman, F; Coomaran, V; Muhajarine, N; Dalidowicz, M; Miller, L. What are the effects of the new COVID variants on transmission and school reopenings in pediatric populations? 2021 Mar 30; Document no.: PH030801 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 14p. (CEST rapid review report)
Studies conducted before mass vaccination campaigns began have reported proper and consistent facemasking by students and staff in school settings are associated with reduced incidence of school-associated transmission or seropositivity.
Fewer studies have reported efficacy of facemasking in the post-mass vaccination period in school settings. The studies available report, however, school-associated transmission were lower, less than 1% secondary attack rate in schools.
Studies of school-associated COVID-19 cases find community exposure to SARS-CoV-2 and/or noncompliance with multiple mitigation measures (e.g. facemask policies, distancing, non-isolation, etc) are key factors of clusters and outbreaks in children.
Badea, A; Groot, G; Muhajarine, N; Howell-Spooner, B; Young, C. What is the evidence for the effectiveness of universal mask use in the pediatric population? 2021 Sep 30, Document no.: EOC210901 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2021. 14 p. (CEST rapid review report).
